THE WORKS of that famous Chirurgeon Ambrose Parey Translated out of Latin and compared with the French. by Th: Johnson. Ne fallare vide, new quae sunt partasaluti, Vertat in exitium, non solers cum medentis. London, Printed by Th: Cotes and R. Young Anno 1634. TO THE RIGHT HONOURABLE SIR EDWARD HERBERT, KNIGHT OF THE BATH, Lord Herbert of Castle Island, and Baron of Cherbury. SIR, IT is not the far fetched pedigree of noble Ancestors, nor those Honours your Lordship deservedly possesses, that make me crave your Patronage to this my Labour; but it is that Heroic mind, enriched with the choice endowments of Nature and Art, and that earnest affection wherewith your Honour entertains all Sciences, Arts, and Artists, with that exquisite Judgement which sees into the inner man, which embolden and incite me to sue for your Honour's assistance, in protecting the fame of him, who by your many favours is made yours. I know the seeming and self-pleasing Wisdom of our times, consists much in cavilling, and unjustly carping at all things that see light, and that there are many who earnestly hunt after the public fame of Learning and Judgement, by this easily trod, and despicable path, which notwithstanding they tread with as much confidence as folly; for that ofttimes which they vainly and unjustly brand with opprobry, outlives their Fate, and flourisheth when it is forgot that ever any such as they had being. I know your Lordship's disposition to be far dissenting from those men, and that you rather endeavour to build up the fame of your learning and Judgement upon a strong laid foundation of your own, than Herostratus like, by pulling down any howsoever fair built fabric of another. I heartily wish that your Honour could propagate this good, and that all Detractors might be turned into Actors, and then I know it would much mitigate their rigour in censuring others, when as they themselves were also exposed unto the same Hazzard. I think it impertinent to acquaint your Honour with the Nature of the Work, my Pains in translating, or the Benefit that may ensue thereon, for that I know your Honour ignorant of nothing in this kind; neither doubt I of your favourable acceptance of the goodwill of him, that thinks himself much honoured by being Yours, THOMAS JOHNSON. To The Reader. I Have here for the public good taken pains to subject myself to common censure, the which I doubt not but to find as various as the faces of the Censurers; but I expect no thanks, nor hunt after other praise, than that I have laboured for my Country's good, if that deserve any. I fear not Calumniation (though sure to hear of it) and therefore I will not Apologise, but inform thee of some things concerning the Author his work, and the reason that induced me to the translation thereof, with some few things besides. For the Author, who was principal Surgeon to two or three Kings of France, he was a man well versed in the writings of the ancient and modern Physicians, and Surgeons, as you may evidently find by sundry places alleged in his works. For his experience, or practice (the chief help to attain the highest perfection in this Art) it was wonderful great, as you may collect by his voyages recorded in the last part of this work; as also by that which James Guillemeau, Surgeon to the French King, a man both learned and judicious in his profession, avers, speaking of his own education and progress in the Art of Surgery. I so laid ( * In his Epistle prefixed before the Latin edition of this author. saith he) the first foundation of this Art in the Hospital of Paris, being, as it were, an ample Theatre of wounds and diseases of all kinds, that for two whole years, during which time I was there conversant, nothing was consulted of, nothing performed, the Physicians, and Surgeons being present, whereof I was not an Auditor of Actor. There flourished at these times, and yet doth, Ambrose Parey, principal Surgeon to the most Christian King, the Author of this great work, most renowned for the gracious favour of Kings, Princes and Nobles towards him, for his Authority amongst his equals, for his Chirurgical operations amongst all men. Therefore I earnestly endeavoured to be received into his family, as unto another Machaon, or Podalitius: once admitted, I so by all dutifulness and due respect acquired his favour, that he, unless I were present and assisting, did nothing (such is his natural gentleness and courtesy to all such as are studious of the Art) at home or abroad, in the field, in the tents, or lastly in this famous City of Paris, about the bodies of Dukes, noblemans, or Citizens, in whose cure, he by the ardent desire of them all, had still the prime place. Now for this work, hear what this same man in the same place affirmeth further: I not content with these means, which may seem sufficient, and too much, as desirous to satisfy my long thirst, determined to try whether I could draw, or borrow any thing from strangers, which our men wanted, to the fuller knowledge of Surgery. To this purpose I travailed over Germany, and then for four years' space I followed the Spanish Army in the Low-countries; whereas I did not only carefully cure the wounded Soldier, but also heedfully and curiously observe what way of curing the renowned Italian, German, and Spanish Surgeons observed, who together with me were employed in the Hospital, for the healing of the wounded and sick. I observed them all to take no other course than that which is here delivered by Parey. Such as did not understand French, got some pieces of this work for large rewards, turned into Latin, or such Languages as they understood, which they kept charily, and made great store of; and they esteemed, admired, and embraced this work alone, above all other works of Surgery, etc. Our Author also himself, not out of a vainglorious ostentation, but a mind conscious of the truth of his assertion, affirms thus much of this his work. I have (saith he) so certainly touched the mark whereat I aimed, that Antiquity may seem to have nothing wherein it may exceed us, besides the glory of invention, nor posterity any thing left, but a certain small hope to add some things, as it is easy to add to former inventions. Thus much concerning our Author, and the excellency of his work. Now come I to my translation, the which, as desiring more a public good, than private praise, I have performed plainly and honestly, labouring to fit it to the capacity of the meanest Artist; for these are they to whom I chiefly commend this work, and from whom I expect acceptation. I being by the earnest persuasions of some of this profession, chiefly, and almost wholly persuaded and incited to take this pains, who knowing the disability of understanding this Author in Latin or French, in many of the weaker members of the large body of their profession, dispersed over this Kingdom, and the rest of his Majesty's Dominions, whose good, and increase in knowledge may be wished, that so they may be the better enabled to do good to such as shall implore their aid in their profession. There are some (I know) will blame me for Englishing this work, as laying open the mysteries of a worthy Art, to the unworthy view of the vulgar. To such I could answer as * Vide Aul. Gel. l. 20. c. 4. Aristotle did to Alexander: but for the present I will give them these, which I think may satisfy any but the purposely malicious: the first is drawn from the goodness of the thing, as intended for those that want such guides to direct them in their Art; for it is commonly granted, that, Bonunm quo communius eo melius. Secondly, it hath been the custom of most Writers in all Ages and Countries thus to do: Hypocrates, Galen, and the other Greeks, writ in their mother tongue the mysteries of their Art: thus did Celsus, Serenus, and others in Latin: Mesue, Avicen, Serapio, and others, in Arabic; as also, to go no further, our Author writ this work in his native French, and learned men have done the like in this, and all other Arts. And it is a great hindrance to us in these days, that we must be forced to learn to understand two or three tongues, before we can learn any science, whereas the Ancients learned and taught theirs in their mother tongue: so that they spent a great deal less time about words, and more upon the study of that Art or Science they intended to learn and follow. Thirdly, I must tell you, that, Ex libris nemo evasit Artifex, No man becomes a workman by book: so that unless they have had some insight in the Art, and be in some sort acquainted both with the terms of Art, as also with the knowledge and use of the instruments thereto belonging, if by reading this, or any other book of the like nature they become Surgeons, I must needs liken them (as Galen doth another sort of men) * Gal. de simp. l. 6. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. To Pilots by book only: to whose care, I think, none of us would commit his safety at Sea, nor any if wise, will commit themselves to these at land, or sea either, unless wholly destitute of other. The other things whereof I must also give you notice, are these. The figures in the Anatomy are not the same used by my Author (whose were according to those of Vesalius) but according to those of ●auline, which were used in the work of Dr. Crook; and these indeed are the better and more complete. Also Page 807. I thought it better to give the true figure of the Helmet flowered Aconite, mentioned out of Pliny, than to reserve the feigned picture of Matthiolus, which in our Author was increased with the further fiction of a Helmet. I have in some few places in the margin, which you shall find marked with a star, put short annotations, for the better illustration of that which is obscure, etc. I have also in the Text to the same purpose, here and there put two or three words, contained in these limits [], which I find here and there turned into a plain Parenthesis, especially toward the latter end of the book, but the matter is not great. Further, I must acquaint you that the Apology and Voyages, being the last part of this work, and not in the Latin, but French editions, were translated into English out of French by George Baker, a Surgeon of this City, since that time, as I hear, dead beyond the Seas. This is all, Courteous Reader, that I have thought necessary to acquaint thee withal concerning this, which I would desire thee to take with the same mind that it is presented to thee, by him that wisheth thee all happiness, THOMAS JOHNSON. THE AUTHOR'S EPISTLE DEDICATORY To Henry the third, the most Christian King of France and Poland. EVen as (most Christian King) we see the members of man's body by a friendly consent are always busied, and stand ready to perform those functions for which they are appointed by nature, for the preservation of the whole, of which they are parts: so it is convenient that we, which are, as it were, Citizens of this earthly Commonweal should be diligent in the following of that calling which (by God's appointment) we have once taken upon us: and content with our present estate, not carried away with rashness and envy, desire different and divers things whereof we have no knowledge. He which doth otherwise, perverts and defiles with hated confusion the order and beauty, on which this Vnivers consists. Wherefore when I considered with myself, that I was a member of this great Mundane body, and that not altogether unprofitable, I endeavoured earnestly, that all men should be acquainted with my duty, and that it might be known how much I could profit every man. For God is my witness, and all good men know, that I have now laboured fifty years with all care and pains in the illustration and amplification of Chirurgery; and that I have so certainly touched the mark whereat I aimed, that Antiquity may seem to have nothing wherein it may exceed us, beside the glory of invention; nor posterity any thing left but a certain small hope to add some things, as it is easy to add to former inventions. In performance whereof, I have been so prodigal of myself, my watchings, faculties and means, that I spared neither time, labour, nor cost, whereby I might satisfy and accomplish my own desires, this my great work, and the desires of the studious Neither may we doubt but their studies would at the length wax cold, if they only furnished with the Theoric and Precepts in Schools and that with much labour, should see no manual operation, nor manifest way of performing the Arte. For which cause I seeking the praise and profit of the French Nation, even with the hindrance of my particular estate, have endeavoured to illustrate and increase Chirurgery hitherto obscure either by the infelicity of the former ages, or the envy of the Prosessors; and not only with precepts and rules, but being alover of carved works I beautified it with 300. forms, or graven figures and apt deliniations, in which whosoever shall attentively look shall find five hundred anatomical, or organical figures belonging to the Art, (if they be reckoned particularly). To every of these I have given their names and showed their use, lest they should seem to have been put in vainly for ostentation or delight. But although there be few men of this profession which can bring so much authority to their writings either with reason, or experience as I can; notwithstanding I have not been so arrogant, but intending to publish my work, I first communicated it with men the most excellent in the Art of Physic, who gave me greater encouragement to perfect and publish it, that it might be in common use: professing they wished nothing more, than that it might be turned into Latin, so by which means it should be known to foreign Nations, that there is no kind of Learning which is not delivered with great dexterity of wit in this kingdom over which you rule. And thus much I dare boldly affirm, that there is scarce any, be he never so stately or supercilious, but that he may here find something which may delight him, and by which he may better his knowledge. Therefore I doubted not to consecrate this book unto your Majesty both as a Pattern and treasury of my labours aswell in respect of my duty, who am yours by nature and education, as that I might manifest to all, your Highness exceeding bounty towards me, in placing me, (having heretofore enjoyed the office of principal Chirurgeon under 3 Kings your Majesty's predecessors) in the same dignity, and that of your own accord. And moreover I did conjecture that it would fall out, as now it doth, that this my work carried through the world by the fame of your Majesty name, should neither fear the face nor view of any, supported by the favour and Majesty of a most invincible Monarch and most excellent and renowned Prince. Neither did King Charles the ninth of happy memory, incited by the relation of the most gracious Queen his Mother, refuse to read it, being he under stood it proceeded from him, who having happily passed all his time in private and public employments, and conversed with all men of all sorts, was judged most worthy to obtain this favour, as to have the front of this work adorned and beautified with the splendour of his prefixed name. I encour aged by this hope, desired that my request should pass as by a certain continuation and succession from a most powerful, to a most Invincible King; and do wholly consecrate these my labours taken for my Country's good unto your sacred Majesty. God grant that your Majesty may have happy success of all your enterprises abundantly added to Nestor's years. Paris. 8. Feb. Anno Dom. 1579. Your most Christian Majesties faithful Servant Ambrose Parey. The Preface. MOst men derive the Original of Physic from heaven; for those who hold the best opinion of the Creation of the world, affirm, the Elements being created and separated each from other, man being not as yet made; incontinently by the divine decree, all herbs and plants with infinite variety of flowers, endued with various scents, tastes, colours and forms, grew and sprung forth of the bowels of the Earth, enriched with so many and great virtues, that it may be thought a great offence to attribute to any other than the Deity, the benefit of so great a blessing so necessary for so many uses: Neither could Man's Capacity ever have attained to the knowledge of those things without the guidance of the divine power. For God the great Creator & fashioner of the world, when first he inspired Adam by the breath of his mouth into a living and breathing man, he taught him the nature, the proper operations, faculties and virtues of all things contained in the circuit of this Universe. So that if there be any who would a scribe the glory of this invention to man, he is condemned of ingratitude even by the judgement of Pliny. But this knowledge was not buried in oblivion with Adam: but by the same gift of God was given to those whom he had chosen and ordained for Physic, to put their helping hands to others that stood in need thereof. Which opinion was not only received in the common manner and by the tacit consent of all Nations, but confirmed by Moses in the Scripture: Which thing jesus the son Genes. 1. Ecclesiast. 38. 1. of Sirach the wisest amongst the jews, hath confirmed saying; Honour the Physician with the honour due unto him, for the most High hath created him because of necessity: and of the Lord cometh the gift of healing. The Lord hath created Medicines of the Earth and he that is wise will not abhor them. Give place and honour to the Physician, for God hath created him, let him not go from thee, for thou hast need of him. The Grecians who first seem more fully and with greater fame to have professed the Art of Physic, do in a manner consent with this opinion, in acknowledging Apollo to have been the Inventor thereof, neither did they it without a reasonable cause. For whether by Apollo they may understand the Sun who by its gentle and vital heat doth bring forth, temper and cherish all things; or else some Heros, who incited by an excellent and almost divine understanding first taught and put in practise the Medicinal virtues of Herbs; in which sense Ovid brings him in speaking thus: Herbs are of mine invention, and through all The world, they me the first Physician call. The original of Physic arising from those beginnings shall always be celebrated, as celestial, and was increased principally after this manner. After Apollo, Aesculapius his son instructed by his father reduced this Art being as yet rude and vulgar into alitle better and more exquisite for me, for which cause he was reputed worthy to be accounted as one of the Gods. At the same time flourished Chiron the Centaur who for that he excelled in knowledge of Plants, and taught Aesculapius, (as many report) their faculties, is thought by Pliny and some others to plin. l. 7, c. 2. have been the inventor of Physic. Aesculapius had two sons Podalirius and Machaon who following their father's steps & professing Physic, did principally beautify and practise that part there of which is called Chirurgery, and for that cause were accounted the Inventors thereof. After those Asclepiades left this Art much enlarged as hereditary to his posterity: by whose study and diligence, that part of the Art was invented and annexed, which by a more curious skill searcheth out and cureth those diseases which lie hid within the body. Hypocrates the Coan the son of Heraclidas, borne of the noble race of Asclepiades, Prince of the Physicians that were before him, perfected Physic and reduced it into an Art and wrote divers books thereof in Greek. Galen succeeded him six hundred years after, who was a man most famous not only for his knowledge in Physic, but also in all other sciences, who faithfully interpreting every thing that was obscure and difficult in the writings of Hypocrates, enlarged the science with many volumes. Thus therefore was the beginning, thus the increase and perfecting the Art of Physic, as much as can be hoped for from man's industry Although indeed we cannot deny but that Experience hath much profited this Art, as it hath and doth many other. For as men perceived that some things were profitable, some unprofitable for this or that disease, they set it down, and so by diligent observation and marking of singularities, they established universal and certain precepts and so brought it into an Arte. For so we find it recorded in ancient Histories, before the invention of Physic, that the babylonians & Assyrians had a custom amongst them, to lay their sick and diseased persons in the porches and entries of their houses, or to carry them into the streets and market places, that such as passed by and saw them, might give them counsel to take those things to cure their diseases, which they had formerly found profitable in themselves or any other in the like affects, neither might any pass by a sick man in silence. Also Strabo writes that it was a custom in Graece that those which were sick should resort to Aesculapius his Temple in Epidaurum, that there as they slept, by their dreams they might be admonished by the God what means they should use to be cured; and when they were freed from their diseases, they writ the manner of their infirmities and the means by which they were cured in tables & fastened them to the pillars of the Temple, not only for the glory of the God, but also for the profit of such, as should afterwards be affected with the like maladies. All which tables (as fame reports) Hippocrdtes transcribed, & so from those drew the Art of Physic. Beasts also have added much to this Arte. For one man was not only instructed by another, but learned also much from brute beasts, for they by the only instinct of nature have found out divers herbs, & remedies, by which they freed & preserved themselves from infirmities, which might presently be transferred to man's use. Wherefore considering that such & so many have concurred to bring this Art to perfection, who hereafter dare call in question the excellency thereof? chiefly if he respect the subject thereof, Man's body, a thing more noble than all other Mundane thing, and for which the rest were created. Which thing moved Herophilus in times past to call Physicians The hands of the Gods. For as we by putting forth our hand, do help any man out of the water or mud into which he is fallen: even so we do sustain those that are thrown down from the top of health to the gates of death by violence of diseases, with happy medicines, & as it were by some special & divine gift deliver them out of the jaws of death. Homer the prince of Greek Poets affirms that one Physician is far more worthy than many other men. All Antiquity gave Physicians such honour, that they worshipped them with great veneration as Gods, or the sons of their Gods. For who is it which is not much delighted with the divine force of health full medicines, with which (we see by daily experience) Physicians, as armed with Mercury's rod, do bring back those languishing souls which are even entering the gates of death? Hence it cometh to pass that the divine Poets of ancient times, as Orpheus, and Musaeus & hesiod; & the most renowned Philosophers, Pythagoras, Plato, Aristotle, Theophrastus, Chrysippus, Cato Censorius, & Varro esteemed nothing more excellent than to excel in the knowledge of Medicines, & to testify the same by written monuments to Posterity. For what can be more noble or worthy of a generous disposition than to attain to that by the benefit of Physic, that adorned with the ornaments of dignity thou mayest have power over other men, & favoured of Princes, Kings & Emperors, mayest appoint & prescribe to them those things which are profitable to preserve health, & cure their diseases? But if you look for benefit by sciences; then know that the Professors here of have besides sufficient gain, acquired much honour & many friends. Hypocrates In what esteem Physicians have formerly been. coming to Abdera to cure Democritus of his madness, not only the men of the city, but also the women, children & people of every age, sex & rank went forth to meet him, giving him with a common consent & loud voice the title of a Tutelary Deity and father of their Country. But the Athenians, for freeing their Country from the plague, with triumphant pomp celebrated plays to his honour, & bountifully set upon his head as if he had been a king, a Crown of gold weighing a 1000 pieces of their golden coin, & erected his statue, for a perpetual monument of his piety and Learning. Erasistratus the Nephew of Aristotle by his daughter, received, freely given him by Ptolemy king of Egypt, for the cure of his son, 100 Talents of gold. The Emperor Augustus honoured Antonius Musa with a golden statue. Quintus Stertinius yearly received out of the Emperor's Treasury 12000. 500 pieces of gold. In the time of our Grandfathers Petrus Aponensis called Conciliator was so famous through all Italy for his knowledge in Physic, that he could scarce be entreated to come to any man of fashion that was sick, unless he gave him 50. crowns, for every day he was absent from home: but when he went to cure Honorius the Bishop of Rome, he received 400. crowns for every day he was absent. Our French Chronicles relate in what credit & estimation James Cotterius the Physician was with Lewis the 11. King of France; for they report he gave him monthly out of his Treasury 10000 crowns. Physic in times past hath been in such esteem with many famous & noble personages, that divers Kings & Princes delighted with the study thereof, & desirous to attain glory & credit thereby, called sundry herbs after their own names. For so Gentian took Names given to Plants. its name of Gentius king of Illyria; the herb Lysimachia of Lysimachus the king of Macedon, the Mithridatick herb or Scordium, of Mithridates the king of Pontus & Bithynia; Achillea of Achilles; century of Chiron the Centaur; Artemisia of Artemisia the Queen of Caria. Attalus king of Pergamus, Solomon of Judea, Evax of Arabia, and Juba the king of Mauritania, were not only inflamed with a desire of the knowledge of plants; but either they have written books of it, or for the great commodity of posterity, invented by their skill many choice Antidotes compounded of divers simples; neither the desire of learning this noble science is yet altogether extinct. As may appear by that Indian plant Tobaco, called by some the noble herb, Catherines' herb & Medici's herb, but commonly the Queen's herb, because Catherine Medici's the mother of our kings, by her singular study and industry made manifest the excellent virtue it hath in curing malign ulcers & wounds, which before was unknown to the French. For these worthy men understood that their glory, thus fastened & engrafted into the deep, & as it were everliving roots of plants, would never decay; but should be propagated to all posterity in many succeeding ages, growing up with their sprouting & budding shouts, stalks, flowers & fruits. Neither did these famous men whilst they adorned this part of physic suffer the other, which treats of the dissection of man's body, be buried in oblivion, & without their knowledge; as instructed with the precepts & learning of the wisest men, how artificial & unimitable by mortal hand this fabric of our body is. Neither is it probable that Apis, Osiris and Ptolemy kings of Egypt, Solomon, Alexander the great, Mithridates, Attalus, seeing they dedicated themselves wholly to the contemplation of natural things; neglected the use of Anatomy, & being men most desirous to know themselves, to have been ignorant of the structure of there own bodies being the habitations of their souls immortal & made to the Image of God: seeing they observed with certain judgement the different lights of the Sun, Moon and stars; and passed over so many lands, so many seas, so many regions so far remote one from another, by ways so terrible by reason of cold, uncouthnes, darkness, by rocks, by fire & sword, with great labour, charge & danger of life, only that they might satisfy their minds thirsting after the knowledge of things; and to have left untouched a thing truly noble, admirable, and most worthy of knowledge, easy to be attained by any, and to be acquired without any danger of life, or fortunes. Seeing there be 3 parts of that Physic which at this time we profess, Physic is divided into 3 parts. Chirurgery which by the use of the hand, Diet which with a convenient manner of feeding & ordering the body, & Pharmacy that by medicines attempt to expel diseases, & preserve health; The prime Physicians do not without reason contend which of these may be accounted the chief. Certainly Herophilus had Pharmacy in such esteem, that he thought medicines were first mixed & administered to the sick by Apollo (whom Antiquity thought a great Deity.) And Pliny had so good an opinion of Diet, that he exclaims; The true remedies & Antidotes against diseases are put into the pot & eaten every day by the poor people. Verily all learned men confess that the manner of curing which is performed by diet, is much more facile & prosperous, than that which is done by medicines; as those things which sought with much labour and cost, are taken with much loathing, and taken are scarce retained ' but retained they oft work with much labour & pain: Which things long ago moved Asclepiades to exclude the use of medicines, as hurtful to the stomach. Yet if we will believe Celsus neither of these parts merit the pre-eminence, but both of them give place to Chirurgery. For seeing that fortune is very powerful in diseases, & the same Meats & Medicines are often good & often vain, truly it is hard to say, whether the health is recovered by the benefit of Diet and Pharmacy, or by the strength of the body. Moreover in those cases, in which we most prevail with medicines; although the profit be more manifest, yet it is evident that health is often sought in vain even by these things, & often recovered without them. As it may be perceived by some troubled with sore eyes, & others with quartan fevers, who having been long troubled by Physicians are sometimes healed without them. But the effect of Chirurgery as it is very necessary, so it is the most evident amongst all the parts of physic. For who without Chirgery can hope to cure broken, or luxated parts, who wounds & ulcers, who the falling of the Matrix, the stone in the bladder, a member infested with a Gangrene, or Sphacele? Besides, this part also is the most ancient; for Podalirius & Machaon following their General Agamemnon to the Trojane wars, yielded no small comfort to their fellow Soldiers. Whom notwithstanding Homer affirms not to have given any help in the pestilence, nor in divers other diseases, but only were accustomed to heal wounds by instruments and medicines. And if the difficulty of learning it argue the excellency The excellency of Chirurgery. of the Art, who can doubt but Chirurgery must be the most excellent, seeing that none ought to be accounted a Chirurgeon or which can perform his duty, without the knowledge of Diet & Pharmacy? But both the other can perform their parts without Chirurgery if we may believe Galen. But if we consider the matter more nearly according to truth; we shall understand those three parts have a certain common bond, and are very near of kindred, so that the one implores the aid of the other; neither can the Physician do any thing praise worthy without the conspiracy and joint consent of these three; therefore in ancient times there was but one performer and user of all the three parts. But the multitude of men daily increasing, and on the contrary man's life decreasing, so that it did not seem able to suffice for to learn and exercise all the three, the workmen divided themselves. Wherefore that which happens to any man either by lot, or counsel, that let him follow, maintain and only use, as mindful how short his life is, and how long the Arte. A Catalogue of the Works of AMBROSE PAREY, the King of France his Chief Chirurgeon, which were set forth in Latin, by James Guillemeau. 1. AN Introduction, or compendious way to Chirurgery. 2. Of living creatures and man's excellency. 3. Of the Anatomy of man's body. 4. Of the vital parts contained in the Chest. 5. Of the Animal parts placed in the head. 6. Of the Muscles and Bones, and other extreme parts of the body. 7. Of Tumours contrary to nature in general 8. Of Tumours contrary to nature in particular. 9 Of wounds in general. 10 Of the green and bloody wounds of each several part. 11 Of wounds made by Gun-shot, and other fiery Engines, and all sorts of weapons. 12. Of Contusions and Gangreenes. 13. Of Ulcers, Fistulas, and Haemorroides. 14. Of Ligatures, or Bandages. 15. Of Fractures. 16. Of Luxations, and Strains. 17. Of divers affects of the parts not agreeable to nature, whose cure commonly is performed by the hand. 18. Of the Gout. 19 Of the Lues Venerea, and those Symptoms that happen by reason thereof. 20. Of the small Pox and Measles and also of Worms, and the Leprosy. 21. Of Poisons, and of the biting of mad dogs, and the stinging and biting of venomous creatures. 22. Of the Plague. 23. Of the Arts to repair those things which are defective, either by nature or accident. 24. Of the generation of Man. 25. Of Monsters and Prodigies. 26. Of the Faculties of simple medicines, together with their composition and use. 27. Of Distillations. 28. A Treatise of reports, and the embalming of dead bodies. 29. An Apology, and Voyages; being not in the Latin, but translated out of the last French Edition, whom also I have followed in the number of the Books, lest any should think some wanting, finding but 26. in the Latin, and 29. in the French. AN INTRODUCTION OR COMPENDIOUS Way to Chirurgery. CHAP. I. What Chirurgery is. CHYRURGERIE is an Art, which teacheth the way by reason, how by the operation of the hand we may cure prevent The definition of chirurgery. and mitigate diseases, which accidentally happen unto us. Others have thought good to describe it otherwise, as that; it is that part of Physic which undertaketh the cure of diseases by the sole industry of the hand; as by cutting, burning, sawing off, uniting fractures, restoring dislocations, and performing other works, of which we shall hereafter treat. Chirurgery also is thus defined by the Author of the medicinal Definitions; The quick motion of an intrepide hand joined with experience: or an artificial action by the hands used in Physic, for some convenientintent. Yet none must think to attain to any great perfection in this Art, without the help of the other two parts of Physic; I say of Diet and pharmacy, and the divers application of proper medicines, respecting the condition of the causes, diseases, sypmtomes, What necessary for a Chirurgeon. and the like circumstances, which comprehended under the names of things natural, not natural, and besides nature (as they commonly call them) we intent to describe in their proper place. But if any reply, that there be many which do the works of Chirurgery, without any knowledge of such like things, who notwithstanding have cured desperate diseases with happy success; let them take this for an answer, that such things happen rather by chance, than by the industry of the Art, and that they are not provident that commit themselves to such. Because that for some one happy chance, a thousand dangerous errors happen afterwards, as Galen (in divers places of his Method) speaks against the Empirics. Wherefore seeing we have set down Chirurgery to be a diligent operation of the hands, strengthened by the assistance of Diet and pharmacy, we will now show, what, and of what nature the operations it are. CHAP. II. Of chirurgical operations. FIve things are proper to the duty of a Chirurgeon; To take away that which The nature of a Chirurgeon. is superfluous; to restore to their places, such things as are displaced; to separate those things which are joined together; to join those which are separated; and to supply the defects of nature. Thou shalt far more easily and happily Experience more necessary for a Chirurgeon, thau Art. attain to the knowledge of these things by long use and much exercise, than by much reading of Books, or daily hearing of Teachers. For speech how perspicuous and elegant soever it be, cannot so vively express any thing, as that which is subjected to the faithful eyes and hands. We have examples of taking away that which abounds, in the amputation, or Examples of taking away that which is superfluous. cutting off a finger, if any have six on one hand, or any other monstrous member that may grow out: in the lopping off a putrified part inwardly corrupted; in the extraction of a dead child, the secondine, mole or such like bodies out of a woman's womb; in taking down of all Tumours, as Wens, Warts, Polypus, Cancers, and fleshy excrescenses of the like nature; in the pulling forth of bullets, of pieces of mail, of darts, arrows, shells, splinters, and of all kind of weapons in what part of the body soever they be. And he taketh away that which redounds, which plucks away the hairs of the eyelids which trouble the eye by their turning in towards it: who cuts away the web, possessing all the * Two tunicles of the eyes. Adnata, and part of the Cornea: who letteth forth suppurated matter; who taketh out stones in what part soever of the body they grow; who pulls out a rotten or otherwise hurtful tooth, or cuts a nail that runs into the flesh; who cuts away part of the uvula, or hairs that grow on the eyelids; who taketh off a Cataract; who cuts the navel or foreskin of a child newly borne, or the skinnie caruncles of women's privities. Examples of placing those things which are out of their natural site, are manifest in restoring dislocated bones; in replacing of the guts and kall fallen into the Examples of replacing. cod, or out of the navel or belly by a wound, or of the falling down of the womb, fundament, or great gut, or the eye hanging out of its circle, or proper place. But we may take examples of disjoining those things which are continued from Example of separating things joined together. the fingers growing together, either by some chance, as burning, or by the imbecility of the forming faculty: by the disjunction of the membrane called Hymen, or any other troubling the neck of the womb, by the dissection of the ligament of the tongue, which hinders children from sucking and speaking, and of that which hinders the Glans from being uncovered of the foreskin; by the division of a varicous vein, or of a half cut nerve or tendon, causing convulsion: by the division of the membrane stopping the auditory passage, the nose, mouth, or fundament, or the stubborn sticking together of the hairs of the eyelids. Refer to this place all the works done by Caustics, the Saw, Trepan, Lancet, Cuppingglasses, Incision Knife, Leaches, either for evacuation, derivation or revulsion sake. The Chirurgeon draws together things separated, which healeth wounds by stitching them, by bolstering, binding, giving rest to, and sit placing the part: which Examples of uniting things dissoyned. repairs fractures; restores luxated parts; who by binding the vessel, stayeth the violent effusion of blood: who cicatriseth cloven lips, commonly called hare-lips; who reduces to equality the cavities of Ulcers, and Fistula's. But he repairs those things which are defective, either from the infancy, or afterwards Examples of suplying defects. by accident, as much as Art and Nature will suffer, who sets on an ear, an eye, a nose, one or more teeth; who fills the hollowness of the palate eaten by the Pox, with a thin plate of gold or silver, or such like; who supplies the defect of the tongue in part cut off, by some new addition; who fastens to a hand, an arm or leg with fit ligaments workemanlike: who fits a doublet bombasted, or made with iron plates to make the body strait; who fills a shoe too big with cork, or fastens a stocking or sock to a lame man's girdle to help his gate. We will treat more fully of all these in our following Worke. But in performing those things with the hands, we cannot but cause pain: (for who can without pain cut off an arm, or leg, divide and tear asunder the neck of the bladder, restore bones put out of their places, open ulcers, bind up wounds, and apply cauteries, and do such like?) notwithstanding the matter often comes to that pass, that unless we use a judicious hand, we must either die, or lead the remnant of our lives in perpetual misery. Who therefore can justly abhor a Chirurgeon for this, or accuse him of cruelty? or desire they may be served, as in ancient times the Romans served Archagatus, who at the first made him free of the City, but presently after, because he did somewhat too cruelly Archagatus the Chirurgeon. burn, cut and perform the other works of a good Chirurgeon, they drew him from his house into the Campus Martius and there stoned him to death, as we have read it recorded by Sextus Cheroneus Plutarche's Niece by his daughter. Truly it was an inhuman kind of ingratitude, so cruelly to murder a man intent to the works of so necessary an Art. But the Senate could not approve the act, wherefore to expiate the crime as well as then they could, they made his Statue in gold, placed it in Aescislapius his Temple and dedicated it to his perpetual memory. For my part I very well like that saying of Celsus; A Chirurgeon must have a strong, stable, and intrepide In prafat. lib. 7. hand, and a mind resolute and merciless, so that to heal him he taketh in hand, he be not moved to make more haste than the thing requires; or to cut less than is needful; but which doth all things as if he were nothing affected with their cries; not giving The properties of a good Chirurgeon. heed to the judgement of the vain common people, who speak ill of Surgeons because of their ignorance. CHAP. III. Of things Natural. THat the Chirurgeon may rightly and according to Art, perform the foresaid works, he must set before his eyes certain Indications of working: Otherwise he is like to become an Empiric, whom no Art, no certain reason, but only a blind temerity of fortune moves to boldness and action. These Indications From when 〈◊〉 we must draw Indications. of actions are drawn from things (as they call them) natural, not natural, and besides nature, and their adjuncts, as it is singularly delivered of the Ancients, being men of an excellent understanding. Wherefore we will prosecute according to that order, all the speculation of this Art of ours. First therefore things natural are so termed, because they constitute and contain the nature of man's body, which wholly What things are called natural. depends of the mixture and temperament of the 4. first bodies, as it is showed by Hypocrates in his Book de Natura humana: wherefore the consideration thereof belongs to that part of Physic which is named Physiologia; as the examination of things not natural to Diaetetice, or Diet, because by the use of such things it endeavours to retain and keep health: but Therapeutice or the part which cures the diseases, and all the To what part of Physic things not natural pertain. To what things besides nature. affects besides nature, challenges the contemplation of those things which are not agreeable to nature. But the things which are called natural may be reduced to seven heads: besides which there comes into their fellowship, those which we term annexed. The seven principal heads of things natural are, Elements. Temperaments. Humours. Parts or members. Faculties. Actions. Spirits. To these are annexed and somewhat near, Age. Sex. Colour. Composure. Time or season. Region. Vocation of life. CHAP. four Of Elements. AN Element (by the definition which is commonly received amongst Physicians) What an Element is. is the least and most simple portion of that thing which it compeseth: or that my speech may be the more plain: the four first and simple bodies are called Elements; Fire, Aire, Water, and Earth; which accommodate and subject themselves as matter to the promiscuous generation of all things which the Heavens engirt, whether you understand thingsperfectly, or unperfectly mixed. Such Elements Elements are understood by reason, not by sense. are only to be conceived in your mind, being it is not granted to any external sense to handle them in their pure and absolute nature. Which was the cause that Hypocrates expressed them not by the names of substances, but of proper qualities; saying, Hot, Cold, Moist, Dry; because some one of these qualities is inherent in Why he expressed the Elements by these names of qualities. every Element, as his proper and essential form, not only according to the excess of latitude, but also of the active faculty; to which is adjoined another simple quality, and by that reason principal, but which notwithstanding attains not to the highest degree of his kind, as you may understand by Galen in his first Book of Elements. So, for example sake, in the Air we observe two qualities, Heat, and Moisture, both principal, and not remitted by the commixture of any contrary quality, Two principal qualities are in each Element. for otherwise they were not simple. Therefore thou mayst say, what hinders that the principal effects of heat show not themselves as well in the Air, as in the Fire? because as we said before, although the Air have as great a heat according to his nature, extent and degree, no otherwise than Fire hath, yet it is not so great in its active quality. The reason is, because that the calfactorie force in the Air is hindered, Why the Air heats not so vehemently, as the Fire. and dulled by society of his companion and adjoined quality, that is, Humidity which abateth the force of heat, as on the contrary, dryness quickeneth it. The Elements therefore are endued with these qualities. Names of the substances; Fire is Hot and dry. Names of the qualities. Aire Moist and hot. Water Cold and moist. Earth Cold and dry. These four Elements in the composition of natural bodies, retain the qualities How the Elements may be understood to be mixed in compound bodies. they formerly had, but that by their mixture and meeting together of contraries, they are somewhat tempered and abated. But the Elements are so mutually mixed one with another, and all with all, that no simple part may be found; no more than in a mass of the Emplaster Diacalcitheos' you can show any Axungia, oil, or litharge by itself; all things are so confused and united by the power of heat, mixing the smalleft particulars with the smallest, and the whole with the whole, in all parts. You may know and perceive this concretion of the four Elementary substances in one compound body, by the power of mixture, in their dissolution by burning a pile or heap of green wood. For the flame expresses the Fire, the smoke the Air, the moisture that sweats out at the ends, the Water, and the ashes, the Earth: You may easily perceive by this example so familiar and obvious to the senses what dissolution is, which is succeeded by the decay of the compound body; on the contrary, you may know that the coagmentation, or uniting and joining into one of the first mixed bodies is such, that there is no part sincere, or without mixture. For if the heat which Why of the first qualities, two are accounted active, and two passive. is predominant in the fire, should remain in the mixture in its perfect vigour, it would consume the rest by its pernicious neighbourhood; the like may be said of Coldness, Moisture, and Dryness; although of these qualities, two have the title of Active, that is, Heat, and Coldness, because they are the more powerful; the other two Passive, because they may seem more dull and slow, being compared to the former. The temperaments of all sublunary bodies arise from the commixture of these substances & elementary qualities, which hath been the principal cause that moved me to treat of the Elements. But I leave the force and effects of the Elementary qualities to some higher contemplation, content to have noted this, that of these first qualities, (so called, because they are primarily and naturally in the four first bodies) Why the first qualities are so called. What the second qualities are. What Elements light, what heavy. others arise and proceed, which are therefore called the second qualities: as of manythese, Heaviness, Lightness, variously distributed by the four Elements, as the Heat, or Coldness, Moistness or Dryness, have more power over them. For of the Elements, two are called light, because they naturally affect to move upwards: the other two heavy, by reason they are carried downward by their own weight. So we think the fire the lightest, because it holds the highest place of this lower world; the Air which is next to it in site, we account light; for the water which lies next to the Air, we judge heavy; and the earth the centre of the rest we judge to be the heaviest of them all. Hereupon it is, that light bodies, and the light parts in bodies, have most of the lighter Elements; as on the contrary heavy bodies have more of the heavier. This is a brief description of the Elements of this frail world, which are only to be discerned by the understanding, to which I think good to adjoin another description of other Elements, as it were arising or flowing from the commixture of the first; for besides these, there are said to be Elements of generation and What the Elements of generation are. Elements of man's body. Which as they are more corporal, so also are they more manifest to the sense. By which reason Hypocrates being moved, in his Book de Natura humana, after he had described the nature of Hot, Cold, Moist and Dry, he comes to take notice of these by the order of composition. Wherefore the Elements of our generation, as also of all creatures which have blood, are seed and menstruous blood. What the Elements of mize bodies. But the Elements of our bodies are the solid and similar parts arising from those Elements of generation. Of this kind are bones, membranes, ligaments, veins, arteries, and many others manifest to the eyes, which we will describe at large in our Treatise of Anatomy. CHAP. V. Of Temperaments. A Temperament is defined a proportionable mixture of hot, cold, moist and What a Temperament is. dry; or, it is a concord of the first disagreeing faculties. That harmony springs from the mixture of the four first bodies of the world. This whether Temperament or concord is given to Plants and brute beasts for the beginning of their life, and so consequently for their * Anima. What the life performs in Plants. life and form. But as Plants are inferior in order and dignity to beasts, so their life is more base and infirm, for they have only a growing faculty by which they may draw an alimentary juice from the Earth, as from their mother's breasts, to preserve them and their life, by which they may grow to a certain bigness; and lastly, by which they may bring forth their like for the perpetual continuance of their kind. But the * Anima. What in beasts. life of beasts have to the three former the gift of sense annexed; by benefit whereof, as by a certain inward knowledge, they shun those things that are hurtful, and follow those which profit them, and by the power of their will, they move themselves whither they please. But the soul of Man's soul comes from above. man far more perfect and noble than the rest, ariseth not from that earthly mixture and temper of the Elements, but acknowledgeth and hath a far more divine offspring, as we shall teach hereafter. The manifold division of a Temperament. They divide a Temperament at the first division into two kinds; as one a temperate, another an untemperate. The untemperate is of two sorts; the one wholly vicious, which hath altogether exceeded the bounds of mediocrity: the other which hath somewhat strayed from the mediocrity of temper, but notwithstanding is yet contained within the limits of health: as that which brings no such evident harm to the actions, but that it somewhat hinders them, so that they cannot so well and perfectly A Temperament, ad Poudus. perform their duties. But the vicious Temperament doth three manner of ways corrupt the functions, either by weaking, depraving or abolishing them. For so stupor, or astonishment, diminisheth and sloweth the quickness of motion; convulsion depraves it; the Palsy abolisheth it, and taketh it away. The temperate Temperament is also divided into two kinds; which is either to equality of weight, or justice. It is called a temperature to weight which ariseth from the equal force of 〈◊〉 Ad poudus, vel ad jus●●ti●…. exactly concurring qualities, and as placed in a perfect balance, draws down neither to this nor that part. They think the example of this Temperament to appear in the inner skin of the fingers ends of a man tempered to justice. For seeing the most exquisite touch resides there, they ought to be far from all excess of contrariety; for otherwise being corrupted by too much heat or cold, moisture or dryness, they could give no certain judgement of the tangible qualities. For which thing nature hath excellently provided in the fabric and coagmentation of the parts of which the skin consists. For it is composed of hot and moist flesh, and therefore soft, and of a tendon and nerve cold and dry, and therefore hard, which are not only equally fitted and conjoined, but wholly confused and mixed together, by which it comes that removed from all extremes of opposition, it is placed in the midst, as a rule to judge of all the excesses that happen to the touch. So it was fit the eye, which was to be the instrument of sight, should be tinctured with no certain colour, that it might be the less deceived in the judgement of colours. So it was convenient the hearing should not be troubled with any distinct sound, whereby it might more certainly judge of equal and unequal sounds, not distinguished by a ratable proportion; neither was it fit the tongue should have any certain taste, lest the access of that taste should deceive it in knowing and judging of so many different tastes. The Temperature tempered to A temperament ad justitiam. justice is that, which although it is a little absent from the exact and severe parility of mixed qualities, yet hath that equality which doth fully and abundantly suffice for to perform all the functions fitly and perfectly which nature doth require, wherefore we can judge no otherwise of it than by the integrity of the Actions. For hence it took its name, for as distributive justice equally gives to every one rewards, or punishment according to their deserts; so nature having regard to all the parts of the body, gives them all that temper which may suffice to perform those duties, for which they are ordained. Let us for an example consider a Bone; no man doubts but that, The temperament of a bone. like as the other similar parts of the body proceeds from the mixture of the four Elements: but nevertheless nature weighing the use of it, and ordaining it to support the rest of the body, would have more of the terrene and dry Element infused into it, that it might be the stronger and firmer to sustain weight. But a Ligament, seeing it was made for other uses, hath less of that earthly dryness than the bone, but more than the flesh, altogether fitted to its nature. So it hath seemed good to nature to endue all the parts of the body, not only with an equal portion, but also proportion of Elements and qualities; we call that a temperament to justice: and we say that it is in Plants, Brute beasts, and all natural bodies, which enjoy that temper and mediocrity, which may be agreeable to their nature. Hereupon by comparison arise eight kinds of intemperate tempers, as Four simple The kinds of untemperate tempers. Hot temperate in Dryness and Moisture. Cold temperate in Dryness and Moisture. Moist temperate in Heat and Cold. Dry temperate in Heat and Cold. Four compounds Hot and moist. Hot and dry. Cold and moist. Cold and dry. But these temperaments are either of the whole body, or of some part thereof and that either principal, as the Brain. the Heart. the Liver. the Stones. or of the rest of the parts composed of other which have no principality in the body. Again, such temperaments are either healthful, which suffice perfectly to perform their actions; or unhealthful, which manifestly hurt them, the signs whereof may be read described by Galen. And you must observe that when we say the body, or Lib. 2. de Temper. & in Art medica. any part of it is hot, we understand more hot than is fit for one of that kind which is tempered to justice; as when we say a man hath a hot liver, we mean his liver is hotter, than a man justly tempered should have; for all other tempers, whether of the whole body, or any of the parts thereof, are to be referred to this; and in the cure of diseases we must look upon it, as the mark, and labour to preserve it by the use of convenient things, as much as lies in our power. Wherefore because it is very necessary to know the distinction of temperaments, I have thought good in this place, briefly to handle the temperaments of the parts of the body, ages, seasons of the year, humours, and medicines. Therefore the temperaments of the parts of our body are of this nature, not only by the judgement of the touch of a man's hand which is justly tempered (who is often deceived by flowing heat, which spread from the heart into all What the temperament, of man's body are. the body, imparts a certain kind of heat to all the parts,) but also by the rule of their reason, composure and sustance, as A Bone is the most dry and cold. A Gristle less than it. A Ligament less than a Gristle. A Tendon is so much drier and colder than the membrane, by how much it in the same temper exceeds a Vein and Artery. Then follow the harder veins, for the softer are in a middle temper of dryness and moisture, like as the skin; although all both soft and hard, are of a cold temper. Wherefore all these parts of their own nature are cold and without blood: although the veins and arteries wax hot, by reason of the heat of the blood they contain, which notwithstanding also borroweth that heat from the heart, as a part most hot, and softer than the skin; the liver next followeth the heart, in the order of the hotter parts, which is far softer than the skin itself: for if, according to Galens' opinion, the heart is somewhat less hard than the skin, and that is far harder than the liver, as appears by touching them, it must Ad finam lib▪ de temper. necessarily follow that the liver much exceeds the skin in softness; I understand the skin simple, and separated from the flesh lying under it, to which it firmly cleaves. The flesh is more moist and hot than the skin, by reason of the blood dispersed in it. The spinal marrow is colder and moister than the skin; but the brain so much exceeds it in moisture, as it is exceeded by the fat. The lungs are not so moist as the fat, and the spleen, and kidneys, are of the like nature, and nevertheless they are all moister than the skin. According to the diversities of ages, the temperaments both of the whole body, The temperaments of ages. and all its parts, undergo great mutations; for the bones are far harder in old men than in children, because our life is, as it were a certain progress to dryness, which when it comes to the height consequently causeth death. Wherefore in this place we must speak of the Temperaments of ages, when first we shall have defined what an age is. Therefore an age is defined, a space of life in which the constitution of the body What an age is. of its self and own accord, undergoeth manifest changes; the whole course of life hath four such ages. The first is childhood, which extends from the birth to the eighteenth year of age, and hath a hot and moist temper, because it is next to the hot and moist beginnings of life, seed and blood: Youth followeth this which is prolonged from the eighteenth, to the twenty fifth year, and is temperate, and in the midst of all excesses; Man's estate succeedeth youth, which they deny to extend beyond the thirty fifth year of age, in its proper temper it is hot and dry: whereby it cometh to pass that then the heat is felt more acride and biting, which in childhood seemed mild; because the progress of the life to dryness hath much wasted the native humidity. Then succeeds old age ever divided into two parts; the first whereof extends from Old age divided into two parts. the thirty fifth, to the forty ninth year; those of this age are called old men ( * Three degrees of the second part of oldage. but we commonly call them middle aged men.) The latter is as it were divided by Galen into three degrees; the first whereof are those, who having their strength sound and firm undergo civil affairs and businesses: which things those which are in the second degree of old age cannot do, because of the debility of their now decaying strength: but those which are in the last degree are afflicted with most extreme weakness and misery, and are as much deprived of their senses and understanding, as of the strength of their bodies; whereof arose this Proverb, Old men twice children. Those old men of the first rank are pleasant, and courteous, and those we say are beginning to grow old, or in their green old-age; those of the second sort delight in nothing but the board and bed; but old decreepit men of the last order, think of nothing else, than their graves and monuments. Their firm and solid parts are of a cold and dry temperature, Old men have their solid parts dry. by reason of the decay of the radical moisture, which the inbred heat causeth in the continuance of so many years. Which thing may happen in a short space, by the vehement flame of the same natural heat, turned by fevers into a fiery heat. But if any to prove old men moist, will object, that they cough up, and spit much, I will answer him, as an old Doctor once said; That a pitcher filled with water may pour forth much moisture; yet no man will deny but that such a vessel of its own terrene nature and matter is most dry; so old men may plainly be affirmed to be moist, by reason of their defect of heat, and abundance of excrements. But this description of ages, is not to be taken so strictly, as always to be measured by the spaces and distances of years, for there are many which by their own misdemeanour, seem elder at forty, than others do at fifty. Lastly, the famous Philosopher Pythagoras, divided man life into four ages, and by a certain proportion compared the whole course thereof to the four seasons of A comparison of the four ages to the four seasons of the year. the year; as childhood to the Spring, in which all things grow and sprout out, by reason of plenty and abundance of moisture. And youth to the Summer, because of the vigour and strength which men enjoy at that age. And man's estate, or constant age to Autumn, for that then after all the dangers of the forepast life, the gifts of discretion and wit acquire a seasonableness, or ripeness, like as the fruits of the earth enjoy at that season. And lastly, he compares old age to the sterile and fruitless Winter, which can ease and consolate its tediousness by no other means, than the use of fruits gathered and stored up before, which then are of a cold and troublesome condition. But for extreme old age, which extends to eighty, or a hundred years, it is so cold and dry, that those which arrive at that decrepit age are troublesome, harsh, touchy, froward, crabby, and often complaining, until at the length deprived of all their senses, tongue, feet, and understanding, they doting, return again to childishness, as from the staff to the start. And thus much of the Temperaments of ages. But now in like manner we will explain the temperatures of the seasons of the The tempers of the seasons of the year. year, which are four, the Spring, Summer, Autumn, Winter. The Spring continues almost from the twelfth or thirteenth day of March, to the midst of May, Hypocrates seemeth to make it hot and moist; which opinion seemeth not to have sprung from the thing itself, but from an inveterate error of the ancient Philosophers, who would fit the temperaments of the four seasons of the year, as answering in proportion to the temperatures of the four ages. For if the matter come to a just trial, all men will say the Spring is temperate, as that which is in the midst of the excess of heat, cold, moisture and dryness; not How the Spring is temperate. only by comparison because it is hotter than Summer, and colder than Winter; but because it hath that quality of its own proper nature. Wherefore it is said of Hypocrates: Aphor. 9 sect. 3 The Spring is most wholesome and least deadly; if so be that it keep its native temper, from which if it decline, or succeed a former untemperate season, as Autumn, or Winter, it will give occasion to many diseases described by Hypocrates; not that it breeds them, but because it brings them to sight, which before lay Aphor. 20. sect. 3● hid in the body. Summer is comprehended in the space of almost four months; it is of a hot and dry temper, a breeder of such diseases as proceed from choler, because that humour at this time is heaped up in many bodies by adustion of blood bred in the Spring; but all such diseases do speedily run their course. The beginning of Autumn, is from the time the Sun enters into Libra, and endures the like space of Autumneunequall. time as the Spring. But when it is dry, it hath great inequality of heat and cold; for the mornings and evening being very cold, the noondayes on the contrary are exceeding hot. Wherefore many diseases are in Autumn, and then long and deadly especially if they incline to wards winter: because all daily and sudden changes to heat and cold are dangerous. The winter possesses the remnant of the year, and is cold and moist, it increases natural heat, stirs up the appetite, and augments Phlegm. It How Winter increases the native heat. increases heat by Antiperistasis, or contrariety of the encompassing air, which being then cold prohibits the breathing out of heat: whereby it happens that the heat being driven in and hindered from dissipation, is strengthened by couniting its forces. But it augments Phlegm, for that men are more greedy, the Appetite being increased by the strengthened heat: from whence proceeds much crudity and a large store of diseases, especially Chronicke or Long which spread and increase rather in this winter season than in any other part of the year. To this discourse of the temper, of the seasons of the years, is to be revoked the variety of tempers which happens very day, which certainly is not to be neglected, that there may be place of election, especially if nothing urge. For hither belongs that saying of Hypocrates; When in the Aphor. 4 sect. 3 same day it is one while hot, another cold, Autumnal diseases are to be expected. Therefore an Indication taken from hence is of great consequence to the judgement of diseases; for if it agree with the disease, the disease is made more contumacious, and difficult to cure. Whereupon the Patient and Physician will have much trouble; but if on the contrary it reclaim and descent, the health of the Patient is sooner to be expected. Neither is it a thing of less consequence to know the customs and habits of the places and Countries in which we live, as also the inclination of the Heavens and temperature of the Air; but let us leave these things to be considered by Natural Philosophers, that we may deliver our judgement of the temperaments of Humours. The temperaments of Humours. blood, as that which answers to the Air in proportion, is of a hot and moist nature, or rather temperate, as Galen testifies; for, saith he, it is certain and sure that the The blood is neither hot, nor moist, but temperate as in its first composure none of the 4 first qualities exceeds other by any manifest excess, as he repeats it upon the 39 sentence. Phlegm, as that which is of a waterish nature, is cold and moist; no otherwise than Choler being of a fiery temper, is hot and dry. But Melancholy affimulated to Earth, is cold and dry. This which we have spoken in general of Phlegm Lib. de natura humana ad sent. 36. Sect. 1 The temperature of the blood. From whence we judge of the temperature of medicines. and Melancholy, is not always true in every kind of the said humours. For salt Phlegm is of a hot and dry temperature, as also all kinds of Melancholy which have arose, or sprung by adustion from the native and Alimentary, as we will teach in the following Chapter. Now the Temperaments of Medicines have not the same form of judgement, as those things which we have before spoken of; as, not from the Elementary quality which conquering in the contention and mixture, obtains the dominion; but plainly from the effects which taken or applied they imprint in a temperate body. For so we pronounce those things hot, cold, moist, or dry, which produce the effects of Heat, Coldness, Moisture or Dryness. But we will defer the larger explication of these things to that place, where we have peculiarly appointed to treat of Medicines; where we will not simply inquire whether they be hot or cold, but what degree of heat and cold, or the like other quality: in which same place we will touch the temperature and all the Nature of tastes, because the certainest judgement of medicines is drawn from their tastes. Hitherto of Temperaments, now we must speak of Humours whose use in Physical speculation is no less than that of Temperaments. CHAP. VI Of Humours. TO know the nature of Humours is a thing notonely necessary for Physicians, but also for Surgeons, because there is no disease with matter which ariseth The knowledge of the Humours is necessary. Lib. de natura Hum. not from some one, or the mixture of more Humours. Which thing Hypocrates understanding, writ, every Creature to be either sick or well according to the Condition of the Humours in the body. And certainly all putrid fevers proceed from the putrefaction of Humours. Neither do any acknowledge any other original or distinction of the differences of Abscesses or Tumours: neither do ulcerated, broken or otherwise wounded members hope for the restauration of continuity, from other than from the sweet falling down of humours to the wounded part. Which is the cause that often in the cure of these affects, the Physicians are necessarily busied in tempering the Blood, that is, bringing to a mediocrity the 4 humours composing the mass of blood, if they at any time offend in quantity, or quality. For whether if any thing abound, or digress from the wont temper in any excess of heat, cold, viscosity, grossness, thinness, or any such like quality, none of the accustomed functions will be well performed. For which cause those chief helps to preserve and restore health have been divinely invented; Phelebotomy, or blood-letting which amends the quantity of too much blood; and purging which corrects and draws away the vicious quality. But now let us begin to speak The helps of Health. of the Humours, taking our beginning from the definition. An Humour (is called by Physicians) what thing so ever is Liquid and flowing in the body of living Creatures endued with Blood, & that is either natural, or againstnature. What an humour is. The natural is so called because it is fit to defend, preserve and sustain the life of a Creature. Quite different is the nature & reason of that which is against nature. Again the former is either Alimentary, or Excrementitious; The Alimentary which is fit to The manifold division of Humours. nourish the body, is that Humour which is contained in the veins and arteries of a man which is temperate & perfectly well; & which is understood by the general name of blood which is let out at the opening of a vein. For blood otherwise taken is an Humour of a certain kind, distinguished by heat and warmness from the other Humours comprehended together with it, in the whole mass of the blood. Which thing that it may the better be understood, I have thought good in this place to declare the generation of Blood by the efficient and material causes, All things which we eat or drink, are the The material and efficient causes of blood materials of blood, which things drawn into the bottom of the ventricle by its attractive force, and there detained, are turned by the force of concoction implanted in it, into a substance like to Almond Butter. Which thing although it appear one and like itself, yet it consists of parts of a different nature, which not only the variety of meats, but one & the same meat yields of itself. We term this Chylus (when it is perfectly What the Chylus ●…s. concocted in the stomach). But the * Vena porta Gate-veine receives it driven from thence into the small guts, and sucked in by the Meseraicke veins, and now having gotten a little rudiment of Change in the way, carries it to the Liver, where by the blood-making faculty which is proper and natural to this part, it acquires the absolute and perfect form of blood. But with that blood at one and the same time and action all the humours are made whether Alimentary or excrementitious. Therefore the Where the blood is perfected. blood that it may perform its office, that is, the faculty of nutrition, must necessarily be purged and cleansed from the two excrementitious humours. Of which the bladder of Gall draws one which we call Yellow Choler, and the Spleen the other The receptacles of Choler and Melancholy. which we term Melancholy. These two humours are natural, but not Alimentary, or nourishing, but of another use in the body, as afterwards we will show more at large. The blood freed from these 2. kinds of excrements is sent by the veins and Arteries into all parts of the body for their nourishment. Which although then it seem to be of one simple nature, yet notwithstanding it is truly such, that four different and unlike substances may be observed in it, as blood properly so named, Four unlike Humours in the Bloody. Phlegm, Choler and Melancholy, not only distinct in colour, but also in taste, effects and qualities. For as Galen notes in his book De Natura humana, Melancholy is acide or sour, choler bitter, Blood sweet, Phlegm unsavoury. But you may know the variety of their effects, both by the different temper of the nourished parts, as also by the various condition of the diseases springing from thence. For therefore such substances ought to be tempered and mixed amongst themselves in a certain proportion, which remaining, health remains, but violated, diseases follow. For all acknowledge that an Oëdema is caused by Phlegmatic, a Scirrhus by Melancholic, an Erysipelas by Choleric, and a Phlegmone by pure and laudable blood. Galen teaches A comparison of blood and now wine. by a familiar example of new wine presently taken from the press, that these 4 substances are contained in that one Mass, and mixture of the blood. In which every one observes 4. distinct Essences; for the flower of the wine working up swims at the top, the dregs fall down to the bottom, but the crude and watery moisture mixed together with the sweet and vinous liquor, is every where diffused through the body of the wine; the flower of the wine represents Choler, which bubbling up on the superficies of blood, as it concretes and grows cold, shineth with a golden colour; the dregs Melancholy, which by reason of its heaviness ever sinketh downward, as it were the Mudd of the blood; the crude and watery portion Phlegm: for as that crude humour, except it be rebellious in quantity, or stubborn by its quality, there is hope it may be changed into wine, by the natural heat of the wine; so Phlegm which is Phlegm is blood half concocted. Why it hath no proper receptacle. blood half concocted, may by the force of native heat be changed into good and laudable blood. Which is the cause that nature decreed, or ordained no peculiar place, as to the other 2. humours, whereby it might be severed from the blood; But the true and perfect liquor of the wine represents the pure blood, which is the more laudable and perfect portion of both the humours of the confused Mass. It may easily appear by the following scheme, of what kind they all are, and also what the distinction of these four humours may be. NATURE CONSISTENCE COLOR TASTE USE. Blood is Of Nature airy, hot and moist, or rather temperate, Of indifferent consistence, neither too thick nor too thin, Of Colour red, rosy or Crimson, Of Taste sweet, Of such use, that it chiefly serves for the nourishment of the fleshyparts, and carried by the vessels imparts heat to the whole body. Phlegm is Of Nature watery, cold and moist, Of Consistence liquid, Of Colour white Of Taste sweet, or rather unsavoury, for we commend that water which is unsavoury, Fit to nourish the brain and all the other cold and moist parts, to temper the heat of the blood, and by its slipperines to help the motion of the joints. Choler is Of Nature fiery, hot and dry, Of Consistence Thin, Of Colour yellow, or pale, Of Taste bitter, It provoketh the expulsive faculty of the guts, attenuates the Phlegm cleaving to them, but the Alimentary is fit to nourish the parts of like temper with it. Melancholy is. Of Nature earthly, cold and dry. Of Consistence gross and muddy, Of Colour blackish Of taste acide, sour or biting. Stirs up the Appetite, nourishes the spleen and all the parts of like temper to it, as the Bones. Blood hath its nearest matter from the better portion of the Chylus: and being begun to be laboured in the veins, at length gets form and perfection in the liver; but it hath its remote matter from meats of good digestion and quality, seasonably eaten after moderate exercise; but for that, one age is better than another, and one time of the year more convenient than another. For blood is made more copiously in the Spring, because that season of the year comes nearest to the temper of the blood, by reason of which the blood is rather to be thought temperate, than hot and moist, for that Galen makes the Spring temperate, and besides, at that time blood-letting Lib. 1. de temp. is performed with the best success: youth is an age very fit for the generation of blood; or by Galens' opinion, rather that part of life, that continues from the 25. to the 35. year of our age. Those in whom this humour hath the dominion, are beautified with a fresh and rosy colour, gentle and well natured, pleasant, merry, and facetious. The generation of Phlegm is not by the imbecility of heat, as some of the ancients thought; who were persuaded that choler was caused by a raging, blood by a moderate, and phlegm and melancholy, by a remiss heat. But that opinion is full of manifest error: for if it be true that the Chylus is laboured and made into blood in the One and the same heat is the efficient cause of all humours at the same time. same part, and by the same fire, that is, the liver; from whence in the same moment of time should proceed that strong and weak heat, seeing the whole mass of the blood different in its four essential parts, is perfected and made at the same time, and by the same equal temper of the same part, action, and bloud-making faculty; therefore from whence have we this variety of humours? From hence, for that those meats by which we are nourished, enjoy the like condition that our bodies do, from the four Elements, and the fouré first qualities; for it is certain, and we may often observe in what kind soever they be united or joined together, they retain a certain hot portion imitating the Fire, another cold, the water; another dry, the earth, and lastly, another moist like to the Air. Neither can you name any kind of nourishment, how cold soever it be, not Lettuce itself, in which there is not some fiery force of heat. Therefore it is no marvel, if one and the same heat working upon the same matter of Chylus, varying with so great dissimilitude of substances, do by its power produce so unlike humours, as from the hot, Choler; from the cold, Phlegm; and of the others, such as their affinity of temper will permit. There is no cause that any one should think that variety of humours to be caused The heat of the Sun alone doth melt wax and harden clay. in us, rather by the diversity of the active heat, than wax and a flint placed at the same time, and in the same situation of climate and soil, this to melt by the heat of the Sun, and that scarce to wax warm. Therefore that diversity of effects is not to be attributed to the force of the efficient cause, that is, of heat, which is one and of one kind in all of us; but rather to the material cause, seeing it is composed of the conflux, or meeting together of various substances, gives the heat leave to work, as it were out of its store, which may make and produce from the hotter part thereof Choler, and of the colder, and more rebellious Phlegm. Yet I will not deny but that more Phlegm, or Choler may be bred in one and the same body, according to the quicker, or slower provocation of the heat; yet nevertheless it is not consequent, that the original of Choler should be from a more acride, and of Phlegm from a more dull heat in the same man. Every one of us naturally have a simple heat, and of one kind, which is the worker of divers operations, not of itself, seeing it is always the same, and like itself, but by the different fitness, pliableness, or resistance of the matter on which it works. Wherefore phlegm is generated in the The divers condition of the matter alone, is the cause of variety. same moment of time, in the fire of the same part, by the efficiency of the same heat, with the rest of the blood, of the more cold, liquid, crude, and watery portion of the Chylus. Whereby it comes to pass, that it shows an express figure of a certain rude or unperfect blood, for which occasion nature hath made it no peculiar receptacle, but would have it to run friendly with the blood in the same passages of the veins, that any necessitiehappening by famine, or indigency, and in defect of better nourishment, it may by a perfecter elaboration quickly assume the form of blood. Cold & rude nourishment make this humour to abound, principally in winter, and in those which incline to old age; by reason of the similitude which phlegm hath with that season and age. It makes a man drowsy, dull, fat, and swollen up, and hasteneth grey hairs. Choler The effects of Phlegm. is as it were a certain heat and fury of humours, which generated in the liver, together with the blood is carried by the veins and arteries through the whole body. That of it which abounds, is sent, partly into the guts, and partly into the bladder of the gall; or is consumed by transpiration, or sweats; It is somewhat probable that the Arterial blood is made more thin, hot, quick and pallid, than the blood of the veins, by the commixture of this Alementarie choler. This humour is chiefly bred and expelled in youth, and acrid and bitter meats give matter to it: but great labours of body and mind give the occasion. It maketh a man nimble, quick, ready for all The effects of Choler. performance, lean, and quick to anger, and also to concoct meats. The Melancholic humour, or Melancholy, being the grosser portion of the blood, is partly sent from the Liver to the Spleen to nourish it, and partly carried by the vessels into the rest of the body, and spent in the nourishment of the parts endued with an earthly dryness; it is made of meats of gross juice, and by the perturbations of the mind, turned to fear and sadness. It is augmented in Autumn, and in the first and crude The effects of Melancholy. old age; it makes men sad, harsh, constant, froward, envious and fearful. All men ought to think, that such humours are wont to move at set hours of the day, as by a certain peculiar motion or tide. Therefore the blood flows from the ninth hour of What motions are in each quarter of the body. the night, to the third hour of the day; then Choler to the ninth of the day; then Melancholy to the third of the night, the rest of the night that remains, is under the dominion of Phlegm. Manifest examples hereof appears in the French-Poxe. From the elaborate and absolute mass of the blood (as we said before) two kinds of humours, as excrements of the second concoction, are commonly and naturally separated, the one more gross, the other more thin. This is called either absolutely choler, or with an adjunct, yellow choler. That is called Melancholy; which drawn by the Spleen in a thinner portion, and elaborate by the heat of the Arteries, which in that part are both many and large, becomes nourishment to the part; the remnant thereof is carried by the veiny vessel into the orifice of the ventricle, whereby it may The Melancholy humour doth not cause, but whet the appetite. not cause, but whet the appetite, and by its astriction strengthen the actions thereof. But yellow Choler drawn into the bladder of the gall, remains there so long, till being troublesome, either in quantity or quality, it is excluded into the guts, whereby it may cast forth the excrements residing in them; the expulsive faculty being provoked by its acrimony, and by its bitterness kills the worms that are bred there. This same humour is accustomed to die the urine of a yellow colour. There is another A Serous or wheyish humour. serous humour, which truly is not fit to nourish, but profitable for many other things, which is not an excrement of the second, but of the first concoction. Therefore nature would that mixed with the Chylus, it should come to the Liver, and not be voided with the excrements, whereby it might allay the grossness of the blood, and serve it for a vehicle; for otherwise the blood could scarce pass through the capillary veins of the Liver, and passing the simous and gibbous parts thereof, come to the hollow vein. Part of this serous humour separated together with the blood which serves for the nourishment of the reins, and strait carried into the bladder, is turned into that urine which we daily make; the other part therefore carried through all the body together with the blood, performing the like duty of transportation, is excluded by sweats into which it degenerates. Besides the forenamed, the Arabians have mentioned four other humours, which they term Alimentary and secondary, Secundary humours. as being the next matter of nourishment, as those four the blood contains, the remote. They have given no name to the first kind, but imagine it to be that humour, which hangs ready to fall like to little drops in the utmost orifices of the veins. They call the second kind, * Ro●. Dew; being that humour, which entered already into the substance of the part, doth moisten it. The third they call by a Barbarous name Cambium, which already put to the part to be nourished, is there fastened. The fourth named Gluten, or Glue, is only the proper and substance-making humidity of the simular parts, not their substance. The distinction of the degrees of nutrition recited by Galen in his Books of Natural faculties, answer in proportion to this distinction of humours. The first is, that the blood flow to the part that requires nourishment; then that being there arrived, it may be agglutinated; then lastly, that having lost its former form of nourishment, it may be assimulated. Those humours are against nature, which being corrupted, infect the body and the Humours against nature. parts in which they are contained by the contagion of their corruption, retaining the names and titles of the humours, from whose perfection and nature they have revolted, they all grow hot by putrefaction, although they were formerly by their own nature cold. And they are corrupted, either in the veins only, or within and without the veins; In the veins Blood and Melancholy; but both without and within the veins, Choler and Phlegm. When blood is corrupted in its thinner portion, Into what humours the blood when it corrupts doth degenenerate. The Melancholy humour corrupted, is of three kinds. it turns into choler, when in its thicker, into Melancholy; for the blood becomes faulty two manner of ways, either by the corruption of its proper substance by putrefaction, or by admixtion of another substance by infection. The Melancholy humour which is corrupted in the veins, is of three sorts: the 1. is of a Melancholy juice putrifying, and by the force of a strange heat, turned as it were into ashes, by which it becomes adust, acride and biting. The other ariseth from that Choler which resembles the yolkes of eggs, which by adustion becomes leeke-coloured, then aeruginous, or of a bluish green, then red, and lastly black, which is the very worst kind of Melancholy, hot, malign, eating and exulcerating, and which is never seen or voided with safety. The third comes from Phlegm putrifying in the veins, which first degenerates into salt Phlegm, but strait by the strength of extraneous heat degenerates into Melancholy. Phlegm not natural is bred, either In the veins, and is either Acide and very crude, as which hath had none or very little impression of heat, but that which it first had in the stomach. Salt, which is bred by the sweet, putrifying and adust, or mixture of adust and salted particles. or without the veins, and is of 4. sorts, either Waterish, as is that thin moisture which distils from the brain by the nostrils. Mucous, as when that waterish is thickened into filth by the help of some accidental or small heat. glassy, or * Albuminca. Albuminous, resembling molten glass, or rather the white of an egg, and is most cold. Gypsea, or Plaisterlike, which is concrete into the hardness and form of chalk, as you may see in the joints of the fingers in a knotty gout, or in inveterate distillations upon the Lungs. Choler not natural is bred, either In the veins, as the * Vitellina. vitelline (like in consistence to the yolk of a raw egg) which the acrimony of strange heat breeds of yellow choler, which same in diseases altogether deadly, degenerates into green, aeruginous, and lastly into a blue, or colourlike that which is dried by woad. Or in the capacity of the upper belly as the ventricle, and this is of five kinds The first is called Porracea or leek-coloured, resembling the juice of a leek in greenness. The 2. agruginosa, or aeruginous, like in colour to verdigreasse. The 3. bluish, or woad-coloured, like the colour died by woad. The 4. red, differing in this from blood, whose colour it imitates, that it never cometh into knots, or clods like blood. The 5. very red, generated by the excess of the former, which causeth burning fevers. The kinds of such choler, are often cast forth by vomit in diseases, the strength of the disease being past; being troublesome to the parts through which they are evacuated, by their bitterness, acrimony and biting. The Signs of a Sanguine Person. I Think it manifest, because the matter and generation of flesh is principally from blood, that a man of a fleshy, dense, and solid habit of body, and full of a sweet and vaporous juice, is of a Sanguine complexion. And the same party hath a flourishing and roasie colour in his face, tempered as with an equal mixture of white and Such as the humour is, such is the colour. red; of white, by reason of the skin lying utmost; of red, because of the blood spread underneath the skin; for always such as the humour is, such is the colour in the face. In manners he is courteous, gentle, easy to be spoken to, not altogether The manners and diseases of Sanguine persons. estranged from the love of women, of a lovely countenance and smooth forehead, seldom angry, but taking all things in good part; for as the inclination of humours is, so also is the disposition of manners. But blood is thought the mildest of all humours; but the strong heat of the inward parts maketh him to eat and drink freely. Their dreams are pleasant, they are troubled with diseases arising from blood, as frequent Phlegmons, and many Sanguine pustles breaking through the skin, much bleeding, and menstruous fluxes. Wherefore they can well endure blood-letting, and delight in the moderate use of cold and dry things; and lastly, are offended by hot and moist things. They have a great and strong Pulse, and much urine in quantity, but mild of quality, of an indifferent colour and substance. The Signs of a Choleric Person. Choleric men are of a pale or yellowish colour, of a lean, slender and rough Choleric are not commonly fat. habit of body, with fair veins and large Arteries, and a strong and quick Pulse: their skin being touched, feels hot, dry, hard, rough and harsh, with a pricking and acred exhalation which breathes forth of their whole body. They cast forth much choler by stool, vomit and urine. They are of a quick and nimble wit, stout, hardy and sharp vindicaters of received injuries, liberal even to prodigality, The manners and diseases, of Choleric persons. and somewhat too desirous of glory. Their sleep is light, and from which they are quickly waked; their dreams are fiery, burning, quick and full of fury; they are delighted with meats and drinks which are somewhat more cold and moist, and are subject to Tertian and burning fevers, the Frenzy, jaundice, Inflammations, and other choleric pustules, the Laske, Bloody flux, and bitterness of the mouth. The Signs of a Phlegmatic Person. THose in whom Phlegm hath the dominion, are of a whitish coloured face, and The manners and diseases of Phlegmatic persons, sometimes livide and swollen, with their body fat, soft and cold to touch. They are molested with Phlegmatic diseases, as oedematous tumours, the Dropsy, Quotidians fevers, falling away of the hairs, and catarrhs falling down upon the Lungs, and the Aspera Arteria, or Weasand; they are of a slow capacity, dull, slothful, drowsy, they do dream of reins, snows, floods, swimming, and such like, that they often imagine themselves overwhelmed with waters; they vomit up much watery, and Phlegmatic matter, or otherwise spit and evacuate it, and have a soft and moist tongue. And they are troubled with a dogge-like hunger, if it at any time should happen that their insipid Phlegm become acide; and they are slow of digestion, by reason of which they have great store of cold and Phlegmatic humours, which if they be carried down into the windings of the cholicke-gut, they cause murmuring and From whence ●oise, or rumbling in the belly proceeds noise, and sometimes the Colic. For much wind is easily caused of such like Phlegmatic excrements wrought upon by a small and weak heat, such as Phlegmatic persons have, which by its natural lightness is diversely carried through the turnings of the guts, and distends and swells them up, and whiles it strives for passage out, it causeth murmurings and noises in the belly, like wind breaking through narrow passages. Signs of a Melancholic person. THe face of Melancholy persons is swart, their countenance cloudy and often Diseases familiar to Melancholy persons. cruel, their aspect is sad and froward; frequent Schirrhous, or hard swellings, tumours of the spleen, Haemorroids, Varices (or swollen veins) quartan fevers, whether continual or intermitting, Quintaine, Sextaine, and Septimane fevers; and to conclude, all such wandering fevers or agues set upon them. But when it happens the Melancholy humour is sharpened, either by adustion, or commixture of Choler, than Tetters, the black Morphew, the Cancer simple and ulcerated, the Leprous and filthy scab, sending forth certain scaly and branlike excrescenses, (being vulgarly called Saint Manis his evil) and the Leprosy itself invades them: They have small veins and arteries, because coldness hath dominion over them, whose property is to straiten, as the quality of heat is to dilate. But if at any time their veins From or by what their veins are swollen. seem big, that largeness is not by reason of the laudable blood, contained in them, but from much windiness; by occasion whereof it is somewhat difficult to let them blood; not only because that when the vein is opened, the blood flows slowly forth, by reason of the cold slowness of the humours; but much the rather, for that the vein doth not receive the impression of the Lancet, sliding this way and that way, by reason of the windiness contained in it, and because that the harsh dryness of the upper skin, resists the edge of the instrument. Their bodies seem cold and hard to the touch, and they are troubled with terrible dreams, for they are observed to seem Their dreams to see in the night Devils, Serpents, dark dens and caves, sepulchres, dead corpses, and many other such things full of horror, by reason of a black vapour, deversly moving and disturbing the Brain, which also we see happens to those, * Hydrophobi. who fear the water, by reason of the biting of a mad dog. You shall find them froward, fraudulent, Their manners. parsimonious, and covetous, even to baseness, slow speakers, fearful, sad, complainers, careful, ingenious, lovers of solitariness, man-haters, obstinate maintainers of opinions once conceived, slow to anger, but angered not be pacified. But when Melancholy hath exceeded natures and its own bounds, then by reason of putrefaction and inflammation all things appear full of extreme fury and madness, so that they often cast themselves headlong down from some high place, or are otherwise guilty of their own death, with fear of which notwithstanding they are terrified. But we must note that changes of the native temperament, do often happen in the course of a man's life, so that he which a while agone was Sanguine, may now be From whence the change of the native temper. Choleric, Melancholic, or Phlegmatic; not truly by the changing of the blood into such humours, but by the mutation of Diet, and the course or vocation of life. For none of a Sanguine complexion but will prove Choleric if he eat hot and dry meats, How one may become choleric. (as all like things are cherished and preserved by the use of their like, and contraries are destroyed by their contraries) and weary his body by violent exercises, and continual labours; and if there be a suppression of Choleric excrements, which before did freely flow, either by nature, or art. But whosoever feeds upon meats generating How melancholic. gross blood, as Beef, Venison, Hare, old Cheese, and all salt meats, he without all doubt sliding from his nature, will fall into a Melancholy temper; especially if to that manner of diet, he shall have a vocation full of cares, turmoils, miseries, strong and much study, careful thoughts and fears; and also if he sit much, wanting exercise, for so the inward heat as it were defrauded of its nourishment, faints, and grows dull, whereupon gross and drossy humours abound in the body. To this also the cold and dry condition of the place, in which we live, doth conduce, and the suppression of the Melancholy humour accustomed to be evacuated by the Haemorrhoides, courses, and stools. But he acquires a Phlegmaricke temper whosoever useth cold & moist nourishment, How Plegmatick●. much feeding, who before the former meat is gone out of the belly, shall stuff his paunch with more, who presently after meat runs into violent exercises, who inhabit cold and moist places, who lead their life at ease in all idleness; and lastly, who suffer a suppression of the Phlegmatic humour accustomely evacuated by vomit, cough, or blowing the nose, or any other way either by nature or art. Certainly it is very convenient to know these things, that we may discern if any at the present be Phlegmatic, Melancholic or of any other temper, whether he be such by nature, or nec●ss●●y. Having declared those things which concern the nature of Temperaments, and deferred the description of the parts of the body to our Anatomy, we will begin to speak of the faculties governing this our life, when first we shall have shown by a practical demonstration of examples, the use and certainty of the aforesaid rules of Temperaments. CHAP. VII. Of the Practice of the aforesaid rules of Temperaments. THat we may draw the Theoric of the Temperaments into practice, it hath seemed good for avoiding of confusion, which might make this our Introduction Four bounds or Regions of the world. seem obscure, if we would prosecute the differences of the Tempers of all men of all Nations, to take those Limits, which nature hath placed in the world; as South, North, East and West, and as it were the Centre of those bounds, that the described variety of Tempers, in colour, habit, manners, studies, actions, and form of life of men that inhabit those Regions situated so far distant one from another, may be as a sure rule, by which we may certainly judge of every The forces of temperatures in particulars. The temperature of the Southern people. Of the Northern. man's temperature in particular, as he shall appear to be nearer, or further off from this, or that region. Those which inhabit the South as the Africans, Aethiopians, Arabians and Egyptians, are for the most part deformed, lean, dusky coloured and pale, with black eyes and great lips, curled hair, and a small and shrill voice. Those which inhabit the Northern parts as the Scythians, Muscovites, Polonians and Germans, have their faces of colour white, mixed with a convenient quantity of blood, their skin soft and delicate, their hair long, hanging down and spreading abroad, and of a yellowish, or reddish colour; of stature they are commonly tall, & of a well proportioned, fat and compact habit of body, their eyes grey; their voice strong, loud and big. But those who are situated between these two former, as the Italians and French, have their faces somewhat swart, are well favoured, nimble, strong, hairy, slender, well in flesh, with their eyes resembling the colour of Goates-eyes, and often hollow eyed, having a clear shrill and pleasing voice. The Southern people are exceeded so much by the Northern in strength and ability of body, as they surpass them in wit and the faculties of the mind. Hence The Southern people prevail in wit, the Northern in strength. is it you may read in Histories, that the Scythians, Goths and Vandals vexed Africa and Spain with infinite incursions, and most large and famous Empires have been founded from the North to the South; but few or none from the South to the North. Therefore the Northern people thinking all right and law to consist in Arms, did by Duel only determine all causes and controversies arising amongst the inhabitants, as we may gather by the ancient laws, and customs of the Lumbards', English, Burgonians, Danes and Germans; and we may see in Saxon the Grammarian that such a law was once made by Fronto king of Denmark. The which custom at this day is every where in force amongst the Muscovites. But the Southern people have always much abhorred that fashion, and have thought it more agreeable to Beasts than Men. Wherefore we never heard of any such thing used by the Assyrians, Egyptians, Persians or jews. But moved by the goodness of their wit, they erected Kingdoms and Empires by the only help of Learning and hidden sciences. For seeing by nature they are Melancholic by reason of the dryness of their temperature, they willingly addict themselves to solitariness and contemplation, being endued with a singular sharpness of wit. Wherefore the Aethiopians, Egyptians, Africans, jews, Phaenicians, Persians, The Southern people learned and religious. Assyrians, and Indians, have invented many curious sciences, revealed the Mysteries and secrets of Nature, digested the Mathematics into order, observed the motions of the heavens, and first brought in the worship and religious sacrifices of the gods: Even so far that the Arabians who live only by stealth, and have only a Wagon for their house, do boast that they have many things diligently and accurately observed in Astrology by their Ancestors, which every day made more accurate and copious, they, as by an hereditary right, commend to posterity, as it is recorded by Leo the African. But the Northern people, as the Germans, by reason of the abundance of humours and blood, by which the mind is as it were oppressed, The Northern famous Warrious, and Artificers. apply themselves to works obvious to the senses, and which may be done by the hand. For their minds oppressed with the earthly mass of their bodies, are easily drawn from heaven and the contemplation of Celestial things, to these inferior things, as to find out Mines by digging, to buy and cast metals, to draw and hammer out works of Iron, steel and brass. In which things they have proved so excellent, that the glory of the Invention of Guns and Printing belongs to them. The people who inhabit the middle regions between these, are neither naturally The endowments of such as inhabit between them. fit for the more abstruse sciences, as the Southern people are, nor for Mechanic works, as the Northern, but intermeddle with civil affairs, commerce and Merchandizing. But are endued with such strength of body as may suffice to avoid and delude the crafts and arts of the Southern Inhabitants; and with such wisdom as may be sufficient to restrain the fury and violence of the Northern. How true this is, any one may understand by the example of the Carthaginians and Africans, who when they had held Italy for some years by their subtle counsels, crafty sleights and devices; yet could not escape but at the length their Arts being deluded, and they spoiled of all their fortunes, were brought in subjection to the Romans. The Goths, Huns and other The Northern know how to overcome, but not how to use the victory Northern people have spoiled & overrun the Roman Empire by many incursions and inroads, but destitute of counsel & providence, they could not keep those things which they had gotten by Arms and valour. Therefore the opinion of all Historians is agreeing in this, that good laws, the form of governing a Commonwealth, all politic ordinances, the Arts of disputing and speaking, have had their beginning from the Greeks, Romans and French. And from hence in times past and The abundance of counsellors and Lawyers from France and Italy. at this day a greater number of Writers, Lawyers and Counsellors of State have sprung up, than in all the world besides. Therefore that we may attribute their gifts to each Region, we affirm that, The Southern people are borne and fit for the studies of learning; the Northern for wars, and those which be between them both for Empire and rule. The Italian is naturally wise, the Spaniard grave and constant; the French quick and diligent, for you would say he runs when he goes, being compared to the slow and womanish pace of the Spaniard, which is the cause that Spaniards are delighted with French servants for their quick agility in dispatching business. The Eastern people are specially endued with a good, firm and well tempered wit, not keeping their counsels secret and hid. For the haste is of the nature The manners of the Eastern people of the Sun, and that part of the day which is next to the rising of the Sun is counted the rightside and stronger; and verily in all living things the right side is always the more strong and vigorous. But the Western people are more tender and effeminate, and more close in their carriage and mind, not easily making any one partaker The manners of the Western people. of their secrets. For the West is, as it were subjct to the Moon, because at the change it always inclines to the West, whereby it happens, that it is reputed as nocturnal, sinister and opposite to the East; and the West is less temperate and wholesome. Therefore of the winds none is more wholesome than the eastwind which blows from The East wind healthful. the west with a most fresh and healthful gale, yet it seldom blows, and but only at Sunset. The Northern people are good eaters, but much better drinkers, witty when they The Northern people great eaters and drinkers. are a little moistened with wine, and talkers of things both to be spoken and concealed, not very constant in their promises and agreements, but principal keepers and preservers of shamefastness and chastity, far different from the inhabitants of the South, who are wonderful sparing, sober, secret and subtle, and much addicted to all sorts of wicked Lust. Aristotle in his Problems saith that those nations are barbarous and who are to be counted Barbarous. cruel, both which are burnt with immoderate heat, and which are oppressed with excessive cold, because a soft temper of the Heavens softens the Manners and the mind. Wherefore both, as well the Northern, as Scythians and Germans; and the Southern, The North●ne and Southern have each their Cruelties. as Africans are cruel; but these have this of a certain natural stoutness, and soldierlike boldness, and rather of anger, than a wilful desire of revenge; because they cannot restrain by the power of reason the first violent motions of their anger by reason of the heat of their blood. But those of a certain inbred and inhuman pravity of manners, wilfully and willingly premeditating they perform the works of cruelty, because they are of a sad and melancholy nature. You may have an example of the Northern cruelty from the Transilvanians against their seditious Captain George, whom they gave to be torn in pieces alive and devoured by his Soldiers, (being kept fasting for three days before for that purpose) who was then unboweled, and roasted, and so by them eaten up. The Cruelty of Hannibal the Captain of the Carthaginians may Valer. Ma●. lib. 9 cap. 2. suffice for an instance of the Southern cruelty. He left the Roman Captives wearied with burdens and the length of the way, with the soles of their feet cut off; But those he brought into his tents, joining brethren and kinsmen together he caused to fight, neither was satisfied with blood before he brought all the victors to one man. Also we may see the cruel nature of the Southern Americans, who dip their children in the blood of their slain enemies, then suck their blood, and banquet with their broken and squeezed Limbs. And as the Inhabitants of the South are free from divers Plethoric diseases, The diseases of the Southern people. which are caused by abundance of blood, to which the Northern people are subject, as Fevers, Defluxions, Tumours, Madness with laughter which causeth those which have it to leap and dance (The people commonly term it S. vittus his Evil) which admits of no remedy but Music: So they are often molested with the Frenzy invading with madness and fury; by the heat whereof they are often so ravished and carried besides themselves that they foretell things to come; they are terrified with horrible dreams, and in their fits they speak in strange and foreign tongues, but they are so subject to the scurf and all kind of scabs and to the Leprosy as their homebread disease, that no houses are so frequently met withal by such as travel through either of the Mauritania's, as Hospitals provided for the Lodging of Lepers. Those who inhabit rough and Mountainous places, are more brutish, tough & able Mountainers, to endure labour: but such as dwell in plains, especially if they be moorish, or fennish are of a tender body, and sweat much with a little labour; the truth of which is confirmed by the Hollanders and Frizlanders. But if the plain be such as is scorched by the heat of the Sun, and blown upon by much contrariety of winds, it breeds men who are turbulent, not to be tamed, desirous of sedition and novelty, stubborn, impatient of servitude, as may be perceived by the sole example of the inhabitants of Narbon a province of France. Those who dwell in poor and barren places are commonly more witty and diligent and most patient of labours; the truth of which the famous wits of the Athenians, Ligurians and Romans, and the plain country of the Boeotians in Greece, of the Campanians in Italy, and of the rest of the inhabiters adjoining to the Ligurian sea, approves. CHAP. VIII. Of the Faculties. A Faculty is a certain power, and efficient cause, proceeding from the temperament What a faculty is. 3. Faculties. of the part, and the performer of some actions of the body. There are three principal Faculties governing man's body as long as it enjoys its integrity; the Animal, Vital and Natural. The Animal is seated in the propertemperament of the Brain, from whence it is distributed by the Nerves into all parts of the body which have sense and motion. This is of three kinds, for one is Moving, another sensative; the third principal The sensative consists in the five external senses, sight, hearing, taste, smell and touch. The Moving principally remains in the Muscles and nerves, as the fit instruments of voluntary motion. The Principal comprehends the Reasoning faculty, the Memory and Fantasy. Galen would have the Common or inward sense to be comprehended within the compass of the Fantasy, although Aristotle distinguisheth between them. The Vital abides in the Hart, from whence heat and life is distributed by the Arteries to the whole body: this is principally hindered in the diseases of the Breast; as the Principal is, when any disease assails the Brain; the prime action of the vital faculty is Pulsation, and that continued agitation of the Heart and Arteries, which is of threefold use to the body: for by the dilatation of the Heart and Arteries the vital spirit is cherished by the benefit of the Air which is drawn in; by the The triple use of the Pulse. contraction thereof the vapours of it are purged and sent forth, and the native heat of the whole body is tempered by them both. The last is the Natural faculty which hath chosen its principal seat in the Liver, it spreads or carries the nourishment over the whole body; but it is distinguished into 3. The natural faculty is threefold. other faculties; The Generative which serves for the generation and forming of the Issue in the womb; the Growing or increasing faculty which flourisheth from the time the Issue is form, until the perfect growth of the solid parts into their full dimensions of Length, height and breadth. The nourishing faculty which as servant to both the other repairs and repays the continual effluxe, and waste of the threefold substance; for Nutrition is nothing else but a replenishing, or repairing whatsoever What Nutrition is. is wasted or emptied This nourishing faculty endures from that time the Infant is form in the womb until the end of life. It is a matter of great consequence in Physic to know the 4 other faculties, which as servants attend upon the nourishing Four other faculties attend upon the nourishing faculty faculty; which are the Attractive, Retentive, Digestive, and Expulsive faculty. The Attractive draws that juice which is fit to nourish the body, that I say which by application may be assimulated to the part. This is that faculty which in such as are hungry draws down the meat scarce chawed, and the drink scarce tasted, into the gnawing and empty stromacke. The Rententive faculty is that which retains the nourishment once attracted until it be fully laboured and perfectly concocted; And by that means it yields no small assistance to the Digestive faculty. For the natural The necessity of the retentive faculty. heat cannot perform the office of concoction, unless the meat be embraced by the part, and make some stay therein. For otherwise the meat carried into the stomach never acquires the form of Chylus, unless it stay detained in the wrinkles thereof, as in a rough passage, until the full time of Chylification. The Digestive faculty assimulates the nourishment, being attracted and detained, into the substance of that part whose Faculty it is, by the force of the inbred heat & proper disposition or temper of the part. So the stomach plainly changes all things which are eat and drunk into Chylus, & the Liver turns the Chylus into blood. But the Bones & Nerves convert the red and liquid blood which is brought down unto them by the capillary or small veins, into a white & solid substance. Such concoction is far more laborious in a Bone and nerve, than in the Musculous flesh. For the blood being not much different from its nature, by a light change and concretion turns into flesh. But this Concoction will Two excrements of every concoction. never satisfy the desire of Nature and the parts, unless the nourishment purged from its excrements, put away the filth and dross, which must never enter into the substance of the part. Wherefore there do not only two sorts of excrements remain of the first and second Concoction, the one thick, the other thin, as we have said before; but also from the third Concoction which is performed in every part. The one of which we conceive only by reason, being that which vanisheth into Air by insensible Transpiration. The other is known sometimes by sweats, sometimes by a thick fatty substance staining the shirt; sometimes by the generation of hair and nails, whose matter is from fuliginous and earthly excrements of the third Concoction. Wherefore the fourth Faculty was necessary which might yield no small help to nourishment; it is called the Expulsive, appointed to expel those superfluous The work of the expulsive faculty. excrements which by no action of heat, can obtain the form of the part. Such faculties serving for nutrition are in some parts twofold; as some common, the benesit of which redounds to the whole body, as in the ventricle, liver & veins; Others only attending the service of those parts in which they remain, and in some parts all these 4. aswell common as proper, are abiding and resident, as in those parts we now mentioned: some with the 4. proper have only two common, as the Gall, Spleen, Kidneys and Bladder. Others are content only with the proper, as the simular and Musculous parts, who if they want any of these 4. faculties, their health is decayed either by want of nourishment, an ulcer, or otherwise. The like unnatural affects happen by the deficiency of just and laudable nourishment. But if it happen those faculties do rightly perform their duty, the nourishment is changed into the proper substance of the part, and is truly assimulated, as by these degrees. First it must flow to the part, then By what degrees the nourishment is assimulated. be joined to it, then agglutinated, and lastly as we have said, assimulated. Now we must speak of the Actions which arise from the faculties. CHAP. IX. Of the Actions. AN Action or Function is an active motion proceeding from a faculty; for as What an Action is. the faculty depends on the Temperament, so the Action on the faculty, and the Act or work depends upon the Action by a certain order of consequence. But although that the words Actions and Act or work are often confounded, yet there is this difference between them, as that the Action signifies the motion used in the performance of any thing; but the Act or work, the thing already done and performed: for example, Nutrition and the Generating of flesh are natural Actions; but the parts nourished, and a hollow ulcer filled with flesh are the works of that motion, or action. Wherefore the Act ariseth from the Action, as the Action An Action and an Act are different. ariseth from the faculty, the integrity or perfection of the instruments concurring in both. For as, if the faculty be either defective, or hurt, no Action will be well performed: so unless the Instruments keep their native and due conformity (which is their perfect health, the operator of the Action proper to the instrument) none of those things, which ought to be, will be well performed. Therefore for the performance of blameless and perfect actions, it is fit a due conformity of the Instrument concur with the faculty. But Actions are twofold; for they are either Natural, or Voluntary. They are termed Natural, because they are performed not by Natural Actions. our will, but by their own accord and against our will: As are that continual motion of the Heart, the beating of the Arteries, the expulsion of the Excrements, and such other like which are done in us by the Law of Nature whether we will, or no. These Actions flow either from the Liver and veins, or from the Heart and Arteries. Wherefore we may comprehend them under the names of Natural and Vital Actions. For we must attribute his Action to each faculty, lest we may seem to constitute an idle faculty, and no way profitable for use. The unvoluntary vital actions are the dilation & contraction of the Heart and Arteries, the which we comprehend under the sole name of the Pulse: by that they draw in, and by this they expel, or drive forth. The unvoluntary vital actions be, Generation Growth and Nutrition which proceed from the Generative, Growing, and Nourishing faculty. Generation is nothing else than a certain producing, or acquiring of matter, and Generation what it is. an introducing of a substantial form into that matter; this is performed by the assistance of 2. faculties; of the Altering which doth diversely prepare and dispose the seed and menstruous blood to put on the form of a Bone, nerve, spleen, flesh and such like: of the Forming faculty which adorns with figure, site and composition, the matter ordered by so various a preparation. Growth is an enlarging of the solid parts into all the dimensions, the pristine and What Growth is. ancient form remaining safe and sound in figure and solidity. For the perfection of every growth is judged only by the solid parts; for if the body swell into a mass of flesh, or fat, it shall not therefore be said to be grown: but then only when the solid parts do in like manner increase, especially the bones, because the growth of the whole body follows their increase, even although at the same time it wax lean, and pine away. Nutrition is a perfect assimulation of that nourishment which is digested, into the What Nutrition is. nature of the part which digests. It is performed by the assistance of 4. subsidiary or helping actions, Attractive, Retentive, Digestive and Expulsive. The voluntary actions which we willingly perform, are so called, because we Action voluntary. can at our pleasure hinder, stir up, slow or quicken them. They are three in general, the sensitive, moving, and principal Action. The sensative * Anima sentiens. Soul comprehends all things in fine senses, in Sight, Hearing, Smell, Taste and Touch. Three things must necessarily concur to the performance of them, the Organ, the Medium or mean, and the Object. The principal Organ, or Instrument, is the Animal spirit diffused by the nerves into each several part of the body, by which such actions are performed. Wherefore for the present we will use the Parts themselves for their Organs. The Mean is a body, which carries the Object to the Instrument. The Object is a certain external quality, which hath power by a fit Medium or Mean to stir up and alter the Organ. This will be more manifest by relating the particular functions of the senses by the necessary concurring of these three. Sight, is an action of the seeing faculty, which is done by the Eye fitly composed How sight is performed. of its coats and humours, and so consequently the Organical body of this Action. The Object is a visible quality brought to the Eye. But such an Object is twofold; for either it is absolutely visible of its self, and by its own Nature, as the Sun, the fire, the Moon and Stars: or desires as it were the help of another that it may be actually such, for so by the coming of light the colours, which were visible in power only, being brought to the Eye do seem and appear such as they actually 〈◊〉. But such Objects cannot arrive at the Eye, but through a clear and ●…inate Medium, as the Air, Water, Glass and all sorts of Crystal. The Hearing hath for its Organ the Ear and Auditory passage, which How hearing. goes to the stony bone furnished with a Membrane investing it, an Auditory Nerve, and a certain inward spirit there contained. The Object is every sound arising from the smitten or broken Air, and the Collision of two bodies meeting together. The Medium is the encompassing Air which carries the sound to the Eare. Smelling (according to Galens' opinion) is performed in the Mamillary processes How smelling produced from the proper substance of the brain, and seated in the upper part of the nose: although others had rather smelling should be made in the very foremost ventricles of the brain. This Action is weak in man in comparison of other Creatures: the Object thereof is every smell, or fumide exhalation breathing out of bodies. The Medium by which the Object is carried to the noses of Men, Beasts and Birds, is the Air, but to Fishes the Water itself. The Action of taste is performed by the tongue being tempered well and according to nature, and How the taste furnished with a nerve spread over its upper part from the third and fourth conjugation of the Brain. The Object is * Sapor. Taste, of whose nature and kinds we will treat more at large in our Antidotary. The Medium by which the Object is so carried to the Organ, that it may affect it, is either external, or internal: The external is that spittle which doth as it were anoint and supple the tongue; the internal is the Spongy flesh of the tongue itself, which affected with the quality of the Object doth presently so possess the nerve that is implanted in it, that the kind and quality thereof by the force of the spirit may be carried into the common sense. All parts endued with a nerve enjoy the sense of touching, which is chiefly done, when a tractable quality doth How touching. penetrate even to the true and nervous skin, which lieth under the Cuticle, or scarfe-skinne; we have formerly noted, that it is most exquisite in the skin which invests the ends of the fingers. The Object is every tractable quality, whether it be of the first rank of qualities, as Heat, Cold, Moisture, Dryness, or of the second, as Roughness, Smoothness, Heaviness, Lightness, Hardness, Softness, Rarity, Density, Friability, unctuosity, Grossness, Thinness. The Medium by whose procurement the instrument is affected, is either the skin or the flesh interwoven with many Nerves. The next Action, is that Motion, which by a peculiar name we call voluntary; Of motion. this is performed and accomplished by a Muscle, being the proper Instrument of voluntary Motion. Furthermore every motion of a member possessing a Muscle is made either by bending and contraction, or by extension. Although generally there be so many differences of voluntary motion, as there are kinds of site in place; therefore Motion is said to be made upward, downward, to the right-hand, to the left, forward and backward; Hither are referred the many kinds of motions, which the infinite variety of Muscles produce in the body. Into How Respiration may be a voluntary motion. this rank of Voluntary Actions, comes Respiration, or breathing because it is done by the help of the Muscles; although it be chiefly to temper the heat of the Heart. For we can make it more quick, or slow as we please, which are the conditions of a voluntary Motion. Lastly, that we may have somewhat in which we may safely rest and defend ourselves against the many questions which are commonly moved concerning this thing, we must hold, that Respiration is undergone and performed by the Animal faculty, but chiefly instituted for the vital. The Principal Action and prime amongst the Voluntary is absolutely divided in The third principal Action, three, Imagination, Reasoning and Memory. Imagination is a certain expressing, and apprehension which discerns and distinguisheth between the forms and shapes of things sensible, or which are known by the senses. Reasoning is a certain judicial estimation of conceived or apprehended forms or figures, by a mutual collating, or comparing them together. Memory is the sure storer of all things, and as it were the Treasury which the mind often unfolds and opens, the other faculties of the mind being idle and not employed. But because all the forementioned Actions whether they be Natural, or Animal and voluntary, are done and performed by the help and assistance of the Spirits; Therefore now we must speak of the Spirits. CHAP. X. Of the Spirits. THe spirit is a subtle and Airy substance, raised from the purer blood What a spirit is. that it might be a vehicle for the faculties (by whose power the whole body is governed,) to all the parts, and the prime instrument for the performance of their office. For they being destitute of its sweet approach do presently cease from action, and as dead do rest from their accustomed labours. Spirits threefold. From hence it is that making a variety of Spirits according to the number of the faculties, they have divided them into three; as one Animal, another Vital, another Natural. The Animal hath taken his seat in the brain; for there it is prepared The Animal spirit. and made, that from thence conveyed by the Nerves is may impart the power of sense and Motion to all the rest of the members. An argument hereof is, that in the great Cold of Winter., whether by the intercepting them in their way, or by the concretion, or as it were freezing of those spirits, the joints grow stiff, the hands numb, and all the other parts are dull, destitute of their accustomed a gillity of motion, and quickness of sense. It is called Animal not Why so called because it is the * Anima. Life, but the chief and prime instrument thereof; wherefore it hath a most subtle and Airy substance: and enjoys divers names according to the various condition of the Sensoryes or seats of the senses into which it enters; for that which causeth the sight, is named the Visive: you may see this by night, rubbing your eyes, as sparkling like fire. That which is conveyed to the Auditory passage, is called the Auditive or Hearing; That which is carried to the Instruments of Touching, is termed the Tactive; and so of the rest. This Animal spirit is made and laboured in the windings and fold of the How it is made. veins and Arteries of the brain, of an exquisite subtle portion of the vital brought thither by the Carotidae Arteriae, or sleepy Arteries, and sometimes also of the pure air, or sweet vapour drawn in by the Nose in breathing. Hence it is, that with Ligatures we stop the passage of this spirit, from the parts we intent to cut off. An Humour which obstructs or stopps its passage, doth the like in Apoplexies and Palsies, whereby it happens that the members situate under that place do languish and seem dead, sometimes destitute of motion, sometimes wanting both sense and motion. The Vital spirit is next to it in dignity and excellency, which hath its chief The Vital spirit. mansion in the left ventricle of the Heart, from whence through the Channels of the Arteries it flows into the whole body, to nourish the heat which resides fixed in the substance of each part, which would perish in short time unless it should be refreshed by heat flowing thither together with the spirit. And because it is the most subtle next to the Animal, Nature (lest it should vanish away) would have it contained in the Nervous coat of an Artery, which is five time more thick, than the Coat of the veins, as Galen, out of Herophilus, hath recorded. It is furnished with matter from the subtle exhalation of the blood, and that air What the matter of it is. which we draw in breathing. Wherefore it doth easily and quickly perish by immoderate dissipations of the spirituous substance, and great evacuations; so it is easily corrupted by the putrefaction of Humours, or breathing in of pestilent air and filthy vapours, which thing is the cause of the so sudden death of those which are infected with the Plague. This spirit is often hindered from entering into some part by reason of obstruction, fullness, or great inflammations, whereby it follows that in a short space, by reason of the decay of the fixed and inbred heat, the parts do easily fall into a Gangrene and become mortified. The Natural spirit (if such there be any) hath its station in the Liver and Veins. It is more gross and dull than the other, and inferior to them in the There is some doubt of the Naturallspirit. dignity of the Action, and the excellency of the use. The use thereof is to help the concoction both of the whole body, as also of each several part, and to carry blood and heat to them. Besides those already mentioned, there are other spirits fixed and implanted in the simular and prime parts of the body, which also are natural, and Natives Fixed spirits. of the same place in which they are seated and placed. And because they are also of an Airy and fiery nature, they are so joined or rather united to the Native heat, that they can no more be separated from it, than flame from heat; wherefore they with these that flow to them are the principal Instruments of the Actions, which are performed in each several part; And these fixed spirits have their nourishment and maintenance from the radical and first-bred moisture, which The radical moisture. is of an Airy and oily substance and is as it were the foundation of these Spirits and the inbred heat. Therefore without this moisture no man can live a moment. But also the Chief Instruments of life are these Spirits together with the native heat. Wherefore this radical Moisture being dissipated and wasted, (which is the seat, fodder and nourishment of the Spirits and heat) how can they any longer subsist and remain? Therefore the consumption of the natural heat followeth the decay of this sweet and substance-making moisture, and consequently death, which happens by the dissipating and resolving of natural heat. Natural death But since then these kind of Spirits with the natural heat, is contained in the substance of each simular part of our body (for otherwise it could not persist) it must necessarily follow, that there be as many kinds of fixed Spirits, as of simular parts. For because each part hath its proper temper and increase, it hath also its proper spirit, and also it's own proper fixed and implanted heat, which here hath its abode, as well as its Original, Wherefore the spirit and heat which is seated in the bone, is different from that, which is impact into the substance of a Nerve, Vein or such other simular part; because the temper of these parts is different, as also the mixture of the Elements from which they first arose and sprung up. Neither is this contemplation of spirits of small account, for in these consist all the force and efficacy of our Nature. These being by any chance dissipated or wasted, we languish, neither is any The use and necessity of the Spirits. health to be hoped for, the flower of life withering and decaying by little and little. Which thing ought to make us more diligent, to defend them against the continual effluxe of the threefold substance. For if they be decayed, there is left no proper Indication of curing the disease, so that we are often constrained, all other care laid aside, to betake ourselves to the restoring and repairing the What the remedy for the dissipation of the spirits. decayed powers. Which is done by meats of good juice, easy to be concocted and distributed, good Wines and fragrant smells. But sometimes these Spirits are not dissipated, but driven in and returned to What the remedy for oppression of the spirits is. their fountains, and so both oppress and are oppressed; whereupon it happens we are often forced to dilate and spread them abroad by binding and rubbing the parts. Hitherto we have spoke of these things which are called Natural, because we naturally consist of them; it remains that we now say somewhat of their Adjuncts and associates by familiarity of Condition. The Adjuncts and Associates to things Natural, are Age: of which, by reason of the similitude of the Argument, we were constrained to speak when we handled the Temperatures. Sex. Colour; of which we have already spoken. The Conformation of the instrumental parts. Time, whose force we have also considered. Region. Order of Diet and Condition of life. CHAP. XI. Of the Adjuncts of things Natural. Sex is no other thing than the distinction of Male and Female, in What sex is, which this is most observable, that for the parts of the body, and the fire of these parts, their is little difference between them; but the Female The nature of women. is colder than the Male. Wherefore their spermaticall parts are more cold, soft and moist, and all there natural actions less vigorous, and more depraved. The Nature of eunuchs is to be referred to that of women, as who may seem Of eunuchs. to have degenerated into a womanish nature, by deficiency of heat; their smooth body and soft and shirle voice do very much assimilate women. Notwithstanding you must consider that there be some Manly women, which their manly voice and chin covered with a little hairiness do argue; and on the contrary, there are some womanizing, or womanish men, which therefore we term dainty and effeminate. The Hermaphrodite as of a doubtful nature and in the middle of both sexes seems to participate of both Male and Female. Of Hermaphrodites. The Colour which is predominante in the habit and superficies of the body and Colour the bewrayer of the Temperament lies next under the skin, shows the temperament of what kind soever it be; for as Galen notes in Comment. ad Aphor, 2. sect. 1. Such a colour appears in us, as the contained humour hath. Wherefore if a rosy hue colour the cheeks, it is a sign the body abounds with blood, and that it is carried abroad by the plenty of Spirits. But if the skin be died with a yellow colour, it argues Choler, is predominante; if with a whitish and pallid hue, Phlegm; with a sable and dusky, Melancholy. So the colour of the excrements which are according to Nature is not of the least consideration. For thus, if an ulcer being broken send forth white matter, it argues the soundness of the part from whence it flows; but if sanious or bloody, green, blackish, or of divers colours, it shows the weakness of the solid part, which could not assimilate by concoction the colour of the excrementitious humour. The like reason is of unnatural Tumours; For, as the colour, so the Dominion of the Humour causing or accompanying the swelling commonly is. The Conformity, and integrity of the Organical parts is considered by their The perfection of the organical parts consists in 4. things. figure, greatness, number, situation and mutual connexion. We consider the figure, when we say almost all the external parts of the body are naturally round, not only for show, but for necessity, that being smooth, and no way cornered, they should be less obnoxious to external injuries; we speak of Greatness, when we say, some are large and thick, some lank and lean. But we consider their number, when we observe some parts to abound, some to want, or nothing to be defective or wanting. We insinuate site and connexion when we search, whether every thing be in its proper place, and whether they be decently fitted, and well joined together. We have handled the varyeties of the four seasons of the year, when we treated of Temperaments. But the consideration of Region (because it hath the same judgement that the Air) shall be referred to that disquisition, or enquiry which we intend to make of the Air, amongst the Things not natural. The Manner of life and order of Diet are to be diligently observed by us, because they have great power either to alter, or preserve the Temperament. Diet. But because they are of almost infinite variety, therefore they scarce seem possible to fall into Art, which may prosecute all the differences of Diet and vocations of life. Wherefore if the Calling of Life be laborious, as that of husbandmen, Mariners, and other such trades, it strengthens and dries the parts of the body. Although those which labour much about Waters, are most commonly troubled with cold and moist diseases although they almost kill themselves with labour. Again, those which deal with Metals, as all sorts of Smiths, and those which cast and work brass, are more troubled with hot diseases, as fevers. But if their Calling be such as they sit much, and work all the day long sitting at home, as shoemakers; it makes the body tender, the flesh effeminate and causeth great quantity of excrements. A life as well idle and negligent in body, as quiet in mind, in all riotousness and excesses of Diet, doth the same. For from hence the body is made subject to the stone, gravel and Gout. That calling of life which is performed with moderate labour, clothing and diet, seems very fit and convenient to preserve the natural temper of the body. The commodities of an indifferent Diet. The Ingenious Chirurgeon may frame more of himself that may more particularly conduce to the examination of these things. Therefore, the things natural, and those which are near or Neighbouring to them being thus briefly declared, the Order seems to require that we make enquiry of Things not Natural. CHAP. XII. Ofthings not Natural. THe things which we must now treat of, have by the latter Physicians Why they are called things not natural. been termed, Not natural; because they are not of the number of those which enter into the constitution, or composure of man's body; as the Elements, Humours, and all such things which we formerly comprehended under the name of Natural: Although they be such as are necessary to preserve and defend the body already made and composed. Wherefore they were called by Galen Preservers, because by the due use of them the body is preserved in health. Also they may be called doubtful; and Neuters, for that rightly and fitly used they keep the body healthful; but inconsiderately, they cause diseases. Whereby it comes to pass that they may be thought to pertain to that part of Physic which is of preserving health, not because some of these things should be absolutely and of their own nature wholesome, and others unwholesome, but only by this, that they are, or prove so by their convenient, or preposterous use. Therefore we consider the use of such like things from 4 conditions, quantity, Galen. 1. ad Glauconem. quality, occasion, and manner of using; if thou shalt observe these, thou shalt attain and effect this, that those things which of themselves are as it were, doubtful, shall bring certain and undoubted health. For these 4. Circumstances do so far extend, that in them as in the perfection of Art, the Rules which may be prescribed to preserve health are contained. But Galen in another place 1. de sanitattnenda. hath in 4. words comprehended these things not Natural; as things Taken, Applied, Expelled, and to be Done. Things Taken are those which are put into the body, either by the mouth or any other way, as the Air, meat and drink. Things Applied are these which must touch the body, as the Air now mentioned, affecting the body with a divers touch of its qualities of heat, cold, moisture or dryness. Expelled are, what things soever being unprofitable are generated in the body and require to be expelled. To be Done are labour, rest, sleep, watching and the like. We may more distinctly and by expression of proper names revoke all these things to six; which are Air, Meat and Drink, Labour and Rest, Sleep and Watching, Repletion and Inanition, or things to be expelled, or retained and kept, Perturbations of the Mind. CHAP. XIII. Of the Air. Air is so necessary to life, that we cannot live a moment without it, if so be How necessary for life the air is. that breathing, and much more transpiration, be not to be separated from life. Wherefore it much conduceth to know, what Air is wholesome, what unwholesome, and which by contrariety of qualities fights for the Patient against the disease; or on the contrary by a similitude of qualities shall nourish the disease, that if it may seem to burden the Patient by increasing or adding to the disease, we may correct it by Arte. So in curing the wounds of the head, especially in Winter, we labour by all the means we may to make the air warm. For cold is hurtful to the Brain, Bones, and the wounds of these parts; and heat is comfortable and friendly. But also the air being drawn into the body by breathing when it is hotter than ordinary, doth with a new warmth overheate the heart, lungs and spirits, and weaken the strength by the dissipation of the spirits too much attenuated; so being too cold, in like manner the strength of the faculties faints and grows dull, either by suppression of the vapours, or by the inspissation, or thickening of the spirits. Therefore to conclude, that Air is to be esteemed healthful, which is clear, subtle, What Air is huttfull. and pure, free and open on every side, and which is far remote from all carrion-like smells of dead carcases, or the stench of any putrifying thing whatsoever: the which is far distant from standing pools, and fens and caves, sending forth strong and ill vapours; neither too cloudy nor moist by the nearness of some river. Such an Air, I say, if it have a vernal temper, is good against all diseases. That air which is contrary to this is altogether unhealthful, as that which is putrid, shut up, and pressed, by the straightness of neighbouring mountains, infected with some noisome vapour. And because I cannot prosecute all the conditions of airs, fit for the expelling of all diseases, as which are almost infinite, it shall suffice here to have set down, what we must understand by this word Aire. Physicians commonly use to understand three things, by the name of Air; The Three things are understood by the name of the airs present state of the Air; The Region in which we live; and the season of the year. We spoke of this last, when we treated of Temperaments. Wherefore we will now speak of the two former. The present state of the Air, one while for some small time, is like the Spring, that is temperate; otherwhiles like the Summer, that is hot and dry; otherwhiles like the Winter, that is cold and moist; and sometimes like the Autumn which is unequal; and this last constitution of the Air, is the cause of many diseases. When upon the same day, it is one while hot, another Aphor. 4. sect. 2. The force of the winds. cold, we must expect Autumnal diseases. These tempers and varieties of constitutions of the Air, are chiefly and principally stirred up by the winds; as which being diffused over all the Air, show no small force by their sudden change. Wherefore we will briefly touch their natures: That which blows from the East, is called the east-wind, and is of a hot and dry nature, and therefore healthful. But the Western wind is cold and moist, and therefore sickly. The South wind is hot and moist, the Author of putrefaction and putrid diseases. The North wind is cold and dry, therefore healthy: wherefore it is thought, if it happen to blow in the dog-days, that it makes the whole year healthful, and purges and takes away the seeds of putrefaction, if any chance to be in the air. But this description of the four winds, is then only thought to be true, if we consider the winds in their own proper nature, which they borrow from these Regions, from which they first proceed. For otherwise they affect the How the winds acquire other faculties, than they naturally have. The west-wind of it self unwhosesome. air quite contrary, according to the disposition of the places over which they came, as snowy places, Seas, Lakes, Rivers, Woods, or sandy plains, from whence they may borrow new qualities, with which they may afterwards possess the air, and so consequently our bodies. Hence it is we have noted the Western wind unwholesome, and breeding diseases, by reason of the proper condition of the Region from whence it came; and such, that is cold and moist; the Gasconies find it, truly to their so great harm, that it seldom blows with them, but it brings some manifest and great harm, either to their bodies, or fruits of the earth. And yet the greeks, and Latins are wont to commend it for healthfulness, more than the rest. But also the rising and setting of some more What force stars have upon the air. eminent stars, do often cause such cold winds, that the whole air is cooled, or infected with some other malign quality. For vapours and exhalations are often raised by the force of the stars, from whence winds, clouds, storms, whirlwinds, lightnings, thunders, hail, snow, rain, earthquakes, inundations, and violent raging of the sea; have their original. The exact contemplation of which things, although it be proper to Astronomers, Cosmographers, and Geographers, yet Hypocrates could not omit it, but that he must speak something in his book De aëre & aquis, where he touches by the way, the description of the neighbouring Regions, and such as he knew. From this force of the air, either hurtful, or helping in diseases, came that famous observation of Gnido of Caulias, That wounds of the head are more difficult to cure at Paris, than at Avignion, and the plain contrary of wounds of the legs; for the air of Paris compared to that of Avignion is cold and moist, wherefore hurtful How the air of Paris comes to be ill for wounds of the head, and good for those of the leg. and offensive to the wounds of the head. On the contrary, the same air, because it obscures the spirits, incrassates the blood, condensates the humours, and makes them less fit for defluxions, makes the wounds of the legs more easy to be healed, by reason it hinders the course of the humours, by whose defluxion the cure is hindered. But it is manifest, that hot and dry places make a greater dissipation of the natural heat, from whence the weakness of the powers; by which same reason the Inhabitants of such places do not so well endure bloudletting; but more easily suffer purgations, though vehement, by reason of the contumacy of the humour, caused by dryness. To conclude, the air changes the constitutions of our bodies, either by its By what meames the air changes our bodies. qualities, as if it be hotter, colder, moister, or drier; or by its matter, as if it be grosser, or more subtle than is fit, or corrupted by exhalations from the earth; or by a sudden and unaccustomed alteration, which any man may prove, who makes a sudden change out of a quiet air into a stormy and troubled with many winds. But because, next to the air, nothing is so necessary to nourish man's body, as meat and drink, I will now begin to speak of them both. CHAP. XIIII. Of Meat and Drink. THat this our Treatise of meat and drink may be more brief and plain, I have thought good to part it into these heads, as to consider the goodness and illness of both of them, their quantity, quality, custom, delight, order, time, and to accommodate them all to the ages and seasons of the year. We judge of the goodness and pravity of meats and drinks, from the condition The goodness of nourishmentes. of the good or vicious humours, or juice which they beget in us. For evil juice causeth many diseases. As on the contrary, good juice drives away all diseases from the body, except the fault happen from some other occasion, as from quantity, or too much excess. Wherefore it is principally necessary, that those who will preserve their present health, and hinder the access of diseases, feed upon things of good nourishment and digestion, as are good wine, the yolkes of eggs, good milk, wheaten bread well baked, the flesh of Capons, Pertridge, Thrushes, Larks, Veal, Mutton, Kid, and such like other, which you may find mentioned in the Books which Galen writ de Alimentorum facultatibus; where also he examines those which are of evil juice by their manifest qualities, as acrimony, bitterness, saltness, acidity, harshness and such like. But unless we use a convenient quantity and measure in our meats, howsoever laudable Their quantity. they be, we shall never reap these fruits of health we hoped for. For they yield matter of diseases, by the only excess of their quantity; but we may by this know the force of quantity on both parts, because often the poisonous quality of meats of ill nourishment doth not hurt, by reason they were not taken into the body into a great quantity. That measure of quantity is chiefly to be regarded in diseases: for as Hypocrates saith, if any give meat to one sick of a fever, he gives strength to the well, The quantity of meats must be esteemed, according to the nature o●… the disease, and strength of the Patient. and increases the disease to the sick, especially if he do not use a mean. Wherefore it is a thing of no small consequence, to know what diseases require a slender and what a large diet; of which thing there is large relation made in the 1. Section of the Aphorisms of Hypocrates; where he teacheth, the sick must feed more largely in the beginnings of long diseases, whereby they may be enabled to endure the length of the disease, and last to the state thereof. But in sharp and violent diseases, which presently come to their height, we must use a slender diet; but most slender, when the disease is in the height; and besides, all our consultations in this kind, must be referred to the strength of the patients. But those who enjoy their perfect health, must use a quantity of meat, agreeable to their evacuation and transpiration; for men by reason of the strength of their heat, and the more copious dissipation of the triple substance, have greater appetite, than women; altogether by the same reason, that young people, and such as grow, need more frequent and plentiful nourishment, than old men; and also amongst young men of the like age, some do rightly require more copious nourishment than othersome, that is, according to the quantity of their evacuations and custom. Certainly for gluttony, it is such as may be extended to all; but we all should take so much meat and drink, that our powers may be refreshed and not oppressed: for by the decree of Hypocrates, these be the two compendiary ways of preserving health; not to be over-filled with meat, and to be quick to work; and thus much of the quantity of meats. Neither must these who are either sound, or sick, have less regard to the qualities of their meats; and those are either the first, as heating, The qualities. of meat. cooling, moistening, drying; or the second, attenuating, incrassating, obstructing, opening, or some other like, working according to the condition of their nature. The manner of our diet is not only to be framed according to these, but also to be varied; for the present state of such as be in health, requires to be preserved by the use of like things. As hot and moist nourishment is to be prescribed to children, as to those which are hot and moist: and cold, and dry, to old men, as to those who are cold and dry; if so be that vulgar saying be true, that, Health delights in the use of like things. Yet because old age how green and new begun howsoever it be, is of it Old age is a disease. self as it were, a disease, it seems to be more convenient, both to truth and for health, that old people should eat meats contrary to their nature, that is, hot, and moist, that so we may defer as much as we can, the causes of death, cold and dryness, which hasten the destruction of that age. For we must resist diseases by the use of their contraries, as those things which are contrary to nature. For otherwise, as much meat as you give to the sick, you add so much strength to the disease. And the same is the cause why Hypocrates said, that a moist diet is convenient for all such Aphor. 16. sect. 1. as are sick of fevers, because a fever is a dry distemperature. Therefore we must diligently pry into the nature of the disease, that knowing it, we may endeavour to abate its fury by the use of contraries. But if custom (as they say) be another nature, the Physician must have a great care The force of Custom. of it, both in sound and sick. For this sometimes by little and little and insensiblely, changes our natural temperament, and instead thereof gives us a borrowed temper. Wherefore if any would presently or suddenly change a custom which is sometimes ill, into a better, truly he will bring more harm, than good; because all sudden changes (according the opinion of Hipocrates) are dangerous. Wherefore if necessity Aphor. 91. sect. 2. require, that we should withdraw any thing from our custom, we must do it by little and little, that so nature may by degrees be accustomed to contraries without violence, or the disturbance of its usual government. For that meat and drink which is somewhat worse, but more pleasant and familiar by custom, is to be preferred (in Hypocrates opinion) before better, but less pleasant and accustomed. Hence Aphor. 38. sect. 2. is it, that Countrymen do very well digest Beef and Bacon, which commonly they use; but will turn into nidorulent vapours, Partridge, Capons, and other meat of good nourishment, sooner than change them into good and laudable Chylus. The cause of which thing is not only to be attributed unto the property of their stronger, and as it were burning heat, but much more to custom, which by a certain kind of familiarity, causeth that meats of hard digestion are easily turned into laudable blood. For the force of custom is so great, that accustomed meats are more acceptable; whereby it comes to pass, that while the stomach delights in them, it more straight embraces them, and happily digests them, without any trouble of loathing, vomiting, or heaviness. All the contrary meet and happen in the use of meats which are unpleasant to the taste and stomach. For the ventricle abhorring Accustomed meats are more grateful, and so by that means more nourishing. those things, makes manifest how it is troubled by its acide and nidorulent belchings, loathing, nauseousness, vomit, heaviness, pain of the head, and trouble of the whole body. Wherefore we must diligently inquire, what meats the Patient chiefly delighted in, that by offering them, his appetite languishing by reason of some great evacuation, vomit, or the like, may be stirred up. For it will be better and more readily restored by things acceptable, though they be somewhat worse, as we noted a little before out of Hypocrates. By which words he plainly taught, that it is the part of a good and prudent Physician to subscribe to, and please the palate of his patient. But seeing that order is most beautiful in all things, it is truly very necessary in The order of eating our meats. eating our meat: for how laudable soever the meats be in their quantity and quality, howsoever familiar by use, and grateful by custom, yet unless they be eaten in due order, they will either trouble or molest the stomach, or be ill, or slowly and difficultly concocted; wherefore we must diligently observe, what meats must be eaten at the first, and what at the second course; for those meats which be hard to concoct, are not to be eaten before those which are easy of digestion; neither dry and astringent things, before moistening and losing. But on the contrary, all slippery, fat, and liquid things, and which are quickly changed We must begin our meals with moist or liquid meat. aught to go before, that so the belly may be moistened; and then astringent things must follow, that the stomach, by their help, being shut, and drawn together, may more straight comprehend the meat on every side, and better perform the Chylification by its proper heat united and joined together. For this cause Hypocrates Lib. de victu in acutis, commands those things to be always eaten in the morning, which are fit to loosen the belly, and in the evenings such as nourish the body. Yet notwithstanding drink ought not to precede, orgoe before meat, but on the contrary meat must precede drink, by the order prescribed by him. Whether ought we in our eating to have less care of the time, than we have of The time of eating. the order: for the time of cating of such as are healthful, aught to be certain and fixed; for at the accustomed hour, and when hunger presses, any sound man, and which is at his own disposure may eat, but exercise and accustomed labours ought to The profit of labour before meat. go before; for it is fit, according to the precept of Hypocrates, that labour preceded meat, whereby the excrements of the third concoction may be evacuated, the native heat increased, and the solid parts confirmed and strengthened, which are three commodities of exercise very necessary to the convenient taking of meat. But in sick persons we can scarce attend, and give heed to these circumstance of time, and accustomed hour of feeding; for that Indication of giving meat to the sick, is the best of all, which is drawn from the motion of the disease, and the declining of the fit: for if you give meat in fevers, specially the fit then taking the Patient, you nourish not him, but the disease. For the meat then eaten, is corrupted in the stomach, and yields fit matter for the disease. For meat (as we noted before out of Hypocrates) is strength to the sound, and a disease to the sick, unless it be eaten at convenient time, and diligent care be had of the strength of the Patient, and greatness of the disease. But neither is it convenient that the meat should be simple, and of one kind, but We must not give meat in a fit of a Fever. of many sorts, and of divers dishes dressed after different forms, left nature by the continual and hateful feeding upon the same meat, may at the length loathe it, and so neither straight contain it, nor well digest it; or the stomach accustomed to one meat, taking any loathing thereat, may abhor all other: and as there is no desire of that we do not know, so the dejected appetite cannot be delighted and stirred up, with the pleasure of any meat which can be offered. For we must not credit those superstitious, or too nice Physicians, who think the digestion is hindered by the much variety of meats. The matter is far otherwise, for by the pleasure of what things soever the stomach Variety of meats. alured doth require, it embraces them more straight, and concocts them more perfectly. And our nature is desirous of variety. Moreover, seeing our body is composed of a solid, moist, and airy substance, and Why variety of meatsis good. it may happen, that by so many labours, which we are compelled to undergo, and sustain in this life, one of these may suffer a greater dissipation and loss than another; therefore the stomach is necessarily compelled to seek more variety, lest any thing should be wanting to repair that which is wasted. But also the age and season of the year, yield Indications of feeding, for some things are convenient for a Indications of feeding, taken from the age. young man, some for an old, some in Summer, some in Winter. Wherefore we ought to know what befits each age and season. Children need hot, moist, and much nourishment, which may not only suffice to nourish, but increase the body. Wherefore we ought to know what befits each age and season. Children need hot, moist, and much nourishment, which may not only suffice to nourish, but increase the body. Wherefore they worst endure fasting, and of them, especially those who are the most lively and spiritful. With old men it is otherwise, for because their heat is small, they need little nourishment, and are extinguished by much. Wherefore old men easily endure to fast, they ought to be nourished with hot and moist meats, by which their solid parts, now growing cold and dry, may be heated and moistened, as by the sweet nourishment of such like meats. Middle aged men delight in the moderate use of contraries to temper the excess of their too acride heat. Young people as temperate are to be preserved by the use of like things. The manner of diet in Winter must be hot and inclining to dryness. Wherefore Indication From the time of the year. then we may more plentifully use rost-meates, strong wines and spices; because in the Winter season we are troubled with the cold and moist air, and at the same time, have much heat inwardly; for the inner parts, according to Hypocrates, are naturally most hot in the Winter and the Spring, but feverish in Summer; so the heat of Summer is to be tempered by the use of cold and moist things, and much drink. In the temperate Spring all things must be moderate; but in Autumn, by little and little, we must pass from our Summer, to our Winter diet. CHAP. XV. Of Motion and Rest. HEre Physicians admonish us, that by the name of Motion, we must understand What motion signifies. all sorts of exercises, as walking, leaping, running, riding, playing at tennis, carrying a burden, and the like. Friction or rubbing is of this kind, which in times past was in great use and esteem, neither at this day is it altogether neglected by Physicians. They mention many kinds of it, but they may be all reduced to three, as one gentle, another hard, a third indifferent; and that of the whole body, Three kinds of frictions. or only of some part thereof. The friction is called hard, which is made by the Hard. rough, or strong pressure of the hands, sponges, or a course and new linen cloth: it draws together, condensates, binds and hardens the flesh, yet if it be often and long used, at length it rarefies, dissolves, attenuates and diminishes the flesh, and any other substance of the body; and also it causeth revulsion, and draws the defluxion of humours from one part to another. The gentle friction which is performed by the light rubbing of the hand, and such like, doth the contrary, as softens, relaxes, and Gentle. makes the skin smooth and unwrinckled, yet unless it be long continued it doth none of these, worthy to be spoken of. The indifferent kinds consisting in the mean betwixt the other two, increaseth the flesh, swells or puffs up the habit of the body, Indifferent. because it retains the blood and spirits which it draws and suffers them not to be dissipated. The benefit of exercise is great, for it increases natural heat, whereby better digestion The use of exercises. follows, and by that means nourishment, and the expulsion of the excrements, and lastly, a quicker motion of the spirits, to perform their offices in the body, all the ways and passages being cleansed. Besides, it strengthens the respiration, and the other actions of the body, confirms the habit, and all the limbs of the body, by the mutual attrition of the one with the other; whereby it comes to pass they are not so quickly wearied with labour. Hence we see that Country people are not to be tired with labour. If any will reap these benefits by exercise, it is necessary that he take opportunity What the fittest time for exercise. to begin his exercise, and that he seasonably desist from it, not exercising himself violently and without discretion; but at certain times according to reason. Wherefore the best time for exercise will be before meat (that the appetite may be increased by augmenting the natural heat) all the excrements being evacuated, lest nature being hungry and empty, do draw and infuse the ill humours contained in the guts, and other parts of the body, into the whole habit, the liver, and other noble parts. Neither is it fit presently, after meat, to run into exercise, left the crude humours and meats not well concocted be carried into the veins. The measure and bounds of exercise must be, when the body appears more full, the face looks red, sweat begins to break forth, we breathe more strongly and quick, and begin to grow weary; if any continue exercise longer, stiffness, and weariness assails his joints, and the body flowing with sweat suffers a loss of the spirituous and humid substance which is not easily repaired; by which it becomes more cold, and lean even to deformity. The quality of exercise which we require, is in the midst of exercise, so that the exercise The quality of ex●●cise. must be nether too slow and idle, neither too strong, nor too weak, neither too hasty, nor remiss, but which may move all the members alike. Such exercise is very fit for sound bodies. But if they be distempered, that sort of exercise is to be made choice of, which by the quality of its excess, may correct the distemper of the body, and reduce it to a certain mediocrity. Wherefore such men as are stuffed with cold, For whom strong exercises are convenient. gross, and viscous humours, shall hold that kind of exercise most fit for them, which is more laborious, vehement, strong, and longer continued. Yet so, that they do not enter into it before the first and second concoction, which they may know by the yellowness of their urine. But let such as abound with thin and choleric humours choose gentle exercises, and such as are free from contention, not expecting the finishing of the second concoction, for the more acride heat of the solid parts delights in such half concocted juices, which otherwise it would so burn up, all the glutinous substance thereof being wasted, that they could not be adjoined, or fastened to the parts. For the repeating, or renewing of exercise, the body should be so often exercised, as there is a desire to eat. For exercise stirs up and revives the heat which lies-buried and hid in the body: For digestion cannot be well performed by a sluggish heat; neither have we any benefit by the meat we eat, unless we use exercise before. The last part of exercise begun and performed according to reason, is named * 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. the ordering of the body, which is performed by an indifferent rubbing, and drying of the members; that so the sweat breaking forth, the filth of the body, and such excrements lying under the skin, may be alured and drawn out; and also that the members may be freed from stiffness and weariness. At this time it is commonly used by such as play at tennis. But, as many and great commodities arise from exercise conveniently begun What discommodities proceed from idleness. and performed, so great harm proceeds of idleness; for gross and vicious juices heaped up in the body commonly produce crudities, obstructions, stones both in the reins and bladder, the Gout, Apoplexy, and a thousand other diseases. CHAP. XVI. Of Sleep and Watching. THat this our speech of Sleep and Watching, which we now intent may be more plain, we will briefly declare, what commodity or discommodity they bring, what time and what hour is convenient for both, what the manner of lying must be, and the choice thereof; what the dreams in sleeping, and what pains or heaviness and cheerfulness after sleep may portend. Sleep is nothing else than the rest of the whole body, and the cessation of the What sleep is. Animal faculty from sense and motion. Sleep is caused, when the substance of the brain is possessed, and after some sort overcome and dulled by a certain vaporous, sweet and delightsome humidity; or when the spirits almost exhaust by performance of some labour, cannot any longer sustain the weight of the body, but cause rest by a necessary consequence, by which means nature may produce other from the meat by concoction turned into blood. Sleep fitly taken much helps the digestion of the parts, because in the time of rest, The use of sleep. the heat, being the worker of all concoction, is carried back to them, together with the spirits. Neither doth sleep only give ease to the wearied members, but also lessens our cares and makes us to forget our labours. The night is a fit time to sleep and to take our rest in, as inviting sleep by its moisture, Fit time for sleep and the nature of the night. silence and darkness. For the Heat and Spirits in the thick obscurity of night, are driven in and retained in the centre of the body; as on the contrary by the daily and as it were friendly and familiar light of the Sun, they are alured & drawn forth into the superficies, and outward part of the body; from whence they leave sleeping and begin to wake. Besides also, which makes not a little, to that opportunity and benefit which we look for from sleep, the night season suffices for the Sleep on the daytime. work of just and perfect concoction. Which is one reason amongst many that sleep on the day time may be hurtful. For we are wakened from our sleep by the heat and spirits called forth to the skin either by the light, or noise on the day time, before that the concoction which was begun be finished. But that sleep cannot but be light which comes without necessity of sleeping. Wherefore the concoction being attempted, but not perfected, the stomach is filled with crudities, distended with acide or sour belchings, and the brain troubled with gross vapours and excremc●titious humidities. From whence proceeds pain and heaviness of the head, and store of cold diseases. But although sleep on the night time be wholesome, yet There aught to be a moderation of our night's sleep. it is fit, that it be restrained within the limits of an indifferent time. For that which exceeds hinders the evacuation of excrements both upwards and downwards: but in the mean time the heat which is never idle, draws from them some portion or vapour into the veins, principal parts and habit of the body, to become matter for some disease. We must measure this time, not by the space of hours, but by the finishing the work of concoction, which is performed in some, sooner than in other some. Yet that which is longest is perfected and done in seven, or eight hours. The ventricle subsiding and falling into its self and its proper coats, and the urine tinctured yellow, gives perfect judgement thereof. For on the contrary the How to be known. extension of the stomach, acide belching, pain of the head, and heaviness of the whole body, show that the concoction is unperfect. In sleeping we must have special care of our lying down, for first we must lie on our right side, that so the meat may fall into the bottom of our stomach, which What the form and site of our body ought to be while we sleep being fleshy and less membranous, is the hotter, and more powerful to assimilate. Then a little after we must turn upon our left side, that so the Liver with its Lobes, as with hands may on every side embrace the ventricle, and as fire put under a Kettle, hasten the concoction. Lastly, towards morning it will not be unprofitable to turn again upon our right side, that by this situation the mouth of the stomach being opened, the vapours which arise from the elixation of the Chylus may have freer passage. Lying upon the back is wholly to be avoided; for from hence the reins The harm of lying on our backs. are inflamed, the Stone is bred, Palsies, Convulsion, and all diseases which have their original from the defluxion into the spinal marrow, and to the Nerves taking beginning from thence. To lie upon the belly is not unprofitable for such as have Upon our bellies. used to lyeso, if they be not troubled with defluxions into the eyes; for so the humour will more easily flow into the part affected. But thus the work of concoction is not a little furthered, because by that form of lying, not only the inward heat is contained and gathered together about the ventricle, but the encompassing warmness of the soft feathers of the bed, aides and assists it. Neither are the Dreams which we have in our sleep to be neglected, for by the The consideration of dreams. diligent consideration of these, the affections and superfluous humours which have chief power in the body are marvailously known. For those who have raging Choler running up and down their bodies while they sleep, all things to them appear bright, shining, fiery, burning, full of noise and contention. Those who abound with Phlegm dream of floods, snows, showers and inundations and falling from high places. Those who are Melancholy dream of gapings and gulfs in the earth, thick and obscure darkness, smokes, caves, and all black and dismal things. But those whose bodies abound in blood dream of marriages, dances, embracings of women, feasts, jests, laughter, of orchards and gardens; and to conclude, of all things pleasant and splendent. Also we must observe how the Patient doth after sleep, whether more lively and cheerful, or more heavy, for by the opinion of Hypocrates, Cum labor à sommo est, laethalem collige morbum: Aphor. 1. sect. 2. Sinprosit somnus, nihil hinc laethale timendum est. Pain sleep ensuing, an ill disease doth show: But if sleep profit bring, no harm from thence will flow. And as sleep so watching, if it exceed measure, is hurtful; for it hurts the temperature of the brain, weakens the senses, wastes the spirits, breeds crudities, heaviness of the head, falling away of the flesh, and leanness over all the body, and to conclude, it makes ulcers more dry, and so consequently rebellious, difficult to heal, and malign. There are many other things may be spoken of sleep and watching, but these may suffice a Chirurgeon. CHAP. XVII. Of Repletion, and Inanition, or Emptiness. THere are, to be short, two sorts of Repletion, or of all excess; one is The kinds of Repletions or rather of Excesses. of a simple quality, without any defluxion, or society of any humour, as appears in distempers without matter: the other is of quantity and mass, the body being distended with too much meat, or too great quantity of humours; from whence proceed an infinite number of diseases. They call the Repletion of meats, satiety or fullness, and it is of two kinds; the one which is called * Repletio advasa advires Repletion or Fullness to the vessels; the other Repletion to the strength. We judge of satiety to the vessels, by the distension and swelling of the veins and entrails, as the stomach. We call satiety to the strength, when the body is loaded with more meats, than it can well bear. But also there is a double Repletion of humours. For either it is of some one humour, or of all the humours; they call this by a peculiar name Plethora. For Galen defines Plethora an equal excess Gal. Meth. 13. cap. 6. of all the humours. For if at any time he define a Plethora to be an excess of blood only, then verily by the name of blood, he understands an equal comprehension of the four humours; as it is taught in Physic schools. The Repletion which is caused by some one humour, is termed by Galen What Cacochymia. in the place before mentioned, Cacochymia, (that is, an evil juice) whether the Repletion proceed of a Choleric, Melancholic, Phlegmatic, or serous humour. Now Inanition, or evacuation is no other thing than the expulsion, or effusion, The kinds of evacuation. 〈◊〉 of humours which are troublesome, either in quantity, or quality. Of evacuations, some are universal, which expel superfluous humours from the whole body; such are purging, vomiting, transpiration, sweats, phlebotomy. Some particular which are performed only to evacuate some part, as the brain by the nose, palate, eyes, ears; the lungs by the weazon; the stomach by vomit and stool, the guts by stool, the liver and the spleen by urine and ordure. These evacuations are sometimes performed by nature, freeing itself of that which is troublesome to it; otherwhiles by the Art of the Physician in imitation of nature. And again, one of these is good and requisite, when only the humour which is hurtful, either in quantity or quality, is evacuated; The other not requisite, or immoderate, when the profitable humours together with the unprofitable, are expclled. But what evacuations soever these be, they are performed and done, either by the The commodities of moderate scratching. scratching and rubbing of the skin, as when a choleric, salt, or serous humour, or some windiness lying between the skin and the flesh, cause itehing. For by scratching the skin, it gets passage out, which is manifest by the effluxe of a serous matter burning, or causing scabs and ulcers, if the humour be somewhat gross, but insensible and not so manifest, if it be windiness, the skin by that rubbing being rarefied, and the gross flatulency attenuated. Wherefore they do ill who hinder their Patients from scratching, unless they scratch so cruelly and hard, that there may be danger, (by reason of the great heat and pain thereby caused) of some defluxion or falling down of humours into the part. Or these evacuations are performed by much matter evacuated frow an opened Bile, or running ulcer, a Fistula, or such like sores. Or by sweats which are very good and healthful, especially in sharp diseases, if they proceed from the whole body, and happen on the critical days. By vomit, which often violently draws these humours from the whole body, even from the utmost joints, which purging The force of vomits. medicines could not evacuate, as we may see in the Palsy, and Sciatica, or Hipgoute. By spitting, as in all who are suppurated either in the sides or lungs. By Salivation, or a Phlegmatic flux by the mouth, as in those who are troubled with the French Pocks. By sneesing and blowing the nose; for by these the brain oppressed Salivation. with moisture, disburdeneth its self, whether it be done without, or with the help of sternutatories and errhines; wherefore children, and such as have somewhat moist brains purge themselves often this way. By hicket and belching; for by The whole body is also purged by urines. these the windiness contained in the stomach, is often expelled. By urine, for by this not only Fevers, but which is more to be admired, the French-Pockes hath often been terminated and cured. For there have been some troubled with the Pocks, in whom a flux of the vicious and venenate humour could not by unctions of quicksilver be procured, either from the mouth, or belly; yet have been wonderfully freed by abundance of urine, both from danger of death and their disease. By bleeding; for nature hath often found a way for grievous diseases, especially in young bodies, by bleeding at the nose, and by their courses in women. By a luxe, or laske, purgation, sweats, insensible evacuation and transpiration; for so tumours, the matter being brought to suppuration, do sometimes vanish away and are dissolved, both of their own accord, as also by dissolving, or discussing medicines. We do the same by exercise, diet, hothouses, long sleep, waking, and shedding of tears. By sucking, as with cupping glasses and horseleeches in wounds made by venomous bitings. In all such kinds of evacuations, we must consider three things, the quantity, quality, and manner of evacuation. As for an example, when an Empyema is opened, We must observe three things in every evacuation. the matter which runs out, aught to be answerable in proportion to the purulent matter, which was contained in the capacity of the breasts; otherwise, unless all the matter be emptied, there may happen a r●…e; the matter should be white, soft, equal, and nothing stinking: Lastly, you must let it forth not altogether, and at one time, but by little and little, and at several times, otherwise not a little quantity of the spirits and heat doth flow out together, with the unprofitable matter, and so consequently a dissolution of all the powers. CHAP. XVIII. Of the Perturbations, or Passions of the mind. THe Perturbations, are commonly called the accidents of the mind; because, as bodily accidents from the body, so may these be present and Why the Passions of the mind, are called Accidents. Their force. absent from the mind, without the corruption of the subject. The knowledge of these must not be lightly passed over by the Chirurgeon; for they stir up great troubles in the bodies, and yield occasion of many & great diseases; of which things, joy, Hope and Love, may give a apparent testimony. For by these motions the heat and spirits are sometimes gently, sometimes violently diffused over all the body, for the enjoying of the present, or hoped for good. For then the heart is dilated, as to embrace the thing beloved, and the face is died with a rosy and lively colour. For it is likely, that the faculty itself is stirred by the object, by whose power the heart itself is moved. For it is first necessary, before we be moved by any Passions, that the senses in From whence they have their force. their proper seats, in which they are seldom deceived, apprehend the objects, and straight as messengers carry them to the common sense, which sends their conceived forms to all the faculties. And then, that each faculty, as a judge may a fresh examine the whole matter, how it is, and conceive in the presented objects some show of good, or ill, to be desired, or shunned. For what man that was well in his wits, did ever fall into a laughter, unless he formerly knew, or saw somewhat said or done, which might yield occasion of laughter? Therefore joy proceeds from the The reason of joy. heart, for the thing causing mirth or joy, being conceived, the faculty moves the heart, which shaken and moved by the faculty which hath dominion over it, is dilated and opened, as ready to embrace the exhilarating object. But in the mean time by the force of that dilatation, it sends forth much heat, and spirits together with the blood into all the body. A great part of which coming to the face, dilates it, the forehead is smooth and plain, the eyes look bright, the cheeks become red, as died with Vermilion, the lips and mouth are drawn together, and made plain and smooth; some have their cheeks dented with two little pits (which from the effects are called laughing cheeks) because of the contraction or curling, which the muscles suffer by reason of their fullness of blood and spirits, all which to be brief is nothing but to laugh. joy recreates and quickens all the faculties, stirs up the spirits, helps concoction, makes the body to be better liking, and fattens it, the heat, blood, The effects of joy. and spirits flowing thither, and the nourishing dew or moisture, watering and refreshing all the members; from whence it is, that of all the Passions of the mind, this only is profitable, so that it exceed not measure; for immoderate and unaccustomed joy, carries so violently the blood and spirits from the heart, into the habit of the body, that sudden and unlooked for death ensues, by a speedy decay of the strength, the lasting fountain of the vital humour being exhausted. Which thing principally happens to those who are less hearty, as women and old-men. Anger causeth the same effusion of heat in us, but far speedier than joy; therefore the spirits and humours are so inflamed by it, that it often causes putrid Anger. fevers, especially if the body abound with any ill humour. Sorrow, or grief dries the body by a way quite contrary to that of anger, because Sorrow. by this the heart is so straitened, the heat being almost extinct, that the accustomed generation of spirits cannot be performed; and if any be generated, they cannot freely pass into the members with the blood; wherefore the vital faculty is weakened, the lively colour of the face withers and decays, and the body wastes away with a linger consumption. Fear in like sort draws in and calls back the spirits, and not by little and little Fear: as in sorrow, but suddenly and violently; hereupon the face grows suddenly pale, the extreme parts cold, all the body trembles or shakes, the belly in some is loosed, the voice as it were stays in the jaws, the heart beat with a violent pulsation, because it is almost oppressed by the heat, strangled by the plenty of blood, and spirits abondantly rushing thither; The hair also stands upright, because the heat Hippocrat. lib. 4. de morb. and blood are retired to the inner parts, and the utmost parts are more cold and dry than stone; by reason whereof the utmost skin and the pores, in which the roots of the hairs are fastened, are drawn together. Shame is a certain affection mixed, as it were, of Anger and Fear; therefore Shame. if, in that conflict of, as it were, contending passions, Fear prevail over Anger, the face waxeth pale, (the blood flying back to the heart;) and these or these Symptoms rise, according to the vehemency of the contracted and abated heat. But if on the contrary, Anger get the dominion over Fear, the blood runs violently to the face, the eyes look red, and sometimes they even some at the mouth. There is another kind of shame, which the Latins call Verecundia (we Shamefastness) Shamefastness. in which there is a certain flux, and reflux of the heat, and blood first recoiling to the heart, then presently rebounding from thence again. But that motion is so gentle, that the heart thereby suffers no oppression, nor defect of spirits; wherefore no accidents worthy to be spoken of, arise from hence: this affect is familiar to young maid es and boys; who if they blush for a fault committed unawares, or through carelessness, it is thought an argument of a virtuous and good disposition. But an agony, which is a mixed passion of a strong fear, and vehement anger, involves An agony. the heart in the danger of both motions; wherefore by this passion, the vital faculty is brought into very great danger. To these six Passions of the mind, all other may be revoked, as Hatred and Discord to Anger: Mirth and Boasting, to joy; Terrors, Frights and Swound, to Fear; Envy, Despair and Mourning, to Sorrow. By these it is evident, how much the passions of the mind can prevail, to alter and overthow the state of the body; and that by no other means, than that by the compression and dilatation of the heart, they diffuse and contract the spirits blood, and heat; from whence happens the dissipation, or oppressions of these spirits. The signs of these Symptoms quickly show themselves in the face; the heart, Why the first signs of passions of the mind appear in the face. by reason of the thinness of the skin in that part, as it were painting forth the notes of its affections. And certainly the face is a part so fit to disclose all the affections of the inward parts, that by it you may manifestly know an old man from a young, a woman from a man, a temperate person from an untemperate, an Ethiopian from an Indian, a Frenchman from a Spaniard, a sad man from a merry, a sound from a sick, a living from a dead. Wherefore many affirm that the manners, and those things which we keep secret and hid in our hearts, may be understood by the face and countenance. Now we have declared what commodity and discommodity may redound to The use of passions of the mind. man from these forementioned passions, and have showed that anger is profitable to none, unless by chance to some dull by reason of idleness, or oppressed with some cold, clammy and phlegmatic humour; and fear convenient for none, unless peradventure for such as are brought into manifest and extreme danger of their life by some extraordinary sweat, immoderate bleeding, or the like unbridled evacuation, Wherefore it behoves a wise Chirurgeon to have a care, lest he inconsiderately put any Patient committed to his charge into any of these passions, unless there be some necessity thereof, by reason of any of the forementioned occasions. CHAP. XIX. Of things against Nature, and first of the Cause of a Disease. HAving entreated of things natural, and not natural, now it remains we What things against nature are. speak of things (which are called) against nature, because that they are such as are apt to weaken and corrupt the state of our body. And they be three in number; The cause of a disease, a Disease, and a Symptom. The What, and how many the causes of diseases be. The primitive cause. cause of a disease is an affect against nature, which causes the disease. Which is divided into Internal and external. The external, original or primitive comes from some other place, and outwardly into the body, such be meats of ill nourishment, and such weapons and hostilely wound the body. The Internal have their essence and seat in the body, and are subdivided into Internal anterecdent. antecedent and conjunct. That is called an antecedent cause, which as yet doth not actually make a disease, but goes near to cause one; so humours copiously flowing, or ready to flow into any part, are the antecedent causes of diseases; The conjunct Internal conjunct. cause is that which actually causes the disease, and is so immediately joined in affinity to the disease, that the disease being present, it is present, and being absent, it is absent. Again, of all such causes, some are borne together with us, as the overgreat quantity, and malign quality of both the seeds, and the menstruous blood, from diseased Parents are causes of many diseases, and specially of those which are called Hereditary. Other happen to us after we be borne, by our diet and manner of life, a stroke, fall, or such other like. Those which be bred with us, cannot be wholly avoided or amended; but some of the other may be avoided, as a stroke and fall; some not, as those which necessarily enter into our body, as Air, Meat, Drink, and the like. But if any will reckon up amongst the internal, inherent, and inevitable causes, The congenit, or inevitable cause of death. the daily, nay hourly dissipation of the radical moisture, which the natural heat continually preys upon; I do not gain say it, no more than that division of causes celebrated and received of Philosophers, divided into Material, Formal, Efficient, and Final; for such a curious contemplation belongs not to a Chirurgeon, whom I only intent plainly to instruct. Wherefore that we have written may suffice him. CHAP. XX. Of a Disease. A Disease is an affect against nature, principally and by itself, hurting What a disease is, and I owe various. and depraving the action of the part in which it resides. The division of a Disease is threefold; Distemperature, ill Conformation, and the Solution of Continuity. Distemperature is a disease of the simular parts dissenting, and changed from their A Distemperature. proper and native temper. That digression from the native temper, happens two ways; either by a simple distemperature from the excess of one quality; and this is fourfold; Hot, Cold, Moist, and Dry; or by a compound distemperature, by the excess of two qualities, which also is fourfold, Hot and Moist; Hot and Dry, Cold and Moist; Cold and Dry. Again, every distemper is the fault of one simple and single quality, as an inflammation; or hath some vicious humours joined with it, as a Phlegmon; Again, a Distemperature is either equal, as in a Sphacele; or uneequall, as in a Phlegmon, beginning, or increasing. Ill Conformity is a fault of the organical parts, whose composure Ill conformation. is thereby depraved. This hath four kinds; the first is when the figure of the part is faulty, either by nature or accident, or some cavity abolished, as if a part, which nature would have hollow for some certain use, do grow or close up; or lastly, if they be rough, or smooth otherwise than they should, as if that part which should be rough, be smooth, or the contrary. Another is in the magnitude of the part increased, or diminished contrary to nature. The third is in the number of the parts, increased, or diminished; as if a hand have but four or else six fingers. The fourth is in the site and mutual connexion of the parts, as if the parts which should be naturally united and continued be plucked asunder, as happens in luxations; or the contrary. The third general kind of disease, is the solution of continuity, Solution of continuity. a disease common, both to the simular and organical parts, acquiring diversity of names, according to the variety of the parts in which it resides. CHAP. XXI. Of a Symptom. WE do not in this place take the word Symptom in the most general acceptation, for every change or accident which happens to man besides his What a Symptom is. own nature; but more reservedly and specially, only for that change which the disease brings, and which follows the disease, as a shadow doth the body. There be three kinds of a Symptom properly taken. The first is, when the action is hurt; I say hurt, because it is either abolished, weakened, or depraved; so blindness Three kinds thereof. is a deprivation, or abolishing of the action of seeing; dulness of sight, is a diminution, or weakening thereof; and a suffusion, such as happens at the beginning of a Cataract, when they think flies, hairs, and such like bodies fly too and fro before their eyes, is a depravation of the sight. The second is a simple affect of the body, and a full fault of the habit thereof being changed, happening by the mutation of some qualities, such is the changing of the native colour into a red by a Phlegmon, and into a livide and black by a Gangrene; such is the filthy stench the nose affected with a Polypus sends forth; the bitter taste, in such as have the jaundice; and the rough and rugged skin in them which are Leprous. The third is the fault of the overmuch retention of excrements which should be expelled, and expulsion of such as should be retained; for the evacuation of an humour profitable both in quantity and quality, is against nature, as bleeding in a body not full of ill humours, nor Plethoric; and also the retention of things hurtful in substance, quantity and quality, as the Courses in women, the urine, and the stone in the bladder. CHAP. XXII. Of Indications. THe knowledge and exercise of Indications befits that Chirurgeon, whom no blind rashness of fortune, but reason; no chance, but counsel directs What an Indication is. in the undertaking and performing the works of his Art. For an Indication is a certain safe and short way, which leads the Physician, as by the hand, to the attainment of his purposed end, of preserving the sound, or curing the sick. For Galen doth define an Indication to be a certain insinuation of what is to be done, See. method. Cap. 7. lib. de oped. secta, Cap. 11. or a quick & judicious apprehension of that which may profit or hurt. And as Falconers, Mariners, Plowmen, Soldiers, & all manner of Artisans, have their peculiar terms and words, which are neither known, nor used by the vulgar; so this word Indication is proper and peculiar to Philisitions and Surgeons, as a Term of Art not vulgar; by consideration of which, as by some sign, or secret token, they are admonished what is to be done to restore health, or repel an imminent danger. There are three prime and principal kinds of Indications, every of which is subdivided The kinds of Indications. into many other. The first is from things natural. The second from these things which are termed not natural. The third from those things which are contrary to nature. Things natural show they must be preserved by their like, and in the compass of these are contained all the Indications which are drawn from the nature of the Patient, that is, from his strength, temper, age, sex, habit, custom, diet. Things not natural may be doubted as uncertain, for one while they indicate the same things with things natural, that is, they coindicate with the strength, temper and the rest; otherwhiles they consent with things against nature, that is, they coindicate Lib. 9 Method. cap. 9 with the disease. Wherefore Galen when he saith, that Indications are drawn from three things; The disease; The nature of the Patient, and the encompassing air, by proposing the familiar example of the air, he would have us to understand the other things not natural; because we may shun, or embrace them more or less as we will ourselves, but we must, whether we will or no, endure the present state of the air. Therefore the air indicateth something to us, or rather coindicates; for if it nourish the disease, as conspiring with it, it will indicate the same that the disease, that is, that it must be preserved in the same state. Things contrary to nature indicate they must be taken a way by their contraries; Indications drawn from things natural. Therefore that we may more accurately and fully handle all the Indications drawn from things natural, we must note, that some of these are concerning the strength of the Patient, by care to preserve which, we are often compelled for a time to forsake the cure of the proper disease: for so a great shaking happening at the beginning of an ague or fever, we are often forced to give sustenance to the Patient, to strengthen the powers shaken by the vehemency of the shaking, which thing notwithstanding lengthens both the general and particular fits of the ague. Other pertain to the temper, other respect the habit, if the Patient be slender, if fat, if well fleshed, if of a rare, or dense constitution of body. Other respect the condition of the part affected in substance, consistence, softness, hardness, quick or dull sense, form, figure, magnitude, site, connexion, principality, service, function and use, From all these, as from notes the skilful Chirurgeon will draw Indications according to the time and part affected: for the same things are not fit for sore eyes, which were convenient for the ears, neither doth a Phlegmon in the jaws and throat admit the same form of cure, as it doth in other parts of the body. For none can there outwardly apply repercussives, without present danger of suffocation. So there is no use of reprecussives What the conditions of the parts affected do indicate. in defluxions of those parts which in site are near the principal. Neither must thou cure a wounded Nerve and Muscle, after one manner. The temperature of a part, as Moisture, always indicateth its preservation, although the disease be moist and give Indication of drying, as an ulcer. The principality of a part always insinuates an Indication of astringent things, although the disease require dissolving, as an Obstruction of the Liver; for otherwise unless you mix astringent things with dissolving, you will so dissolve the strength of the part, that hereafter it cannot suffice for sanguification. If the texture of a part be rare, it shows it is less apt, or prone to obstruction; if dense, it is more abnoxious to that disease; hence it is that the Liver is oftener obstructed than the Spleen. If the part be situate more deep, or remote, it indicateth the medicines must be more vigorous and liquid, that they may send their force so far. The sensibleness, or quicke-sense of the part, giveth judication of milder medicines, than paradventur the signs, or notes of a great disease require. For the Physician which applies things equally sharp to the Horny tunicle of the eye being ulcerated, and to the Leg, must needs be accounted either Indications from the ages. cruel, or ignorant. Each sex and Age hath its Indications, for some diseases are curable in youth, which we must not hope to cure in old age; for hoarseness and great distillations in very old men, admit no digestion, as Hypocrates saith; Aphor. 40. li. 2. Nunquam decrepitus Branchum coquit, atque Coryzam. The feeble Sire, for age that hardly goes, ne'er well digests, the hurtful Rheum or pose. Moreover according to his decree the diseases of the reins, and whatsoever pains molest the bladder, are difficultly healed in old men; and also reason persuades that a quartan admits no cure in Winter, and scarce a Quotidian, and Aphor. 6: sect. 6. ulcers in like manner are more hard to heal in Winter; that hence we may understand certain Indications to be drawn from time; and to increase the credit of the variety and certainty of Indications, some certain time, and seasons in those times command us to make choice of Medicines; for as Hipocrates testifies; Ap hor. 5. sect. 4. Ad Canis ardorem facilis purgatio non est. In Dog-days heat it is not good, By purging for to cleanse the blood. Neither shalt thou so well prescribe a slender diet in Winter, as in the Spring, for the air hath its Indications. For experience teaches us, that wounds of the head are far more difficultly and hardly cured, at Rome, Naples, and Rochel in Xantoigne. But the times of diseases yield the principal Indications, for some Medicines are only to be used at the beginning and end of diseases, others at the increase and vigour of the disease. We must not contemn those Indications which are drawn From our Diet. from the vocation of life, and manner of Diet; for you must otherwise deal with the painful Husbandman (when he is your Patient) which leads his life sparingly and hardly, than with the Citizen who lives daintily and idly. To this manner of life and Diet may be referred a certain secrt and occult property, by which many Hatred arising from secret properties. are not only ready to vomit at eating of some meats, but tremble over all their bodies when they hear them but spoken of. I knew a prime Nobleman of the French Nobility, who was so perplexed at the serving in of an Eel to the Table, at the midst of dinner & amongst his friends, that he fell into a swound, all his powers failing him. Galen in his book de Consuetudine tells that Arius the Peripatetic died suddenly, because compelled by the advice of those Physicians he used, he drank a great draught of cold water in the intolerable heat of a Fever. For no other reason saith Galen, than that, because he knowing he had naturally a cold stomach from his childhood, perpetually abstained from cold water. For as much as belongs to Indications taken from things against nature; the Length Indications taken from things against nature. and depth of a wound or ulcer indicateth one way; the figure cornered, round, equal and smooth, unequal and rough, with a hollowness strait or winding, indicate otherwise; the site right, left, upper, lower in an other manner, and otherwise the force and violence of antecedent and conjunct causes. For oftentimes the condition of the cause indicateth contrary to the disease, as when abundance of cold and gross humours cause and nourish a Fever. So also a Symptom often indicateth contrary to the disease, in which contradiction, that Indication must be most esteemed, which doth most urge; as for example sake, if swooning happen in a Fever, the feverish burning shall not hinder us from giving wine to the Patient. Wherefore these Indications are the Principallest and most noble which lead us, as by the hand, to do these things which pertain to the cure, prevention and mitigating of diseases. But if any object, that so curious a search of so many Indications is to no purpose, because there are many Surgeons, which setting only one before their eyes, which is drawn from the Essence of the disease, have the report and We do not always follow the Indication which is from the disease. famce of skilful Surgeons, in the opinion of the vulgar; but let him know that it doth not therefore follow, that, this indication is sufficient for the cure of all diseases; for we do not always follow that which the Essence of the disease doth indicate to be done. But chiefly then, where none of the forerecited Indications doth resist or gainsay; you may understand this by the example of a Plethora, which by the Indication drawn from the Essence of the thing requires Phlebotomy; yet who is it, that will draw blood from a child of three months old? Besides, such an Indication is not artificial but common to the Chirurgeon with the common people. For who is it that is ignorant, that contraries are the remedies of contraries? and that broken bones must be united by joining them together? but how it must be performed and done, this is of Art and peculiar to a Chirurgeon, and not known to the vulgar. Which the Indications drawn from those fountains we pointed at before, abundantly teaches, which, as by certain limits of circumstances, encompass the Indication which is taken from the Essence of the disease, lest any should think, we must trust to that only. For there is some great and principal matter in it, but not all. For so the meanest of the common people is not ignorant, that the solution of continuity is to be cured by repairing that which is lost. But in what parts we may In what parts we cannot hope for restoring of solution of continuity. hope for restitution of the lost substance, and in which not, is the part of a skilful Chirurgeon to know and pronounce. Wherefore he will not vainly bestow his labour to cure the Nervous part of the Diaphragma, or Midriff being wounded, or the Heart, small Guts, Lungs, Liver, Stomach, brain or bladder; and that, I may speak in a word, Empirics are not much more skilful than the common people, although they do so much extol themselves above others by the name of experience. For although experience be another instrument to find out things with reason, yet Exherience without reason, is like a blind man without a guide. without reason, it will never teach, what the substance of the part in which the disease lies, may be; or what the action, use, site, connexion, from whence special and proper Indications are drawn; With which the Chirurgeon being provided and instructed shall not only know by what means to find out a remedy, but also, lest he may seem to mock any with vain promises, he shall discern what diseases are uncureable, and therefore not to be meddled withal. But implicit, or intricate diseases require each to be cured in their several order, Indications in implicit diseases. except some one of them be desperate, or so urge and press that the Physician think it necessary after a preposterous order, to begin with it, although often he be forcedto make some one of these diseases incurable, or give occasion of causing some new one, into which straits we are necessarily compelled to fall, when, (for example) we determine to pull, or take away some extraneous body; for the performance whereof we are compelled to enlarge the wound. So we are forced by necessity to open the neck of the bladder, (that so we may draw forth the stone therein contained) with a wound which often degenerates into an uncurable Fistula. For that disease which threatens danger of present death is of such moment, that to shun that, it may be counted a small matter, and commodious for the sick to bring in other diseases, though uncureable. For if a convulsion happen by pricking a Nerve which we cannot heal by any remedies, then by cutting the Nerve asunder we end the convulsion, but deprive the part into which that Nerve did go, of the use of some voluntary motion. So if in any great joint there happen a Luxation with a wound, because there is danger of convulsion by trying to restore and set right the Luxated part, we are forcte for shunning thereof, to attend the wound only, and in the mean time to let alone the Luxation. Otherwise in implicit diseases if there be nothing which may urge, or call us from the ordinary cure, we must observe this order, that beginning with that affect, which hinders the cure of the principal disease, we prosecute the rest in the same and their proper order, until all the diseases being overcome we shall restore the part affected to its integrity. Therefore let us take for an example, an ulcer in the Leg, a An example of Indications in implicit diseases. Varix (or big swollen vein) and a Phlegmonous tumour round about it; and lastly, a body wholly plethoric and filled with ill humours; order and reason require this, that using the advice of some learned Physician we prescribe a convenient diet, and by what means we may, bring him to an equality by purging and blood-letting, and then we will scarify in divers places the part where it is most swollen, then presently apply Leeches that so we may free it from the burden of the conjunct matter; then use Cauteryes to help the corruption of the bone, and in the mean time change the circular figure of the ulcer into an oval, or triangular; then at the length we will undertake the cutting of the Varix, and cure the ulcer which remains according to Art, and so at the length cicatrise it. In all this whole time the Patient shall neither walk, nor stand, nor sit, but lie quietly, having his Leg orderly and decently rolled up. But if (as it often happens) the temper of the hurt part, be different from the temper of the whole body, the manner of curing must be so tempered, that we increase the What we must do when the temper of the part is different from the temper of the whole body. Dosis of hot or Cold medicines, according to the ratable proportion of the Indications requiring this, or that. Therefore imagine the part ulcerated to be such, as that it is two degrees drier than the just temper; but the whole body to exceed the same temper in one degree of humidity: reason and Art will require, that the medicine applied to the ulcer be drier by one degree than that which the part would otherwise require if it were temperate; but on the contrary let us suppose thus. The whole body to be one degree more moist than the temper requires, & the ulcerated part to be one degree dryer, truly in this case the medicine that is applied to the ulcer by reason of the part itself, shall not be increased in dryness, but wholly composed and tempered to the Indication of the ulcer, because the force of the moisture exceeding in the like degree, doth counterpoise the superfluous degree of dryness. But it is more easy by an artificial conjecture to determine of all such things, than by any rules or An artificial conjecture is of much force in Indications. precepts. To these so many and various Indications, I think good to add two other; the One from similitude; the Other of a certain crafty device, and as the latter Physicians term it, of a certain subtle stratagem. We draw Indication from similitude, in diseases which newly spring up and arise, as which cannot be cured by Indications Indication from similitude. drawn from their contraries, as long as their Essence is unknown and hid; wherefore they think it necessary to cure them by a way and Art like those diseases, with which they seem to have an agreeing similitude of Symptoms and Accidents; Our Ancestors did the same in curing the French Pocks, at the first beginning thereof, as long as they assimulated the cure to that of the Leprosy, by reason of that affinity, which both the diseases seem to have. But we follow crafty devices and subtle counsels, Indication of a subtle device. when the Essence of the disease we meet with is wholly secret and hid, either because it is altogether of a hidden and secret nature, and which cannot be unfolded by manifest qualities, or else resides in a subject which is not sufficiently known to us, nor of a Physical contemplation, as the Mind. For than we being destitute of Indications taken from the nature of the thing, are compelled to turn our cogitations to impostures and crafty counsels; and they say this Art and Craft is of chief use in Melancholy affects and fictions, which are often more monstrous and deformed than the Chimaera so much mentioned in the fables of the Ancients; to which purpose, I will not think much to recite two Examples. A certain man troubled with a Melancholic Examples. disease, I know not by what error of opinion, had strongly persuaded himself that he was without a head; the Physicians omitted nothing, by which they might hope to take this mad opinion out of his mind. But when they had in vain tried all medicines, at length they devised this crafty, but profitable device, they fastened and put upon his head a most heavy helmet, that so by the pain and trouble of his head nodding and drawn down by that weight, he might be admonished of his error. It is reported, another molested by the obscurity and darkness of the same disease, did verily believe, that he had horns upon his head; neither could he be drawn or diverted from that absurd and monstrous opinion, until that binding up his eyes, they miserablely bruised and scratched his forehead with the bony roughness of the lower parts of an ox's horns, that so he begun to believe by the painful drawing of the blood that ran down his face, that those bloody horns, were forciblely plucked from him. Ingenious Surgeons in imitation of these examples may in like cases do the A Physician should be of a quick apprehension. like. For that case requires a man of a quick apprehension and advice, who may give manifest proof of his diligence and skill by medicinal stratagems, as who forthwith can politikly device stratagems of divers sorts. But, now coming to the end of this our tract of Indications, we must chiefly and Indications indicative. principally observe; That of Indications some are Indicative; which absolutely and of themselves command this to be done; other coindicative, which indicate the same with the Indicative, and jointly show it to be done, but in some sort secundarily Coindicative. and not primitively; some are repugnant, which of themselves and their own nature persuade quite contrary to that the indicative primitively did; or which dissuade Repagnant. us from doing that, to perform which the indicative did persuade us; other correpugnant, which give their voice after the same form and manner with the repugnant Correpugnant against the indicative, as the coindicative consent to and maintain them. Let this serve for an example of them all. A Plethora, or plenitude of humours of its own nature, requires and indicateth blood-letting, the Springtime persuades and coindicates the same, but to this counsel is quite opposite and repugnant, a weak faculty, and childhood is correpugnant. Wherefore these four must be diligently weighed and considered when we deliberate what is to be done, and we must rather follow that which the indicative, or repugnant show and declare, as what the disease and strength of the Patient require, than that which the coindicative, or correpugnant shall persuade, becausethey have a weaker and but secundary power of indicating, and not essential and primitive. But because the kinds of Indications are so many and divers, therefore that the knowledge of them may be more perspicuous and less confused, I have thought good to describe and distinguish them by this following scheme. A Table of Indications. An Indication is a certain plain and compendious way which leads the Chirurgeon to a certain, determinate and proposed end for the cure of the present disease; of which there are 3. kinds, The first is drawn from things natural which indicate their preservation by their like; of this kind are many other which are drawn, either From the strength and faculties of the patient. For whose preservation, oftentimes the proper cure of the disease must be neglected; for where these fail, it is impossible the Chirurgeon should perform what he desires and expects. From the temperament, as if the Patient shall be— Sanguine, Choleric, Phlegmatic Of preservation of which the Chirurgeon must have care, and if they swarve from equality, to reduce them to that which formerly they naturally were. Melancholic From the habit of the body, as the patient shall be Dainty and delicate, Slender and weak. Low of stature. Rare, or else dense and compact. From the native condition of the hurt or affected part, in which we consider, either The substance thereof, as for as much as it is simular' we connider whether it be hot, cold, moist, dry, or as it is organical, and then whether it be a principal and noble part, or a subordinate and ignoble part. Or, the sense whether quick, or dull, by reason whereof the eye cannot endure such sharp & acrids medicines, as simple flesh can. Or the form, figure, magnitude, number, site, connexion, action, use. From the Age, for each age yields his peculiar Indications, hence you may observe most diseases to be incurable in old men, which are easily cured in young, others which in youth admit of no cure, unless by the change of age and th'ensuing temperament. From Sex, for medicines work upon women far more easily than upon men. From the time of the year, for some meats and medicines are fit in Winter, some in Summer. From the Region, for as there are diversities of situations and habits of places, so also there are motions of humours, and manners of diseases: hence it is that wounds on the head at Paris, & sore shinns at Avignion are more difficult to be cured. From the times of diseases, for some things in the beginnings, others in the increase, state and declining of the disease, are more convenient. From the manner of diet, for this, as the proper temper, must be preserved. Wherefore such must be fed otherwise who live daintily, than those who lead their lives sparingly and hardly. Hereunto add certain peculiar natures, which by a certain hidden property are offended at this, or that kind of meat. For there are some which not only, cannot concoct Ptisane, Apples, Soles, Pertrige, Water and such like, but can scarce behold them without nauseousness. The second is drawn from things not natural, which one while indicate their preservation by their like, another while their change by their contraries; for so If the Air, have as it were conspired with the disease by a certain similitude of qualities to the destruction of the Patient, it must be corrected by its contraries according to Arte. But if by the disagreement of qualities it resist the disease, it must be kept in the same temper. The third from things contrary to nature which show they must be taken away by the use of their contraries, as The disease, the Indication being drawn from these The greatness The complication or commixtion with other; so In implicit, or mixed diseases we may draw Indications from these 3. heads. From that which is most urgent From the cause and From that, without which the disease can not be taken away such are Bitterness of pain, a defluxion into a part, a Varix, or big swollen vein, a distemperature if they be joined with a disease. Cause of the disease which two often indicate & require medicines contrary to the disease. Symptoms CHAP. XXIII. Of certain wonderful and extravagant ways of Curing diseases. AS Monsters sometimes happen in nature, so also in diseases, and in the events Monstrom diseases. and cures of diseases. I understand by monsters certain marvellous successes in diseases, or certain ways of curing them, which swarve from Art, and happen besides reason, nature, and common use. Alexander ab Alexandro, and Peter Gilius tell, that in Apulia a part of Italy, they The wonderful force of the bite of a certain Spider. have a certain kind of Spider very frequent, the natives call it Tarentula, Petrus Rhodius calls it Phalangium; The Inhabitants find these Spiders in the first heat of Summer so venenate and deadly, that whomsoever they touch with their virulent biting, he presently, without he have speedy remedy, deprived of all sense and motion falls down, or certainly if he escape the danger of death, he leads the remnant of his life in madness. Experience hath found a remedy by Music for this so speedy Music the remidy thereof. and deadly a disease; Wherefore as soon as they can they fetch Fiddlers and Pipers of divers kinds, who by playing and piping may make Music, at the hearing whereof, he which was fallen down by reason of the venomous bite, rises cheerfully and dances so long to their measures and tunes, until by the painful & continued shaking and agitation of the whole body, all the malignity is dissipated by transpiration and sweats. Alexander adds that it happened once in his sight, that the Musicians their wind & hands failing them ceased playing, and then the Danser presently fell down as if he had been dead; But by and by the Music beginning anew, he rise up again and continued his dancing till the perfect dissipation of the venom. And that it hath happened besides, that one not so perfectly healed, certain relics of the disease yet remaining, when a long time after he heard by chance a noise of Musicians, he presently fell a leaping and dancing, neither could he be made to leave before he was perfectly cured. Some affirm according to the opinion of Asclepiades, that such as are Frantic Music gives ease to pain. are much helped with a sweet and Musical harmony. Theophrastus and Aulus Gellius say that the pain of the Gout and Sciatica are taken away by Music. And the Sacred Scripture testifies, that David was wont by the sweet sound of the Harp to refresh and ease King Saul when he was miserablely tormented by his evil spirit. Herodotus in Clio tells, that Croesus' the King of Lydia had a Son, which of a long time could not speak, and when he came to man's estate was accounted dumb: but when an Enemy with his drawn sword invaded his father (overcome in a great fight, and the City being take in which he was) not knowing that he was the King, the young man opened his mouth endeavouring to cry out, and with A strong perturbation of the mind helps by moving the spirits. that striving and forcing of the Spirit he broke the bonds and hindrances of his tongue, and spoke plainly and Articulately, crying out to the Enemy that he should not kill King Croesus. So both the Enemy withheld his sword, and the King had his life, and his Son had his speech always after. Plutarch in his book, Of the benefit to be received from our Enemies, tells that a Thessalian called Proteus, had a certain inveterate and incurable ulcer in a certain part of his body, which could not be healed, before he received a wound in a conflict in the same place, and by that means the cure being begun afresh, the wound and ulcer were both healed. Quintus Fabius Maximus, as Livye writes, was long and very sick of a quartan Chance sometimes exceeds Arte. Ague, neither could have wished success from medicines administered according to Art, until skirmishing with the Allobroges he shaked off his old feverish heat, by a new heat and ardent desire of fight. It was crediblely reported to me of late by a Gentleman of the Lord of Lansackes Chamber, that there was a French Gentleman in Polonia who was greivously tormented with a quartan Fever, who on a time walking upon the bank of the River Wixell to take away the irksomeness of his fit, was thrust in jest into the River by a friend of his that met him by chance, by which (although he could swim, as he also knew that thrust him in) he conceived so great fear, that the quartan never troubled him after. King Henry the second commanded me to go from the Camp at Amiens to the City Dorlan, that I might cure those that were hurt in the conflict with the Spaniards, the Captain S. Arbin although at that time he had a fit of a quartan ague, yet would he be present at the fight, in which being shot through the side of his neck with a Bullet, he was strucken with such a terror of death, that the heat of the Fever was assuaged by the cold fear, and he afterwards lived freed from his Ague. Franciscus Valleriola the famous Physician of Arles, tells that john Berlam his Observat. 4. lib. 2. fellow Citizen troubled with a Palsy of one side of his body for many years, his house taking fire, and the flame coming near the bed in which he lay, he strucken with a great fear, suddenly raised himself with all the force he had, and presently recovering the strength of his body, leaps out at the window from the top of the house, and was presently cured of his disease, sense and motion being restored to the part, so that afterward he went upright without any sense of pain, who lay unmoveable for many years before. He tells the like in the same place of his cousin john Sobiratius; he was a long time lame at avignon, by reason that the nerves of his hams were shrunk and drawn up so that he could not go; being moved with a vehement and sudden passion of anger against one of his servants whom he endeavoured to beat, he so stirred his body that forthwith the Nerves of his hams being distended, and his knees made pliant he began to go and stand upright without any sense of pain, when he had been crooked about the space of six years before, and all his life after he remained sound. Galen tells he was once fetched to staunch the bleeding; for one who had Cap ult. lib. de cur. rat. per sanguinis miss. an Artery cut ne'er his ankle, and that by his means he was cured without any danger of an Aneurisma (ay) a relaxation of a veinous vessel; and besides by that accidental wound he was freed from most grievous pain of his hip, with which he was tormented for four years before: but although this easing of the pain of the Sciatica happened according to reason by the evacuation of the Galen by a dream cures the Sciatica. conjunct matter, by the artery of the ankle of the same side being opened; yet because it was not cut for this purpose, but happened only by chance, I judged it was not much dissenting from this argument. Pliny writes that there was one named Phalereus, which casting up blood at his mouth, and at the length medicines nothing availing, being weary of his life, went unarmed in the front of the battle against the enemy, and there receiving a wound in his breast, shed a great quantity of blood, which gave an end to his spitting of blood, the wound being healed, and the vein which could not contain the blood being condensate. At Paris Anno 1572. in july a certain Gentleman being of a modest and courteous carriage fell into a continual Fever, and by that means became Frantic, moved with the violence of which he cast himself headlong out of a window two stories high, and fell first upon the shoulder of Vaterra the Duke of Alenzons Physician, and then upon the pavement; with which fall he cruelly bruised his ribs and hip, but was restored to his former judgement and reason. There were present with the Patient besides Valterra, witnesses of this accident these Physicians, Alexis, Magnus, Duretus, and Martinus. The same happened in the like disease, and by the like chance to a certain Gascoigne lying at the house of Agrippa in the Pavedostreete. 〈◊〉 〈◊〉 Doctor of Physic of Mompelier and the King's professor, told me that a certain Carpenter at Broquer a village in Switzerland, being frantic cast himself headlong out of an high window into a river, and being taken out of the water was presently restored to his understanding. But if we may convert casualties into counsel and Art, I would not cast the Patient headlong out of a window. But would rather cast them suddenly and The cause of the last recited cures. thinking of no such thing into a great cistern filled with cold water, with their heads foremost, neither would I take them out until they had drunk a good quantity of water, that by that sudden fall and strong fear; the matter causing the Frenzy might be carried from above downwards, from the noble parts to the ignonoble; the possibility of which is manifest by the forerecited examples, as also by the example of such as bit by a mad Dog, fearing the water are often ducked into it to cure them. CHAP. XXIIII. Of Certain juggling and deceitful ways of Curing. HEre I determine to treat of those Impostors, who taking upon them the person of a Chirurgeon, do by any means either right or wrong put themselves upon the works of the Art; but they principally boast themselves amongst the jgnorant common sort, of setting bones which are out of joint and broken, affirming as falsely as impudently that they have the knowledge of Sciences are not hereditary those things from their Ancestors; as by a certain hereditary right; which is a most ridiculous fiction; for our minds when we are borne, is as a smooth table, upon which nothing is painted. Otherwise what need we take such labour and pains to acquire and exercise sciences? God hath endued all brute beasts with an inbred knowledge of certain things necessary for to preserve their life, more than man. But on the contrary he hath enriched him with a wit furnished with incredible celerity and judgement, by whose diligent and laborious agitation he subjects all things to his knowledge. For it is no more likely, that any man should have skill in Chirurgery because his father was a Chirurgeon, than that one who never endured sweat, dust nor Sun in the field, should know how to ride and govern a great horse, and know how to carry away the credit in tilting, only because he was begot by a Gentleman and one famous in the Art of War. There is another sort of Impostors far more pernicious and less sufferable, A most impudent sort of Impostors. boldly and insolently promising to restore to their proper unity and seat, bones which are broken and out of joint, by the only murmuring of some conceited charms, so that they may but have the Patient's name and his girdle. In which thing I cannot sufficiently admire the idleness of our Countrymen so easily crediting so great and pernicious an error; not observing the inviolable law of the ancient Physicians, and principally of Divine Hypocrates, by which it is determined, that three things are necessary to the setting of bones dislocated and Three things necessary for the cure of a Luxation. out of joint; to draw the bones asunder; to hold the bone receiving, firmly immovable with a strong and steady hand; to put the bone to be received into the cavity of the receiving. For which purpose the diligence of the Ancients hath invented so many engines, Glossocomies and bands, lest that the hand should not be sufficient for that laborious work; What therefore is the madness of such Impostures to undertake to do that by words, which can scarce be done by the strong hands of so many Servants, and by many artificial engines? Of late years another kind of Imposture hath sprung up in Germany, they bear into fine powder a stone within there mother tongue they call Bembruch, and give it in drink, to any who have a bone broken, or dislocated, and affirm that it is sufficient to cure them. Through the same Germany there wander other Impostors who bid to bring to them the Weapons with which any is hurt; they lay it up in a secret place and free from noise, and put and apply medicines to it, as if they had the patient to dress, and in the mean time they suffer him to go about his business, & impudently affirm that the wound heals by little and little by reason of the medicine applied to the weapon, But it is not likely that a thing inanimate which is destitute of all manner of sense, should feel the effect of any medicine; and less probable by much, that the wounded party should receive any benefit from thence. Neither if any should let me see the truth of such jugdling by the events themselves and my own eyes, would I therefore believe that it were done naturally and by reason, but rather by charms and Magic. In the last assault of the Castle of Hisdin the Lord of Martigues the elder was shot through the breast with a Musket bullet. I had him in cure together with the Physicians, and Surgeons of the Emperor Charles the fist and Emanuel Philibert the Duke of Savoy, who because he entirely loved the wounded prisoner, caused an assembly of Physicians and Surgeons to consult of the best means for his cure. They all were of one opinion, that the wound was deadly and incurable, because it passed through the midst of his lungs, and besides had cast forth a great quantity of knotted blood into the hollowness of his breast. There was found at that time a certain Spaniard, a notable Knave, and one of those Impostors who would pawn his life, that he would make him sound; wherefore this Honourable Personage being in this desperate case was committed to his care. First of all he bid they should give him the Patient's shirt, which he tore into shreds and pieces, which presently framing into a Cross, he laid upon the wounds whispering some conceived or coined words, with a low murmur. For all other things he wished the Patient to rest content, and to use what diet he pleased, for he would do that for him, which truly, he did. For he eat nothing but a few Prunes, and drunk nothing but small beer, yet for all this the wounded Prince died within two days; the Spaniard slipped away, and so scaped hanging. And whilst I opened the body in the sight of the Physicians and Surgeons to embalm him, the signs and accidents of the wound did evidently and plainly appear to be as we had pronounced before. And there be also other juggling companions of this tribe, who promise to cure all wounds with lint, or Tents either dry, or macerated in oil, or water, What wounds may be cured only by lint, or by tents and water. and bound to the wound, having murmured over some charm or other, who have had sometimes, good success, as I can witness. But the wounds upon which trial was made were simple ones, which only required union, or closing for to perfect the cure. So verily the bones of beasts when they be broke, grow together by the only benefit of Nature. But when the affect shall be compound by diversity of Symptoms, as a wound with an ulcer, inflammation, contusion and fracture of a bone, you must hope for no other from Tents or Lints, nor charms than death. Therefore the common sort who commit themselves to these Impostors to be cured, do not only injure themselves, but also hurt the Commonwealth, and the common profit of the Citizens; for whose good and justice sake a prudent Magistrate ought to deprive impostors of all freedom in a free and Christian commonweal. Witches, Conjurers, Diviners, Soothsayers, Magicians and such like, boast of curing many diseases; but if they do or perform any thing in this kind, they do it all by slights, subtleties and forbidden Arts, as Charms, conjurations, Witcheries, Characters, Knots, Magical Ligatures, Rings, Images, Poisons, laces tied across, and other damnable tricks, with which they pollute, pervert and defame the prime and sacred Art of Physic & that with the danger of menslives. Who certainly are to be banished by the laws of our country, especially seeing it is decreed in Moses Law. Let none be found among you that useth witchcraft, or a regarder of Deuteron. 18. times, or a marker of the flying of Fowls, or a Sorcerer or a Charmer, or that counselleth with Spirits, or a Soothsayer, or that asketh counsel at the dead; for all that do such things, are abomination to the Lord, and because of these abominations the Lord thy God doth cast them out before thee. But the Miracles of our Lord jesus Christ the Son of God, and of his Saints and Apostles in curing diseases beyond nature and all Art, are of another kind, which we ought to believe so firmly and constantly, that it should be counted an impiety for a Christian to doubt of them. All holy writings are full of these; as to give sight to the blind, hearing to the deaf, power to go to those sick of the Palsy, to drive forth Devils, to cure the Leprosy, to give fruitfulness to women, to raise the Dead, and perform by the holy Ghost other Miracles which exceed the condition and law of Nature; whom here we earnestly entreat to free and protect us from unclean Devils and the spirits of diabolical deceit, and to give us the mind that we may will and be able always to aspire to Heaven and fasten the hope, safety and anchor of all our fortunes in God alone. Amen. The End of the first Book. THE SECOND BOOK OF LIVING CREATURES, AND OF THE EXCELLENCY Of Man. BEfore I come to speak of the Anatomy of man's body; The difference of brute beasts. I have thought fit to say a little of the nature of brute Beasts. There is between beasts a great deal of difference by nature; for of these, some are hardy and bold, others fearful; some wild and savage, others tame; some walking in herds, others wand'ring alone; some covered and defended with shells and scales, as the Crocodile, the Tortoise and many kinds of fish, others have stings and prickles. The Horse hath his hard and strong hooves, his crest (as being a generous beast) beset with a thick and harsh mane, The defence of the magnanimous Lion, are his teeth, his crooked paws and tail; Bulls are formidable by their horns; the Bear by his tusks standing out, as it were natural hunting spears. The Hare being a timorous creature, is naked and unarmed, but in recompense thereof nature hath made her nimble and swift of foot. For what the more noble and courageous beasts have in arms, is supplied in the fearful by nimbleness and celerity. Infinite are the other endowments of brute beasts, and such as can hardly be imagined, or described. For if we diligently search into their nature, we shall observe the impressions and Some shadow of virtue in beasts. shadows of many virtues, as of magnanimity, prudence, fortitude, clemency, and docillitie: for they entirely love one another, follow those things that are good, shun those that are hurtful, and gather and lay up in store those things that are necessary for life and food. Lastly, they give undoubted presages of the weather, and Air. They have taught men many things, and are of a most exquisite and quick sense; of rare▪ Art in vocal music, prdent and careful for their young, and faithful lovers of their native soil. They are religiously observant of the rights of friendship and chastity. They have their weapons whereby they are prepared, both to invade, and to defend themselves being invaded; they submit themselves to the discipline of man, practice and imitate his speech, and mutually prattle and chant one to another. They have a kind of weale-puklicke amongst themselves, and know how to preserve their present welfare, and to depel the contrary, being in this their own Counsellors, and not tutored by man. Yea man is beholden to them for the knowledge of many wholesome things. The consideration of which bred so great a doubt amongst the ancient Philosophers, that it was a question amongst them, whether beasts had use of reason, or no? Therefore also the wise Solomon sends us for examples of parsimony and diligence unto the Ant or Pismire; and Esaias in exprobration of the people of Israel for their ingratitude and rebellion against God, sends them to the Ox and Ass; for they do not only know, but reverence their Masters. But from whence is the knowledge of these medicines, wherewith the Art of Lib. 8. cap. 27. Physic is so richly adorned, but from brute beasts, as Pliny affirmeth. The infallible virtue of the herb Dictamnus, in drawing darts out of the flesh, was taught usby the Hart, who wounded with the Huntsman's darts or arrows, by means hereof draws out the weapons which remains sticking in her. Which is likewise practised by the Goats of Candie, as Aristotle writeth. The wonderful effect which Celandine hath upon the sight, was learned by the practice of Swallows, who have been observed with it to have besmeared, and so strengthened the eyes of their young. Serpents rub their eyelids with fennel, and are thought by that means to quicken and restore the decaying sight of their eyes. The Tortoise doth defend & strengthen herself against the biting of Vipers, by eating of savoury. Bears by eating of Pismires, expel that poison that they have contracted by their use of Mandrakes. And for correction of that drowsiness and sloth which grows upon them by their long sleep in their dens, they eat the herb Aron ay Cuckopint. But the Art they use in the The craftiness of Bears. enticing and catching of Pismires is very pretty; They go softly to the holes or hills of the Pismires, and there lay themselves all their length upon the ground, as if they were dead, hanging out their tongue wet with their foam, which they draw not again into their mouth, before they feel them full of Pismires, which are enticed by the sweetness of the foam: And having taken this as a purging medicine, they expel by the guts, those ill humours wherewith they were offended. We see that Dogs give themselves a vomit, by eating of a kind of grass, which is from thence called Dogge-grasse. Swine, when they find themselves sick, will hunt after smalt or river lobsters. Stockdoves, Blackbirds, and Partridges, purge themselves by bay leaves. Pigeons, Turtles, and all sort of Pullen, disburden themselves of gross humours, by taking of Pellitory of the wall. The bird Ibis (being not much unlike the Stork) taught us the use of Clysters. For when he finds himself oppressed with a The bird Ibis the first inventor, or shower of Clysters. burden of hurtful humours, he fills his bill with salt-water, and so purgeth himself by that part, by which the belly is best discharged. The invention of the way of removing the Cataract of the eye, we must yield unto the Goat, who by striking by The invention of removing a Cataract. chance against the thorny bushes, pulls off the Cataract which hinders the sight, and covers the ball of the eye, and so recovers his sight. The benefit of Phlebotomy, we The invention of Phlebotomy. owe unto the Hippotamus or River-horse, being a kind of Horse, and the inhabitant of the river Nilus; who being a great devourer, when he finds himself surcharged with a great deal of blood, doth by rubbing his thigh against the sharp sands on the bankeside, open a vein, whereby the superfluous blood is discharged, which he stoppeth likewise when it is fit, by rolling himself in the thick mud. The Tortoise having chanced to eat any of the flesh of a Serpent, doth make origanum and marjerom her Antidote. The ancients found help from brute beasts, even against the dreadful and none-sparing force of lightning; for they were of opinion A preservative against thunder. that the wings of an Eagle were never struck with lightning, and therefore they put about their heads little wreathes of these feathers. They were persuaded the same thing of the Seal, or Sea-calf, and therefore were wont to encompass their bodies with his skin, as a most certain safeguard against lightning. It were a thing too long, and laborious, to speak of all those other muniments of life and health (observed here and there by Aristotle and Pliny) which we have learned of brute beasts. I will therefore end this Chapter, after that I have first added this; That we are beholding to beasts not only for the skill of curing diseases, and of preservation of health, but for our food, our raiment, and the ornament and beautifying the bodies. Of the Faculty of brute Beasts in Presaging. THe first knowledge and skill of Prognostication, and observation of weather by the Air, was first delivered unto us from beasts of the land and water, and from fowl. For we see in daily observation, that it is a sign of change of weather, when What the butting of Rams signifies. Lambs and Rams do butt at one another with their horns, and playing wantonly do kick, and keep up their heels. The same is thought to be presaged when the Ox licks himself against the hair, and on the sudden fills the Air with his lowing, and smells to the ground, and when he feeds more greedily than he used to do. But if the Pismires in great multitudes fetch their prey so hastily, that they Presages of rain. run and tumble one upon another in their narrow paths, it is thought a sign of rain; As is also the busy working of Moales, and the Cats rubbing and stroking of her head and neck, and above her ears, with the bottom of her feet. Also when Fishes play and leap a little above the water, it is taken for a sign of rain. But if the Dolphins do the same in the sea, and in great companies, it is thought to presage The sign at sea of a storm at hand. a sudden storm and tempest. Whereby the Mariners forewarned, use all care possible for the safety of themselves and their ships, and if they can, cast Anchor. And it is sufficiently known what the louder croaking of Frogs than ordinary portends. But the faculty of birds in this kind of presaging is wonderful. If Cranes fly through the air without noise, it is a sign of fair weather, and of the contrary, if they make a great noise and fly stragglingly. As also if Sea-fowle fly far from the sea, and light on the land. The cry or screeching of Owls portends a change of the present weather, whether foul or fair. Plutarch saith, that the loud cawing of the Crow betokens winds and showers, as also when he flappes his side with his wings. Geese, and Ducks, when they dive much, and order, and prune, and pick their feathers with their beaks, and cry to one another, foretell rain; and in like manner Swallows when they fly so low about the water, that they wet themselves, and their wings. And the Wren, when he is observed to sing more sweetly than usual, and to hop up and down. And the Cock when he chants, or rather crows presently after the setting of the Sun. And Gnats, and Fleas, when they bite more than ordinary. If the Herne soar aloft into the air, it betokeneth fair weather, if on the contrary he fly close by the water, rain. If Pigeons come late home to the Dove-house, it is a sign of rain. If Bats fly in the evening, they foreshow wet weather. And lastly, the Crocodile lays his eggs in that place, which must be the The Crocodile by laying her eggs, shows the b●●●●…s of the increase of the river Nilus. bounds of the overflowing of the river Nilus; And therefore he that first meets with these eggs, tells the rest of the country people, and shows them how high the flood will rise, and what inundation it will make upon their grounds. A thing most worthy of admiration, that in this monster, there should be that strong faculty of presaging. Of the Industry of Fishes. MAny sea-fish, when they feel a tempest coming, do gravel or ballast How Fishes provide for their safety against a storm. themselves, to the end they may not be tossed up and down at the pleasure of the waves. Others when the fury of the sea is at the height, hide themselves in the holes of rocks. But in that they swim against the stream, they do it, for this cause and reason, that the force of the stream, and the flood may not take from them, How they swim against the stream. and strike off their scales, and that their gills may not fill with water which would hinder their swimming, and intercept their respiration. As by the same advise Cranes fly against the wind, whereas if they should fly down the wind, their feathers would be displaced and broken, and they would not be able to fly. Of the industry of Birds in the building of their nests. THe industry of Birds in the building of their nests, is such, that it doth far Of what things birds build their nests. exceed the art and skill of all Masons, and Architects. From whence it is become a Proverb, That men know, and can do all things but make Birds nests. They are built within with wool, and feathers, and such kind of soft things, which are as a kind of a pallet for the young ones. Swallows build their nests in a round form, In what shape. that they may be the more firm, and less subject to be hurt by any thing that shall strike against them, and likewise more capacious. They choose their matter out of dirt and chaff (interlacing it with many straws) as it were their plaster, or lime. Those that build in trees, do make choice of the soundest boughs, as if they meant to have them as a sure foundation for the building which they should erect thereon. The Cock and the Hen do by turns sit over their eggs, and likewise fetch With what care Sparrows breed their young. their meat, interchanging each others labour, neither do they ever forsake their young, before they are able to get their own living. I had at my house a great number of Sparrows nests in earthen pots, And when the young ones begun to wax pretty big, and to be covered with feathers, I made the whole nest be taken down, and set upon the ground, that I and my friends might delight ourselves in beholding the care of the old ones in the feeding of their young; for they feed them every one in order, skipping none, neither will they (to the wrong of the rest) give one two parts, although he gape, and be importunate for it.; dividing most justly to every one his own share, according to the exact rule of distribution. And often times for experiment, I would make trial with a strange Sparrow of the same age, laid near, or put among the rest of the young ones, whether the old ones would feed the stranger, as if it were legitimate. But this as a stranger and a bastard they would suffer to starve, skipping it when it gaped after the meat. And in like manner Lambs and young Kids do in the fields, in the midst of a great flock, run every one to his own dam, who being most certainly able to distinguish between the legitimate and a bastard, will not suffer herself to be sucked but by her own young. Of the industry of Spiders. THe Spider spins her web with wonderful artifice, hanging and fastening it to How the Spider's weave every tack or stay that is nigh, drawing of his thread, and running upwards, and downwards, and every way. And although the diligence of the chamber maid beats down, and mars this pendulous and new begun work, yet her seat and her hold, the Spider keeps still, neither is she, or will she desist from the work she hath begun, but in a very short time, weaves a great deal more unto the ruins of her former work, than can be unweaved again with much labour. So that from hence all cloth and linen Weavers, all imbroiderers, and workers with the needle, (you will easily think) have learned their Arts, if either you observe the exactness of the weaving, the fineness of the thread, or the continuation and indissoluble knitting together of the whole web; for being abrupt and troubled with no ends of threads at all, it resembles a thin membrane, anointed with a kind of glue, wherewith How they catch their prey. when the prey is entangled, the Spider runs presently in, and as it were drawesher nets, and infolds, and takes the captive after the manner of huntsmen. If this were not daily seen with our eyes, it would be thought fabulous. Of Bees. I cannot pass in silence the great industry of Bees. For having established a kind of Weal-public, they make election of a King, who is such a one, as in proceri●… Bees choose themselves a King of body, and excellency of feature, exceedeth all the rest. He is remakeable by his short wings, his strait legs, his grave gate, and in stead of a Diadem or regal Crown, either he hath no sting, or else doth not use it, which is the Artillery of the rest. He never goeth unattended out of the hive, but always environed with a princely retinue, the rest of his train following after, neither goes he at any time abroad, but upon urgent affairs which concerns the whole state. His progress is forewarned by the voice and sound of trumpets, and as it were with singing, and they all draw nigh. Every one gets as near to his person as he can, and when he is weary with flying, they all bear him up with their own bodies. On what place soever he alighteth, there they forthwith pitch their tents. If he Their pitching their tents. chance to die, they go not abroad to feed, but stand all mourning round about the corpse; then carry him out of the hive, and (as it were) follow his hearse and bury Their obsequies for their dead King. him; and lastly, having with solemnity performed all the funeral rites and obsequies, they choose themselves another King, for without a King they cannot live. He than taketh care of all things, having his eye every where, whilst that the rest intent the performance of the work. And supervising all, giveth them encouragement, and chastiseth negligence. For their time of going forth for food, they choose a clear and fair day; for they have a natural faculty of presaging of the weather. They are Their justice. such observers of justice and equity, that never, either with their sting, or by any other way, do they molest any creature, neither do they exercise and prepare their spears against any, but for the safeguard of themselves and their hives. Of the care of Bees. THey manage and order their affairs in this manner, in the day time they appoint before their gates a station of watchmen, and guarders. In the night, they Their watch. rest from their labours, so long, till that one (who is appointed to this charge) by one or two hums, as by a sound of a Trumpet, rouseth all the rest. Then Their divers employments. come they together to observe what is the state of the weather, which if they foresee will be fair, then abroad go they into the fields, and pastures. Some therefore bring into the hive little fascicles of flowers on their thighs, others water in their mouth, and others a dewey moisture gathered on their bodies. These are met by others, who receive their burdens, which they dispose in their due and proper places. Those that are sent out into the fields for food, are the youngest and the smallest. And therefore if the wind chance to rise any thing high, they expect until it cease, and that the force and violence thereof be over. But if it continue violent, then do they ballast themselves with a little stone flying close by the ground, to prevent their being driven too and fro by the force of the wind. They are exceeding diligent in all their business, and do punish the sloth of the lazy oftentimes with death. Some of them are the builders, others polish the building, and the rest bring in their materials. The building in their arched hives is with wonderful artifice, being made with two doors, one to come in, and the other to go out at. They have all things alike, lest that the inequality, either of their food or labour, should give occasion of dissension. Their care is, that their houses may show both state and handsomeness, Idle drones, borne for nothing but to eat, and consume the fruits of their labours, They punish sloth with banishment. they chase from their hives. Those that chance to lose their stings, are utterly disabled, and in a short time their guts come out that way, and they die. They bring to their owners wonderful increase of wax and honey. Aristomachus the Philosopher doth boast, that for fifty eight years together, he Aristomachus a diligent observer of Bees. had with great care been a nourisher of Bees, only that he might the better attain to the knowledge of their state and condition. Of Pismires, and Ants. NEither truly is the industry, diligence, and experience of the Pismire less worthy of admiration, than that of the Bees. Insomuch as that Solomon bids the sluggard to take an example of diligence from the Pismire. Truly if experience did not witness it, it would seem incredible, that so small a creature should be able to store up such abundance of corn, to dispose and manage her affairs in that good order that we see she doth. Pliny saith, that they have among them the form of a well Lib. 11. &. 30 governed and well ordered common weal. For how pretty a sight it is to see them, when they seize upon a grain which they have a mind to carry away, how they set to it, and lift it with head and shoulders. And how lest the corn which they carry Wonderful care. to their store-house, should put forth and grow, they bite it at one end. If it be so big that they cannot carry it into their little hole, they divide it in the middle. If it be dampish, they lay it out to dry in the Sun and open air. When the Moon is at the full, they follow their work in the night, when she doth not shine, they take their rest, whereby they show themselves to have some knowledge of heavenly things. Pliny affirmeth that they have their set Fairs and Markets, whither they come in great companies, and where they use to establish leagues of amity and friendship one with another. And when one marks them well, would he not think that they were in conference one with another, and that they did discourse among themselves of their business? Do we not see that the often trampling of their little feet doth wear a path even upon hard flint stones? From whence we may note, what in all kind of things is the effect of assiduity. There is nothing but may be attained by diligence. They say also that they perform the rites of burial one unto another, after the manner of men. What words shall I use (saith Plutarch) to express sufficiently the diligence and industry of the Pismires. There is not among all the great things in nature, a sight of greater wonder than these. For in the Pismires are seen the marks of all virtue. Their great meetings argue that they maintain a kind of friendship. Their alacrity in the undergoing of their labours, seems to show their fortitude The forms of all virtues expressed in Pismires. and magnanimity; and lastly, they are eminent examples of temperance, providence, and justice. Their mutual charity appeareth in this, that if one of them that is not loaden meets another (in one of their narrow paths) that is, he will give him the way, that he may the better go on in his intended journey. They say that the first entrance into their hole, is not strait, but full of many diverticles and crooked paths, which all end, which will bring you to three little cells; in one of which they have their conventicles, in the other they lay up their provisions, and in the third they bury the carcases of their dead. This doth Plutarch speak concerning Pismires. Of Silkworms. WIth the industry of these creatures, I shall not unfitly join that of the Silkworms, of whose pains and care, both in the making of their nests, and the spinning of their thread and bottoms (wherewith Kings are so magnificently adorned) Philosophers have written very strange things. And who can choose but wonder at those great endowments of skill and knowledge, and that exceeding industry, (the mother of so much wealth) in the little Diligence the mother of wealth. body of so small a creature? The providence therefore of God, doth not only appear in this, that he hath adorned each creature with a peculiar and proper endowment, but in this especially, that on the least creatures of all, he hath bestowed the greater portion of skill, industry, and ingenuity to supply their defect of bodily strength. Of the love of Beasts one towards another and to their young. PLutarch writeth; That all kind of creatures bear a singular love, and have a kind of care of those that are generated of them, and the industry of the The industry of Partridge in preserving their young. Partridges, this way is much commended; for during the time that their young ones are weak and unable to fly, they teach them to lie upon their backs, and to hide themselves among the clods on the ground, that so being almost of the same colour, they may not be discerned by the Faulkoner. But if notwithstanding, they see any body, coming, and that he is near them, they do with a hundred dodges and stoop of themselves, as if they were weary with flying, entice him away from their young to follow after them, and when they have their purpose, they then, as if they had recovered some fresh strength, fly quite away; who can but wonder at this both affection and subtlety? Neither are those things less wonderful that are reported of Hares, for when How Hares provide for themselves and their young, for fear of hunters. they would go to their seat, they sever their young, and commit them to the trust of divers places, it may be two acres asunder one from another, lest peradventure, a Huntsman, a dog, or any man should chance to come that way, and they might be in danger to be lost at once. And then after they have traced up and down, hither and thither, and every way that the dogs may not trace them, nor the Huntsman prick them, they take a leap or two, and leap into their forms. Nor inferior to this is the craft of the hedgehog, for when the Fox pursueth him, and is now at his heels, he rowles himself up in his prickles like a chestnut in the outward shell, so that every part being rounded and encompassed with these sharp and dangerous pricks, he cannot be hurt. And so saves himself by this trick; for his young he provides in this manner. In the time of Vintage he goes to the vines, and there with his feet he strikes off the boughs and the grapes, and then rolling his body makes them stick upon his The care of the Hedgehog to provide for her young. prickles, and so doth as it were take his burden upon his back, and then returns to his hole; you would think that the grapes did move of themselves; the prey he divides between himself and his young. Of the affection of Birds, and of Dogs, towards their Masters. THe young Stork provides for the old which is disabled by age, and if any one The piety of Storks. of their equals come to any mischance, that he is not able to fly, they will give him their assistance, and bear him on their backs and wings. And therefore this affection and piety towards the old ones, and as it were brotherly love towards their equals, is commended in the Stork. The Hen in any kind of danger gathers her chickens under her wings, and as it were with that guard, defends them as well as she can. For their sake she exposeth herself to the cruelty of the fiercest beasts, and will fly in the eyes of a dog, a Wolf or a Bear, that by chance offers to meddle with her chickens. But who is there that doth not admire the fidelity and love of dogs towards their Masters, whereby they recompense them for their keeping? A dog will The fidelity of Dogg●. never forsake his Master, no, if he be never so hardly used. For there is no man can find a stick hard enough to drive that dog clean away from him which hath once taken a love to him. There is no kind of creature that doth more certainly and readily remember his master, he will know the voice of all the household, and of those which frequent the house. There cannot be a trustier keeper (as Cicero himself saith) than a Dog is; I speak not of their faculty of smelling, whereby they follow their Masters by the foot, and find them, neither do I speak of those infinite examples of the fidelity of Dogs, which were too long to rehearse. Pigeons, as well the Cock as the Hen, although they are all very venereous, Doves free from adultery yet they know no adultery, yea and the Hen will bear with the frowardness of the Cock, neither will she ever leave him, but reconciling him unto her by her officious diligence, bring him to his wont dalliance and kisses, neither is the love of either of them less towards their young. There is the like mutuallbond of love between Turtles, for if one of them die, the survivor never solicits Hymen more, neither will he ever choose other seat than Turtles never couple twice. a dry withered bough. Of the strength, piety, docility, clemency, chastity, and gratitude of Elephants. AMong the beasts of the field there is none more vast, more strong, or more to be feared, than the Elephant. His strength is sufficiently shown by those towered Castles of armed men, which he carries, and fiercely rusheth with into the battle. The Roman soldiers being otherwise of undaunted spirit, yet in that battle which they fought against Antiochus being terrified with the vastness and immanity of these bodies which they had never before seen, presently turned their backs and fled, which notwithstanding, it is a wonderful thing what stories natural Philosophers tell of the virtues of the Elephant. Pliny writeth, that an Elephant cometh very near to the understanding that Lib. 8. cap. 1. men have, and that he hath a rude kind of knowledge of language; that his facility and obsequiousness is wonderful, that his memory in the performance of his wont duties, is no less wonderful. And for Religion (Plutarch saith) that The religion of the Elephant. they pray unto the gods, and sprinkle and purge themselves with salt water, and that with great reverence, they worship the Sun at his rising, lifting their trunks up towards heaven, for want of hands. Pliny addeth, that they do with the like reverence worship the Moon and the Stars. For it is related in the Histories of the Arabians, that at a new Moon the Elephants go by troops down unto the rivers, and there wash themselves with water, and being thus purged, kneel down and worship the Moon, and then return to the woods, the eldest going first, and the other following after according to their age. Of the Lamprey. Lest that the heat of affection may seem to lie quenched under the waters, let us by one example, (it were an infinite thing to speak of all) see in what kind of mutual love the creatures of the water come short of those of the land. The Lamprey of all the creatures of this kind doth worthily bear the praise for its piety towards those of whom it was generated, its affection towards those that are generated of her; for first she breeds eggs within her, which in a short time after are spauned. But she doth not as soon as her young ones are form and procreated, bring them strait way forth into the light after the manner of other fishes, that bring forth their young alive, but nourisheth two within her, as if she brought forth twice, and had a second brood. These she doth not put forth before they are of some bigness, than she teacheth them to swim and to play in the water, but suffers them not to go far from her, and anon gapes and receives them by her mouth into her bowels again, suffering them to inhabit there, and to feed in her belly so long as she thinks fit. That Savage, or brute beasts may be made tame. THevet reporteth, that the Emperor of the Turks hath at Cairo (it was once called Cosmograph. Tom. 2. lib. 19 cap 7. Memphis) and at Constantinople, many savage beasts kept for his delight, as Lions, Tigers, Leopards, Antilopes, Camels, Elephants, Porcupines, and many other of this kind. These they use to lead about the city to show. The masters of them are girt with a girdle, hung about with little bells, that by noise of these bells the people may be forewarned to keep themselves from being hurt by these beasts. But in hope of reward and of gifts, they show them to Ambassadors of strange nations, before whom they make these beasts do a thousand very delightful tricks, and in the interim, they play their country tunes and music upon their pipes, and other instruments, and make many sports in hope of gain. That Fishes also may be tamed. But it is far more wonderful, that the creatures of the water should be made tame, and be taught by the Art of man. Among which, the chiefest are held to be the Eel. The same things also are reported of the Lamprey. For we have it recorded, that Marcus Crassus had a Lamprey in his Fish-poole, that was so tame, and so well taught, that he could command her at his pleasure. Therefore as a domestical and tame beast he gave her a name, by which when he called her, she would come. And when this Lamprey died, he mourned for her in black, as if she had been his daughter. Which when his Colleague, Cnaeus Domitius objected to him, by way of reproach, he replying, told him, that he had buried three wives, and had mourned for none of all them three. That men were taught by beasts to polish, and to whet their weapons, and to lie in ambush. Soldiers are careful to keep their weapons from rust, and therefore they carry them to the Armourers to be polished. But in this care, many beasts are nothing inferior unto them; for Boars whet their tusks against they fight. And the Elephant knowing that one of his teeth is doubled with digging at the roots of trees to get meat, keepeth the other sharp, and touches nothing with it, preserving it for his combat with the Rihnocerot his enemy; but the craft of the Rhinocerot is very remarkable, that being in continual enmity with the Elephant, at the time when he prepares for the battle, he whets his horn against a rock, as if it were Tke craft of the Rhinocerot about to fight with the Elephant: with a whetstone; nor (if he can choose) will he strike any other part of the Elephant but the belly, because he knows that part of the Elephant is so tender, that it may be easily pierced. This beast is in length equal to the Elephant, but i● height he is inferior unto him, by reason of the shortness of his feet; he is of a palish yellow colour, and full of many sports. Of the Lion, the Ichneumon, and those other beasts which are not easily terrified. THe Lion when he goes, hath his claws always clutched, and as it were put up in their sheaths, not only because he would leave no mark of his feet, The providence of the Lion in his going. whereby he may be traced and so taken, but because by continual walking, he should wear off, and blunt the points of his claws. Bulls when they fight charge one another with their horns, and like valiant soldiers, provoke, and animate one another to the battle. The Ichneumon seems to imitate the most valiant soldier in his preparation, and access to battle, for he bedawbes himself with mud, and doth as it were buckle and make tight his armour; especially when he is to encounter with the Crocodile; who although he be a vast beast, is put to flight by this little creature. And this truly hath been observed to be by the singular providence of nature, The greatest are terrified by the least. that the most vast creatures are terrified by the least things, and such from whence there can arise no danger; so they say the Elephant doth startle at the grunting of an hog, and the Lion, at the crowing of a Cock; although it be reported of the Lion that no fear can make him turn his face. These kind of fears, terrors, and affrightments, arising upon light, and most ridiculous occasions, we find as well in the ancient as modern Histories of our times, to have dispersed and put to flight mighty legions of soldiers, and most potent armies. Of Cocks. Cocks are kingly birds, and therefore nature hath adorned them with a comb, Cock's are Kingly and martial birds. as with a princely Diadem, and wheresoever they come, their magnanimity and courage makes them Kings. They fight with their beaks and their spurs; and with their martial voice they fright the Lion who is otherwise the King of beasts. Of Coneys. Coneys have taught us the Art of undermining the earth, whereby the most lofty Cities, and structures reaching the very skies, are by taking away their Coneys have taught us undermining. foundation leveled with the ground. Marcus Varro writeth, that in Spain there was a town, and that no mean one, which standing on a sandy ground was so undermined by a company of Coneys, that all the houses tumbling and falling down to the ground, the inhabitants were fain to depart and seek new dwellings. Of Wolves. MEn have learned the arts of waging war from the wolves, for they The deceits and ambushes of Wolves. come out by troops, and lie in ambush near the towns which they have appointed, and then one of them runs unto the town and provokes the dogs. And making as if he run away incites the dogs to follow him, until he hath gotten them unto the place where their ambush lieth, which on a sudden appeareth, and rusheth out upon them. And so they kill and eat all, or as many of the dogs as they are able to catch. Of the Fox. IN subtlety and craft the Fox exceedeth all other beasts; when in the chase the The craft of the Fox. Dogs are at his heels, he bewrays and bepisses his tail, and swings it in the face and eyes of the Dogs that follow him, and so blinding them, in the mean time gets ground of them. To fetch the Hens down from their perch he hath this devise, he shakes and swings his tail upwards and downwards, as if he meant to throw it at them; which they fearing tumble down, & he takes up one of them for his prey. His wariness when he passeth over a River that is frozen is wonderful, for he goes softly to the bank, and lays his ear to listen, if he can hear the noise of the water running under the ice. For if he can, back he goes, and will not venture to pass over. The knowledge of which thing he could never merely by his subtlety and The Fox seems to reason with himself. craft attain unto, but that of necessity he must have some faculty of reasoning. joined with it, which by discourse and by proving one thing by another arrives at this Conclusion: Whatsoever is liquid and maketh a noise is in motion, whatsoever liquid is in motion is not concrete and frozen, that which is not concrete and His Sorites frozen is liquid, whatsoever is liquid will not bear a heavier body, whatsoever will not bear a heavier body, cannot with safety be adventured on; And therefore back again must I go, and not pass over this River. Of Swine. SWine, if in the woods, they hear any one of the same Herd with them crying out, they strait make a stand, and marshalling their forces haste all, as if they had been warned by the sound of a martial trumpet, to the assistance of their fellows. Of the fishes Scarus and Anthia. PLutarch reports of the Scari, that when one of them chances to swallow a hook and be taken, the rest of the same kind come in to his rescue, and shearing the The love of Fishes one to another. Line with their teeth set him at liberty. But the readiness of the Anthiae to the mutual assistance of one another, is yet more manifest, for by casting the Line upon which the hook hangeth, on their back, with the sharpness of their fins they cut it asunder, and so set free themselves and their captived fellows. Of the Pilot Fish. THere is great kindness between the Pilot Fish and the Whale. For although in bulk of body the Whale so far exceed him, yet he leads the Whale and goes always before him as his Pilot, to keep him from running himself into any strait or muddy place, whence he might not easily get out. And therefore the Whale always follows him, and very willingly suffers himself to be led by him, it being for his own good. And in like manner he gets into the Whale's mouth, and there The Whale's pilot or g●●d. lodging himself sleeps when he sleeps, and leaves him not either by day, or night. Of Cranes. Crane's when they are to take a long journey into some Country cross the seas, put their company in so good order, that no Captain can put his soldiers in Crane's order themselves in ranks. better. For before they stir out of any place, they have as it were their trumpets to call them together, and encourage them to fly. They come together and then fly up on high, that they may see a far off, choosing a Captain whom they are to follow. They have their Sergeants to take care of their ranks, and keep their nightly watches by turns. Plutarch tells us that the Crane, which is appointed to stand The sentinel Crane. Sentinel for all the rest, holds a stone in her foot, to the end that if she chance to give way to nature and sleep, she may be waked by the noise of the falling stone. The leader lifting up his head, and stretching out his long neck, looks about him far and wide, and gives warning to the rest, of any danger, that may befall them. The strongest lead the way, that they may the better with the flapping of their wings break the force of the air, and this they do by turns. And that they may the easilier prevail against the force and opposition of the winds, they dispose their company into a wedge in the form of the Greek letter Δ or a triangle; and being skilful in the stars they foresee when tempests are coming, and fly down to the ground to keep themselves from the injury of the approaching storm. Of Geese. THe Geese of Sicily do with great wariness take care that by their ceeking and their noise, they do not expose themselves to the rapacity of Birds of prey: (for Plutarch saith) that when they are to fly over the hill Taurus, for fear of the Eagles that are there, they hold stones in their mouths to keep themselves from The care of the Geese, that their gagling, do them no harm. gaggling, until that they come unto a place where they may be secure. Of Dragons. NEither are the Dragons less crafty; for thus do they overcome those vast and otherwise invincible beasts the Elephants. They lie in ambush and suddenly The craft of Dragons fight against the Elephant. set upon the Elephants where they fear no such matter, and involve their legs with the twines of their tail, in such sort, that they are not able to go forward; and stop their nostrils with their heads so that they cannot fetch their breath, they pull out their eyes, and wheresoever they find the skin most tender, there they bite and suck the blood until they make them fall down dead. Pliny saith, that there are Dragons found in Aethiopia of ten Cubits long, but that in India there are Dragons of an Lib. 8. cap. 11. and 12. 100 foot long, that fly so high, that they fetch Birds and take their prey even from the midst of the clouds. Of the Fish called, the Fisherman. THis Fish is called the Fisherman, because he hunts and takes other Fishes, which The craft of the Fisherman-fish in taking her prey. he doth almost by the same cunning which the Cuttell uses; for he hath hanging at his throat a certain bag like the Wattells of a Turckycocke. This when he listeth he casteth out, and layeth before the little fishes for a bait, and then by little and little draws it up again until he catch for food the little fishes seizing upon it as a prey. Of the Cuttell Fish. Wonderful is the craft of the Cuttell Fishes, for they carry a bladder at their The craft of the Cuttell to save herself. neck full of a black juice or Ink, which they pour forth as soon as they feel themselves taken; that so they may blind the eyes of the Fishermen, as Plutarch saith; and as Aristotle witnesseth, they with their long fangs do not only Lib. 9 de Hist. animal. Cap. 37. hunt and take little Fishes, but oftentimes also Mullets. Of the Arms or weapons of brute beasts. BRute beasts are naturally so furnished with arms, that they have no need to get, make or borrow in any other place. And some of them nevertheless are so furnished with such arms that they captivate those which hold them prisoners; an example of this is the Torpedo, which doth not only hurt by touch, but also by the net being between, he breathes such a quality from him, as stupifies the hands of the Fishermen, so that they are forced to let go their nets, and so let him go; moreover if it touch a ship it makes it stay. Thevet writes, that the Persian bay towards Arabia nourishes a Fish equal in length and Cosmog. Tom. 1. lib. 10. cap. 10. thickness to a carp, on every side encompassed with sharp and strong pricks, like our Porcupine, with which he fights against all kinds of fish. If a man chance but to be lightly hurt either with these or his teeth, he will dye within 24. hours. Of the fish Vtelif. He saith moreover, that as he was carried by force of tempest through the Atlantic Ocean, he saw this fish having as it were a Saw in his forehead of three foot long, and four fingers broad, armed on each side with sharp spikes; They call it Vtelif in their Country speech. Of the fish Caspilly. THere is another fish to be seen in the Arabian Gulf, which the Arabians call Caspilly, it's two foot long and as many broad, it hath a skin not much unlike a Dogfish, but armed with spikes, one whereof he carries in his forehead a foot and half broad, in sharpness and force of cutting not much short of a graver or chisel: with this weapon when she is oppressed with hunger she assails the first fish she meets, neither doth she give over before she carry her as a prey, Tom. 1. lib. 5. cap 2. whither she please, as Thevet saith he hath seen. Of Crabs. CRabs and Lobsters though in the quantity of their body they be but small, yet they use their forked claws before, not only in feeding but also in defending themselves and assailing others. Of the Docility of Beasts, and first of the Dog. Beast's are apt to learn those things which men desire, whereby they show themselves not wholly void of reason. For Dogs, Apes and Horses learn to creep through the jugglers' hoops, and rise on their hinder feet as though they would dance. Plutarch tells, that a juggler had a Dog which would represent many things The wonderful docility of Dogs. upon the stage befitting the occasion and argument of the play; amongst the rest, he exceeded all admiration in that, that taking a soporificke medicine, he excellently feigned himself dead; for first as taken with a giddiness in his head he begun to tremble, then presently fell down, and lying on the ground, as it were contracted his dying members, and lastly as if truly dead he waxed stiff; and moreover suffered himself diversely to be fitted according to divers parts of the Theatre, the fable so requiring. But when he, by those things that were said and done, A spectacle full of admiration and mirth knew it was time to rise, he first begun to move his legs by little and little, as if he had been wakened from a sound sleep; then presently with his head a little lifted up, he looked this way and that way to the great admiration of all the beholders, and finally rise up and went familiarly and cheerfully to him he should; the which sight the Emperor Vespasian (who was then present in Marcellus his Theatre) never saw any which more delighted him. Of the Ape. AN Ape is a ridiculous Creature, and which makes men much sport, in imitating Gal. lib. 1. de us● partium. their actions. There hath been seen an Ape which would pipe and sing, and besides dance and write, and endeavour to perform many other things proper to men. I remember I saw in the Duke of Somes house a great and cursed Ape, who because he much troubled many, had his hands cut off, who suffering himself to be cured, when the wound was cicatrized, he grew more mild and docile. Wherefore clothed in a green coat, and girt over his loins with a girdle, he carried hanging thereat a case of spectacles, a pair of knives & a child's handkerchief. He was committed to the charge of the Master Cook to teach, because he had taken up his lodging in the Chimney corner, he was taught many pretty tricks and feats. If at any time he swarved from his doctrine and precepts, in a trice the whip was upon his back & loins, and much was abated of his daily allowance, for as Persius saith, The belly is the master of Arts and sharpener of wit. By these means be profited so, in a short time, that he much exceeded all the Apes of his time in the glory of his wit; & there was none counted more skilful in leaping and dancing to the pipe, running up a pole and nimbly leaping through his Master's legs. To conclude; he performed all the actions of a strong Ape, and very reverently carried up dishes with the waiters & servingmen, and made clean the dishes and platters by licking, and did much other drudgery, so that he was commonly called Master john Do-all. At dinner and supper sitting in a chair he said grace, and cast his eyes up towards heaven, and rolled them this way and that way, and smote his breast with the stumps of his hands with much lamentation, and imitated prayer by the gnashing, or beating together of his teeth. He would turn up his tail to any that offended him (for his coat scarce covered half his buttocks lest he should have filled it) he made much other pastime, always going upright by reason of the cutting away of his hands, unless at any time through weariness he were forced to sit on his buttocks. Of Ravenous birds. But let us take a view of Falconers teaching ravenous birds, how with swift wings The diligence of Falconers in training up their Hawks. carried aloft into the Air, they may seize upon other Birds and cast them down dead to the ground; in performance whereof, they often too freely soar up to the clouds so that they carry themselves out of the Falconers sight, with a desire to sun themselves, neglecting in the mean time their designed prey. The Herne when she sees herself kept under and below the Falcon carried up by The fight of the Herne and Falcon, his strong wings with a merveilous swiftness, with her beak, which is long & sharp, hid under her wings and turned upwards, she receives the Falcon blinded with the heat of fight and desire of prey, carelessly flying down and rushing upon him; so that he often strikes him through the gorge, so that oft times they both fall down dead to the ground. But if the Falcon without harm escape the deceits by Art & the happy turning of his body, and the Herne be not cast down, the Falconer calling her back with never so loud a voice, yet by setting up her Feathers she dares her to the pretended fight. Of the Camels. THe Camel is a very domestical and gentle beast, and which is easily tamed Camel both tame and wild. and taught all kind of obedience and service; although some of them are cruel wild and troublesome by biting and striking such as they meet, no less than untamed horses. There is no need to house them in the night, for they may be left in the plain fields in the open and free air, feeding upon the grass and trees and cropping the tops of the thistles, neither in the morning do they any whit the worse undergo or carry their burdens. They are not put to carry burdens before they be four year old. The Arabians geld them young, that they may enjoy their labour the The easy and not chargeable keeping of Camels. longer, neither being gelt do they rage for love or desire of venery. At the putting in of the Spring they endure hunger and thirst for eight days; they are so dutiful, that at the beck of the Turkish slaves, or but touched on the neck with a twig, they presently kneel on the ground to take up their burden, neither do they lift themselves up before that they find they have a sufficient load laid upon them. Those which have but one bunch on their back are of Africa; but such Camels know when they have a sufficient load. as have two bunches are of Asia, or Scythia. Those kind of Camels that are the bigger are used to carry packs, but the lesser are used to ride upon, as our horses are. They love nothing so well as beans, and yet they live content with four Camels both ●o carry burdens and to ride upon. handfuls of beans for a day. The greatest wealth of the Arabians consists in Camels, and so they estimate their riches, not by the quantity of silver, or gold, but by the number of Camels. The Turkish Emperor (Thevet being the reporter) made a Captain over the herds of his Camels, giving him a great troop, of African and Christian slaves, that they might be the better looked unto. I have heard it reported (saith Thevet) by certain Arabian, African and jewish Merchants who were present, at that time when Sultan Selim the first of that name, besieged Cairo in Egypt (which in former times was called 〈◊〉) that there, Mighty troop of Camels. was then in that Emperor's army sixty thousand Camels, besides a mighty company of Mules. That Birds have taught us musical tunes. THe Nightingales are sweet and excellent singers, tuning rheir notes with infinite To sing like a Nightingale quavering, and diversities of sounds, so prettily and sweetly, that humane industry can scarce equal the sweetness thereof, by so many musical instruments; so that we say he sings like a Nightingale, who varies his voice with much variety. In which thing Birds much excel men, because they have that admiral sweetness of singing from nature itself without any labour of learning; which men can scarce attain to in any school of music, by having their ears a thousand times plucked by the hand of a cursed master. That Beasts know one another's voice. Beast's know one another by their voice, so that they may seem to talk and The voice to beasts is of the same use, as speech is to men. to laugh together, whilst flattering with their ears, they pluck in their noses, with a pleasant aspect of their eyes; and as speech is given to men, so Birds have their natural voice which is of the same use to them, as speech is to us. For all birds of the same species, as men of the same country, chant and chirp to one another, when men understand not the speech of other men, unless of the same nation. Wherefore the Scythian tongue is no more profitable to one living in Egypt, than if We are as ill as deaf, when we hear an unknown language. he were dumb; nor the Egyptians understand it no more than if they were deaf: Wherefore an Egyptian is dumb and deaf to a Scythian. This those which travel well understand how many dangers, how many troubles they undergo, because they cannot express their minds, and require things necessary for life. Wherefore to the assistance of this unprofitable tongue, we are compelled to call the rest of the members, and to abuse the gestures of the head, eyes, hands, and feet. Truly the condition of brute beasts is not so miserable, seeing that all of the same kind wheresoever they be, may answer each other with a known voice. Truly if any should hear a German, Briton, Spaniard, Englishman, Polonian, and Greek, speaking amongst themselves in their native tongues, not understanding any of them, he could scarce discern, and certainly judge, whether he heard the voice of men or of beasts. That Birds may counterfeit Man's voice. LInets, Larks, Pies, Rooks, Dawes, Crows, Stairs, and other such like Birds, speak, sing, whistle, and imitate the voices of men, and other creatures. In this Parrots are wonderful imitaters of man's voice. Parrots excel all other, being wondrous skilful imitaters of men's voices, and very merry, but specially when they have drunk a little wine. Plutarch reports that there was a Barber at Rome, who kept a Pie in his shop, which spoke exceeding well, and that of her own accord, none teaching her, when A talking Pie. she first heard men talking together; she imitated the voice or cry of all beasts she heard, as also the sound of Drums, and the noise of Pipes, and Trumpets; to conclude, there was nothing which she did not endeavour to imitate. There have been Crows that have spoken and articulately sung songs, and Psalms, and that of some length. To which purpose the History of Macrobius is notable; for he tells that Lib. 2. Saturn. cap. 4. there was one amongst those, who went forth for luck sake to meet with Augustus Caesar, returning from the war against Antonius, who carried a Crow, which he had taught plainly to pronounce this salvation; Salve Caesar Imperator augustissime, that is, God save thee, O most sacred Emperor Caesar. Caesar taken with the novelty of this spectacle, bought this obsequious Bird with a thousand pieces of silver. Pliny and Valerius have reckoned up amongst prodigies, Oxen and Asses that have spoken. I omit infinite. other things recorded by the ancients, Plato, Aristotle Pliny, Plutarch, and other Philosophers of great credit, of the docility of beasts, and their admirable felicity of understanding. Which things, if untrue, these learned men would never have recorded in writing, lest so they might brand with vanity, (than which nothing is more base,) the rest of their writings to posterity in all ensuing ages. Of the Sympathy and Antipathy of Living creatures amongst themselves. HAving briefly described the understanding of brute beasts, it seems not impertinent to set down some things more worthy of knowledge, happening unto them by reason of Sympathy and antipathy; that is, mutual agreement and disagreement, which happens not only to them living, but also dead, by a certain secret and hidden property, through occasion whereof some desire, other shun, and others prosecute one another even to death. In testimony whereof; The Lion fears a cock, The Lion the king of beasts excelling all other in courage and magnanimity, fears the Cock, for he is not only terrified by his presence, but also by his crowing being absent. So an Elephant fears a Hog; but he is so afraid of Mice and Rats, that he will not touch the meat that is given him, if he smell that it hath been defiled with such creatures. There is deadly hatred between the Elephant and Rhinocerot; yet when the Elephant is furious and angry, he becomes quiet and calm at the sight of a Ram. A horse is so afraid of a Camel, that he cannot endure A horse fears a Camel his sight. The Dog hates the Wolf, the Hart flies the Dog. The Snake flies from and fears a naked man, and follows him being clothed. There is deadly hatred between the Aspis and Ichneumon, for he when he hath rolled himself in the clay, dries himself in the Sun, and so being covered over (by doing thus divers times) as it were with shells, or armour, he enters into Combat, stretching out his tail and presenting his back, until he get opportunity to choke his adversary, by leaping and fastening on her jaws, by which stratagem he also kills the Crocodile. The green Lizard is a capital enemy to the Serpent, but most friendly to man, as Erasmus witnesseth by many histories concerning that matter, in his dialogue of Sympathy and Antipathy. There is a great deal of hatred between a man and a Wolf, which is most manifest by this, that if the Wolves first see a man, his voice is taken away, and his intended cry hindered. If the Weasel intent to set upon the Aspis that most venomous Serpent, she arms herself by eating Rue, as a most certain Antidote. The Ape fears the Torpedo, as Erasmus manifests by a pleasant history in the fore mentioned Dialogue; where also he prettily shows the deadly Water foul fear the Falcon. hatred between the Serpent called Areus and the Toad. The like hate is between the Owl and Crows, so that the Owl dares not go out, fly abroad, or seek her food unless by night. The water or River fowl are afraid of the Falcon; that if they but hear her bells, they had rather be killed with staves and stones, than take wing to fly into the air. So the Lark yields herself to be taken by a man, lest she fall into the talents of the Hobby. The Castrill, or Merlin is naturally a terror to Hawks, so that they both shun his voice and presence. The Kites are all at perpetual enmity with the Crows, wherefore the Crow always The enmity between the Kites and Crows. gets away the Kites provision. All kind of Pullen fear the Fox. The Chicken fears neither a Horse, nor an Elephant, but scarce hatched, it presently runs away at the voice or sight of a Kite, and hides itself under the hen's wings. The Lamb and Kid fly from the Wolf when they first see him, nether doth The discord between the Lamb and Wolf is not ended by deal. death give an end to that hatred, but it supervives their funeral. An Experiment whereof (they say) is, that if one drum be headed with Wolves skins and another with Sheep's, and beaten up together, you shall scarce hear the sound of the Drum covered with sheep's skins. And besides, if you string one Harp with strings made of sheep's guts, and another with strings of Wolves guts, you cannot bring it to pass, by any Art, to make them agree and go in one tune. It is reported from the experiments of many men, that if a Wolves head be hanged up on high in the place where Sheep are, that they will not touch the grass how good and fresh soever it be, nor rest quiet in any place, but tumultnously run up and down, until all such kind of terror be taken away; The hate betwixt Mice and Weasells appears by this, that if you mix never so little of the How to make these that Mice will not gnaw. brains of a Weasel in the rennet, with which you crudle you Cheese, the Mice will never gnaw or touch that cheese. The Linnet doth so hate the bird Florus, that both their bloods put into one vessel cannot be mixed together. A Wolves head hung up in a dove-house, drives away Poll. Cats and Weasells. The Panther and Hyaena burn with so great hatred, that if both their skins be laid one against the other, the Panthers will shed the hair, the hairs of the Hyaena remaining entire and not moved, which thing, they say, happens to the feathers of other birds if any one chance to tie them up in a bundle with the Eagles. Let these suffice for some few examples of many, of the Antipathy amongst beasts. But of the Sympathy, and consent of beasts amongst themselves, I think needless to write any thing, being it is sufficiently known to all, that one jay associates another, and the cruel Bears agree amongst themselves; and beasts of the same species do wonderfully consent one with another. That Man excels all beasts. I Now think it fit to assay to write of that excellency of man over beasts, which I have so long intended. Neither would I that Epicures and other too much natural and materiate Philosophers, so take those things I have written of the endowments of beasts, as though we should think, there were no difference between man and beast. I had no such meaning, no such intention; but only that man should not become too stately, or too ingrate in less acknowledging God to be the Author of so many benefits with which he abounds. For whatsoever we have largely spoken of beasts, yet there is no comparison between beasts and man, for there is too great a difference between them. For man's mind is adorned with religion, justice, prudence, magnanimity, faith, piety, modesty, clemency, fortitude and other virtues as lights, which shine much more bright in man than in beasts. For they are sometimes all in some one man, each whereof are thought great in beasts. For seeing that man is made to the Image of God, it cannot be, how much soever he Man bears God's image: defile himself with the pollution of vices, that he can so obscure that inbred light, but that always some beam of the divine wisdom will be inherent and shine in him. But although by collation to some beasts, he may seem a defective and weak Creature; yet no fortitude nor strength of beasts can be so great as to equal the fortitude of man. For God hath engraven in man the character of his divine virtue, by the assistance whereof, he might have all beasts under and obedient to him. And though by that we have formerly said, beasts may seem to have a certain shadow of reason, yet that small light is not fit for many and divers uses, but there is only given them so much providence, as should be sufficient for them and the preservation of their bodies. But men have reason given them to crop or gather the fruits of eternal life, (as Lactantius saith) whereby it comes to pass, that man only, amongst so many creatures, hath sense and understanding of divine things. Which Cicero thought to be known by that, because man only had a certain knowledge of God in his mind. Wherefore he was enriched by God with reason, speech and hands as helps for the performance of all his actions; moreover by his singular and almost divine wit he easily excels all brute beasts. For first, reason being his guide, he invented Man hath given names to things. things necessary for life, firly imposed names on the things invented befitting their natures, framed letters and Characters, invented all liberal Art and handicrafts, and found means to measure the Land and Sea. He hath observed and drawn into an Art the spaces of the Celestial Globe, the distinctions of the Stars, the changes and orders of days and nights, of times and seasons, the risings and settings of Stars, and their power and effects over these lower bodies. Lastly, he records in writing to perpetual memory that which concerns his own nature, or the nature of other things, the precepts and ordinances of life and manners, by which singular gift, we can now confer with Socrates, Plato, Aristotle, and other Philosophers of ancient times, as if they were living. What benefit man hath by reason of his native nakedness and ignorance. But as Man's body is by nature naked and unarmed, so is his mind like a smooth Gal. cap. 4. lib. 1. de usu part●um. table in which nothing is painted, nothing graven; but for help of his nakedness he hath hands, and for supply of his ignorance, reason and speech. And by these three being as it were the ministers of infinite variety of things, he clothes and defends his body with all things needful: & inriches his mind with the knowledge of Arts & sciences. Now if he had certain weapons borne with him, he should use them only; if he should be borne skilful in any Art, he would meddle with none else. Therefore because it was more expedient to use all sorts of weapons with the hand, and be skilful in all Arts; therefore he must be borne wanting and ignorant of all. Aristotle very wittily As the hand is the instrument of instruments so Reason is the Art of Arts. called the hand the instrument of instruments: in imitation of which speech, one may rightly affirm, That Reason is the Art of Arts: for as the hand in worth exceeds the other instruments, because it can make, handle and fit them for use; so reason and speech, though names of no Art, yet comprehend and increase all Arts. Therefore man seeing he hath his mind instructed by Art, that is, by reason; it is fit he should have his body defended with a weapon, or instrument, that is, the hand, which in agility and excellency should excel all other instruments. For so Man hath his hands in stead of all weapons, which he may use in war and peace as the instruments of all Arts; he wants not the Bulls horns, the Boars tusks, the horses hoves, nor to conclude, any arms of any other beast. For by the benefit of his hands he can handle other arms far more profitable and safe, as a Lance, Sword, Spear, halberd; but man also can use at some distance the bow, sling and handgun, when the horn and the hose cannot be used but near at hand. But some may say; A Lion exceeds a man in swiftness of foot; what then? is man therefore inferior to him? no for by the means of his hands and the guidance of his reason he bridling and riding upon a horse, out runs the Lion, and being victor follows him to and again as he himself pleases, or vanquished flies away, and from the horses back as from a tower wounds the Lion with what weapons he pleases. To conclude, man is abundantly provided with means, to defend himself from the violence of all other beasts. For this purpose he doth not only harness himself as with brazen walls, but also makes ditches and Bulwarks; he makes by the ministry of his hands all kind of weapons, weaves himself graments, casts into the water and draws forth nets to catch fish; and to conclude, he performs all things to his own contentment, and having that privilege granted him by God, Man under God is the king and Emperor of the world. he rules over all the earth; all things which lie hid in the bowels of the earth, which go, or creep upon the earth, which swim in the sea, and fly through the air, or are any where shut up in the compass of the sky, are in man's dominion. How wonderful God hath showed himself in making man. GOds Deity and providence hath principally showed itself in the creation of man; Men is the end of all mundans things. neither his so admired light hath so shone in the production of other creatures, seeing that God would have them to live and have their being, only for man's sake, that they might serve him. Therefore man is, if we diligently consider all his endowments, a certain pattern and rule of the divine majesty & (if If I may so say) Artifice. For being made to God's image, he is as it were his coin, exceeding the capacity of all Man a little world, yea almost a great world. humane understanding. Which seemed a just reason to the ancient Philosophers, that he should be called Microcosmos, or a little world, because the particles of all things contained in the compass of heaven and earth, are contained in his mind and body, that in the mean time I may in silence pass over his soul more great and noble than the whole world. Why Nature hath not given Man the faculty of presaging. THis seems the reason, that men by the instinct of nature do not foresee the future seasons and dispositions of the heaven and air; because, seeing they have Man is not obnoxious to the Air and stars. received certain sparks of prudence from God, by whose care and guidance they are led to the knowledge of things by no deceitful but certain judgement, being not obnoxious to the conditions and changes of times and seasons, as beasts are. Wherefore knowing all these airy changes to be placed under them, that is to say their minds, according as occasion serves, and their minds desire, they give themselves to mirth when the Air is wet, stormy and dark, and on the contrary in a clear and fair season to a sincere and grave meditation of things sublime & full of doubt. But beasts accommodating themselves to that disposition of the air which is present & at hand, are lively, or sad, not from any judgement as men, but according to the temper and complexion of their bodies following the inclinations of the air, and of the humours one while diffused, another while contracted. Neither ought we to blame man, because he can imitate the voice of beasts, but rather much commend him, that he can infinitely One man will counterfeit the voices of infinite varieties of beasts. wrest and vary one thing, that is his voice; for men can bark like Foxes and dogs, grunt like hogs; whet and grind their teeth like boars; roar like Lions; bellow like Bulls; neigh like horses; knack their teeth like Apes; howl like Wolves; bray like Asses; bleat like Goats and Sheep; mourn like Bears, Pigeons and Turtles; Keeke and gaggle like geese; hisse like Serpents; cry like Storks, caw like a Crow, and crow like a Cock, clock like Hens; chatter as Swallows and Pies; sing like Nightingales; croak like Frogs; imitate the singing of Wasps and Humming of Bees; Mew like Cats: The singing of Birds scarce seems to merit the name of Musical, compared to the harmony of men fitted and tuned with The power of Music. infinite variety of voices. For with this they possess the ears of Kings and Princes; provoke and temper their wrath, and carry men's minds beyond themselves, and transform them into what habits they please. But if those cruel beasts have any humanity, they owe it all to man. For he tames Lions, Elephants, Bears, Tigers, Leapards, Panthers and such other like. Of the Crocodile. PLutarch reports of the Crocodile (whose figure is here delineated) that being tamed, and taught by man, he doth not only hear man's voice, and answers A ●ame Crocodile. to his call, but suffers himself to be handled, and opening his throat, lets his teeth be scratched and wiped with a towel. How small a part of Physic is that, which beasts are taught by nature? Certainly nothing in comparison of man, who by the study and practise of a few years can learn at his finger's ends all the parts of Physic: and practise them not only for his own, but also for the common good of all men. But why cannot beasts attain unto the knowledge of Physic so well as men? I think, because so great an Art as Physic is, cannot be attained unto by the dull capacities of Beasts. But for that I have written of the Religion of Elephants, if I must speak according to the truth of the matter, we cannot say they worship God, or In what sense we said Elephants had religion. have any sense of the divine Majesty. For how can they have any knowledge of sublime things or of God, seeing they wholly following their food, know not how to meditate on celestial things? Now for that they behold and turn themselves to the Moon by night, and to the Sun in the morning, they do not that as worshipping, or for that they conceive any excellency or divinity in the Sun; but because nature so requiring and leading them, they feel their bodies to rejoice in that light, and their entralls and humours to move and stir them to it. Therefore when we attributed religion to Elephants, we said it rather popularly, than truly, and more that we might exhort men to the worship of God, than that we thought Elephants had any knowledge of divine worship implanted in their minds. That man may attain unto the knowledge of all voices and tongues. THe docility of man's wit is so great, and the facility of the body obeying that divine gift of wit such, that he is not only able to learn to understand and speak the tongues of divers nations differing in so many peculiar languages; and not only to imitate and counterfeit the voices of all beasts though so much different from Man not only the imitater, but the interpreter of the voices of beasts and birds. man, which many flattering and juggling companions, followers of other men's tables, will do; but also may be able to know and understand both what they pretend and signify. In confirmation of which thing they cite the Philosopher Apollonius most famous in this kind of study and knowledge. He walking on a time amongst a company of his friends through the field, and seeing a Sparrow come flying and chirping much to divers other Sparrows sitting upon a tree, is reported, to have said to those which were with him: That bird, which came flying hither, told the other in her language; that an Ass laided with corn was fallen down at the City gate, and had shed the wheat upon the ground. Wherefore Apollonius and all his friends which were with him went thither to see whether it were so, and found that it was so, as he had told them, and observed that the Sparrows moved thereto by the coming of the other, were eating up the grains of Corn shed on the ground. But for Crows and Pies artificially taught to counterfeit men's voices, it is too small a thing, that for that cause they should contend with men. For they have quickly babbled all they have learned with longer cost and labour, tediously singing still the same song, and whatsoever they prate they do it without sense, understanding or any reason for what they say. But man always contemplating somewhat more high, still thinks of greater things than these present, and never rests. But burning with an The unquenchable desire of learning in ●an. infinite and endless desire of knowledge, he doth not only covet to know these things which appertain to food and clothing, but by casting up his eyes towards heaven, and by the light of his mind, he learns and understands things divine. Which is so certain an argument of the celestial original of our soul, that he which considers those things can no ways doubt, but that we have our minds seasoned, by the universal divine understanding. But now it is time for us to set upon the description of the body, the habitation and fit instrument of all the functions of that divine mind. The end of the second Book. THE THIRD BOOK TREATING OF THE Anatomy of Man's body. I Following custom and the manner of such as before me have written of Anatomy, will first, (that I may make the minds of the Readers more attentive and desirous of these studies) declare how necessary it is, and also how profitable, and then show the order to be observed in it, before I come to the particular description of man's body. Furthermore, how Anatomy may be defined, and the manner of the definition of the parts. For the first, the knowledge The necessity of the knowledge of Anatomy. of Anatomy seems in my judgement very necessary to those that desire to excel, or attain to perfection of Physic; that is, whereby they may be able to preserve the present health of the body, and the parts thereof, and drive away diseases. For how can either Physician or Chirurgeon preserve health by the use of the like things, which consists in the temperament, conformation, and natural union of the parts; or expel the disease which hurts those three, by the like use of their contraries, unless he shall know the nature and composure of the body, and understand as by the rule of this knowledge, how much it swerves from the nature thereof? Wherefore it is excellently said of Hypocrates; that Initio lib. de Offic. ●edici, the Physician called to cure the sick Patient, ought diligently to consider, whether those things that are in him, or appear to be in him, be like or unlike, that is, whether the Patient be like himself and his own nature in all his parts and functions, temperature, composure and union; that he may preserve those which are yet contained in the bounds of nature, and restore those that are gone astray. Which thing Galen hath also confirmed, specially where he saith; he must well know the Lib. de cssibus. nature and structure or composure of the bones, who takes upon him to restore them broken or dislocated to themselves and their proper seats or places. Moreover seeing that healing doth not only consist in the knowledge of the disease, but as well in prescribing fit medicines and like application of them to the body and the parts thereof, all which by their natural dissimilitude, do require unlike medicines, according to Galens' opinion: I prithee tell me, who can perform this, which is ignorant 1. de loc. affectis, & lib. 3. M●●h. of the description of the whole and the parts thereof, taught by Anatomy? We may say the like of the Apothecary, who ignorant of the situation of the parts in the body, cannot apply Emplasters, Ointments, Cataplasms, Fomentations, Epithemes, bags to the fit places, as to the sutures of the skull, to the Heart, Liver, Stomach, Spleen, reins, Womb or Bladder. For example, let us imagine the Liver to be troubled with a hot distemperature, but on the contrary the stomach with a cold (which commonly happens, seeing the Liver hotter than it ought to be, Why when the liver is hot, the stomach is commonly cold. sends up many vapours to the head; from whence cold humours fall into the stomach) if hot things to be applied to the stomach by the Physicians prescription, be by the Apothecary making no difference, applied both to the stomach and neighbouring Liver (which may chance if he be ignorant that the stomach bends somewhat to the left side under the breast-blade; but the liver so takes up the right side of the body that with a great parr thereof, it covers almost all the stomach) will not he much offend by increasing the hot distemper of the liver, and not thereby giving case, or help to the disease? Shall not by this his ignorance, the Patient be frustrated of his desire, the Physician of his intent, and the medicine of its effect? By these examples I think it most manifest, that the anatomical knowledge of the parts of the body is exceeding necessary to all Physicians, Surgeons, and Apothecaries, who will practise Physic with any praise to the glory of God, and the benefit and good of man, for whose sake we have writ these things, and illustrated them by figures, subjecting the parts to the eye, and fitly put them in their proper places, But Anatomy is commodious four manner of ways; the first is, because thus The knowledge of Anatomy, is commodious four manner of ways. we are led to the knowledge of God the Creator, as by the effect to the cause; for as we read in Saint Paul, The invisible things of God are made manifest by the visible. The second is, That by means hereof we know the nature of man's body, and the parts thereof, whereby we may more easily and certainly judge and determine of sickness and health. The third is, that by the knowledge of the body and its parts, and together therewith its affections and diseases, we may prognosticate what is to come, and foretell the events of diseases. Lastly, the fourth is, that considering the nature of the diseased part, we may fitly prescribe medicines, and apply them in their due places. Now we must declare in what order Anatomy may be fitly delivered; but first we must observe there is a threefold Method; The first is called of Composition, being There is a threefold method. very commodious for the teaching of Arts, which Aristotle hath used in his Works of Logic, and natural Philosophy, the order and beginning taken from the least and most simple to the more compound. The second of Division, fit for the inventing or finding out of sciences. Galen hath followed this order in his Books of anatomical Administrations, and of the use of the parts. The third of Definition, which showeth the nature and essence of things, as appears by Galen in his Book De Arte parva. And because this order doth also prosecute the divisions, therefore it is commonly accustomed to be comprehended in the compass of the second. Therefore I will follow this in my anatomical Treatise, deviding man's body into The Author's intent. its parts, which I will not only subject to the eye in the way of knowing them, but also to the mind in the faithful understanding them. For I will adjoin those things that are delivered of them by Galen in his Book of Anatom. Administrations, with those which he hath taught in his Books of the use of the parts. For there he fitly lays the parts of man's body before our eyes, to the sense. But here he teaches to know them, not to see them; for he shows why, and for what use they are made. Having briefly handled these things, we must declare what Anatomy is; that as Cicero saith out of Plat●es Phaedro, it may be understood of what we dispute. And because we attain that by definition (which is a short and plain speech, consisting of the Genus and difference of the things defined, being the essential parts, by which the nature and essence of the thing, is briefly and plainly explained) first we define Anatomy, then presently explain the particular parts of the definition. Wherefore Anatomy, (if you have regard to the name) is a perfect and absolute division, or artificial resolution of man's body into its parts, as well general as particular, What Anatomy is. as well compound as simple. Neither may this definition seem illegitimate, specially amongst Physicians and Surgeons. For seeing they are Artisans humiliated to the senfe, they may use the proper and common qualities of things for their essential differences and forms. As on the contrary, Philosophers may refuse all definitions How a definition differs from a description. as spurious, which consist not of the next Genus and the most proper, and essential differences. But seeing that, through the imbecility of our understanding, such differences are unknown to us, in their places we are compelled in defining things, to draw into one many common and proper accidents, to finish that definition which we intent, which for that cause we may more truly call a description, because for the matter and essential form of the thing, it presents us only the matter adorned with certain accidents. This appears by the former definition, in which Division and Resolution stand for the Genus, because they may be parted into divers others, as it were into species. That which is added over and besides, stands in place of the difference, because they separate and make different the thing itself from all other rash and unartificial dissections. We must know an artificial division, is no other than a separation of one part from another, without the hurt of the other, observing the proper circumscription of each of them; which if they perish or be defaced by the division, it cannot be said to be artificial; and thus much may suffice for the parts of the definition in general. For as much as belongs to the explication of each word; we said of Man's body, because, as much as lies in us, we take care of, preserve the health, and depel the disease's thereof, by which it may appear that man's body is the subject of Physic, The Subject of Physic. not as it is man's, or consists of matter and form, but as it is partaker of health and sickness. We understand nothing else by a part, according to Galen, than some certain Gal lib. 1. de. usu pars. lib. 1. Meth. body, which is not wholly disjoined, nor wholly united with other bodies of their kinds; but so that, according to his opinion, the whole being composed therewith, with which in some sort it is united, and in some kind separated from the same, by their proper circumscription. Furthermore by the parts in general, I understand the head, breast, belly, and their adjuncts. By the particular parts of those, I understand, The simular parts are 9 the simple parts, as the similar, which are nine in number, as a gristle, bone, ligament, membrane, tendon, nerve, vein, artery, musculous flesh; some add fibers, fat, marrow, the nails and hairs; other omit them as excrements; but we must note that such parts are called simple, rather in the judgement of the sense, than of reason. For if any will more diligently consider the nature, they shall find none absolutely simple, because they are nourished, have life and sense, either manifest or obscure, which happens not without a nerve, vein, and artery. But if any shall object, that no nerve is communicated to any bone, except the teeth; How the bones come to feel. I will answer, that nevertheless the bones have sense by the nervous fibers, which are communicated to them by the Periosteum, as by whose mediation the Periosteum is connext to the bones, as we see it happens to these membranes, which involve the bowels. And the bones, by this benefit of the animal sense expel the noxious and excrementitious humours from themselves into the spaces between them and the Periosteum, which as endued with a more quick sense, admonisheth us, according to its office and duty, of that danger which is ready to seize upon the bones, unless it be prevented. Wherefore we will conclude according to the truth of the thing, that there is no part in our body simple, but only some are so named and thought, according to the sense; although also otherwise some may be truly named simple, as according to the peculiar and proper flesh of each of their kinds. Those parts are called The compound, or organical parts. compound which are made or composed by the mediation, or immediately of these simple, which they term otherwise organical or instrumental; as an arm, leg, hand, foot, and others of this kind. And here we must observe, that the parts are called simple and similar, because they cannot be divided into any particles but of the same kind; but the compound are called dissimular from the quite contrary reason. They are called instrumental and organical, because they can perform such actions of themselves, as serves for the preservation of themselves and the whole; as the eye of itself, without the assistance of any other part, seeth, and by this faculty defends the whole body, as also itself. Wherefore it is called an instrument or organ, but not any particle o● it, as the coats, which cannot of itself perform that act. Whereby we must understand, Four particles to be observed in ●a●● organical pa●●. that in each instrumental part we must diligently observe four proper parts. One by which the action is properly performed, as the Crystalline humour in the eye; another without which the action cannot be performed, as the nerve & the other humours of the eye. The third, whereby the action is better and more conveniently done, as the tunicles and muscles. The fourth, by which the action is preserved, as the eyelids and circle of the eye. The same may be said of the hand, which is the proper instrument of holding, for it performs this action; first by the muscle, as the principal part; Secondly, by the ligament, as a part without which such action cannot be performed. Thirdly by the bones and nails, because by the benefit of these parts, the action is more happily performed. Fourthly by the veins, arteries and skin, for that by their benefit and use, the rest, and so consequently the action itself is preserved. But we must consider, that the instrumental parts have a fourfold order. They Four sorts of instrumental parts. as said to be of the first order, which are first and immediately composed of the simple, are only the authors of some one action, of which kind are the muscles and vessels. They are of the second which consist of these first simple, and others besides, as the fingers. They are counted of the third rank, which are composed of parts of the second order and some besides, as the hand taken in general. The fourth order is the most composed, as the whole body, the organ and instrument of the soul. But you must observe, that when we say the muscles and vessels are simple parts, we refer you to the sense and sight, and to the understanding, comparatively to the parts which are more compound; but if any consider their essence and constitution, he shall understand they are truly compound, as we said before. Now it remains, that we understand, that in each part, whether simple or compound, nine things are to be considered, as substance, quantity or magnitude, figure, composition, number, connexion, (by which name, we also understand the orginal and insertion) temperature, Nine things to be considered in each part. action, and use; that by the consideration of these things, every one may exercise the art of Physic, in preserving health, curing diseases, or foreseeing their events and ends. But also we must note, that of the organical parts, there be three, by whose power the body is governed; which for that cause they call regent and principal; Why the three principal parts are so called. because they govern all the rest; they are the liver, heart, and brain. But they are called principal, not only because they are necessary for life (for the stomach, windpipe, lungs, reins, bladder, and such like parts perhaps are equally as necessary for life) but because from each of these three, some force, power, and faculty, or also matter necessary for the whole body, flow over all the body, when no such thing proceeds from the rest of the parts. For from the liver a matter fit for nourishment, is distributed by the veins through all the body; from the heart the vital force diffused by the arteries, imparts life to the whole body; from the brain by the nerves a power or faculty is carried through all the parts of the body, which gives them sense and motion. Galen would have the Testicles to be of this kind, not for the necessity of the individual, 〈◊〉 de Art● medica. or peculiar body, but for the preservation of the Species or kind. And moreover in his book de Semine comparing the Testicles with the heart, he makes them the more noble by this reason, that by how much it is better to live well and happily, than simply and absolutely to live, by so much the testicles are more excellent than the heart, because with them we may live well and pleasantly, but with this simply live, as we see by the example of eunuchs, and such as are gelt, by which the Testicles seem rightly to be accounted amongst the principal parts; for nature seeing it desired, that this its work should be immortal, for the attaining of that immortality which it intends, frames those parts, like as prudent founders of a City, who do not only procure to furnish their city with many inhabitants, so long as they are in building it, but also that it may remain in the same state and condition for ever, or at least for many ages. And yet notwithstanding of so many cities built in the first memory of man, there remains none, whose fame and state, together with the bvilder's The use and function of the parts serving for generation. name is not decayed and perished. But this humane work of nature, stands yet secure for this many thousand of years, and shall endure hereafter, because it hath found a way, by which every one may substitute another in his place before he depart. Hence it is that all creatures have members fit for generation, and pleasures inserted in those members, by which they might be enticed to mutual embraces and copulations. But the mind, which hath dominion over those members, hath an incredible desire of propagating the issue, by which also brute beasts, incited, desire to propagate their kinds for ever. For seeing that nature understands all these her works considered particularly by themselves, are frail and mortal, it hath done what it could to recompense that fatal necessity of dying, by a perpetual succession of individuals. Hitherto we may seem to have abundantly showed what necessity of knowledge in Anatomy belongs to all Artisans in Physic, and also what order is to be observed in the same. And lastly, how it is defined, and the reason of the parts of the definition. Wherefore it remains that we prosecute what we have taken in hand; which is, that we show and declare how to know all and every the parts of man's body, how many, and what they be, and to understand wherefore they be. For although the true knowledge of Anatomy may be perfected by the sight of the eye, and touching and handling each part with the hand, yet nevertheless the labour of describing Anatomy is not unprofitable. For by reading, such as have often exercised themselves in the dissecting of men's bodies may refresh and help their memories, and such as have not, may make plain and easy the way to the understanding of dissections. CHAP. I. The Division or partition of Man's body. BY reason the partition of man's body can hardly be understood, if the distinction of the proper faculties of the soul be not understood, for whose cause the body enjoys that form (which we see) and division into divers instruments; Therefore I thought good in few words to touch that distinction of the faculties of the soul, for the better understanding of the partition of the body which we intent. Wherefore the soul, the perfection of the body, and What the soul● is, and with how many faculties it is endued. beginning of all its functions, is commonly distinguished and that in the first and general division, into three faculties, which are the Animal, vital, and natural. But the Animal is divided into the principal, sensitive, and motive; Again, the principal is distinguished into the imaginative, reasonable, and memorative. And the sensitive into Seeing, Hearing, Smelling, Tasting, and Touching. But the motive into progressive and apprehensive. And the vital is divided into the dilative, and contractive faculty of the heart and arteries, which we know or understand by the pulsificke faculty. But the natural is parted into the nutritive, auctive, and generative faculties; which three perform their parts by the help and ministry of five other faculties, which are, the Attractive, Retentive, Concoctive, Assimulative, and Expulsive. After the self same manner, the organ or instrument of the soul, to wit, Man's body, All the parts of man's body are distinguished into three. at the first division is distinguished into three parts, which from their office they call Animal, vital, and natural. These again, according to the subdivision of the subalternal faculties, are divided particularly into other parts; so that any one may know the organ of each faculty, by the property of the function. For while other Anatomists divide man's body into four universal and chief parts, they distinguish from the three first, those which they call the Extremities; neither do they teach to what rank of the three prime parts each extremity should be reduced. From whence many difficulties happen in reading the writings of Anatomists; for shunning whereof, we will prosecute, as we have said, that distinction of man's body, which we have touched before. Wherefore, as we said before, man's body is divided into three principal and What parts are here called Animal. general parts, Animal, Vital, and Natural. By the Animal parts; we understand not only the parts pertaining to the head, which are bounded with the crown of the head, the coller-bones, and the first Vertebra of the breast, but also the extremities, because they are organs and instruments of the motive faculty; 〈…〉 seems to have confirmed the same, where he writes; Those who have a thick and Lib. 6. Epidem. great head, have also great bones, nerves, and limbs. And in another place: h●●●aith, those who have great heads, and when they stoop show a long neck, such have all their parts large, but chiefly the animal. Not for that Hypocrates would therefore have the head the beginning and cause of the magnitude and greatness of the bones, and the rest of the members; but that he might show the equality, and private-●are or government of nature, being most just and exact in the fabric of man's body, as if she hath well framed the head, it should not be unlike, that she idly or carele●…y neglected the other parts which are less seen. I thought good to dilate this passage, lest any might abuse that authority of Hypocrates, and gather from thence, that not only the bones, membranes, ligaments, gristles, and all the other animal parts, but also the veins and arteries depend on the head as the original. But if any observe this our distinction of the parts of the body, he will understand we have a far other meaning. By the vital parts, we understand only the heart, arteries, lungs, windpipe, and What parts are called vital. other particles annexed to these. But by the natural, we would have all those parts understood which are contained in the whole compass of the Peritonaeum or Rim of the body, and the processes of the Erythroides, the second coat of the Testicles. For as much as belongs to all the other parts, which we call containing; they must be reckoned in the number of the animal, which notwithstanding, we must thus divide into principal, sensitive, and motive; and again, each of these in the manner following. For first the principal is divided into the imaginative, which is the first and upper part of the brain, with its two ventricles and other annexed particles; into the The division of the animal parts. reasoning, which is a part of the brain, lying under the former, and as it were the top thereof with its third ventricle. Into the memorative, which is the cerebell●… or afterbraine, with a ventricle hollowed in its substance. Secondly, the sensitive is parted into the visive, which is in the eyes; the auditive, in the ears; the smelling▪ in the nose; the tasting, in the tongue and palate; the tactive, or touching which is in the body, but most exquisite in the skin which invests the palms of the hands. Thirdly, the motive, is divided into the progressive, which intimates the legs, and the comprehensive, which intimates the hands. Lastly, into simply motive, which are three parts, called bellies, for the greatest part terminating and containing; for the vital, the instrument of the faculty of the heart, and dilatation of the arteries, are the direct or straight fibers, but of the constrictive the transverse; but the three kinds of fibers The division of the vital parts. together, of the pulsificke; or if you please you may divide them into parts serving for respiration, as are the lungs, and weazon, and parts serving for vital motion, as are the heart and arteries, furnished with these fibers, which we formerly mentioned. The division of the natural parts remains, which is into the nourishing, auctive and generative, which again are distributed into attractive, universal, and particular; The division of the natural parts. retentive, concoctive, distributive, assimulative, & expulsive. The attractive, as the gullet and upper orifice of the ventricule; the retentive, as the Pylorus or lower passage of the stomach; the concoctive, as the body of the ventricle, or its inner coat; the distributive, as the three small guts; the expulsive, as the three great guts; we may say the same of the liver, for that draws by the mesaraicke and gate veins, retains by the narrow orifices of the veins dispersed through the substance thereof; it concocts by its proper flesh; distributes by the hollow vein, expels by the spleen, bladder of the gall and kidneys. We also see the parts in the testicles divided into as many functions; for they draw by the preparing vessels; retain by the varieous crooked passages; in the same vessels they concoct the seed by the power of their proper substance and faculty; they distribute by the ejaculatory, at the glandules called Prostata, and the horns of the womb, supplying the place of prostates; Lastly, they expel or cast forth by the prostates, horns, and adjoining parts. For as much as belongs to the particular attraction, retention, concoction, distribution, assimulation of each part, that depends of the particular temper, and as they term it, occulte property of each similar and simple part. Neither do these particular actions differ from the universal, but that the general are performed by the assistance of the three sorts of fibers, but the special by the several occult property of their flesh, arising from their temperature, which we may call a specific property. Now in the composition of man's body, nature principally aims at three things. The first is, to create parts necessary for life, as are the heart, brain, and liver. The second, to bring forth other for the better and more commodious living, as the eyes, nose, ears, arms and hands. The third is, for the propagation and renewing the species or kind, as the privy parts, testicles, and womb. And this is my opinion, of the true distinction of man's body, furnished with so many parts, for the performance of so many faculties; which you, if you please, may approve of and follow. If not, you may follow the common and vulgar, which is, into three bellies, or capacities, the upper, middle, lower (that is, the head, breast and lower belly) and the limbs or joints. The vulgar division of man's body. In which by the head we do not understand all the Animal parts, but only those which are from the crown of the head to the first vertebra of the neck, or to the first of the back, if according to the opinion of Galen Lib. de ossibus, where he makes mention of Enarthrosis and Arthrodia, we reckon the neck amongst the parts of the head. By the breast, whatsoever is contained from the collar bones to the ends of the true and bastard, or short ribs, and the midriff. By the lower belly, the rest of the trunk of the body, from the ends of the ribs to the sharebones; by the limbs, we understand the arms and legs. We will follow this division in this our anatomical discourse, because we cannot follow the former in dissecting the parts of man's body, by reason the animal parts are mutually mixed with the vital and natural, and first of the lower belly. Nature would not have this lower belly bony, because the ventricle might be Why the belly is not bony. more easily dilated by meat and drink, children might grow the better, and the body be more flexible. It is convenient we begin our anatomical administration from this, because it is more subject to putrefaction than the rest, both by reason of its cold and moist temperature, as also by reason of the feculent excrements therein contained. Yet before we go any further, if the anatomical administration must be performed in public, the body bring first handsomely placed, and all the instruments necessary for dissection made ready, the belly must be divided into its parts, of which some contain, and othersome are contained. They are called containing, which make all that capacity which is terminated by the Peritonaeum or Rim of the belly. The upper part whereof is bounded by Galen The division of the lower belly. within the compass of the direct muscles, and by a general name is called Epigastrium, or the upper part of the lower belly. That again is divided into three parts, that is, into that which is above the navel, and which carries the name of the whole, into that which is about the navel, and is called the umbilical or middle part; and lastly, into that which is below the navel, called the Hypogastrium, or the lower part of the lower belly. In every of which three parts there be two lateral, or side parts to be considered, as in the Epigastrium, the right and left Hypochondria, which are bounded above and The Hypochondria. below, in the compass of the midriff, and the short ribs. In the umbilical the two Lumbares (some call them Latera sides) which on both sides from the lowest parts of the breast, are drawn to the flanks, or hanch-bones; in the Hypogastrium, the two Ilia, or flanks, bounded with the haunch and sharebones. Neither am I ignorant, the Ilia or flanks, which the greeks call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signify all the empty parts, from the ends of the ribs, even to the hanch-bones, whereupon they also call them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as if you should say, empty spaces, because they are not encompassed with any bone. Yet I thought good that this doctrine of deviding the belly should be more distinct, to call the parts which are on each side the navel Lumbares, and those on the lower part of the lower belly Ilia, flanks. But we must observe that the Ancients have been so diligent in deciphering the containing parts, that as exactly as might be, they designed the bowels contained in the belly, which being divers lie in sundry places; for the greater portion of the liver lies under the right Hypochondrium; under the left almost all the ventricle and spleen. Under the Epigastrium the lower orifice of the ventricle, and the smaller portion of the liver; In the Lumbares, or fides, in the right and upper part the right kidney, in the lower part towards the flank, the blind gut; in the middle part thereof the colic and empty guts. In the upper part of the left side lies the left kidney, in the middle part, the rest of the empty and colic guts. Under the region of the navel, lies the girdle or upper part of the kall, the colic gut thrusting itself also through that way. Under the Ilia or flanks, the right and left, lie the greater part of the gut Ileon, the horns of the womb in women big with child, and the spermaticke vessels in men and women. Under the Hypogastrium in the lower part lies the right, or strait gut, the bladder, womb, and the rest of the kall. If we know, and well understand these things, we shall more easily discern the A most certain note of the part affected, by the place where the pain is. parts affect by the place of the pain, and cure it by fit application of remedies, without the hurting of any part. The distinction of such places, and the parts in those places, as seeming most profitable, I have thought good to illustrate by the placing these two following figures, in which thou hast deciphered, not only the forefaid parts, containing, and contained, but also of the whole body, and many other things which may seem to conduce to the knowledge of the mentioned parts. The Figures are these. The Figure showing the foreparts of the body. A The hairy Scalp, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. b the forehead called Frons. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. c the temples called tempora, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. From b to d The compass of the face. e The greater or inward corner of the eyes, called Canthus internus. f The lesser or external angle of the eye, called Canthus externus, * The lower eyebrow which is immovable, Palpebra. g The cheek-ball called mala, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. h The chek-puf called bucca, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. i The ridge of the nose called Nasus externus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. k The nostrils called nares, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. l The outward care; auris externa. m The mouth made of the two lips, Os. n The chin called mentum, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. o The neck, collum 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. From o. to e. the pillar of the neck, truneus, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. pp The hollow of the neck, called iuguli, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. qq The patel bones, claves 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. r The chest pectus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. s The right breast. ss The left breast: to this Region we apply cordial Epithemations moist and dry. tt The nipples of the breasts, Papillae 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. u The trench of the heart which the Ancients called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The Latins scrobiculus Cordis. This part is anointed for the mouth of the stomach. From u to E, the lower belly, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. χ. The Epigastirum or upper part. of the lower belly. yy. The Hypocondria or Praecordia. * The outward Liver-remedies are applied to this place. Z. The region of the navel, c●llep umbilicalis, or the middle part of the lower belly. A. The navel umbilicus. The root of the belly 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. BB. The side, Latera, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. and in our Author, Lumbi seu Lumbaris regio. C. Hypogastrium, the watercourse, Aqualiculus, the lower part of the lower beelley, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. DD. The flanks called Ilia and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. E. The Groin called pubes or pecten, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. FF. The Leske called inguen, where those tumours are called Bubones. G. the yard with the foreskin, penis cumpraeputi●. H. the stones or testicles, with the cod or scrotum. II. the shoulders humeri, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. KK. the arms Brachia, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. L. the bout of the arm, called Gibber, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. M. the out side of the lower part of the arm called cubitus 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. N. the wrest called Brachial● 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. O. the afterwrest postbrachiale, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. P. the Palm called Palma or volo manus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Q the back of the hand Dorsum manus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. QQ. the fore ann middle part of the thigh, where we apply cuppingglasses to bring down women's courses, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. RR. the knee, genus 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. SS. the leg, Tibia 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. TT. the calf of the leg sura, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. W. the instep, tarsus, XX. the top of the foot Dorsum pedis, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. YY. the inner Ankles, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ZZ. the outward ankles. 〈◊〉 the toes of the feet, 〈◊〉 the place under the inward ankle, wher● the vein called Saphe●● is opened. The Figure of the back parts of a man. A The forepart of the head, synciput, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. B. the top or crown of the head vertex, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. C. the hinderpart of the head, occiput, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. From D. to D. the face, Fancies. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. * E. the eyebrows supercilia, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. F. the upper eyelid, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. * The tip of the nose called globulus nasi. H. the back part of the neck, called cervix, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. and the nuke or nape of the neck. There is a hollowness at the top of this cervix, where we apply seaton's. I. the back part of the shoulder top, called axilla, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. KK. the shoulder blades scapulae, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 1, 2, 3. On this place we set cupping glasses. 4, 5, 6, 7. the back dorsum, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 8, 9 the ridge, spina dorsi, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. L the arm hole, ala, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. * the elbow, Gibber brachij. M M M M. the sides, Latera. N N the loins Lumbi, or the region of the kidneys, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. O O. the place of the hips, coxendices, where we apply remedies for the Sciatica. P. the place of the holybone, or Os sacrum where we apply remedies in the diseases of the right gut. Q. the place of the Rump or Coccyx. RR. the buttocks Nates, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. SS. the back parts of the thigh, Femen. TT. the ham, Poples, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. W. the calf of the leg, sura. XX. the foot or paru●s pes, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. YY. the utter ankle, Malleolus externus. ZZ. the heel, calx or calca●eus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. aa the sole of the foot Planta pedis, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. b the inside of the lower part of the arm called Vlna, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. c. the outside of the same, Cubitus 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. dd the wrest, Carpus ee the back part of the hand, dorsum manus. g. the forefinger index 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. h, the thumb, pollex, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. i. the middle finger, medius, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. k the rig-finger Annularis, medicus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. l. the little finger, Auricularis, minimus, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. CHAP. II. Of the containing parts of the Epigastrium, and the preparation to anatomical administration. THe containing parts of the Epigastrium are the Epidermis or thin outward The containing parts of the lower belly. skin, the true skin, the fleshy or fatty Pannicle, the eight muscles of the Epigastrium with their common coat, the Rim of the belly, the five vertebrae of the loins, all the holybone, the hanch-bone, share-bone, the white line, and midriff. Of these parts some are common to the whole body, as the three first; the other proper to the parts contained in the Epigastrium taken in general. Which that you may see in their order, first you must cut round about the navel, to the upper superficies of the muscles, that so we may keep it, till such time, as occasion shall offer itself, to show the umbilical vessels lying in that place, which are one vein, two arteries, & the urachus (if it be there.) Which being done, you must draw a strait line from the chest, over the breast-blade, even to the share-bone, which may divide the common containing parts, even to the white line. Then presently it will be convenient to draw two other lines across, or overtwhart, of the like depth on each hand, from the circumference of the navel, even to the sides, that so on each part we may draw the skin more commodiously from the parts lying under it; the sight of which otherwise it would hinder. These things being done, the skin must be divided from the parts lying under it from the designed circumference left about the navel. We must teach how the skin is twofold, the true and false, and render a reason of the name, which we will every where do, as far as the thing will suffer, and it shall lie in our power. And in doing or examining these things, it will be convenient diligently to inquire into the nine things mentioned in the preface. We will begin with the skin, because that part is first obvious to our senses. CHAP. III. Of the utmost skin or Cuticle. THe skin being the first part, and spread over all the body, is twofold, that The skin twofold. From what parts the skin cannot be separated. is, the true, and bastard skin. The true is called by the greeks Derma, which may almost every where be pulled from the parts lying under it, which it invests; except in the face, ears, the palms of the hands, soles of the feet, fingers, and privities, where it sticks so close that it cannot be separated. The bastard (which first of all we will declare, because it first presents itself to our sight) is by the greeks called Epidermis; because it covers the true skin, they term it commonly the Cuticle. The substance of it is excrementitious, and as it The matter of the Cuticle. were a certain dry flowering, or production of the true skin. That it draws not its substance from the seed is apparent by this, that as it is easily lost, so it is easily repaired, which happens not in parts truly spermaticall. This utmost thin skin, or cuticle, may two manner of ways be made apparent by itself, and separated from the other, as by burning with fire, or ardent heat of the Sun (in some delicate bodies, and such as are not accustomed to be conversant in Sunshine.) The quantity in thickness is very small; but the extent is most large, because it covers The quantity. all the skin; the figure of it is round, and long, like those parts which it invests. The figure. The composure. The composure of it is obscure; yet because this Cuticle is the excrement of the true skin, we say it hath its matter from the excrementitious superfluity of the nerves, veins, arteries, and substance of the true skin. It is in number one, like as the true skin which it outwardly covers, that it might be a medium between the object, and fixed faculty of touching, diffused over The number. all the true skin which every where lies under it. For the temperature, by the common consent of Physicians, it is in the midst of all excess; for that seeing it is The temperatuer. the medium between the object and faculty, if it should be hotter, colder, moister, or drier, it would deceive the faculty by exhibiting all objects, not as they are of themselves, but as it should be; no otherwise than as to such as look through red or green spectacles, all things appearered, or green. Wherefore for this reason it was convenient the cuticle should be void of all sense. It hath no action in the body; but it hath use, for it preserves and beautifies the true skin; for it seems to be given by the singular indulgence of nature, to be a muniment and ornament, to the true The use skin. This providence of nature, the industry of some Artisans (or rather Courtesans) doth imitate, who for to seem more beautiful, do smooth and polish it. By this you may understand; that not all the parts of the body have action, yet have they their use, because, according to Aristotle's opinion; Nature hath made nothing in vain. Also you must note that this thin skin, or cuticle being lost, may every where be regenerated, unless in the place which is covered with a scar. For Why the cuticle cannot be restored in scars. here the true skin being deficient, both the matter and former faculty of the cuticle is wanting. CHAP. four Of the true skin. THe true skin called by the greeks Derma, is of a spermaticke substance, The substance wherefore being once lost, it cannot be restored as formerly it was. For in place thereof comes a scar, which is nothing else but flesh dried beyond Magnitude. measure. It is of sufficient thickness, as appears by the separating from the flesh. But for the extent thereof it encompasses the whole body, if you except the eyes, ears, nose, privities, fundament, mouth, the ends of the fingers where the nails grow, that is, all the parts by which any excrements are evacuated. The figure of it Figure. is like the cuticle round and long, with its productions, with which it covers the extremities of the parts. It is composed of nerves, veins, arteries, and of a proper flesh and substance Composure, of its kind, which we have said to be spermaticall, which ariseth from the process of the secundine, which lead the spermaticke vessels even to the navel, in which place each of them into the parts appointed by nature, send forth such vessels, as are spread abroad and diffused from the generation of the skin. Which also the similitude of them both, that is, the skin and membrane Chorion do argue. For as the Chorion is double, without sense, encompassing the whole infant, lightly fastened to the first coat which is called Amnios; so the skin is double, and of itself insensible (for otherwise the nerves were added in vain from the parts The skin of itself is void of sense. lying under it) ingirting the whole body, lightly cleaving to the fleshy Pannicle. But if any object that the Cuticle is no part of the true skin, seeing it is wholly different from it, and easily to be separated from it, and wholly void of sense: I will answer, these arguments do not prevail. For that the true skin is more crass, thick, sensible, vivide, and fleshy, is not of itself, being rather by the assistance and admixture of the parts, which derived from the three principal it receives into its proper substance; which happens not in the cuticle. Neither if it should happen would it be better for it, but verily exceeding ill for us, because so our life should lie fit and open to receive a thousand external injuries, which encompass us on every side, as the violent and contrary access of the four first qualities. There is only one skin, as that which should cover but one body, the which it every The number. where doth, except in those places I formerly mentioned. It hath connexion with the parts lying under it by the nerves, veins, and arteries, with those subjacent parts Connexion: put forth into the skin investing them, that there may be a certain communion of all the parts of the body amongst themselves. It is cold and dry in its proper temper in respect of its proper flesh and substance, Temperature, for it is a spermaticall part. Yet if any consider the finewes, veins, arteries, and fleshy threads which are mixed in its body, it will seem temperate, and placed as it were in the midst of contrary qualities, as which hath grown up from the like portion of hot, cold, moist, and dry bodies. The use of the skin is to keep safe and sound the continuity of the whole body, and all the parts thereof, from the Use. violent assault of all external dangers, for which cause it is every where endued with sense, in some parts more exact, in others more dull, according to the dignity and necessity of the parts which it ingirts, that they might all be admonished of their safety and preservation. Lastly, it is penetrated with many pores, as breathing places, as we may see by the flowing out of sweat, that so the arteries in their diastole might draw the encompassing air into the body, for the tempering and nourishing of the fixed inbred heat, and in the Systole expel the fuliginous excrement, which in Winter suppressed by the cold air encompassing us, makes the skin black and rough. We have an argument and example of breathing through these, by drawing the air in by transpiration, in women troubled with the mother, who without The reason why the skin is blacker and rougher in Winter. respiration live only for some pretty space by transpiration. CHAP. V. Of the fleshy Pannicle. AFter the true skin, follows the membrane, which Anatomists call the fleshy Pannicle, whose nature that we may more easily prosecute and declare, we must first show what a membrane is, and how many ways the word is taken. Then wherefore it hath the name of the fleshy Pannicle. A membrane therefore is a simple part, broad and thin, yet strong and dense, white and nervous, and the which may easily, without any great danger be extended What a membrane is. and contracted. Sometimes it is called a coat, which is, when it covers and defends some part. This is called the fleshy Pannicle; because in some parts it degenerates Why it is sometimes called a coat, sometimes the fleshy and fatty Pannicle. into flesh, and becomes musculous, as in a man from the collar bones, to the hair of the head, in which part it is therefore called the broad muscle, where as in other places it is a simple membrane, here and there entangled with the fat lying under it, from whence it may seem to take or borrow the name of the fatty Pannicle. But in beasts (whence it took that name, because in those a fleshy substance maketh a Why beasts have this pannicle wholly, fleshy or musculous. great part of this Pannicle) it appears manifestly fleshy and musculous over all the body, as you may see in Horses, and Oxen; that by that means being movable, they may drive and shake off their flies, and other troublesome things, by their shaking and contracting their backs. These things considered, we say the fleshy Pannicle in its proper body, is of a nervous or membranous substance, as that which hath its original The substance from the coat Amnios, (which is next to the infant) dilated near to the navel and stretched forth for the generation of this Pannicle; in which thing I think good to note, that as the membranes Chorion and Amnios mutually interwoven with small nervous fibers, encompass and invest the child, as long as it is contained in the womb; so the skin and fleshy Pannicle knit together by such like bands, engirt the whole body. Therefore the fleshy Pannicle is equal in magnitude and like in figure to the The magnitude and figure. true skin, but that it lies under it, and is contained in it, in some places mixed with the fat, in others increased by the flesh interwoven with it, and in other some is only a simple membrane. Number. Composure. The composition of it is such, as the sight of it presents to our eye, that is, of veins, arteries, nerves, and the proper flesh, some whites mixed and interlaced with fat, and sometimes with musculous flesh. It is but one, by reason of the use we shall presently show; It is situated between the skin and fat, or common coat of the muscles, annexed to these and the other parts lying under it, by the veins, nerves, and arteries ascending from these inward parts, and implanting themselves into the substance thereof, and then into the true skin. The temperature thereof is divers, according to the variety of the parts interwoven with it. The use of it is, to lead, direct, and strengthen in their passage, the The temperature. The use. vessels which are disseminated into the true skin, and the whole superficies of the body. But in beasts it hath another commodity, that is, it gives a shaking or trembling motion to their skin and back, for that cause we formerly touched. CHAP. VI Of the Fat. THe fat coming near the condition of an excrement, rather than of a The fat is rather an excrement than a part. The substance part (as we said, when we treated of the simular parts) is of an oily substance, bred of the airy and vaporous portion of the blood, which sweeting through the pores of the coats, or mouths of the vessels, becomes concreate about the membranes, and nerves, and cold bodies, and turns into fat by the coldness of the place. Whereby we may know that cold, or a more remiss heat, is the efficient cause of fat, which is manifest by contemplation not only of creatures The efficient cause of fat. of divers kinds, but also by those of the same species and sex, if so be that the one be colder than the other. By which we may understand that the fat is the more or less in quantity according The quantity. to the different temper of the whole body, and of its particular parts; for its composition, it consists of that portion of the blood which we formerly mentioned, intermixed The composure. with certain membranes, nervous fibers, veins and arteries. The greatest part of it lies between the fleshy pannicle and the common coat of the The site. Muscles, * I was pres●…at the opening a body, Feb: 1630▪ 〈◊〉 which the ●at, in the lower part of the lower belly was in thickness above 8, inches, upon the breast between a and 5 nche which I thought good to remember in this place both for the rarity of the thing, as also because it was increased by report, and the place mistaken some saying the O●…um or Call was so thick, which was false, for it did not much exceed the quantity of that part, in other fa●men. The Temper. The use. The solider fat, or seam. Otherwiseit is diffused over all the body, in some places more, in some less, yet it is always about the nervous bodies, to which it delights to cleave. Most Anatomists inquire whether the fat lie above or beneath the fleshy pannicle. But me thinks this question is both impertinent and idle; being we often see the fat to be on both sides. It is of a middle temper between heat and cold, being it ariseth of the more airy portion of the blood; although it may seem cold in respect of the efficient cause, that is, of cold by which it concreats. For the rest, moisture is predominant in the fat. The use thereof is, to moisten the parts which may become dry by long fasting, vehement exercise or immoderate heat, and besides to give heat, or keep the parts warm. Although it do this last rather by accident, than of its own nature, as heated by exercise, or by some such other chance; it heats the adjacent parts, or may therefore be thought to heat them, because it hinders the dissipation of the native and internal heat; like as cold heats in winter, whereby the bellies are at that time the hotter. I know some learned Physicians of our time stiffly maintained, that the fat was hot, neither did they acknowledge any other efficient cause thereof, than temperate heat and not cold. But I think it best to leave the more subtle agitation of these questions to natural Philosophers. But we must note, that at the joints which are more usually moved, there is another sort of fat, far more solid and hard, than that which we formerly mentioned, often found mixed with a viscid and tough humour like the whites of Eggs, that so it might be sufficient for a longer time to moisten these parts, subject to be hurt by dryness, and make them slippery & so fitter for motion, in imitation whereof they usually grease hard bodies, which must be in frequent motion, as coach wheels and axeltrees. And there is another kind of fat, which is called Sevum, seam, in one thing differing from the ordinary fat, that is much drier; the moister and softer portion of the fat being dissipated by the raging heat of the place. For it is found principally about the midriff, where there are many windings In what parts and for what cause the fat is more dense. of arteries and veins, and it is also about the reins, Loins, and basis of the heart. The fat is wasted by long fasting; is dried and hardened by vehement exercise and immoderate heat. Hence it is that it is much more compact in the palms of the hands, and soles of the feet, about the eyes and heart, so that it resembles the flesh in density and hardness; because by the continual motion and strong heat of these parts, the thinner portion being dissipated & diffused, the more Gross & terrestrial remain. CHAP. VII. Of the common coat of the Muscles. NExt under the fat, appears a certain coat, spread over all the Muscles, and called the common coat of the Muscles, it is of a nervous substance; The substance as all other membranes are. The quantity and breadth thereof is bounded The quantity by the quantity of the Muscles which it involves, and fits itself to, as that which encompasses the Muscles of the Epigastrium, is of equal largeness with the same Muscles. The figure of it is round: It is composed of veins, nerves, arteries and its The Composure. peculiar flesh consisting of three sorts of fibers; the beginning of it is from the Periostium, in that part where the bones give ligaments to the Muscles; or according to the opinion of others, of the nervous and ligamentous fibers of the Muscles, which rising up and diffused over the fleshy superficies thereof, are united for the generation of this coat. But this membrane arising from the Periostium (as every membrane which The Original is below, the head takes its original from the Periostium either primarily, by the interposition of no Medium, or secondarily) is stretched over the Muscles by their tendons. But if any object, that this membrance plucked from the belly of the Muscle, may seem to end in a ligament. I will answer, that it is the condition of every nervous part, so to bind or fasten itself to another part of his own kind as to a stay, so that it can scarce be plucked from thence. We see the proof hereof, in the Peritonaeum or Rim in the Epigastrium or lower part of the lower belly. That which covers the Muscles of the Epigastrium is but one, unless you had rather part it in two, the right and the The number. left distinguished by the interposition of the Linea Alba, or white Line. It is situate betwixt the fat and Muscles; for it is fastened above and below to these parts with The site. fibers, which in smallness and fitness exceed the Spider's web. But by its vessels, it participates with the three principal parts, and is of a cold and dry temper. The use The use, of it is, to contain the Muscles in their natural union, and to keep them as much as in it lies, from putrefaction, which may happen to them from pus or matter, which is often cast forth of the simular parts into the empty spaces and distances of the Muscles. Wherefore going about to separate the fat of the Epigastrium (where thou must begin the dissection of man's body) you must have a care, that you hurt it not with your knife, but that, before you touch the Muscles, see you artificially take it away, that you may the more easily separate the Muscles lying under it, distinguished by a manifest space at the white Line, which is made by the meeting together What the white lime is. of the proper coats of all those muscles. CHAP. VIII. What a Muscle is, and how many differences there be thereof. A Muscle is the instrument of voluntary motion; and simple voluntary motion is performed six manner of ways, upwards, downwards, forwards, What a Muscle is. backwards, to the right hand and to the left; but the compound one How the circular motion is performed. way, which is circularly, the which is performed by the continual succession of the motion of the Muscles ingirting the part. Such a Motion Falconers use when they stretch forth their hand and Lure their Hawk. We have some parts, which have motion without a Muscle, but that motion is not voluntary; such parts be the heart, stomach, guts, both the bladders (that is, that of the Gall and that of the urine) and divers other which have the motions of attraction, expulsion and retention, by the means of the three sorts of fibers; for they draw by the right, expel by the transverse; and retain by the oblique. The differences of Muscles which are many From whence the differences of muscles are drawn. and divers, are taken from their substance, original, insertion into the part which they move, for me or figure, holes or openings, magnitude, colour, site, kind of fibers, their conjugation or connexion, heads, bellies, tendons? opposition in action and office. Some in substance are nervous, venous, arterious, because they have manifest Differences of muscles from their substance. nerves, veins and arteries, as the Midriff, the intercostal and Epigastricke Muscles and many more, and that for their difference from other Muscles, into which neither nerve nor vein, or Arteries are manifestly inserted, although secretly they admit them all for sense and motion, life and nourishment, such are the Muscles of the wrist, the wormy muscles of the hands and feet; for if there be any nerves observed in them, they are very small. Some had rather make the difference of Muscles thus, that some of them are fleshy, some nervous, others membranous. From their Original, Differences of Muscles from their original. some arise from the bones, as these which move the hands, arms and Legs; others from gristles, as the Muscles of the throat; others from membranes which invest the tendons, as the wormy Muscles of the hands and feet; others from ligaments as the Extenders of the fingers; others from other muscles, as the two lower Muscles of the yard which proceed from the Sphincter Muscle of the fundament. Others have no original, as the membrane which we call the fleshy pannicle assumes flesh in certain places, and degenerates into a Muscle; such are the Cremaster or hanging Muscles of the testicles, the large Muscles of the face, and if you please the Midriff, as that which is composed of two coats, the one in compassing the ribs and the Peritonaeum, hath flesh in the midst between the two membranes. And moreover some Muscles have their original from one only bone, as these which bend and extend the Cubite, others arise of many bones as the oblique descending, the Dorsall and many Muscles of the neck, with arise together from many spondyls and sides of spondyls. There be others according to the opinion of some men, both from the bones and gristles of the Pubis at the right or direct Muscles of the Epigastrium, yet by their favour I think otherwise. Because by the anatomical and received axiom, A Where a muscle hath its original. Muscle is there thought to take his beginnings from whence he receives a nerve; but these Muscles take a nerve from the intercostal muscles, wherefore their original ought to be referred to the sides of the breast blades, as shall be showed in due place. Differences of muscles from their insertion From their insertion arise these differences, some are inserted into a bone, as those which move the head, Arms and Legs; others into a gristle, as those of the Throttle, eyelids, nose and the obliqueascendant muscles of the Epigastrium; some into a bone and gristle both, as the right muscles of the Epigastrium and the Midriff; some into the skin, as the muscles of the lips; others into the Coats as the muscles of the eyes; others into Ligaments, as the muscles of the yard. But these differences following may be drawn both from their insertion and original. For some muscles arising from many parts, are inserted into some one part, as divers of these which move the arm, and the shoulder, which arising from many spondiles are inserted into the bone of the shoulder and the shoulder blade. Others arise from one part, and insert themselves into more, as those which arise from the bottom of the shoulder blades, are extended and inserted into some eight or nine of the upper ribs, to help respiration; and the benders and extenders of the fingers and toes; Others arising from many bones are inserted into as many, as some of those which serve for respiration, to wit those which we call the hinder Saw-muscles and the Semispinatus, which sends a tendon into all the ribs. Others have their original from many bones, and end in gristles of the seven ribs, as those two which lie under the Sternon. Moreover also these differences of muscles may be drawn from the original and insertion, that some proceed from bones and are inserted into the next bone, to help and strengthen the motion thereof, as the three muscles of the Hip; others arise from an upper bone & are not inserted into the next, but into some other, as the long muscles. Some are named from the part they move, as the temporal muscles because they move the temples; others from their office, as the grinding muscles, because they move the skin as a mill, to grind asunder the meal. From their form or figure, because some are like Differences of muscles taken from their figure. Mice, other like Lizards which have their Legs cut off, for that they imitate in their belly, body or tendon, the belly or tail of such creatures, & from whence the names of Musculus and Lacertus are derived. Such are those which bend the wrist, and which are fastened to the bone of the Leg, & which extend the foot; Others are triangular, as that which lifts up the arm, called Epomis or Deltoides, and that which draws the arm to the breast, called the pectoral muscle. Others quadrangular as the Rhomboides, or Lozenge muscle of the shoulder blade and the two hindesum-muscles serving for respiration, and two of the wrists which turn down the hand; Others consist of more than four angles, as the oblique descending, and that muscle with joins itself to it from the shoulder blade; others are round and broad, as the Midriff, others circular as the Sphincter muscle of the fundament and bladder; others are of a pyramidal figure, as the seaventh muscle of the eye, which compasses the optic nerve in beasts but not in men. Others have a semicirculer form, as that which shuts up the eye feated at the lesser corner thereof. Others resemble a Monk's cowl, or hood, as the Trapezius of the shoulder blade. Besides others at their first original are narrow, but broad at their insertion, as the Saw-muscle of the shoulder and the transverse of the Epigastrium; others are choir contrary, as the three Muscles of the Hip; others keep an equal breadth or bigness in all places, as the intercostal muscles and these of the wrist; others are long and slender, as the long muscle of the thigh; others are long and broad, as the oblique descending muscles of the Epigastrium; others are directly contrary, as the intercostal, which are very narrow. From their perforations, Differences from their perforations. for some are perforated, as the Midriff which hath three holes, as also the oblique and transverse of the Epigastrium, that so they may give passage forth to the preparing spermaticke vessels, and to the ejaculatory vessels, the Coat Erythroides associating and strengthening them; others are not perforated. From their magnitude From their magnitude. for some are most large, as the two muscles of the Hipp, others very small, as the eight small muscles of the neck, and the proper muscles of the Throttle, and the wormy muscles. Others are of an indifferent magnitude. From their colour, for From their Colour, some are white and red, as the Temporal muscles, which have Tendons coming from the midst of their belly; others are livide, as the three greater muscles of the calf of the leg, which colour they have by the admixtion of the white, or tendinous nervy coat with the red flesh, for this coat by its thickness darkening the colour of the flesh, so that it cannot show its redness and fresh colour, makes it seem of that livide colour. From their situation, for some are superficiary, as those which appear From their site. under the skin and fat; others deep in and hid, as the smooth and four twin muscles; some are stretched out and as it were spread over in a straight and plain passage, as the muscles of the thigh which move the leg, except the Ham-muscle; others oblique, as those of the Epigastrium; other some transverse, as the transverse of the Epigastrium, where you must observe; that although all the fibers of the muscles are direct, yet we call them oblique, and transverse by comparing them to the right muscles, as which by the concourse of the fibers make a straight or acute angle. From the sorts of fibers; for some have one kind of fiber; yet the greatest part enjoy two sorts running so up and down, that they either are crossed like the letter From their fibers. X, as happens in the pectoral and grinding muscles; or else do not concur, as in the Trapezij. Others have three sorts of fibers, as the broad muscle of the face. From their coherence and connexion, or their texture of nervous fibers; for From thire connexion. some have fibers somewhat more distant and remote immediately at their original, than in other places, as you may see in the muscles of the buttocks; Others in their midst and belly, which by reason thereof in such muscles is more big or tumid, their head and tail being slender, as happens in most of the muscles of the arm and leg, in which the dense mass of flesh interwoven with fibers, disjoines the fibers in so great a distance; in other some the fibers are more distant in the tail, as in the greater Saw-muscle arising from the bottom of the shoulder blade; in others they are equally distant through the whole muscle, as in the muscles of the wrist and between the ribs. From their head; for in some it is fleshy interwoven with few fibers, as in the muscles of the buttocks; in others it is wholly nervous, as in the most-broadmuscle From their head. common to the arm and shoulder blade, and in the three muscles of the thigh proceeding from the tuberosity of the hucle bone; in some it is nervous and fleshy as in the internal and external muscle of the arm. Besides some have one head, others two, as the bender of the elbow and the external of the leg, others three as the Threeheaded muscle of the thigh. But we must note that the word nerve or sinew is here taken in a large signification, for a ligament, nerve and tendon, as Galen saith (Lib de Ossibus) and moreover we must observe, that the head of a muscle, is one while above, another while below, otherwhiles in the midst as in the Midriff, as you may know by the insertion of the Nerve, because it enters the muscle by its head. From their belly also, there be some differences of muscles taken; for some have From their belly. their belly immediately at their beginning, as the muscles of the buttocks, others at their insertion, as the Midriff. Others just at their head, as those which put forth the Calf of the leg; in others it is somewhat further off, as in those which draw back the arm, and which bend the leg; in others the belly extends even from the head to the tail, as in the intercostal muscles and these of the wrist; in others it is produced even to their insertion, as in those of the palms of the hands and soles of the feet; some have a double belly, distinguished by a nervous substance; as those which open the mouth, and those which arise from the root of the lower process of the shoulder blade. Moreover the differences of muscles are drawn also from the Tendons, for some From their Tendons. have none, at lest which are manifest, as the muscles of the lips and the sphincter muscles, the intercostal and those of the wrist; others have them in part; and want them in part, as the Midriff; for the Midriff wants a Tendon at the ends of the shorter ribs, but hath two at the first Vertebra of the Loins in which it is terminated; Others have a Tendon indeed. But some of these move with the bone, some not, as the muscles of the eyes, and besides, some of these have broad and membranous tendons, as the muscles of the eyes and Epigastrium, except the right muscles; in others they are thick and round, as in the benders of the fingers; in others they are less round, but more broad than thick, such is the Tendon arising from the twin muscles and Soleus' of the leg: others have short Tendons, as the muscles which turn down the hand; othersome long, as those of the plames of the hands and soles of the feet; besides others produce Tendons, from the end of their belly which Tendons are manifest, others from the midst, as the Temporal muscles. Besides also others diffuse many tendons from their belly, as in the hands the benders of the fingers, and the extenders of the feet. Othersome put forth but one, which sometimes is divided into many, as those which bend the third articulation of the foot; otherwhile many muscles by their meeting together make one Tendon, as the three muscles of the Calf of the leg, and those which bend the cubit and leg. All tendons have their original, when the nerves and ligaments dispersed through the fleshy substance of a muscle, are by little and little drawn and meet together, until at last carried to the joint they are there fastened for the fit bending and extension From their Action. thereof. From the contrariety of their Actions, for some parts have contrary muscles, benders and extenders; Other parts have none, for the Cod and fundament have only lifters up. From their function, for some are made for direct motions as those From their function. which extend the fingers and toes; others for oblique, as the Supinators of the hand and the Pronators; others perform both, as the pectoral muscle, which moves, the Arm obliquely upward and downward, as the upper and lower fibers are contracted; and also out right, if all the fibers be contracted together, which also happens to the Deltoides and Trapezius. I have thought it good to handle particularly these differences of muscles, because that by understanding them the prognosticke will be more certain; and also the application of remedies to each part; and if any occasion be either to make incision, or suture, we may be more certain, whether the part affected be more, or less nervous. CHAP. IX. Of the parts of a Muscle. HAving declared the nature and differences of a muscle, we must note that The compound & simple 〈◊〉 of a muscle. some of the parts thereof are compound, or universal, others simple or particular. The compound are the head, Belly and tail. The simple are ligaments, a nerve, flesh, a vein, artery and coat. For the compound parts, by the head we understand the beginning and original of a muscle, which is one while ligamentous and nervous, otherwhiles also fleshy. By the belly, that portion which is absolutely fleshy; But by the tail, we understand a Tendon consisting partly of a nerve, partly of a ligament promiscuously coming forth from the belly of the muscle. For as much as belongs to the simple, which are six in number, three are called proper, and three common. The proper are a Ligament from a bone, a nerve proceeding from the Brain, or spinal marrow, and flesh compact by the concretion of blood. The Common are, a vein from the Liver or trunk arising from thence; an artery proceeding from the Heart, a Coat produced by the nervous & ligamentous fibers spreading over the superficies of the muscle. But for the simple use of all such parts, the nerve is as it were the principal part of a muscle, which gives it sense and motion, the Ligament gives strength, the flesh contains the nervous and ligamentous What use each simple particle hath in a muscle. fibers of the muscle and strengthens it filling up all the void spaces, and also it preserves the native humidity of these parts and cherisheth the heat implanted in them; and to conclude, defends it from all external injuries; for like a fan it opposeth itself against the heat of the Sun; and is as a garment against the cold; and as a cushion in all falls and bruises, and as a buckler or defence against wounding weapons. The vein nourishes the muscle, the artery gives it life, the coat preserves the harmony of all the parts thereof, lest they should be any ways disjoined or corrupted by purulent abscesses breaking into the empty or void spaces of the muscles, as we see it happens in a Gangrene, where the corruption hath invaded this membrane by the breaking out of the more acride matter or filth. CHAP. X. A more particular inquisition into each part of a muscle. HAving gone thus far, it remains, that we more particularly inquire into each part of a muscle, that (if it be possible,) nothing may be wanting to this discourse. Wherefore a Ligament properly so called, is a simple part The nature of a Ligament. of man's body, next of a bone and gristle, the most terrestrial, dry, hard, cold, white, taking its original immediately, or by the interposition of some Medium from the BOnes, or Gristles (from whence also the Muscles have their beginning) whereby it comes to pass that a ligament is void of sense, unless it receive a nerve from some other place; (For so the Ligaments which compose & strengthen the Tongue and yard, are partakers of sense) and it inserts itself into the bone and gristle that so it may bind them together, and strengthen and beautify the whole joint or connexion; (for these three be the principal uses of a Ligament) then diffusing itself into the membranes The three fold use of a Ligament. and muscles to strengthen those parts. A nerve to speak properly, is also a simple part of our body, bred and nourished by a gross and Phlegmatic humour, What a nerve is. such as the brain, the original of all the nerves, and also the spinal marrow endued with the faculty of feeling and oftentimes also of moving. For there be divers parts of the body which have nerves, yet are destitute of all voluntary motion, having the sense only of feeling, as the membranes, veins, arteries, guts and all the entrailes. A nerve is covered with a double cover from the two membranes of the brain, and besides also with a third proceeding from the ligaments which fasten the hinder part of the head to the Vertebrae, or else from the Pericranium. We understand no other things by the fibers of a nerve, or of a Ligament, than long and slender threads, white, What we mean by the nervous and Ligamentous fibers. solid, cold, strong more or less according to the quantity of the substance, which is partly nervous and sensible, partly Ligamentous and insensible. You must imagine the same of the fleshy fibers in their kind; but of these threads some are strait for attraction, others oblique for retention of that which is convenient for the creature, and lastly some transverse for the expulsion of which is unprofitable. But when these transverse threads are extended in length, they are lessened in breadth; but when they are directly contracted, they are shortened in length. But when they are extended all together as it were with an unanimous consent, the whole member is wrinkled as contracted into itself, as on the contrary it is extended when they are relaxed. Some of these are bestowed upon the animal parts, to perform voluntary motions; others upon the vital to perform the agitation of the Heart and Arteries; others upon the natural for attraction, retention and expulsion. Yet we must observe, that the attraction By what power the simular parts principally draw, or attract. What and of how many sorts the flesh is. of no simular part is performed by the help of the foresaid fibers or threads, but rather by the heat implanted in them, or by the shunning of Emptiness, or the familiarity of the substance. The flesh also is a simple and soft part composed of the purer portion of the blood insinuating itself into the spaces between the fibers, so to invest them for the uses formerly mentioned. This is as it were a certain wall and Bulwark against the injuries of heat and cold, against all falls and bruises, as it were a certain soft pillow or cushion yielding to any violent impression. There be three sorts of flesh; one more ruddy, as the musculous flesh of perfect creatures and such as have blood; for the flesh of all tender and young things having blood, as Calves, and also of all sorts of fish, is whitish, by reason of the too much humidity of the blood. The second kind is more pallid, even in perfect creatures having blood, such is the flesh of the heart, stomach, weasand, guts, bladder, womb. The third is belonging to the entrails, or the proper substance of each entrail, as that which remains of the Liver (the veins, arteries and coat being taken away) of the bladder of the Gall, brain, kidneys, milt. Some add a fourth sort of flesh which is spongy, and that they say is proper to the tongue alone. A vein is the vessel, pipe or channel of the blood, or bloody matter; it hath a What a vein is. spermaticke substance, consists of one coat composed of 3 sorts of fibers. An Artery is also the receptacle of blood but that spirituous and yellowish, consisting What an artery is. in like manner of a spermaticke substance; But it hath two coats, with three sorts of fibers, the utmost whereof is most thin, consisting of right fibers and some oblique: But the inner is five times more thick and dense than the utmost, interwoven with transverse fibers; and it doth not only contain blood and spirit, but also a serous humour, which we may believe because there be two emulgent Arteries, aswell as veins. But the inner coat of an Artery is therefore more thick, because it may contain Why an Artery is more thick and dense than a vein. blood which is more hot, subtle and spirituous; for the spirit, seeing it is naturally more thin and light and in perpetual motion, would quickly fly away, unless it were held in a stronger hold. There is other reason for a vein, as that which contains blood gross, ponderous and slow of motion. Wherefore if it had acquired a dense and gross coat, it could scarce be distributed to the neighbouring parts; God the maker of the universe, foreseeing this, made the coats of the vessels contrary to the consistence of the bodies contained in The mutual Anastomosis of the veins and arteries. them. The Anastomosis of the veins and Arteries, that is to say, the application of the mouths of the one to the other, is very remarkable, by benefit of which they mutually communicate and draw the matters contained in them, and so also transfuse them by insensible passages, although that anastomosis is apparent Where it is manifest. in the vein and artery that meet together at the joint and bending of the Arm, which I have sometimes showed in the Physic schools, at such time as I there dissected Anatomyes'. But the action or function of a muscle is either to move, or confirm the part From whence a muscle hath its beginning or head. according to our will, into which it is implanted; which it doth when it draws itself towards its original, that is to say, it's head. But we define the head by the insertion of the nerve, which we understand by the manner of the working of the Muscle. CHAP. XI. Of the Muscles of the Epigastrium, or lower belly. NOw seeing that we have taught, what a muscle is, and what the differences thereof are, and what simple and compound parts it hath, and what the use, action and manner of action in each part is; it remains that we come to the particular explication of each Muscle, beginning with those of the lower belly, as those which we first meet withal in dissection. These are 8 in number, 4 oblique, 2 on each side, two right or direct one, on eight muscles of the Epigastrium. the right, another on the left side; and in like manner 2 transverse. All these are alike in force, magnitude and action, so mutually composed, that the oblique descendant of one side, is conjoined with the other oblique descendant on the other side, and so of the rest. We may add to this number the 2 little. Supplying or Assisting muscles, which are of a Pyramidal form and arise from the share-bone, above the insertion of the right muscles; Of the oblique muscles of each side the one ascends, the other descends, whereupon it comes to pass, that they are called the Oblique descendant and The Oblique descendant. Their substance. Their greatness and figure. Ascendant Muscles. Those oblique which we first meet with, are the descendant, whose substance is partly sanguine, partly spermaticke; for they are fleshy, nervous, ligamentous, veinous, arterious and membranous. Yet the i'll shy portion is predominant in them, out of which respect Hypocrates is wont to express the muscles by the name of flesh's; their greatness is indifferent between the large and the small muscles; Their composur and fire. their figure 3 square. They are composed of the forementioned parts, they are two in number; their site is oblique taking their beginning, from the touching of the great saw Muscle and from the sixth and seventh true ribs, or rather from the spaces between the six lower ribs, and rather on the forepart of the muscles than of the ribs themselves, from whence shunning the Veriebra's of the loins, the fleshy parts of them are terminated in the external and upper eminency of the Haunch-bone, and the Membranous end in the lower eminency of the share-bone and the White-line. Yet Columbus dissenting from this common description of the oblique Muscles, thinks that they are only terminated in the White line and not in the share-bone. For (saith he) wherefore should they be inserted into the share-bone which is not moved? But because it would be an infinite labour and trouble to set down at large the several opinions of all Authors of Anatomy, I have thought it sufficient for me to touch them lightly by the way. Their connexion is with the oblique ascendant Their connexion. Their temperament. Their action. lying under them, and with the direct, or right. Their temperament is twofold, the one hot and moist by reason of the belly and the fleshy portion of them; the other cold & dry in respect of their ligamentous and tendinous portion. Their action is to draw the parts into which they are inserted towards their original, or else to unite them firmly. Yet each of these privately and properly draws the hip in an oblique manner towards the Cartilago Scutiformis or brestblade. Then follow the oblique ascendant, The oblique ascendant. who have the same substance, quantity, figure, composure, number and temper the descendant have. They are situate between the descendant and transverse with whom Their site and connexion. they have connexion, especially by the vessels which are brought from the parts beneath. All the fleshy parts arise from the rackbones of the Haunch to the ends of the bastard ribs, which they seem to admit above and below, being fleshy even to the fourth, and then becoming membranous they take their way to the white line, with a double aponeurôsis, which passes through the right Muscles above and below, as we may plainly see from the navel downwards. In their fleshy part they draw their original from the spin of the Haunch bones a little lower than the descendent end in their fleshy part. But for their membranous parts, they arise before from the share bone, but behind from the spondiles of the Holy bone, and Vertebrae of the loins obliquely ascending upwards to the white line, into which they are terminated by an aponeourôsis or membranous tendon (which seems to penetrate the right Muscle upwards and downwards, especially under the navel) but by their fleshy part at the ends of all the bastard ribs, which they seem to receive above and below. And because these muscles are terminated in the white line, they have also another use, yet such as is common to all the muscles of the Epigastrium, that is, to press down the Guts. Their action is (if they perform it together) to draw Their Action down the chest, and dilate the breast; but if their actions be separate, they draw the chest to the hip with an oblique motion. After these follow the right muscles, so called The right muscles of the Epigastrium. because they descend according to the length of the body, & because they have right or straight fibers. We will say nothing (to shun prolixity, which in all other places we will avoid, of their substance and other conditions, which they have common with the fore mentioned Muscles. They are situate in the eminentest or extuberating region of the belly, bounding the Epigastrium taken in general, (or the superficiary belly,) they Their site. are divided by the manifest intercourse of the white line, even to the Navel, in which place they seem to be united even to the place of their insertion. They draw their original not from the share bone, as some would have it, but according to the insertion Original. of their nerves, from the sides of the Cartilago scutiformis & the ends of the sixth seventh and eight ribs; but they end in the share bone where they make a common tendon sufficiently strong and short. Silvius, Vesalius and Columbus think they arise from the share bone, because they cannot be inserted into that bone, because it is immovable. You may perceive in these Muscles certain nervous & transverse intersections, often times three in number for the strength of these Muscles (of which Galen makes no mention, although they may be seen in Apes.) And also in the inner side of these muscles you may see four veins and as many arteries, of which some creep upwards, others run downwards. The upper called the Mamillary descend from the axillary by the side and lower parts of the Sternon, the slenderer portions thereof being distributed by the way, to the Mediastinum, and about the fourth and fifth rib to the Dugs, from whence they take their name. That which remains breaking out by the sides of the Brestblade inserts itself into those muscles creeping along, even almost to the navel; in which place The meeting together of the Epigastrick and mamillary veins and arteries. they are manifestly united (that is the veins with the veins, and arteries with the arteries) with the Epigastricke, which ascend from the upper part of the Iliackes on each side under the said muscles until they meet with these 4 mamillary vessels. That you may find this concourse of the veins and arteries about the navel, you must follow both the upper and the lower somewhat deep into the flesh: pressing the blood on both sides from above downwards, and from below upward; until you shall find the exosculation of these vessels, which will appear by this, that the blood will flow from this into that and from that into this; otherwise you can scarce perceive it, by reason of the smallness of such vessels which want blood. But that by the benefit of such concourse of the vessels, the matters may be communicated and transported both from the womb to the dugs, and again from the dugs to the womb, appears in Nurses, who want their courses, when the milk comes into their dugs, and on the contrary lose their milk when their courses flow plentifully. Otherwise to what purpose should there be such concourse between the vessels of the paps and womb, for there are veins and arteries diffused to the sides of the womb from the root of the Epigastrickes; for indeed the Epigastrickes which in their ascent meet with the mamillary, go not to the womb, though they be next to them, and arise from the same trunk with the Hypogastricke vein of the womb. The Action of these muscles is, to move or draw near together the parts of the Hypogastrium to the praecordia or Hypochondryes'. Their use, in Their action. Columbus opinion is, to draw the Breast downwards so to dilate it. At the Their use. ends of these Nature hath produced two other small Muscles from the upper part of the share bone, of a triangular figure for the safety of the thick and common tendon of the right Muscles, whereupon they are called Succenturiati, or assisters. Some (moved with I know not what reason) would have these two small Muscles The Pyramldal or assisting muscles. to help the erection of the yard. Columbus thinks they should not be separated from the right, and that they only are the fleshy beginnings of the right. But on the contrary Fallopius manifestly proves them different and separate from the right and shows their use. The Transverse remine to be spoken of, so called by The transverse muscles of the Epigastrium. reason of their fibers which make right angles with the fibers of the right Muscles. They have a quadrangular figure situate upon the greatest part of the Peritonaeum, Their figure and site. to which they stick so close that they scarce can be separated. They take their original from the production of the loins, the Eminency of the Haunch-bone, the transverse productions of the vertebrae of the loins and the ends of the bastard ribs; contrary to the opinion of many, whom the insertion of the nerve convinces, but they end in the white line, as all the rest do. Their action is to press the guts, especially for the expulsion of excrements. Their Action. But all the 8 recited Muscles, besides their proper use, have another common, The common use and action of the eight muscles of the Epigastrium. that is, they stand for a defence of Bulwark for all the parts lying under them, and serve for the expulsion both of the excrements, infant, and vapours, and also for the strenghtening of the voice, as experience shows in those who sound Trumpets and Cornets. Therefore these Muscles do equally on every side press the Belly; But the Midriff, the intercostal Muscles assisting it, doth drive from above downwards, from which conspiring contention follows the excretion of the excrements by the fundament; but unless the Midriff should assist, these Muscles would press the excrements no more downwards, than upward to the mouth. Although to this excretion of the excrements, it is not sufficient that the Epigastricke, Midriff and intercostal Muscles press the belly, but the Muscles Why when the mouth is open the excrements go more slowly forth. of the throttle must be also shut. For the mouth being open the excrements never go well forth; because the vapours that pass out of the mouth, which being restrained and driven to the Midriff, by stretching it powerfully thrusts down the excrement. Wherefore Apothecaryes' when they give glisters, bid Why when the mouth is open the excrements go more slowly forth. the Patient to open his mouth, that the glister may easilyer go up, which otherwise would scarcely go up, the mouth being shut, because so we should have no place empty in us, into which the clyster might be admitted. The first Figure of the Lower belly. AABCD. The upper, lower and lateral parts of the Peritonaeum. EE. The white Line from the Gristle of the Breastbone, called the Brestblade, to the Commissure or meeting of the Sharebones, F. The Gristle of the Breastbone Cartilago ensiformis or the Breast-Blade. G. The Navel which, all the Muscles being taken away, must be kept for the demonstration of the umbilical Vessels. H H. The productions of the Peritonaeum which contain the Seminary Vessels on either side. **. The hole which giveth way to the Seminary Vessels of Men. II. A Vein and an Artery from the Epigastricke, which being carried upward under the right Muscles, do here hang down, and are distributed into the lower part of the Abdomen. KK. A Vein and an Artery from the internal Mammarie proceeding from under the Bone of the Breast, are carried downward through the right Muscles and are disseminated into the upper part of the Abdomen. 1, 2. The place wherein the right Muscles arise, which being here cut off, do hang down, that their Vessels may the better be scene. 3, 4. The Anastomosis or inocculation of the foresaid Vessels, making the consent of the Abdomen and the Nose, & of the Womb with the Breasts, as some think. LL. Branches of Veins running into the sides of the Peritonaeum. N. The place of the Haunch Bone bared, to which the Oblique and the Transverse Muscles do grow. Of the whiteline, and Peritonaeum or Rim of the belly. The white line is nothing else, than the bound and extremities of the Muscles of the Epigastrium distinguishing the belly in the midst into two parts, the right What the white line is and left. It is called white, both of its own colour, and also for that no fleshy part lies under it, or is placed above it. It is broader above the navel, but narrower below, because the right muscles do there grow into one, Now we must treat of the Coat or membrane, Peritonaeum or Rim of the belly; it is so called, because it is What the Peritonaeum is. stretched over all the lower belly, and particularly over all the parts contained in the ventricle, to which also it freely lends a common coat. It hath a spermaticke substance as all other membranes have; the quantity of it in thickness is very small, (for it is almost The substance and quantity. as thin as a spider's web) yet differing in divers places in men, and women; for men have it more thick and strong above the Navel, that so it may contain the extension of the stomach, often stretched beyond measure with meat and drink. On the contrary women have it so thick and strong below their navel that it seems double, that so they may more easily endure the distension of their womb caused by the child contained in it. But above the navel men and women have the Peritonaeum of an equal strength, for the self same reason. The longitude and latitude of it is known by the circumscription of the belly. The figure is round and some what long; it puts forth some productions, The figure. like finger stalls, both for the leading and strengthening the spermaticke vessels and the Cremaster muscles of the Testicles, and besides it the eiaculatory vessels, as also to impart a coat to the testicles and all the natural parts. It is composed of slender, membranous and nervous fibers, certain small The composition. branches of veins and arteries concurring with them, which it receives for life and nourishment from the adherent parts. The number. This membrane is one in number, and besides every where one and equal, although Galen would have it perforated in that place where the spermaticke vessels Lib. de 〈◊〉. descend to the Testicles; But in truth we must not think that a hole, but rather a production as we said before. The latter Anatomists have observed, the Coat Peritonaeum is doubled below the Navel, and that by the spaces of these reduplications the umbilical arteries ascend to the Navel. It is situate near the natural parts and compasses them about, and joined by The fire and connexion. the coat, which it gives them, as also on the sides, it is joined to the vertebrae of the loins, from whose ligaments, (or rather periostium) it takes the original: on the lower part it cleaves to the share bone, and on the upper to the midriff whose lower part it wholly invests; on the fore or outer part it sticks so close to the transverse muscles, that it cannot be plucked from them but by force, by reason of the complication and adhaesion of the fibers thereof with the fibers of the proper membrane of these muscles, which membrane in Galens' opinion proceeds Lib. 6, Meth, from this Peritonaeum, that so it is no marvel that we may more easily break, than separate these two coats. It is of temperature cold and dry, as all other membranes are. It hath many uses, the first whereof is, to invest and cover all the parts of the Use. lower belly, specially the kall, lest it should be squeezed by great compressures and violent attempts into the empty spaces of the muscles, as it sometimes happens in the wounds of the Epigastrium, unless the lips of the ulcer be very well united: for than appears a tumour about the wound by the Guts and kall thrusting without the Peritonaeum into those spaces of the muscles; from whence proceeds cruel pain. Another use is to further the casting forth of the excrements by pressing the ventricle and gutson the foreside, as the Midriff doth above, as one should do it by both their hands joined together. The third use is, it prohibits the repletion of the parts with flatulency after the expulsion of the excrements, by straitening and pressing them down. The fourth and last is, that it contains all the parts in their seat and binds them to the backebone, principally that they should not fly out of their places by violent motions, as leaping and falling from on high. Lastly we must know, that the Rim is of that nature that it will easily dilate itself, as we see in Dropsies, in women with child, and in tumours against nature. CHAP. XIII. Of the Epiploon, Omentum, or Zirbus, that is the Kall. AFter the containing parts, follow the contained, the first of which is the Epiploon, (or Kall) so called, because it as it were swims upon all the guts. The substance, magnitude, figure. The substance of it is fatty and spermaticke, the quantity of it for thickness is divers in divers men according to their temperament. The latitude of it is described by the quantity of the guts. It is in figure like a Purse, because it is double. It is composed of veins, arteries, fat and a membrane, which sliding The composure. down from the gibbous part of the ventricle, and the flat part of the Gut Duodenum and spleen over the Guts, is turned back from the lower belly to the top of the Colon. It is one as we said covering the Guts. It hath its chief connexion with the first Vertebrae of the loins, from which place in beasts it seems to take a coat, as in men from the hollow part of the spleen and The connexion. gibbous of the ventricle and depressed part of the Duodenum, from whence doubled it is terminated in the fore and higher part of the Colic gut. Which moved Galen to write that the upper part of the membrane of the Kall was Lib. Anatom. ●dminist. annexed to the ventricle, but the lower, to the laxer part of the Colic Gut. From the vessels of which parts it borrows his, as also the nerves, if it have any. The temper of it in lean bodies is cold and dry, because their Kall is without fat; but in fat bodies it is cold and moist by reason of the fat. The use of it is twofold: The tempor. The first is to heat and moisten the Guts, and help their concoction, although The use twofold. it do it by accident, as that which through the density of the fat hinders the cold air from piercing in, and also forbids the dissipation of the internal heat. Another use is, that in want of nourishment in times of great famine, for sometimes it cherishes, and as it were by its dew preserves the innate heat both of the ventricle and the neighbouring parts, as it is written by Galen. Moreover we must observe, that in a rupture or relaxation of the Peritonaeum the Lib. 4 de usu partium. Kall falls down into the scrotum, from whence comes that rupture we call, Epiplocele. But in women that are somewhat more fat it thrusts itself between the bladder and the neck of the womb, and by its compression hinders, that the seed comes not with full force into the womb, and so frustrates the conception. Besides, when by a wound or some other chance, any part of it be defective, than that part of the belly which answers to it, will afterwards remain cold and A cause of frustrating conception. raw, by reason of the forementioned causes. The second figure of the lower belly. A, A, B, B. The inner face of the Peritonaeum cut into four parts, and so turned backward. B. The upper B showeth the implantation of the umbilical Vein into the Liver. C. The Navel separated from the Peritonaeum. From D to the upper B. the umbilical Vein. E, E. The fore part of the stomach blown up, neither covered by the liver nor the Kall. F, F. A part of the Gibbous side of the Liver. G. Vessels disseminated thorough the Peritonaeum. * The Brestblade. H. The bottom of the Bladder of Urine. I. The connexion of the Peritonaeum to the bottom of the Bladder. K, K, K, K. The Kall covering the Guts. M. N. Vessels and Sinn●… embracing the bottom o● the Stomach. O. The meeting of the Vessels of both sides, so that M, N, and O, show the seam which Aristotle mentions 3. hist. and 4 de part. Anim. where he saith; that the Kall arises and proceeds from the midst of the belly. P. P. Branches of vessels r●…ing alongst the bottom of the stomach. Q Q. Q. Q. Certain branches of the Vessels distributed to the upper membrane of the Omentum, & compassed with Fat. a, a. The two umbilical arteries, going down by the sides of the bladder to a branch of the great artery. b. The Ligament of the Bladder which is showed for the Vrachus. CHAP. XIIII. Of the Ventricle or Stomach. NOw we must speak of the Stomach, the receptacle of the food necessary for the whole body, the seat of appetite, by reason of the nerves dispersed into its upper orifice, and so into its whole substance. The substance What the ventricle is. thereof is rather spermaticke than sanguine, because that for one fleshy membrane, it hath two nervous; The quantity or magnitude of The substance the ventricle is divers, according to the various magnitude of bodies, and gluttony of men. The figure of it is round and somewhat long, like a Bagpipe. The stomach The magnitude. is composed of two proper coats, and one common from the Peritonaeum, together The figure. The composure. with veins, sinews, and arteries; the innermost of its proper coats is membranous woven with right fibers, for the attraction of meats, it is extended and propagated even to the mouth thereof, whereby it comes to pass that the affections of one part may easily be communicated to the other by sympathy, or consent. This coat hath its original from the membranes of the brain which accompany the The cause of the consent of the mouth and stomach. nerves descending from the third and fourth conjugation to the mouth thereof. And in like sort from other productions descending by the passages of the head, from whence also another reason may be drawn from that, which they commonly bring from the nerves of the sixth conjugation; why in wounds of the head, the stomach doth so soon suffer by consent with the brain. The exterior, or outer is more fleshy and thick, woven with oblique fibers, to retain and expel. It draws it original from the Pericranium, which as soon as it comes to the gullet, takes unto it certain fleshy fibers. There be nerves sent into the stomach from the sixth conjugation of the brain, as it shall be showed in its proper place. Veins and arteries are spread into it from the Gastrica, the Gastrepiploides, the Coronaria and splenicke, from the second, third, and fourth distribution of the vena Porta, or gate-veine; and the third of the descendent artery to the natural parts, as soon as it passes forth of the midriff. It is one in number. The greater part of it is situated on the left side between the spleen, the hollowness of the liver, and the guts, that assisted by the heat of such The number. neighbouring parts, it may more cheerfully perform the concoction of the meat. Neither am I ignorant that Galen hath written, that a great part of the stomach lies Lib. 〈◊〉 usu partium. on the left side. But inspection itself, and reason makes me derogate from Galens' authority, for because there is more empty space on the left side, by reason the spleen is less than the liver, it was fit it should lie more on the left side. The more The connexion. proper connexion of it is with the gullet and guts, by its two orifices; with the brain by its nerves; with the liver and spleen by its veins; with the heart●… its arteries; and with all the natural parts by its common membrane. The temper of the ventricle in men of good habit, is temperate, because it is almost composed of the equal commixture of sanguine and spermaticke parts; or The temper. according to Galens' opinion, it is cold of its self, and by the parts composing it; Lib. 9 Meth. and hot by the vicinity of the bowels. But in some it is hotter, in others colder, according to the divers temper and complexion of divers bodies. That stomach is to be thought well tempered, that powerfully draws down the meat and drink, and embraces and retains them so drawn, until by concoction and elixation, they shall be turned into a juice like cream (which the greeks call Chylos;) and last, which doth strongly send from it, and repel the excrements of this first concoction. The stomach is known to be hotter by this, that it better concocts and digests Notes of a hot stomach, course and hard meats, as beef, hard eggs, and the like, than soft ●… digestion, which it corrupts and turns into belchings. For so a young, 〈…〉 sooner burnt than well roasted at a great fire. The stomach which is colder, 〈…〉 much meat, but is slow in concocting them, especially if they be cold and 〈◊〉 of digestion, which for that cause quickly turn sour. The action of a well conditioned stomach, is twofold, one common, another proper. The common is to attenuate The action twofold. mix and digest the meats taken in at the mouth, for the nutrition of itself and the whole body, after the liver hath performed its duty, which before it be done, the ventricle only enjoys the sweet pleasure of the Chylus, and comforts its self against the heat and impurity of the adjacent parts, wherefore it is called the workhouse of concoction. Its first action is to attract, retain, and assimilate to itself that which is convenient; but to expel whatsoever shall be contrary, either in quantity, or quality, or in the whole substance. It hath two orifices, one above, which they commonly call the stomach and heart, the other lower, which is called the Pylorus, or lower mouth of the stomach. The two orifices of the stomach. The upper bends to the left side near the back bone; it is far more large and capacious than the lower, that so it may more commodiously receive meats half chewed, hard and gross, which Gluttons cast down with great greediness; it hath an exquisite sense of feeling, because it is the seat of the appetite, by reason of the nerves encompassing this orifice, with their mutual embracings; whereby it happens that the ventricle in that part is endued with a quick sense, that perceiving the want and emptiness of meat, it may stir up the creature to seek food. For albeit nature hath bestowed four faculties on other parts, yet they are not sensible of their wants, but are only nourished by the continual sucking of the veins, as plants by juice drawn from the earth. This orifice is seated at the fifth Vertebra of the chest, upon which they say it almost The 〈◊〉. rests. Yet I had rather say that it lies upon the twelfth Vertebra of the chest, and the first of the loins; for in this place the gullet perforates the midriff, and makes this upper orifice. The lower orifice bends rather to the right side of the body, under the cavity of the liver. It is far straighter than the upper, lest any thing should pass away before it be well attenuated and concocted; and it doth that by The glandudulous ring of the Pylorus. the help or assistance of, as it were a certain ring, like to the sphincter muscle of the fundament, which some have thought a glandule made by the transposition of the inner and fleshy membrane of the ventricle into that which is the outer of the guts. I know Columbus laughs at this glandulous ring, but any one that looks more attentively shall perceive that the Pylorus is glandulous. The stomach in its lower and inner side, hath many folds and wrinkles, which serve to hold and contain the meats, until they be perfectly concocted. In the ventricle we observe parts gibbous and hollow; the hollow is next to the liver and midriff; the gibbous is towards the guts. Now we must note, that the ventricle when it is much resolved or loosed, may slide down even to the navel near the bladder, the which we have The falling down of the stomach. observed in some bodies dissected after their death: The third and fourth Figure. The first figure shows the fore-side of the stomach and gullet. A. showeth the orifice of the gullet cut from the throat. B. the strait and direct course of the gullet from A. to B. C. how the gullet above the first rack bone of the chest, from B. to C. inclineth to the right hand. D. his inclination to the left hand, from C. to D. EE. the two glandules called the Almonds, set close to the gullet in the end of the throat, called also Paristmia, Antiades, Tonsilla and Salviares glandulae. FF. Another glandulous body in the midst of the gullet, about the fifth rack bone, from which place the gullet gives place to the great artery, somewhat declining to the right side: Vesalius, Lib. 5, Cap. 3. and Columbus Cap. ult. lib. 9 write, that those Glandules are filled with a certain moisture, with which the gullet is moistened, that the meats may slide down more easily into the stomach, as through a slippery passage. No otherwise than the Glandula prostata, filled with a kind of gross and oily moisture, smooth the passage of the urine, that so it may flow through it, with a more free and less troubled course. G. the connexion of the gullet with the stomach, where the upper orifice of the stomach is fashioned. H. the lower orifice of the stomach called Pylorus. I. K. the upper part of the stomach at I. the lower at K. LL. the foreside of the stomach. P. the gut called Duodenum. T. V. the right and left nerves of the sixth pair encompassing about the gullet and the uppermost left orifice of the stomach. The second Figure showeth the back parts of the Ventricle and Gullet. A. EE. FF. G. H: P. TU. show the like parts as in the former. From C. to D. the inclination of the stomach to the left hand. M. N. O. the backside of the stomach. M. showeth the prominence of the left side. N. of the right. O showeth the dock or impression, where it resteth upon the rack bones. Q. R. the passage of the bladder of the gall into the Duodenum at R. S, a glandulous body growing under the Duodenum, bearing up the vessels. X. Y. a nerve on the left side▪ creeping up to the top of the stomach, and so running out to the liver. CHAP. XV. Of the Guts. THe Guts thc instruments of distribution and expulsion, are of the same Their substance. substance and composure with the stomach, but that the site of the coats of the stomach is contrary to those of the guts. For that which is the innermost coat of the stomach is the outermost of the guts, and so on the contrary. The figure of the guts is round, hollow and capacious, some more, Figure. some less according to the divers bigness. But for the quantity of the guts, some are small, some great, more or less, according to the variety of bodies. But they are six in number, for there be three small; Their number the Duodenum, the jejunum, or empty gut, and the Ilium. Three great, the Blind, the The Duodenum. Colic, and the Right gut. All which have had their names for the following reasons; the first, because it is extended the length of twelve fingers, like another stomach, without any turning, or winding; of which greatness it is found in great bodied men, such as were more frequenly to be met withal in Galens' time, than in this time of ours, in which this gut is found no longer than seven, eight, or nine fingers at the most, The cause of this length is, that there may be a free passage to the gate vein, coming out of the liver, as also to the artery and nerve which run into it. For seeing that this gut may sometimes rise to the top of the liver, it would possess the space under the bladder of the gall (with which it is often tinctured) if it had any revolutions that way, which is the passage for such like vessels. Others give another reason of this figure, which is, that there should be nothing to hinder the easy and fit distribution of the perfectly concocted Chylus to the liver. The second is called jejunum, or the empty gut, not because it is absolutely so, The jejunum. but because it contains little in comparison of the other. There is a triple cause of this emptiness; the first the multitude of the meseraick veins and arteries which are about it, whereupon there is a greater and quicker distribution of the Chylus. The second is the vicinity or neighbourhood of the liver strongly drawing the Chylus contained in it; the third is the flowing down of the choleric humour from the bladder of the Gall into it, which ever and anon by its acrimony cleanses away the filth, and by continual flowing solicits it to expulsion. The third is called Ileon because it Ileon. lies between the Ilia or flanks, it differs nothing from the rest in substance and magnitude, but in this one thing, that there is more matter contained in it than in the rest, by reason of the paucity of the vessels terminated in it, that it is no marvel that there can be no exact demonstration made of them. The fourth is called Caecum or the Blind, because it hath but one passage to send out and receive in the matter. Caecum. This gut hath a long and straight production, which according to the opinion of some (though altogether erroneous) often falls down into the Scrotum in the rupture, or relaxation of the Rim of the Belly; for that production in the lower belly strongly sticks to the Peritonaeum or Rim, which hinders such falling down. But Galen seems by such a blind gut to have meant this long and narrow production, and certainly so thinks the common sort of Anatomists, but here Vesalius justly reprehended Galen. Wherefore Silvius that he might free Galen of this fault, would have us by the blind gut to understand the beginning of the colic gut. The fifth is called Colon (or colic Colon. gut) because it is greater and more capacious than the rest. The sixth and last, Rectum: the Right gut, by reason of the rightness or straightness of the passage. This in beasts especially, hath a certain fatness in it to make the passage slippery, and lest the gut should be exulcerated in the passage, by the sharpness of hard and acrid excrements. The site of these guts in thus, The Duodenum upon the backbone bends to the right hand; the jeiunum possesses a great part of the upper umbilical region, diffuses Their site, itself into both sides with windings, like to these of the gut Ileum, even to the flanks. The gut Ileon is situate at the lower part of the umbilical region, going with many turnings and windings, even to the hollownesses of the holybone above the bladder and side parts of the Hypogastrium, which they call the flanks. The Blind bends to the right hand, a little below the kidney, above the first and fourth Vertebra of the loins. The Colon or Colic gut is crooked and bend, in the form of a Scythian bow, filling all the space from the blind gut, below the right kidney, even to the hollowness of the liver, and then it goes by the gibbous part of the stomach above the small guts, even to the hollowness of the spleen; from whence sliding under the left kidney, with some turnings, it is terminated upon the Vertebrae of the loins. By all which turnings and windings of the colic gut, it is easy to distinguish the The distinction between the colic and the stone in the kidneys. Their connoxion. pain of the stone of the kidneys, which remains fixed in one certain place, from the colic wand'ring through these crooked passages we mentioned. The right gut tends with an oblique site towards the left hand, upon the holy bone even to the very fundament. They have all one and a common connexion; for they are all mutually joined together by their coats, because there is but one way from the gullet even to the fundament, but they are joined to the principal parts by their nerves, veins, and arteries. But a more proper connexion is that, where the Duodenum on the upper part of it, is joined with the Pylo●us; but on the lower part, to the jeiunum, and the parts lying under it, by the coat of the Peritonaeum. The jeiunum, or empty gut, is joined to the Duodenum and Ileon. The Ileum with the emprie and blind guts. The blind with the Ileon and Colon, and with the right side of the backbone where it is tied more straight. The Colon with the blind and right guts, and in his middle part, with the kidneys and the gibbous part of the stomach; whereby it comes to pass, that being distended with wind in the colic, it overturnes and presses the stomach, and so Why vomiting ha●pens in the colic. causes vomiting. Lastly, the right gut is annexed with the colic gut and fundament. At the end whereof there is a muscle fastened, of figure round and circular called the Sphincter, The S●incter muscles of the fundament. arising from the lower Vertebrae of the holy bone and rump, by the benefit of which as of a door or gate, the excrements are restrained at our will, lest man borne for all honest actions, without all shame, in every time and place, should be forced every where to ease his belly. For such as have lost the benefit of this muscle by the palsy, Gal. lib. 5. de usu partium. ●ap. 〈◊〉▪ have their excrements go from them against their wills. There is a body situate at the end of the right gut, of a middle substance between the skin and flesh, as it were arising from the mixture of them both, like the extremities of the lips, of the same use with the Sphincter, but that it is not altogether so powerful. But there are also certain veins situate about it called the haemorrhoidal, of which we will speak in their place. Besides, there are two other muscles that descend to the end of this gut, being broad and membranous on each side, one arising from the side and inner parts of the share and hippe-bones, which inserted above the Sphincter pull up the fundament falling down, wherefore they are called Levatores Any, or the lifters up of the fundament. Levatores Ani. Wherefore when as either they are too weak, or resolved, or the fundament oppressed with the weight of phlegmatic, salt, choleric and sharp humours, the gut is scarce restored into its place, that there is need of the help of the fingers for that purpose. The guts follow the temper of the stomach. Their action is the distribution of The action of the guts. the Chylus by the meseraicke veins (which of duty belongs to the three small guts) and the receiving the excrements of the Chylus, and retention of them, till a fi●…ime of expulsion, which belongs to the third quarter. Besides, these small guts finish up the work of concoction, begun in the stomach, although they be not altogether made for that use. But nature is often accustomed to abuse the parts of the body for some better use. The fisth figure of the lower belly. A. The breast blade, Cartilago Ensiformis. BB. The Rim, with the midriff and broken ribs bend outwards. CC. the gibbous part of the liver. D. a ligament tying the liver to the midriff. E. part of the umbilical vein. FF. the stomach filled full of meat. G. a part of the spleen. H. the blind gut of the late writers, for the Ancients took the top of the colon for it. I. the beginning of the great or thick guts. I. and so to K. showeth the passages of the colic gut from the right kidney to the liver. And so the colic and the stone on this side are in one place, and therefore hardly distinguished. K. to L. the same colic gur lieth under the whole bottom of the stomach, which is the reason that those which are troubled with the colic cast so much. L. to M. The passage of the Colon from the spleen to the share bone, by the left kidney, a way, which maketh the pain of the stone and the Colic on the left side very hard to distinguish. N. The Colon ending in the right gut. O. The beginning of the right gut unto the bladder. P. Q. The sunken or fallen side of the Colon at P. and his Chambers or Cells at Q. R. S. T. The lesser guts, especially lying under the Navel. a. a. The two umbilical arteries. b. The bottom of the bladder. * The connexion of the bladder and the Peritonaeum. But we must note, that for the composure of the guts, they have only transverse fibers, for expulsions sake, unless that at the beginning of the Colon, and the end Their fibers. of the right gut, you may see certain right fibers added to the transverse to strengthen them, left these guts should chance to be broken and torn by the passage of hard excrements, and the laborious endeavour of expulsion (specially in brute beasts.) But if any ask, how they have retention, being they want oblique fibers, he may know that the faeces are retained in the right gut, by the force of the Sphincter muscle, How the guts become fit to retain. but oft times in the blind, by their hardness and abundance, whereby they stick in the passage; but in the rest, by reason of their conformation into many windings and turnings. The length of the guts, is seven times more than the length of the whole body; to this length they have windings, lest the nourishment should quickly slide Their length. away, and least men should be withdrawn by gluttony from action and contemplation. For so we see it comes to pass in most beasts, which have one Gut, stretched strait out from the stomach to the fundament; as in the Lynx and such other beasts of insatiable gluttony, always, like plants, regarding their food. CHAP. XVI. Of the Mesentery. AFter the Guts follows the Mesentery, being partly of a fatty and partly of a spermaticke substance. The greatness of it is apparent enough, although The substance in some it be bigger, and in some lesser according to the greatness magnitude. of the body. It is of a round figure and not very thick. It is composed of a double coat arising from the beginning and root of the peritonaeum. Figure, Composure. In the midst thereof it admits nerves from the costal of the sixth conjugation, veins from the Vena Porta or Gate vein; Arteries from the descendant artery, over and besides a great quantity of fat and many glandulous bodies, to prop up the division of the vessels spread over it, as also to moisten their substance. It is in number one, situate in the middle of the guts, from whence it took its name. Yet some divide it into two parts, to wit, into the Meseraeum, that is, the portion interwoven Number. with the small guts, and into the Mesocolon which is joined with the Great. It hath connexion by its vessels with the principal parts, by its whole substance with the The connexion. guts, and in some sort with the kidneys, from whose region it seems to take its coats. It is of a cold and moist temper, if you have respect to his fatty substance; but if to the rest of the parts, cold and dry. The temper. The action and use of it is, to bind and hold together the guts, each in his place, lest they should rashly be folded together; and by the Meseraicke veins (which they The action and use. term the hands of the Liver) carry the Chylus to the liver. In which you must note, that all the Meseraicke veins come from the liver, as we understand by the dissection of bodies; although some have affirmed, that there be All the meseraicke veins come from the liver. some veins serving for the nourishment of the guts, no ways appertaining to the Liver, but which end in certain Glandulous bodies, dispersed through the Mesentery, of whose use we will treat hereafter. CHAP. XVII. Of the Glandules in general, and of the Pancreas, or sweet bread. AGlandule is a simple part of the body, sometimes of a spongye and soft substance, sometimes of a dense and hard. Of the soft Glandules are the Tonsillaes, or Almonds, like in substance to blanched Almonds; the Thymus, Substance of the glandules. Pancreas, Testicles, Prostata. But the dense and hard are the Parotides and other like. The Glandules differ amongst themselves in quantity and figure, for some Quantity and figure. are greater than other some, and some are round and others plain, as the Thymus and Pancreas. Others are compounded of veins, nerves, arteries, and their proper flesh, as the Composition. Almonds of the ears, the milky glandules in the breasts and the testicles. Others want nerves, at lest which may be seen, as the Parotides, the axillary, or those under the armholes and others. The number of glandules is uncertain, by reason of the infinite multitude and variety of sporting nature. You shall find them always in these Number, places, where the great divisions of vessels are made; as in the middle ventricule of the brain, in the upper part of the Chest, in the Mesentery and other like places. Although othersome be seated in such places, as nature thinks needful to generate and cast forth of them a profitable humour to the creature; as the almonds at the roots of the tongue, the kernels in the dugs, the spermatick vessels in the scrotum and at the sides of the womb; or where nature hath decreed to make emunctoryes for the principal parts, as behind the ears, under the armholes, and in the groins. The connexion of glandules is not only with the vessels of the parts concurring to their Connexion. composition, but also with those, whose division they keep and preserve. They are of a cold temper, wherefore Physicians say the blood recrudescere, (ay) to become raw again Temper. in the dugs, when it takes upon it the form of milk. But of these some have Action and use. action, as the almonds, which pour our spittle useful for the whole mouth, the dugs milk, the Testicles seed; others, use only as those which are made to preserve, underprop and fill up the divisions of the vessels. Besides this we have spoken of glandules in general, we must know that the Pancreas is a glanduleus, and fleshlike body, The substance of the Pancreas. The ●ite. as that which hath every where the shape and resemblance of flesh. It is situate at the flat end of the liver, under the Duodenum with which it hath great connexion, and under the gate-veine, to serve as a bulwark, both to it and the divisions thereof, whilst it fills up the empty spaces, between the vessels themselves, and so hinders, that they be not plucked asunder, nor hurt by any violent motion, as a fall, or the like. CHAP. XVIII. Of the Liver. HAving gone thus far, order of dissection now requires, that we should treat of the distribution of the gate vein; but because it cannot well be understood unless all the nature of the liver from whence it arises, be well known, therefore putting it off to a more fit place, we will now speak of the Liver. Wherefore the liver (according to Galens' opinion, lib. de form. fatus) is the first of all What the liver is. the parts of the body, which is finished in conformation, it is the shop and Author of the blood, and the original of the veins; the substance of it, is like the concrete It's substance and quantity. mud of the blood, the quantity of it is divers, not only in bodies of different, but also of the same species; as in men amongst themselves, of whom one will be gluttonous and fearful, another bold, and temperate, or sober; for he shall have a greater liver than this, because it must receive and concoct a greater quantity of Chylus: yet the liver is great in all men, because they have need of a great quantity of blood for the repairing of so many spirits & the substantificke moisture, which are resolved and dissipated in every moment by action and contemplation. But there may be a a twofold reason given, why such as are fearful have a larger liver. The first, is because Why coward● have great livers. in those the vital faculty (in which the heat of courage and anger resides) which is in the heart, is weak; and therefore the defect of it must be supplied by the strength of the natural faculty. For thus nature is accustomed to recompense that which is wanting in one part, by the increase and accession of another. The other reason is, because cold men have a great appetite, for by Galens' opinion In arte parva, coldness increases the appetite; by which it comes to pass that they have a greater quantity of Chylus, by which plenty the liver is nourished, and grows larger. Some beasts, as Dogs, and swine, have the liver divided into five or more Lobes, but a man hath but one Lobe, or two, or three at the most; and these not so much distinguished, as which cherish the upper and hollow region of the ventricle, with embracing to help forward the work of concoction. Therefore the liver is almost content with one Lobe, although it is always rend with a small division, that the umbilical vein piercing into the roots and substance of it, may have a free passage; but also oftentimes there is as it were a certain small lobe of the liver, laid under that umbilical vein, as a cushion. The figure of the liver is gibbous; rising up and smooth towards the Midriff; towards The figure. the stomach is the simous or hollow side of it somewhat unequal, and rough by reason of the distance of the Lobes, the original of the hollow vein, and the site of the bladder of the Gall. The composition of the liver is of veins, nerves, arteries, the coat and proper The composure. The vessels. substance thereof which we call the gross and concreet blood, or Parenchyma. Veins and arteries come to it from the navel; but nerves immediately from these which are diffused over the stomach according to Hypocrates; yet they penetrate not very deep into its substance, for it seems not to stand in need of such exact sense, but they are distributed upon the coat and surface there of, because this part made for distribution over the whole body, keeps to itself no acrid or malign humour, for the perception of which it should need a nerve, although the coat investing it, sends many nervous fibers into its substance, as is apparent by the taking away of the coat from a boiled liver; we must think the same of the other entrails. The coat of the liver is from the Peritonaeum, waxing small from the umbilical vein, when it divides itself for the generation of the gate and hollow veins, as is observed by Galen, lib. de format▪ Fatus. The liver is only one, situate in the greater part on the right side, but with the The number and site. The connexion. lesser part on the left, quite contrary to the stomach. It's chief connexion is with the stomach, and guts, by the veins and membranes of the Peritonaeum; by the howllow vein and artery, with the heart; by the nerve with the brain, and by the same ligatu res with all the parts of the whole body. It is of a hot and moist temper, The temper. and such as have it more hot, have large veins and hot blood; but such as have it cold, have small veins, and a discoloured hue. The Action of the Liver is the The action. conversion of the Chylus into blood, the work of the second concoction. For although the Chylus entering into the meseraicke veins, receive some resemblance of blood, yet it acquires not the form and perfection of blood, before it be elaborate, and fully concoct in the liver. It is bound and tied with three strong ligaments, two The ligaments on the sides in the midst of the bastard ribs, to bear up its sides, and the third more high and strong, descending from the breast-blade, to sustain its proper part, which with its weight would press the lower orifice of the stomach, and so cause a falling or drawing down of the sternon and collar bone. And thus much may suffice for is proper ligaments, for we before mentioned its common, the veins, arteries, nerves, and coat of the Peritonaeum, by which it is knit to the loins, and other natural parts. But we must note, that besides these three proper ligaments, the liver is also bound with others to the bastard ribs, os Silvius observes in his anatomical observations, and Hollerius in his Practife, Cap. de Pleuritide. CHAP. XIX. Of the bladder of the Gall. NOw we must come to the bladder of the Gall, which is of a nervous substance, and of the bigness of a small pear; it is of figure round, with the The substance, greatness, and figure thereof The composition. bottom more large, but the sides and mouth more narrow and straight. It is composed of a double coat, one proper, consisting of three sorts of fibers, the other from the peritonaeum. It hath a vein from the Porta or gate vein, and an artery from that which is diffused into the liver, and a nerve from the sixth conjugation. It is but one Number and connexion. and that hid on the right side under the greater lobe of the liver, it is knit with the touching of its own body, and of the passages and channels made for the performance of its actions with the liver, and in like manner with the Duodenum, and not seldom with the stomach also, by another passage; & to conclude to all the parts by its veins, nerves, atteries, and common coat. It is of a cold temper, as every nervous part is. Temper. The action of it is to separate from the liver the choleric humour, and that excrementitious, but yet natural by the help of the right fibers, for the purifying of the Action. blood, and by the oblique fibers, so long to keep it being drawn, until it begin to become troublesome in quantity, quality, or its whole substance, and then by the transverse fibers, to put it down into the Duodenum to provoke the expulsive faculty of the guts. I know Fallopius denies the texture of so many fibers, to be the minister of such action to the gall. But Vesalius seems sufficiently to have answered him. The bladder of the gall hath divers channels, for coming with a narrow neck, The channels of the gall. even to the beginning of the gate vein, it is divided into two passages, the one whereof suffering no division is carried into the Duodenum, unless that in some it send another branch into the bottom of the stomach, as is observed by Galen; which Lib. 2. de temper. men have a miserable and wretched life, being subject to choleric vomitings, especially when their stomaches are empty, with great pains of their stomach and head, as is also observed by Galen Cap. 74. Artis Med. The other coming out of the body of the liver divides itself into two or three passages, again entering the substance of the liver, is divided with infinite branches, accompanying so many branches of the gate vein through the substance of the liver, that so the blood unless it be most elaborate and pure, may not rise into the hollow vein, all which things Dissection doth manifestly teach. The sixth Figure of the bladder of the Gall. M. The Pylorus joined to the Duedenum. N. the Duodenun joined to the Pylorus P. shows the bottom of the bladder of the gall. QQ. the holes of the bladder of gall dispersed through the liver, betwixt the roots of the hollow and gate veins. R. the root of the gate vein in the liver. S. the root of the hollow vein in the liver. a. the concourse or meeting of the passages of choler into one branch. b. the neck of the bladder into which the passage is inserted. c. the passage of the gall into the Duodenum. d. the Duodenum opened, to manifest the insertion of the porus biliaris. e. anarterie going to the hollow part of the liver, and the bladder of the gall. f. a small nerve belonging to the liver and the bladder of gall, from the rib branch of the sixth pair. gg. the cysticke twins from the gate vein. CHAP. XX. Of the Spleen or Milt. But because we cannot well show the distribution of the gate vein, unless the spleen be first taken away, and removed from its seat: therefore before we go any further, I have thought good to treat of the spleen. Therefore The substence the spleen is of a soft, rare, and spongious substance (whereby it might more easily receive and drink up the dreggs of the blood from the liver) and of a flesh more black than the liver. For it resembles the colour of its muddy blood, from which it is generated. It is of an indifferent greatness; but bigger in some, Magnitude. than in othersome, according to the divers temper and complexion of men. It hath, Figure. as it were, a triangular figure, gibbous on that part, it sticks to the ribs and midriff, but hollow on that part next the stomach. It is composed of a coat, Composition. the proper flesh, a vein, artery, and nerve. The membrane comes from the peritonaeum, the proper flesh from the feceses or dregges of blood, or rather of the natural melancholy humour, with which it is nourished. The fourth branch of the venaporta, or gate vein, lends it a vein; the first branch of the great descendant artery presently after the first entrance without the Midriff, lends it an artery. But it receives a nerve from the left costal, from the sixth conjugation on the inner part, by the roots of the ribs; & we may manifestly see this nerve, not only dispersing itself through the coat of the liver, but also penetrating with its vessels the proper flesh thereof, after the selfsame manner, as we see it is in the heart and lungs. It is one in number, situate on the left side, between the stomach and the bastard ribs, or rather the midriff Number, and site. which descends to their roots. For it oft times cleaves to the midriff on its gibbous part, by a coat from the peritonaeum, as also on the hollow part to the stomach, both by certain veins which sends it into the ventricle, as also by the kall. It hath connexion, either primarily, or secundarily, with all the parts of the body, by these its Connexion, vessels. It is of a cold and dry temper; the action and use of it is to separate the melancholic Temper and use. humour, which being feculent and drossy, may be attenuated by the force of many arteries dispersed through its substance. For by their continual motion, and native heat, which they carry in full force with them from the heart, that gross blood puts off its grossness, which the spleen sends away by passages fit for that purpose, retaining the subtler portion for its nourishment. The passages by which it purges itself from the grossness of the melancholy blood, are a vein ascending from it into the stomach to stir up the appetite by its sourness, and strengthen the substance thereof by its astriction; and also another vein, which sometimes from the spleen branch, sometimes from the gate vein, plainly under its orifice, descends to the fundament, there to make the haemorrhoidal veins. CHAP. XXI. Of the Vena Porta, or Gate-veine, and the distribution thereof. THe gate-veine, as also all the other veins, is of a spermaticke substance, The substance and figure. of a manifest largeness, of a round and hollow figure, like to a pipe or quill. It is composed of its proper coat, and one common from the perit●naeum. It is only one, and that situate in the simous or hollow part of the Compositiors. Number end Site. l●ver, from whence it breaks forth (or rather out of the umbilical vein) into the midst of all the guts, with which it hath connexion, as also with the stomach, spleen, sphincter of the fundament and Peritonaeum, by the coat which it receives from thence. It is of a cold and dry temper. The Action of it is, to suck the Chylle out Temper and Action. of the ventricle and guts, and so to take and carry it to the Liver, until it may carry back the same turned into blood for the nutriment of the stomaeke, spleen and guts. This Gate vein coming out of the simous part of the liver, is divided into six Division thereof into 6 branches of which 4 simple. 1● Cysticae genellae. branches, that is 4 simple and two compound, again divided into many other branches. The first of the simple ascends from the fore part of the trunk to the bladder of the Gall by the passage of the Choler (and are marked with g. g.) with a like arterye for life and nourishment, and this distribution is known by the name of the Cystica gamellae or Cysticke twins. The second is called the Gastrica or stomach 2 Gastrica. vein arising in like manner from the fore part of the trunk, is carried to the Pylorus and the simous or back part of the stomach next to it. The third is called Gastrepiplois, the stomach and kall vein, which coming from 3 Gastrepiplois. the right side of the gate vein goes to the gibbous part of the stomach next to the Pylorus and the right side of the kall. The fourth going forth from behind and on the right hand of the gate vein, ascends 4 Intestinalis. above the root of the Meseraicke branch, even to the beginning of the gut jeiunum, along the gut Duodenum, from whence it is called Intestinalis, or the gut-veine. And Two compound. 1 Ramu● splenicus sending ●orch. 1 Coronali●. 〈◊〉 these are the four simple branches. Now we will speak of the compound. The first is the spleenicke, which is divided after the following manner. For in its first beginning and upper part, it sends forth the Coronalis, or crown vein of the stomach, which by the back part of the stomach ascends into the upper and hollow part thereof; to which place, as soon as it arrives, it is divided again into two branches, the one whereof climbs up even to its higher orifice, the other descends down to the lower, sending forth by the way other branches to the fore and back parts of the stomach. These engirt on every side encompass the body of the ventricle, for which cause they are named the crown veins. I have sometime observed this coming forth of the trunk, a little above the orifice of the splenicke branch. But this same splenicke branch on its lower part, produces the branch of the Haemorroidall veins, which descending 2 Haemorrhoidal▪ interna. to the fundament above the left side of the loins, diffuses a good portion thereof into the least part of the colic gut, and the right gut, at the end whereof it is often seen to be divided into five haemorrhoidal veins, sometimes more, sometimes less. Sylvi●● writes that the haemorrhoidal branch descends from the mesentericke, and truly we have sometimes observed it to have been so. Yet it is more suitable to reason, that it should descend from the splenicke, not only for that we have seen with our eyes that it is so, but also because it is appointed by nature for the evacuation of the excrementitious melancholic humour. But this same spl●●ick branch out of the 3. Gastrepiplois maj●r ●…stra. middle almost of its upper part produces the third branch going to the gibbous part of the stomach, and the kall; they term in the greater, middle and left Gastrepiplois. But on the lower part towards the spleen it produces the simple Epiplois, or kall-veine, 4. Epiplois simplex. which it diffuses through the left side of the kall. Moreover from its upper part, which touches the liver, it sends forth a short branch called vas breve, or venosum, to 5. Vas breve scu venosum. the upper orifice of the ventricle for stirring up the appetite. We have oftentimes and almost always observed, that this veinie vessel, which Galen calls vas breve, comes from the very body of the spleen, and is terminated in Lib. 4. de ●s●… partium. the midst of the stomach on the left side, but never pierces both the coats thereof. Wherefore it is somewhat difficult to find, how the melancholy juice can that way be poured, or sent into the capacity of the stomach. Now the splenicke branch, when it hath produced out of it those five forementioned branches, is wasted and dispersed into the substance and body of the spleen. Then follows another compound branch of the vena porta; called the mesentericke, which is divided into three parts; the first and least whereof goes to the blind 2 Ramus mesentericus, divided into three parts. gut, and to the right and middle part of the collicke-gut, divided into an infinite multitude of other branches. The second and middle is wasted in the Ileon; as the third and greater in the jeiunum or empty gut. It is called Mesentericke because it is diffused over all the Mesentery; as the splenicke is in the spleen. And thus much we have to say of the division of the gate vein, the which if at any time thou shalt find to be otherwise, than I have set down, you must not wonder at it; for you shall scarce ●inde it the same in two bodies, by reason of the infinite variety of particular bodies, which (as the Philosophers say) have each their own, or peculiar gifts. Our judgement is the same of other divisions of the vessels. Yet we have set down that which we have most frequently observed. CHAP. XXII. Of the original of the Artery, and the division of the branch, descending to the natural parts. THose things being thus finished and considered, the guts should be pulled aaway, but seeing that if we should do so, we should disturb and lose the division of the artery descending to the natural parts; therefore I have thought it better to handle the division thereof, before the guts be plucked away. Therefore we must suppose, according to Galens' opinion, that as all the veins come from the liver, so all arteries proceed from the heart. This presently at the beginning is divided into two branches, the greater whereof descends downwards to The original of arteries. The division of the great descendant artery, is into these. 1 Arteria inter●…. the natural parts upon the spin of the back, taking its beginning at the fifth vertebra thereof, from whence it goes into the following arteries. The first called the intercostal, runs amongst the intercostal muscles, and the distances of the ribs, and spinal marrow, through the perforations of the nerves on the right and left hand from the fifth true, even to the last of the bastard ribs. This is going this progress makes 7. little branchings, distributed after the forementioned manner, and going forth of the trunk of the descendant over against each of the intercostal Muscles. The second being parted into two goes on each side to the midriff, whence it 2 Phrenica. 3. Caeliaca. may be called, or expressed by the name of the Diaphragmatica or Phrenica (i) the midriff arterye. The third being of a large proportion, arising from the upper part of the artery presently after it hath passed the midriff, is divided into two notable branches, whereof on goes to the stomach, spleen, kall, to the hollow part of the liver and the gall; the other is sent forth to the mesentery and guts after the same manner, as we said of the meseraicke veins, wherefore it is called the 〈◊〉, 〈◊〉 stomach artery. But we must note all their mouths penetrate even to the innermost coat of the guts, that by that means they may the better and more easily attract the Chylus contained in them. The fourth is carried to the reins, where it is named the reinall o● emulgent, because it sucks fit matter from the whole mass of blood. 4. Emulgent. 5. Spermatica. The fifth is sent to the testicles with the preparing spermaticke veins, whence also it is named the spermaticke artery, which arises on the right side, from the very trunk of the descendant artery; that it may associate the spermaticke vein of the same side, they run one above another, beneath the hollow vein, wherefore we must have a great care whilst we labour to lay it open, that we do not hurt and break it. The seventh Figure of the lower belly. A. A. the midriff turned back with the ribs and the peritoneum. BB. the cave or hollow part of the liver, for the liver is lifted up that the hollow part of it may be better seen. C. the least ligament of the liver. D. the umbilical vein. E. the hollowness in the liver, which giveth way to the stomach. F. the left orifice of the stomach. GG. certain knubs, or knots, and impressions in the hollow part of the liver. H. the bladder of gall. I. the gate-veine, cut off, and branches which go to the bladder of gall. K. a nerve of the liver coming from the stomachical nerve. L. an artery common to the liver and bladder of gall. M. a nerve common also to them both, coming from the right costal nerve of the ribs. N. the passage of the gall to the guts cut off. OO. the hollow of the fore parts of the spleen. P. they line where the vessels of the spleen are implanted. Q. the trunk of the hollow vein. R. the trunk of the great artery. S. the coeliacal artery cut off. T. V. the kidneys yet wrapped in their membrane. X. Y. the fatty veins called venae adiposa. a. b the emulgent veins with the arteries under them. cc. dd. the ureter from either kidney to the bladder. c. f. the spermaticall veins to the testicles, the right from the hollow vein, the left from the emulgent. g. g. veins coming from the spermaticall to the peritonaeum. h. i. the spermaticall arteries. k. the lower mesenterical artery. l. the ascending of the great artery above the hollow vein, and the division of it, and the hollow vein into two trunks. m. the artery of the loins called lumbaris. n. the holy artery called sacra. o. a part of the right gut, p. the bladder of urine. * the connexion of the bladder with the peritonaeum. q. a part of the vessels which lead the seed from the testicles, is here reflected. r. s. the scrotum, or cod, that is, the skin that invests the yard and testicles. t. the fleshy pannicle or membrane which is under the cod. u. the coat which is proper to the testicles with his vessels. x. a part of the yard excoriated or flayed, and hanging down. The sixth going from the fore and upper part of this descendant artery, descends Haemorrhoidali● seu mesen●●rica inferior. with the Haemorroidall veins to the fundament; presently from his beginning, sending forth certain branches alongst the colic gut, which by 〈◊〉 〈◊〉 united with other branches of the Coel●…call arteries; for whosoever shall lock more attentively, he shall often observe that veins are so united amongst themselves, and also arteries, and sometimes also the veins with the arteries. For an ●…s is a communion and communicating of the vessels amongst themselves, by the application of their mouths, that so by mutual supplies they may ease each others defects. But they call this the lower meseraicke artery. The seventh proceeding from the trunk with so many branches as there be vertebrae 7. Lumbaris. in the loins, goes to the loins and the parts belonging to them, that is, the spinal marrow of that part, and other parts encompassing these Vertebrae, whereupon it is styled the Lumbaris or Loin Artery. The eight maketh the Iliacke arteries, until such time as it departs from the Peritonaeum 8 Iliaca. where the crural Arteries take their original. This Iliacke Artery sends many divarications towards the Holy bone where it takes its beginning, and to the places lying near the Holy bone, which because they run the same course as the Iliacke veins, for brevity's sake, we will let pass further mention of them, till we come to treat of the Iliacke veins. CHAP. XXIII. Of the distribution of the Nerves to the natural parts. IT remains, that before the bowels be taken away, we show the nerves The original of the nerves which are carried to the natural parts. sent to the entrailes and natural parts, that as wise and provident men we may seem to have omitted nothing. First we must know that these nerves are of the sixth conjugation, which descend as well to the stomach all alongst the Gullet and the ●ides thereof, as those at the roots of the ribs on both sides within. But when they are passed through the Midriff, those which are distributed amongst the natural parts follow the turnings of the veins and arteries, but specially of the arteries. Wherefore if you have a mind to follow this distribution of the nerves, you must chiefly look for it in those places, in which the artery is distributed amongst the Guts above the loins. These nerves are but small, because the parts serving for nutrition, needed none Their magnitude and use. but little nerves, for the performance of the third duty of the nerves, which is in the discerning and knowing of what is troublesome to them. For unless they had this sense, there is nothing would hinder, but these bowels necessary for life, being possessed with some hurtful thing, the creature should presently fall down dead; but we have this benefit by this sense, that as soon as any thing troubles and vellicates the bowels, we being admonished thereof may look for help in time. And besides if they were destitute of this sense, they might be gnawn, ulcerated and putrified by the raging acrimony of the excrements falling into and staying in them; but now (by means hereof) as soon as they find themselves pricked, or plucked, presently by the expulsive faculty they endeavoure to expel that which is troublesome, and so free themselves of present and future dangers. CHAP. XXIIII. The manner of taking out the Guts. WHen the Guts are to be taken out, you must begin with the Right Gut. And you must divide it, being first straight tied in two different places, at a just distance about four fing●is from the end, with 〈…〉 between the two ligatures. Th●● you must sh●… proper coats, and fibers, and that common one which it hath from the Peritonaeum. This being done, you must in like manner bind the trunk of the gate vein as near the original as you can; that so all his branches being in like manner tied there may be no fear of effusion of blood: you must do the like with the Caeliacke Arterye at the left kidney, and in the lower Mesentericke, which descends to the Right gut with the haemorrhoidal veins. This being done, pull away the guts even to the Duodenum, which being in like manner tied in two places, which ought to be below the insertion of the Porus Cholagogus or passage of the Gall, that you may show the oblique insertion thereof into that gut, for the obliquity of its insertion is worth observation, as that which is the cause that the Gall cannot flow back into its bladder, by the compression of this Gut from below upwards. Then all these windings of the Guts may be taken away from the body. CHAP. XXV. The Original and distribution of the deseendent Hollow vein. BEcause the rest of the natural parts, do almost all depend upon the descendent Hollow vein, therefore before we go any further, we will show its original and distribution. We said before that all veins proceeded from the Liver, but yet in divers places. For the gate vein goes out of the hollow The original of the hollow vein. It is divided into two trunks, part, and the Hollow vein out of the Gibbous part of the liver, which going forth like the body of a tree, is divided into two great branches, the lesser of which goes to the vital and animal parts, and the extremities of these parts, as we shall show in their place. The greater descending from the back part of the Liver above the Vertebrae of the loins to the parts beneath, goes in the manner following. The first division The division of the greater branch of the hollow vein. 1. Adipos, thereof is to the membranes of the reins, which come from the Peritonaum. Wherefore there it produces the Venaeadiposae, or fatty veins, so called because they bring forth a great quantity of fat in those places; Of these fatty veins, there is a divers original, for the right doth oftentimes arise from the right emulgent because it is higher; but the less comes from the very trunk of the hollow vein, because the emulgent on that side is lower, and you shall scarce see it happen otherwise. The second being the Kidney or Emulgent veins, go to the Reins, Which at 2. Emulgent. their entrance, or a little before, is divided into two branches, like as the Artery is, the one higher, the other lower; and these again into many other through the substance of the Kidneys, as you may learn better by ocular inspection, than by book. They are thick and broad that the serous humour may without impediment have freer passage. Their original is different, for the right Emulgent, often times comes forth of the Hollow vein somewhat higher than the left; that seeing their office and duty is to purge the mass of blood from the choleric and serous humour, that if any part thereof slide by the one, it may not so scape, but fall as it were into the other. Which certainly would not have happened if they had been placed the one just opposite to the other. For the Serous or wheyish humour would have stayed as equally balanced or poised, by reason of the contrariety of the action and traction, or drawing thereof. But we must remember that in dissecting of bodies, I have oft times found in such as have been troubled with the stone, seven Emulgent veins and so many arteries; four from the left side coming from divers places, of which the last came from the Iliacke; three from the right hand likewise in divers places. The third division is called the spermaticke or seed vein, it goes to the Testicles; the original thereof is thus, that the right arises on the fore part of the trunk of the 3 Spermatica. hollow vein; but the left most commonly from the emulgent. Besides you shall sometimes find that these have companions with them, to the right emulgent; but to the left another from the hollow vein, in some but on one side, in others on both. But also I have sometimes observed the left emulgent to proceed from the sper●… or seed vein. The forth because it goes to the loins, is called Lumbaris; which in his original 4. Lumbaris. and insertion is wholly like the Artery of the loins. But there are 4 Lambares or Loin veins on each side, that is, one in each of the 4 spaces of the 5 Vertebras of the loins. The fifth division makes the Iliacae, until passing through the Peritonaeum, they take 5 Iliacae, which are divided into. the name of crural veins; These are first divided into the Musculous, so called, because they go to the oblique ascendent and transverse muscles, and to the Peritonaeum. Sometimes they have their original from the end of the Trunk. And then the same 1 Musculosae. Iliacae are divided into the Sacrae, or holy, which go to the spinal marrow of the 2 Sacrae. Holy bone, through those holes, by which the nerves generated of this marrow, have their passage. 3 Hypagastrica, which produce the Haemorrhoidales externae. Thirdly the Iliacae are divided into the Hypogastricae so called, because they are distributed to all the parts of the Hypogastrium, or lower part of the lower belly, as to the right Gut, the muscles thereof, the musculous skin, (in which place they often make the external Haemorrhoidall, ordained for the purging of such blood as offends in quantity, as those other [that is, the inward Haemorrhoidall] which descend to the right Gut from the Gate vein by the spleenicke branch, serves for cleansing of that which offends in quality) to the bladder and the neck thereof even to the end of the yard, to the womb, and even to the neck of the womb and utmust parts of the privities; from whence it is likely the courses break forth in women with child and virgins. But this same vein also sends a portion of it without the Epigastrium by that perforation which is common to the share and haunch bones, which strengthened by meeting of the other internal crural vein descends even to the Ham, but in the mean time by the way it is communicated to the muscles of the thigh called Obturatores and other parts within. Fourthly, the Iliaca produce the Epigastrica which 4 Epigastrica. on both sides from below ascend according to the length of the right muscles, spreading also by the way some branches to the oblique and transverse muscles and also to the Peritonaum. Fiftly, these Iliacae produce the Pudendae or veins of the privities 5 Pudenda, because they go in women to their privityes, and into men to the Cod, where they enter that fleshy coat filled with veins, and go to the skin of the yard, they take there beginning under the Hypogastricae. CHAP. XXVI. Of the Kidneys or reins. NOw follow the Kidneys, which that they may be more easily seen, (after that you have diligently observed their situation) you shall despoil of there fat, if they have any about them, as also of the membrane they have from the Peritonaeum. First you shall show all their conditions, beginning at their substance. The substance of the Kidneys is fleshy, dense and solid, lest they should be hurt Their substance. Magnitude. Figure. Composition. by the sharpness of the urine; Their magnitude is large enough, as you may see. Their figure is somewhat long and round almost resembling a semicircle, and they are lightly flatted above and below. They are partly hollow and partly gibbous; the hollow lies next the hollow vein, and on this side they receive the emulgent veins and Arteries, and send forth the ureters; there gibbous part lies towards the loins. They are composed of a coat coming from the Peritonaeum, their own peculiar flesh, with the effusion of blood about the proper vessels (as happens also in other entrails) generates a small nerve, which springing from the costal of the sixth conjugation is diffused to each Kidney on his side into the coat of the kidney itself, although others think it always accompanies the vein and arterye. But Fallopius that most diligent Author of anatomy hath observed, that this nerve is not only oftentimes divaricated into the coat of the kidneys, but also pierces into their substance. They are two in number that if the one of them should by Number. chance be hurt, the other might supply those necessities of nature, for which the Kidneys are made. They lie upon the loins at the sides of the great vessels, on which Site, they depend by their proper veins and arteries; and they stick to them, as it were by a certain second coat, lest that they might be shaken by any violent motions. Wherefore we may say that the Kidneys have two coats, one proper adhering to their substance, the other as it were coming from the Peritonaeum on that part they stick to it. The right Kidney is almost always the higher, for those reasons I gave, speaking of the original of the Emulgent vessels. Columbus seems to think the contrary, but such like controversies may be quickly decided by the Eye. They have connexion Connexion. with the principal vessels by the veins, nerves and arteries, by the coats with the loins and the other parts of the lower belly, but especially with the bladder by the ureters. They are of a hot and moist temper, as all fleshy parts are. Their action Temper, Action. is to cleanse the Mass of the blood from the greater part of the serous and choleric humour. I said the greater part, because it is needful that some portion thereof should go with the alimentary blood to the solid parts, to serve in steed of a vehicle lest otherwise it should be too thick. Besides you must note that in each kidney there is a cavitye bounded by a certain Their strainer. membrane, encompassed by the division of the emulgent veins and arteries, through which the urine is strained partly by the expulsive faculty of the kidneys, partly by the attractive of the ureters, which run through the substance of the kidneys on the hollow side, no otherwise than the Porus cholagogus through the body of the Liver. The ninth and tenth figure of the vessels of seed and urine. The first figure showeth the foreside, the second the hinder-side. a. a. a. 1. The forepart of the right kidney. b. b. b. 2. The back part of the left kidney. c. 1. the outside. d. d. 1. 2. The inner side. e. e. 1. 2. The two cavities wherinto the emulgent vessels are inserted. f. f. 1. 2. The trunk of the hollow vein. g. g. 1. 2. The trunk of the great artery▪ h. i. 12. The emulgent vein and artery. k. k. 1. 2. The right fatty vein. l. 1. The left fatty vein. *. 1. The coeliacal artery. m. n. 1. 2. The ureters: o. p. q. 1. 2. The right spermaticke vein which ariseth near p. the left near q. r. i. The place where the Arteries of seed arise. s. 1. 2. Small branches distributed from the spermaticall veins to the Peritonaeum. t. 1. 2. The spiry varicous body, called Varicosum vas pyramidale. u 1. 2. The Parastatae, or Epididymis. x. 1. The testicle yet covered with its coat. y. 1. 2. The place where the leading vessel called vas deferens doth arise α. 1. 2. The descent of the same leading vessel. β. 1. 2. The revolution of the same leading vessel. γ. 1. 2. The passage of the same vessel reflected like a recurrent nerve. δ. 2. The meeting of the same leading vessels. γ. 1. 2. The bladder of urine, the first figure showeth it open, the second showeth the back parts. 33. 1. The small bladder of the seed opened. η. η. 2. The Glandules called Glandulae Prostatae. θ. 2. The sphincter muscle of the bladder. 〈◊〉. 1. 2. The two bodies which make the substance of the yard. χ. χ. 1. The vessels which go unto the yard and neck of the bladder. λ. 1. The passage which is common to the urine and seed, cut open. ψ. 2. The implantation of the ureters into the bladder. CHAP. XXVII. Of the spermaticke Vessels. NOw we should have spoken of the ureters, because as we said before, they are passages derived from the Kidneys to carry the urine to the bladder. But because they cannot be distinguished and showed unless by the corrupting and vitiating the site of the spermaticke vessels; therefore I have thought it better to pass to the explication of all the spermatick parts. And first of all you must gently separate them, (that so the declaration of them may be more easy & manifest) and that from the coat which comes from the peritonaeum, and the fat which invests them even to the share-bone, having diligently considered their site before you separate them. Then you shall teach that the substance Their substance. Quantity. of these vessels, is like to that of the veins and arteries. Their quantity is small in thickness, but of an indifferent length, by reason of the distance of their original from the Testicles. They arelonger in men than in women, because these have their Testicles hanging without their belly, but women have them lying hid within their belly. Their figure and composure is wholly like the figure and composition of the veins Figure and composure. and arteries, except in this one thing, that from that place where they go forth of the great capacity of the Peritonaeum, they are turned into many intricate windings, like crooked swollen veins, even to the Testicles. That the spermaticke matter in that one tract, which yet is no other than blood, may be prepared to concoction, or rather be turned into seed in these vessels, by the irradiation of the faculty of the Testicles. These vessels are six in number, four preparing, and two ejaculatory, of which we will speak hereafter. Therefore on each side there be two preparing Number. vessels, that is, a vein and an artery, arising as we told you when we spoke of the distribution of the hollow vein. They are inserted into the Testicles through that coat which some call Epididymis, others Darton. Their site is oblique above the loins and Site. flanks, whilst they run down between the ends of the share and haunch bone, they are knit to the parts lying under them, both by certain fibers which they send from them, as also by the membrane they have from the Peritonaeum. They have like temperature as the veins and Arteries have. Their action is to carry blood to the Testicles, for generating of seed. CHAP. XXVIII. Of the Testicles, or Stones. THe Testicles are of a Glandulous, white, soft and loose substance, that Their substance. so they may the more easily receive the spermaticke matter: their magnitude and figure equal, and resemble a small pullet's Egg somewhat Magnitudeand figure. Composition. flatted; Their composure is of veins, arteries, coats and their proper flesh. Their veins and arteries proceed from the spermaticke vessels, their nerves from the sixth conjugation, by the roots of the ribs and out of the holy bone. They are wrapped in four coats, two whereof are common, and two proper. The common are the Scrotum or skin of the Cod, proceeding from the true skin; and the fleshy coat, which consists of the fleshy Pannicle in that place receiving a great number of vessels, through which occasion it is so called. The proper coats are first the Erythroris arising from the process of the Peritonaeum, going into The Coa● Erythr●is the Scrotum together with the spermaticke vessels which it involues and covers; this appears red both by reason of the vessels as also of the Cremaster muscles of the Testicles; Then the Epididymis or Dartos which takes its original of the membrane The Epididymis, or Darte●. of the spermatick preparing vessels. The flesh of the Testicles is as it were a certain effusion of matter about the vessels, as we said of other entrailes. But you must observe that the Erythrois encompasses the whole stone, except its head, in which place it sticks to the Epididymis which is continued through the whole substance of the Testicle. This Epididymis or Dartos was therefore put about the stones, because the Testicles of themselves, are loose, spongeous, cavernous and soft, so that they cannot safely be joined to the spermaticke vessels which are hard and strong. Wherefore Nature that it might join extremes by a fit Medium, or mean, form this coat Epididymis. This is scarce apparent in women by reason of its smallness. The two forementioned common coats, adhere or stick together by their vessels not only amongst themselves, but also with the Erythrois. You must besides observe the Cremaster muscles are of the said substance with other muscles, small and thin, of an oblique The Cremaster muscles. and broad figure, arising from the membrane of the Peritonaeum, which (as we said before) assumes flesh from the flanks. Their composition is like that of other muscles. They are two, one each side on. They are situate from the ends of the flanks, even to the stones. They have connexion with the process of the Peritonaeum and Testicles. Their temper is like that of other muscles. Their action is to hang and draw up the Testicles towards the belly, whence they are called, hanging muscles. The Testicles are most commonly two in number, on each side one, sometimes there be three, sometimes one alone, as it happens also in the Kidneys; for some have but one Kidney. They lie hid in the Serotum at the very roots of the share bone, connexed to the principal parts of their vessels, with the neck of the bladder and yard; but by their coats they adhere to the parts from whence they have them. They are of a cold and moist temper, because they are glandulous; although they may be hot by accident by reason of the multitude of the vessels flowing thither. Those whose testicles are Temper. more hot are prompt to venery, and have their privities and the adjacent parts very hairy, and besides their testicles are more large and compact. Those on the contrary that have them cold are slow to venery, neither do they beget many children, and those they get are rather female than male, their privities have little hair upon them, and their testicles are small, soft and flat. The action of the testicles is to generate seed, to corroborate all the parts of the body, and by a certain manly irradiation to breed or increase a true masculine courage. Action. This you may know by eunuchs or such as are Gelt, who are of a womanish nature, and are oftentimes more tender and weak than women. As Hypocrates, teaches by the example of the Scythians, lib. de Aëre, locis et aquis. CHAP. XXIX. Of the varicous bodies or Parastats, and of the ejaculatory vessels and the glandulous or Prostates. THe varicous Parastatae are nervous and white bodies, like as the nerves, round and close woven amongst themselves, they are stretched even from Their substance. the top to the bottom of the testicles, from whence presently by their departure they produce the Vasa ejaculatoria, or trading vessels. But unless we do very well distinguish their names, we shall scarce shun confusion. For that which I call Parastatae, that is, as it were the head of the testicle, being as it were Here the Author speaks otherwise then Galen. like another stone, is called Epididymis by Galen libi. de semine. But I by the example and authority of many Anatomists, understand by the Epididymis the proper coat of the testicles, of which thing I thought good by the way to admonish you of. Their Action is by their crooked passages to hinder the seed from departing out of the preparing into the leading vessels, before it shall be most perfectly laboured Action. and concocted in these vessels by the power and force of the testicles. For in the first windings, the blood looks pure; but in the last it is not so red, but somewhat whitish. For Nature commonly doth thus delay the matter in its passage either by straightness, or obliquity, which it desires to make more perfect and elaborate by any new concoction; this we may learn by the foldings of the Rete mirable, the windings of the Guts, the wrinkles in the bottom of the stomach, the straightness of the Pylorus, the capillary veins dispersed through the body of the Liver; certainly nature hath intended some such thing in the making of the spermaticke vessels. Their Their quantity, figure and composure. quantity is visible, and figure round tending some what to sharpness. They are composed of veins, nerves and arteries (which they enjoy from the vessels of the testicles, from the Epididymis, or the coat, from the Peritonaeum and their proper substance. Their temper is cold and dry. They be two in number, one to each testicle. But these Their temper and number. varicous bodies are called Parastatae, Assisters, because they superficially assist, and are knit to the testicles according to their length, or long-ways. Out of the Vasa ejaculatoria the ejaculatory or leading vessels. Parastatae proceed the Vasa ejaculatoria, or leading vessels, being of the same substance as their progenitors, that is, solid, white and as it were nervous. Their quantity is indifferent, their figure round, and hollow, that the seed may have a free passage through them, yet they seem not to be perforated by any manifest passage, unless by chance in such as have had a long Gonnorrbaea. They have like temper as the Parastats, between which and the Prostates they are seated, immediately knit with them both; as both in the coat and the other vessels with the parts from whence they take them. But we must note, that such like vessels coming out of the parastats ascend from the bottom of the stones even to the top, in which place meeting with the preparing vessels, they rise into the belly by the same passages, and bind themselves together by nervous fibers, even to the inner capacity of the belly; from whence turning back, they forsake the preparing, that so they may run to the bottom of the share-bone, into the midst of two glandulous bodies which they call prostats situate at the neck of the bladder, that there meeting together they may grow into one passage. For thus of three passages, that is, of the 2 leading vessels and 1 passage of the bladder, there is one common one in men for the casting forth of seed and urine. A Caruncle rising like a crest at the beginning of the neck of the bladder argues this uniting of the passages, which receiving this same passage which is sufficiently large, is oft times taken by such as are ignorant in anatomy for an unnatural Caruncle, then especially when it is swollen through any occasion. These leading vessels are two in number, on each side one. Their action is to convey the seed made by the testicles Their number and action. to the Prostats and so to the neck of the bladder, so to be cast forth at the common passage. But if any ask whether that common passage made by the two leading vessels between the two glandulous bodies be obvious to sense or no? We answer it is not manifest, though reason compel us to confess that that way is perforated by reason of the spe●maticle, gross and viscous matter carried that way. But peradventure the reason why that passage cannot be seen is, because in a dead carcase all small passages are closed and hid, the heat and spirits being gone, and the great appear much less, by reason all the perforations fade, and fall into themselves. Yet certainly these passage must needs be very straight, even in a living man, seeing that in a dead they will not admit the point of a needle. Wherefore we need not fear, least in searching, whilst we thrust the Catheter into the bladder, it penetrate into the common passage of the leading vessels which runs within the Caruncle, unless peradventure by some chance, as a Gonnorr●aea, or some great Phlegmon, it be much dilated besides nature. For I have sometimes seen such passages so open, This Caruncle must be observed and distinguished from a Hypersarcosis or fleshy excrescence. that they would receive the head of a Spatherne; which thing should admonish us, that in searching we take great care, that we do not rashly hurt this Caruncle, for being some what rashly handled with a Catheter it casts forth blood, especially if it be inflamed. But also the concourse of the spirits flowing with great violence together with the seed, much helps forward such ejaculation thereof performed through these straight passages by the power of the imaginative faculty in the Act of generation. After the leading vessels follow the Prostatae, being glandulous bodies of the same The Prostatae. Their quantity and figur●. substance and temper that other Glandules are. Their quantity is large enough, their figure round, and some what long, sending forth on each side a soft production of an indifferent length. They are composed of veins, nerves, arterics, a coat (which they have from the neighbouring parts) and last their proper flesh, which they have from their first conformation. They are two in number, situate at the root of the Number and site. neck of the bladder, some what straight bound, or tied to the same, to the leading vessels, and the parts annexed to them. But always observe, that every part which An anatomical axiom. enjoys nourishment, life and sense, either first or last hath connexion with the principal parts of the body, by the intercourse of the vessels which they receive from thence. The use of the Prostats is, to receive in their proper body the seed laboured in Their use. the testicles, and to contain it there, until it be troublesome either in quantity or quality or both. Besides they contain a certain oily and viscide humour in their glandulous body, that continually distilling into the passage of the urine, it may preserve it from the acrimony and sharpness thereof. But we have observed also on each side other Glandules, which Rondeletius calls Appendices glandylosae, Glandulous Roud. in method. med. ad morbos. dependences to arise from these Prostats, in which also their is seed reserved. The 10. figure, where in those things showed in the former figure, are more exactly set forth. aa A part of the Midriff and of the Peritonaum with the ribs broken. bb cc The Convex or gibbous part of the Liver marked with bb. the hollow or concavous part with cc. d e The right and left ligaments of the Liver. f The trunk of the gate veire. g The trunk of the hollov vein. h l The fatty veins both left and right. i The ascent of the great ●●ery above the hollow vein, and the division thereof. k The Caliacall artery. n n The emulgent vessels. oo pp The fat tunicles or coats torn from both the kidneys. qq The ureters that go unto the bladder. t u. The right spermaticall vein which ariseth near to u. x y. The double original of the left spermaticall vein. x. from the emulgent, y from the hollow vein. α The original of the spermaticall arteries β Certain branches from the spermaticke arteries which run unto the Peritonaeum γ The passage of the spermaticall vessels through the productions of the Peritonaeum, which must be observed by such as use to cut for the Rupture. & δ The spirie bodden body's entrance into the testicle, it is called Corpus varicosum pyramidale. The Parastatae. ζ The stone or testicle covered with his inmost coat. 〈◊〉 The descent of the leading vessel called Vas deferens. V y. The Bladder. * The right gut. ξ The glandules called prostatae into which the leading vessels are inserted. ρ The muscle of the bladder. ςτυ Two bodies of the yard, 〈◊〉 and τ and ν his vessels. φχ. The coat of the Testicle. 〈◊〉 The muscle of the Testicle ψ. his vessels ω. CHAP. XXX. Of the ureters. NOw it seems sit to speak of the ureters, bladder, and parts belonging to the bladder. Therefore the ureters are of a spermaticke, white, The substance magnitude, figure and composure of the ureters. dense and solid substance, or an indifferent bigness in length and thickness. Their figure is round and hollow. They are composed of two coats, one proper consisting of right and transverse fibers, which comes from the emulgent veins and arteries; the other common from the Peritonaeum; besides they have veins, nerves and arteries from the Neighbouring parts. They be two in number on each side one; They are situate between the Kidneys Number and site. (out of whose hollow part they proceed) and the bladder. But the manner how the ureters insert or enter themselves into the bladder, and the Porus Cholagogus into the Duodenum, exceeds admiration; for the ureters are not directly but obliquely implanted near the orifice of the bladder & penetrate into the inner space thereof; for within they do as it were divide the membrane or membranous coat of the body of the bladder, and inflnuate themselves into that, as though it were double. But this is opened at the entrance of the urine, but shut at other times, the cover as it were falling upon it, so that the humour which is fall'n into the capacity of the bladder cannot be forced or driven back, no not so much as the air blown into it can come this way out, as we see in swine's bladders blown up and filled with air. For we see it is the Air contained in these which fills them thus, neither can it be pressed forth but with extraordinary force. For as this skin or coat turned in by the force of the humour gives way, so it being pressed out by the body contained within, thrusts its whole body into the passage as a stopple; like to this is the insertion of the Porus Cholagogus into the Guts. The ureters have connexion with the above mentioned parts, with the muscles Connexion. of the loins; upon which they run from the Kidneys to the bladder. Wherefore nothing hinders, but that the stone sliding through the ureters into the bladder, may stupify the thigh as much as it did when it was in the Kidney. They are of a cold and dry temper. Their use is, to serve as passages, or channels for carrying the urine into the Temper and use. bladder. CHAP. XXXI. Of the Bladder. THe bladder is of the same substance that the ureters, that is, nervous, that The substance so it may be the more easily dilated. It is of a large proportion, in some bigger in some less, according to the difference of age, and habit of body. It is of a round figure and as Figure. it were Pyramidal. It is composed of two coats, one proper which is very thick and strong composed Composition. of the three sorts of fibers, that is, in the inner side of the direct; without of the transverse; and in the midst of the oblique. The other common Coat coming from the Peritonaum hath veins and arteries on each side one, from the Hypogastrick vessels above the holybone, also it hath nerves on each side from the sixth conjugation mixed with the nerves of the holybone. For these nerves descend from the brain even to the end of the holybone. It is but one and that situate in men in the lower belly upon the light Cut and below the share bone, but in women between the womb and that bone, to which it cleaves with its membranous ligaments, as it doth to the yard by its neck, and to the right gut by its common coat and proper vessels. It is of a cold and dry temper. Temper, use or action. The use and action thereof is by the fibers continually to draw the urine, and contain it as long as need requires, and then to expel it by the neck, partly by compression either of itself, or rather of the muscles of the Epigastrium and Midriff, because this motion, seeing it is voluntary cannot be performed unless by a muscle which the bladder wants; partly also by the dilatation and relaxation of the sphincter muscle composed of transverse fibers, like the sphincter of the fundament, after the same manner to shut up the orifice of the bladder, that the Their sphincter of the bladder. urine flow not out against our will. But the bladder as it fills is dilated, but as it is emptied, it is contracted like a purse. You may easily observe this Muscle in a Sow's bladder, it is stretched from the orifice of the bladder and beginning of the urinarye passage even to the privities even in women; but in men it is terminated in the Perinaeum, as soon as it hath left the right Gut. Besides, this muscle is thus far stretched forth, that the urine by its compression should be wholly pressed out of the bladder, which by too long stay would by its acrimony do some harm. This is the common opinion of Anatomists concerning the Sphincter of the bladder, which nevertheless Fallopius allows not of. For (saith he) if this muscle should be situate beneath the glandulous bodies, the seed in copulation could never be cast forth without some small quantity of urine. Wherefore he thinks that this muscle is situate above the Prostats, and that it is nothing else but the beginning of the neck of the bladder, which becomes more fleshy whilst it is woven with transverse fibers. The eleventh figure of the bladder and yard. AB, 1, 2, 3, 4, 5, 7, 9 The two bodies which make the yard. CC 2, 3. The place where these two bodies do first arise. D 1, 2, 4, 5, 7, 9 The nut of the yard called glans penis. EE 4, 5. The fungous and red substance of the bodies of the yard. F 4, 5. The mutual connexion of the bodies of the yard, and the nervous outward substance of the same, compassing round about the former fungous' substance. G 1, 2, 3, 4, 5, 7, 9 The passage of the urine, or common pipe running under the yard all along his length. H. I. 1. 2. The first pair of Muscles of the yard, which in the first figure do yet grow to it, but in the second they hang from their original. K. L. 1. 2. The second pair of Muscles of the yard, in the first figure growing, in the second hanging from their insertion. M 1. 2. The sphincter of the right gut. N 3, 7, 8, 9 The round sphincter Muscle of the bladder. O O, A Membrane which is over the holes of the share bone. P 2. Arounde Ligament from the meeting of the share bones unto the head of the thgh. Q. 3. 7. 8. The body of the bladder. R R, 3, 7. The Prostatae, into which seed when it is perfectly laboured, is led. SS, 3, 8. Portions of the ureters. T T* 3, Portions of the vessels which lead down the seed. V V, 7, 8, The umbilical arteries. X 7, 8, The ligament of the bladder called Vrachus. Y, 7, 8. The navel or umbilicus. Z, 7, 8. The umbilical vein. aa 7, The vein and artery of the yard. b 5. The artery distributed through the body of the yard. For the neck of the bladder it differs nothing in substance, composure, number, and The neck of the bladder. temper from the bladder, but only in quantity, which is neither so large, nor round in figure, but somewhat long together with the yard representing the shape of the letter S. It is placed in men at the end of the right Gut and Perinaeum, rising upwards even to the roots of the yard, and with it bending itself downwards; in women it is short, broad, and straight, ending at the orifice of the neck of the womb between the nervous bodies of the Nymphae. In men it hath connexion with the bladder, the ejaculatory vessels, the right gut The connexion and use thereof. and yard; but in women only with the neck of the womb and privities. The use of it is in men to cast forth seed and urine, in women only urine. But we must note that the share bones must be divided and pulled asunder, in that part where they are joined, that so you may the more exactly observe the situation of these parts. Besides you must note that by the Perinaeum we understand nothing else, in men and women, than that space which is from the fundament to the privities in which the seam is called Taurus. CHAP. XXXII. Of the yard. NOw follows the declaration of the Privy parts of men and women, The substance quantity and figure of the yard. and first we will treat of men's. The yard is of a ligamentous substance because it hath its original from bones, it is of an indifferent magnitude in all dimensions, yet in some bigger, in some less; the figure of it is round, but yet some what flatted above and beneath. It is composed of a double coat, Nerves, veins, arteries, two ligaments, the Composure. passage of the urine, and four muscles. It hath its coats both from the true skin; as also from the fleshy pannicle, but the veins and Arteries from these of the lower part of the lower belly which run on the lower part of the Holybone into the yard, as the seminary vessels run on the upper part. The ligaments of the yard proceed on both sides from the sides and lower The ligaments commissure of the sharebones; wherefore the yard is immediately at his root furnished with a double ligament, but these two presently run into one spongy one. The passage of the urine situate in the lower part of the yard comes from the neck of the bladder between the two ligaments. For the four muscles, the two side ones composeing or making a great part The muscles. of the yard, proceed from the inward extuberancy of the Hipbone, and presently they are dilated from their original, and then grow less again. The two other lower arise from the muscles of the fundament and accompany the urinary passage the length of the perinaeum until they enter the yard; but these two muscles cleave so close together, that they may seem one having a triangular form. The action of these four muscles in the act of generation is they open and Their Action. dilate this common passage of urine and seed, that the seed may be forciblely or violently cast into the field of nature; and besides they then keep the yard so stiff, that it cannot bend to either side. The yard is in number one, and situate upon the lower parts of the share bone that it might be more stiff in erection. It hath connexion with the share-bone and neighbouring parts; by the particles of which it is composed. It is of a cold and dry temper. The action of it is to cast the seed into the womb, for preservation of mankind. The head of it begins where the tendons end, this head from the figure thereof The Nut. The Praeputium, or foreskin. is called Glans and Balanus, that is the Nut, and the skin which covers that head is called Praeputium that is, the foreskin. The flesh of this Glandule is of a middle nature between the Glandulous flesh and true skin. But you must note that the Ligaments of the yard are spongy contrary to the condition of others, and filled with gross and black blood. But all these stirred up by the delight of desired pleasure and provoked with a venereal fire, swell up and erect the yard. CHAP. XXXIII. Of the spermaticke vessels and testicles in women. NOw we should treat of the Privy parts in women but because they depend upon the neck and proper body of the womb, we will first speak of the womb, having first declared what difference there is between the In what the sperematicke vessels in women differ from those in men. spermaticke vessels and testicles of men and women. Wherefore we must know that the spermatick vessels in women do nothing differ from those in men in substance, figure, composure, number, connexion, temper, original and use, but only in magnitude and distribution; for women have them more large and short. It was sit they should be more large, because they should not only convey the matter fit for generation of young and nourishment of the testicles, but also sufficient for the nourishment of the womb and child; but shorter because they end at the testicles Why they are larger but shorter than mens. and womb within the belly in women. Where you must note that the preparing spermaticke vessels, a little before they come to the Testicles, are divided into two unequal branches, of which the lesser bended, after the same manner as we said in men, goes into the head of the testicle, through which it sends a slender branch into the coats of the testicles for life and nourishment, and not only into the coats but also into the leading vessels. But the bigger branch descends on each side by the upper part of the womb between the proper coat and the common, from the Peritonaeum where it is divided into divers branches. By this difference of the spermaticke vessels you may easily understand why women cast forth less seed than men. For their Testicles, they differ little from men's but in quantity; For they are lesser and in figure more hollow and flat, by reason of their defective heat which could In what their testicles differ from mens. not elevate or lift them up to their just magnitude. Their composure is more simple, for they want the scrotum or cod, the fleshy coat, and also according to the opinion of some the Erythroides, but in place thereof they have another from the Peritonaeum which covers the proper coat, that is the Epididymis, or Dartos. Silvius writeth that women's Testicles wants the Erythroides; yet it is certain that besides their peculiar coat Dartos, they have another from the peritonaeum, which is the Erythroides, or as Fallopius calls it the Elythroides, that is as much as the vaginalis or sheath. But I think that this error hath sprung from the misunderstanding that place in Galen where he Lib. 14. de usu part. writes, that women's testicles want the Epidedymis. For we must not understand that to be spoken of the coat, but of the varicous parastats (as I formerly said). They differ nothing in number, but in fire; for in men they hang without the belly at the Site. share bone above the Peritonaeum; women have them lying hide in their belly, ne'er the bottom at the sides of the womb, but yet so as they touch not the body of the womb. But these testicles are tied to the womb both by a coat from the Peritonaeum, as also by the leading vessels descending to the horns of the womb, but Connexion. to the rest of the body by the vessels and the nerves arising from the holy bone and costal nerves. They are of a colder Temper than man's. The ejaculatory, or leading Temper. Their ejaculatory vessels. vessels in women differ thus from men's, they are large at the beginning, and of a veinie consistence, or substance, so that you can scarce discern them from the coat Peritonaeum, then presently they become nervous, and wax so slender, that they may seem broken or torn, though it be not so; but when they come nearer to the horns of the womb, they are again dilated; in their other conditions, they agree with men's, but that they are altogether more slender and short. They have a round figure, but more intricate windings than men's; I believe, that these windings might Why they have more intricate windings. Their fire. supply the defect of the varicous Parastats. They are seated between the testicles and womb, for they proceed out of the head of the testicle, than presently armed with a coat from the Peritonaeum, they are implanted into the womb by its horns. The twelfth Figure, of the Womb. A. The bottom of the womb laid open without any membrane. BB. The neck of the womb turned upward. CD. a part of the bottom of the womb like the nut of the yard, swelling into the upper part of the neck of the womb, in the middle whereof the orifice appeareth. EE. a membrane knitting the womb to the Peritonaeum, and holding togethe vessels thereof. F. the left testicle. G. the spermaticall vein and artery. H. a part of the spermaticall vessels reaching unto the bottom of the womb. I. one part of the vessels coming to the testicles * a vessel leading the seed unto the womb. K. the coat of the testicle with the implication of the vessels. L. the cavity of the bladder opened. M. the insertion of the ureters into the bladder. N. the ureters cut from the kidneys. O. the insertion of the neck of the bladder into the lap or privity. The second Figure. aa. The spermaticall vein and artery. bb. branches distributed to the Peritonaeum from the spermaticall vessels. c. the bottom of the womb. d. the neck of the womb. e. certain vessels running through the inside of the womb, and the neck thereof. ff, vessels reaching to the bottom of the womb produced from the spermaticall vessel. gg. the leading vessel of seed called Tuba the Trumpet. hh. a branch of the spermaticall vessel compassing the trumpet. two. the testicles. kk. the lower ligaments of the womb, which some call the Cremasteres or hanging muscles of the womb. l. the lap or privity into which the Cremasteres do end. m. a portion of the neck of the bladder. The third Figure. aa. the spermaticall vessels. bb. a branch from these spermaticall vessels to the bottom of the womb. cc. the body or bottom of the womb. d. the neck of the same, e. the neck of the bladder ending into the neck of the womb. ff. the tefticles. gg. the leading vessels, commonly though not so well called the ejaculatory vessels. hh. the division of these vessels, one of them determining into the horns at double kk. two. the other branch ending in the neck, by which women with child avoid their seed. kk. the horns of the womb. The fourth Figure. AB. The bosom of the bottom of the womb, at whose sides are the horns. CD. a line like a suture or seam, a little distinguishing that bosom. EE. the substance of the bottom of the womb, or the thickness of his inner coat. F. a protuberation or swelling of the womb in the middle of the bosom. G. the orifice of the bottom of the womb. HH. the coat or second cover of the bottom of the womb, coming from the Peritonaeum. four a portion of the membranes which tie the womb. KK. the beginning of the neck of the womb. L. the neck of the bladder inserted into the neck of the womb. m. the Clitoris in the top of the privity. n. the inequality of the privity where the Hymen is placed. o. the hole or passage of the privity in the cleft. p. the skinny caruncle of the privity. CHAP. XXXIIII. Of the Womb. THe Womb is a part proper only to women, given by nature instead of Wherein the privy parts in women differ from those in men. the Scrotum, as the neck thereof, and the annexed parts in stead of the yard; so that if any more exactly consider the parts of generation in women and men, he shall find that they differ not much in number, but only in situation and use. For that which man hath apparent without, that women have hid within, both by the singular providence of Nature, as also by the defect of heat in women, which could not drive and thrust forth those parts as in men. The womb is of a nervous and membranous substance, that it may be more easily dilated and contracted, as need shall require. The magnitude thereof is divers, according to the diversity of age, the use of The substance and magnitude of the womb. venery, the flowing of their courses, and the time of conception. The womb is but small in one of unripe age, having not used venery, nor which is menstruous; therefore the quantititie cannot be rightly defined. The figure of the womb is absolutely like that of the bladder, if you consider it Figure. without the productions, which Herophilus called horns, by reason of the similitude The horns of the womb. they have with the horns of Oxen at their first coming forth. It consists of simple and compound parts. The simple are the veins, arteries, nerves, and coats. The veins and arteries are four in number, two from the preparing spermaticke vessels, Composure. The veins and Arteries. the two other ascend thither from the Hypogastricke, after this manner. First, these vessels before they ascend on each side to the womb, divide themselves into two branches, from which othersome go to the lower part of the womb, othersome to the neck thereof, by which the menstruous blood, if it abound from the conception, may be purged. Nerves come on both sides to the womb, both from the sixth conjugation, descending Nerves. by the length of the back bone, as also from the holy bone, which presently united and joined together, ascend and are distributed through the womb, like the veins and arteries. The utmost or common coat of the womb, proceeds from the Peritonaeum, on The Coats. that part it touches the holy bone; but the proper it hath from the first conformation, which is composed of the three sorts of fibers, of the right on the inside for the attraction of both seeds; the transverse without to expel, if occasion be; the oblique in the midst for the due retention thereof. The womb admits no division, unless into the right and left side, by an obscure line or seam, such as we see in the Scrotum, but scarce so manifest; neither must we afterthe manner of the ancients, or imagine any other cells in the womb. For by the No cells in the womb. law of nature, a woman at one birth can have no more than two. An argument hereof is, they have no more than two dugs. If any chance to bring forth more, it is besides nature, and somewhat monstrous, because nature hath made no provision of nourishment for them. Nature hath placed the womb at the bottom of the belly, because that place The site. seems most fit to receive seed, to carry and bring forth the young. It is placed between the bladder and right gut, and is bound to these parts much more straight, by the neck, than by the body thereof; but also besides it is tied with two most strong ligaments on the sides, and upper parts of the sharebone, on which it seems to hang; but by its common coat from the Peritonaeum, chiefly thick in that place, it is tied to the hollow bone, and the bones of the haunch and loins. By reason of this straight connexion, a woman with child feeling the painful drawings back, and as it were convulsions of those ligaments, knows herself with child. It is of a cold and moist temper, rather by accident, than of itself. The action The temper and action. thereof is to contain both the seeds, and to cherish, preserve, and nourish it, so contained, until the time appointed by nature; and also besides, to receive, and evacuate the menstruous blood. The compound parts of the womb are, the proper body and neck thereof. That body is extended in women big with child, even to the navel, in some higher, in some lower. In the inner side the Cotyledones come into our consideration, which are nothing else The Cotyledones. than the orifices and mouths of the veins, ending in that place. They scarce appear in women, unless presently after childbearing, or their menstrual purgation; but they are apparent in sheep, Goats, and Kine, at all times like wheat corns, unless when they are with young, for than they are of the bigness of hazel nuts: but then also they swell up in women, and are like a rude piece of flesh of a finger and a half thick; which begird all the natural parts of the infant shut up in the womb; Columbus justly reproved. out of which respect this shapeless flesh, according to the opinion of some, is reckoned amongst the number of coats investing the infant, and called Chorion, because, as in beasts, the Chorion is interwoven with veins, and arteries, whence the umbilical vessels proceed; so in women this fleshy lump is woven with veins, and arteries, whence such vessels have their original. Which thing, how true and agreeable to reason it is, let other men judge. There is one thing whereof I would admonish thee, that as the growth of the Cotelidones in beasts, are not called by the name of Chorion, but are only said to be the dependants thereof, so in women such swollen Cotelidones merit not the name of Chorion, but rather of the dependences thereof. This body ends in a certain straightness which is met withal, in following it towards the privities, in women who have borne no children, or have remained barren some certain time; for in such as are lately delivered, you can see nothing but a cavity and no straitnsse at all. This straightness we call the proper orifice of the womb, The orifice of the womb. The proper orifice of the womb is not always exactly shut in women with child. The neck of the womb. which is most exactly shut after the conception, especially until the membrane, or coats encompassing the child be finished, and strong enough to contain the seed, that it flow not forth, nor be corrupted by entrance of the air; for it is opened to send forth the seed, and in some the courses and serous humours, which are heaped up in the womb in the time of their being with clild. From this orifice the neck of the womb taking its original, is extended even to the privities. It is of a musculous substance, composed of soft flesh, because it might be extended and contracted, wrinkled, and stretched forth, and unfolded, and wrested, and shaken at the coming forth of the child, and after be restored to its former soundness and integrity. In process of age it grows harder, both by use of venery, and also by reason of age, by which the whole body in all parts thereof becomes dry and hard. But in growing, and young women, it is more tractable and flexible for the necessity of nature. The magnitude is sufficiently large in all dimensions, though divers, by reason of the infinite variety of bodies. The figure is long, round, and hollow. The composition It's magnitude. Composition. is the same with the womb, but it receives not so many vessels as the womb; for it hath none but those which are sent from the Hypogastricke veins, by the branches ascending to the womb. This neck on the inside is wrinkled with many crests, like the upper part of a dog's mouth, so in copulation to cause greater pleasure by that inequality, and also to shorten the act. It is only one, and that situate between the neck of the bladder and the right Number and site. gut, to which it closely sticketh, as to the womb by the proper orifice thereof, and to the privities by its own orifice; but by the vessels to all the parts from whence they are sent. It is of a cold and dry temper, and the way to admit the seed into the womb, Temper. to exclude the infant out of the womb, as also the menstrual evacuation. But it is worth observation, that in all this passage there is no such membrane found, as that they called Hymen, which they feigned to be broken at the first coition. Yet notwithstanding No Hymen. Columbus, Fallopius, Wierus, and many other learned men of our time think otherwise, and say, that in Virgjns a little above the passage of the urine, may be found and seen such a nervous membrane, placed overtwhart as it were in the middle way of this neck, and perforated for the passage of the courses. But you may find this false by experience; it is likely the Ancients fell into this error through this occasion, because that in some a good quantity of blood breaks forth of these places at the first copulation. But it is more probable, that this happens by the violent attrition of certain vessels lying in the inward superficies of the neck of the womb, not being able to endure From whence the blood proceeds that breaks forth in some virgins in the first coition. without breaking so great extension as that nervous neck undergoes at the first coition. For a maid which is marriageable, and hath her genital parts proportionable in quantity and bigness to a man's, shall find no such effusion of blood, as we shall show more at large in our Book of Generation. This neck ends at the privities, where its proper orifice is, which privy parts we must treat of, as being the productions and appendices of this neck. This Pudendum, or privity, is of a middle substance, between the flesh and a nerve; the magnitude is sufficiently large, the figure round, hollow, long. It is composed of veins, arteries, nerves, descending to the neck of the womb, and a double coat proceeding from the true skin and fleshy pannicle; both these coats are there firmly united by the flesh coming between them; whereupon it is said, that this part consists of a musculous coat. It is one in number, situate above the Perinaum. It hath connexion with the fundament, the neck of the womb and bladder by both their peculiar orifices. It hath a middle temper, between hot, and cold, moist and dry. It hath the same use as a man's Praeputium or foreskin, that is, that together with the Numpha it may hinder the entrance of the air, by which the womb may be in danger to take cold. The lips of the privities called by the greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, by the Latins Ala, contain Alae. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. all that region which is invested with hairs; and because we have fall'n into mention of these Nympha, you must know that they are as it were productions of the musculous skin, which descend on both sides, from the upper part of the share-bone downwards, even to the orifice of the neck of the bladder, oft times growing to so great a bigness, that they will stand out like a man's yard. Wherefore in some they must be cut off in their young years, yet with a great deal of caution, left if they be cut too rashly, so great an effusion of blood may follow, that it may cause, either death to the woman, or barrenness of the womb by reason of the refrigeration by the too great effusion of blood. The latter Anatomists, as Columbus and Fallopius besides these parts, have made mention of another particle, which stands forth in the upper part of the privities, and also of the urinary passage, which joins together those wings we formerly mentioned: Columbus calls it Tentigo, Fallopius Cleitoris, whence proceeds that infamous word Cleitorizein, (which signifies impudently to Cleitoris, tentige handle that part.) But because it is an obscene part, let those which desire to know, more of it, read the Authors which I cited. The thirteenth Figure, showing the parts of women different from these in men. A. B. C. D. The Peritonaeum reflected or turned backward, above and below. E. F. the gibbous part of the liver 〈◊〉 the cave or hollow part E. G. The trunk of the gate vein. H. the hollow vein. I. the great artery. K. the roots of the Coelicall artery which accompanieth the gate vein. L. M. the fatty vein going to the coat of the kidneys. N. O. the forepart of both the kidneys. T. V. the emulgent veins and arteries. aa. the right ureter at the lowest a, cut from a part which near to b, sticketh yet to the bladder, because the bottom of the bladder is drawn to the left-side. c. the left ureter inserted into the bladder near to r. dd. the spermaticke vein which goeth to the left testicle marked with i. ee. the spermaticke vein which goeth to the left testicle with i, also. f. the trunk of the great artery from whence the spermaticall arteries do proceed. g. h. the spermaticall arteries. two. the two testicles. ll, a branch which from the spermaticke vessels reacheth unto the bottom of the womb. mm. the leading vessel of the seed which Falopius calleth the tuba or trumpet, because it is crooked and reflected. n. a branch of the spermaticke vessel, compassing the leading vessel. oo. a vessel like a worm which passeth to the womb, some call it Cremaster. p. the bottom of the womb called fundus uteri. q. a part of the right gut. r. s. the bottom of the bladder whereto is inserted the left ureter, and a vein led from the neck of the womb near unto r. t. the neck of the bladder. u. the same inserted into the privity or lap. x. a part of the neck of the womb above the privity. yy. certain skinnie Caruncles of the privities, in the midst of which is the slit, and on both sides appear little hillocks. The Figures belonging to the Dugs and Breasts. αα, The veins of the Dugs which come from those, which descending from the top of the shoulder, are offered to the skin. β. the veins of the dugs derived from those which through the armhole are led into the hand γ. the body of the Dug or Breast. δδ. the kernels and fat between them. εε. the vessels of the Dugs descending from the lower part of the neck called iugulum, under the breast bone. CHAP. XXXV. Of the Coats containing the Infant in the womb, and of the Navel. THe membranes or coats containing the infant in the womb of the mother, are of a spermaticke and nervous substance, having their matter from the seed of the mother. But they are nervous that so they may be the more easily extended, as it shall be necessary for the child. They are Their substance, magnitude, figure, and composure. of good length and breadth, especially near the time of deliverance, they are round in figure like the womb. Their composition is of veins, arteries, and their proper substance. The veins, and arteries, are distributed to them (whether obscurely, or manifestly, more or fewer) from the womb by the Cotyledones, which have the same office, as long as the child is contained in the womb, as the nipples or paps of the nurses after it is borne. For thus the womb brings the Cotyledones, or veins, degenerating into them, through the coats like certain paps to the infant shut up in them. These coats are three in number according to Galen; one called the Chorion, Secundine, or afterbirth; the other Allantoides; the third Amnios. I find this number Their number. of coats in beasts, but not in women, unless peradventure any will reckon up in the number of the coats, the Cotyledones swollen up, and grown into a fleshy mass, which many skilful in Anatomy do write, which opinion notwithstanding we cannot receive as true. I could never in any place find the Allantoides in women with child, neither in the infant borne in the sixth, seventh, eight, or in the full time, being the ninth month, although I have sought it with all possible diligence, the Midwives being set apart, which might have violated some of the coats. But thus I went about this business, I divided the dead body of the mother crosswise upon the region of the womb, and taking away all impediments, which might either hinder, or obscure our diligence, with as much dexterity as was possible, we did not only draw away that receptacle or den of the infant, from the inward surface of the womb, to which it stuck by the Cotyledones, but we also took away the first membrane which we called Chorion, from that which lies next under it, called Amnios, without any rending or tearing; for thus we poured forth no moisture, whereby it might be said, that any coat, made for the containing of that humour, was rend, or torn. And then we diligently looked, having many witnesses and spectators present, if in any place there did appear any distinction of these two membranes, the Allantoides, and Amnios, for the separating the contained humours, and for other uses which they mention. But when we could perceive no such thing, we took the Amnios' filled with moisture on the upper side, and having opened it, two servants so holding the apertion, that no moisture might flow out of it into the circumference of the Chorion or womb; then presently with sponges we drew out by little and little all the humidity contained in it, the infant yet contained in it, which was fit to come forth, that so the coat Amnios' being freed of this moisture, we might see whether there were any other humour contained in any other coat besides. But having done this with singular diligence and fidelity, we could see no other humour, nor no other separation of the membranes besides. So that, from that time I have confidently held this opinion, that the infant in the womb, is only wrapped in two coats, the Chorion and Amnios. But yet not satisfied by this experience, that I might yet be more certain concerning this Allantoides, having He shows by three several reasons that there is no Allantoides. passed through the two former coats, I came to the infant, and I put a quill into its bladder, and blew it up as forceably as I could, so to try, if by that blowing I might force the air into that coat which we questioned, as some have written. But neither thus could I drive any air from hence, through the navel into the controvetted coat, but rather I found it to fly out of the bladder by the privities. Wherefore I am certainly persuaded that there is no Allantoides. Moreover I could never find nor see in the navel that passage called the urachus, which they affirm to be the beginning and original of the coat Allantoides. But if it be granted that there is no such coat as the Allantoides, what discommodity will arise hereof? specially seeing the sweat and urine of the infant may easily and without any discommodity be received, collected and contained in the same coat, by reason of the small difference which is between them. But if any object that the urine by its sharpness and touching will hurt the infant; I will answer, there can be no so great sharpness in the urine of so small an infant, and that, if that there be any, it is tempered by the admixture of the gentle vapour of sweat. Besides, if you consider, or have regard to the use of such an humour (which is to hold up the child, lest by its weight it breaks the ties, by which it is bound to the womb;) we shall find no humour more fit for this purpose than this serous, as which by its thickness is much more fit to bear up a weight, than the thin and to liquid sweat. For so we see the sea or salt water carries greater weights without danger of drowning, than fresh rivers do. Wherefore I conclude that there is no need, that the urine should be kept and contained in one coat, and the sweat in another. The Ancients who have writ otherwise, have written from observations made in beasts. Wherefore we make but only two coats the Chorion and Amnios, the one of which seeing it contains the other, they both so encompass the child, that they vest ●on every side. Fallopius in some sort seems to be of this opinion; for he only makes two coats; the Chorion and Amnios, but he thinks the infant makes the water into a certain pat of the Chorion, as you may perceive by reading of his Observations. Both these coats are tied between themselves by the intercourse of most slender nervous fibes, and small vessels penetrating from the outer Chorion to the inner Amnios. Wherefore unless you warily handle these coats you may easily tear the Amnios in seprating it. They are of the same temper with other membranes. Their use is different Their temper and use. for the Chorion is made both for the preservation of the vessels, which it receives from the womb for the generating of the umbilical veins and arteries, as also, to keep whole and safe the parts which it invests. Bt the Amnios is to receive and contain the excrementitious and ferous humours which the child shut up in the womb is accustomed to evacuate. But this coat; very thin and soft, but strong and smooth, lest by its touch it might hurt the infant whereupon it is called the Lamb-kinne coat. CHAP. XXXVI. Of the Navel. THe Navel follows these coats; It is a white body somewhat resembling What the navel is. the wreathen cord, or girdle of the Franciscan Friars, but that it hath not the knots standing so far out, but only swelling in certain places, resembling a knot, only lifted up on one side; it arises and takes its original from a fleshy mass which we expressed by the name of swelling C●…dones, and goes into the midst of the lower belly of the infant, yea verily Their Navel is the Centre of the body. into th●…idst of the whole body, whose root it is therefore said to be. For even as a t●… by the root, sucks nourishment from the earth, so the infant in the womb draw its nourishment by the navel. The greatness of it in breadth and thickness, eq●…ll the bigness of the little finger. But it is a foot and a half long, so that children 〈◊〉 brought forth with it, encompassing their middle, neck, arms, or legs. The fig●…e of it is round. It is composed of two arteries, one vein and two The figure and composure. coats. It hath ●…se vessels from that great multitude of capillary veins and arteries, which are seen ●…ispersed over the Chorion. Wherefore the vein entering in at the navel, penetra●… from thence into the hollow part of the liver, where divided into two, according ●alens opinion, it makes the gate and hollow veins. But the arteries, Lib. de format; fatus in uter●. carried by th●…selves the length of the navel, cast themselves into the Iliacae, which they make, as also all other, that from thence the vital spirit may be carried by them over all the infant. It hath its two coats from the Chorion. But seeing they are mutually woven and conjoined without any medium, and are of a sufficient strength and thickness over all the navel, they may seem to make the infants external skin and fleshy pannicle. I know very many reckon two umbilical veins, as also arteries, and the urachus by, or through which the urine flows into the coat Allantoides. But because this is not to be found in women, but only in beasts, I willingly omit it, because I do not intend to mention any parts, but such There is only one vein in a child's navel, but no Vrachus. as belong to humane bodies. Yet if there be any, which can teach me, that these parts, which I think proper to brute beasts, are to be found in women, I will willingly confess, and that to his credit, from whom I have reaped such benefit. The other things that may be required concerning the navel as of its number, site, connexion, temper, and use, may easily appear by that we have spoken before. For we have apparently set down the use, when we said the navel was made for that purpose, that the infant may be nourished by it, as the tree by the root, by reason of the continuation of the vessels thereof, with the preparing spermaticke vessels, made by God for that purpose, to whom be honour and glory for ever and ever. Amen. The End of the third Book. THE FOURTH BOOK TREATING OF THE Vital parts contained in the Chest. The Preface. HAving finished the first Book of our Anatomy, in explanation of the natural parts contained in the lower belly, now order requires, that we treat of the Breast; that so the parts in some sort already explained (I mean the veins and arteries) may be dispatched after the same order and manner, without interposition of any other matter. And besides also that we may the more exactly and cheerfully show the rest of the parts which remain, as the head and limbs, knowing already the original of those vessels which are dispersed through them. To this purpose, we will define what the Chest is, and then we will divide it into its parts. Thirdly, in these we will consider which parts contain, and which are contained, that so we may more happily finish our intended discourse. CHAP. I. What the Thorax, or the Chest is; into what parts it may be divided, and the nature of these parts. THe Thorax or Chest is the middle belly, terminated or bounded above with the coller-bones, below with the midriff, before with the Sternun or breast, behind, with the twelve Vertebrae of the back on both sides, The containing parts of the Chest. with the true and bastard ribs, and with the intercostal and intercartilagineous muscles. Nature hath given it this structure and composition, lest that being a defence for the vital parts against external injuries, it should hinder respiration; which is no less needful for the preservation of the native heat, diffused by the vital Why nature hath made the Chest partly bony, partly gri●t●ely. spirits, and shut up in the heart, as in the fountain thereof, against internal injuries, than the other forementioned parts against external. For if the chest should have been all bony, verily it had been the stronger, but it would have hindered our respiration or breathing, which is performed by the dilating, and contracting thereof. Wherefore lest one of these should hinder the other, nature hath framed it, partly bony and gristlely, and partly fleshy. Some render another reason hereof, which is, that nature hath framed the chest, that it might here also observe the order used by it in the fabric of things, which is, that it might conjoin the parts much disagreeing in their composure, as the lower belly, altogether fleshy, and the head all bony, by a medium partaker both of the bony and fleshy substance; which course we see it hath observed in the connexion of the fire and water, by the interposition of the air; of the earth and air, by the water placed between them. The Chest is divided into three parts, the upper, lower, and middle: the collar bones contain the upper, the midriff the lower, and the Sternon the middle. The The number of the bones of the Sternon. Sternon in Galens' opinion is composed of seven bones, I believe by reason of the great stature of the people that lived then. Now in our times you shall oft find it compact of three, four, or five bones, although we will not deny but that we have often observed it, (especially in young bodies) to consist of seven or eight bones. Wherefore those who have fewer bones in number in their Sternon, have them larger, that they might be sufficient to receive the ribs. This is the common opinion of the Sternon. Yet Fallopius hath described it far otherwise, wherefore let those who desire to know more hereof, look in his observations. At the lower part of the Sternon there is a gristle, called commonly Furcula, and Cartilago scutiformis the brestblade. Malum granatum, or the Pomegranate, because it resembles that fruit; others call it Cartilago scutiformis, that is, the brestblade. It is placed there to be as it were a bulwark or defence to the mouth of the stomach, endued with most exquisite sense; and also that it should do the like to that part of the midriff, which the liver bears up in that place, situate above the orifice of the ventricule by the ligament coming between, descending from the lower part of the same gristle into the upper part of the liver. The common people think that this gristle sometimes falls down. But it so adheares, and is united to the bones of the Sternon, that the falling thereof may seem to be without any danger, although oft times it may be so moistened with watery and serous humidities, with which the orifice of the stomach abounds, that as it were soaked and drunk with these, it may be so relaxed, that it may seem to be out of its place; in which case it may be pressed and forced by the hand, into the former place and seat, as also by applying outwardly, and taking inwardly astringent and drying medicines to exhaust the superfluous humidity. This gristle at its beginning is narrow, but more broad and obtuse at its end, somewhat resembling the round or blunt point of a sword, whereupon it is also called Cartilago Ensiformis or the swordlike gristle. In some it hath a double, in others a single point. In old people it degenerates into a bone. Now because we make mention of this gristle, we will show both what a gristle is, and how many differences thereof there be, that henceforward as often as we shall have occasion to speak of a gristle, you may understand what it is. A gristle is a similar part of our bodies, next to aboue most terrestrial, cold, dry, What a Gristle is. hard, weighty and without sense, differing from a bone in dryness only, the which is more in a bone. Wherefore a gristle being lost cannot be regenerated, like as a bone without the interposition of a Callus. The difference of these are almost the same with bones, that is from their consistence, The differences thereof. substance, greatness, number, site, figure, connexion, action, and use. Omitting the other for brevity sake, I will only handle those differences which arise from site, use, and connexion. Therefore gristles, either adhere to the bones, or of, and by themselves make some part, as the gristles of the eyelids called Tarsi, of the Epiglottis and throttle. And others which adhere to bones, either adhere by the interposition of no medium, as those which come between the bones of the Sternon, the collar bones, the share and haunch bones and others; or by a ligament coming between, as those which are at the ends of the bastard ribs to the Sternon by the means of a ligament, that by those ligaments being softer than a gristle, the motions of the chest, may be more quickly and safely performed. The gristles which depend on bones, do not only yield strength to the bones, but to themselves, and the parts contained in them, against such things as may break and bruise them. The gristles of the Sternon, and at the ends of the bastard ribs are of this sort. By this we may gather that the gristles have a double use, one to polish and levigate the parts to which that slippery smoothness was necessary for performance of Their two fold use. their duty; and for this use serve the gristles which are at the joints, to make their motions the more nimble. The other use is to defend those parts upon which they are placed, from external injuries, by breaking violent assaults, by somewhat yielding to their impression, no otherwise than soft things opposed against cannon shot. We will prosecute the other differences of gristles in their place, as occasion shall be offered and required. CHAP. II. Of the containing, and contained parts of the Chest. THe containing parts of the chest are both the skins, the fleshy pannicle, the fat, the breasts, the common coat of the muscles, the muscles of that The division of the chest into its parts. place, the forementioned bones, the coat investing the ribs and the Diaphragma or midriff. The parts contained are the Mediastinum, the Pericardium or purse of the heart, the heart, the lungs & their vessels. Of the containing parts, some are common to all the body, or the most part thereof, as both the skins, the fleshy pannicle and fat. Of which being we have spoken in our first Book, there is no need now further to insist upon; Others be proper to the chest, as its muscles, of which we will speak in their place, the breasts, the forementioned bones, the membrane investigating the ribs, and the Diaphragma or midriff. We will treat of all these in order, after we have first showed you the way, how you may separate the skin from the rest of the chest. Putting your knife down even to the perfect division of the skin, you must draw a straight line from the upper part of the lower belie, even to the chin; then draw another strait line, overtwhart at the collar bones even to the shoulderblades; and in the places beneath the collar-bones: (if you desire to shun prolixity) you may at once separate both the skins, the fleshy pannicle, the fat, and common coat of the muscles; because these parts were showed and spoken of in the dissection of the lower belie. Yet you must reserve the breasts in dissecting of the bodies of women; wherefore from the upper parts of the breasts, as artificially as you can, separate only the skin from the parts lying under it, that so you may show the Pannicle which there becometh fleshy and musculous, and is so spread over the neck, and parts of the face, even to the roots of the hairs. CHAP. III. Of the Breasts or Dugs. THe Breasts, as we said, when we spoke of the nature of glandules, are of a glandulous substance, white, rare, or spongious, in maids, and Their substance. women that do not give suck, they are more solid and not so large. Wherefore the bigness of the Dugs is different, although of a sufficient magnitude in all. Their figure is round, somewhat long, and in some sort Magnitude, Figure. Pyramidal. Their composure is of the skin, the fleshy pannicle, glandules, fat, Composure. nerves, veins, and arteries, descending to them from the Axillaris under the Sternon betwixt the fourth and fifth, and sometimes the sixth of the true ribs. And there they are divided into infinite rivulets by the interposition of the glandules and fat, by which fit matter may be brought, to be changed into milk by the faculty of the dugs. We will speak no more of the nature of glandules, or kernels, as having treated of them before; only we will add this, that some of the glandules have nerves, as Which glandules have nerves and which have none. those of the breasts, which they receive from the parts lying under them, that is, from the intercostal, by which it comes to pass that they have most exquisite sense. Others want a nerve, as those which serve only for division of the vessels, and which have no action, but only use. They be two in number, on each side one, seated at the sides of the Sternon upon the fourth fifth and sixth true ribs. Wherefore they have connexion with the mentioned parts with their body, but Their Connexion. by their vessels with all other parts, but especially with the womb by the relics of the mamillary veins and arteries, which descend down at the sides of the brestblade; in which place these veins insinuating themselves through the substance of How the breasts and womb communicate each with other. the muscles, are a little above the navel conjoined with the Epigastricks, whose original is in some sort opposite to the Hypogastrickes, which send forth branches to the womb. By the meeting of these it is more likely that this commerce should arise, than from other and those almost capillary branches, which are sometimes seen to descend to the womb from the Epigastrick. They are of a cold and moist temper, wherefore they say that the blood by being Their temper. converted into milk * Recrudescere. Their action and use. becomes raw, phlegmatic and white by the force of the proper flesh of the dugs. Their action is to prepare nourishment for the new borne babe, to warm the heart from whence they have received heat, and to adorn the breast. By this you may know that some Glandules have action, others use, and some both. At the top of the dugs there are certain hillocks, or eminencies called tears or nipples, by sucking of which the child is nourished through certain small and The Nipples. crooked passages; which though they appear manifest to the sight, whilst you press out the milk by pressing the dug, yet when the milk is pressed out they do not appear, nor so much as admit the point of a needle, by reason of the crooked ways, made by nature in those passages, for this use, that the milk being perfectly made should not flow out of its own accord against the nurses will. For so the seed is retained and kept for a certain time in the Prostats. CHAP. four Of the Clavitles, or Choler bones and Ribs. IF we should handle these parts after the common order, we should now treat of the Muscles of the Chest which move the arm, and serve for respiration, and which first offer themselves to our sight. But for that they cannot be fitly showed, unless we hurt the muscles of the shoulder blade and neck, therefore I think it better, to defer the explanation of these muscles until such time as I have showed the rest of the contained and containing parts, not only of the chest, but also of the head, that having finished these we may come to a full demonstration of all the rest of the muscles, beginning with those of the head, which we first meet with, and so prosecuting the rest even to the muscles of the feet, as they shall seem to offer themselves more fitly to dissection, that so, as much as lies in us, we may shun confusion. Wherefore returned to our proposed task, after the foresaid muscles come the Collar bones, the sternon and ribs. But that these parts may be the more easily understood, we must first know what a bone is, and whence the differences thereof are drawn. Therefore a bone is a part of our body most terrestrial, cold, dry, hard, wanting What a Bone is. all manifest sense, if the teeth be excepted. I said manifest sense, that you may understand that the parts have a double sense of touching, the one manifest, such as resides in the flesh, skin, membranes, nerves, A double sense Teeth and certain other parts; the other obscure, yet which may suffice to Lib. 1. de Locis affectis. discern the helping and hurting tactile qualities, such sense the bowels and bones have; for very small fibers of the nerves are disseminated to these parts by mediation of their coat, or membrane, I say so small, that they can scarce be discerned by the eyes, unless (as Galen saith) by plucking such coats away from the parts. But it is no marvel if nature would have these parts in like manner to have such Why the bones have such small vein.. small veins, contrary to the lungs and most part of the Muscles, only to yield so much nourishment to the part, as should be needful; for seeing the substance of the bones is cold, hard, dense and solid, it wastes the less. Wherefore they need not so much blood for their nourishment, as the hot and soft parts; and besides the lesser bones have neither veins, nor arteries, but draw fit nourishment, only by the force of the attractive faculty implanted in them. The differences of bones are taken from many things, as from their Apophyses, Epiphyses, Whence the difference of bones may be taken. gristles, necks, heads, solidity, cavity, eminencies, marrow, consistence, bigness, number, figure, site. We will prosecute all these as they shall offer themselves in the demonstration of the bones; to which doctrine we will give a beginning at the Clavicles or collar bones. The Clavicles are two very hard and solid bones, without any great or notable The Clavicles or collar bones cavity, situate on each side betwixt the side and upper part of the sternon and top of the shoulderblade, for the strength and stability of these parts, whence they take the name of Claviculae Clavicles (from the Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which signifies a key or any other bar or fastening of a door.) They carry the shape of a surgeon's Levatory. But you must note that the Clavicles seems to be fastened to the sternon by the mediation of a gristlely bone. Moreover the space and cavity contained within the Collar bones is called by the Latins Ingulum, by the French the upper furcula, because the jugular veins pass that way; it sticks to the upper process of the shoulder by a Gristle which Galen calls the small gristle bone, although it be nothing else but a production Lib. 13. damn 〈◊〉 part. Cap. 11. of the Os juguli. For the sternon, which we said is framed of divers bones, as sometimes 3, sometimes 4, 5, 6, 7, and sometimes 8, you must note they are very spongy and full of pores, and of a far softer consistence than the collar bones, wherefore more subject to corruption; besides they are mutually joined by interposition of muscles. Their use is to be as a shield to defend the vital parts. The Ribs are 24. in number, on each side 12, seven of these are called true or perfect The Ribs. ribs, because they make a circle, at the one end joined to the sternon, on the other to the vertebrae; the other are called bastard or short ribs because they falshort in their way and come not to the sternon; but they are fastened on the fore-side to the sternon by gristles and ligaments, but on the back part to the transverse vertebrae of the backbone, and to the sides of the said vertebrae. But the short ribs are only knit to the vertebrae, wherefore that part of the vertebrae is called the root of the ribs. The exterior or forepart of the Bastard or short ribs is gristely, that they should not be broken, and that they might be the easier lifted up in the distensions of the Their consistence. stomach filled with meat. They are of a consistence sufficiently hard, yet more towards their root, than at the stërnon, where they come nearer together, and are more hardly broken; they are smooth both within and without, but in the midst they have some sign of being double, or hollow to receive the veins and arteries, which nourish their bony substance; they are fashioned like a bow; their use is the same with the sternon, and besides to carry and strengthen the muscles serving for respiration. CHAP. V. The anatomical Administration of the Sternon. THe Coat investing the ribs, which the common Anatomists call Pleura, is the last of the containing parts of the Chest, which because it lies hid in the inner part thereof, it cannot be shown unless by pulling asunder of the Sternon; wherefore we must now show the manner of opening the Sternon, that hereby we may not violate the original or insertion of any of the muscles. Wherefore first you must understand that he which will show in their proper place the original and insertion of the pectoral muscles, of the Mastoides, of the two muscles of the bone Hyois, of the Muscles subclavii and intercartilaginei, ought first of all to separate all the pectoral muscles from the sternon and the gristles from the true ribs; then to cut the ligaments, next the bones themselves, even from the sixth true rib to the clavicles. And then showing the Mediastinum stretched under the sternon all the length thereof, he must separate the sternon with his knife and bend it up to the clavicles, and there cut it, reserving together with it the four muscles, that is, the two Mastoides and the two moving the bone Hyois, because they either wholly or for the most part arise from the sternon. Lastly the Clavicles being somewhat thrust upwards, the Gristles must on each side be turned outwards towards the arm; that so the containing parts of the chest may not only lie open to view and be easily showed, but also the muscles may be contained in their place, until they come to be showed in their order. And because the Collar bones must be lifted up very high, that the recurrent nerves may be more easily seen and the distribution of the veins and arteries, the two small subclavian muscles one on each side must be shown by the way, who have their original from the inner and fore part of the Clavicles, and an oblique descent to the sternon towards the gristle of the first rib. For the Clavicles cannot be thus separated, but that these muscles must be violated and spoiled. Also you may divide the sternon in the midst, that you may show the inward pectoral muscles whole, having separated the muscles which arise from the upper part. All which things being performed as they ought, we must come to the Coat investing the ribs and then to the Mediastinum as arising from it. CHAP. VI Of the Pleura, or coat investing the Ribs. THe Tunica subcostalis, or coat investing the ribs being the last of the containing parts of the Chest, is a large and a broad membrane answerable What the membrane investing the Ribs is. in proportion of use and action to the Peritonaeum of the lower belly. For as the Peritonaeum generally and particularly covers all the natural parts, binding and holding them in their places, so this coat invests all the vital parts in general because it is stretched over all the inside of the Chest, but in particular, whilst it gives each a coat from itself. It hath its original from the Periostium, (or as others will have it from the pericranium,) investing the vertebrae of the Chest at the roots of the ribs. Wherefore it It's original. sticks very fast to the ribs, scarce to be separated, as also to all the parts bounding the Chest, and contained in it. Vesalius reprehends Galen, because he said, that this was double on both sides; yet Columbus defends Galen, and verily it is seen to be double in the inner part of the Chest, under the ribs and the muscles of the ribs, that in that space there may be way for the veins, arteries and nerves. Some have made it two fold, and divided it into the internal and external; as those which have made two sorts of pleurisyes, the true and bastard; placing the external Whether, as there is a twofold pleurisy, so also a double Pleura above the Ribs and intercostal muscles; but the internal under the Ribs, muscles, Diaphragma and sternon. But we to shun ambiguity, intent only to prosecute those things which are manifest to the eyes; wherefore we say that the ribs are lined on the inside with a double coat; one which immediately and firmly sticks to them on every side called the Periostium, which is common to them and other bones. The Magnitude and figure. The other which lies upon that Periostium and on the inside invests all the ribs, whence it is called the subcostalis tunica. The substance, temper and composure are the same, as in other membranes. The magnitude in length, as also the figure is the same with the compass of the inner part of the chest; the thickness of it is very little. This coat is commonly called the Pleura from the name of the part which it covers or lines (for the greeks call the ribs 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉,) and in like manner which happens betwixt the Periostium and this Pleura, is called either a true or bastard Pleurisye. CHAP. VII. Of the Mediastinum NOw we must speak of the parts contained in the Chest, seeing we have The substance and magnitude. already handled the containing, beginning with the Mediastinum as being a part which in dissection first presents itself to our sight. The Mediastinum is of the same substance, thickness, composure, number, temper as the Pleura. For the substance of the Mediastinum is membranous, and though it be stretched all the length of the Chest, yet it is of a small thickness, receiving veins, nerves and arteries from all the parts to which it is knit, like as the Pleura doth; but especially from the mamillary vessels descending under the sternon. It is in number one, but it is made of two membranes produced from the subcostall, for this ascending on each side by the hollowness of the chest to the sternon, and then at right angles it is reflected to the bodies of the vertebrae, whence the Pleura hath its original. In that reflection there is so much distance between each membrane, as may be sufficient to receive 2 fingers. For otherwise, seeing that they cannot penetrate through the hart, it was fit each side of the Pleura should turn to the Pericardium, that so they might arrive at the appointed place without offence. Nether yet is that space void and empty, but woven with many small nervous fibers; Columbus adds, that, that place is often filled with a certain humour besides nature, which you may draw our, or evacuate by opening the sternon. Yet I would gladly learn of Columbus, by what signs we may know that such an The figure. humour is contained there. For the figure, the Mediastinum with the Pleura on each side represents the figure of a Leather bottle, whose flat side is the Mediastinum, whose other side the Pelura; the bottom that part of the pleura which is next the Midriff, the mouth the upper part of the Pleura at the first ribs. We showed the site and con nexion of the Mediastinum, when we declared its original. The use thereof is to separate the vital parts, as it were into 2 cells, the right and The use. le●t, that if peradventure it happen that the one be hurt, the creature may live by the benefit of the other. And it hath another use which is to prop and hold up the Pericardium, that it fall not upon the heart with its weight, but tossed with the motions of the heart and Chest, it may move to this or that side. CHAP. VIII. Of the Diaphragma or Midriff. ALthough the Midriff may seem to be accounted rather a part containing What the midreffe is. than contained, yet for commodities sake we have deferred the demonstration thereof till now. Therefore it is a muscle round and long, terminating the lower part of the Chest. It is of the same substance, composition and temper, as the muscles of the Epigastrium, It's substance, composition etc. it is made of two coats the lower whereof is from the Peritonaeum, and the upper from the Pleura. Which getting to them flesh but not there, but in their circumference, by the benefit of the blood brought thither by the veins and arteries distributed through it, turn into a muscle, whose middle is nervous and membranous, but the extremityes by which it is inserted, one while fleshy as in that part next to the bastard ribs; another while tendonous, as where it touches the first & second vertebrae of the loins, for it ends in them by 2 tendons manifest enough. It is one in number, interposed with an oblique site betwixt the natural and vital parts. It hath connexion with the lower part of the sternon and short ribs, and the two first Connexion. vertebrae of the loins, but by its coats and vessels with the parts from whence it received them. The extent thereof is equal to the compass of the lower part of the Chest. The Quantity. length of it is from the breast blade even to the first and second vertebra of the loins. The thickness is divers, for it is far thicker in its fleshy extremity, than in its nervous original. The Action thereof is to help the expulsion of the Excrements by the mutual assistance of the Epigastrick muscles, but the chief use is for respiration, of which it is Action. one of the prime instruments. This partition the Ancients called Phrenes, because the inflammation thereof caused like symptoms as the inflammation of the Brain, by Why the Diaphragma was called Phrenes. reason of the large nerves on each side one which come to it directly & primarily from the third, fourth and fifth vertebra of the neck. This muscle differs from other muscles, specially in figure. It is preforated in three places, to give way or passage to the ascendent Hollow-veine, to the Artery Aorta, and the Gullet. CHAP. IX. Of the Lungs. THe Lungs are of a soft substance and flesh, rare and like a sponge, of a various colour pale red, their quantity is sufficiently large; for most commonly they Their substance, quantity. The Lobes thereof. are divided into 4 lobes disjoined with a manifest and visible division, on each side two, whereby they may be the more easily opened and contracted, and the air may the better enter. Besides also in large bodies, who have a very great chest, there is found a fifth lobe, arising from the second lobe of the right side, as a cushion, or bolster to bear up the hollow vein ascending from the midriff to the heart. In little men who have a shorter Chest, because the Heart is so near as to touch the Diaphragma, this Lobe is not seen, yet it is always found in Dogs. The Lungs represent the figure or shape of an Ox's foot, or hoof, for like it they Figure. are thicker in their basis, but slenderer in their circumference, as you may see in blowing them up, by the weazon, with your mouth or a pair of bellowes. They are compounded of a coat coming from the Pleura, which on each side receives sufficient Composition. number of nerves from the sixth conjugation; and also of the Vena arteriosa coming from the right ventricle of the heart, and the Arteria venosa from the left, as shall be showed in the Anatomy of the heart; besides the Aspera arteria or Weazon coming from the throat, and lastly its own flesh, which is nothing else than the concretion of choleric blood poured out like foam about the divisions of the foresaid vessels, as we have said of other parts. The body of the Lungs is one in number, unless you will divide it into two, by reason of the variety of its site, because the Lobes of the Lungs stretched forth into the right & left side do almost involve all the heart, that so they may defend it against the hardness of the bones which are about it; they are tied to the heart, chiefly at its basis, but to the roots of the ribs and their vertebrae by the coat it hath from thence; but by the vessels to these parts from whence they proceed. But oft times presently The sticking of the lungs to the Ribs. from the first and natural conformation they are bound to the circumference of the ribs by certain thin membranous productions which descend from thence to the Lungs, otherways they are tied toe the ribs by the Pleura. The nourishment of the Lungs is unlike to the nourishment of other parts of the Their nourishment. body; for you cannot find a part equally rare, light and full of air, which may be nourished with blood equally thin and vaporous. In temper they incline more to heat than to cold, whether you have regard to their composure of choleric blood, or their use, which is to prepare and alter the air that it hurt not the heart by its coldness. The Lungs is the instrument of voice and breathing by the Weazon or windpipe. For the Lobes are the instruments of voice, and the ligaments, of respiration. But the Larinx or Throttle is the chief instrument of the voice, for the Weazon first prepares the voice for the Throttle, in which it being in some measure form is perfected in the palate of the mouth, as in the upper part of a lute, or such like instrument, by the help of the Gargareon or uvula as a certain quill to play withal. But as long as one holds his breath, he cannot speak; for then the muscles of the Larinx, Ribs, the Diaphragma and the Epigastrick muscles are pressed down, whence proceeds a suppression of the vocal matter, which must be sent forth, in making or uttering a voice. Nature would have the Lungs light for many reasons, the first is that seeing they Why the lungs are light. are of themselves immovable, they might be more obsequious and ready to follow the motion of the chest, for when it is straitened, the Lungs are straitened and subside with it; and when it is dilated, they also are dilated, and swell so big that they almost fill up all the upper capacity thereof. Another cause is that by this their rarity they might more easily admit the entering Air, at such times as they have much, or sudden necessity, as in running a race. And lastly, that in Pleurisies and other purnient abscesses of the Chest the Pus or matter poured forth into the capacity of the Chest may be sucked in by the rare substance of the Lungs, and by that means the sooner sent forth and expectorated. The use of respiration is to cool and temper the raging heat of the Heart. For The use of Respiration, or breathing. it is cooled in drawing in the breath by the cool air, and in sending out thereof by avoiding the hot fuliginous vapour. Therefore the Chest performs two contrary motions, for whilst it is dilated it draws in the encompassing air, and when it is depressed it expels the fuliginous vapour of the Heart; which any one may easily perceive by the example of a pair of Smiths bellowes. CHAP. X. Of the Pericardium or purse of the Heart. THe Pericardium is as it were the house of the Heart, which ariseing at the Whence it hath its matter basis thereof (either the ligaments of the vertebrae situate there or else the vessels of the heart yielding it matter) is of a nervous, thick and dense substance without any fibers. It retains the figure of the Heart, and leaves an empty space for the heart to perform its proper motions. Wherefore the bigness of the Pericardium exceeds that of the heart. It consists of a double coat, one proper of which we have spoken, another common coming from the pleura; and also of veins, arteries and nerves; the vessels partly coming from the mamillary, partly from the Diaphragma, chiefly there where it touches it; the nerves come on each side from the sixth conjugation. It is only one, placed about the heart and annexed to it at the Basis thereof by its Number and connexion. membranes, to the original of the Lungs, and the vertebrae lying under them, and by the vessels to the parts from whence it received them. It is of a cold and dry temper as every membrane is. The use thereof is to cover the heart, and preserve it in its native humidity, by a Use. certain natural moisture contained in it, unless you had rather say that the moisture we see contained in the Pericardium, is generated in it after death by the condenfation and concretion of the spirits. Although this seems not very likely; because it grows and is heaped up in so great quantity in living bodies, that it hinders the motion of the heart, and causes such palpitation or violent beating thereof; that it often suffocates a man. For this Palpitation happens also to hearty and stout men, whose hearts are hot, but From whence the matter of the watery humour contained in the Pericardium. blood thin and waterish by reason of some infirmity of the stomach or Liver; and this humour may be generated of vapours which on every side exhale into the pericardium from the blood boileing in the ventricules of the heart, where kept in by the density thereof, they turn into yellowish moisture, as we see it happens in an Alembeck. Nature would have the pericardium of a dense and hard consistence, that by the force The Consistence. thereof the heart might be kept in better state; for if the Pericardium had been bony, it would have made the heart like iron by the continual attrition; on the contrary, if it had been soft and fungous, it would have made it spongy and soft like the Lungs. CHAP. XXX. Of the Heart. THe Heart the chief mansion of the Soul, the organ of the vital faculty, What the heart is, and of what substance. the beginning of life, the fountain of the vital spirits, & so consequently the continual nourisher of the vital heat, the first living and last dying, which because it must have a natural motion of itself, was made of a dense solid and more compact substance than any other part of the body. The flesh thereof is woven with three sorts of fibers, for it hath the right in the inner part descending from the basis into the point, that they might dilate it, and so The three sorts of fibers of the Hear●. draw the blood from the hollow vein into the receptacles thereof, and the breath or air from the lungs by the Arteria venosa; it hath the transverse without, which pass through the right at right angles, to contract the Heart, and so drive the vital spirits into the great Artery Aorta, and the choleric blood to the Lungs by the vena arteriosa, for their nourishment; It hath the oblique in the midst to contain the Air and blood drawn thither by the forementioned vessels until they be sufficiently claborate by the heart. All these fibers do their parts by contracting themselves towards their original, as the right from the point of the heart towards the basis, whereby it comes to pass that by this contraction of the fibers the heart dilated becomes shorter, but broader, no otherwise than it is made more long and narrow by the contraction of the transverse, but by the drawing of the oblique it is lessened in that part which looks towards the vertebrae, which chiefly appears in the point thereof. It is of an indifferent bigness, but yet in some bigger, in some less according to The magnitude the divers temper of Cold or hot men, as we noted in the liver. The figure thereof is Pyramidal, that is, it is broader in the basis, and narrower at Figure. his round point. It is composed of the most dense flesh of all the body, by the affusion of blood at Composition the divisions and foldings of the vessels, and there concrete; as it happens also to the other Entrails. For the blood being there a little more dried, than that which is concrete for the making of the Liver, turns into a fleshy substance more dense than the common flesh, even as in hollow ulcers, when they come to a cicatrise. It hath the coronal veins and arteries, which it receives either on the right side The proper vessels. from the hollow vein, or on the left from the basis at the entranc of the Artery Aorta. You cannot by your Eye discern that the Heart hath any other Nerves than those The Nerves, which come to it with the Pleura. Yet I have plainly enough observed others in certain beasts, which have great Hearts, as swine; they appeared seated under the fat which covers the vessels, and basis of the heart, lest the humid substance of these parts should be dissolved and dissipated by the burning heat of the Heart. Whereby you may perceive that the heat of the heart is different from the Elementary heat, as that which suffers fat to grow about this Entrail, where otherwise it doth not concrete unless by cold or a remiss heat, which thing is chiefly worth admiration. The Heart is one alone, situate most commonly upon the fourth Vertebra of the Number and site. Chest, which is in the midst of the Chest. Yet some think that it inclines somewhat to the left side because we there feel the motion or beating thereof; but that happens by reason of its left ventricle, which being it is filled with many spirits, and the beginning of the arteries, it beats far more vehemently, than the right. It required that seat by the decree of Nature, because that Region is the most safe and armed, and besides it is here on every side covered as it were with the hands of the Lungs. It hath connexion with the fore mentioned Vertebrae, but by the parts composeing Connexion. it, with those parts from whence it hath them; with the Lungs by the Vena arteriosa, and the Arteria venosa, and lastly with all the parts of the body by the Arteries which it sends to them all. It is of a hot and moist temper, as every fleshy part is. The action thereof is, first Temper and action. to prepare the blood in its right ventricle, for the fit nourishment of the Lungs, for from hence it is that Galen saith; this right ventricle was made for the necessity of the lungs. Secondly to generate the vital spirits in its left ventricle for the use of the whole body. But this spirit is nothing else than a certain middle substance between What the vital spirit is. air and blood fit to preserve and carry the native heat, wherefore it is named the vital, as being the author and preserver of life. In the inner parts of the heart there present themselves to our consideration the ventricles and the parts contained in the ventricles and between them; such are the Valvulae or valves, the vessels and their mouths, their distribution into the lungs, the wall or partition, and the two productions or Ears of the heart; which because they are doubtful, whether they may be reckoned amongst the external or internal parts of the heart, I will here handle in the first place. Therefore these Auriculae or Ears are of a soft and nervous substance, compact The Auriculae Cordis, or ears of the heart. of three sorts of fibers, that so by their softness they might the more easily follow the motions of the heart, and so break the violence of the matters entering the heart with great force when it is dilated. For otherwise by their violent and abundant entrance they might hurt the heart, and as it were overwhelm and suffocate it; but they have that capacity which we see given by nature, that so they might as it were keep in store the blood and air, and then by little and little draw it forth for the use or necessity of the heart. But if any inquire, if such matters may be drawn into the heart by the only force of the Diastole ad fugam vacui, for avoiding of emptiness; I will answer that that drawing in, or attraction is caused by the heat of the heart; which continually draws these matters to it no otherwise than a fire draws the adjacent Air, and the flame of a candle the tallow which is about the weak for nourishments sake. Whilst the heart is dilated it draws the air, whilst it is drawn together or contracted, it expels it. This motion of the heart is absolutely natural, as the motion of the Lungs is animal. Some add a third cause of the attraction of the heart; to wit the similitude of the whole substance. But in my judgement, this rather takes place in that attraction which is of blood by the venae coronales for the proper nourishment of the heart, than in that which is performed for attraction of matters for the benefit of the whole body. These ears differ in quantity, for the right is far more capacious than the left because Their magnitude and numbers. it was made to receive a greater abundance of matter. They are two in number, on each side one, situate at the Basis of the heart; The greater at the entrance of the hollow vein into the heart, the less at the entrance of the veinous and of the great Artery with which parts they both have connexion. We have formerly declared Their 〈◊〉. what use they have; that is, to break the violence of the matters, and besides to be stays or props to the Arteria venosa and great Arterye, which could not sustain so rapid and violent a motion as that of the Heart by reason of their tenderness of substance. Of the ventricles of the Heart. THe ventricles are in number two, on each side one, distinguished with a fleshy The partiti●… between the ventricules of the Heart. partition strong enough, having many holes in the superficies, yet no where piercing through. The right of these ventricles is the bigger and encompassed with the softer and rarer Why the right ventricule is more capacious and less compact. flesh; the left is the lesser but is engirt with a threefold more dense and compact flesh; for the right ventricle was made for a place to receive the blood brought by the hollow vein, and for distributing of it, partly by the vena arteriosa into the Lungs for their nourishment, partly into the left ventricle, by sweeting through the wall or partition, to yield matter for the generation of the vital spirits. Therefore because it was needful there should be so great a quantity of this blood, Why the right ventricle is more capaciout and less compact. it was likewise fit that there should be a place proportionable to receive that matter. And because the blood which was to be received in the right ventricle was more thick, it was not so needful, that the flesh to contain it should be so compact; but on the contrary the arterious blood and vital spirit have need of a more dense receptacle, for fear of wasting and lest they should vanish into air; and also less room that so the heat being united might become the stronger, and more powerfully set upon the elaboration of the blood and spirits. Therefore the right ventricle of the heart is made for the preparation of the blood The action of the right ventricle. appointed for the nourishment of the Lungs, and the generation of the vital spirits, as the lungs are made for the mitification, or qualifying of the Air. Which works were necessary, if the Physical Axiom be true; That like is nourished by like, as the rare and spongious lungs with more subtle blood; the substance of the heart gross and dense, with the veinous blood as it flows from the Liver, that is gross. And it hath its Cororall veins from the Hollow vein, that it might thence draw as much as should be sufficient. But the left ventricle is for the perfecting of the vital spirit, and the preservation of The action of the left ventricle. the native heat. Of the Orifices and Valves of the Heart. THere be four Orifices of the heart, two in the right, & as many in the left ventricle; The uses of the four orifices of the Heart. the greater of the two former gives passage to the vein, or the blood carried by the hollow vein to the heart; the lesser opens a passage to the vena arteriosa or the choleric blood carried in it for the nourishment of the lungs. The larger of the two other makes a way for the distribution of the Artery Aorta and the vital spirit through all the body; but the lesser gives egress and regress, to the Arteria venosa, or to the air and fuliginous vapours. And because it was convenient that the matters should be admitted into their proper ventricles by these orifices, by the Diastole, to wit, into the right ventricle by the greater orifice, and into the left by the lesser, and because on the contrary it was fit that the matters should be expelled by the systole from their ventricles by the forementioned orifices. Therefore nature to all these orifices hath put cleaven valves, that is to say, six The valves. in the right ventricle, that there might be three to each orifice; five in the left, that the greater orifice might have three, and the lesser two, for the reason we will presently give. These valves differ many ways; first in action; for some of them carry in matter to How they differ. the heart, others hinder that which is gone out that it come not back again; Secondly they differ in site, for those which bring in have membranes without, looking in; those Action. Site. which carry out have them within looking out. Thirdly in figures, for those which carry in, have a pyramidal figure, but those which hinder the coming back again Figure. are made in the shape of the Roman letter C. Fourthly in substance, for the former Substance, for the most part are fleshy, or woven with fleshy fibers into certain fleshy knots ending towards the point of the heart. The latter are wholly membranous. Fiftly they differ in number, for therebe only five which bring in, three in the right ventricle at the greater orifice, and two in the left at the lesser orifice; those which Number. prohibit the coming back are six in each ventricle, three at each orifice. Lastly Motion. they differ in motion; for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit, and contrary wise are shut in the systole, that they may contain all or the greater part of that they brought in. The membranous on the contrary are opened in the systole to give passage forth to the blood and spirits over all the body, but shut in the Diastole, that that which is excluded might not flow back into the Heart. But you shall observe that nature hath placed only two valves Why there be only two valves at the Arteria venosa at the Orifice of the Arteria Venosa, because it was needful that this Orifice should be always open, either wholly, or certainly a third part thereof; that the Air might continually be drawn into the heart by this orifice in inspiration, and sent forth by expiration in the contraction of the heart. Whereby we may gather this, that there is but one third part of that Air we draw into the heart in breathing, sent forth again in the form of vapour in expiration, because nature would have but one third part of the orifice to lie open for its passage out. Therefore the expiration or breathing out, and the systole of the heart and arteries, is shorter than the inspiration, so that we may truly say, that the inspiration, or drawing the breath in, is equally so long as the expiration is together with the rest, which is in the midst between the two motions. CHAP. XII. Of the Distribution of the Vena arteriosa, and the Arteria venosa. HAving hitherto showed the original of each of the vessels of the Heart, we must now speak of their distribution. The Vena arteriosa, or the arterious vein, and the arteria venosa or the veinous artery each proceeding out of his proper ventricle, that is, the right and left, are divided into two The Artery always lies under the vein. large branches; one of which goes to the right and the other to the left hand, the one lying cross ways over the other, the vein always riding over the arterye, as you may understand better by the sight of your eyes, than by reading of books. These branches at their entrance of the lungs are divided into two other large branches, and each of them go to his peculiar Lobe of the lungs; and these again run almost into infinite other branches, dispersed in three places over the Lungs. These vessels have acquired their names by reason of that transmutation of consistence, whereby the composure of a vein degenerates into an arterye, and that of an arterye into a vein, for the commodity of life. For this is a miracle of prudent nature A twofold reason why the vein was made Arterious, or like are Artery. to change the coats of the vessels of the lungs; producing a vein which in its body should imitate an arterye, and an arterye which should represent a vein: For if the vena arteriosae should have retained its proper consistence, the arterious blood which is carried by it from the heart to nourish the lungs, might by reason of its subtlety penetrate through, and flow away by reason of the rarity of the veinous texture: and so nature should never have attained her conceived end, that is, to nourish the Lungs, by reason of the continual motion of their contraction and dilatation. For nourishment cannot be assimulated to the part, unless it be put and cleave to it. Wherefor it was fit, that nature should make the body of this vein solid; that it might be immovable, unshaken and stubborn (in respect of a vein which by its softness would have been too obsequious and yielding to the agitation of the Lungs) that so it might have nourishment, which might be diffused into all parts thereof, and which might neither be drawn by its Diastole, nor driven back into the heart by its systole. But the arterye hath the consistence of a vein, that by that veinous Why the Artery was made like a vein. softness according to the necessity of nature it might be the more readily contracted and dilated, to bring the Air in and carry the vapours forth of the heart. Here we meet with a difficulty, which is, by what way the blood is carried out of the right into the left ventricle of the heart. Galen thinks that there be certain holes in the partition made for that purpose, By what way blood may pass out of the right into the left ventricle. and verily there are such, but they are not perforated. Wherefore Columbus hath found out a new way, which is, that the blood is carried to the lungs by the vena arteriosa, and there attenuated; and carried from thence together with the air by the Arteria venosa to the left ventricle of the heart; this he writes truly very probablely. Botallus in his treatise De Catarrho hath found out a third way, to wit a vein, which he calls Arteriarum nutrix, that is, The nurse of the Arteries, which creeps a little The vein called the nurse of the Arteries above the coronal to the right ear of the Heart, and then goes into the left ear thereof. But yet I am very much afraid, that this vein observed by Botallus, is that vessel observed by Fallopius, whereby the Vena arterialis is joined to the Aorta, & Fallop. initio obser Arteriarum. by which all the vital blood is carried for the forming and nourishment of the lungs whilst the infant is yet in the womb. Of which also Galen makes mention, but it had lain hid from his time to this day, but that Fallopius raised up the memory of it again. Gal. lib. 15 de ●su part. cap. 6. CHAP. XIII. The distribution of the ascendent Hollow vein. THe Hollow vein rising out of the gibbous part of the Liver, and resembling (according to Galen) the body of a tree, is divided into two notable Gal. lib. de form. saetut. branches, but not of a like bigness. For the greater, by the hind part The greater descondent branch of the hollow vein. of the Liver upon the back bone and by the way, receives certain other branches from the substance of the Liver which entered not into the great trunk with the rest. You may often see this descendent branch even to the back bone upon which it lies in this its descent, covered with the substance of the liver, so that it may seem that branch proceeds not from that common trunk together with the ascendant, although indeed it always doth. But the lesser branch ascends to the upper The upper branch of the hollow vein is the less. parts, and is distributed after this manner following. For first ariseing into the midriff it bestows two small veins upon it, on each side one, which from that part are called Phrenicae. But from thence when it arrives at the right Ear of the Heart, it makes the Coronales, the coronal or Crown veins, which compass the basis of the heart in Venae phrenicae. Coronales. manner of a Crown. Thirdly entering somewhat more deeply into its right Ear, in its greater part it produces the vena arteriosa. Fourthly lifted up above the heart, on Vena Arteriosa the right side it produces the vein Azygos or sine pari (that is, without a fellow) which descending to the fourth rib, (reckoning from above downwards) nourisheth the intercostal muscles and also the membranes of the 8 lower ribs, on both sides, sending a branch into each of the muscles at the lower part of the rib, which may be sufficient for their nourishment. Besides also oftentimes, especially in little men, this vein Azygos nourishes all the spaces between all the ribs by the like branches, which Vena Azygos, or sine part. it sends in the same manner to the four upper ribs. Moreover also this Azygos sometimes, though but seldom, is found double, that is, on each side one. Here you must This Azygos sometimes two chiefly observe, that this vein after it hath nourished the spaces between the lower ribs, in its remainder descends under the Diaphragma and is joined on the left side to How the matter of a pleurisy may be evacuated by urine. the Emulgent vein; by which it is manifest how an Abscess, may be critically evacuated by the urine, in a pleurisye. But this same Azygos is more depressed on the right side, and meets with the Venae lumbares, but especially with one of them, which goes down to the thigh, whereby Fallopius gathers that it is very convenient in the beginnings of Pleurisyes to open the vena poplitis, the vein of the Ham. Fifthly above Interrestalis. the Azygos (when it is wanting there) it sends forth the branch called Intercostalis to the other spaces between the upper ribs; although this is sometimes seen to come from the Axillares, which Silvius calls the subclaviae. Sixtly it brings forth the Mammariae so called, because in their greater part they run to the dugs between the fourth and fifth ribs, for the uses formerly mentioned; men and women have on each side one Mammaria. of these coming from the Subclaviae. They are sometimes found to proceed by a certain common orifice from the hollow vein, before it be divided into the Subclavian branches, but it is rather in beasts than in men; these veins descending by the sides of the sternon yield nourishment to the 2 inner muscles of the chest, to the 7 intercostal muscles of the true ribs, to the sternon itself and to its ligaments and gristles, as also to the Mediastinum and the upper part of the right muscles, and the adjacent parts. Seaventhly it produces the Cervicalis which on both sides through the holes Cervicalis. of the productions of the Vertebrae of the neck, ascends to the head, sending many small branches into the spinal marrow through the holes by which the nerves pass, and also into the membranes, ligaments, gristles, bones, and neighbouring muscles. Musculosa. Eightly the Musculosa or musculous, which also ariseing out of the Subclavis is divided In what place cupping glasses may be fitly applied in a bastard Pleurisy. into two other branches; the one whereof goeth upon the breast to the paps, nourishing the foremost muscles; wherefore in a bastard pleurisy Cupping glasses may be fitly applied in this place. The other branch descends to the upper muscles of the chest, but specially to that which is called Latissimus. The tenth is the Axillaris. The eleventh the Humeralis, of Axillaris. Humeralis. jugularis interna, et externa. Into what parts the jugularis interna goes. which we will treat in their place. The twelfth and last is the jugularis properly so called, which is twofold, the internal and external. The internal being the lesser doth presently on both sides from this very beginning ascend by the sides of the Aspera Arteria or weazon even to the mouth and skull, yielding nourishment to the parts by which it passes, as to the next membranes and nerves. But when it comes to the basis of the Cranium it is divided into two branches, the greater whereof going back along the basis of the Cranium to the hind part thereof, sending abranch to the long muscle situate upon the oesophagus, it enters the Cranium with the small Carotides through the hole of the nerves of the sixth conjugation, where they become one common vessel. The lesser sending a slip to the organ of hearing by the hole called Cacum (or the blind) also enters the Cranium and is spent in the thicker meninx ne'er to the hole of the third and fourth conjugation of nerves. The external jugular vein being greater and fairer, most commonly simple, yet sometimes double, either presently Into what parts the jugularis externa goes. at his beginning, or a little after, ascends superficially on both sides of the neck, between the broad muscle or fleshy pannicle, being there easy to be discerned, and other muscles situate at the sides of the neck, into which as also into the skin it sends certain branches for nourishment. The Figure of the hollow vein whole and freed from the rest of the body. A, The trunk of the hollow vein. the lower AA, At this place of the Liver, is seated the left part of the vein, and distributeth branches to the left side. B, showeth how the trunk of the hollow vein in the chest (to give way to the heart) is curved or bowed to the right hand. Betwixt A. and B. that part of the hollow vein which is betwixt the gibbous side of the Liver and the Midriff. C. the left midriff vein called Phrenica sinistra, from which surcles do run in a man unto the purse of the heart, for the midriff and it do grow together. D, The orifice of the hollow vein which groweth unto the heart. E, the crown-veine called coronaria, which like a crown compasseth the basis of the heart, and sprinkleth his surcles on the outside thereof as far as to the cone or point. F F, The trunk of the vein, Azygos or non parill, descending along the right side of the rackebones unto the loins. GG, the lower intercostal veins, to the branches of the vein Azygos, which go unto the distances betwixt the ribs, & afford surcles unto the muscles which lie upon the ribs & the rackebones, & the membranes of the chest. H, the division of the hollow vein into two subclavian trunks near the jugulum under the brestbone. ll, the subclavian branch tending on either side unto the arm; called by some Axillaris. K, the upper intercostal vein which commonly sendeth three slips unto the distances of the upper ribs, unto which the first intercostal vein sent no branches. LL, the descending mammary vein: this descendeth under the brestbone unto the right muscles of the Abdomen, & affordeth surcles to the distances of the griftles of the true ribs, to the Mediastinum, the muscles that lie upon the breast and the skin of the Abdomen. M, the conjunction of the mammary with the Epigastricke vein ascending about the navel under the right muscles. N, the vein of the neck called Ceruicalis, ascending toward the Scull, which alloweth surcles to those muscles that lie upon the neck. O, the vein called Muscula, which is propagated with many surcles into the muscles that occupy the lower parts of the neck and the upper parts of the chest. P, Thoraeica superior, the upper chest vein which goeth to the muscles lying upon the chest, to the skin of that place and to the dugs. Q, the double Scapularis distributed into the hollow part of the shoulderblade and the neighbour muscles: so also betwixt P and R, sometimes small veins do reach unto the glandules that are in the armholes. R, Thoracica inferior running downward along the sides of the chest, and especially distributed into the muscle of the arm called Latissimus. S, the inner jugular vein which entereth into the Scull after it hath bestowed some surcles upon the rough artery. T, the external jugular vein. V. the division of this vein under the root of the ear. X. a branch of the external jugular which goeth into the inside of the mouth, and is diversely divided into the parts therein contained. Y. the exterior branch distributed near the Fauces into the muscles of the chaps and the whole skin of the head. Z. a portion of the branch, y, reaching unto the face. a, ae. the vein of the forehead. a. a portion of it creeping through the temples ae. * a propagation that goeth unto the skin of the Noll or Occiput. a a. the vein called Cephalica, or the external vein of the arm which others call Humeraria. b. Muscula superior, a propagation of the Cephalica vein which goeth unto the backward muscles of the neck. Betwixt b. and d. on the backside jssueth a branch from the Cephalica which passeth unto the outside of the blade, and a portion thereof runneth betwixt the flesh and the skin. d. d, a vein from the Cephalica which attaineth unto the top of the shoulder, and is consumed into the muscle that elevateth or lifteth up the arm and into his skin. e, e. a small vein from the Cephalica dispersed through the skin and the muscles of the arm. f. the division of the Cephalica into three parts. g. the first branch runneth deep unto the muscles which arise out of the external Protuberation of the arm. h. the second branch which goeth to make the median vein. i i. the third branch running obliquely above the wand and the outside of the arm. k. from this branch certain circles are divided into the skin, the chief whereof is marked with k. l. the third branch at the wrist which is joined at l, with the branch of the Basilica marked with x. m. the Basilica which on the right hand is called Hepatica, on the left hand Lienaris. n. o. a branch of the Basilica going to the heads of the muscles of the cubit at n, and to the muscles themselves at o. p, a notable branch of the Basilica running obliquely, and bestowing surcles upon the muscles that issue from the external protuberation. This branch descendeth together with the fourth nerve. q, division of the Basilica into two branches, and that is noted with q, is ever accompanied with an arterye. s, a branch of this vein bestowed upon the skin of the arm. t, a branch of the Basilica which together with the branch of the Cephalica marked with h, makes the mediana or middle vein marked wirh a. u, a branch of the Basilica going to the inner head of the arm. xx, a branch issuing out of the former that creepeth along unto the wrist and toward the little finger conjoining itself with a branch of the Cephalica. y, A vein running out unto the skin at the outside of the cubit. Upper Z. A propagation issuing out of a branch of the Basilica marked with t. Lower z. A branch of the Basilica x, going to the inside of the Arme. a. The Median or common vein, β, The partition of the Median vein above the wrist: This division should have been made above γ. γ. The external branch of the partition which goeth to the outside of the head. δ, From which issueth a small branch to the inside. 〈◊〉, The internal branch under 〈◊〉, which toward the middle and the ring finger is especially disposed. que, The vein of the thumb dispersed into the mountenet or hillock, which is conjoined with the branch noted with δ ζ, the trunk of the hollow vein from which issue branches unto the parts seated under the liver. 〈◊〉, The fatty vein called Adiposa sinistra, which goeth unto the fat of the kidneys. θ μ, The two Emulgents which lead wheyey blood unto the kidneys. λ μ, the two spermaticall veins leading the matter of the seed unto the testicles. V, the beginning of the bodden vessel called vas varicosum. ξ, the veins of the loins called Lumbares which are sent in the knots or knees to the rackebones, to the marrow of the back, to the muscles that lies upon the loins, and to the Peritonaum. ο, the bifurcation of the hollow vein into the Iliacke branches, which bifurcation is not unlike λ. ω, Muscula superior, a transverse branch going to the muscles of the Abdomen, and to the Peritonaenm. ρ σ, the division of the left Iliacke vein, into an inner branch at ρ, and an utter at τ. τ, Muscula media the utter propagation of the branch ρ, distributed through the muscles of the coxa and the skin of the buttocks. ν, An inner propagation of the same branch ρ which goeth unto the holes of the holy bone. φ, the vein called Sacra, which goeth to the upper holes of the holy bone. χ ψ, the vein Hypogastrica distributed to the bladder, to the muscles of the fundament, and the neck of the womb. ω, A vein arising from the utter branch marked with σ which is joined with some branches of the internal vein, near the holes or perforations of the share bone. ȝ ι, A vein which when it hath passed the share bone distributeth one branch into the cup of the coxendix and to the muscles of that place. χ, Another small branch which runneth under the skin at the inside of the thigh. χ, The congress or meeting of the foresaid vein, with a branch marked with char. 2. and distributed into the leg. ay, The Epigastricke vein, a propagation of the utter branch σ perforating the Peritonaeum, whereto as also to the muscles of the Abdomen, and the skin it offereth branches, the chief branch of this vein is joined with the descending mammary above the navel at M. Δ, Pudenda an inner propagation of the branch σ, running overthwart unto the privities. Θ, Saphaena or the ankle vein or the inner branch of the crural trunk, which creepeth through the inside of the leg under the skin unto the tops of the toes. Λ, the first interior propagation of the Saphaena offered to the groin. Ξ, The utter propagation thereof divided to the foreside or outside of the thigh. Π, The second propagation of the Saphaena going to the first muscle of the leg. 〈◊〉, The third propagation of the Saphaena going to the skin of the whirle-bone, and unto the ham. φ, The fourth propagation of the Saphaena dispersing his muscles forward and backward. Ψ, Branches from this unto the foreside of the inner ankle, to the upper part of the foot, and to all the toes. Ω, Ischias minor called also muscula interior, the utter branch of the crural trunk divided into the muscles of the coxendix, and to the skin of that place. 1, 2, And this also may be called muscula. 1, the exterior and lesser which passeth into some muscles of the leg. 〈◊〉, the interior greater and deeper unto the muscles of the thigh. 3, 4. The vein called Poplitea, made of two crural veins divided under the knee. 5, From this a surcle is reached upward unto the skin of the thigh. 6. But the greater part runs by the bent of the knee under the skin as far as the heel. 7, Also to the skin of the outward ankle. 8, The vein called Suralis or calf vein, hecause it runneth unto the muscles that make the calf of the leg. 9, The division of the sural vein into an exterior trunk 9, and an interior 14. 10, 11, The division of the exterior trunk under the knee into an external branch, which along the brace attaineth unto the muscles of the foot 11, and in internal. 12, 13, 12, 13, Which descending along the outside of the leg to the upper part of the foot is cloven into divers branches, and in the back of the foot mixeth itself with Poplitea, or the ham vein 20. 14, The interior branch of the sural vein which runneth into the backside of the leg. 15, A branch hereof descending to the inside of the heel and the great toe, and is divided into divers surcles. 17, Ischias maior issuing out of the internal trunk at 14, and running through the muscles of the calf. 18, A propagation hereof derived unto the upper part of the foot, & affording two surcles to every toe. 19, the remain- of the inner trunk 14, behind the inner ankle, approacheth to the bottom of the foot and is consumed into all the toes. 20, the commixtion of the vein Poplitea with the sural or calfe-branch at 13. But when it arrives to the basis of the lower part of the head, it is divided into Where the external jugular vein may be fitly opened in inflammations of the parts of the mouth. more branches, one whereof is carried to the muscles of the bone Hydis, the Larinx, the tongue and the lower part of the tongue (in which place it is commonly opened in squinancies, and other inflammations of the mouth) and to the coat of the nose. Another is carried to the Dura matter, passing on both sides through a hole situate under the bone mastoides, and besides, ascending to the bone of the back part of the scull, it comes obliquely to the upper part of the suture lambdoides, where these branches meeting together, pass into the reduplication of the Dura matter, deviding the forepart of the brain, that so joined and united, they may make the torcular; the third ascendent is distributed upon the back part and basis of the lower jaw, to the lips, the sides of the nose, and the muscles thereof: and in like manner to the greater corner of the eyes, to the forehead and other parts of the face, and at length by meeting together of many branches, it makes in the forehead the vein which is called vena recta or vena frontis, that is, the forehead vein. The fourth, ascending by the glandules Vena recta behind the ears, after it hath sent forth many branches to them, is divided into two others, one whereof passing before, and the other behind the ear, are at length spent in the skin of the head. The fifth and last wand'ring over all the lower part of the head, going to the back part thereof, makes the vena pupis, which extended the length of the head by the null's suture, at the length goeth so far, that it meets with the vena frontis, which meeting is the cause, that a vein opened in the forehead, is good in griefs of the hinder parts of the head, and so on the contrary. But we must observe that in the Cranium of some, the vena pupis by one or more manifest passages Vena pupis sends some portion thereof to the inner part of the head, so that the vena pupis being opened may make revulsion of the matter which causeth the internal pains of the head. CHAP. XIIII. The distribution of the nerves, or sinews of the sixth conjugation. BEcause the Distribution of the arteries cannot be well showed, unless we Three pair of nerves of the sixth conjugation. violate those nerves which are carried over the Chest, therefore before we show the distribution of the arteries, we will as briefly as we can, prosecute the distribution of these nerves. Now the sixth conjugation brings forth three pair of nerves; for passing out of the skull, as it comes down to the Chest, it by the way sends forth some branches to certain muscles of the neck, and to the three ascendant muscles of the Larinx on each side of the Sternon and upon the clavicles. Then the remainder descending into the Chest, is divided on each side into these three pair. The first pair makes the Ramus costalis. The second, the Ramus recurrens. The third pair, the Ramus stomachicus. Ramus Costalis The Ramus costalis, or costal branch is so called, because descending by the roots of the ribs, even to the holy bone, and joining themselves to these which proceed from each of the Vertebrae of the spin, they are carried to all the natural parts. The Recurrens, or recurrent is also called, because as it were starting up from the chest, it runs upwards again, but these two Recurrent nerves do not run back from the Recurrens same place; but the right from below the artery, called by some the axillary, by others Subclavian, and the left from beneath the great artery, descending to the natural parts. But each of them on each side ascending along by the weazon, even to the Larinx, and then they infinuate themselves by the wings of the Cartilago scutiformis, and Thyroydes into the proper muscles, which open and shut the Larinx. An anatomical Axiom. By how much the nerves are nearer the original, to wit, the brain, or spinal marrow, they are by so much the softer. On the contrary, by how much they are further absent from their original, they are so much the harder and stronger, which is the reason, that Nature would have these recurrent nerves to run back again upwards, that so they might be the stronger to perform the motions of the muscles Why nature would have the vocal nerves recurrent. Ramus stomachicus. of the Larinx. But the Stomachicus or stomacke-branch is so called, because it descends to the stomach or ventricle. For this branch descending on both sides by the sides of the gullet, sends many branches from it into the inner substance of the lungs, into the coat thereof, into the Pericardium and heart; and then coming into the upper orifice of the stomach, it is spent in many branches, which folded after divers manners and ways, chiefly makes that mouth or stomach, which is the seat of the Animal appetite (as they term it) and hunger, and the judger of things convenient or hurtful for the stomach. But from thence they are diversely disseminated over all the body of the ventricle. Moreover, the same branch sends forth some small branches to the liver and bladder of the gall, giving each part by the way, so much sense as should be sufficiently necessary for it. Here you must note, the stomach branch descends on each side one, knit to the gullet, and by the way they divide themselves into two branches, each of which goes to the opposite side, that it may there join itself to the nerve of that side. To which purpose the right is carried above the gullet, the left below it, so that these two stomaticke become four, and again these four presently become two. CHAP. XV. The division of the Arteries. THe Artery arising forth of the left ventricle of the heart, is presently (the two coronal arteries being first spread over the substance of the heart) divided into two unequal branches. The greater whereof descends to the lower parts, being distributed, as we formerly mentioned in the third Book, and The left branch of the ascendant artery is less than the right. The distribution of the left subclavian artery into the, 1 Intercostalis. 22. Chapter. The lesser ascending to the upper parts, is again divided into two other unequal branches, the lesser of which ascending towards the left side, sends forth no artery from it, until it arrive at the first rib of the Chest, where it produces the subclavian artery, which is distributed after the manner following. First, it produces the intercostal, and by it imparts life to the three intercostal muscles of the four upper ribs, and to the neighbouring places. Secondly, it brings forth the Mammillary branch, which is distributed as the Mammillary vein is. Thirdly, the Cervicalis, which ascends along the neck by the transverse productions 2 Mammaria. to the Dura matter, being distributed as the vena cervicalis is. Fourthly, passing out of the Chest, from the back part of the Chest, it sends 3. Cervicalis. forth the musculosa, whereby it gives life to the hind muscles of the neck, even to the back part of the head. 4 Musculosa. Fiftly, having wholly left the Chest, it sends forth the two Humerariae, or shoulder arteries, the one whereof goes to the muscles of the hollow part of the shoulder 5 Humoraria duplex. blade, the other to the joint of the arm and the muscles situate there, and the gibbous part of the shoulder blade. 6 Theracica duplex. The distribution of the right subclavian Artery. The Carotides, or sleepy arteries. Their division. The distribution of the internal branch of the sleepy arteries. Sixthly and lastly, it produces the Thoracica, which also is two fold, for the one goes to the fore muscles of the Chest, the other to the Latssimus, as we said of the vein, the remnant of it makes the Axillaris of that side. The other greater branch likewise ascending by the right side, even to the first rib of the Chest, makes also the subclavian of that side, which besides those divisions it makes on this side, like those of the left side, hath also another which makes the right and left Carotides or sleepy arteries, which ascending undivided with a nerve of the sixth conjugation and the internal jugular vein, by the sides of the Aspera Arteria or windpipe, when they come to the Pharinx, they are divided on each side into two branches, the one internal, the other external. The internal and greater is sent to the Pharinx, Larinx and tongue; then entering into the head by the long hole, and the back part of the upper jaw, it sends many branches to the nose, eyes, the inside of the temporal muscles and to the Crassa meninx, or Dura matter: the remainder of this branch going by the side holes of the same, that it might there make the Plexus admirabilis as we see. And then it is spent upon the basis of the brain abundantly diffused over the tenuis meninx or Pia matter, and the membrane or Plexus Choroides. The external or lesser branch of the sleepy arteries goes to the cheeks, To what parts the external branch of the sleepy artery arrives. the temples, and behind the ears; lastly, it sends a branch into the long muscle of the neck, with which the internal jugular vein insinuates itself into the Dura matter, entering by the hole of the nerves of the sixth conjugation. The Figure of the Arteries. A. The orifice of the great Artery, or the beginning thereof, where it issueth out of the heart. B. Coronaria, so called, because like a crown it compasseth the basis of the heart. C. The division of the great artery into two trunks V i. D. the left subclavian climbing obliquely upward unto the ribs. E. the upper intercostal artery, or a branch which bestoweth four propagations unto the distances of the lower rib. F. the neck artery which through the transverse processes of the rackebones of the neck, attaineth to the scull, bestowing surcles unto the marrow and his neighbour muscles. G. the left Mammary artery running under the breastbone, and to the navel. It distributeth surcles to the Mediastinum, the muscles of the breast, and of the Abdomen. H. Muscula, or a branch attaining to the backward muscles of the neck. I. the Scapular arteries which go unto the hollowness of the blade, and of the muscles that lie thereon. K. Humeraria which climbeth over the top of the shoulder. L. Thoracica superior, sprinkled unto the forward muscles of the Chest. M. Thoracica inferior, which passing along the sides of the Chest, attaineth to the broad muscles of the arm. N. the axillary artery running out into the arm and affording branches unto the muscles thereof. O. A branch reaching to the outside of the cubit lying deep. PP. Branches to the joint of the cubit with the arm. Q. the upper branch of the artery running along the Radius and offering surcles to the thumb, the forefinger and the middle finger. k A surcle creeping unto the outside of the hand and led betwixt the first bone of the thumb and that of the after-wrist, supporteth the forefinger where we use to feel the pulse. S. the lower branch of the artery running along the Vlna and communicating surcles to the little finger, the ring finger, and the middle finger. A little branch unto the muscles about the little finger. T. the distribution of the upper and lower branches into the hand and the fingers V. the trunk of the great artery ascending to the jugulum, and the division thereof in that place into X, Y, Z. X, the left Carotis or sleepy artery. Y, Subclavian dextra is divided into branches, as the right is divided. Z. Carotis dextra, called also Apoplectica and Lithargica. a, The division of the left Carotis in the chaps. b, the exterior branch of that division going into the face, the temples, and behind the ears. c, the inner branch going to the throttle, the chops and the tongue. d, the division hereof at the basis of the scull, into two branches which enter the sinus of the Dura matter. e, A propagation of the branch b, unto the muscles of the face. f, the distribution of the branch b, under the root of the ear. g. the fore-branch hereof creeping up the temples. h. the back branch running on the backside of the ear under the skin. i, the trunk of the great artery, descending unto the spondels of the back. kkk, the lower intercostal arteries which go unto the distances of the eight lower ribs, from which are offered surcles to the marrow, and to the muscles that grow to the back and to the Chest. l, the artery of the midriff called Phronica or Diaphragmatica. ζ, Mesenterica Superior, but you must note that above ζ, the trunk of the coeliacal artery is taken away, left the multitude of letters in so small a Table should breed obscurity. r, 〈◊〉, the right and left emulgents running from the Aorta or great artery unto the kidneys. 〈◊〉, 〈◊〉, the spermaticall arteries on either side going to the testicles. λ, the lower mesenterical artery on the left below μ, running especially into the Colic gut on that side. μμ, the arteries called Lumbares which run overthwart and like knees, affording surcles to the muscles that grow to the loins, and to the Peritonaeum. μ, the lower; Muscula superior running into the sides of the Abdomen and the muscles. v v, the byfurcation of the great artery into two Iliacke trunks, and at the sides, but somewhat inward are branches which make those that are called Sacrae. T, the division of the left Iliacke trunk into an inner branch at ξ and an utter at φ. ξ, the inner Iliacke branch. 〈◊〉, Muscula inferior, the utter propagation of the inner branch going unto the muscles which cover the branch bone and the Coxendix. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, Hypogastrica, the inner propagation of the inner branch going to the bladder, the yard and the neck of the womb. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the umbilical artery. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the remainder of the branch ξ, assuming an addition from the utter branch near φ, and so falling through the hole of the share bone into the leg. τ, Epigastrica, it ascendeth upward unto the right muscle of the Abdomen, and about the navel is joined with the mammary artery. ν, Pudenda, it creepeth overthwart the share bone. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the crural trunk without the Peritonaeum. χ, Muscula cruralis exterior, going into the fore muscles of the thigh. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, Muscula cruralis interior, going unto the muscles of the inside of the thigh. ω, The conjunction of this artery with the branches. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, Poplitaea, going to the muscles on the backside of the thigh. ΔΔ, which communicateth small branches to the joint of the knee, and the muscles that make the calf of the leg. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the division of the crural artery under the ham into three branches. Λ, Tibiaea exterior, it accompanieth the brace-bone, and is consumed into the muscles. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the chief part of the crural artery. Σ, the upper & backer Tibiaea. Πφ, the lower and backer Tibiaea running unto the upper side of the foot at φ. ψ, A propagation of the crural artery going to the inner and upper side of the foot, and sprinkling a branch unto the ankle. Ω, A propagation unto the lower part of the foot which affordeth surcles to each toe. But we must note that there be more veins in a man's body, than arteries, and besides that the veins are far thicker. For there is no need for preserving the native heat in the parts themselves, either of so many, or so large instruments of that kind. Therefore you may often find veins without arteries, but never arteries without veins. But we understand that an artery is a companion to a vein, not only when it touches it, or adheres to it by common membranes, as usually it happens; but also when it is appointed together with the vein for the use of the same part. CHAP. XVI. Of the Thymus. THe Thymus is a glandule of a soft, rare, and spongeous substance, of large bigness, situate in the furthest and highest part of the Chest, amongst the What the Thymus is. divisions of the subclavian or jugular veins and arteries, as yet contained in the Chest, for this use; that it might serve these vessels for a defence against the bony hardness of the Chest, and besides, that as it were by this prop or The use. stay, the distributions of these vessels might become the stronger; for so we see that nature hath provided for others, especially such as are the more noble and worthy. This glandule appears very large in beasts and young men, but in such as have The magnitude. attained to full growth it is much less, and scarce to be seen. CHAP. XVII. Of the Aspera Arteria, the rough Artery or Weazon. THe Aspera Arteria or Weazon seeing it is the instrument of voice and respiration, is of a gristly, ligamentous, and wholly various substance. For if it The substance had been one rough, and continued body with the Larinx or throttle, it could be neither dilated, nor compressed; opened, nor shut, neither could it order the voice according to our desire. It is composed of veins from the internal jugular, of arteries arising from the Composure. Carotides, and of nerves proceeding from the Recurrent branch, of a double membrane, of which the external comes from the Peritonaeum; the internal, which is the stronger and woven with right fibers, from the inner coat of the mouth, the which is common with the inner coat of the oesophagus or gullet. And also it consists of round gristles, yet not drawn into a perfect circle, composed in manner of a channel, and mutually joined together in order, by the ligaments that proceed from their sides and ends. These same ligaments perfect the remnant of the circle of this Aspera Arteriae, on Why the back part of the weazon is ligamentous. that part next the gullet; which is thought to be done to this end; that that softness of a ligament, might then give place, when we swallow harder and greater gobbets of meat. Of the two sorts of ligaments which are annexed to the gristles of the weazon, some tie and fasten together the rings or circles, which give means both to it, and these circles to be drawn out in length; othersome bring these gristles into a perfect circle, which also yield them means of dilatation. These ligaments cover the inner superficies, but the gristles are placed without, to resist the incursion Why the forepart is gristlely. of external injuries. But we must note, that by this communion of the inner coats of the weazon and gullet, we reap this benefit in the commodiousness of the action, that one of these parts being depressed, the other is lifted up, like a rope running in a wheel or pulley. For thus whilst the gullet is depressed to swallow any thing, the weazon is lifted up; and on the contrary when the stomach rises up in vomiting, the weazon is depressed. It is only one, and that seated between the Larinx (from which it takes its beginning) and the lungs in which it ends; first dividing it The number and site. The division of the weazon through the Lobes of the Lungs. self into two large branches, the right and the left, and besides each of these entering into the substance of the lungs, is again divided into two others; to each of the Lobes one; and to conclude, these be subdivided into infinite others, through the substance of the Lobes. All these branches are gristlely even to the ends. They are situate between the ends of the Arteria venosa, and the Vena arteriosa, that the entrance of the air into the heart by the arteria venosa might be speedier, as also the passage out of the vapour, by the vena arteriosa. Thus it hath connexion with these in the ends, or utmost parts thereof, but by the other parts compassing it, with the members from whence it takes them. The temperament thereof is cold and dry. The action is to carry the The temper and action. air to, and vapours from the lungs; that by dilating, but this by pressing the gristles together. The Figure of the Aspera Arteria or Weazon. A. The orifice of the great artery cut from the heart, aa. the coronal arteries of the heart. B. C. D. the division of the great artery into two trunks, the descending C. the ascending D. E. the left axillary, or subclavian artery. F. the right axillary or subclavian artery. G. the right Carotis or sleepy artery. H. the left Carotis. I. the trunk of the rough artery or weazon. K. L. The division of the rough artery into two branches, of which the right goes into the right, and the left into the left side of the lungs; which branches are again subdivided into many other. M. The head of the Rough Artery called the Larinx or Throttle. N. N. Certain Glandules or Kernels at the root of it. OO. The right and left Nerves of the sixth and seventh conjugation. P. A Revolution of small branches of the right nerve, to the right Axillary Artery. Q Q. The right Recurrent Nerve. R. A revolution of small branches of the left nerve unto the descending trunk of the great Artery. S S. The left Recurrent Nerve. CHAP. XVIII. Of the Gullet. THe OEsophagus, or Gullet which is the passage of the meat and drink, The substance is of a middle substance between the flesh and sinews, because it consists of one nervous membrane and another fleshy. The nervous is placed the innermost, and is continued to the inner Coat of the mouth even to the Lips (whereby it comes to pass,) that the Lips tremble in diseases which are ready to be judged by a critical vomiting and to the inner part Attractive force thereof. of the Aspera Arteria; it consists of right Fibers for the attraction of the meat, which we see is sometimes so quick and forcible in hungry people, that they have scarce time to chaw it, before they find it, to be plucked down, as it were with a hand. The fleshy Coat placed without is woven with transverse fibers, to hasten The composure. the going of the meat into the stomach, and for expulsion in vomiting and breaking of wind. These two coats are continued with the two coats of the stomach, and have the like site. Besides, the Gullet hath these parts composing it, as a vein from the Gate and Hollow ascendent vein, a nerve from the sixth conjugation, an Artery from that which creeps alongst the bottom of the stomach with the vena Gastrica, or else from the Arteries ascending the hollow part thereof; but also besides all these vessels it may have a third coat from the membrane investing the Ribs, or Pleura. The magnitude of the Gullet is large enough, yet some be bigger, some less according to the variety of bodies. The figure of it is round, that so it might be The magnitude. The figure. Site. more large to swallow meat, and less subject to offence. It is placed between the back bone and the weazon from the roots of the tongue even to the stomach. But as it descends alongst the back bone, when it comes to the fourth Vertebra of the Chest, it turns to the right side, to give way to the great Artery Aorta and the descendent Artery, than it turns to the left side to the stomach, or mouth of the ventricle. Nature hath fastened it to the Diaphragma with strong membranous ties, lest that, if it had lain upon the Artery it should have hindered the passage of the vital spirit to the lower parts. It is only one and that tied to the forementioned parts, both by its vessels and membranes. It is of temper rather cold than hot, as all those parts, which are more nervous than fleshy, are. The Action thereof is to draw Temper and action. and carry down the meat, and to cast forth such things by vomit as trouble the stomach. Here you must note, that whilst we swallow down, the Gullet is drawn Why we cannot sup and blow at one time. downwards, and the weazon upwards, which is the cause that we cannot sup and blow, swallow and breathe together at the same instant; which we must think to happen by God's singular providence; to whose name be glory for everlasting, Amen. The End of the fourth Book. THE FIFTH BOOK OF THE ANIMAL parts contained in the Head. CHAP. I. A General description of the Head. HAving hitherto declared two general parts of man's body, that is, the Natural and vital, it is now fit to betake ourselves to the last, that is, the Animal, beginning with the head. Whrefore we will first define the head, then divide it into its parts; thirdly describe each of these parts; fourthly demonstrate them after the order they offer themselves to our sight in dissection. The head therefore is the seat of the senses, the Palace and habitation of reason and wisdom, from whence as from a What the head is. fountain infinite actions and commodities arise. It is seated above the rest of the body, that the Animal spirit from thence, as from a tower, may govern and moderate Why seated in the highest place. the whole body, and perform all actions according to the prescript of nature. By the head we understand all that which is contained from the Crown of the head to the first vertebra of the neck. The best figure of the head is round, lightly flatted on each side, extuberating something The figure. to the fore and hind part thereof. For from hence is taken an argument of the goodness of the senses; on the contrary, those which are exactly round, or acuminate, and sharp towards the top, are not thought good. The head is divided into the face, forehead, temples, the forepart, the crown and hind part. The division thereof. By the face we understand, whatsoever is contained between the Eyebrows and the lower part of the chin. By the forehead, all the space from the eyebrows even to the coronal future. By the temples, whatsoever is hollowed from the lesser Corner of the eye, even to the ears. By the forepart of the head, whatsoever runs in length from the top of the forehead, or the coronal suture, even to the suture lambdoides, and on each side to the Ossa petrosa, the stony bones, or scaly sutures. By the Crown we signify a certain point exquisitely in the midst of the sagittal future, which is sufficiently known. By the Occiput or hindepart of the head, that which is terminated by the suture lambdoides, and the first vertebra of the neck. Of all these parts there be some simple, some compound, besides some are containing, some contained. Of the containing some are common to all the parts of the head, as the skin, the fleshy pannicle and pericranium; others are proper to certain The ●…ining parts of the head. parts, as the fleshy pannicle to the neck, face, forehead, and skin covering the Cranium, the common coat of the muscles to the fat and face; The skull and both the Meninges to the brain. The parts contained are the substance of the brain, the four ventricules, and the bodies contained in them, the nerves, the mamillary processes; the Plexus Choroides or The parts contained. Rete Admirabile, the Glandula Basilaris, and others of which we will speak hereafter. We must now speak of the containing parts beginning with the skin; for the order of teaching requires that we take our Exordium from the more simple, but first we will say some thing of the hairs. The hair is nothing else than an excrement generated and form of the more What the hair is. gross and terrene portion of the superfluities of the third concoction, which could not be wasted by insensible transpiration. The benefit of it is, that consuming the gross The use thereof. and fuliginous or sooty excrements of the brain it becomes a cover and ornament for the head. This hair of the head and eyebrows have their original from the first conformation of the infant in the womb, the rest of the hairs of the body arise and grow forth as the body grows and becomes more dry, of which sort are the hairs which cover the Chin, armholes, groins and other parts of our bodies. CHAP. II. Of the musculous skin of the Head, (commonly called the hairy scalp) and of the Pericranium. THe skin which covers the Scull, and is covered with the hair, is far more fleshy, thick, hard and dry than any other part of the body, especially What the hairy scalp is. It's connexion. which wants hair. The skin hath almost the like condition of quality as those parts have, which it doth simply cover, but is as it were lost in them, or grown into one with them, as in the lips and forehead with the fleshy pannicle, wherefore it is there called musculous; in other places it adheres to the gristles, as on the sides of the nostrils and corners of the Eyes, whereupon it is there called gristlely. It hath connexion with the Pericranium because joined to it, it receives nerves from the first and second vertebra of the neck, and from the third conjugation of the brain which are disseminated through all its substance, whereby it comes to pass, that the wounds, contusions, and impostumes that happen in or upon this skin, are not to be neglected. The * Our Author with Fallopius and Laurentius confounds the pericranium and peri●stium: but Vesalius Bauhinus and Bartheolinus distinguish them making the pericranium thin and soft, and the periostium most thin and nervous, and of most exquisite sense. Why the wounds thereof must not be neglected. The Pericranium and periostium of the same nature. Whence all the membranes proceed. Why when any membranous part is hurt in any part of the body, the head is affected by consent. The use of the Pericranium. Pericranium (but I suppose it should be the Periostium) is a most thin membrane, which next and immediately covers all the bones of the body, and this on the head is called by a peculiar name the Pericranium by reason of the excellency of the Cranium or skull, in other bones it is termed the Periostium: And as the Pericranium takes its original from the Crassa meninx propagating itself by certain strings or threads sent forth by the sutures and holes of the skull, so all other membranes of the body have their original either from this Pericranium, or the Crassa meninx, sending forth their productions, as well by the holes or passages of the head, as by these of the spinal marrow or back bone itself, even to the Holy bone. Of which this is an argument, for in what part soever of the body a membrane is hurt, presently the hurt or sense thereof comes to the Crassa meninx. For so those who have but their little Toe hurt when they sneeses, or cough, perceive an increase of their pain, by the passage thereof to the brain. The use of this Pericranium is to cover the skull, and to give notice of things hurtful, by the power of the quick sense which it is endued withal, and the Periostium doth the like in other bones. Besides it sustains and fastens by the sutures the Crassa meninx to the skull; lest it should fall by reason of its weight upon the Pia matter, and so hurt it, and hinder the pulsation of the brain and arteries that are plenteously spread through both the Meninges. Wherefore the Pericranium hath most straight connexion with the Crassa meninx, because it takes the original from thence. We must think the same of the other membranes of the body, which thing is very notable in the solution of the continuity of the membranes. CHAP. III. Of the Sutures. THe Sutures do sew or fasten together the bones of the skull; these be Their use and number. 5 in number. Three are true and legitimate, two false and spurious. The Coronal, the first of the true sutures, is seated in the forepart of the head, descending downwards overtwhart the forepart of the head to the midst of the temples; it is so called, because Corollae, that is, wreaths, crowns or garlands, are set upon that place: The second is called the Sagittalis, or right suture, as that which running through the crown divides the head into two equal parts, as with a straigth line, running the length of it from the coronal to the Lambdoides or hind suture. But this third suture Lambdoides, is so called because it represents this Capital greek letter Lambda, Λ. You must understand this description of the sutures, not as always but as for the greater part to be thus. For there be some skulls that want the foremost Some sculls want Sutures. suture, othersome the hind, & sometimes such as have none of the true sutures, but only the false & spurious. But also you shall sometimes find the Sagittal to run to the nose. And oft times there be three or four sutures in the back part of the head, so that indeed the number of the sutures is not certain. Which also we find observed by Cornelius Celsus, where he writes, that Hypocrates was deceived by the sutures by Cells. lib. 8. Cap. 4. chance, for that he conjectured that the bones of the back part of the head, were broken, because his Probe thrust to the roughness of the second suture Lambdoides, stayed as at a Cleft made in the bone by a stroke. The other two are called the false, stony and scaly sutures, by reason they are made by a scaly conjunction of the bones, but not by a toothed saw or combe-like connexion. But if any ask, why the head consists not of one bone, that so it might be the Why the scull consists of divers bones. stronger: I answer it is, that so it might be the safer both from internal and external injuries. For the scull being as it were the tunnel of the chimney of this humane fabric, to which all the smoky vapours of the whole body ascend, if it had been composed of one bone, these vapours should have had no passage fourth. Wherefore the grosser vapours pass away by the sutures, but the more subtle by the pores of the scull; some have their sutures very open; but others on the contrary very close. Therefore nature hath otherwise compendiously provided for such as want sutures; In what bodies and by what means the vena pupis sometimes enters into the parts within the scull. For it hath made one or two holes, some two fingers breadth from the Lambdoides, through which the Vena pupis enters into the skull, and they are of that largeness that you may put a points tag into them, that so the vapours may have free passage forth, otherwise there would be danger of death; thus nature hath been careful to provide for man against internal injuries; and in like manner against external, for it hath made the head to consist of divers bones, that when one bone is broken the other may be safe, the violence of the stroke being stayed in the division of the bones. Whereby you may know, that if the skull chance to be broken in the opposite side In what men one part of the head being stricken, the opposite is broken. to that which received the blow, that it happens either by reason of the defect of Sutures, or else because they are unperfect, and too firmly closed; otherwise it is impossible such fractures should happen by reason of the separation of the bones, which breaks the violence of the blow that it can go no further. And certainly as it is rare to find a skull without Sutures, so it is rare to find such kind of fractures. Therefore Surgeons must diligently observe the Sutures and site of them, lest they be deceived and take them for fractures, or unawares apply a Trepan to them, whence by breaking the veins, arteries and nervous fibers by which Why we must not apply a Trepan to the Sutures. the internal parts communicate with the external, there may ensue increase of pain, a violent defluxion of blood upon the Crassa meninx, and the falling thereof upon the brain, (the fibers being broken by which it stuck to the Pericranium) and so consequently a deadly interception of the pulsation of the Brain. CHAP. four Of the Cranium, or Skull. THe Cranium, or Skull covering the brain like an Helmet, is composed and What the Cranium or scull is. consists of seven bones, of which some are more dense, thick and hard than other some. The First is the Os occipitis, or Noll bone seated in the back part of the head, more hard and thick than the rest, because we want Why the noll bone is harder than the rest. hands and eyes behind, whereby we may keep or save ourselves from falling. This bone is circumscribed, or bounded by the suture Lambdoides, and the * My Author means by the Os Basilarae in this place the wedge bone: but some Anatomists make it a Synonimons of this O● occipitis. The forehead bone, next to the nowl: bone is harder than the rest. A Cavity to be observed in the forehead bone. Os basilare. The eminencies and as it were heads of this bone are received into the first vertebra; for upon this the head is turned forwards and backwards, by the force of fourteen muscles and strong ligaments, which firmly tie these heads of the Noll bone in the cavityes of this first vertebra. The Second bone of the skull is in the forepart, and is called the Os coronale or Os frontis the forehead bone, it hath the second place in strength and thickness. It is bounded by the Coronal suture, and the ends of the wedgebone: in this forehead bone there is often found a great cavity under the upper part of the eyebrows, filled with a glutinous, gross, viscide and white matter or substance, which is thought to help to elaborate the air for the sense of smelling. Surgeons must take special notice of this cavity, because when the head chances to be broken in that place, it may happen, that the fracture exceeds not the first table; wherefore they being ignorant of this cavity, and moved with a false persuasion that they see the brain, they may think the bone wholly broken, and to press the Meninges, whereupon they will dilate the wound, apply a Trepan and other instruments to lift up the second table of the bone, without any need at all, and with the manifest danger of the life of the patient. The third and fourth bones of the Skull are the Ossa parietalia, or Bregmatis, having Ossa parietalia and bregmatis. the third place of density and thickness; although this density and thickness be different in divers places of them. For on the upper part of the head, or crown, (where that substance turns not to a bone in children until they have all their teeth, so that it feels soft in touching, and through it you may feel the beating of the brain) these bones are very tender, so that oft times, they are no thicker than one's nail, that so the moist and vapourous excrements of the brain, shut up where the greater portion of the brain resides, may have a freer passage by the Brains Diastole and Systole. These two square bones are bounded above with the sagittal suture, below with the scaly, on the forepart with the coronal, and on the hind part with the Lambdoides. The fifth and sixth bone of the skull are the two Ossa petrosa stony or scaly bones which are next to the former in strength. They are bounded with the false or bastard Ossa petrosa, or the scaly bones Suture, and with part of the Lambdoides, and wedgebone. The seaventh is the Os sphenoides, basilare or Cuneiforme that is, the wedgebone. It Os Sphenoides, or the wedgebone. is called Basilare, because it is as it were the Basis of the head. To this the rest of the bones of the head are fitly fastened in their places. This bone is bounded on each side with the bones of the forehead, the stony bones, and bones of the Noll and palate. The figure represents a Bat, and its processes her wings. There is besides these another bone at the Basis of the forehead bone, into which Os Ethmoides or cribrosum. the mamillary processes' end, the greeks call it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the Latins Cribrosum and Spongiosum, the Spongy bone, because it hath many holes in it not perforated in a direct passage, as in a sive, but winding and anfractuous, that the air should not by the force of attraction presently leap or ascend into the brain, and affect it with its qualities, before it be elaborated by its lingering in the way. There are besides also The three bones of the auditory passage. six other little bones lying hid in the stony bones, at the hole, or Auditory passage; on each side three, that is to say, the Ineus or Anvil, the Malleolus or Hammer, and the Stapes or stirrup, because in their figure they represent these three things; the use of these we will declare hereafter. But also in some skulls there are found some divisions of bones, as it were collected fragments to the bigness almost of ones thumb, furnished and distinguished by their proper commissures, or sutures, which thing is very fit to be known to a Chirurgeon in the use of a Trepan. Verily he may give a conjecture hereof, whilst he separates the Pericranium from By what means a Chirurgeon may conjecture, that there are extraordinary sutures in certain places of the scull. The sculls of such as inhabit the Southern countries are more hard and dense. We must observe the excuberancies beside 〈◊〉 nature which are in some sculls. the skull, for the pericranium is with greater difficulty plucked away from the sutures, because the Crassa meninx hath straighter connexion therewith by his nervous fibers sent forth in such places. The Skulls in women are softer and thinner than in men, and in children more than in women, and in young men more than in men of a middle age. Also the Aethiopians or Blackamoor's, as also all the people inhabiting to the South, have their skulls more hard and composed with fewer sutures. Therefore as it is written by Hypocrates, such as have their Skulls the softer, the Symptoms in fractures are more dangerous and to be feared in them. But the skull by how much the softer it is, by so much it more easily and readily yields to the perforating Trepan. Moreover in some skulls, there be bunches standing out besides nature, made either round, or cornered, which the Chirurgeon must observe for two causes; the first is for the better consideration of a blow or fracture. For in these bunches, or knots, the solution of the continuity cannot be, if it seem to be stretched in length, but that the wound must penetrate to the inner parts. For in a round body there can be no long wound; but it must be deep, by the weapon forced the deeper; because as a round body touches a plain but only inpuncte in a prick or point, so whatsoever falls only lightly or superficially upon it, only touches a point thereof. But on the contrary a long wound must be upon a plain surface, which may be but only superficial. Another cause is, because such bunches change the figure and site of the Sutures. The site and substance of the Diploe. And the Chirurgeon must note that the skulls hath two tables, in the midst whereof the Diploe is; which is a spongy substance into which many veins and arteries & a certain fleshynesse are inserted, that the skull should not be so heavy, and that it might have within itself provision for the life thereof; and lastly that there might be freer passage out for the fuliginous vapours of the brain. The upper table is thicker, denser, stronger and smother than the lower. For this as it is the slenderer, so it is the more unequal, that it may give place to the internal veins and arteries (which make a manifest impression into the second table on the inside thereof) from which branches enter into the skull by the holes which contain the eyes. Which thing fastens the Crassa meninx to the skull, and is therefore very worthy to be observed. For in great contusions when no fracture or fissure appears in the skull by reason There may be a deadly rupture of the vessels of the brain without any fracture of the Scull. Caution to be had in the use of the Trepan of the great concussion or shaking of the brain, these vessels are often broken, whence happens a flux of blood between the skull and membranes, and lastly death. But it is fit the Chirurgeon take good heed to the tender and soft substance of the Diploe, that when he comes to it, having passed the first table, he may carefully use his Trepan, lest by leaning too hard, it run in too violently, and hurt the membranes lying underneath it, whence convulsion and death would follow. To which danger I have found a remedy, by the happy invention of a Trepan, as I will hereafter more at large declare in handling the wounds of the head. CHAP. V. Of the Meninges, that is, the two membranes called Dura Mater and Pia Mater. THe Crassa meninx is one of the first and principal membranes of the body; Why the bone Ethmoides is perforated. it goes forth by the future's and the holes of the nerves that proceed out of the skull; and it passes forth by the bone Ethmoides perforated for that purpose, to carry smells to the Brain, and purge it of excrementitious humours. This same Crassa meninx invests the inner coat of the Nose; also it passes forth of the great hole through which the spinal marrow passes, vested with this Crassa meninx, with all the nerves and membranes. For which cause, if any membrane in the whole body be hurt, by reason of that continuation which it hath with the Meninges, it strait communicates the hurt to the head by consent. The Crassa meninx is thicker and harder than all other membranes in the body; The consistence of the Crassa meninx whereupon it hath got the name of the Dura matter, besides also it begirts, produces, and defends the other membranes. The use of it is to involve all the brain, and to keep it when it is dilated, that The use. it be not hurt by the hardness of the Scull. For the course of nature is such, that it always places some third thing of a middle nature, betwixt two contraries. Also the Crassa meninx, yields another commodity, which is, that it carries the veins and arteries entering the Scull fora long space. For they infinuate themselves into that part, where the duplicated or folded Meninges separate the brain from the Cerebellum, and so from thence they are led by the sides of the Cerebellum, until they come, as it were, to the top thereof; where being united they infinuate themselves into that other part of the Crassa meninx, where in like manner being duplicated and doubled, it parts the brain at the top into the right and left; These united veins run in a direct passage even to the forehead, after the manner of the sagittal suture; They have called this passage of the mutually enfolded veins, the Torcular, What the Torcular is. or Press, because the blood which nourishes the brain is pressed and drops from thence by the infinite mouths of these small veins. Therefore also here is another use of the Crassa meninx, to distinguish the brain by its duplication, being it thrusts itself deep into its body, into two parts, the fore and hind, and presently One part of the brain being hurt the other keeps the creature alive. to separate the same into the right and left; that one part being hurt, the other may remain safe and sound, performing its duty to the creature, as we see in some that have the Palsy. Columbus observed that this Meninx was double, and verily I have found it true by my own sight. The other Meninx or membrane of the brain, called Pia mater, is most slender The consistence of the Pia mater. interchased with divers veins and arteries, for its own and the brains nourishment and life. This doth not only involve the Brain, as the Crassa meninx doth, but also more deeply penetrates into the anfractuous passages thereof, that it may every where join and bind it to itself, not easily to be drawn from thence, by many small fibers whereby it descends even to the cavities of the ventricles thereof. Wherefore you must see it absolutely in the site as we have mentioned, and not pluck it away unless with the substance of the Brain. These membranes when they are hurt or afflicted, cause grievous and most bitter torment and pain; wherefore I dare say, that these membranes are rather the authors The sense of ●he Meninges. of sense than the brain itself, because in diseases of the Brain, as in the Lethargy, the party affected is troubled with little or no sense of pain. CHAP. VI Of the Brain. NOw followeth the Brain, the beginning of the nerves and voluntary motion, What the brain is. the instrument of the first and principal faculty of the Soul, that is, the Animal and Rational. Man hath this part in greater plenty than any other The quantity Creature, for it almost fills the whole Scull. But if it should have filled it all, the Brain could not be moved, that is, dilated and contracted in the Scull. It is of a cold and moist Temperature. The laudable temper of the brain is known by the integrity and perfection of the internal and external senses, the indifferency of Temper, sleep and waking, the Maturity or ripeness of judgement, and constancy of opinions, from which, unless it meet with better and more probable, it is not easy to be moved. The first figure of the head, as it appears when the scull is taken away. The second figure showing the Brain, the scull and Dura matter being taken off. AA, BB. The Dura meninx or thick membrane. CCC. The third Sinus of this membrane. DD. The course of the veins as they run through the membrane, or the second vein of the brain. EE. The first vein of the brain. FFF. Certain small veins which perforate the scull and reach to the periçranium or Scull-skin. GGG. Fibres of the Dura meninx passing through the coronal Suture, which fibres make the Pericranium. HH. fibres passing through the sagittal Suture. II. Others passing through the Lambdall Suture. K. A knub which useth to grow to the Sinus of the Scull. L. A cavity in the forehead bone. M. The Scull. N. The Pericranium or Scull-skinne. Fig. 2. AAA. A part of the Crasse meninx dividing the brain. BB. the third Sinus of the same Crasse membrane opened. CC. the beginning of the vessels out of the third Sinus into the Pia mater. DDD. the propagation or branches of these vessels. EEE. the Pia mater or thin meninx immediately compassing the brain. FFF. Certain vessels running through the convolutions or branches of the brain. GGG. Certain branches of veins running through the sides of the dura meninx. HHH. The thick membrane reflected downward. You shall know the brain is more hit, by the quickness of the senses and motions of the body, by shortness of sleep, the sudden conceiving of opinions and change of them, by the slippery and failing memory, and lastly by easily receiving hurt from hot things, as the Sun and Fire. Such as have a cold brain, are slow to learning, and to conceive other things, but they do not easily put away their once conceived opinions. They have slow motion to action, and are sleepy. Those who have a dry brain, are also slow to learn; for you shall not easily imprint any thing in dry bodies, but they are most constant retainers of those things they have once learned; also the motions of their bodies are quick and nimble. Those who have a moist brain do easily learn, but have an ill memory, for with like facility as they admit the species of things and imprint them in their minds, do they suffer them to slide and slip out of it again. So Clay doth easily admit what Character or impression soever you will, but the parts of this Clay which easily gave way to this impression, going together again, mixes, obliterates and confounds the same. Therefore the senses proceeding from a cold brain are dull, the motions flow, the sleep profound. The Action of the brain is to elaborate the Animal Spirit and necessary sense The Action. serving the whole body, and to subject itself as an instrument to the principal faculties, as to reason. The brain is twofold, the fore and hind. The hind by reason Number. of its smallness is called the Cerebellum, (the little or Afterbraine). But the fore by reason of its magnitude hath retained the absolute name of the brain. Again this fore-braine is twofold, the right and left, parted by that depression, which we formerly mentioned, of the Meninges into the body of the brain. But this division is not to be here so absolutely taken, as though the Brain were exactly divided and separated into so many parts, but in the sense, as we say the Liver and Lungs are divided a pretty way; whereas at their Basis they have one continued body. The outward surface of the Brain is soft, but the inward hard, callous and very smooth; when on the contrary, the outward appears indented and unequal with many windings, and crested as it were with many wormelike foldings. CHAP. VII. Of the ventricles and mamillary processes of the Brain. FOr the easy demonstration of the ventricles of the brain, it is convenient The substance of the brain is porous and swe●●s forth blood. you cut away a large portion thereof, and in your cutting observe the blood sweeting our of the pores of it. But besides, it is fit you consider the spongy substance by which the excrements of the brain are heaped up, to be presently strained out, and sent away by the hollow passage. In the substance of The four ventricles thereof. the brain you must observe 4 ventricles, mutually conjoined by certain passages, by which the spirits endued with the species of things sensible, may go from one into another. The first and two greater, one on each side are placed in the upper brain. The third is under them in the middle part of the brain. The fourth and last at the The magnitude of the upper ventricles of the brain. fore side of the Cerebellum, towards the beginning of the spinal marrow. The two foremost are extended the length way of the brain in the form of a semicircle, whose horns look or bend outwards. They are spacious and large, because it was meet the Spirits contained there together with their excrements, should be there purified and cleansed; but in other ventricles, the pure and already elaborate spirits are only received. These ventricles are white and smooth in their inner superficies; but that on each side they have an extuberancy at the midst of the semicircle, situate at the basis of the Pillar of the middle ventricle towards the nose under the Septum lucidum or clear partition, severing or parting in sunder these two ventricles. This Septum lucidum, or clear or thin partition, is nothing else than a portion of The Septum Lucidum. the brain indifferently solid, but very clear, that so through this partition the animal spirits contained in these two ventricles may mutually pass and be communicated, and yet no other grosser substance may pierce the thin density thereof. Wherefore it is not to be feared, that the water contained in one of the ventricles Why the Palsy o●●●de i●… presently communicated to the other. may pass to the other through this partition, as I have oft times observed to the great admiration of the spectators in the dead bodies of such as died of the Palsy, in which I have found the ventricle of that side which was taken with the palsy much dilated, according to the quantity of the water contained therein, the other being either wholly empty and without any; or certainly no fuller than in any other, dead through any other occasion. For some affirm that there is a certain kind of waterish moisture always to be found in the ventricles, which may be made by the condensation of the Animal spirits by the force of the deadly cold. But these two first ventricles of the brain go into one common passage, as both the bellowes of a furnace, whereby the spirit instructed with the species of things goes into the under, or middle ventricle from the former. In these same first ventricles the Plexus Choroides is to be considered, and in like manner the passage by which the grosser excrements are driven or sent into the pituitary Glandule. The Third Figure represents the Cerebellum with the wormy processes separated from it. AB, The right and left part of the Afterbraine. C D, The anterior and posterior regions of the middle part of the After brain. E, The anterior wormy process. F, The posterior wormy process. GG, In this place the Afterbraine did grow to the spinal marrow. H, The cavity in the spinal marrow maketh the forth ventricle. I K. The anterior and posterior processes of the brain, called vermiformes or the wormy processes. This Plexus Choroides is nothing else, but a production of the Pia matter diversely The Plexus Choroides. folded with the mutual implication of veins and arteries woven in the form of a net. These vessels are of magnitude and capacity sufficient, both to yield life and nourishment to that particle to which they are fastened, as also for the generation of the Animal spirits, as which take fit matter from the veins stretched fourth into this same Plexus, the hind artery and vein Torcular; and also from the air entering The Processus Mammillares. into the brain by the mamillary processes. But the mamillary processes are certain common ways for conveyance of the air and smells into the brain, and carrying of excrements from the brain. For thus in them who have the Catarrh and Corizae or pose, neither the air, nor smells can penetrate into the brain; whence frequent sneezings ensue, the brain strongly moving itself to the expulsion of that which is troublesome to it. But of the excrements of the brain, whether bred there, or proceeding from some other part, some are of a fumide and vaporous nature which breathe insensibly through the Sutures of the skull; Others are gross and viscide, of which a great part is expelled by both these productions, or through each of them. For thus in the Pose you may see some who have one of their nostrils stopped, the other running, and some who have both obstructed. The most proper benefit of the two first ventricles of the brain is to entertain the Fantasy as in a convenient seat and habitation, seeing the mind The use of the upper ventricles of the Brain. there estimates and disposes in order the species of things brought in from the external senses, that so it may receive a true judgement of them from reason which resides in the middle ventricle. The third ventricle is seated between the hindermost extremityes of the former The seat of the third ventricle of the brain. The parts to be considered in it. ventricles; and the last ventricle of the Cerebellum. In this six parts present themselves to our consideration, that is the Psalloides or Arch, the Conarium, or pine Glandule, the Buttocks, wormelike productions, the Basin and passage which is from this middle into the last and hindemost ventricle. The Psalloides or arch is nothing else, but the cover of the middle ventricle, resembling a roof borne up with three stays or pillars, the one whereof is extended to the nose under the Septum lucidum, the two What the fornix or Arch is, and the use thereof. other on each side one, look towards the back part of the brain. This is the reason of this figure which is outwardly convexe and inwardly concave, to wit, that there might be free space for that motion which the Animal spirit inwardly produces, and besides that it might more easily sustain the burden of the brain lying upon it. For an arched figure is the most convenient of all other to sustain a weight. The Conarium or Pine glandule, is a small Glandule of the same substance with What the Conartum or pinc Glandule is. the brain, round and somewhat long, like a pine Apple, from whence it hath the name; this Glandule is seated over against a small hole which descends to the lowest ventricle. It hath this use, to strengthen the division of the vessels led thither with the production of the Pia matter for the generation of the animal spirits, and the life and nourishment of the brain. The Nates or Buttocks are subjected or placed under this Glandule, that is, bodies What the Nates or Buttocks are. of a solid and white substance drawn out in length like a child's buttocks, especially in beasts, and chiefly in a sheep. These buttocks have such a solid substance, that so they may keep open and free the passage, or channel that runs down from the middle to the lower ventricle, by means of which the Brain participates with the Cerebellum. The worm is a production of the Cerebellum or Afterbraine, to wit a portion of the same being in the top or beginning and as it were in the entrance thereof, What the worm is. being like many little circles or wheels mutually knit together by slender membranes; and it is so called because it resembles those thick white worms which are found in rotten wood. It doth as it were perform the office of a porter to the formerly mentioned passage, that it may give way and entrance into the Cerebellum to a necessary quantity of spirits, when need requires; lest that, if they should rush with a sudden violence into the Cerebellum, they might confound the imprinted notions of things to be remembered. The Pelvis or Bason is a passage appointed for the carrying away of the gross excrements Here the Pelvis or Bason is confounded with the tunnel. by the palate, and is so called because it hath the similitude and use of a basin or tunnel: it descends from the third ventricle into the Glandule which is seated between the processes of the wedgebone called the saddle thereof, as you may perceive by putting in a spatherne. Now there remains the last of the six parts proposed to our consideration in the third ventricle, that is, the Channel or passage running from this third ventricle into the fourth, for the use formerly mentioned. This Channel descending in its original from the Basin, goes from thence under the buttocks into the last ventricle, the Meninges being perforated; which that you The Channel from the third into the fourth ventricle. may show, it is fit you put the end of a spatherne through it. The benefit of the third ventricle is; that it may be as a Tribunal or judgement seat to the Reasoning faculty, when the mind will draw conclusions from things seen. The fourth ventricle is seated in the place we formerly mentioned; it is less than The fourth ventricle of the Brain. the rest, but more solid; less as that which was not to receive the spirit before it was purified, and cleansed from all impurities; but more solid that it might contain it the safer. The use thereof is, to be as a Treasury and store-house of the opinion, and judgements which reason shall decree, that when need requires, we may fetch and draw them from thence as laid up in store. I know Galen, and the Greek Physicians have not so distinguished in places the three forementioned faculties; but have written, that they all are all over confused through the whole substance of the brain, which opinion also Fernelius in his Pathologia hath renewed. Yet I had rather follow this opinion, as commonly received and celebrated by the Arabian Physicians. The Mammillary processes are the instruments and passages of smelling, being of The use of the Mammillary processes. the same substance with the brain, and like nerves, which run out from the hind horns of the upper or foremost ventricles of the brain to the Ethmoides and spongy bones of the nose, that hence they may receive the divers kinds of smells, and carry them into the Brain. But although they be like nerves, yet they are not accounted nerves because they go not out of the scull. The Fourth and fifth figures of the Brain. Figure 5. R R R, The lower superficies of the callous body reflected. S T V, The triangular surface of the Fornix or Arch. X X, The lower part of the partition of the ventricles continuated with the Arch. Y Y, The upper part of the partition continued with the callous body. Figure 6. A A A, The lower surface of the Arch. B C, Two corners of the Arch, by which it is continuated with the ventricles. D E, The right and left ventricles. F G, Arteries climbing up from the sleepy arteries through the lower side of the ventricles for the forming of that complication of vessels which is called Plexus choroides. H, A vessel issuing out of the fourth Sinus under the Arch, and passing into the third venticle. I K L, The division of this vessel, a part whereof goeth to the right venticle at K, and another to the left at L. M N, The Plexus choroides made of the artery F G, and the vessel H. O O, Small veins passing through the ventricles of the brain, produced from the vessels K and L. P, Other veins arising from the same, dispersed without the ventricles into the Pia mater. Q. A passage from the third ventricle unto the Basin or tunnel. R S, Canales or Sinus graven or furrowed in the substance of the ventricles, in which the phlegm is led along to the orifice of the foresaid passage marked with Q. The Sixth figure of the Brain. Figure 10. A A, Parts of the spinal marrow cut from the brain. BC, The places where th●… marrow did grow unto the brain. D E, The Testicles. FG, The buttocks, H. the pine-glandule. From I to K, A part of the third ventricle going to the fourth, under the Testicles. K L M N, A part of the fourth ventricle which is engraven in the marrow. O, The top of the fourth venticle. P, The place where the spinal marrow goeth out of the skull. Figure 11. AB. Parts of the optic nerves. C D, The sleepy arteries. E, The Basin or tunnel hanging down. F, A hole or perforation of the dura meninx, through which the tunnel reacheth unto the glandule. GG, Parts of the second conjugation of sinews. Figure 12. A, The Glandule. B, The Basin or tunnel called Peluis or Infundibulum. C D E F, The four holes through which the phlegmatic excrement issueth. CHAP. VIII. Of the 7. conjugations of the Nerves of the Brain, so called, because they always show the Nerves conjugated and doubled, that, is on each side one. THe nerves are the ways and instruments of the animal spirit and faculties What a Nerve or Sinew is. of which those spirits are the vehicles, as long as they are contained in the brain; they consist of the only and simple marrowey substance of the brain; or spinal marrow. But passing forth of the brain, they It's substance. Whether the nerves have a third membrane from the Ligaments of the Vertebrae. have another membranous substance which involves them joined with them from the two membranes of the brain; and according to the opinion of some Anatomists, they have also a third from the ligaments drawn as well from divers others, as from these by which they are tied to the Vertebrae; Yet this opinion seems absurd to me, seeing such a membrane, as that which is insensible, wholly repugns the condition of a nerve, which is to give sense to the parts to which it is inserted. The magnitude of the nerves is different, according to the divers necessity of sense incident to the parts into which they are inserted. Their figure is round, and long Their magnitude. Their figure. like to a conduit pipe to carry water in; the membranes of the brain, with which the nerves are covered, being dilated and stretched over them, after the same manner that the processes of the Peritonaeum involves the spermatick vessels, with which they go down to the Testicles, and take life and nourishment by the capillary veins and arteries, which descend to them with the membranes. They are made for this use, that they may impart sense to the sensitive parts, and motion to these that are fit to Their use. be moved. All the nerves descend from the brain either mediately, or immediately; their Number is seven and thirty pair, or conjugations, whereof seven have their Their number original immediately from the brain, the other thirty from the spinal marrow. The first conjugation of the nerves of the brain is thicker than all the rest, and The first conjugation of nerve●. goes to the eyes, to carry the visive spirit to them. These ariseing from divers parts of the brain, in the middle way before they go out of the skull meet together crossewise like the Iron of a Mill (which is fastened in the upper stone) going into one common passage with their cavityes not visible to the eye; that so the spirits brought by those two nerves may be communicated, and they are mutually joined and meet together so, that being driven back from one eye they may fly back into the other. An argument whereof may be drawn from such as aim at any thing, who shutting one of their eyes, see more accurately; because the force of the neighbouring spirits united into one eye, is more strong than when it is dispersed into both. This conjugation when it comes into the glassy humour, is spent in the structure of the netlike coat which contains this humour on the back part. The second conjugation goes into many parts, at its passing forth of the skull, and The second conjugation. in the bottom of the circle of the eye it is distributed into the seven muscles moving the eyes. The Seventh figure showing the eight conjugations of the Nerves of the brain. A A, 2. The brain. BB 1, 2. The Afterbraine. CC 1, 2, the swelling of the brain which some call the mammillary processes. D 1, the beginning of the spinal marrow out of the Basis of the brain. E 1, 2, a part of the spinal marrow when it is ready to issue out of the skull. F F 1, 2, the mammillary processes which serve for the sense of Smelling. GG 1, 2, the optic nerves. H 1, the coition or union of the optic nerves. two 1, 2, the coat of the eye whereinto the optic nerves is extended. K K 1, 2, the second pair of the sinews, ordained for the motion of the eyes. LL 1, 2, the third pair of sinews, or according to the most Anatomists the lesser root of the third pair. MM 1, 2, the fourth pair of sinews, or the greater root of the third pair. N 2, a branch of the third conjugation derived to the musculous skin of the forehead. O 2, a branch of the same to the upper jaw. P P 2, another into the coat of the nostrils. Q 2, another into the temporal muscles. R 2, a branch of the fourth conjugation crumpled like the tendrill of a vine. S 2, a branch of the same reaching unto the upper teeth and the gums. T 2, another of the same to the lower jaw. V 2, a Surcle of the branch T, to the lower lip. XX 2, another surcle from the branch T, to the roots of the lower teeth. YY2, the assumption of the nerves of the fourth conjugation unto the coat of the tongue. Z 1, 2, the fourth pair are vulgarly so called which are spent into the coats of the palate. a 1, 2. the fifth pair of sinews which belong to the hearing. Φ, the Auditory nerve spread abroad into the cavity of the stony bone. ●, a hard part of the fifth conjugation above, the * which may be counted for a distinct nerve. b 1, 2, a small branch derived from this harder part of the first pair. c 1, 2, a lower branch from the same original. d 1, 2, this nerve is commonly ascribed to the fifth pair, but indeed is a distinct conjugation which we will call the Eight, because we would not interrupt the order of other men's accounts. e 1, 2, the sixth pair of sinews. f 2, a branch from them derived to the neck and the muscles couched thereupon. g 2, another branch to the muscles of the Larinx or throttle, h 1, 2, the seventh pair of sinews. i 1, the union of the seventh pair with the sixth. l 2, a propagation of the seventh pair to those muscles which arise from the Appendix called Styloides. m 2, Surcles from the seventh conjugation to the muscles of the tongue, the bone Hyois and the Larinx. oh p q 1, three holes; through the hole o the phlegm issueth out of the third ventricle of the brain to the tunnel, and at p q, is the passage of the Sop●rary arteries to the ventricles of the Brain. The third is twofold, in the passage out of the skull it is likewise divided into The third conjugation. many branches, of which some are carried to the temporal muscles, into the Masseteres or Grinding muscles, into the skin of the face, forehead and nose; Othersome are sent into the upper part of the cheek, and the parts belonging to it, as into the teeth, gums and the muscles of the upper lip; and those which are called the round which encompass the mouth on the inside; the last are wasted in the coat of the tongue, to bestow upon it the sense of tasting. The fourth conjugation is much smaller, and is almost wholly wasted upon the The fourth conjugation. coat of the palate of the mouth, to endue it also with the sense of tasting. The fifth at its original and having not as yet passed forth of the skull, is divided The fifth conjugation. into two, and sends the greater portion thereof to the hole of the ear, or passage of hearing, that it may support the auditory faculty; and it sends forth the other lesser portion thereof to the temporal muscles by the passage next to it; by which the second conjugation passes forth. The sixth being the greatest next to the first, passing entire forth of the skull, imparts The sixth conjugation. some small branches to certain muscles of the neck and throttle, and then descending into the chest, it makes the recurrent nerves, and dispersed over all the parts of the two lower bellies, it passes even to the bladder and testicles, as we showed in the former book. The seventh is inserted and spent upon the muscles of the bone Hyois, the tongue The seventh conjugation. and some of the throttle, to give them motion; it passes forth of the skull by the hole of the noll bone at the extuberancies thereof. CHAP. IX. Of the Rete Mirabile, or wonderful Net, and of the Wedgebone. THe Animal spirit is made of the vital, sent from the heart by the internal sleepy Arteries to the brain. For it was requisite that it should be the The existence of the Animal spirit. more elaborate, because the action of the Animal is more excellent than that of the vital; nature hath framed a texture of Arteries in many places What the Rete Mirabile is, running cross one another, in the form of a Net divers times doubled; (whereupon it had the name of the wonderful Net) that so the spirit by longer delay in these Labyrinthean or maze-like turnings, might be more perfectly concocted and elaborate, and attain to a greater fitness to perform the Animal functions. This wonderful Net situate at the sides of the Apophyses clinoides or productions The site, and number. of the wedgebone, is twofold; that is, divided by the pituitary Glandule which is situate between the said Apophyses Clinoides, having the wedgebone lying under them, next to the Crassa Meninx, being perforated on the right and left side, next to which lie bones as rare as a sponge even to the palate, by which the Phlegm is purged by the mouth and nose; and therehence, I think, that spittle flows, which such as have a moist brain, continually spit out of their mouth. The Eight figure of the brain. A, The Brain. B, The Cerebellum or after brain. C, A process of the brain, but not that which is called Mammillaris. D D, The marrow of the back as it is yet within the skull. E, The Mammillary process or instrument of smelling. F, The optic nerve. G, The coat of the eye into which the optic nerve is spread. H, The nerve that moveth the eye or the second pair: I, The third conjugation; or the harder and lesser branch of the nerves of the third conjugation brought forward. K, The fourth conjugation or the greater and thicker nerve of the third pair bending downward. L, A branch of the nerve marked with ay, which goeth to the forehead. M, Another branch of the nerve I, reaching to the upper jaw, NN, A nerve proceeding from the branch I, intexed or woven with the coat of the nose. O, The nerve of the temporal muscle issuing from the branch I P, A nerve contorted of the nerves K and b. Q, A nerve proceeding from the branch K, to the sockets of the upper teeth. R, A nerve creeping from the nerve K, to the lower jaw. S. A surcle of the branch R, offered to the lower lip. TT, Other surcles from the branch R, attaining to the lower teeth, W, A branch of the nerve K, diffused into the coat of the tongue. X X, The fourth pair of sinews which go into the coat of the palate. Y, The fifth pair of sinews which are the nerves of hearing. a, the membrane of the ear, unto which that fifth nerve goeth. b c, two small branches of the fifth conjugation uniting themselves with the nerve P. à, the eight conjugation or a nerve of the fifth pair attaining unto the face. ee, the sixth pair of nerves. f, A branch from the nerve e, reaching to the muscles of the neck. g, Small branches derived unto the throttle or larynx. h, the byfurcation of the nerve into two branches. iii, An inner branch hanging to the rackbones, and strengthening the intercostal nerves, and is therefore called Intercostalis. kk, Surcles of the utter branch going to the heads of the muscles, to the breastbone and to the coller-bones. l m, branches of the right nerve l, making the right Recurrent nerve. m n, the insertion of the recurrent sinews into the muscles of the larinx. oh p, branches of the left nerve making the left recurrent sinew p. qq, branches from the sixth conjugation going to the coat of the lungs. r, small nerves of the heart and of the purse thereof called the Pericardium, as also some approaching to the coats of the lungs. s, nerves on either side sent to the stomach. t, the right stomach nerve going to the left orifice of the stomach. u u, the left stomach nerve going to the right orifice of the stomach. x, a nerve from the branch u, passing into the hollowness of the liver. y, the nerve belonging to the right side of the kell. z, the nerve belonging to the colic gut. α, a nerve creeping to the gut called duodenum and the beginning of the ieiunum or empty gut. β, a nerve implanted in the right side of the bottom of the stomach. γ, a nerve belonging to the liver and bladder of gall. δ, a nerve reaching unto the right kidney. 〈◊〉, a branch reaching the Mesenterium and the guts. ζ, a branch sprinkled to the right part of the bladder. η, a branch going through the left part of the kel. θα, surcles derived to the colic gut and the kel. χ, small branches inserted into the spleen. λλ, a nerve approaching to the left side of the bottom of the stomach. μ, a branch belonging to the left side of the Mesentery and the guts. ν, a branch which attaineth to the left kidney. ξ, small nerves creeping through the left side of the bladder. o, the seven pair of finewes. 〈◊〉, a branch derived from the sixth conjugation to the muscles which arise from the process called Styloides. 〈◊〉, a branch of the seaventh conjugation which goeth to the muscles of the tongue, of the bone hyois, and of the throttle or larinx. 〈◊〉, A conjunction or coition of the 6. and 7. pair into one nerve. These Apophyses clinoides are certain productions of the Osbasilare or wedgebone, What the Apophyses Clinoides are. (called the Saddle thereof,) between which, as I said, the pituitary glandule lies with part of the wonderful net. There is a great controversy amongst Anatomists concerning this part; for Vesalius denies that it is in man, Columbus admits it, yet he seems to confound it with the Plexia Choroides. Truly I have observed it always Whether the Rete mirabio differ from the Plexus choroides. after the manner, as Silvius alleges against Vesalius. It remains, that we recite the perforations of the skull, because the knowledge of these much conduces to the understanding of the insertions of the veins, arteries and nerves. CHAP. X. Of the holes of the inner Basis of the Scull. IN the first place are reckoned the holes of the bone Ethmoides; then those of the optic nerves; thirdly of the nerves moving the eyes. Fourthly of that portion, of the nerves, of the fourth conjugation which go to the temporal muscles. Fifthly are reckoned, these holes scarce visible, situate under the pituitary glandule, by which the spittle is evacuated. Sixthly that hole which is in the wedge bone made for the entrance of the internal sleepy Arteries, composing the wonderful Net, and then passing into the brain by a great slit. That perforation which we reckon in the seventh place is commonly double, made for the entrance of one of the branches of the internal jugular vein. The eight hole is somewhat long, of an oval figure, by which, part of the third conjugation and all the fourth conjugation passes forth. The ninth are the auditory passages. The tenth are very small holes, and give way to the vein and artery going to the auditory passage, above the for a men coecum. In the eleaventh place are reckoned the perforations which yield passage forth to the sixth pair of nerves, to part of the sleepy Arteries, and of the internal jugular. In the twelfth those which yield a way out to the seventh conjugation; The great hole of the Noll bone through which the spinal marrow passes is reckoned the thirteenth. The fourteenth is that, which most commonly is behind that great hole, by which the Cervicall veins and arteries enter in. CHAP. XI. Of the perforations of the external Basis of the Brain. THere is a hole on each side at the Eyebrows, by which passes a small nerve from the third conjugation coming out of the cavity of the Orb of the eye, and going by the forehead bone to the eyebrows, that it may give motion to the two muscles of the upper eyebrow and forehead. Yet oftentimes the hole is but to be seen on one side, oft times there is a cleft instead thereof, otherwhiles it is not perforated nor cleft at all. The second, is the perforation of the greater corner of the eye, by which a portion of the nerves of the third conjugation descends to the coat of the nose; in this hole the Glandula Lachrymalis is seated. The third is seated under the eye, that it may give way to the other portion of the nerves of the third conjugation going to the parts of the face, and the teeth of the upper jaw. The fourth is at the beginning of the palate, amongst the cutting or shearing teeth, through which a vein, an artery and the coat of the palate passes out. In the fifth order are reckoned the perforations of the palate, by which the nerves descend from the fourth conjugation, to give, or cause the taste. In the sixth order are ranked the holes of the palate serving for respiration, and the phlegm falling from the brain by the nostrils. And there is a cleft under the yoke bone ascending into the Orb of the eye, by which there is a way, as well for the nerves of the third conjugation to the Temporal muscles, as also for certain veins and arteries. But also there is noted another hole at the mammillary process, which is not perforated in the judgement of the sense. Besides there is thought to be another at the hind root of the same process, by which a certain small vein passes from the jugular to the Torcular. But I have only noted these three passages by the way, because there is so much variety in them, that nothing can be certainly said of them. CHAP. XII. Of the spinal Marrow, or Pith of the Back. THe spinal Marrow is like a River running from the fountain of the brain. What the spinal marrow is. This sends nerves for sense and motion to all the neighbouring parts under the head, spreading its branches as from the body of a tree. These branches, as we shall hereafter show, are on each side thirty. This same spinal marrow is covered The coats of the spinal marrow. with the two membranes investing the brain, distinguished by no distance of place, as in the brain. But also it hath another membrane added to these, being very hard and dense, which keeps it from being broken and violated by the violent bending of the body forewards and about. The diseases of this marrow do almost cause the The diseases from the hurting of the spinal marrow. like Symptoms, as the diseases of the brain; For they hurt the sense and motion of all the parts lying beneath them, as for example; If any of the vertebrae of the back bone, be moved out of their place, there follows a distortion or wresting aside of the Marrow; but then especially if it happen that one of the vertebrae be strained, so sharp and bitter a compression urges the marrow by reason of the bony body of the vertebra, that it will either rend it, or certainly hinder the passage of the spirit by it. But by these same holes of the vertebrae the veins and arteries go to the spinal marrow for to give life and nourishment to it, as the nerves by them pass forth into a●… the lower parts of the body. Figure 1. showeth the form of the spinal marrow properly so called, with its membranes, and the nerves proceeding from it. Figure 2. The spinal marrow naked and bare, together with its nerves, as most part of Anatomists have described it. The tenth figure of the spinal marrow. A, The beginning of the spinal marrow where it falls out of the skull. B, The thickness thereof in the spondels or rackbones of the loins. C, The division thereof into strings, or hairy threads. D, the seven nerves of the neck. From D to E or from 7, to 19, show the nerves of the back. From E to F, the nerves of the loins. From F to G, the nerves of the os s●crum or holy bone. H, the end of the marrow. I K L, do show how the nerves do● issue from the marrow in strings. M M, the knots of the sinews made of the conjunction of those strings. N O, the membranes that invest the marrow: Figure 2. A, The beginning of the spinal marrow in the scull. 3, 4, 5, 6, 7, These Characters show (according to Vesalius opinion) how the conjugations of the nerves of the brain do take their original from the marrow remaining yet within the Skull. B, The egress of the spinal marrow out of the skull. C, The cords or strings whereinto it is divided. D 7, The marrow of the neck and seven pair of sinews. E 19, twelve pairs or conjugations of nerves proceeding from the marrow of the Chest. F 24, The marrow of the loins and 5. pair of sinews. G 30. the marrow of the holybone and 6, pair of sinews. H, the extremity or end of the spinal marrow. The End of the Fifth Book. THE six BOOK TREATING OF the Muscles and Bones, and the other Extreme parts of the Body. The Preface. PEradventure some may wonder, that I have ended my fifth book of Anatomy, before I have fully described all the parts of the head, the which seemed as it were only appointed for that purpose. Therefore I must yield a reason of this my intention. I have a desire in one Treatise and as it were at one breath, to prosecute the Anatomy of the Muscles. Wherefore because the parts of the head not yet described, principally consist of the Muscles, therefore I desired to comprehend them together with this same description The description of the bones being unknown is must necessarily follow that the original and insertion of the muscles must be so also of the extreme parts of the body; beginning at the upper part of the face, to wit, the eyes: but having first described the bones of the face, without the knowledge of which it is impossible to show the original and insertion of the Muscles. We have formerly noted that by the face is meant whatsoever lies from the Eyebrows even to the Chin. In which there is such admirable industry of nature, that of the infinite multitude of men you cannot find two so like, but that they may be distinguished by some unlikeness in their faces; also it hath adorned this part with such exquisite beauty, that many have died by longing to enjoy the beauty desired by them. This The endowments of the face. same face albeit it little exceeds half a foot, yet it indicateth and plainly intimates by the sudden changes thereof, what affections and passions of hope, fear, sorrow and delight possess our minds; and what state our bodies are in, sound, sick or The countenance is the bewrayer of the will. neither. Wherefore seeing the face is of so much moment, let us return to the anatomical description thereof, which that we may easily and plainly perform we will begin with the bones thereof, whereby, as we formerly said, the original and insertion of the Muscles may be more certain and manifest to us. CHAP. I. Of the bones of the Face. THe bones of the face are 16, or 17, in number. And first, there be reckoned Bones in each orb of the Eye. 6 about the Orbs of the eyes, that is 3 to each orb, of which one is the bigger, another lesser, and the third between both; each of these touch the forehead bone in their upper part. Besides, the greater is joined with a suture to the process of the stony bone, and so makes What the Zygoma is and what use it hath. the Zygoma, that is, the Os jugale or yoke bone, framed by nature for preservation of the temporal muscle. The l●sser is seated at the greater corner of the eye, in which there is a hole perforated to the nose, and in this is the glandule in which the Aegylops The Aegylops. doth breed. The middle is in the bottom, or inner part of the orb, very slender & as The two bones of the nose. The two inner bones of the palato. it were of a membranous thinness: then follow the two bones of the nose which are joined to the forehead bone by a suture, but on the foreside between themselves by harmony. But on the back or hind part with two other bones, on each side one, which descending from the bone of the forehead (to which also they are joined by a suture) receive all the teeth. These two in Galens' opinion are seldom found separated. But these are the thickest of all the bones of the face hitherto mentioned, knit by a suture with the greatest bone of the Orb, on the back part with the wedgebone, on the inner side with the two little inner bones of the palate, which on the inside make the extremity thereof, whereby it comes to pass, that we may call these bones the hinder, or inner bones of the palate. They reckon one of these bones the eleventh and the other the twelfth bone of the head; these two little bones on their sides next to the winged productions of the wedgebone, receive on each side one of the nerves of the fourth conjugation, which in the former book, we said were spent upon the membrane of the palate. And in Galens' opinion there be other two in the lower jaw, joined at the middle of The two bones of the jaw. the chin; although some think it but one bone, because by the judgement of sense there appears no division or separation therein. But you may see in children how true this their supposition is, for in men of perfect growth it appears but one bone; Two productions on each side of the lower jaw. these two are reckoned for the thirteenth and fourteenth bones. Now these two bones making the lower jaw, have in their back part on each side two productions, as they lie to the upper jaw, the one of which represents the point of a sword, and is called the Corone; the other is obtuse and round, which is inserted into the cavity seated at the root of the process of the stony bone, ne'er to the passage of the ear. This may be strained to the forepart by violent gaping, by retraction of the muscles The Luxation of the lower jaw. arising from the wing-like processes, and ending at the lower angles of the broader part of the same jaw. This jaw is hollow as also the upper, especially in the backpart, being filled with The lower jaw filled with a marrowy humour. a white and glutinous humour, conducing to the growth of the teeth. This humour hath its matter from the blood brought thither by the vessels, veins, Arteries and nerves from the third conjugation entering in here by a passage large enough. Whereby it comes to pass, that this part is not only nourished and lives, but also the teeth receive sense by the benefit of the nerves entering thither with the vein and artery, by small holes to be seen at the lower roots of the teeth; and thence it is that a beating How the teeth feel. pain may be perceived in the toothache, because the defluxion may be by the arteries; or rather because the humour flowing to the roots of the teeth may press the Why the teeth have a beating pain. artery in that place; beside also you may see some appearance of a nervous substance in the root of a tooth newly plucked out. But also you must consider, that this jaw from its inner capacity produces at the The nerves of the Lower jaw must be observed. fides of the chin two nerves of a sufficient magnitude, over against the lower dog-teeths and the first of the smaller grinding teeth, as I have noted in the description of the nerves of the third conjugation. I have thought good to put thee in mind of these, that when thou shalt have occasion to make incision in these places, thou mayest warily and discreetly handle the matter, that these parts receive no harm. There remains another bone seated above the palate, from which the gristlely The bone of the nose above the palate, or the partition of the nose, partition of the nose arises, being omitted of all the Anatomists, for as much as I know. Now therefore that you may the better remember the number of the bones of the face, I will here make a repetition of them. There are six of the orbs of the eyes, at each three. The seventh and eight we may call the Nasall, or nose bones. The ninth and tenth the jawbones. The eleventh and twelfth are called the inner bones of the palate. The thirteenth and fourteenth the bones of the lower jaw. The partition of the nose may be reckoned the fifteenth. Now it remains having spoken of these bones, that we treat of the teeth, the Eyebrows, the skin, the fleshy pannicle, the Muscles, and lastly the other parts of the face. CHAP. II. Of the Teeth. THe Teeth are of the number of the bones, and those which have the most The teeth 〈◊〉 bones. have thirty two, that is, sixteen above, and so many below; of which in the forepart of the mouth there are four above and as many beneath, which are called Incisorij cutting or shearing teeth, to cut in sunder the The shearing teeth. meat, and they have but one root. To these are joined two in each jaw, that is, on each side of the other one, which are called Canini dentes, Dogges-teeths, because The Dogteeth they are sharp and strong like dogs teeth; these also have but one root, but that is far longer than the other have. Then follow the Molares or Grinders, on each side five, that is, ten above and as The Grinding teeth. many below, that they may grind, chaw and break the meat, that so it may be the sooner concocted in the stomach; for so they vulgarly think, that meat well chawed is half concocted; those grinders which are fastened in the upper jaw, have most commonly three roots, and oft times four. But these which are fastened in the lower, have Why the upper grinding teeth have more roots. only two roots, and sometimes three, because this lower jaw is harder than the upper so that it cannot be so easily hollowed, or else because these teeth being fixed and firmly seated, needed not so many stays as the upper, which as it were hang out of their seats. The shearing teeth cut the meat because they are broad and sharp; the The use of the teeth. Dog-teeths break it because they are sharp pointed and firm; but the grinders being hard, broad and sharp, chaw and grind it asunder. But if the grinders had been smooth, they could not fitly have performed their duty, for all things are chawed and broken asunder more easily by that which is rough and unequal. Wherefore they sharpen their Millstones when they are smother than they should The teeth are fastened in the jaws by Gomphosis. be, by picking them with a sharp Iron. The teeth are fastened in the jaws by Gomphosis, that is, as a stake or nail, so are they fixed into the holes of their jaws; for they adhere so firmly thereto in some, that when they are plucked out, part thereof follows together with the tooth; which I have often observed to have been also with great effusion of blood. This adhesion of the teeth fastened in their jaws is besides The fastening of the teeth into the jaws is to be observed. strengthened with a ligament, which applies itself to their roots together with the nerve and vessels. The teeth differ from other bones; because they have action whilst they chaw the meat; because being lost they may be regenerated, and for that they grow as long as the party lives, for otherwise by the continual use of chawing they would be worn and wasted away by one another. You may perceive this by any that have lost one of their teeth, for that which is opposite to it becomes longer than the rest, because it is not worn by its opposite. Besides also they are more hard and solid than the rest of the bones, and endued with a quick sense by reason of the nerves of Wherein the teeth differ from the other bones. the third conjugation which insert themselves into their roots; for if you rub, or grind a tooth newly plucked out, you may see the remains of the nerve; they have such quick sense, that with the tongue they might judge of tastes. But how feel the teeth, seeing For what use the teeth have sense. they may be filled without pain? Fallopius answers, that the teeth feel not in their upper or exterior part, but only by a membrane which they have within. And the teeth have another use, especially the foreteeth, which is, they serve for distinct and articulate pronunciation; for those that want them falter in speaking, as also The foreteeth help for the articulation of the voice. such as have them too short, or too long, or ill ranked. Besides, children speak not distinctly before they have their foreteeth. And you must note that the infant as yet shut up in its mother's womb hath solid and bony teeth; which you may perceive by dissecting it presently after it is borne. But even as there are two large cavities, in the forehead bone at the eyebrows, filled with aviscous humour, serving for the smelling; and in like manner, the air shut up in the mamillary processes is for hearing; so in the jaws there be two cavities furnished with a viscide humour for the nourishment of the teeth. CHAP. III. Of the Broad Muscle. NOw we should prosecute the containing parts of the face, to wit the skin, the fleshy pannicle and fat; but because they have been spoken of sufficiently before, I will only describe the sleshy pannicle, before I come to the dissection of the eye, that we may the more easily understand, all the motions performed by it, whether in the face or forehead. First that you may more easily see it, you must curiously separate the skin in some part of the face. For unless you take good heed, you will pluck away the fleshy pannicle together with the skin, as also this broad muscle to which it immediately adheres, and in some places so closely and firmly, as in the lips, eyelids and the whole forehead, that it cannot be separated from it. Nature hath given motion, or a moving force to this broad muscle, that whilst it extends, or contracts itself, it might serve to shut and open the eye. It will be convenient to separate the muscle thus freed from the skin, beginning from the forepart of the clavicles even to the chin, ascending in a right line, and then turning back as far as you can; for thus you shall show how it mixes itself with the skin and the muscles of the lips. When thou shalt come to the Eyes, thou shalt teach how the eye is shut and opened by this one muscle, because it is composed of the three sorts of fibers; although by There are no particular muscles appointed to open and shut the eye, for that is the work of the broad muscle only. Divers reasons to that purpose. the opinion of all who have hitherto written of Anatomy, those actions are said to be performed by the power of two muscles appointed for that purpose; one of which is at the greater corner on the upper part, the other resembling a semicircle at the lesser corner, from whence extending itself to the middle of the gristle Tarsus, it meets with the former ending there, but they are in part extended over all the eyelid, whereby it cometh to pass that it also in some sort becometh movable. But although in public dissections these two muscles are commonly wont to be solemnly showed, after the manner I have related; yet I think, that those which show them know no more of them, than I do. I have grounded my opinion from this, that there appears no other musculous flesh in these places, to those which separate the fleshy pannicle, or broad muscle, than that which is of the pannicle itself, whether you draw your incision knife from the forehead downwards, or from the cheek upwards. Besides when there is occasion to make incision on the eyebrows, we are forbidden to do it transverse, lest this broad muscle falling upon the eye, make the upper Why you must take heed of making a transverse incision upon the eyebrows. Eyelid unmoveable: but if such a cut be received accidentally, we are commanded presently to stitch it up; which is a great argument that the motion of the upper eyelid is not performed by its proper muscles, but wholly depends and is performed by the broad muscle. Now if these same proper muscles which we have described should be in the upper eyelid, it should be meet, (because when one of the muscles is in action, the other which is its opposite or Antagonist, rests or keeps holieday,) that when that which is said to open the eye is employed, the opposite thereof resting, the The action of a muscle. upper eyelid should be drawn towards its original, as we see it happens in convulsions: because the operation of a muscle is the collection of the part which it moves towards its original. Therefore seeing such a motion or collection appears not any where in the eyelid, I think it therefore manifest that all the motion of this upper eyelid depends upon this broad muscle, and that it alone is the author of the motion thereof. The original of this broad muscle is from the upper part of the Sternon, the clavicles, The original of the broad muscle. The insertion and reason why we express so many motions with the face. the shoulder blades, and all the spines of the vertebrae of the neck: but it is inserted into all these parts of the head which want hair, and the whole face, having divers fibers from so various an original. by benefit of which it performs such manifold motions in the face (for it so spreads itself over the face, that it covers it like a vizard) by reason of the variety of the original and the production of the divers fibers of this muscle. But I have not in the description of this muscle prosecuted those nine conditions, which in the first book of my anatomy I required in every part, because I may seem to have sufficiently declared them in the description of the muscles of the Epigastrium. Wherefore hence forward you must expect nothing from me in the description of muscles besides their original, insertion, action, composition, and the designation of their vessels. CHAP. four Of the Eyelids and Eyebrows. BEcause we have fallen into mention of the Eyelids and Eyebrows, and What the eyebrows are. because the order of dissection also requires it, we must tell you what they are, of what they consist, and how and for what use they were framed by nature. Therefore the Eyebrows are nothing else, than a rank of hairs set in a semicircular form upon the upper part of the orb of the Eye, from the greater to the Their use lesser corner thereof, to serve for an ornament of the body and a defence of the eyes against the acrimony of the sweat falling from the forehead. But the Eyelids on each side two, one above and another below, are nothing else What the eyelids are. than as it were certain shutting appointed and made to close and open the eyes when need requires, and to contain them in their orbs. Their composure is of a Their composure and use. musculous skin, a gristle and hairs set like a pale at the sides of them to preserve the eyes when they are open, chiefly against the injuries of small bodies, as motes, dust & such like. These hairs are always of equal and like bigness, implanted at the edges of the gristly part, that they might always stand strait and stiff out. They are not thick, for so they should darken the eye. The gristle in which they are fastened is encompassed with the pericranium stretched so far before it produce the Coniunctiva. It was placed there, that when any part thereof should be drawn upwards or downwards by the force of the broad muscle or of the two proper muscles, it might follow, entirely and wholly by reason of its hardness. They call this same gristle, especially What the Tarsus is. the upper, Tarsus. The upper and lower eyelid differ in nothing, but that the upper hath a more manifest motion, and the lower a more obscure; for otherwise nature should have in vain encompassed it with a musculous substance. CHAP. V. Of the Eyes. THe Eyes are the instruments of the faculty of seeing, brought thither by What the eyes are. the visive spirit of the optic nerves, as in an aqua-ducte. They are of a soft substance, of a large quantity, being bigger or lesser according to the bigness of the body. They are seated in the head, that they might overlook Their site. the rest of the body, to perceive and shum such things as might endanger, or endamage the body; for the action of the eyes is most quick, as that which is performed The quickness, and excellency of their action in a moment, which is granted to none of the other senses. Wherefore this is the most excellent sense of them all. For by this we behold the fabric and beauty of the heavens and earth, distinguish the infinite varieties of colours, we perceive and know the magnitude, figure, number, proportion, site, motion and rest of all bodies. The eyes have a pyramidal figure whose basis is without, but the Cone or point within at the optic nerves. Nature would have them contained in a hollow circle, that so Figure. by the profundity and solidity of the place they might be free from the incursions of bruising and hurtful things. They are composed of six muscles, five coats, three humours, and a most bright spirit, (of which there is a perpetual afflux from the brain) two nerves, a double Composition. vein, and one artery, besides much fat, and lastly a Glandule seated at the greater angle thereof, upon that large hole which on both sides goes to the nose, and that, Glandula Lachrymalis. lest that the humours falling from the brain should flow by the nose into the eyes, as we see it fares with those whose eyes perpetually weep, or water, by reason of the eating away of this glandule, whence that affect is called, the Fistula lachrymalis, or Fistula Lachrymalis. weeping Fistula. But there is much fat put between the muscles of the eye, partly that the motion Why fat is placed about the eyes. of the eyes might be more quick, in that slipperines of the fat, as also that the temper and complexion of the eyes, and chiefly of their nervous parts, might be more constant and lasting, which otherwise by their continual and perpetual motion would be subject to excessive dryness. For nature, for the same reason hath placed Glandules flowing with a certain moisture, near those parts which have perpetual agitation. CHAP. VI Of the Muscles, Coats and humours of the Eye. THere are six muscles in the eye, of which four perform the four direct motions of the eye: they arise from the bottom of the orb, and end in the The number, site and action of the muscles. midst of the eye encompassing the optic nerve. When they are all moved with one endeavour, they draw the eye inwards. But if the upper only use its action, it draws the eye upwards; if the lower, downwards; if the right, to the right side; if the left, to the left side. The two other muscles turn the eye about, the first of which being the longer and slenderer, arises almost from the same place, from which, that muscle arises which draws the eye to the right side to the greater corner. But when it comes to the utmost part of the inner angle, where the Glandula lachrymalis is seated, it ends in a slender Tendon, there piercing through the middle membrane which is there, as through a ring; from whence it presently going back is spent in a right angle towards the upper part of the eye, betwixt the insertions of those 〈◊〉 muscles, of the which one draws the eye upwards, the other directly to the outward corner, as it is observed by Fallopius or rather, which I remember I have always observed, they turn between the muscles which move the eye upwards, and to the inner corner. This fifth muscle when it is drawn in towards its beginning, so draws the eye with its circular tendon, that it carries it to the greater corner. The sixth muscle is contrary to that; for it hath its original from the lower part of the orb at a small hole, by which a nerve of the third conjugation passes forth; and being that it is most slender, whilst it ascends transversely to the outward corner, it involves the eye so also, that it is inserted in it by a small Tendon, so that the Tendons of them both are oftentimes taken but for one. That thou mayest truly and accurately observe this anatomical description of the eye; the eye must not be plucked out of its orb, but rather the orb itself must be broken and separated. For thus thou shalt certainly and plainly see the forementioned original of the muscles. For the five coats, the first which is first met with in dissection, comes from the pericranium, and is extended over all the white of the eye, even to the 〈◊〉 or The 5 coats of the eye. Rainbow. The duty of it is to strengthen, bind and contain the eye in its orb, wherefore it had the name Coniunctiva, others call it Adnata, or Epipephycos. Conjunctiva, or Adnata. The second is called the Cornea, because it resembles a horn in colour and consistence; 2. Cornea, or the Horny coat. this coat differs and varyes from itself, for in the forepart, as far as the Iris goes, it is clear and perspicuous, but thick & obscure in the bind part, by reason of the divers polishing. On the forepart it is dense that it may preserve and contain the Crystalline and waterish humour, but withal transparent so to give the object a freer passage to the Crystalline. It hath its original from the Crassa meninx, proceeding forth from the inner holes of the orb of the eye, for it compasses the eye on every side. The third is called the Wea or Grapy coat, because in the exterior part it represents Uvea, or the grapye coat. the colour of a black grape; it arises from the Pia mater, and encompasses all the eye, except the pupilla or apple of the eye, for here being perforated, it adheres to the horny coat by the veins and arteries which it communicates to it for life and nourishment. But when it arrives at the Iris, then forsaking the Cornea, it descends deep into the eye, and in some sort is turned about the Crystalline humour, to which also it most firmly adheres, so bounding the waterish humour, and also prohibiting that the Albugineous humour do not overwhelm the Crystalline. This grapy coat is as it Why the grapy coat resembles divert colours. were died on the inside with divers colours, as black, brown, blue, or green like a rainbow, and that for these ensuing benefits. The first is, if that it had been tinctured with one colour, all objects would have appeared of the same colour, as it comes to pass when we look through green or red glass. But it must be coloured, that so it may collect the spirits dissipated by the Sun and seeing. Thirdly it was convenient it should be painted with infinite variety of colours for the preservation of the sight. For as the extreme colours corrupt and weaken the sight, so the middle refresh and preserve it, more or less as they are nearer, or further remote from the extremes. It was fit it should be soft, that so it might not hurt the Crystalline humour upon whose circumference it ends; and perforated in the part objected to it, least by its obscurity it should hinder the passage of the objects to the Crystalline, but rather that it might collect by its blackness as a contrary, the great and as it were diffused variety of colours, no otherwise than we see the heat is strengthened, by the opposition of cold; some call this coat Choroides, because it is woven with many veins and arteries, like the coat Chorion which involves the infant in the womb. Now follows the fourth coat called Ampiblistroides or Retiformis, the Netlike 4 Amphiblistr●●des or Retiformis, Net: like coat. coat, because proceeding from the optic nerve dilated into a coat, it is woven like a net with veins and arteries which it receives from the grapy coat, both for the life and nourishment both of its self, as also of the glassy humour which it encompasses on the back part. The principal commodity of this coat is, to perceive when the Crystalline humour shall be changed by objects, & to lead the visive spirit instructed or furnished with the faculty of seeing, by the mediation of the glassy humour, even to the Crystalline being the principal instrument of seeing. It is softer than any other coat, lest the touch of it should offend that humour. Wherein thou wilt admire the singular order of nature, which as in other things it passes not from one extreme to another unless by a Medium, so here it hath not fitted the hard horny coat to the soft An anatomical Axiom. humours, but by interposition of divers media of a middle consistence. For thus after the harder coats Adnata and Cornea it hath placed the Grapy coat, by so much softer than these two, as the Netlike coat is softer than it, that thus it might pass from extreme to extreme as it were by these degrees of hardness and softness. The fifth and last coat is called Arachnoides, because it is of the consistence of a 5 Arachnoides, sive Araneosa, the Cowebcoa●e. spider's web. And we may well resemble this coat, to that skin of an union which exceeds the other in clearness, whiteness and thinness. This Araneosa or Cobweb-like coat encompasses the Crystalline humour on the fore fide, peradventure that so it might defend it, as the chief instrument of seeing, if the other humours should at any time be hurt. It hath its original from the excrementitious humidity of the Crystalline humour, hardened into that coat by the coldness of the adjacent parts; The 3 humours of the Eye. 1 Aqueus, or matery. absolutely like the thin skin which encompasses the white of an Egg. The first humour of the eye is called the Aqueus or waterish, from the similitude of water; it is seated between the transparent part of the Horny coat, the portion of the Crystalline humour lying towards the apple of the eye, and that reflection of the Grapy coat which comes from the Iris to the circumference of the Crystalline humour, that filling the empty space it may distend the Cornea, and so hinder the falling thereof upon the Crystalline which would spoil the sight; as also that by its moisture it might hinder the drying of the Crystalline humour. Peradventure it is made of the whayish humour sweeting out of the vessels of the coats, having their orifices for the most part in that place, where this waterish humour resides. The second humour and middle most in situation is called the Crystalline because it imitats Crystal in the brightness and colour; if so be that we may attribute any 2 Crystallinus, Crystalline. colour to it. For indeed it was fit that none of the three humours should be tinctured with any colour, as those which should be the instruments of sight, lest they might beguile us in seeing as Red and green spectacles do; for that is true which we have read written by the Philosopher; That the Subject or matter appointed A Philosophical Axiom. for the reception of any form should want all impression thereof. Hence Nature hath created a formelesse matter, the humours of the eyes without colours, wax without any figure, the mind without any particular knowledge of any thing, that so they might be able to receive all manner of forms. The figure of the Crystalline humour is round, yet somewhat flatted on the foreside, but yet more flatted behind that so the objects might be the better retained in that, as it were, plane figure, and that they might not fly back as from a Globe, or round body, in which they could make but short stay; lest it might be easily moved from its place, by the force of any thing falling or hitting against it, because that body which is exactly round touches not a plane body but only in a point or prick. Half this humour swims in the Glassy humour, that so it may be nourished from it by transposition of matter; or rather (seeing it is encompassed on every side with the fist coat, that the matter cannot easily be sent from the one into the other) by the benefit of the vessels produced even unto it as well by the Netlike coat, as by the Grapye; but it is filled with a bright spirit on the forepart, which lies next to the waterish humour, and the space of the Apple of the eye. Of which thing this is an argument, that as long as a man remains alive, we see Gal. Cap. 5. lib. 10. de usu part. the eye every way full, and swollne, but lank and wrinkled when he is dead; besides also one of the eyes being shut, the Pupilla of the other is dilated by the spirit compelled to fly thither. And also for the same cause the horny coat is wrinkled in very old men, and the Pupilla is straitened by the wrinkles subsiding into themselves, which is the cause that they see little, or not at all; for by age and success of time the humour is consumed by little and little, the implanted spirit vanishes away, and smaller quantity of spirits now from the brain, as from a fountain which is also exhausted. The Horny coat at his original, that is, in the parts next the Iris, seemeth to be very nigh the Crystalline Humour, because all the coats in that place mutually cohere as touching one another, but as it runs further out to the Pupilla, so it is further distant from the Crystalline. Which you may easily perceive by anatomical dissection, and the operation of touching or taking away a Catarrhact: for whereas a Catarrhact is seated between the horny coat, and Crystalline humour, the needle thrust In what place Catarrhacte or suffusion breeds. in, is carried about upwards, downwards, and on every side through a large and free space, neither touching the horny coat nor Crystalline humour, by reason these bodies are severed by a good distance filled with spirit and a thin humour. The use of it is, that it may be like a looking glass to the faculty of seeing carried thither with the visive spirit. The third and last humour is the Vitreus the glassy, or rather Albugineous humour, called so, because it is like molten glass, or the white of an Egg. It is seated in the 3 Vitreus, seu 〈◊〉, that is Glassy, or like the white of an Egg. hind part of the Crystalline humour that so it may in some sort break the violence of the spirit flowing from the brain into the Crystalline humour, no otherwise than the watery humour is placed on the foreside of the Crystalline to hinder the violence of the light and colours entering that way. This glassy humour is nourished by the netlike coat. The figure of the eye. Table 3. figure 1. showeth the Membranes and humours of the eye by lines drawn after the manner of a true eye. Figure 2. showeth the horny coat with a portion of the Optic Nerve. Figure 3. showeth the same divided by a transuerse section. Figure 4. showeth the Wea or Grapy coat with a portion of the Optic Nerve. Figure 5. The Grapy coat of a man's eye. Figure 6. The Horny, Grapy and the Choroides. Figure 7. The interior superficies of the Grapy coat. Figure 8. The Posterior part of the horny coat together with the said Net coat separated from the Eye. Figure 9 The coat of the vitreous or glassy humour called Hyaloides. Figure 10. Three humours joined together. Figure 11. The forward part of the Crystalline. Figure 12, The Crystalline humour covered yet with his coat. Figure 14. The Crystalline of a man's eye. Figure 15, His Coat. Fig. 16, The watery humour disposed upon the Crystalline round about. Fig. 17. The hairy processes beamingly sprinkled through the foreside of the coat of the glassy humour. Fig. 18, The foreside of the glassy humour. Fig. 19 The place of the watery humour. Fig. 20. The glassy humour containeing or comprehending the Crystalline. The explication of the first Figure by itself. a, The Crystalline humour. b, The Glassy humour. c, The watery humour. d, The utmost coat called Adnata. e, The dark part of the horny Tunicle which is not transparent. f, The Grapy coat called Wea. g, The Netlike coat called Retiformis. h, The coat of the glassy humour called Hyaloides. i, The coat of the Crystalline. k k, The hairy processes called Processus ciliares. l, The impression of the Grapy coat where it departeth from the thick coat. m, The horny coat, a part of the thick coat. n n, The fat betwixt the Muscles. o, The optic Nerve. p, The Dura meninx. q, The Pia Mater or thin Meninx. r r, The Muscles. The explication of the other 19 figures together. a 2, 4, 8, The Optic Nerve. b 2, 4, The thin Meninx clothing the Nerve. c 2, 3, The thick Meninx clothing the nerve. d 8. the posterior part of the horny coat. e 8. The coat called Retina gathered together on an heap. f 23. The rainbow of the eye. g 2, 3, The lesser circle of the eye or the pupilla. h 2, 3. Vessels dispersed through the Dura Meninx. i 3, 6, The grapy coat, but i, in the 3. Fig. showeth how the vessels do join the hard membrane with the grapy coat. k 6. The horny or hard membrane turned over. ll 3. 4, Certain fibres and strings of vessels, whereby the grapy coat is tied to the horny. m m 4, 5. The impression of the grapy coat where it recedeth or departeth from the horny coat. n n, 4, 5, 6, 7, The pupilla or apple of the eye. o o, 7, The Ciliar or hairy processes. p 7, The beginning of the Grapic coat made of a thin membrane dilated, but p, in the 17. figure showeth the ciliar processes sprinkled through the fore part of the glassy humour. r 9, The bosom or depression of the glassy humour receiving the Crystalline. s 12. 15. The breadth of the coat of the Crystalline, t 12, 13, 14, 16, The posterior part of the Crystalline humour which is spherical or round. u 11, 14, 20, The forepart of the same Crystalline depressed x 10, 20. The amplitude of the glassy humour. y 10; 16, 19 The amplitude of the watery humour. z. 19, The place where the glassy humour is distinguished from the watery by the interposition of the Hyalaeides or coat of the glassy humour. & α10, 16, The place where the grap●e coat swimmeth in the watery humour. & β18. The cavity or depression of the glassy humour which remaineth when the Crystalline is exempted or taken from it. δ 19 the cavity or depression of the watery humour made by the same means. CHAP. VII. Of the Nose. THe Nose is called in Greek Ris, because the excrements of the Brain flow forth by this passage, thou mayest understand it hath a divers substance by composition. The quantity, figure and site are sufficiently known to all. But it is composed of the skin and muscles, bones, gristles, a membrane or coat nerve●, veins and arteries. The skin and bones both contained and containing, have formerly been explained, as also the nerves, veins and arteries. The gristles of the Nose are six in number; the first is double separating both the nostrils in the top of the nose extended even to the bone Ethmoides. The second lies under the former. The Gristles of the nose. The third and fourth are continued to the two outward bones of the nose. The fifth & sixth being very slender and descending on both sides of the nose, make the wings or movable parts thereof. Therefore the use of these gristles is, that the nose movable about the end thereof, should be less obnoxious to external injuries, as fractures & bruises, and besides more fit for drawing the air in & expelling it forth in breathing. For nature for this purpose hath bestowed four muscles upon the nose, on each side two, one within, and another without. The external taketh its original from the cheek, and descending obliquely from The muscles thereof. thence and after some sort annexed to that which opens the upperlip, is terminated into the wing of the nose, which it dilates. The internal going on the inner cider from the jaw bone, ends at the beginning of the gristles that make the wings, that so it may contract them. The coat which inwardly invests the nostrils and their passages, is produced by the sieve-like bones from the Crassa meninn, as the inner coat of the Palate, throttle, weazon, Gullet and inner ventricle, that it is no marvel, if the affects of such parts be quickly communicated with the brain. This same coat on each side receives a portion of a nerve from the third conjugation, through the hole which descends to the nose by the great corner of the eye. The nose in all the parts thereof is of a cold and dry temper. The Action and profit The temper, action and use thereof is to carry the air and oft times smells to the mammillary processes, and from thence to the four ventricles of the brain, for the reasons formerly showed. But because the mammillary processes being the passages of the air and smells are double, & for that one of these may be obstructed without the other, therefore nature hath also distinguished the passage of the nose with a gristly partition put between, that when the one is obstructed, they air by the other may enter into the brain for the generation and preservation of the animal spirit. The two holes of the nose first ascend upwards; and then downwards into the mouth, by a crooked passage, lest the cold air, or dust should be carried into the lungs. But the nose was parted into two Why the nose was parted●… two. passages as we see, not only for the forementioned cause, but also for helping the respiration and vindicating the smell from external injuries, and lastly for the ornament of the face. CHAP. VIII. Of the muscles of the face. NOw we must describe the muscles of the face pertaining as well to the There number. lips as to the lower jaw. These are 18. in number, on each side nine, that is, four of the lips, two of the upper, and as many of the lower. But there belong five to the lower jaw. The first of the upper lip being the longer, and narrower, ariseing from the yoake-bone descends by the corner of the mouth to the lowerlip, that so it may bring it to the upper lip, and by that means shut the mouth. The other being shorter and broader, passing forth of the hollowness of the cheek, or upper jaw (by which a portion of the nerves of the third conjugation descends to these two muscles, and other parts of the face) ends in the upper part of the same upper lip, which it composes together with the fleshy pannicle and skin, and it opens it by turning up the exterior fibers towards the nose, and shuts it by drawing the internal inwards towards the teeth. The first of the lower lip being the longer and slenderer, entering out of that region which is between the external perforation of the upper jaw (through which on the inner part of the same, a nerve passeth forth to the same muscles) and the muscle Masseter, (of which hereafter) then ascending upwards by the corner of the mouth, it ends in the upper lip, that so it may draw it to the lower. The other broader and shorter begins at the lower part of the Chin and the hollowness thereof, and ends at the lower lip which it makes, opening it within and without by its internal and external fibers, as we also said of its opposite. And that I may speak in a word, Nature hath framed three sorts of Muscles for the motion of the mouth, of which some open the mouth, others shut it, and othersome wrest it and draw it awry; but you must note that when the muscles of one kind jointly perform their functions (as the a upper which we described in the first place, on each side one which draw the lower lip to the upper, and the muscles opposite to them) they make a right or strait motion; but when either of them moves severally, it moves obliquely, as when we draw our mouth aside. But these muscles are so fastened and fixed to the skin, that they cannot be separated; so that it is no great matter whether you call it a musculous skin, or a skinny muscle (Which also takes place in the palms of the hands and soles of the feet) but these muscles move the lips, the upper jaw being not moved at all. CHAP. IX. Of the Muscles of the lower jaw. WE have said these muscles are five in number, that is, four which shut it, and one which opens it, and these are alike on both sides. The first Their number and greater of these four muscles which shut the jaw is called Crotophita or Temporal muscle, it arises from the sides of the forehead and Bregms The Temporal Muscle. bones, and adhering to the same and the stony bone, it descends under the yoak-bone, from whence it inserts itself to the process of the lower jaw which the Greeks call Corone, that it may draw it directly to the upper, so to shut the mouth. But you must note, that this muscle is tendinous even to his belly, and that it fills and makes both the temples. It is more subject to deadly wounds than the rest by Why the wounds of the temporal Mulcle are deadly. reason of the multitude of nerves dispersed over the substance thereof, which because they are near their original, that is, the brain●, they infer danger of sudden death by a convulsion which usually follows the affects of this muscle; but also in like manner it causes a fever, the Frenzy and Coma. The Figure of the chief muscles of the Face. A. The muscle of the forehead and the right fibers thereof. B. The Temporal muscle. α. β. γ. his semicircular original. D. The muscle of the upper lip. G. The yoake-bone unaer which the temporal muscles pass. I. The Masseter, or Grinding Muscle. K. The upper gristle of the nose. M. A muscle forming the cheeks. N. The muscle of the lower lip. O. A part of the Fifth muscle of the lower jaw called Digastricus, that is, double bellied. Q. R. The first muscle of the bone Hyoides growing unto the rough Artery. S. The second muscle of the bone Hyoides under the Chin. T. The third muscle of the bone Hyoides stretched to the law. T. K. the seveneth muscle of the head and his insertion at T. V. V. The two ventures of the fourth muscle of the hone Hyoides. φ. The place where the vessels pass which go to the head, and the nerves which are sent to the Arme. Therefore that it should be less subject or obvious to external injuries, Nature hath, as it were, made it a retiring place in the bone, and fortified it with a wall of bone raised somewhat higher about it. The other Muscle almost equal to the former in bigness, being called the Masseter, or grinding muscle, makes the Cheek, The Masseter, or grinding muscle. it descends from the lowest part of the greatest bone of the orb (which bends itself as it were back, that it may make part of the yoke bone) and inserts itself into the lower jaw, from the corner thereof to the end of the root of the process Corone, that so it may draw this jaw forward and backward, and move it like a handmill. Wherefore nature hath composed it of two sorts of fibers, of the which some from the neck (the cheek in that place under the eyes standing somewhat out like an apple arising from the concourse of the greater bones of the orb and upper jaw) descend obliquely to the corner and hinder part of the lower jaw, that it may move it forwards. Othersome arise from the lower part of the same yoak-bone, and descending obliquely intersect the former fibers after the similitude of the letter X, and insert themselves into the same lower jaw at the roots of the process Corone, that so they may draw it back. Truly by reason of these contrary motions it is likely this muscle was called the Masseter or grinder. The third, which is the round Muscle, arises from all the Gums of the upper jaw, The round muscle. and is inserted into all the gums of the lower, investing the sides of all the mouth with the coat, with which it is covered on the inside, being otherwise covered on the outside with more fat than any other muscle. The action thereof is, not only to draw the lower jaw to the upper, but also as with a shovel to bring the meat dispersed over all the mouth under the teeth, no otherwise then the tongue draws it in. The lesser muscle of the lower law. The fourth being shorter and less than the rest arising from all the hollowness of the winged process of the Wedgebone, is inserted within into the broadest part of the lower jaw, that so in like manner it may draw the same to the upper. This is the muscle through whose occasion, we said this lower jaw is sometimes dislocated. The fifth and last muscle of the lower jaw from the process styloides of the stony The fifth and last muscle. bone, ascends to the forepart of the Chin, ne'er to the connexion of the two bones of this jaw, to draw this jaw downwards from the upper in opening the mouth. This muscle is slender and Tendinous in the midst, that so it might be the stronger, but it is fleshy at the ends. All these Muscles were made by the singular providence of nature Theuse of these mentioned muscles. and engrafted into this part for the performance of many uses and actions, as biting asunder, chawing, grinding and severing the meat into small particles, which the tongue by a various and harmless motion puts under the teeth. Thus much I thought good to say of the parts of the face, as well containing as contained. The Figure of the Muscles of the lower jaw. A. A hole in the forehead bone in the brim of the seat of the eye, sending a small nerve of the third pair to the muscles of the forehead and the upper eyebrow. B. The Temporal muscle. CHAP. X. Of the Ears and Parotides or kernels of the Ears. THe Ears are the Organs of the Sense of hearing. They are composed The nature and composition of the ears. of the skin, a little flesh, a gristle, veins, arteries and nerves. They may be bended or folded in without harm, because being gristlely, they easily yield and give way; but they would not do so, if they should be bony, but would rather break. That lap at which they hang pendants What the Fibra and pinna are. and lewels, is by the ancients called Fibra; but the upper part pinna. They have been framed by the providence of nature into twining passages like a Snails shell, which as they come nearer to the foramen caecum, or blind hole, are the more straitened, The figure and the reason thereof. that so they might the better gather the air into them, & conceive the differences of sounds and voices, and by little and little lead them to the membrane. This membrane which is indifferently hard hath grown up from the nerves of the fifth conjugation, which they call the auditory. But they were made thus into crooked windings, lest the sounds rushing in too violently should hurt the sense of hearing. Yet for all this we oft find it troubled and hurt by the noise of thunder, Guns and Bels. Other wise also lest that the air too suddenly entering in should by its qualities, as cold, cause some harm: and also that little creeping things and other extraneous bodies as fleas & the like, should be stayed in these windings and turnings of the ways, the glutinous thickness of the choleric excrement or earwax hereunto also conduceing, which the brain purges and sends forth into this part, that is, the For what use the earwax serves. auditory passage framed into these intricate Maeanders. The Figure of the ears and bones of the auditory passage. Tab, 10. showeth the ears and the divers internal parts thereof. Fig. 1. showeth the whole external ear, with a part of the Temple bone. Fig. 2. showeth the left bone of the Temple divided in the midst by the instrument of hearing, whereabout on either side there are certain passages here particularly described. Fig. 3, and 4. showeth the three little Bones. Fig. 5. showeth a portion of the bone of the temples which is seenneere the hole of Hearing divided through the midst, whereby the Nerves, Bones and Membranes may appear as Vesalius of them conceiveth. Fig. 6. showeth the Vessels, Membranes, Bones and holes of the Organ of hearing, as Platerus hath described them. Fig. 7, and 8. showeth the little bones of the hearing of a man and of a Calf, both joined and separated. Fig. 9 showeth the Muscle found out by Aquapendens. For the particular declaration see D. Crookes Anatomy, pag. 577. But that we may understand how the hearing is made, we must know the structure of the organ or instrument hereof. The membrane which we formerly mentioned For what use the membrane stretched under the auditory passage serves. to confist of the auditory nerve, is stretched in the inside over the auditory passage like as the head of a Drum. For it is stretched and extended with the Air, or auditory spirit implanted there, & shut up in the cavity of the mammillary process and foramen caecum, that smitten upon by the touch of the external air entering in, it may receive the object, that is the sound, which is nothing else then a certain quality arising What sound is, from the air beaten or moved by the collision, and conflict of one or more bodies. Such a collision is spread over the air, as the water which by the gliding touch of a stone produces many circles and rings one as it were rising from another. So in rivulets running in a narrow channel, the water strucken and as it were, beaten back in its course against broken, craggy and steep rocks, wheels about into many turnings: this collision of the beaten air flying back divers ways from arched and hollow roofed places, as Dens, Cisterns, Wells, thick Woods and the like, yields and produces The cause of an echo. a double sound, and this reduplication is called and Echo. Wherefore the hearing is thus made by the air, as a medium, but this air is twofold, that is, external and internal. The exterior is that which encompasses us, but the interior is that which is shut The 3 bones of the auditory passage. up in the cavity of the mammillary process and for amen caecum, which truly is not pure and sole air, but tempered and mixed with the auditory spirit. Thence proceeds the noise or beating of the Ears, when vapours are there mixed with the air instead of spirits, whereby their motion or agitation is perturbed and confused. But neither do these suffice for hearing, for nature for the more exact distinction of sounds hath also made the little bones, of which one is called the Incus or anvil, another the Malleolus or hammer, the third the Stapes or stirrup, because the shapethereof resembles a Germane stirrup. Also it may be called Deltoides, because it is made in the shape of the Greek letter Δ. They are placed behind the membrane; wherefore the anvil and hammer moved Their use. by the force of the entrance of the external air, and beating thereof against that membrane, they more distinctly express the difference of sounds, as strings stretched within under the head of a Drum; as for example, these bones being more gently moved represent a low sound to they common sense & faculty of bearing, but being moved more vehemently and violently, they present a quick and great sound; to conclude, according to their divers agitation, they produce divers and different sounds. Whence the difference of sounds. The Glandules should follow the Ears in the order of Anatomy, as well those which are called the emunctoryes of the brain, that is, the Parotides (Which are placed as it were at the lower part of the ears) as these which lie under the lower jaw, the muscles of the bone Hyoides & the tongue, in which the Scrophulae and other such cold abscesses breed. It shall here suffice to set down the use of all such like Glandules. Therefore the Parotides are framed in that place by nature, to receive the virulent and malign matter sent forth by the strength of the brain, by the veins and arteries spread over that place. The rest serve to strengthen the division of the vessels, to moisten the ligaments and membranes of the jaw, lest they should be dried by their continual motion. Their other conditions and uses are formerly handled in our first book of Anatomy. CHAP. XI. Of the bone Hyoides, and the muscles thereof. THe Substance of the Bone Hyoides is the same with that of other bones, The reason of the name, The figure thereof imitates the greek letter v from whence it took the name, (as also the name 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; and from the letter λ it is in like sort called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; by some it is styled Os Guttur is and os Linguae, that The composition. is, the Throat bone and Tongue bone. The composition thereof composition thereof consists of many bones joined into one by the interposition of gristles. This bone is bigger in beasts and composed of more bones, and that not only by the intercourse of gristles, but also of ligaments. It is seated with its basis (being gibbous The free. on the forepart for constancy, and arched on the inside that it might receive and contain the root of the tongue) upon the upper part of that gristle of the throttle which is called scutiformis or Shieldlike, (for this seems to prop it up by the strength of two processes rising at the basis thereof) and the root of the tongue. From this basis it sends forth two horns to the sides of the tongue on each side one, which in men are tied to the Appendix styloides by ligaments sent from itself. Contrary then it is in beasts, who have it of many bones united as we said, by the intercourse of ligaments even to the root of the stiloides. Wherefore this bone hath connexion The temper and use. with the forementioned parts, and other hereafter to be mentioned. It hath the same temper as other bones have. The use of it is, to minister ligaments to certain muscles of the tongue, and insertion as well to the two foremost and upper muscles of the throttle, as to its own, of which we will now treat. The muscles of the bone Hyoides, according to the opinion of some are eight, on each side four; of which there be two, one of which Galen refers to the common The muscles of the bone Hyoides. muscles of the larinx or throttle; and the other to those which move the Shoulderblade upwards. Howsoever it be, the first of the four before mentioned arises from the Appendix Styloides, and passing over the Nervous substance of the muscle opening the lower law, is inserted into the horns of the bone Hyoides. This muscle is very thin, yet somewhat broad, the which in that respect may easily be cut, unless you have a care in separating the muscle which opens the lower Chap. The second ascends obliquely from the upper part of the shoulderblade near the production thereof called Coracoides, to the beginnings of the horns of the said bone Hyoides. This is round and nervous in the midst that so it might be the stronger, as that is which we formerly said opens the lower law; and it is referred by Galen amongst those which move the shoulderblade upwards. The third arises from the upper part of the sternon, and is inserted at the root and basis of the bone Hyoides; yet Galen refers it to the common muscles of the Larinx; whose opinion takes place rather in beasts, than in man, seeing in man this muscle cannot be found either to proceed, or be inserted into the throttle, as it is in beasts. The fourth and last descends within from the chin to the root of the bone Hyoides. The first of these muscles The action of these muscles. with its companion or partner moves the bone Hyoides upwards; the second downwards; The third backwards; and the fourth forewards. I would declare whence these muscles have their vessels, had I not abundantly satisfied that thing, when I treated of the distribution of the nerves, veins and arteries. CHAP. XII. Of the Tongue. THE tongue is of a fleshy, rare, loose and soft substance; it enjoys flesh What kind of flesh the tongue hath. of a different kind from the rest of the flesh, as chiefly appears when you cut it from the first original of the muscles thereof; which thing hath moved some, that they have made a fourth kind of flesh proper to the tongue and different from the rest, viz. the Fibrous, musculous, and that of the bowels. The quantity thereof is such that it may be contained in the mouth, and The quantity, easily moved to each part thereof. The figure of it is triangular, which it rather expresses The figure. in the basis, which is at the root of the bone Hyoides, than in its point, or forepart, where from a triangle it becomes more dilated. It is composed of a membrane Composure. (which it hath from that which lines all the inside of the mouth) muscles 4. nerves two on each side, the one whereof is sent from the third conjugation, into the coat thereof; the other from the seaventh is sent into the musculous substance The nerves. even to the end thereof for motions sake; so that those sensificke nerves from the third conjugation only give to judge of tastes, compose the coat, and touch or enter not the flesh. Besides it is composed of veins and arteries on each side one, which it receives from the external jugular and Carotides, running manifestly to the end thereof on the lower side, that so they might be easily opened in the diseases of the mouth and throttle; they commonly term these the Vena nigra or black veins. The muscles of the tongue are absolutely ten, on each side five. The first narrow at the beginning, and broader at the end, descends into the upper side of the tongue The muscles of the tongue. from the Appendix Styloides, and together with its copartner draws it upwards. The second hath its original within from the lower jaw about the region of the Grindinge teeth, and is inserted into the lower side of the tongue, the which with its partner draws it downward. The third proceeds from the inner part of the Chin and goes to the root of the tongue, that when need requires it may put it forth of the mouth. The fourth the greatest and broadest of them all, composed of all sorts of fibers, passes forth from the basis of the bone Hyoides, and ends at the lower part of the tongue, which with its companion plucks it back into the mouth. The fifth & last most usually arises from the upper part of the horns of the bone Hyoides and goes to the roots of the tongue between the two first, that it may move it to the sides of the mouth. The temper thereof, as of all other flesh, is hot and moist. The first The temper, action, and manifold use of the tongue. action & commodity thereof is, to be the organ of the sense of tasting, wherefore it was made fungous & spongy, that by reason of the rarity of it, it might more easily admit the tastes conjoined with the spittle, as a vehicle. Another to be an instrument to distinguish the voice by articulate speech, for which it was made movable into each part of the mouth. The third is to be a help to chaw & swallow the meat. For which cause it is like a scoop or dish with which we throw back the corn into the mill, which hath scaped grinding. And because, when the tongue is dry, it is less nimble & quick to perform its motions, as appears by those which can scarce speak by reason of thirst, or a burning fever: therefore nature hath placed very spongy glandules at the The use of the glandules placed at the roots of the tongue. roots thereof, on each side one, which like sponges suck and receive, both from the brain & other places a waterish and spettley humour, with which they humect and make more glib, not only the tongue, but also the other parts of the mouth, as the throat and jaws; these glandules are called the Tonsillaes, or Almonds of the throat. CHAP. XIII. Of the Mouth. THe mouth is that capacity which bounded with the cheeks & lips contains What it is. The use. within its precincts the teeth, tongue, and the beginnings of the throttle and gullet. Therefore the use of the mouth is to contain the tongue, & serve it in the fitter performance of its actions; & although many parts hereof have been formerly handled, as the lips, teeth, jaws, tongue, almonds, & passages of the palate coming from the nose, yet it remains, that we declare, what the palate, the Gargareon; or Wula the Pharinx, & fauces or Chaps are. The palate (or as it is commonly called, the Roof What the palate is. of the mouth) is nothing else but the upper part of the mouth bounded with the teeth gums & upper jaw. In which place the coat common to the whole mouth, is made rough with divers wrinkles, that the meats put up & down between the tongue & the Palate might be broken & chawed more easily by that inequality and roughness. If any Then nerves thereof. would find the nerves, which descend into the palate from the fourth conjugation, let him separate that coat & cast it from the fore to the hind part of the mouth; for so he shall find them at the sides & hind parts of the bones of the Palate, which encompass the palate, & at the beginning of the inner holes of the mouth, which descend from the nose, & region of the productions of the wedgbone called the Saddle. These holes or Why the holes of the palate are open. passages are open, that we may breathe the better when we sleep, & that when the nose is not well, the excrements which seek their passage by it, may be easilier drawn away by the mouth. This same coat is woven with nervous fibers, that, like the tongue, it might judge of tastes; these fibers compose a coat that hath a middle consistence betwixt What kind of coat the palate hath. soft & hard. For if it should have been any harder, like a bone or gristle, it would have been without sense, but if softer hard, acride and sharp meats would have hurt it. CHAP. XIIII. Of the Gargareon, or Wula. BY the Gargareon we understand a fleshy & Spongy body, in shape like a pine What the Gargareon, or Wlua is. apple, hanging directly down at the further end of the palate & basis of the bone Ethmoides where the two holes of the palate come from the nose, above the entrance of the throttle. This little body is situate in this place, to break the violence of the air drawn in by breathing, & that by delay it might in some sort The site and manifold use, thereof. temper & mitigate it by the warmness of the mouth. Besides, that it might be as it were the Plectrun, or quill of the voice, so to diffuse the fuliginous vapour sent forthin breathing that it may be dispersed over all the mouth, that resounding from thence it may be articulate, & by the motion of the tongue distinguished & form, into a certain voice. Which use is not small, when we see by experience that such as have this particle cut The discommodities that ensue the loss of the Wula. away, or eaten or corrupted by any accident, have not only their voice vitiated and depraved, but speak ill favouredly, and as they say, through the nose; and besides, in process of time they fall into a consumption by reason of the cold air passing down before it be qualified. This same particle, is also a means to hinder the dust from flying down through the weazon into the Lungs. By the Pharinx and fauces is meant the What the Pharinx and fauces are. inner & back part of the mouth, set or placed before the entrance of the Throttle & Gullet; being so called, because that place is narrow & straight, that as it were by these straits, the air drawn in by the mouth might be forced down by the Throttle, and the meat into the Gullet. CHAP. XV. Of the Larinx or Throttle. FIrst we must show what is meant by the Larinx or throttle, than prose qunte the other conditions of it after our accustomed manner. Therefore by the Larinx we What is m●… by the Larinx. understand nothing else in this place, than the head & extremity of the rough Artery, or weazon, which comes nearer to Gristlely substance, then to any other. The quantity thereof is sufficiently large, yet divers according to the diversity of bodies. It resembles in shape the head of a german pipe. The composure of it consists of 18. The magnitude, figure and composute. muscles, on each side nine, which as they are like in quantity, so also in strength & action; of three gristles, veins, arteries and nerves, as we showed, when we spoke of the distribution of the vessels; as also of a double coat, the one external, the other internal, as we showed when we spoke of the weazon. These three Gristles are joined together The description of the 3 gristles of the Larinx. by certain Ligaments & muscles; the foremost gristle, which also is the greater is called by the greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in Latin commonly Scutiformis, that is shield like, because it resemblest shield. The second being the hinder and middle in magnitude, wants a name, wherefore it is called the innominata or nameless gristle. The last & lest which notwithstanding may be parted into two, so lies upon the edges of the other, that it resembles the mouth of an oil pot, or a pitcher, whereupon the greeks call it Arytonoides. These gristles thus fitted amongst themselves utter a distinct voice, by the Whence the infinite variety of voices proceed. benefit of the Epiglottis, or After tongue, & also of the muscles opening & shutting, dilating & compressing them, whence proceed infinite varieties of voices. For thus when they are opened and dilated they yield a heavy, or dull sound; when they are shut or drawn together, a quick, or sharp sound, and to conclude, they make it infinite ways different according to the infinite variety of the dilatation, or constriction thereof. Therefore because it was fit these gristles should be movable, especially the Arytenoides, & Thyroides, nature hath put to them on each side 9 muscles, of which three are The muscles of the Larinx. Their number common and 6 proper. The first of the common lying hid under the third muscle of them that move the bone Hyoides, arises from the root of the same bone, & by an oblique descent inserts itself at the basis of the shield-like gristle, to dilate it upwards & downwards. The second ascends obliquely from the inner part of the sternon according to the length of the weazon (whence it is called Bronchius) to the bottom & sides of the same shield-like gristle, that it may open and dilate it with its wings. This muscle is seen from the first original thereof, even a great part of the way straight to cohere with the third muscle of the bone Hyoides; therefore under each of the muscles, there is a glandulous body spread about the fore & upper part of the weazon, on that place where it applies itself to the throttle; this body although it resemble a fleshy substance, yet it is a glandule, which being plucked away by a certain Empiric taking upon him to A notable history. cure the kings evil, caused a defect of voice on one side, because be pulled away the recurrent nerve lying upon that glandule as it goes to the throttle, as Galen reports, Lib. de locis affectis. The third & last arises from the part of the Vertebrae of the neck lying transversly upon the sides of the gullet, & ends at the wings & sides of the shield-like gristle, that it may tie it more straight to the second Gristle. But these three are called common muscles, because they take their original from some other place than the throttle that so they may be inserted into some part thereof; for they are called the proper muscles which arise from the Throttle itself, which we have said to be 6. on each side. The first of which arising from the fore part of the second gristle, makes a circle under the basis of the sheld-like gristle; whilst ascending obliquely to the basis thereof, it is afterwards inserted in a part of it, so to strengthen and dilate it. The second in like manner arising from the second gristle, from that place where it adheres to the first, it runs obliquely crossing the first to the inner and forepart of the gristle Thyroides near to the bafis thereof, that it may join it to the second. The third from the hind basis of the second gristle ascends directly to the basis of the third gristle Arytenoides, that with the second muscle it may open & shut it. The fourth ascends from the sides of the second gristle, near the original of the second muscle, to the sides of the Arytenoides, that with the second muscle it may open and shut it. The fifth arises from the inner middle of the sheild-gristle, and ends in the fore part of the Arytenoides at the insertion of the fourth muscle, that so it may press down the said gristle. The sixth and last ascends by the hind basis of the Arytenoides to the fore basis of the Whence the muscles of the Throttle have their nerves. same, to press it down. But you must note, that all such muscles, as arise from below upwards, receive branches from the recurrent, but especially those who open and shut the gristle Arytenoides. But the site, temper, connection, and use of the throttle may easily be known by that we have said before: Although it be a thing very full of difficulty to search out and demonstrate all the conditions of the organical parts, by reason of the diversity of their composition. Wherefore hence forward concerning the substance, temper, and other circumstances of such parts as we shall omit, you may have recourse to those things which we have written in the Demonstration of the simple and simular parts, of which these organical are composed; as if any should ask of what temper the Larinx is, you shall answer, of a cold, dry, and hot, and moist, because it consists both of a gristlely and fleshly substance. He which reckons up all the parts of the mouth, must not omit that gristlely and membranous The Epiglottis or After-tongue. body which arises from the roots of the tongue, which that it might be more quick for motion, that is, whereby it might be more easily erected and depressed (for those things which are more soft do continually slide away, but those which are too hard cannot be bended) it was convenient it should be neither too hard nor too soft, that it might be erected whilst we breathe, but depressed when we swallow. It is a principal instrument of the voice, for it cannot be well articulated unless the way were straight. Therefore it straitens that way, and the passage of the gristles of the throttle, but specially the Arytenoides; it is always moist by a certain native, and inbred humidity; wherefore if it happen to be dried by a fever, or any other like accident the speech is taken away. It is bound on both sides by the common membrane of the mouth to the sides of the Arytenoides even to the back part thereof, that so like a cover it may open and shut the orifice of the throttle, that none of the meat and drink in swallowing may fall into the weazon, in such abundance as may hinder the egress Of potable things somewhat always falls upon the Lungs. and regress of the air. For we must not think that this body doth so closely shut the orifice of the throttle, but that some small quantity of moisture always runs down by the inner sides, as the walls thereof, to moisten the lungs; otherwise Eclegmas should be of no use in the diseases of the Chest. And because that this little body is partaker of voluntary motion, therefore according to the opinion of The muscles of the Epiglottis. some there are four muscles bestowed upon it, two which may open it and two that shut it, on each side one. The opening muscles descend from the root of the bone Hyoides, and in their insertion growing into one they are terminated in the root of this body, that is, the Epiglottis in the back part thereof. The shutting muscles (in those creatures where they are found) arise on the inside between the coat & gristle thereof. Truly I could never observe and find these four muscles in a man, though I have diligently and earnestly sought for them, but I have always observed them in beasts. Therefore some have boldly affirmed that this little body in swallowing lies not upon the orifice of the Throttle, unless when it is pressed down by the heaviness of such things as are to be swallowed; but that, at all other times by reason of the continual breathing it stands upright, the Throttle being open: There remain as yet to The use of the cavities or fissures of th● Throttle. be considered, two small bosoms, or cavities, or rather fissures which nature hath hollowed in the very throttle under the Epiglottis, on each side one, that if by chance any of the meat or drink should fall, or slip aside in the Larinx, it might be there stayed & retained. Beside that, the Air too violently entering, should be in some sort broken by these cliffs, or chinks, no otherwise than the blood and spirit entering into the heart through the Auricula or Ears thereof. CHAP. XVI. Of the Neck and the parts thereof. FIrst we will define what the neck is, then prosecute the parts thereof aswel proper, as common, especially those of which we have not as yet treated. For it were superfluous to speak any more of the skin, the fleshy pannicle the veins, arteries, nerves, gullet, weazon & muscles ascending & descending to the parts into which they are inserted alongst the neck; wherefore you must not expect that we should say any thing of the neck, more than to describe the Vertebrae or rack bones, being the proper parts thereof, & the ligaments aswell those proper to the neck, as those which it hath in common with the head; & lastly the muscles, aswel those it hath in common with the head & chest, as those of its own. Therefore the neck What the neck is. is nothing else, than a part of the head, which is contained between the noll bone & the first vertebrae of the back. First in the neck the Vertebrae must be considered, & we must show what they have proper & peculiar, & what common amongst themselves, that we may the more easily show the original and insertion of the muscles growing out of them & ending in them. The neck consists of seven Vertebrae or Rackbones, in What to be considered in the vertebrae of the neck. which you must consider their proper body; and than the holes by which the spinal marrow passes; thirdly the Apophyses or processes of the Vertebrae; fourthly the holes through which the nerves are disseminated into other parts from the spinal marrow, & besides the perforations of the transverse productions by which the veins, & arteries which we call Cervicales ascend alongst the neck, & lastly the connexion of these same vertebrae or Rackbones. For the first, by the body of the vertebrae, we understand the forepart thereof upon which the gullet lies. For the hole, that is not always the largest in those vertebrae which are nighest the head; but it is always encompassed with the body of the vertebrae, & besides with three sorts of processes, except in the first Rackbone, that is right, transverse & oblique. By right we understand these extuberancies Which be the right processes of the vertebrae. in the Rackebones of the neck which are hollowed directly in the upper part of them & rise up crested on each side to sustain and receive the basis of the Rackbone which is set upon it. By the oblique processes, we understand the bunchings outby Which the transverse. which these Rackbones are mutually knit together by Ginglymos; these are seated between the righr & transverse processes. By the transverse we understand the protuberations next the body, which divide the Vertebra or Rackbone in a strait line. These Which the transverse. processes are perforated that they may give to the before described veins & arteries, which entering the spinal marrow by the holes of the nerves nourish the Rackebones & parts belonging to them. Besides you must note that the perforations of the Rackbones of the neck by which the nerves proceed from the spinal marrow to the ourward parts, are under the transverse process, that is growing or made by the upper & lower vertebra, contrary to all the other which are in the rest of the Rackbones. For the connexion of the Rackbones, you must know that all the Vertebrae of the spin The connexion's of the vertebrae of the neck. have six connexion's, two in their own bodies, and 4 in their oblique processes. By the two first connexion's they are so mutually articulated in their own bodies that each are joined with other both above and below. But by the 4 other, by their oblique ascendent & descendent processes, on each side 2, they are so mutually inarticulate that as the fourth Rackbone of the neck by its oblique ascendent processes, is received of the descendent processes of the third Rackebone; so it receives the oblique ascendent processes of the first, by its oblique descendants, for always the oblique ascendants are received, and the descendants receive. Yet we must except the first Rackbone of the neck which is contained with 4 connexion's by his lower oblique processes, & by its upper by which it receives the oblique processes both of the noll bone, & of the second Rackbone. The second Vertebra or Rackbone must also be excepted which is holden by 5 connexion's, that is to say, four by its oblique processes, & the fifth by its own body, by which it is knit to the body of the third Vertebra. But we must note, that whereas nature hath not given a Spine to the first Rackbone, yet it hath given it a certain bunch or extuberancy instead thereof; in like manner, seeing it makes no common passage with the second Vertebra for the passage forth of the nerve, it is perforated at the sides of its body, and it is made very thin on the fore side, as if it were without body, that it might receive the fore process raised in the upper body of the second The process called the tooth. Rackebone, which Hypocrates calls the tooth, to which the principal Ligament of the head is fastened, which descends within from the hind part of the head under the Apophyses clinoides or processes of the wedgebone. Table 20. Figure I. showeth all the rackebone of the back knit together. Figure 2. showeth the fore and upper face of the neck, etc. See D. Crook, pag. 398. From A, to B, the seven vertebres of the neck. From C, to D, The twelve vertebres of the chest. From E, to F, The five rackbones of the Loins. From G, to H, The Os sacrum or Holybone consisting commonly of 6. vertebrae. From I, to K, The bone Coccyx or the rump-bone according to the late writers. LL, The bodies of the vertebrae. M, The transverse processes of the vertebrae. N, The descendent processes. OO, The ascendent processes. PP, The backward processes. QQ, The holes that are in the sides of the vertebrae through which the nerves are transmitted. RR, A gristly Ligament betwixt the vertebrae. A, 2, 3, 4, The hole whereout the marrow of the back issueth. B, 2, 3, The cavity which admitteth the root of the second rackbone. C, 3, 4, A cavity or Sinus in the same place crusted over with a gristle. D, 2, A prominence in the outward region of this Sinus. OF, 2, 3. The Sinus or cavity of the first rackebone which admitteth the 2. heads of the nowle-bone. GG, 2, 3, 4. the transverse process of the 1. Vertebra. H, 1, The hole of this transverse process. ay, 3. The Sinus, which together with the cavity of the nowle-bone marked with ay, maketh a common passage prepared for the nerves. K, 3, 4, A rough place where the spin of the first rack is wanting. LL, 4, Two cavities of the first rack receiving the 2. bunches of the second rack marked with MN. MN, 5, 6, The 2. bunches of the second rack which fall into the cavities of the first: O, 7, The appendix or tooth of the second rack. P, 5, A knub of this appendix crusted over with a gristle. Q, 6, The backside of the tooth. R, 6, the Sinus or cavity of the same, about which a transverse Ligament is rolled containing the said tooth in the cavity of the first rack. ST 6. Certain cavities at the sides of the tooth whence the roots issue of the fore-branch of the second pair of sinews. V, 5, the point of the tooth. X, 3. An asperity or roughness where is a hole but not thrilled through. Y, 6, A cavity of the second rack which together with the cavity marked with Z, maketh a hole, through which the nerves do issue. Z, 4, the Sinus of the first rack. a, 5, 6, 7, the double spin of the second rack. b, 5, 6, 7, the transverse process of the second rack. c, 7, the hole of the said transverse process. d, 6, 7, the descending process of the second rack whose cavity is marked with d, in the 6. figure. e, 6, 7, the place where the body of the second rack descendeth downward. f. gg, 8, the lower side of the body of the third rack at f, the two eminent parts of the same at gg. high, 8, the ascending processes. l m, 8, the two descending processes. n o p q, 8, the transverse processes. r, 8, 9, the spin or backward process. st, 8, the two tops of the spin. u, 9, the descending process of the third rack. x, 9, the ascending process. y, the transverse process of the third rack. α, 8, 9, the hole of this transverse process. β, 9, the upper hollowed part of the body of the third rack. δ, 9, the Sinus or cavity which maketh the lower part of a hole through which the conjugations of the nerves are led. ε, 7, the upper part of the same hole. And by this articulation the head is bended forewards and backwards, as it is moved to the sides by the articulation of the first Rackebone with the second. That By what articulation the head is bended backwards and forewards process is bound by two Ligaments, the first of which being the greater and broader is external, comprehending in the compass thereof all the upper articulation, ascending from the Rackebones to the head, or rather descending from the head to them, as any other Ligament going from one bone to another; The other is the stronger and also encompasses the articulation mixing its self with the gristle, which by its interposition binds together all the Rackebones, the first excepted, as you may see in pulling asunder the Rackebones of a Swine; and the whole Spine or Backebone is tied together and composed throughout with such Ligaments. The Holy bone is composed of 4. Vertebrae [or rather of five, or six, as in the figure following] Besides the Rumpe-bone, it receives, and holds fast the Ossa Ilium, or The Vertebrae of the Holy bone. Hanch-bones, and is as a Basis to all the Rackebones placed above it, whereby it comes to pass that the Rackebones from the head to the Holybone grow still thicker, because that which supports aught to be bigger than that which is supported. There is a certain moisture, tough and fatty, put between the Rackbones, as also in other joints, to make them glib and slippery that so they may the better move. Whilst this motion is made, the Rackebones part one from another. The commodities or uses of the Spine are said to be four. The first is, that it is, as it were the seat and foundation of the composure and construction of the whole The manifold uses of the backbone. body, as the Carcase is in a ship. The second, that it is a way or passage for the marrow. The third is, because it contains and preserves the same. The fourth is, that it serves for a wall or bulwark to the entrailes which lie and rest upon it on the inside. And because we have fallen into mention of Ligaments, it will not be amiss to insert in this place, that which ought to be known of them. First therefore we will declare what a Ligament is, then explain the divers acceptions thereof, and lastly prosecute their differences. Therefore a Ligament is nothing else than a simple part of man's body, next to a bone and Gristle the most terrestrial, and which most usually arises from the one or What a Ligament is. other of them either mediately or immediately, and in the like manner ends in the one of them, or in a Muscle, or in some other part; whereby it comes to pass that a Ligament is without blood, dry, hard, and cold and without sense, like the parts Why it is without sense. from whence it arises, although it resemble a Nerve in whiteness and consistence, but that it is somewhat harder. A Ligament is taken either generally, or more particularly; in general, for every part of the body, which ties one part to another, in which sense the skin may be What parts may be called Ligaments in a general signification. called a Ligament, because in contains all the inner parts in one union. So the Peritonaum comprehending all the natural parts, and binding them to the backebone: so the membrane investing the Ribs, (that is the Pleura) containing all the vital parts; thus the membranes of the brain, the nerves, veins, arteries, muscles, membranes, and lastly all such parts of the body, which bind together and contain other, may be called Ligaments, because they bind one part to another; as the nerves annex the whole body to the brain, the Arteries fasten it to the heart: and the veins to the liver. But to conclude, the name of a Ligament more particularly taken, signifies that part of the body, which we have described a little before. The differences of Ligaments are many, for some are membranous and thin; others The differences of Ligaments properly so called. broad, othersome thick and around, some hard, some soft, some great, some little; some wholly gristlely, others of a middle consistence between a bone and a gristle, according to the nature of the motion of the parts, which they bind together in quickness, vehemency and slowness. We will show the other differences of Ligaments, as they shall present themselves in dissection. CHAP. XVII. Of the Muscles of the Neck. THe Muscles of the neck as well proper as common, are in number Their number twenty, or else twenty two, that is, ten, or eleven on each side; of which seven only move the head, or the first vertebra with the head; the other 3 or 4, the neck itself. Of the 7 which move the head, & with the head the first Vertebra, some extend & erect it, others bend and decline it, others move it obliquely, but all of them together in a successive motion move it circularly; and the like judgement may be of the Muscles of the Neck. The fourth Figure of the Muscles. This Figure showeth the cavities of the middle and lower bellies, the bowels being taken out, but most part of the bones and muscles remaining. AB, The first musclebending the neck called Longus. C C, The second bender of the neck called Scalenus. D D D D, The outward intercost all muscles. E E E E, The inner intercostal muscles. F F F, The second muscle of the chest called serratus maior. G, The first muscle of the shoulderblade called s●rratus minor, separated from his original. H, The first muscle of the arm called Pectoralis, separated from his original. ay, The second muscle of the arm called Deltoides. K, The bone of the arm without flesh. L, The first muscle of the cubite called Biceps. M, The second muscle of the cubit called Brachiaus. N, The clavicle or coller-bone bend backward. O, The first muscle of the chest called subclavius. P, The upper process of the shoulderblade. Q, The first muscle of the head called obliquus inferior. R, The second muscle of the head called Complexus. S, The fourth muscle of the shoulder blade called Levator. TV, The two bellies of the fourth muscle of the bone Hyois. X X, a a, The fist muscle of the back whose original is at a a. Y Y, b b, c c, The sixth muscle of the thigh called Psoae, whose original is at c c, and tendon at b b. Z Z, The seaventh muscle of the thigh. d, the holy bone. o o o, the holes of the holy bone out of which the nerves do issue. e, A portion of the fist muscle of the thigh arising from the share-bone. f, the share-bone bared. k, the ninth muscle of the thigh or the first circumactor. The fifth Figure of the muscles in which some muscles of the head, Chest, arm, and shoulderblade are described. ay, The process of the shoulderblade, called the top of the shoulder. O, The fourth muscle of the arm or the greater round muscle, to which Fallopius his right muscle is adjoined, which some call the lesser round muscle. Q Q The sixth muscle of the arm or the upper bladerider. X, The second muscle of the shoulderblade or the Levator or heaver. Z, the second muscle of the chest or the greater Saw muscle. Y, the fifth muscle of the chest or muscle called Sacrolumbus. αβ, His place wherein he cleaveth fast to the longest muscle of the back. γγ, the Tendons of the muscle obliquely inserted into the ribs. ΔΔ, the first pair of the muscles of the head or the Splinters. Ch. 8. 9, their length whose beginning at 8 and insertion at 9 10, 11. the sides of this muscle. 12, that distance where they depart one from the other. 13, the two muscles called Complexi, near their insertion. Φ, the second muscle of the back or the Longest muscle. Ω, the fourth muscle of the back or the Semispinatus. δ, the shoulderblade bare. p, A part of the transverse muscle of the Abdomen. The sixth Figure of the muscles, showing some of the muscles of the Head, Back, Chest, Shoulderblade and Arme. A D, the second pair of the muscles of the head, or the two Complexi, the first part is at A D. B C. the second part. E F, the third part rising up under G and inserted at F. G, the fourth part of this muscle or the right muscle of the head according to Fallopius, which Vesalius made the 4. part of the 2. G G, (Betwixt the ribs) the external intercostal muscles. L, the original of the 2. muscle of the back. M, His tendons at the rackebone of the neck. The upper O the fourth muscle of the arm or the greater round muscle. O O, the lower, the 6 muscle of the chest, or the Sacrolumbus hanging from his original. Q, the sixth muscle of the arm or the upper Bladerider inverted. V, the third ligament of the joint of the arm. X, the fourth muscle of the shoulderblade or the heaver. Z, the second muscle of the Chest or the greater Saw-muscle. 〈◊〉, the 3. muscle of the neck called Transuersalis. π, the 4. muscle of the neck called Spinatus. Σ, the first muscle of the back or the Square muscle. Φ, the 2. muscle of thebacke or the Longest, whose original is at L and his tendons at the Vertebrae at M M. Ω, the fourth muscle of the back called Spinatus. δ, the back of the shoulderblade flaied. The seventh Figure of the muscles; showing some muscles of the head and Chest, the Trapezius or Table-muscle being taken away: as also of the blade and arm. A, The prominent part of the fourth muscle of the chest called Serratus posticus superior. Δ, the first muscle of the head called splenius. E E, the insertion of the second muscle of the head called Complexus. ay, the collar bone bared. M, the backpart of the second muscle of the arm called Deltois. ζH, His backward original. θ, His implantation into the arm. N N, the fourth muscle of the arm called Latissimus. s μ, His original from the spines of the rackbones and from the holy bone 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. the connexiou of this muscle with the hanch-bone, which is led in the inside from μ to 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the place where it lieth upon the lower angle of the Basis of the shoulderblade. O, the 4. muscle of the arm called Rotundus maior. e, some muscles of the back do here offer themselves. P, the fifth muscle of the arm called Superscapularis Inferior. Q, the sixth muscle of the arm called Superscapularis Superior. S, the beginning of the third muscle of the arm called Latissimus. V, the third muscle of the blade called Rhomboides. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 X, His original from the spines of the rackebones. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, His insertion into the basis of the shoulderblade. χ, the fourth muscle of the blade called Levator. * A part of the oblique descendent muscle of the Abdomen. The eight Figure of the muscles; especially of those of the Chest, Head, and Shoulderblade, the Trapezius, Latissimus, and Rhomboides, being taken away. A, The fourth muscle of the chest, or the upper and hinder Saw-muscle. B, the 5 muscle of the chest, or the lower and hinder Saw-muscle. a, b, A membranous beginning of the muscle of the Abdomen, descending obliquely down from the spin of the back. C, the first muscle extending the Cubit at c, his original is from the neck of the arm, and from the lower basis of the blade at d. E, the original of the fourth muscle of the bone hyois from the blade. G G, the outward intercostal muscles. ay, the Clavicle or coller-bone bared. N, the upper, the second muscle of the arm called Deltois, char. 4, 5, the beginning of this muscle. N, the third muscle of the arm or the broad muscle separated. O, the fourth muscle of the arm or the lower Superscapularis or bladerider. 1, 2, 3. Char. His original at the basis of the shoulderblade at 1 2, and his insertion into the joint of the arm at 3. Q, the sixth muscle of the arm or the upper Superscapularis. X, the fourth muscle of the blade called Levator or the heaver. Z, the second muscle of the Chest or the greater Saw-muscle. 7, 7, Char. the ribs. 〈◊〉, the sixth muscle of the chest, or the muscle called Sacrolumbus. 〈◊〉, the first muscle of the head or the splinter. E E, the second muscle of the head or the insertion of the muscles called complexei. Φ, the second muscle of the back or the longest muscle. Ω, the fourth muscle of the back called Semispinatus. Wherefore when the first oblique moves the head obliquely forwards, the second pulls it pack by the first Vertebra, this with his associate of the other side, may Which may be truly called the proper muscle of the neck. be truly termed the proper muscles of the neck, because they belong to no other part; whereas it is contrary in other muscles. But we must note, that the head (according to Galens' opinion) hath two motions, one directly forwards and backwards, as appears The two motions of the head. in beckoning it forwards; and casting it backwards; the other circular. The first in Galens' opinion is performed by the first Vertebra moved upon the second; the second by the head moved upon the first Vertebra; for which he is reproved by the latter Anatomists, who teach that the head cannot be turned round or circularly upon the first Vertebra without putting it out of joint. The ninth Figure of the muscles, showing the muscles of the Head and Neck. A B, the third pair of the Muscles of the head called Recti Maiores. C, the Mammillary process. D, the transverse process of the first rackebone. E, the process of the 2 rackebone of the neck. F G, the fourth pair of muscles of the head called Recti Minores. H I, the fifth pair of muscles of the head called Obliqui Superiores. K L, the sixth pair of muscles of the head called Obliqui Inferiores. X, the fourth pair of muscles of the shoulderblade. Λ, the second muscle of the neck called Scalenus, which Falopius maketh the eight muscle of the chest. Π, the fourth muscle of the neck called spinatus. Σ, the first muscle of the back called Quadratus. Φ, the second muscle of the back called Longissimus. a, the sinus or bosom of this muscle, whereby it giveth way unto the third muscle of the back, called Sacer. b, His Original. ψ, the third muscle of the back called Sacer. γ, His Original. δ, His end. Ω, the fourth muscle of the back called Semispinatus. 〈◊〉, His upper end under the fourth muscle of the neck. After the showing of these muscles, we must come to three or four of the neck, ●f which number two (which some reduce to one) extends, another bends, and the ●…st moves side ways, and all of them with a motion succeeding each other turn it ●…bout, as we said of the muscles of the head. The first of these which extend, taking ●…s original from the six transverse processes of the six upper rackebones of the ●…acke, or rather from the root of the oblique, ascends directly to the spin of the second Vertebra of the neck, and the oblique process thereof; some call it the Trans●…versarius; The Transversa●… that is, the transverse-muscle. This, if you desire to take it away, it is best first to separate it from the spin, then to turn it upwards to the transverse processes; ●nlesse you had rather draw it a little from its partner and companion in that place where their originals are distinct, seeing it is the last and next to the bones. Marvel not, if you find not this distinction of their original, so plain and manifest, for it is commonly obscure. For the muscle Spinatus, as it most commonly comes to pass, arising from the roots of the seven upper spines of the back, and the The Spinatus, last of the neck, is inserted into other spines of the neck, so that it might easily be confounded with the former by Galen. The third bends the neck, and arising within from the body of the five upper Vertebrae of the back (though with a very obscure original, specially in lean bodies) it ascends under the gullet alongst the neck, even to the nowle-bone, into whose inner part it is obscurely inserted. Wherefore it is likely that it helps not only to bend the neck, but also the head. This muscle is made of oblique fibers proceeding from the body of the vertebrae, all the way it passes to the transverse processes of the other Vertebra. But it seems with its copartner which is opposite to it, to make a certain hollow path upon the bodies of the Vertebrae, to the The L●… gullet, and it is called the long muscle. The fourth and last, which we said moves the neck to one side, is called Scalenus from the figure thereof; it ascends from the hinder and upper part of the first rib of the Chest, inserting its self into all the transverse The Scalenus processes of the neck by its fibers, which as it were for the same purpose, it hath sufficiently long, that it may fasten itself from the furthest or lowest process of the neck into the first or highest thereof. The passage of the nerves through this to the arm makes this muscle seem double or divided into two. For the veins and arteries pertaining to the neck, they have been declared in the proper Chapters of the distributions of the vessels; it remains that you note, all these muscles receive nerves from the Vertebrae whence they arise. CHAP. XVIII. Of the Muscles of the Chest and Loins. WE must now speak of the Muscles both of the Chest which serve for respiration, as also of the Loins. But first we must know that the hind In what the Vertebrae of the neck and loins agree and disagree. part of the Chest called the Metaphrenum, or back, consists of twelve Vertebrae, the loins of five, all which differ not from the Vertebrae of the neck, but that they are thicker in their bodies than these of the neck; neither are they lesser in holes, neither they have their transverse processes perforated, or parted in two, as the rackebones of the neck have. Besides each of these rack bones alone by itself, on each side in the lower part thereof makes a hole, through which a nerve hath passage from the spinal marrow to the adjacent parts, when on the contrary in the Vertrebrae of the neck, such holes or passages are not made, but by meeting together of two of them. Concerning the processes of the Rackbones of the Chest, whether transverse, right or oblique, they differ nothing from these of the neck (I mean even to the tenth) but that the transverse seeing they are not perforated, as we said before, do as it were sustain the ribs, being straight bound to them with strong ligaments both proper and common; but after the tenth Vertebrae of the back, the two other of the back, and all those of the loins are different, not only from those of the neck, but also from the ten first of the back, by reason of their oblique processes, because from the eleaventh (which is received, as well by that which is above it, as by that under it, for the strength of the whole back, and the easier bending thereof without fear of fracture or dislocation) the above mentioned processes of the lower rackbones which were wont to receive, are received; as on the contrary they receive which were wont to be received. They differ besides from all the forementioned, by reason of their spines, because from the eleaventh they begin by little and little to look upwards, contrary to the former. But if any ask, how the tenth Vertebrae of the back may be termed the midst of How the tenth Vertebrae of the back, may be said to be the middle of the spin. the spin, being the whole spin consists of twenty four Vertebrae? He may know that this may be true, as thus; if the six bones of the holybone, and the fourth of the Rump (being more gristlely than bony) be numbered amongst the bones of the Spine; for then from the setting on of the head to the eleaventh rack bone of the back, are seventeen in number, and so many from thence downwards. But let us return to the muscles of the Chest serving for respiration. First, you The number of the muscles of the Chest. must know that these Muscles are fourscore and nine, that is, on each side forty four, alike in strength, thickness, site, and action; and one besides in the midst which they call the Diaphragma or Midriff. Of these forty four, there are 22. The muscles dilating the Chest. which dilate the chest in drawing in the breath; that is, the Subclavius, the Dentatus, or Serratus major in the opinion of some, both the Rhomboides, or Serrati postici; the oblique ascendent of the lower belly, the eleven Intercostales, and the six Intercartilaginei externi. On the contrary, as many contract the breast in expiration; to wit, the Sacrolumbus, the oblique descendent, the Right and transverse of the lower belly, the inner Trangular, the six Intercartilaginei, and the eleven inner Intercost●les. The muscles contracting the Chest. The Subclavius is the first of the muscles dilating the chest. Serratu● major. Of these twenty two dilating the Chest, the first, from the site is called the Subclavius, for it descends obliquely from the inner and forepart of the Clavicula or Coller bone, into the gristle of the first rib, even to the Sternon, and dilates it. The second is the Serratus major, the greater Saw-muscle arising according to the opinion of some from the whole basis of the shoulderblade on the inside, and it is transversely inserted into the nine upper ribs, producing certain toothed or saw-like processes running further to the bones of the rib, than to the spaces between them, or intercostal muscles, whereupon it hath the name of the saw-muscle; yet some have referred this muscle to them of the shoulderblade. The third descends from the three lower spines of the neck, and the first of the back, by means of a membranous and most thin ligament, into the three or four upper ribs, running further into their spaces or intercostal muscles, than into the ribs themselves, whereupon it is called Serratus posterior, & superior, that is, the hinder and upper saw-muscle. The fourth in like manner ascends by means of a membranous and thin ligament from the Serratus posterior and superior. three upper spines of the loins, and the two last of the chest, or back, into three or four of the lower, or last of the bastard ribs, sent forth further into them or their bones, than into the intercostal muscles possessing the spaces between them, wherefore it is called Serratus posterior & inferior, the hinder and lower saw-muscle. Moreover these two last muscles have been called by a common name from their figure the Rhomboides, that is, the square muscles. The fifth which we said The oblique ascendent of the lower belly. The eleven Intercostales externi. was the ascendent of the Epigrastrium, hath already been sufficiently described in his place. The eleven Intercostales externi, or external intercostal muscles descend obliquely from the back part of the lower side of the upper rib, into the forepart of the upper side of the rib lying next under it, after a quite contrary manner to the six Intercartilaginei, who having like original and insertion amongst the gristles, as the intercostal amongst the ribs, descend obliquely from the forepart 6. Intercartilaginei. backwads. And thus much of the muscles dilating the Chest in inspiration. But the first, of the other muscles, being as many in number, which contract the The Sacrolumbus, the first of those which contract the chest. Chest in expiration, arising from the holybone, and the oblique processes of the loins, ascends (firmly and confusedly adhering with the Musculus sacer, or holy-muscle, which we shall describe hereafter) to the roots of the twelve ribs, imparting in the ascent a small tendon to each of them, by which it draws these ribs towards the transverse processes; and by reason of its Original it is called Sacrolumbus, that is, the Holy loine-muscle. The second, third, and fourth, which we said were the oblique descendent, right, The oblique descendent, the right and transverse of the Epigastrium, and transverse of the Epigrastium, have been formerly described in their place. But by the way you must note that these three muscles of the Epigastrium help expiration rather by accident, than of themselves, to wit, by driving back the midriff towards the lungs by the entrailes, which also they force upwards, by drawing the parts into which they are inserted towards their Original. The fifth which we called the Triangulus, or Triangular, may be called the Compressor of the gristles, Triangulus muscul●s. which proceeding from the inner sides of the Sternon, goes to all the gristles of the true ribs; this is more apparent under the Sternon in beasts, than in men, though it be not very obscure in them neither. For the internal intercostal muscles, Intercostalc● incerni. in my judgement, they arise from the lower sides of the upper rib, and descending obliquely from the fore part backwards, are inserted into the upper side of the rib next under it; so that they may follow the production of the fibers of the external Intercartilaginei; as the six internal Intercartilaginei follow the site of the external Intercartilaginei interni. intercostal proceeding from behind forwards; wherefore as well the intercostal, as the Intercartilaginei, every where intersect each other, after the similitude of the letter X. I know some have written that the internal muscles (whether intercostal or Intercartalaginei) ascend from the upper sides of the lower rib forwards, or backwards. But if this were true, it would follow that these muscles admitted their nerves in Muscles always receive their nerves in their heads. their tail and not in their head, seeing the nerve always goes under the rib, and not above it. The last muscle of the Chest, that is, the Diaphragma or Midriff, is sufficiently described The midriff, before; wherefore it remains we describe the muscles of the Loins. These are six in number, on each side three, equal in thickness, strength and situation; The muscles of the loins. They are three pair●… Triangulu●. one of these bends, and the other two extend the Loins; it is called by reason of the figure the Triangulus, or Triangular which bends the Loins, it ascends from a great part of the hind side of the Hanch-bone into the transverse processes of the Loins, and the last of the Chest on the inside, for which cause it is made of fibers short, long, and indifferent, answering to the nearness or distance of the said processes. The first of the extenders is called the Semispinatus, because even to the middle Semispinatu, of its body it takes the original from the spines of the holy-bones and Loins; this with its oblique fibers ascends from all the said spines to the transverse processes as well of the Loins as Chest. The other is called Sacer, the Holy-muscle, because it Sacer, takes its original from the Holybone, or the sides thereof; it ascends with its oblique fibers to the spines of the Loins, and of the eleven lower Rackbones of the Chest. CHAP. XIX. Of the Muscles of the Shoulderblade. NOw we must describe the muscles of the extreme parts, and first of the Arm, taking our beginning from these of the Shoulderblade. But first, that we may the better understand their description, we must observe the nature and condition of the shoulderblade. Therefore the The description of the blade-bone, or shoulderblade. blade bone on that part, which lies next unto the ribs, is somewhat hollowed; wherefore on the other side it some what buncles out. It hath two ribs, one above, another below: by the upper is meant nothing else than a border or right line, which looking towards the temples is extended from the exterior angle thereof under the collar-bone, even to the Process Coracoides which this rib produces in the end thereof: By the lower, the underside which lies towards the lower belly and the short ribs. Besides in this shoulderblade we observe the basis, head and spin. By the bast The basis of the blad●. we understand the broader part of the shoulderblade, which looks towards the backebone. By the head we understand the narrower part thereof, in which it receives the head of the Arm in a cavity, indifferently hollow, which it produces both The head of the shoulderblade. by itself, as also by certain gristles, which there fastened encompass that cavity. This kind of cavity is called Glene. This receives and contains the bone of the arm, by a certain strong ligament encompassing & strengthening the joint, which kind of ligament is common to all other joints; this ligament arises from the bottom of the cavity of the shoulderblade, and circularly encompasses the whole joint, fastening itself to the head of the arm; there are also other ligaments besides this, which encompass & strengthen this articulation. The spin of the blade, The processes' Acromion and Coracoides. By the spin is meant a process, which rising by little and little upon the gibbous part of the blade, from the basis thereof where it was low and depressed, becomes higher until it ends in the Acromion, or upper part thereof. Nature hath made two productions in this bone (that is to say, the Acromion from the spin, and the Coracoides from the upper side) for the strengthening of the articulation of the arm and shoulderblade, that is, left the arm should be easily strained upward or forwards; The muscles of the shoulder blade. besides, it is fastened to the clavicle, by the process Acromion. The muscles which move the shoulderblade are six in number, of which four are proper, and two common. The first of the four proper seated in the forepart, . ascends from the bones of five or six of the upper ribs, to the Coracoides, which it draws forwards, and is called Serratus minor, that is, the Lesser saw-muscle; which that you may plainly show, it is fit you pull the pectoral muscle from the collar-bone, almost to the middle of the Sternon. The other first opposite against it, is placed on the fore side, and draws its original from the three lower spines of the neck, and the three upper of the Chest, from whence it extends itself, and ends into all Rhomboides. Levator. the gristly basis of the shoulderblade, drawing it backwards; it is called the Rhomboides. The third from its action, is called the Levator, or the heaver, or lifter up, seated in the upper part, it descends from the transverse processes of the four first Vertebrae of the neck into the upper angle and spin of the blade. The fourth called Trapezius, Trapezius, or the Table-muscle, is seated in the back part, and is membranous at the original, but presently becomes fleshy: it arises from almost all the backpart of the head, from all the spines of the neck, and the eight upper Vertebrae of the chest, and then is inserted by his nervous part, almost into the whole basis of the blade, extending itself above the muscles thereof, even to the midst of its spin, where being fleshy it is inserted even to the Acromion, the upper part of the calvicle, and in some sort to the upper rib. This muscle hath a threefold action, by reason of its triple original. The first is to draw the shoulderblade towards its original, that is, to the noll, and spin of the neck; the other is to draw it towards the back, because of the contraction of the middle or transverse fibers which lead it directly thither; and the other is to draw it downwards by reason of the original it hath from the fifth, sixth, seventh, and eight spin of the Vertebrae of the Chest. But we must note that these divers actions are not performed by this muscle, by the assistance of one only nerve, but by more, which come into it by the spinal marrow, by the holes of the Vertebrae, as well of the neck as the chest, from whence it takes the original. For the two other which are the common muscles of the blade, and arm, or shoulder, we will describe them with the muscles of the shoulder or Latissimus. arm: for one of these which is called the Latissimus, that is, the broadest, ascends from the holybone to the shoulderblade and arm. Pectoralis. The other named the Pectoralis comes from the Sternon and collar-bone to the shoulderblade and arm. CHAP. XX. The Description of the Hand taken in General. NOW it befits us to to describe in order the muscles of the arm; but first we must know, what it is that we call the arm. But seeing that cannot fitly be understood, unless 1. we know what the hand is, seeing that the arm is a part of the hand; therefore first we must define what a hand is, and then divide it into its parts. Therefore the hand is taken two manner of ways, that is, generally and specially. The hand generally taken, signifies all that which is contained from the joining of What is meant by the hand in general. the arm to the shoulderblade, even to the ends of the fingers. But in particular it signifies only that which is comprehended from the furthest bones of the cubit, or the beginning of the wrist, to the very fingers ends. Therefore the hand in general is an instrument of instruments made for to take up and hold any thing. It is composed of three great parts, that is, of the Arm, Cubite, and Hand, vulgarly, and properly so called; but the hand taken thus in particular is again divided in three other parts, the Carpus or Brachiale, the Wrest, the Metacarpium, or Postbrachiale, the afterwrest, and the fingers; all these parts (seeing each of them are not only organical parts, but also parts of organical parts) are composed of all, or certainly of the most of the simular parts; that is, of both the skins, the fleshy pannicle, the fat veins, arteries, nerves, muscles or flesh, coats both common and proper, bones, gristles and ligaments, all which we will describe in their order. But first I think good to admonish you of the differences of the hand taken from The differences of the hand from the site thereof. the site thereof; and these differences are six in number, the fore, the hind, the internal, the external, the upper and lower side or part thereof. By the fore we mean that part which looks directly from the thumb to the shoulder: by the hind, we understand the part opposite to it, which from the little finger looks towards the basis of the shoulderblade. By the inside we signify that part which lies next to the sides of the body, when the hand retains its natural site; by the outside, the part opposite to it. The upper and lower side you may know by the very naming thereof. The hand properly so called is divided into five fingers, that so it may hold and take up bodies of all figures, as round, triangular, square and the like, and gather up Why the hand is divided into so many fingers. the leasts bodies with the fingers ends, as needles, pins, and such like. Nature hath bestowed two hands upon us, that so they may belpe each other, each moving to each side. But for the taking up and holding of small bodies it was Why the nails are added to the soft flesh of the fingers. fit, that the fingers of their own nature soft, should be armed with nails, that consisting of soft flesh and an hard nail, they might serve for all actions; for the nail is a stay to the soft flesh, which otherwise would turn away in meeting with an hard body; the use of the nails is to scratch, shave, and pull off the skin, to rend, pinch, and pluck asunder small bodies. They have not bony hardness, that so they might not break, but bend. Yet other creatures have hard nails, to serve them in stead of weapons. Their Why the nails grow continunally. figure is round, because fuch a figure is less obnoxious to external injuries; and by reason they are subject to wearing, they grow continually. Nature hath placed flesh on the inner and side part of the fingers, so to press more straight, the things they once take hold of, so that by holding them close together, we can hold water that it may not run out. The length of the fingers is unequal, that when they are opened and stretched forth, they make as it were a circular figure; for so it comes to pass, that the hand can hold all bodies, but especially round. It remains that we prosecute the distribution of the veins, arteries, and sinews, which run over all the parts of the hand taken in general and particular, whereby we may more commodiously hereafter handle all the proper parts thereof. CHAP. XXI. The Distribution of the Subclavian vein, and first of the Cephalica, or Humeraria. TWo large veins descend from the Subclavian, the one from the lower side, the other from the higher. Yet sometimes, and most usually, both these proceed from the same common orifice, as in men of a low statnre in the arm. The one of these is called the Axillaris, the other the Humeraria, or Cephalic; therefore this Cephalic passing forth of the Subclavian runs superficially along the foreside between the muscle Deltoides, and the Tendon of the pectoral muscle, and descends in the midst between The Cephalic vain. the common coat of the muscles and the fleshy pannicle, even to the bending of the cubite, where in lean bodies it is plainly to be seen, whereas in fat bodies it is hardly to be perceived, being as it were buried in abundance of fat. This vein having in its descent, sent forth some small branches, both to the skin, as also to certain muscles over which it runs, is divided into two, a little above the outward protuberation of the arm. One of the branches into which it is divided descending obliquely to the fore part of the cubite, a little below the bending of the cubite, it meets, and is united with the like branch in the same place, as shall be shown hereafter. That which arises from this concourse, is called the median vein, because it arises from two branches, and is seated between them. They usually open this median vein in the diseases of the head and liver, which require Phlebotomy; but if it shall The median vein. not be sufficiently manifest, when you judge it must be opened, for a general evacuation of the whole body; you may cut one of these branches, by whose concourse it is made, which you shall think the fitter; and because each branch draws from the next parts, according to the straightness of the fibers, rather than from the opposite Howby opening the median vein, you may draw more or less blood from the head or liver. side; if you would evacuate the head, and liver equally, by opening either of these branches; it is convenient that opening that branch (for example) which comes from the Cephalic, you presently lay your thumb upon it, until you suppose, you have drawn a just quantity of blood from the liver, by the Basilica, or liver vein; which done, you may take off your thumb, and suffer the blood to follow freely, by the open branch of the Cephalic, until you have drawn as much blood as you shall judge requisite; otherwise you will draw it but from one part, to wit, the head. So you shall evacuate it only from the liver, if you open the branch which comes from the Basilica, and concurs to the generation of the median. Moreover, when there is need to open the Basilica, and it shall be no where conspicuous, the Cephalic or median being easy to be discerned at the same time, you may in stead thereof open the median, or if it be not to be found, the Cephalic, pressing but the trunk thereof with your thumb, as we said before, lest the head should be evacuated in stead of the liver. You may do the same in the Basilica, if when there shall be necessity to open the Cephalic, it shall not appear. Most of those which at this day open a vein, in stead of the median, open that branch of the Basilica which ascends, together with the Cephalic to make the median. But you must understand that the median descends between the two bones of the cubit, even to the end thereof, and then divided into many branches, it is at length spent on the back of the hand behind the thumb, the fore and middle fingers, or the afterwrest. Sometimes it runs back into the following branch, and then at the wrest it departs from it, to be bestowed upon the forementioned parts. The other branch of the Cephalic, which we may call the fore and outward Cephalic, descending directly down to the midst of the wand, thence wanders overthwart into the hind part of the arm, where increased with a branch from the Basilica, it is distributed over all the back of the hand, which with the median it nourishes. But the branches of these veins do so run through the forenamed parts, that by the way, they yield them necessary provision. CHAP. XXII. The Description of the Axillary vein. THe Axillary arising at the insertion of the pectoral muscle, or a little The axillary is divided into higher, after it hath produced the two Thoracicae it is divided under the tendon of that muscle into two fair branches, that is to say, into the inner deep Axillary, and the skin or outward axillary. The deep or The deep axillary, and outward axillary. inner having still for his companion in his descent, the axillary artery, and the nerves of the third conjugation, after it hath produced the small external musculous of the arm, it goes into the bending of the elbow, where running somewhat deep with the artery and nerve into the muscles of the cubite, it is divided into three other branches, of which one descending with the wand, slides under the ring, into the inner side of the hand, and hath bestowed two small branches on the thumb, two others on the fore, and one upon the middle finger, so that all of them ascend by the sides of these fingers, the other descending with the artery, as the former alongst the cubite, sends branches to the rest of the fingers, like as the former. The third goes on the foreside between the two bones even to the wrist, and the square muscle. But you must note that the veins of which we now treat, do not only make these devisions mentioned by us, but infinite others besides, as well in the parts which they go to, as also in the inner muscles of the hand which they nourish. And thus much of the internal and deep axillary vein. For the external or skin Axillary (which first appears under the skin, especially in lean bodies, a little above the inward production of the arm) it is divided in that place into two branches, the one whereof descending to the bending of the arm meets, and is united with the Cephalike branch, sooner or later, that so it may produce the median, as we formerly mentioned. The other branch having sent forth many shoots of a different length and thickness, as well into the skin, as into the other neighbouring parts, descending alongst the lower side of the bone of the cubite, properly so called, is at length spent upon the fore and outward Cephalic branch, which we said descended alongst the wand; and thus united, they run over all the hand, where in the right hand, between the middle and fore finger, they make the Salvatella; but in The Selvatella and Splenitica the left, in the same place, they produce the Splenitica. But always remember, (if in dissection you find any thing otherwise than we have delivered it) that the distribution of the vessels is so various (especially in the hands) that there can no certain rule be delivered thereof. CHAP. XXIII. The Distribution of the Axillary Artery. THe Axillary artery from the first original, which is presently after the two Thoracica, descending between the muscle called Biceps, or the two headed muscle, and the Brachiaeus, with the deep axillary vein, distributes a large branch amongst the outward muscles of the arm, which extend the cubite, and is spent in the external muscles of the same, which arise without, from the productions of the arm. And this is called the Ramus Musculus, or Musculous branch, as also the vein that accompanies this Arterye. Then this Arterye when it comes to the bending of the cubite, thrusting itself into the muscles bending the fingers, communicates certain branches to the parts pertaining to the dearticulation of the cubit with the shoulder, and other parts there situate, as it did in the upper parts, by which it descended hither. Verily it may it may be a general rule; that every vessel sends or bestows certain portions thereof by the way to all the parts by which it passes. But if you should An Aontomicall Axiom. ask, why I have not prosecuted these productions; I would answer; I never intended, to handle other than large and fair branches of vessels, by rash incision of which, there may happen danger of death or a disease. For it would be both an infinite and needle's business to handle all the small divarications of the veins, arteries and nerves. Therefore this Artery sunk into these muscles, when it comes almost to the midst of the Cubit, presently or a little after it is divided into two large branches, the one of which alongst the wand, & the qther alongst the Cubite is carried into the hand on the inside under the Ring. For both these branches are distributed and spent upon the hand after the same manner as the branches of the internal Axillary vein, that is, having sent by the way some little shoots into the parts by which they pass, at the length the branch which descends by the Wand of the remainder thereof, bestows two sprigs upon the Thumb, on each side one, & two in like manner on the fore finger, and one on the middle; the other which runs alongst the Ell, performs the like office to the little and the middle or ring finger, as you may see by dissection. CHAP. XXIIII. Of the Nerves of the Neck, Back, and Arme. NOw we should handle the sinews of the Arm, but because these proceed from the Nerves of the Neck and Back, I think it fit therefore The 7 pair of nerves of the neck. to speak something of them in the first place. Therefore from the Neck there proceed seven pair of Nerves, the first of which proceeds from the noll bone, and the first Vertebra The first pair. of the neck; as also the first pair of the Back from the last Vertebra of the Neck and the first of the Chest. But all these Nerves are divided into two or more branches of the first pair (that is to say, on each side) go, the one to the small right muscle, ascending from the first rackebone of the neck to the noll bone, the other to the long muscle on the foreside of the neck. The branches of the second pair are distributed, some with a portion which they The second pair. receive from the third pair over all the skin of the head; the two others go as well to the muscles, which are from the second Vertebra to the back part of the head, and from the same to the first Vertebra, as also to the long muscle before mentioned. One of the third pair of Sinews is communicated to the head, as we said before, but others to the Muscles which extend, or erect the head and the Neck; there is also The third pair. one of these distributed into the neighbouring ●●de muscle and part of the long. The nerves of the fourth pair go, one to the muscles aswel of the neck as the head, & The fourth pair. to the broad muscle; the other after it hath sent some portion thereof into the long muscle & the side muscles of the neck, it descends with a portion of the fifth and sixth pair to the Midriff. One of the branches of the fifth pair is bestowed on the hind muscles The fifth pair. of the neck and head, the other upon the long muscle and Midriff; the third is communicated to the Levatores, or Heaving muscles of the Arm and shoulder. One of the Nerves of the sixth pair goes to the hind muscles of the Neck and The sixth pair head, another to the Midriff, the third with a portion of the seventh pair of the neck, and of the first and second of the Chest go to the Arms and heaving muscles of the shoulderblade. One of the branches of the seventh pair runs to the broad muscle and to the neighbouring muscles both of the neck and head; another increased with a portion The seventh pair. of the fifth and sixth pair of the neck, and a third joined to the second and third pair of the Chest descending into the Arm go to the hand. But you must note that the Muscles which take their original from many Vertebrae, whether from above downwards, or from below upwards, admit Nerves not only from the Vertebrae, from whence they take their original, but also from them which they come near in their descent, or ascent! There pass twelve conjugations of Nerves from the Rackbones of the Chest. The 12. pair● of Nerves of the Chest. The first pai●●▪ The first entering forth from between the last Rackebone of the neck and the first of the Chest, is divided (that is, on each side, each Nerve from his side) into two or more portions, as also all the rest. Therefore the branches of this first conjugation go some of them to the Arms, as we said before, others to the muscles as well these of the Chest, as others arising there, or running that way. The branches of the second conjugation are distributed to the same parts, that these The second pair. of the first were. But the branches of all the other conjugations even to the twelfth, are communicated, The other▪ pairs. some to the intercostal muscles running within under the true ribs even to the Sternon, and under the bastard ribs even to the right and long muscles; and the costal Nerves of the sixth conjugation are augmented by meeting these intercostal branches by the way as they descend by the roots of the Ribs. Other particles of the said Nerves are communicated to the muscles as well of the Chest, as spin, as the same Muscles pass forth, or run alongst by the Vertebrae, from whence these nerves have either their original, or passage forth. Having thus therefore showed the original of the Sinews of the Arm, it remains The Nerves which are carried to th● Arms. that we show their number and distribution. Their number is five or six; proceeding from the fifth, sixth, and seventh Vertebra of the neck, and the first and second of the Chest. The first of which not mixed with any other from the fifth Vertebra of the neck, goes to the Muscle Deltoides and the skin which covers it. The other 4 or 5 when they have mutually embraced each other, not only from their first original but even to the shoulder, where they free themselves from this convolution, are distributed after the following manner. The first and second descending to the Muscle mentioned a little before, and thence sometimes even to the hand, is by the way communicated to the Muscle Biceps, and then under the said Muscle it meets and is joined with the third Nerve. Thirdly it is communicated with the Longest muscle of the Cubite, in the bending whereof it is divided into two branches descending alongst the two bones of the Cubit, until at last borne up by the fleshy pannicle it is spent upon the skin and inner side of the hand. The third lower than this, is first united with the second, under the Muscle Biceps, then strait way separated from it, it sends a portion thereof to the Arm which lies under it, and to the skin thereof; lastly at the bending of the Cubit on the fore side, it is mingled with the fifth pair. The fourth, the largest of all the rest, coming down below the third branch under the Biceps with the internal Axillary vein and Artery, is turned towards the outward and back part of the Arm, there to communicate itself to the Muscles extending the Cubit, and also to the inner skin of the Arm and the exterior of the Cubit; the remainder of this branch when in its descent it hath arrived at the joint of the Cubit, below the bending thereof it is divided into two branches, the one whereof descending alongst the Cubit is spent on the outside of the Wrest; the other associating the Wand is on the outside in like manner in two branches bestowed upon the Thumb, and in as many upon the fore finger, and by a fifth upon the middle finger though more obscurely. The fifth branch being also lower than the rest, sliding between the muscles bending and extending the Cubite, when it comes behind the inner protuberation of the Cubite (in which place we said before the third branch meets with this) it is communicated to the internal muscles of the same, and then divided into three portions one of which on the outside alongst the middle of the Cubite goes in two sprigs to the little finger, & so many to the middle finger, and one to the Ring finger; the other two, the one without and the other within the Ring, go to the hand, where after each of them hath bestowed what was requisite on the muscles of the hand, they are wasted into other five small portions, of which these which are from that portion which descends without the Ring, send two sprigs to the little, two to the fore and one to the middle finger; but these which come from that which passes under the Ring, by such a distribution communicates itself to other fingers, as two sprigs to the thumb, two to the fore and one to the middle finger. The sixth the lowest and last runs between the skin and fleshy Pannicle, by the inner protuberation of the Arm, and then is spent upon the skin of the Cubit. CHAP. XXV. The description of the bone of the Arm, and the Muscles which move it. BEcause we cannot perfectly demonstrate the original of the muscles of the Arm, (especially of the two Arm muscles) not knowing the description of this bone; first therefore we will describe it, then return to the original of the muscles arising from thence. The bone of the arm is the greatest The greatness and figure. The Appendix of the Arme. The processes of the Arm, of all the bones in the body, except the Thighbone; it is round, hollow and filled with marrow, with a great Appendix or head on the top thereof, having an indifferent neck, to which it is knit by Symphysis, for appendices are no otherwise united to their bones. In the lower part thereof it hath two processes, or protuberations, one on the fore side, another on the hind, between which swellings there is a cavity like to half the compass of a wheel, about which the Cubit is moved. The extremityes of this cavity ends in two holes, of which one is the more external, the other more internal: these cavityes receive the heads of the Cubite, that is, the fore, or internal receives the fore process when the arm is bended inwards, but the external or hinder the exterior, as it is extended. For the head of the arm it hath a double connexion, the one with its own neck by Symphysis, that is, a natural union of the bones without any motion; the other with the lightly engraven cavity of the shoulderblade, which we call Glene, by that kind of Dearticulation which is called Arthrodia; this connexion is made firm and stable by the muscles descending into the arm from the shoulderblade, as also by the proper Ligaments descending from the circle and brow of the cavity of the Acromion and Coracoides to this head of the arm; this same head of the arm is, as it were more cleft and open on the inner side, than on the fore side, that so it may give way to one of the Ligaments coming from the shoulderblade to the muscle Biceps. For as much as belongs to the lower end of the bone of the arm (which we said hath two processes) we may say that it is fastened to the bones of the Cubit by two sorts of articulation, that is, by Ginglymos with the Ell or proper bone of the Cubit, and by Arthrodia with the Radius or Wand, which in a lightly engraven cavity receives the fore process of the arm, and is turned about it for the motion of the hand. The hinder process is chiefly added for the safety and preservation of the veins, arteries and nerves. These things thus shown, it is worth our labour to know the figure of the arm it The figure of the Arme. self, as it lies between the forementioned appendices and processes, that in the case of a fracture, we may know how conveniently to restore it; therefore first we must understand, that this bone is somewhat bended and hollowed on the inside under the cleft of the head thereof, but bunching out on the out and fore side. Table 24. showeth the Brain together with the Aster-braine, the spinal marrow and the Nerves of the whole body. A, That part of the brain that is 〈◊〉 the nostrils. B, That part which is at the side of the ventricles. C, The back part of the brain. D, The Cerebellum or Afterbraine. E, The Mamillary process in the right side. F, The original of the optic nerve. G, Their conjunctions. H, The coat into which the optic nerve is extended. ay, The second pair of the sinews of the brain. K, The lesser root of the third conjugation. L, The thick root of the same conjugation according to the common opinion. M, The fourth conjugation of the sinews N, The lesser root of the fifth pair. O, The bigger root of the same pair: P, The small membrane of the ear which they call the Tympany. Q, The lower branch of the bigger root of the fifth conjugation. S, The sixth pair of sinews. T, The seventh pair. V, The beginning of the spinal marrow out of the middle of the basis of the brain. X, The right sinew of the midriff cut off. Y, A branch from the fifth pair creeping to the top of the shoulder. Z, The first nerve of the arm from whence there goeth a branch to the skin. A, The second nerve of the arm, and a branch there from into the first muscle of the Cubite. B, The third nerve of the arm and a branch going to the skin on the outside. C, A branch from the 3. nerve to the 2. muscle of the Cubite. D, The congress or meeting of the second nerve with the third. E, A small branch from the 3. nerve to the 2. muscle of the Radius. F, The distribution of the second nerve into two branches. * The lesser branch of this division lengthened out to the skin as far as the thumb. a, The place of the spinal marrow where it issueth out of the brain. 1, 2, 3, etc. Thirty pairs of nerves arising from the spinal marrow are here noted by their Char. that is to say, 7. of the neck, 12, of the Chest, 5. of the loins and 6, of the holybone. b, The thicker branch of the 2, nerve divided into 2, parts. c, Branches of the 3, nerve sprinkled here and there. d, Nerves from the third pair to the thumb, the forefinger and the middle finger. ●e, The 4, nerve of the arm. f, The passage hereof through the inside of the shoulder. g, A tripartition of this branch where it toucheth the Cubit. hh, A branch distributed from the 4. nerve to the outward skin of the Cubite. i, the upper branch of the division of the 4. nerve. kk, A branch of i, reaching to the outside of the hand. ll, the lower branch of the division of the 4. nerve passing through the backside of the Cubite. m, the 5. nerve of the arm. n, Branches of this nerve dispersed here and there, oo, A branch of the 5. nerve reaching to the inside of the hand and the fingers. p. A surcle of the branch o, derived to the outside of the hand and the fingers. qq, the 6, nerve of the arm and the course thereof under the skin. rr, the intercostal nerves there cut off where they are together with the ribs reflected forward. ss, branches on each side running backward. tt, Nerves attaining unto the Chest. vu, the commixtion of the nerves rr, with the descending branch of the 6. conjugation of the brain. xx, Nerves from the loins led unto this place. y, A branch going to the testicle here cut off. z, A nerve reaching to the 1. muscle of the thigh. c, the 1. nerve of the leg. αβ, A surcle of the former nerve derived to the skin at α, and inserted into the muscles at β. γ, the 2. nerve of the leg. δδδ, A nerve from the former, allowed unto the skin as low as to the foot, and passing along the inside of the leg. ε, a branch of the 2. nerve running unto the muscles. ζ, the 3 nerve of the leg. n, a surcle thereof unto the skin. θ, another surcle unto the muscles. 〈◊〉, the 4. nerve of the leg. xx, the anterior propagations of the nerves proceeding from the holybone. λ, the end of the spinal marrow. μ, a branch from the 4 nerve inserted into the muscles arising from the Coxendix or hip bone. ν, another branch going to the skin of the thigh on the backside. ξ, a propagation derived to the 4. muscle of the leg and to the skin of the knee. oo, nerves attaining to the heads of the muscles of the foot. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the division of the 4: crural nerve into two trunks. σ, a branch from the trunk π, dispersed into the outward skin of the leg. τ, a surcle of the trunk π, derived to the muscles. ν, another surcle to the skin of the leg on the foreside., a branch of the trunk ρ, to the skin of the inside of the leg and of the foot. χ, a surcle of the trunk ρ, to the hindmost skin of the leg. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, a branch of the whole trunk ρ, led along to the forward part of the leg and the soot? ω, the descent of the trunk ρ, into the foot. But to come to the original and insertion of these muscles; the one of these two The original and insertion of the pectoral muscle. which move the arm forwards called by reason of his original, the pectoral, arising from more than half of the Collar bone, and almost all the Sternon and the 6, 7. and 8, Rib, goes up and fastens itself to the Coracoides, by a membrane or a membranous tendon sufficiently strong (for which cause it is said to be common to the shoulder & arm) and it goes into the arm between the muscles Deltoides and Biceps with a strong tendon composed of fibers crossing each other, of which some descend from the Collar-bone and the upper part of the Sternon, others ascend from the lower original hereof, that is, from the 6, 7, and 8, Ribs: and although the action of this muscle be divers, by reason of the diversity of its fibers arising from divers places, yet always it draws the arm forwards, whether it be moved upwards, downwards, or to the Breast; the other which is his companion descends from the whole lip or brow of the simous or hollow part of the Blade, which it fills in the forepart of the arm near the head thereof. For the two Levatores, or the Lifters up of the arm, the first named Deltoides descends from almost half the Clavicle, the process Acromion and all the spin of the shoulderblade into the foreside of the arm the breadth of four fingers The Deltoides below the joint. It hath divers actions according to the diversity of the fibers, as also every muscle hath; yet howsoever it is contracted, whether by the fibers from the clavicle alone, or by the spinal alone, or by both at once, it always lifts and heaves the arm upwards. The other which is his associate descends from the gibbous part of the Shoulderblade contained between the upper rib thereof & the spin between the processes' Acromion and Coracoides, to the neck of the arm; and this we will call the The Epomis, or Scapularis. Epomis or Scapularis, that is, the shoulder Muscle. But the first and larger of the two muscles, which draw the arm backwards, arises from the greatest part of the utter lip of the gibbous part of the shoulderblade, which is under the spin thereof, & lying upon the blade itself, it goes into the hind part of the arm above the neck thereof. The other which is contiguous to it & his partner in working, but lesser, passes from the upper and exterior part of the lower rib of the shoulderblade, and thence as it were in some sort extending itself upon the gibbous part thereof near unto that rib, it goes into the arm. This muscle seems to be the same with the former, being fleshy without even above the top of the shoulder. One & the lesser of these two which draw downwards, enters out from the straight line of the lower Rib of the blade, & goes into the lower part of the arm about the neck thereof. The other called the Latissimus or broadest, ascends from the spines of the holybone, of the Loins, & often also from the nine lower of the Chest, by the lower corner of the shoulderblade into which it is inserted by a membranous tendon, as also it is into the inner part of the arm near unto the neck by another strong tendon; whereupon this muscle is called a common muscle of the shoulder and arm. But when this muscle happens to be wounded, the arm cannot easily be stretched forth, or lifted up. CHAP. XXVI. The Description of the bones of the Cubit and the muscles moving them. AFter these muscles, follow those which bend & extend the cubit, but because their insertion cannot be fitly demonstrated, unless the bones of the cubit be first described; therefore first of all we will delineate the bones themselves. But verily lest this doubtful word cubit should cause obscurity, first we must note, that What is meant by the Cubit. it hath a threefold signification; for ofttimes it is used for all that part of the hand which lies between the arm & wrest, oft times for the lower bone of this part, sometimes for the upper part of this bone which is turned within the Orb or Cavity of the arm (no otherwise than a cord in the wheel of a Pulley) and this is called the Olecranon. Here What the Olecranum is. The 2 bones of the Cubit. truly we use this word Cubit in the first signification. Wherefore we say the cubite is composed of two bones, the one of which we call the Radius or Wand, or the lesser Focile of the Arm; the other we properly call the Cubit or Ell. These two bones stick together at their ends being firmly bound together by strong Ligaments; but the middle parts of them are a pretty way distant from each other, & chiefly towards their lower ends, for the better situation and passage of the muscles and vessels from the inner side, to the exterior, as shall be showed in fit place. The wand hath two Epiphyses The two Appendices of the wand. or Appendices, the one at the upper end, the other at the lower. The upper is round & hollowed on the surface like a basin, it receives the fore process of the bone of the arm, bound to the same by strong ligaments, descending as well from that process of the arm, as the Olecranon into the circumjacent parts of this appendix of the Wand. This connexion is made for this use, that we may turn our hand upwards and downwards by the Cubit turned and twined about this process. But the lower appendix of this wand is hollowed on the inside that so it might more commodiously receive the bones of the wrist, but gibbous without, that it might be safer; now this wand is softer The figure and fire of the wand. and thicker at the lower end, but lesser and harder above, where on the inside it hath a swelling out, whereby to receive the muscle Biceps, besides on the outside of the mlddle thereof it is somewhat gibbous and round, so to become more safe from the injuries of external bodies; but it is hollowed, or bended on the inside for the better taking or holding any thing in the hand. But that side which lies next to the Ell is flatted for the fitter original and seat of the muscles; lastly it is seated upon the bone of the Cubit, or Ell, just against the thumb. But the Ell, or bone of the cubit properly & particularly so called, hath in like manner two appendices, the one above, the other beneath. The The 2 Appendices of the bone of the Cubit. upper which also is the greater, is fitted to the Orb of the arm, in which it goes to & again for the extension & bending of the arm, no otherwise than a rope runs in a pulley but that it turns not absolutely & perfectly round, which is caused by the two processes of unequal bigness, the which are therefore stayed in the holes or cavities of the bone of the arm, the greater process which we called Olecranon is letted by the exterior hole that so the extension of the arm can be no further, but the lesser process by the inner hole makes the bending thereof the less perfect. The Composure of these bones is by Ginglymos, & it is strengthened not only by common Ligaments coming from the muscles, which move the bones themselves, but also by proper Ligaments descending from the processes of the arm & the lips of the holes and cavities standing about the Appendix of the Cubit. The other lower and lesser appendix is in some sort hollow on the inside for the fitter receiving the bones of the wrist, but the outside is round & ends in a point, whence it is called by the Greeks Styloides. But now this Ell (contrary The figure of the Cubit bone or Ell. in this to the wand) is thicker towards the arm, but slenderer towards the wrist. And besides in the thicker part thereof it is hollowed or bended towards the inside, & in the same place is gibbous or bunching forth on the out side; but it is round & strait, unless on that side which lies next the wand, for the rest, it is hollow & full of marrow like the wand. The site of the Radius or wand is oblique, but that of the Cubit or Ell is right, that the arm might be the better & more easily moved; because the motion by which the arm is extended & bended is according to a right line, but that by which the inside of the hand is turned upwards & downwards, is performed obliquely & circularly. Wherefore it was expedient that the wand should be oblique, & the cubit straight for the cubit-bone is appointed for to extend & bend the arm; but the wand to perform the wheeling & turning about thereof, & this is the cause that it was fitting there should be a different connexion of these bones with the arm. These things were fitting to be spoken concerning the nature of these bones, that in the cure of fractures we may work the more safely & happily, taking indication from that which is agreeabl● to nature: wherefore now it remains that we come to the description of the muscles The muscles moving the Cubite. The Biceps, or 〈◊〉 headed muscle. which are seated in the arm, the cubit-bone, or Ell. These are 4, in number, two extending it, & two bending it. The first of the Benders is called Biceps, by reason of its two heads; the one whereof descends from the Coracoides, that other from the lip of the cavity of the shoulderblade by the fissure or cleft of the head of the bone of the arm. These two heads under the neck of this arm becoming fleshy, are firmly united at the belly & midst of the arm, & thus united are at length implanted by a strong tendon to the inner protuberation of the wand. The other is called the Brachiaus, by reason The Brachiaus. of the straight coherence thereof with the bone of the arm; this fastened under the Biceps descends obliquely on the back and upper part of the bone of the arm into the top of the wand and the inner side of the Ell. But the first of the extenders is called the longus or Long muscle, this descends from the lower Rib of the shoulder, and The Longus. cleaving to the bone of the Arm goes thither (fastened and as it were always most straight joined with his fellow muscle, specially near the Cubite) where you shall presently hear. The other termed the Brevis or short Muscle, being the companion of the long, descends on the hind part of the neck of the bone of the Arm, as it were The Brevis. growing to and lying under the former long muscle, so that making one common broad Tendon outwardly fleshy, inwardly nervous, they are inserted into the Olecranum, so by mutual assistance to extend the Cubite. CHAP. XXVII. The Description of the Bones of the Wrest, Afterwrest and fingers. WE said before that the Hand taken more particularly and properly, is divided into the Wrest, afterwrest & fingers, & that the hand in this signification What the Hand properly so called is. is bounded by the ends of the bones of the cubit and fingers. All the parts of the wrist, which it hath common with the afterwrest, have been already also plentifully explained, this only remains to be noted, that the skin aswell of the hands as of the feet, is of a middle nature between pure flesh and pure skin, no otherwise than that which covers the forehead, but that this which covers the palms of the hands & soles of the feet is unmoveable; But it is most thick, especially on the feet, left it should be easily offended by continual going. Besides the common parts, the wrist is composed of eight small bones mutually knit together in a certain order, and by Diarthrosis with the two bones of the Cubite, but mutually and amongst themselves by Synarthrosis, by interposition of Gristles and Ligaments aswell common, that is, coming from the muscles, as proper, descending always from the upper to the lower. But these same bones are some less than othersome, besides they are hard and without marrow, gibbous on the outside for the security and comeliness of the hand, but hollow on the inside for to give way to the tendons going into the fingers. These bones are disposed in two ranks. The first Rank contains only three, but the second five. The three of the first Rank are thus arrayed, or placed, that one of them may receive the Appendix Styloides of the Cubite; the other the Ell and the Wa●d together, and the third may be received by the Wand. But three of the five bones of the second order sustain the four bones of the afterwrest & are knit to the same by Synarthrosis, after which manner of connexion they are joined to the bones of the first rank; the fourth sustains the first bone of the Thumb to which also it is coarticulate by Synarthrosis; the fifth and last is seated on the inside against the Ell, chiefly above that bone of the first order, which receives the Appendix Styloides of the Cubite, this is the least and weakest of them all by reason of its gristlely substance, which makes the Ring with certain Ligaments running from one of the inner sides of the wrist to the other. What the Annulus o● Ring is. This Ring is placed there as well for the preservation of the sinews, veins & Arteries passing under it (lest when we lean upon our hand, or wrest, these parts should be hurt by compression) as also for the commodity of the Action of the muscles bending the finger, which in the performance of their action & the contracting themselves might deform the hand by their passing forth of the Cavity of the wrist. For what attraction soever is made by strings, if it be free and not hindered, is according to a straight line. Now follow the bones of the second part of the hand, or of the afterwrest. These The bones of the Afterwrest are four in number, gibbous without, but arched within, or hollow in the middle; for hence is the palm of the hand, or certainly the greater part thereof; their ends next the fingers are somewhat remote from each other, that in these cliffs the Muscles Interosses might find a place and seat. But these ends have each an Appendix, as you may perceive in the Sceleton of a child. But you must note that by the first bone of the wrist or Afterwrest, we mean that which is in the foreside of the hand, that is to say, that in the wrist which lies under the Thumb, and that in the Afterwrest, which it seated under the forefinger, as these which keep in order the fingers which exceed the rest in necessity and dignity. After these follow the fifteen bones of the fingers, that is, three in each, which are The bones of the fingers. hollow and fistulous full of a thin and liquid marrow, and not of gross and thick as in the arm and thigh. They are outwardly gibbous, but inwardly hollow and flat for the fitter seat of the Tendons ascending alongst the fingers on the inside even to the upper joint. The which that nature might the better strengthen and preserve, it hath produced from the lips of the inner Cavities of these bones a membranous & strong Ligament, which running overtwhart from one side to the other doth so straight close the Tendons to their bones, that they cannot go forth of their places, or incline to either side. They are connexed on the outside, that they might be more fit to hold any thing. But for the first bones of the 4 fingers and Thumb, four are joined together with so many bones of the afterwrest by Synarthrosis, for the bones of the afterwrest are moved by no manifest motion; the fifth is knit to the second rank of the bones of the wrist, therefore that bone cannot be attributed to the afterwrest, as some have written, seeing it hath manifest motion and is knit by Diarthrosis, but the bones of the afterwrest are only fastened by Synarthrosis. For the second and third rank of bones of the fingers, they are knit the second to the first, and the third to the second by diarthrosis and Arthrodia, because besides the manifest motion they have, they receive each other by a superficary cavity, as those of the first rank, the bones of the afterwrest, and those of the second rank, them of the first; those of the third them of the second. And all the bones of the fingers are larger and thicker at their basis, but smaller towards the ends; and they are bound by Ligaments especially proper, which (as we said formerly) descend from the first to the second; so that the last bones seeing they have not to whom to communicate their nerve, make & produce nails thereof: Wherefore the nails are generated by the fibers of the Ligaments, and the excrement When at the nails are generated. The ossa Sesamoid. or Seedbones. of the tendons which are terminated at the bottom of the nails. Now remain the Ossa Sesamoidea, or seedbones: these are 19 in number in the inner joints of each of the hands, and as many in each foot, viz. two in the first joint of the four fingers and in the second of the thumb, and one in each of the rest. For the inner fide of the joints, you may for the most part observe one in each of them; yet in the second joint of the thumb there be two, above the two tendons, which are somewhat gristlely. They are made for this use, that they firm and strengthen the joints, so that the bones of the fingers may not be turned awry, or thrust forth of their places by strong Their use. and violent motions, as it sometimes happens in the whirle-bone of the knee. They are called Sesamoidea from the resemblance they have to the seed of Sesamum, which is somewhat long and flat. The Figure of the bones of the Hand. The 1. shows the inside of the right hand, and the 2. shows the back side of the same. The Charact. 1, 2, 3, 4, 5, 6, 7, 8. show the eight bones of the wrist. A, 1, 2, The first bone of the Afterwrest lying under the thumb. I. II. III. four The 4. other bones of the Afterwrest annexed to the fingers. B, C. The two bones of the thumb. D, E, F. 1, 2. The 3 bones of the forefinger, which are the same in the other fingers. M, 1, 2. A little bone sometimes fastened outwardly at the joint of the eight bone of the wrist. N, 1. A process of the eight bone of the wrist, swelling out into the ball of the hand. O, 1. A process of the fifth bone of the wrist, from which a Ligament proceeds. P, 2. An Appendix of the bones of the wrist, by which they are articulated to the afterwrest. Q, 2. Another appendix which with its head entereth into the Cavity of the finger. R, 1, 2. The space between the bones of the afterwrest. S, 1, 2. Two little seedbones set on the inside and outside of the first joint: T, 1. Two seedbones in the first of the 4 fingers. V. V. 1. One seed-bone in the second and third joint of the fingers. CHAP. XXVIII. Of the muscles which seated in the Cubite move the Wand and with it the Hand. NOw must we describe the muscles of the formerly described parts, that is, those which are seated in the Cubit, which are carried to the inside of the The museles of the Cubite. hand, and those which are called the Interosses. Now the muscles of the Cubitare 14, 7 external, and 7 Internal; two of the seven external do primarily twine or turn up the Wand, and secondarily or by accident turn the Palm of the hand upwards, whereupon they have called them supinatores, or turners up of the hand; The Supinatores. The Carpitensores. The Digitumtensores. The Obliquator externus. The first of the Supinatores. The second. The upper of the Carpitensores. two extend the wrist, whereupon they are named Carpitensores or the Wrest-extenders; two the fingers, whence they are styled Digitumtensores or finger-stretchers; to conclude, the seventh & last is termed Abductor or Obliquator externus. The first of the two supinatores is called the Long, or Longest, because it descends from the outside of the Arm above the processes thereof, and is inserted by a round and strong tendon into the lower Appendix. The other descends obliquely from the outward and upper process of the arm, and is inserted at the third part of the Wand by a membranous & fleshy tendon before and on the inside thereof. The upper of the two Extenders of the Wrest, descending above the wand from the external and upper process of the arm is inserted by two Tendons into the first and second bone of the Afterwrest, which sustain the fore and middle fingers. The other & lower, descending from the same place as the former, above the Cubit The lower. is inserted into the fourth bone of the Afterwrest which bears up the little finger. These muscles whilst they move alone, that is, each with his Antagonist, to wit the wrest-benders, they move obliquely upwards or downwards the whole hand properly so called. The first and greater of the Extenders of the fingers, or finger-stretchers The greater of the Digitumtensores. arising from the Olecranum, or bone of the Cubit, descends superficiarilie between the two bones of the Cubite even to the wrist, in which place it is divided into 4 tendons, which passing under the Ring seated there, end (each distinguished by a common ligament above the bone of the Afterwrest) in the last joints of the four fingers, adhering nevertheless firmly to the bones, which are above these joints. The other which is the lesser arising almost in the middle of the Wand, goes obliquely to the Thumb into which it is inserted by two Tendons; the one thicker The lesser. which is inserted into the root thereof, and draws it from the other fingers; the other slenderer continued even to the upper joint thereof, and by its action extending the Thumb. The seventh which is the Abductor or Obliquator, is seated at the hind part of the The Obliquator, or Abductor externus. hand, that is, towards the little finger; we have often found this divided in two, yea verily we have found it trifide, or divided into 3. this year in three or 4 dead bodies. one portion thereof went to the lower side of the Ring-finger with two Tendons, the other in like manner to the middle and fore-fingers, and the third to the Thumb. And for all that it is thus divided, yet some have taken and accounted it for one Muscle, because it hath one original and action, which is to draw the fingers backwards; some have added to this the extender of the Thumb by reason of their common original; and thus of 4. muscles they have made one divided into 7. tendons, distributed, as is formerly showed. But when the Obliquator of the Ring-finger is wanting, as it often happens, the extender of the finger supplies that defect by certain productions oftendinous strings. But some also have written, that this muscle which we said hath 7. tendons, is only a production of the deep fore muscle, which should be sent through the space between the bones of the Cubit; yet I had rather make it a muscle of itself, by reason of its straight adhesion with the bones of the Arm and Wand. And let thus much suffice for the external muscles of the Cubit, which you may comprehend in the number of seven, as we have done; or in six, if you take away one of the 4. or in nine, if you had rather resolve it into 4. with Galen; or in eight, if you divide this muscle only into three. For in very deed the Abductor or Obliquator of the Ring-finger is not often found in men. Now must we come to the inner muscles of the Cubit, the first of which compasses The muscles of the inner part of the Cubit. the skin of the palm of the hand, whence it is called the Palmaris. The second and third joined by the communion of their action turn down or prone the Wand, and consequently the hand, so that the palm looks towards the feet, whereupon they are called Pronatores. The 4. and 5. joined also in affinity of action bend the Wrest, wherefore they are named Carpiflexores, Wrest benders. The sixth and seaventh are appointed to bend the first, second, and third joints of the fingers, wherefore they are termed Digitumflexores, Fingerbenders. For their original; the Palmaris the least & uppermost The Palmaris of them all, descends fleshy from the hind process of the inner arm, & a little after ending in a long and slender Tendon, it is spent in the skin of the Palm of the hand even to the roots of the fingers. For it was necessary that this skin should straight cohere with the subjacent parts, not only for the fitter taking or comprehension of any thing, lest that skin in holding should be wrinkled & drawn away from the palm and fingers, and so be an impediment; but besides that the hand might have a more exact sense to distinguish of hot, cold, moist, dry, smooth, equal, rough, soft, hard, great, little, and such other qualities. Then follow the two Pronatores, of which one The Pronatores. called the round, comes obliquely from the inner side of the hind process of the arm almost to the middle of the Wand, to which it adheres by a membranous & fleshly tendon, even to the place appointed for insertion. The other square three or four fingers broad, yet somewhat slender, seated within under all the muscles which descend on the inside to the wrist or fingers, upon the ends of the bones of the Cubit, ascends transverse from below the Ell, unto the top of the Wand where it ends in a membranous tendon. Both the Carpiflexores, or Wrest-benders arise from the hind, but The Carpiflexores. inner process, and descend obliquely (the one more, or less than the other) the one alongst the Ell, but the other alongst the wand; and that which descends alongst the Ell, is inserted into the eight bone of the wrist, which we said made part of the Ring; the other which follows the Wand is inserted with his greater part into the bone of the wrist, and with the rest into the first bone of the Afterwrest which sustains the forefinger. The Digitumflexores. Now remain the Digitumflexores, or Fingerbenders, which because they lie upon one another, the upper is called the sublimis, but the lower the Profundus. The Sublimis The Sublimis Digitumflexor. or upper, arising from the inner part of the hind process of the arm, and from the upper parts of the Ell and Wand descends between these two bones of the Cubit even to the wrist and Ring; divided into 4. tendons it is inserted into the second dearticulation of the four fingers, which it bends by the force of this his proper insertion; as also the first, as well by the power of the common ligament, as by certain fibers coming from it, which it sends thither by the way in its passage. But these 4 tendons ne'er unto this their insertion are divided into two, so to give passage and ad strength to the tendons of the Deep muscles descending into the third and last joint of the fingers. The profundus Digitumflexor. But this same Profundus or Deep muscle arising from the upper and inner parts of the Ell and Wand, descends between these two bones under the Sublimis, also undivided even to the wrist, where it is divided into 5. Tendons which it brings forth under the common Ligament, and the divisions of the Tendons of the Sublimis even to the last joint of the fingers, which they bend, by this their proper insertion, as also the bones of the first and second joints of the fingers by the means of the common Ligament and fibrous productions which they bestow upon them by the way. Besides these forementioned there is seen also a certain membranous Ligament which engirts the tendons in the compass of the fingers. CHAP. XXIX. Of the Muscles of the inside of the hand. THe muscles of the inside of the hand are 7 in number; the first is called Thenar The number of the muscles of the inside of the hand. because it makes the greater part of the Palm; the second from the site is called the Hypothenar; the third the external Abductor of the Thumb. The 4. other are called by reason of their figure the Lumbrici or wormy muscles, or the Adductores, or Drawers of the four fingers to the thumb. Now the first called Thenar, The Thenar. thicker than the rest, arises from all the bones of the Afterwrest, taking its beginning from that bone which bears up the Ring finger, whence ascending alongst the Vital line even to the end thereof at the first bone of the Afterwrest sustaining the fore finger, & it is at length inserted into the last joint of the Thumb by the longest fibers, but by the middle and shortest fibers almost into all the inner part of the first bones of two joints, and by reason of this, the thumb is drawn to the other fingers, and from them again by his lower original. Some divide this muscle into three, by reason of his divers actions, making the first to arise from the root of the bone of the afterwrest which bears up the ring finger; but the other from that middle bone of the afterwrest which sustains the middle finger; but of the third, from the upper end of that bone which underprops therefore finger, and that the infertion of them all, is, as we formerly mentioned. But the former opinion likes me better, both for shunning confusion, and abbreviating the doctrine of the number of muscles. The Hypothenar arises from the fourth bone of the afterwrest, and that bone of The Hypothenar. the wrist which sustains it, and then with its longest fibers, it is inserted into the second joint of the ring-finger, and by the shortest into the first, through which occasion, as also in respect of its twofold action, some have divided it into two, that the one of them might lead it from the rest, and the other might draw it to the thumb. The third the external Abductor of the thumb, descends from the first bone of the The external Abductor of the thumb. The Lumbrici. afterwrest, into the first and second joint of the thumb; wherefore some have divided it into two. The Lumbrici, or four external Abductores of the four fingers arise from a membrane, investing and binding together the tendons of the Digitumflexores, or fingerbenders, and at length on the sides towards the thumb even by a small tendon, running even to the second joint of the four fingers. Now the Interosses of the afterwrest, remain to be spoken of; these are six, two The Interosses. in each of the spaces between the fingers, one Internal, the other external, of which the Internal descending with oblique fibers from the side of the first bone of the afterwrest, goes also into the sides of the fingers, that so it may the more closely bind together the bones of the afterwrest, whose action is manifested when we thrust our fingers into a straight glove, or when we bend our hand. Some think that it helps also the drawing of the fingers towards the thumb. The external ascends also by oblique fibers from the sides of the second bone of the afterwrest, to the first joints of the fingers, intersecting the internal which we now described after the manner of the letter X, for to extend the palm of the hand, and help the drawing away of the fingers from the thumb. Here concluding the description of the muscles of the whole hand taken in general, The number of the muscles of the whole taken in general. you shall note that they are 39 in number, that is, eight appointed to move the arm; four set to move the cubit in general; seven seated on the outside of the cubit, and as many on the inside in the same cubite, moving the wand, and with it the hand; seven on the inside of the hand: and lastly, the six Interosses. Some increase this number, saying, there are nine on the external part of the cubite, and eleven on the inside of the hand. CHAP. XXX. A Description of the Leg taken in general. AFter the hand follows the description of the leg. Wherefore to take a-away all doubtfulness, we will first define the leg; then divide it into the parts more and less compound; thirdly we will prosecute all things common to all these parts; fourthly, those which are peculiar to each, and then, God willing, we will give an end to our Anatomy. Now this word Crus, or Leg, is used two manner of ways, that is, either generally The divers acception of the Leg. and specially, and specially again after two sorts, that is, either absolutely and simply so, or with an adjunct. It is simply taken for all that which is between the knee and the foot. But with an adjunct for the greater bone thereof. But the leg taken in general, is the instrument of going, containing all whatsoever is from the hips, to the very ends of the toes. It is divided into three great parts, that is to say, the Thigh, the Leg, or Shank, and the Foot. By the thigh we mean that The thigh. The leg or shank. The foot. which lies between the hip and the knee. By the leg, properly so called, or shank, that which is contained between the knee and the foot. By the foot all from thence to the ends of the toes. Again, they divide the foot into three parts, that is, the Tarsus or Instep, the The division of the foot. The Instep. Pedion or top of the foot, and the Digitipedum, or toes. We understand by the instep, that which is contained in the first seven bones, which answers in proportion to the wrest of the hand. By the top of the foot, that which is comprehended in the The top of the foot. The toes. five following bones, which is answerable to the afterwrest That which remains, we call the toes. But because all these parts have other common and proper parts, we will only follow the distribution of the veins, arteries, and nerves; seeing we have sufficiently explained the rest, when we described the containing parts of the body in general. CHAP. XXXI. A Description of the crural vein. THe crural vein begins then, when the hollow vein passing forth of the The beginning of the crural vein. The two branches thereof. Peritonaum, and stretched to the haunch bone, and the sides of the Pubis in the groin, is first divided into two large branches; the one of which descends on the inside alongst the bones of the whole leg, together with the artery and nerve; the other runs down outwardly and superficially alongst the leg, between the fat lying under the skin, and the muscles even to the foot, and is spent in the skin thereof. This because it is always apparent and manifest, is called properly by the greeks Sapheia, but commonly Saphaena. This vein by the way presently at its original is divided into two branches, the By what veins, the matter causing those tumours called Bubones flows down. one internal, the other external; of which the internal is spent upon the Bubones, and other glandules of that place and the skin, and by this branch come the defluxions called Bubones; the other branch is wasted in the fore and utter skin of the upper part of the thing; then a little lower, that is, about the breadth of three or four fingers, it is gathered again into one branch made of many little ones, which is spent in the fore and hind skin of this thigh. Thirdly, a little below the middle of the thigh it is again divided into two other branches, of which the one goes into the skin on the fore side, and the other on the hind side. Fourthly, it is distributed by two other small sprigs into the skin, on the fore and hind part of the knee; which oftentimes are not found, especially when the Poplitea or ham vein, is somewhat larger than ordinary. Fiftly, a little below the knee, it produces two other branches, lying upon each other in their passage out into the fore and hind skin of that place. You must note, that branch which runs into the skin of the hind part, is carried by a certain other sprig, which it produces, into a branch of the Poplitea passing forth of the two twin muscles. Sixthly, in the bigger part of the calf of the leg, it is divided into two other branches, which in like manner are distributed into the skin, as well in the fore side as the back side of the leg. At length after many other divisions, which for brevity sake, I omit, when it arrives Where and in what diseases, the Sapheia must be opened. at the fore and inner side of the ankle (where it is commonly opened in the diseases of the parts below the midriff which require blood-letting) it is parted into two other branches, the lesser of which descends to the heel; the other in many sprigs is spent upon the skin of all the upper and lower part of the foot and toes. The second branch of this crural vein, which we said descends within together To what places, and by how manifold devisions the internal branch of the crural vein goes. Ischiadica Vena. with the artery and nerve, even into the foot, is divided; first piercing somewhat deep in, it produces four divarications; one internal descending below the original of the Sapheia into the muscle called Obturator externus, and into certain other external muscles. The three other run outwardly, the first towards the huekle bone, by which the Ischias is made, the two other into the fore muscles of the thigh, neither are these sprigs far remote from one another. Secondly, all that branch is divided into two other branches, the one above, the other below, an artery always accompanying it; the lower of which is spent upon many of the hinder Musc●la 〈◊〉 muscles of the thigh, ending nigh the ham. The upper, besides, that it bestows many branches upon the fore and inner muscles of the thigh, descending to the ham, it produces the Poplitea or ham vein, made sometimes of two branches, the one proceeding from above, and the other from below. This Poplitea descending by the Poplitea 〈◊〉. bending of the ham, is spent one while upon the skin of the calf of the leg, another while upon the knee, otherwhiles increased with branches of the Sapheia, it goes on the outside of the ankle to the skin, on the upper side of the foot, and sometimes on the lower. Thirdly, a little below the original of the ham vein, and under the bending of the knee, it brings forth the Suralis, which is bestowed upon the muscle of the Sura, Suralis vena● or calf of the leg, and upon the skin of the inner side thereof, and of the foot continued sometimes even to the inner part of the great toe. Fourthly, under the head of the hinder appendix of the bones of the leg, it produces between these two bones, another vein, which nourishing the fore muscle of the leg, is consumed upon the foot. Fiftly, and lastly, it brings forth the Ischiadica mayor or greater Ischias, which is divided Ischiadica maior. into two branches of an unequal bigness; the larger whereof, from his original descending alongst the inner part of the leg bone, insinuates itself under the muscles of the calf, between this and the heel, into the sole of the foot, upon which it is wasted, divided into ten small sprigs, two for each toe; the other being the lesser descending alongst the P●rone, or shinbone, is consumed between it and the heel, yet sometimes it is produced, not only even to the muscle the Abductor of the toes, but also by five surcles, even to the fourth toe, and the sides of the middle toe. CHAP. XXXII. The Distribution of the crural Artery. THe crural artery arising from the same place whence the crural vein proceeded, and descending with the internal crural vein is distributed as followeth. First, into the muscle of the thigh, which spreading itself through the muscula. muscles thereof meets with the utmost hypogastrica, descending with the vein through the common hole of the huckle and share bone, and is joined with it. Secondly, when it arrives at the ham, between the Condyles or processes of the leg, it sends two branches into the knee. Thirdly, a little after it produces another branch, which it sends to the exterior muscles of the leg, and when it arrives at the middle of the leg, it is divided into two branches, between the twin muscles and Solaeus, the one internal, the other external; the internal, some surcles communicated by the way to the parts by which it passes, but specially to the joint of the ankle, stretches itself over the sole of the foot, between the lower extremity thereof and he'll, whither, when it arrives it is divaricated into five surcles, of which it bestows two on the great toe, two on the next, and one on the middle toe. The external descending in like manner to the sole of the foot, between the fibula and the heel, besides other sprigs, which it may spread by the way, it produces one without on the joint of the ankle, another in the muscle, the Abductor of the toes, to the wrist and back of the foot. But the remainder is divided into five portions, of which two are sent to the fourth, and two to the little toe, and one to the middle. CHAP. XXXIII. Of the Nerves of the Loins, Holybone and Thigh. THere arise five conjugations of nerves from the loins, divided into external & internal branches; the external are disseminated into the Rachitae The five conjugations of the nerves of the loins. or chin muscles, the muscles Semispinatus and Sacer and the skin lying over them. The internal are sent into the oblique ascendent and transverse muscle of the lower belly, into the Peritonaeum, into the loin and chest muscles arising there, but after a different manner; for some are absolutely carried thither, as the nerves of the first conjugation of the loins, and oftentimes also of the second, but that sometimes they send a small sprig to the testicles, when the costal have Where the testicles have their nerves. sent none thither; but some lower are partly distributed there, and partly sent some other way; for the greater portions first united amongst themselves, then presently with the portions of these of the holybone, go into the thigh, as we shall show in the distribution of the nerves of the holybone. Now from the holy bone, proceed six conjugations of nerves, reckoning that The conjugations of the nerves proceeding through the holybone. for the first which proceeds from the last Vertebra of the loins, and first of the holybone; and that the sixth which proceeds from the lowest part of the holybone, and the first of the rump; these conjugations of nerves are divided into external and internal branches. The lesser external passing forth by the external and hinder holes of the holybone, are distributed into the parts properly belonging thereto, to wit, the muscles and skin thereof; for every nerve by the law of nature first and always yields to An Anatomis call axiom. the neighbouring parts, that which is needful, then presently to others as much as it can. Wherefore if thou wouldst know whence each part hath his vessels at the next hand, that is, the veins, arteries and nerves, thou must remember the site of each part and the course of the vessels, and to consider this, that the veins and arteries as speedily and conveniently as they can, insinuate themselves into the parts, sometimes at the head or beginning, somewhiles by the middle, or extremes thereof, as there is occasion. But a nerve principally enters a muscle at the head thereof, or at least not far from thence, but never by the tail, whereby it may easily be understood by what branch of each vein, artery, and nerve, each part may have nourishment, lift, and sense. The other internal branches of the foresaid conjugations go, especially the four uppermost united from their original with the three lowermost of the loins, into all the leg, as you shall presently hear. But the two lower are consumed upon the muscles called Levateres Any, the Sphincter muscle of the same place; besides, upon the muscles of the yard, and neck of the bladder in men, but in women upon the neck of the womb and bladder. For these parts admit another in their bottom from the costal nerve, being of the sixth conjugation of the brain; these thus considered, let us come to the nerves of the thigh, which (as we said) from their first original, as it werecompacted and composed of the greater portion of the three inner and lower branches of the loins, and the four upper of the holybone, are divided in the thigh into four branches, of which the first and higher descending from above the Peritonaeum, to the little Trochanter, is wasted upon the in ward and superficiary muscles of the thigh, and the skin which covers them a little above the thigh. The second, descending with the crural vein and artery by the groin, is divided into two branches like as the vein, the one internal, the other external, of which the internal descending with the vein and artery is sent into the inner and deep muscles of the thigh ending above the knee. But the external descending superficially with the Saphaeia, even into the foot, gives branches by the way to the skin which covers it. The third seated under these former, passing by the hole common to the share and hanch-bone, sends certain branches to the groins, to the muscles called Obturatores, to the Tricipites, and sometimes to the muscles of the yard, and it ends at the midst of the thigh. The fourth, which is the thickest, solidest, and hardest of all the nerves in the body, descending wholly from the productions of the holybone, and descending out-wardly between the lower part of the same bone, and the Os Ilium, or Hanch-bone to the thigh, bestows certain sprigs to the hind muscles thereof proceeding from the proturberation of the Ischium or hucklebone, and in like sort it gives othersome to the skin of the buttocks, and also to the skin covering the forementioned muscles. A little after, it is parted into two branches descending undevided even to the bending of the knee, they both are communicated by divers surcles of the muscles of the leg; yet so as the lesser produces another branch from the rest of the portion thereof descending on the fore part of the leg, alongst the shinbone unto the top of the foot, where it is divided into ten surcles scarce apparent to the sight, two running to each of the toes. The other greater descending in like manner in the remainder of its portion by the hindepart of the leg into the sole of the foot, casts its self with the veins and arteries between theheele and leg bone; where first divided into two branches, each of which presently parted into five, send two sprigs to the sides of the toes. And these are the most notable and necessary distributions of the vessels and nerves; we purposely omit others which are infinite, and of which the knowledge is impertinent. CHAP. XXXIIII. Of the proper parts of the Thigh. HAving explained the common parts of the leg in general; now we must come to the proper, beginning at the Thigh. The proper parts of the Thigh, are muscles, bones, and ligaments But because the demonstration of the muscles is somewhat difficult, if we be ignorant of the description of the bones from whence they arise, and into which they are inserted; therefore we judge it worth our labour, first to show the bones, and the dearticulation of these of the Thigh; beginning with these bones which are knit with the upper part of the holybone. And they are two in number, on each side one, commonly called the Ossa Ilium; each of these is composed of three bones, of which one Of how many bones the Ossa Ilium consist. What the Os Ilium strictly taken is. is the upper, another the lower and anteriour, and the third the middle, and after a manner the posteriour. The upper by a particular name is called the Os Ilium, the hanch-bone, and it is the largest and biggest, having a gristlely appendix in the compass thereof, even to the connexion it hath with the other neighbouring bones, whose upper part we term the right line thereof; but the basis, which is adjoined to it by Simphysis, we call the lip or brow thereof, because it stands both somewhat out and in, after the manner of the brow. But that which lies between the basis and What theline, lip, brow, and rib, of the Os Ilium are. strait line we name the rib; this same upper bone hath two hollow superficies, the one internal, the other external. The connexion thereof by Symphysis, is twofold, the one with the upper part of the holybone; the other with that bone we called the middle, and after some sort the posteriour; which taking its beginning from the narrower part of the Os Ilium, makes that cavity in which the head of the The Os Ischium, or hucklebone. thigh is received; this cavity the greeks call Cotyle, the Latins Acetabulum, and it is ended by the side of the hole common to it, and the share-bone; this middle, and in some sort posteriour bone is called properly and particularly the Os Ischij, or hucklebone, and contains nothing else but the forementioned cavity, but that on the hind and lower part thereof, it brings forth a process, which adjoins itself to the share bone at the lower part of the common hole, in which place it appears very rough and unequal, and it is called the tuberosity of the hucklebone, at whose extremity also it brings forth a little head somewhat resembling the process of the lowerjaw called Corone. The third bone named Os pubis or the share-bone, The Os pubis, or share-bone. flretches itself even to the highest part of the pecten, where meeting with the like bone of the other side, it is united to it by Symphysis, after which manner also, all these three bones are united; it is reported, that this bone opens in women in their travel, yet hitherto I can find no certainty thereof. The Figure of the Thighbone. A 1, 2. The head of the thigh going into the cup of the hipbone. B, 2, A sinus in the head of the thigh, into which is inserted a round Ligament. C 1, 2, The conjunction of the appendix of the thigh with the bone itself. D 1, 2, 3, the neck of the thigh. E, F, the two lower heads of the thigh. G, 1, 2, The conjunction of the lower appendix. H, 1, 12, A sinus betwixt the two heads of the thigh. K 2, A part of the lower head of the thigh, from whence the first muscle of the foot doth proceed. L 2, Another part from whence the second and first muscles arise. M 2, Another part to which the Tendon of the fifth muscle of the thigh is infixed. N 1, 2, A sinus of the outward side of the head for the fourth muscle of the leg. O 2, A sinus of the inside through which the tendons do pass. P 2, A protuberation at which the said tendons are reflected. Q 2. the upper process of the thigh, and betwixt Q and D is the sinus. R 1, 2, the union of the process with the thigh. S S 2, a rough line from the impression of the external processes. T 1, the anterior impression of the internal processes. e, betwixt T and V another impression higher than the former. V 1, 2, the fourth impression in the top of the process. X 3. Four X, show the four appendices of the thigh. Y 3, Three Y, show the three heads of the thigh. Z Z 3, Two processes of the thigh. a 1, the interior process of the thigh. b 1, the conjunction of the process with the thigh. c c 2, a line descending obliquely from the inner process. d d 2, a line running through the length of the thigh. e 2, the largeness of the thigh in this part. f 1, a roughness from which the eight muscle issueth. g, h 5, a knub of the Whirle-bone going into the sinus marked with I, which is betwixt the heads of the thigh. i 5, a sinus sitted for the inner head of the thigh. k 5, a sinus agreeing with the external head of the thigh. l 5, the lower asperity or roughness. m 4, the foreside of the patel or whirle-bone rough and unequal. You may perceive a manifest separation of these three bones in the Sceleton of a child; for in those who are of more years, the gristles which run between these connexion's turn into bones. Now follows the thighbone, the biggest of all the bones of the body; it is round, The descript of the thighbone. and so bended, that it is gibbous on the exterior and fore part thereof, that so it might be the safer from external injuries; but on the hind and inner part, it is hollow or simous, like to the back of an Ass, whereby the muscles might have a more commodious original and insertion. That simous part a little below the midst thereof, is divided into two lines, the one whereof goes to the internal tuberosity, the other to the external of the lower appendix of the same thigh. These are chiefly to be observed, because the oblique fibers of the vast muscles thence take their original. Besides, this bone hath two appendices in the ends thereof, as easily appears in The two appendices of the thighbone. a child's thigh; the upper appendix, makes the round head of the thigh itself, which (as every other appendix) seated upon a long neck, is received in the cavity of the hanch-bone by Enarthrosis; it is stayed and fastened there by two sorts of ligaments, of which the one is common, proceeding from the muscles, which descend from above, about the neck thereof; the other is proper, which is twofold, that is, one membranous and broad, proceeding from the whole cavity of the orb, or cup, descending about all the head of the thigh, above the neck thereof; the other thick and round, descending from the second cavity of the Cotyle itself, which is extended, even to the common hole at the top of the head thereof. Besides, under this head, that bone hath two processes, the one great and thick, The two processes of the thighbone make the two Trochanters. the other little and short. The greater seated in the hind part, is called the great Trochanter; the lesser situate in the inner part, is named the little Trochanter. But you must note, that the great Trochanter, on the higher and hind part thereof, which looks towards the head of this bone, makes a certain small sinus or bosom, into which the twin muscles and others, whereof we shall hereafter speak, are implanted; we must also consider the multitude of holes encompassing this neck, between the head and the two Trochanters, which yield a passage to the Whence the marrow becomes partaker of sense. vessels, that is, the veins, arteries, and nerves, into the marrow of the bone itself, whence the marrow itself becomes partaker of sense, especially on that part which is covered with a coat, and the bone lives and is nourished. The other Appendix of the thigh, that is, the lower, is the greatest and thickest, rising, as it were with two heads, which are divided by two cavities, the one superficiary and on the fore side, whereby it receives the whirle-bone of the knee; the other deep, and on the back part, by which it receives the gristlely and as it were bony ligaments, proceeding from the eminency which is seen between the two cavities of the upprer, appendix of the bone of the leg, which Hypocrates, lib. de fracturis, calls in his tongue Diaphysis. CHAP. XXXV. Of the muscles moving the thigh. THe muscles of the thigh are just fourteen in number, that is, two Their number. bend it, whereupon they are called the Flexores, or benders; three extend it, whereupon they are called Tensores, extenders; three move it inwards, driving the knee outwards, and drawing the he'll inwards, as when we cross our legs; yet some make these three one, and call it the Triceps, or threeheaded muscle. Six spread it abroad, and dilate it, as happens in the act of venery. Four of these are called Gemini or Twins, by reason of the similitude of their thickness, original inserrion and action; the two other are called Obturatores, because they stop the hole which is common to the share and backe-bones. Now one of the two Flexores, being round, descends on the inside with fibers of an The two flexores. unequal length from all the transverse processes of the loins, above the hind commissure of the haunch and sharebones, and is inserted into the little Trochanter; the other broader and larger from the original passes forth of the whole lip, and inner brow of the hanch-bone, and filling the inner cavity thereof, is inserted above the fore part of the head of the thigh, into the little Trochanter by a thick tendon, which it with the follow muscle lately described, produces, even from the fleshy part thereof, wherefore you need to take no great pains in drawing, or plucking them away. The three Tensores or extenders, make the buttocks, of which the first being the thicker, larger, and external, arising from the rump, the holybone, and more The three Tensores. than half of the exterior and hinder lip of the hanch-bone, is inserted by oblique fibers, some four fingers breadth from the great Trochanter at the right line, which we said, resembled an Asses back. The second, which is the middle in bigness and site, descends from the rest of the lip, and from the for● and outward rib of the hanch-bone, and above the midst of the bone, is inserted into the upper part of the great Trochanter by a triangular insertion above the upper and exterior part thereof. The third being lesser, shorter and thinner, lying hid under these former, proceeds from the middle of the external surface of the hanch-bone, and then is ins●ted into the greater part of the right line of the great Trochanter. These three muscles have a great and large original, but a narrow insertion, as it were by oblique fibers. Then follow those three muscles which move the thighs inwards, straiten and cross then, so that the knee stands forwards or outwards, but the heel is drawn inwards, Three Intromoventes. as you may understand by their insertion, although some think otherwise; But these three muscles by their original, partly fleshy, and partly membranous, arise from the upper and fore part of the circumference of the share-bone, and thence are inserted into the hind line of the hucklebone, some higher than othersome; for the lesser and shorter stays at the roots of the little Trochanter, the middle descends a little deeper, the 3. with the longest of his fibers, descends even to the midst of the line. This if it be so, that is, these muscles proceeding from the fore and upper part, to be inserted into the hinder line of the hucklebone, whilst they alone perform their action, and draw the thighs together, they will turn them outwards, just so as when we put them across, but they will not draw one heel to another, and put t●… he'll outwards, for such like motion is performed by the inner vast muscle of the thigh, moving the leg. Now follow the six which move the buttocks. The movers of the buttocks. The first, and higher of the Quadrigemini, or the four twin muscles, passes forth of the commissure of the holybone, with the bone of the rump, or rather from the lowest extreme of the holybone, and thence it is inserted into the cavity of the great Trochanter by a tendon of a sufficient largeness. The second proceeding from the hollow part or fissure, which is between the extremity of the hucklebone, and the tuberosity, or swelling out of the same, is inserted in like manner into the cavity of the great Trochanter. The third, ascends from the inner part of the swelling out of the hucklebone, a little above, between the two Trochanters, into the cavity of the greater of them. The fourth, and last, the lowest and broadest of them all proceeds from all the exterior protuberancie of the hucklebone, and thence is inserted into the great Trochanter, and these four muscles lie hid under the thick and more eminent part of the buttocks; wherefore that you may the better show them, they must be turned up towards their original. The two Obturatores remain to be spoken of, that is, the internal and external, The two Obturatores. both which arise from the circuit and circumference of the hole which they stop, which as we said is common to the share and hucklebone, but the internal ascends to the exterior root of the great Trochanter by the middle fissure between the upper part of the protuberancy of the hucklebone, and the spin which stands up in the hinder basis of the hanch-bone. But the external proceeds from the exterior cavity, and the middle space between the tuberosity of the hucklebone and cavity thereof, and is inserted in the lower part into the cavity of the great Trochanter, together with the Quadrigemini. If you would plainly see the exterior Obturator, you must either cut off the beginning of the threeheaded muscle, or handsomely pluck it away, and then extend it, and turn it up; The internal is easily discerned when the bladder is taken away. CHAP. XXXVI. Of the bones of the Leg, or Shank. THose which would describe the muscles of the leg, ought first to describe What the Paiella, or whirl bone of the knee is. the bones thereof, beginning at the Rotula, or whirle-bone of the knee. This bone is gristlely on the outside, and round in compass, but on the inner and middle part after some sort gibbous, but somewhat flatted at the sides, that so it may be fitlier applied to the joint of the knee, and fitted within the anteriour cavity of the two appendices of the thigh, and the upper and foremost of the leg. The use thereof is to strengthen the joint of the knee, and to hold the leg The use thereof. at his due extent, so that it may not be bended so far forwards, as it is backwards. The bones of the leg are two, the one thicker, called by the particular and proper What, and how many bones the leg hath. name, the Os Tibiae or legge-bone; the other which is lesser, is termed Perone, or Fibula, but commonly the lesser focile, (and in English it may be termed the shinbone.) The thicker being hollow and marrowie, is seated in the inner part of the leg, The legge-bone. having two processes, the one bigger, the other less. The bigger seated on the upper part of the bone, and conjoined to it by Symphysis, makes two superficial and side cavities disjoined by an indifferent rising; wherefore this bone is connext to the bone of the thigh by Ginglymos. For in the cavities thereof it receives the lower and hinder protuberances of the Appendix of the thighbone, but the middle eminency thereof, is received by it between the two protuberances thereof. This joint is strengthened, not only by the force of the tendons, or muscles ending there, but also of three strong ligaments, of which one proceeds from all the external, another from all the internal part of that connxeion; the third which we, out of Hypocrates, called Diaphysis, from the distance or space between them. What Diaphysis is. The other process of the legge-bone, which we called the less, seated in the lower part thereof, makes as it were a double cavity, whereby it receives the Astragalus or Pastern bone; but on the inside it makes the ankle, as the Perone makes it without: between these ankles the Astragalus is received on the sides, and turned as the nut in a Crossbow, as often as there is need to bend or extend the foot. Besides, this same leg-bone, being triangular hath three eminencies made in the shape of an Asses back; the sharper descends alongst the fore part, called by the greeks Anticnemion; the second resides on the inner part, and the third on the outer; all these must be diligently observed, and chiefly, that on the fore part; because it is as a guide and rule to a Chirurgeon in the well setting of a broken leg. The Perone, or shinne-bone, is The Perone fibula, or shinne-bone. seated, as it were, on the outside, and as behind the legge-bone; it hath also two appendices hollow on the inside, but gibbous on the out. This bone by the upper of these is fastened and inserted under the inner, and in some sort the hinder appendix of the legge-bone, so that it is in no sort articulated with the thigh, but serves only in stead of a leaning stock. But by the lower, this same bone is not only received in the lowest part of the leg, or ankle, or pastern bone, but also receives part thereof, which is joined on the same side with the heel, especially then when we bend our foot outwards. This bone is fastened to the forementioned bones by Synarthosis, but bound by strong ligaments proceeding from the same bones, and mutually sent from one to another, or if you had rather, from the upper into the lower, as we said in the arm. But this same fibula or shinbone is also triangular, having three lines, of which one stands outwards, another on the foreside, and the third behind. CHAP. XXXVII. Of the Muscles of the Legs. ALL the motions of the leg are performed by eleven muscles, of which Their number. there be six on the foreside, and five on the hind. But of these, some move the leg only, as those which take their original from the bone of the thigh; others truly move the leg, but with the thigh, as those which arise above the thigh, that is, from the haunch, huckle, and sharebones. The first of these on the foreside, called the Long, but commonly the Sutorius (or The Longus. Tailor-muscle by reason of its action) it arises from the lower and fore extremity of the spin or appendix of the hanch-bone, and descending obliquely above the other muscles, is inserted by a large and membranous tendon, into the fore and inner part of the leg under the knee; the action thereof is to cross the legs, but being first bended by the muscles presently to be treated of, it helps also the three headed muscle in the performance of the forementioned action. The second of these fore muscles is termed the membranosus, or membranous, The Membranosus. because it is wholly such, unless at the original where it descends fleshy from the root and basis of the above mentioned spin of the hanch-bone, and that obliquely with its membranous and broad tendon (mixed with the common coat of the muscles) into the outward part of the leg, which it moves outwards, as also the thigh with the four twin muscles; for as we have in another place observed, of two oblique motions, concurring in one, is made a right motion; and besides, almost all the motions of the body, are thus performed; the muscles which perform such motions are placed and opposed in an oblique site, as may be perceived by the motions and site of the muscles of the hand taken in general. The third, called the Rectus, or right (because it descends above the Crurcus, alongst The Rectus. the right fore-line of the thigh, between the two vast muscles) comes forth between the extremity of the appendix of the hanch-bone and cavity thereof, with a very strong ligament, and then is inserted into the fore part of the leg, passing over the midst of the whirle-bone of the knee; it extends the leg, with the three following, but by accident it may help the bending of the thigh. The fourth and fifth are called Vasti, vast or huge muscles, by reason of their largeness; the one of these is internal, the other external: they both arise The two Vasti. with right fibers, from their original, but with oblique at their insertion, by reason whereof they both seem to have a compound action from a right and oblique motion; the right helping for the extension of the leg, but the oblique to draw one knee to another, or to desjoine both the knees; the internal comes by its right fibers from the root of the little Trochanter, but by its oblique from the innerdescendent line of the thigh. The external passes forth by its right fibers from the root of the great Trochanter, but by the oblique from the external descendent line of the same bone. But all these fibers are in certain places so mixed with the Crureus that they cannot be separated unless you violate the one of them; they go into the leg (each on his side) above the whirle-bone of the knee alongst the sides of the right muscle, with which it makes an unseparable tendon, as you shall presently hear. The sixth and last of these fore muscles called the Crurcus, or Thigh-muscle, The Crurcus. (by reason of the strait and firm adhesion, which it hath with the thighbone, which is by some called Crus) from the space between the two Trochanters descends under the right muscle, and two vast muscles into the fore part of the thigh, even to the whirle-bone of the knee. But we must note that these four last muscles make a common thick and broad tendon with which they cover the Patella, or whirle-bone, and all the fore dearticulation of the knee, that they cannot be separated without tearing; wherefore we must think that this tendon, serves the knee for a ligament; now all these muscles performing their action together, extend the leg. The five hind muscles follow to be spoken of, of which three arise from the tuberosity of the hucklebone, going into the inner part; the fourth from the middle The three Internal. of the Pubis, called Biceps, that is, the two headed muscle into the outside of the leg. Of the internal, one passing from the forementioned tuberosity, descends ligamentous even into the midst of the thigh, and then becoming fleshy, is inserted by its tendon, after the manner we formerly mentioned. The other being slender, passing forth also from the same place, with its tendon, is inserted with the tendon of the long muscle, and ends in the inner part of the leg, which with its companion, it draws inwardly, and brings to the other, which same thing it performs in the thigh, by the help of the three headed muscle. The third, being the inner, or hinder, descends from the middle part of the share-bone, with a broad and slender ligament, and is inserted with a round tendon, into the inner part of the leg after the manner of the forementioned. The fourth called Biceps takes one of the two heads, of which it consists, from the last mentioned tuberosity; the other from the outer line of the thigh, but is inserted The Biceps, or two-headed muscle. into the external part of the leg, as we formerly said. The fifth and last called the Popliteus descends obliquely fleshly from the external condyle or knot of the thigh, into the inner and hinder part of the leg, at the The Popliteus or ham muscle. joining thereof to the shinne-bone; the action thereof is, to draw the leg, after a manner inwards. CHAP. XXXVIII. Of the Bones of the Foot. THe Order of Anatomy requires, that we now prosecute the muscles moving the foot; but because we should in vain deliver their insertion, the disposition and condition of the bones of the foot, not being first known, wherefore it first behoves us, to set forth their description. Therefore the bones of the foot are six and twenty in number, distinguished into three ranks, that is, the bones of the Tarsus or Instep, are seven; these of the Pedium, the afterwrest, Their number The bones of the Instep. or back of the foot, five, and those of the toes fourteen. Of the seven bones of the instep, there are 4. named, and 3. unnamed. The first of the named immediately following the bones of the leg, is called Astragalus, the pastern, or ankle-bone. This hath three connexion's, one, as we said before, in the upper and broader The Astragalus, it's three connexion's, and their use. part with the bones of the leg, of which it is received; the other in the lower and hind part, by which it receives the upper and inner process of the bone of the heel; the third on the foreside by which it is received in the cavity of the Os naviculare or Scaphoides, that is, the boate-like-bone. By the first connexion the foot is extended and bended; by the second it is moved with the heel to the sides: the two first connexion's are by Diarthrosis, the last by Synarthrosis. But it is strengthened by strong and broad ligments, descending, and ascending from one bone into another; also they are strengthened by membranes, muscles and tendons, descending to the foot, above and under these joints. But this bone hath 3. processes, as 3. feet fastened to the bone of the heel; of which the first and least is under the outer ankle; the It's three processes. bigger (which Galen saith, makes a round head, fastened on a long neck) looks towards the fore part of the foot, over against the great toe, and the next toe to it; the middlemost is at the heel, behind the legge-bone. I pass over in silence many other things, as the smoothness and asperity or roughness of the bone, which I had rather you should learn by ocular inspection, than by book. The second bone lying under this is called the Calcaneum, or heelebone, being The description of the Calcaneum or C●…. the biggest of all the bones of the foot, upon which all the body relies when we go. It hath two upper processes, the one great, the other little. The great is received in the hind and outer process of the Astragalus; the lesser is received on the inside in the 3. process of the same bone, which we said had a round head fastened to a long neck. Besides, it is round on the hind part, and much disjoined from the legge-bone, but on the fore and longer part, it is knit by Synarthrosis to the Die-bone, whose lower and inner part, it seems to receive; the superficies thereof is wholly unequal, and rising up with many swellings. On the inner side it makes as it were a channel, so to give way, as well to the vessels as tendons going to the sole of the foot and toes. Lastly, we must consider the holes by which the vessels pass into that bone to give it nourishment; by reason of which vessels the fracture of this heelebone, is very Why a fracture of the heel is so dangerous. Hypocrates, Sect. 3. lib. de fracturis. dangerous, because of the pressing and contusion of the vessels; as Hypocrates shows. For the ligaments of this heel, or heelebone they are such, as these of the Astragalus, to wit, tendons, membranes and ligaments properly so called, coming from one bone to another. The third bone of the foot is named Scaphoides or boatelike, from the resemblance it hath to a boat, for on that part which looks towards The Os Scaphoidos, or boate-like-bone. the postern bone, it is hollow; but on that part which is next the three Innominata, or nameless bones (which it sustains, and of which it is received, as it in the cavity thereof receives the head of the Astragalus) it is gibbous like the bottom of a boat. The connexion's thereof are by Synarthrosis, and they are strengthened by the forementioned ligaments; this same bone is arched on the upper part, but somewhat hollowed or flatted below: the inner part ends in a point, like the prow of a ship, but the outer obtuse like the stern of a ship. The fourth bone of these which have names, is called the Cuboides, from the resemblance of a Die; although that similitude be very obscure. On the fore part it sustains the toes; which by a certain proportion The Os Cuboides or Die-bone. to the fingers of the hand, may be called the Ring and little toes, but it is sustained on the hind part, with the back part of the heel; on the inner side it is joined with the boat-like-bone, and that nameless bone which sustains the middle toe; on the outside, it produces a rising like the back of an Ass, which on the lower part is extended transversly all the length thereof; at the two sides of this eminency or rising, there are two small cavities, in the form of a channel. The first and the greater of the Ossa innominata, or nameless bones, sustains the great toe; the lesser and second, The Ossa innominata, or nameless bones. the next toe thereto; the third and middle in bigness, the middle toe. These three bones are arched on their upper part, but somewhat hollowed below. They are knit to the three forementioned bones by Synarthrosis, of which they are received, but on the hind part with the boatelike bone which they receive. Now we must come to the bones of the second rank, that is, of the Pedium, or back of the foot; these are five in number, bearing up the five bone of the toes. They are somewhat The bones of the foot or Pedium. gibbous on their upper part, but hollow below; each of them hath two processes at the end thereof, by the lower and first of which they receive the three nameless and Die-bone, but by the upper made into a round head, they are received of the first bones of the toes. Their connexion's, whether with the toes, or bones of the instep, are by Synarthrosis. The ligaments as well proper as common are such, as we said of the former. The bones of the third order now remain to be spoken of, which we said, make the toes, and they are fourteen, two of the great toe, but three of each The bones of the toes. of the other toes. The first is somewhat longish, but the rest are very short, except that of the great toe, all of them on the upper side are round and convexe, but on the lower somewhat hollow, and plain longwise, that the tendons which bend them, may pass more straightly and safely without inclining to either side, even to their furthest joints; although such passages are much helped by the membranous and common ligament, which rising from the sides of these bones, involves these tendons, as we mentioned in the fingers. To conclude, each of these bones the last excepted, have a double connexion by Diarthrofis, they are all unequal in their bigness, that is, thick at their beginning (where they receive the heads of the precedent bones, upon which they move, as a door upon the hinges) and so they grow smaller towards the ends, but by their ends, they are received of the following bones: at their ends they rise into two eminencies on their sides; distinguished by a cavity between them, through which occasion they are far thicker at their ends, than in their middle. The Figure of the bones of the Foot properly so called. Figure 1. and 2, show the bones of the right foot fastened together their upper face and their neither face. Fig. 3, 4, 5; and 6, show the upper, lower, inner and outer sides of the Talus or pastern. Fig. 7, 8, 9, sheweth the same sides of the Heel. Fig. 10, and 11. showeth the forward and backward side of the boat bone. Fig. 12, and 13, show the fore and back part of the wrest made of four bones. ABCD 3, 5, 6. The protuberation of the Talus joined to the appendix of the leg-bone, and of this protuberation four sides. EE, 3, A sinus ensculpted in the protuberation of the Talus. FF 3, two bunching parts of the Talus. G 3, the inner side of the protuberation of the Talus crusted over with a gristle, joined to the inner ankle. H6, The outward sinus of the protuberation of the Talus covered over with a gristle, and receiving the inner ankle. I5. A rough sinus of the Talus, receiving a gristly ligament from the inner ankle. K6, a sinus of the Talus receiving a griftly ligament from the outward ankle. LM 5, 6, two sinus in the hinder part of the Talus. N 3, 4, 5, 6, the neck of the Talus or pastern bone. O 3, 4, 5, 6. the head of the Talus going under the sinus of the boat bone. P 7, 8, 9 the head of the bone of the heel crusted over with a gristle, and going under the sinus of the Talus or the pastern bone. Q, 4. a large sinus of the Talus receiving the head of the heel. R 7, 8, 9 a sinus of the heel whereto the lower part of the head of the Talus is joined. S 4, the lower part of the head of the Talus going into the sinus of the heel. TT 4, a sharp sinus of the heel receiving a gristly ligament from the pastern bone. XYZ 2, the place of the heel. YZ 2, Y 8, Z 9 a process of the heel made for the production of muscles. a b 7 8, 9, from a to b the distance of the upper part of the heel. c 8, 9 the hinder part of the heel. d 2, 8, the inner side of the heel. e 8, the place where the tendons that run to the bottom of the foot are reflected. f 7 8, the utter side of the heel. g 1, 7, 9, here the tendons of the 7 and 8 muscles of the foot are stretched out. h 7. the forepart of the heel which is joined to the pastern bone. i 7, that part of the heel which is joined to the Cubebone. k 11, the sinus of the Boat-bone receiving the head of the Talus. Imn 10, three surfaces of the Boat-bone lightly prominent, which are articulated to the bones of the wrist, op 11, the upper part of the Boat-bone regarding the top of the foot. q r 10, and q 11, his lower part. q 10, 11, A sinus through which the sixth muscle of the foot is led. s t u 13. the plain surfaces of the three inner bones of the wrest whereby they are articulated to the Boat-bone. x 13, a shallow sinus of the Cubebone whereby it is articulated to the heel, αβ 12, the place of the Cube bone to which that bone of the Afterwrest is joined which supporteth the last Toe save one. γ 12. 13, the place of the Cube bone where the third bone of the wrist is articulated. δ 12, 13. that part of the Cube bone which respecteth the outside of the foot. ε 12, 13. the surface of the Cubebone in the upper part of the foot. ζ 2, 13, that part of the Cube bone which regardeth the earth. ● 2, a sinus of the Cubebone at which the tendon of the seventh muscle of the foot is reflected. B 13, a process of the third bone of the wrest whereinto the fifth muscle of the foot is inserted. ● 12. the place of the inner bone of the wrist to which that bone of the Afterwrest which sustaineth the great Toe is coupled. χ 12, the place of the second bone of the wrest whereto the bone of the Afterwrest that supporteth the fore Toe is articulated. λ 12 the place of the third bone of the wrest whereto that bone of the Afterwrest which supporteth the middle toe is articulated. μ 1, 2, a small bone whereby that bone of the Afterwrest which sustaineth the little toe is joined unto the Cubebone. yy 1, 2 the distances betwixt the bones of the Afterwrest. ξξ, 1, 2, the heads of the bones of the Afterwrest which enter into the bosoms of the toes. π 2, a process of the bone of the afterwrest wherein the tendon of the seventh muscle of the foot is implanted. ● 2, a process of the Bone of the Afterwrest, which sustaineth the little toe, which process receiveth the tendon of the eight muscle of the foot. ζ, τ, ν, 1, 2, the three bones of the foretoe. Ψ, ω, 2, two seed bones placed under that bone of the afterwrest which sustaineth the great toe, ● 2 under X. a seed bone set to the second joint of the great Toe. Γ, 1, 2, the Talus or pastern. Δ, 1, 2, the Heel. θ, 1, 2, the Boat-bone. Λ, Ξ, 1, 2, the bones of the toes. φ, Χ, 1, 2, two bones of the great toe I, two, III, IV, V, 1. the five bones of the afterwrest. The Ligaments by which their connexion's are fastened, are such as the former. The Ossa sesamoidea or Seedbones of the feet are like in number and site to these of the hands. But this is to be noted, that those Seedbones which are in the first articulation are somewhat bigger than the rest, and they are round and longish on the out side, but smooth and hollow on the inside, seated between two cavities, encompassed The Seedbones of the foot. by three risings, of which two are on the sides, and the third in the midst of the extremity of the first bone of the Pedium, which chiefly bears up the great toe. To conclude, before we come to speak of the muscles, we must observe that the foot was made for two commodities. The first is to stay and bear the whole body when we stand, for which cause nature set not the great toe contrary to the other, as it placed the Thumb on the hand. The other is for apprehension, or taking hold of, wherefore nature framed and made the foot and these movable and jointed in the toes, as in the fingers of the hand. Besides also for that we must go upon The twofold use of the feet. our feet, Nature hath made them in some places hollow on the lower side, & in other some plain in a triangular figure, that so our feet may carry us over every soil, plain mountainous, equal and unequal, through all parts of the world. CHAP. XXXIX. Of the Muscles moving the foot. THe muscles of the Leg moving the foot are absolutely nine, three in the fore part and six in the hind. Two of the three fore muscles bend the Their number. foot, when they jointly perform their action, but when severally, each draws it to his side; the third chiefly extends the Toes, for other whiles it seems by its slenderer and longer Tendon (which exceeds not that bone of the Pedium which sustains the little Toe) to help also to bend the foot. The first is called Peronaeus, because it descends alongst the bone Perone; the other the Tibiaeus anticus, for that it descends along the Os Tibiae, or bone of the Leg. The Musculus Peronaus. third from its action is called the Digitumtensor, or Toestretcher. For their original the Peronaeus which seems to have two heads, descends from the upper appendix of the Perone or shinbone by its first head, but by the other from the middle of the same bone from the fore side into the hind, as the superficies shows which passes between the fore and outward line of the said bone; but after it arrives at the lower and hinder appendix of the same bone, behind the outer Ankle it produces two tendons, which by the guidance of the Ligaments as well proper, as common, go the thicker under the sole of the foot, ending in the Die-bone and that bone of the Pedium which sustains the great Toe; the lesser goes on the outside to the Die-bone, & the last & least bone of the Pedium which bears up the little Toe, sometimes a slender portion thereof is produced even to the side of the little Toe, extending it and drawing it from the rest. The Tibiaeus anticus or Fore leg muscle proceeding Tibiaeus anticus. from the upper and outer appendix of the Leg-bone descends above the surface of the same bone, which is between the fore and outer line to which it adheres, as also to that surface even to the midst, from which place it produces one tendon, which descending on the fore and lowest part, ends on the outside into two of the nameless bones, that is, into the first which is the thicker, and into the middlemost, but besides by a slender portion thereof it is extended into the first and greater bone of the Pedium, so to extend the great Toe, drawing it inwards to the other foot. And this muscle with the precedent bends the foot, if they both perform their parts at once; but if severally, each draws the foot towards his side. The third which is the Digitumtensor, or Toestretcher, is two fold; the one takes its original from the top of the Leg, and running alongst the shinbone and passing under the ring, carries itself into the foot, in which it ends by five tendons going to all the joints of the Toes, and by a sixth at that bone of the Pedium which The Toestretcher is twofold. sustains the little Toe, whereby (as we formerly said) it helps the bending of the foot. The other descends into the midst of the shinbone, and somewhat fastened thereto by one tendon passing under the Ring it goes to the great Toe. But you must note that all these Tendons have nervous, ligamentous and fleshy fibers so separated from each other, that they can equally alone perform their function, as if they were more distinct muscles. And we must think the same of the rest which have distinct Tendons presently from their fleshy part. The 6 hind muscles. The six hind muscles follow, of which the two first are called the Gemelli or Twins by reason of the similitude of their thickness, original, insertion and action. The third is called the Plantaris, because it is spent upon the sole of the foot, as the Palmaris upon the palm of the hand. The fourth is termed the Soleus' or sole muscle by reason of the resemblance it hath to the fish of that name. The fifth the Tibiaeus posticus or hindlegge Muscle which descends alongst the back part of the leg-bone. The sixth and last the Digitumflexor or Toe-bender, equivalent to the Deep muscle of the hand, some make but one muscle of this and the Tibiaeus posticus, The 2 Gemeli or Twins muscles. which produces three tendous; others had rather make three, as thus, that one should be the Tibiaeus, the other the bender of four Toes, the third the bender of the great Toe. Now for the two Gemelli or Twins, the one is internal, the other external; the internal passes forth from the root of the inner Condyle of the Thigh; but the external from the external Condyle; and from this their original presently becoming fleshy, especially on the out side, they meet together a little after in their fleshy parts, and with the soleus they make the thick and great Tendon at the midst of the leg, which from thence is inserted into the back part of the heel; in this very Tendon breed painful kibes. The action thereof is, to help our going by putting Yn what place the kibes breed forth the foot, whilst it draws the Heel towards its original. The Plantaris the least and slenderest of them all, passes forth fleshy from the outward head of the legge-bone, and from thence the space of some four fingers breadth The Plantaris it ends in a strong and slender Tendon, which it sends between the Twin and sole muscles to the sole of the foot, there to produce a membrane which covers the sole of the foot, and a muscle equivalent to the upper bender of the Hand. The Soleus', or sole muscle the thickest of them all, and seated under the Twin The Soleus'. muscles, descends from the commissure of the leg and shinbones, and about the midst of the leg, after it hath mixed his tendon with that of the Twin muscles, it runs into the foresaid place that it may extend the foot for the foresaid use, The Tibiaeus posticus descends from the hinder appendix of the leg and shinbones, The Tibiaeus Posticus. and adhering, to them almost as far as they go, by a strong Tendon, being as it were bony at the end thereof, it is inserted into the Boatlike bone and the two first nameless bones so to help the oblique extension of the foot. The last being the Digitumflexor or Toe-bender is twofold, for one arises from the legge-bone, in that place where the Poplitaeus ends, and inserted into that same bone it The Digitumflexor twofold. goes even to the backside of the inner ankle & from thence into the joints of four of the toes. The 〈◊〉 draws his original from almost the middle of the shinbone, and somewhat inserted into it, it goes by the heel and pastern bone to the great toe, mixed with the precedent; their action is to bend the first joint of the Toes, rather by the force of the common Ligament, than by the small portion of the Tendon which ends there. But it is their action to bend the last dearticulation of the Toes by their proper insertion. CHAP. XL. Of the Muscles moving the Toes of the feet. NOw follow the muscles moving the Toes; these are eight in number, one on the upper, and seven on the lower side. The first proceeds Their number. from the Pastern, heel and Die bones below the external Ankle, or the Ligament of these bones with the Legge-bone, and obliquely stretched to the top of the foot is parted into five small tendons to the sides of the five toes, so to draw them outwards towards its original, whereupon The Abductor of the Toes, or Pediosus. it is called the Abductor of the Toes, and also Pediosus, because it is stretched over the Pedium, or back of the foot. The first of the seven of the lower side called the flexor superior or upper bender, The Flexor superior. arises from the heel and stretched alongst the foot under the strong membrane, (which from the heel is straight fastened to the extremity of the bones of the Pedium to strengthen the parts contained under it) is inserted by four Tendons, at the second joints of the four Toes which it bends. Here you must note that near the insertion thereof, this muscle divides itself, like that muscle of the hand which is called sublimis, that so it may give way to the Deep, which (as we said) descends alongst the fingers, to which a certain common membranous Ligament adjoins itself, which involues and fastens it to the bone all alongst the lower part of the fingers, even to the last dearticulation. The second equivalent to that muscle of the hand which is called Thenar, seated The muscle equivalent to the Thenar. on the inner side of the foot, arises from the inner and hollow part of the heel and pastern bones and ends in the side, and inner part of the great Toe, which it draws from the rest, inwards. This may be divided into two or three muscles, as the Thenar of the hand, to draw the great Toe to the rest, as much as need requires, just as we said of the Hand. The third answerable to that of the hand which is named the Hypothenar, passes from the outer part of the heel and ascending by the sides of the foot it is in like manner inserted into the side of the little Toe, so to draw it from the rest; to which same action a certain flesh contained under the sole of the feet may serve, which is stretched even to these Toes, that also it may serve to hollow the foot. The four Lumbrici or wormy muscles follow next, which from the membrane of the The 4 Lumbrics. Deep Toe-bender are inserted into the inner & side part of the four Toes, so to draw them inwards, by a motion contrary to that which is performed by the Pediosus. The Interosses or bone-bound muscles of the Pedium or back of the foot, remain to be spoken The description of the upper and lo●… Interosses. of: These are eight in number, ●oure above, and as many below, different in their original, insertion and action; for the upper because they draw the foot outwards with the pediosus, arise from the fore and inner part of that bone of the pedium, which bears up the little Toe (and so also the rest each in its order) and are inserted into the outward & forepart of the following bone. The lower on the contrary pass from the fore and outer part of that bone of the pedium, which bears up the Great Toe (and so each of the rest in its order,) but are inserted into the inner and upper part of the following bone, so with the wormy muscles to draw it inwards, or to hollow the foot as the outwards, or to flat the foot, as we said of the Interosses of the hand. CHAP. XLI. A● Epitome or brief recital of the bones in a man's body. This first showeth the forepart of the Sceleton of a man, etc. The Declaration of these three figures put into one. A 3. The coronal Suture called in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. B 23. The suture like the letter 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. C 2, The sagittal Suture called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. D 2, 3. The scale-like Conjunction called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. α 2, 3, Os verticis, or syncipitis, the bone of the Synciput, called Os 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. β, 1, 3. The forehead-bone, that is, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. γ, 2, 3. The bone of the Noll or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. δ, 2, 3. The bones of the temples or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ε, 3. An appendix in the temple-bone like a Bodkin, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ζ 1, 2, 3. A process in the temple-bone like the teat of a dug, called therefore Mamillaris & 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 E, 2, 3. the wedgebone, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 〈◊〉, 3, the stony part of the Scull. 〈◊〉, 3, a process of the wedgebone much like the wing of a Bat, and therefore called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The 2 and 3 Figures showeth the backside of the Sceleton. and the lateral part of the Sceleton. F, 1, 2, 3. the yoke-bone 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. G 1, 3. the lower jaw. ay, K, L, M, N, 1, 2, 3. the back or the spin, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. From I to K, the Neck, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. From K to L, the Rackebones of the Chest. From L to M, the rackebones of the Loins. From M to N, the Holybone, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. N, the Rump bone, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. O, 1, 3. the brestbone, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. P, 1, 3. the Sword-like gristle of the breast, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Char. 1, 2, 3, as far as to 12. in all three Tables, show the twelve ribs of the Chest 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Q 1, the clavicles or collar bones, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. R, 1, 2, 3 the shoulderblade, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. λ, 1, 2, 3, the upper process of the shoulderblade, or the top of the shoulder, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 μ, 1, 3, The lower process of the shoulderblade: called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. S, 1, 2, the bone of the arm, called Humerus and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. T, V, 1, 2, 3, the Cubit 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. X, 1, 2, 3: the wand or the upper bone of the Cubit, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Y, 1, 2, 3, the ell or lower bone of the Cubit, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. y 3, the process of the Cubit, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ξ, 13, the process like a bodkin or probe, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ZZ: 1, 2, 3, the wrest 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ΓΓ, 1, 3, the afterwrest 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ΔΔΔ. 1, the finger's 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. θ, 1, 2, 3, the bones joined to the sides of the Holy bone, on each side, distinguished as it were into three parts. 0, 1, 2, 3, the first part called the Hanch-bone, Os Ilium, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. α, 1, 2, 3, the second part the bone of the Coxendix 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 〈◊〉, 1, 2, 3, the third part the share-bone, Os pubis 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. σ, 1, 2, 3, a gristle going between the conjunction of the sharebones. Λ, 1, 2, 3, the thigh, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. τ, 1, 2, 3, the greater outward process of the thigh called Rotator 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ν, 1, 2, 3, his lesser and inner process. 〈◊〉, 1, 2, 3, the whirl bone of the knee, Patella Rotutula, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Π, Σ, 1, 2, 3, the leg, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, φ, 1, 2, 3, the inner & greater bone of the leg 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. ψ, 1, 2, 3, the utter and smaller bone of the leg, called the Brace-bone, Fibula, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. φ, 1, 2, 3, the process of the Leg or the inner ankle called Malleolus internus. Χ, 1, 2, the process of the brace of the outward ankle, both of them are called in greek, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. φ, 1, 2, 3, the bone called the cockal, Talus, balista, Os 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. a, 2, the Heel Calx, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. b, 1, 3, the bone called Os Naviculare, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. cc, 1, 2, 3, the wrist of the foot called Tarsus, consisting of four bones, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. d, e, f, 1, 2, 3, three inner bones of the wrist of the foot, called by some 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 g, 1, 2, 3, the utter bone of the wrist of the foot like a die, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. hh, 1, 2, 3, the after wrest of the foot called Pedium, by some 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. two, 1, 2, 3, the toes of the foot. k, 1, 2, 3, the seed bones of the foot, called oscicula sesamina, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. This figure showeth the Sceleton of the bones & gristles of a woman, that it may appear all her bones are in proportion lesser than the bones of a man. But in this figure only those parts are marked with letters wherein a woman differeth from a man in her bones and gristles. A, The sagittal suture descending into the nose, & dividing the fore head bone, which is sometimes found in women, very rarely in men, but always in Infants. BB, the Chest somewhat depressed before, because of the Paps. CC, the collar bones not so much crooked as in men, nor intorted so much upward. D, the brestbone perforated sometimes with a hole much like the form of a heart, through which veins do run outward, from the mammary veins unto the paps. E, the gristles of the ribs, which in women are somewhat bony, because of the weight of the Dugs. F, a part of the back reflected, or bend backward above the loins. GG, the compass of the hanch-bones running more outward, for the womb to rest upon, when a woman is with child. HH, the lower processes of the sharebones, bearing outward that the cavity marked with K, might be the larger. ay, the anterior commissure or conjunction of the sharebones filled up with a thick gristle, that in the birth they might better yield somewhat for Nature's necessity. K, A great and large cavity circumscribed by the bones of the coxendix and the Holybone. L, The Rump or Coccyx, curved backward to give way in the time of the birth. M, the thigh bones by reason of the largeness of the foresaid cavity, have a greater distance betwixt them above, whence also it is that women's thighs are thicker than men's. For the bones of the face, there are six within or about the Orb of the Eye, that The bones of the face 15. is, on each side three; two bones of the Nose, two lesser jaw bones, and two bigger, which are always in beasts seen distinguished by a manifest difference, but it is so rare in men, that I have not found it as yet; therefore these only are distinguished by manifest difference, two which contain all the upper teeth, the two inner of the palate, the two of the lower jaw in children; And last of all the Os Cristae, whence the middle gristle or partition of the nose arise. The two and thirty teeth are equally distributed in the upper and lower jaws; and of these there be eight shearers, four fangs, or Dog-teeths, and twenty Grinders. The teeth 32. And there is another bone at the root of the tongue called Os Hyoides, always The bone Hyoides composed of three bones, sometimes of four. Now follow the bones of the Spine, or Backbone, which are just four and thirty, The bones of the spin 34. that is, seven of the neck, twelve of the Chest, five of the loins, fix of the holybone; and four of the rump. Besides there are two bones of the throat, or Collar bones. 2 Coller-bones. The Ribs 24. The bones of the Sternon 3. The Ribs are twenty four, that is, fourteen true and ten bastard ribs. The bones of the Sternon or Breastbone most frequently three, other whiles seven, as sometimes in young bodies. Hence coming to the Arms there are reckoned 62, beginning with the shoulderblade; as there are two shoulderblades; two Arm bones; four bones of the Cubite; The bones of the whole arm 62. that is, two Ell-bones and two Wands; sixteen of the Wrest, eight of the Afterwrest, and thirty of the fingers: into this number also come the Sesamoidea, or seedbones, of which some are internal, & these always twelve at the least, although sometimes there may be more found, a great part of which rather merit the name of Gristles, than bones; there are others external if we believe Silvius. Now remain the bones of the Leg, which (if we reckon the Ossa Ilium on each side three, as in young bodies, it is fit they should) they are sixty six, besides the seedbones, The bones of the whole leg, 66. that is to say, two Haunch-bones, two share bones, two Hucklebones, two thigh-bones, two Whirlbones' of the knees, four of the leg, that is two leg-bones, and two shinbones. Fourteen of the Instep, as two heel, two pastern, two boatlike, two Die, & six nameless bones. Ten of the Pedium or back of the foot, that is, five in each foot; & twenty eight of the Toes: & as many seedbones in the feet, as the hands enjoy. But I have thought good to add these figures for the better understanding of what hath been spoken hereof. CHAP. XLII. An Epitome of the names and kinds of composure of the bones. BEcause it is as nececessary for a Chirurgeon to know the manner of setting & repairing broken bones, as to put them in their places when they are dislocated, or out of joint; but seeing neither of them can be understood when the natural connexion of the bones is not known, I have thought it a work worth my What the Sceletoes is. labour, briefly to set down, by what and how many means the bones are mutually knit and fastened together. The universal composure and structure of all the bones in a man's body is called, by the greeks; Sceletoes. But all these bones are composed The bones are composed two manner of ways. after two sorts, that is, by Arthron, an Articulation or joint, and by Symphysis a natural uniting or joining together. There are many other kinds of both these sorts. For there are two kinds of Articulation, that is Diarthrosis or Dearticulation, and Synarthrosis, 2 Sorts of Articulation. What Diarthosis and Synarthrosis are. 3. Sorts of Diarthrosis. What Enarthrosis is, or Coarticulation; which differ as thus, Dearticulation is a composition of the bones with a manifest and visible motion; Coarticulation hath a motion of the bones, yet not so manifest, but more obscure. But these two do again admit a subdivision into other kinds. For Diarthrosis contains under it Enarthrosis, Arthrodia & Ginglymos. Now Enarthrosis or Inarticulation is a kind of Dearticulation, in which a deep Cavity receives a thick and long head, such a composition hath the Thighbone with the Hucklebone. Arthrodia is when a lightly engraven civity admits a small and short head, such What Arthrodia. a connexion is that of the Armebone with the shoulderblade; of the first Vertebra with the second. The greeks have distinguished by proper names these two kinds of Cavities and heads; For they call the thick and long head Cephale, that is, a What Cephale is. What Corone is. What Cotyle is What Glene is What Ginglymos. Head absolutely; but the lesser they term Corons, or Coronon which the Latins call Capitulum, a Litle-head. But they call a deep Cavity Cotyle, and a superficiary one Glene. The third sort called Ginglymos, is when the bones mutually receive and are received one of another; as when there is a cavity in one bone, which receives the head of the opposite bone, and also the same bone hath a head which may be received in the Cavity of the opposite bone; such a composure is in the Cubite and knee, that is in the connexion of the Thighbone. And thus much of Dearticulation and the three kinds thereof. Synarthrosis 3 Kind's of Synarthrosis. or Coarticulation, another kind of juncture, hath also three kinds thereof (Gal. lib. de Ossibus) to wit, Sutura, Gomphosis and Harmonia. Suture is a composition of the bones after the manner of sowing things together, What a Suture is. What Gomphosis is. What Harmonia is. example whereof appears in the bones of the Scull. Gomphosis is when one bone is fastened in another as a pin is fastened in a hole, after which manner the teeth are fastened in their sockets in both the jaws. Harmony is when the bones are composed by the interposition of a simple line, after which manner many bones of the nose and face are joined together. Hitherto we have spoken of the first construction of the bones by articulation and the kinds thereof; now it follows we treat of Symphysis. What Symphyasis is. Symphysis, or Growing together as we formerly said, is nothing else, than natural union of the bones; such union is made two manner of ways, that is, either by interposition of no other thing; after which sort in success of time the bones of the lower jaw grow together, which formerly in children were manifestly distinguished; or by the mediation of some Medium; but that happens three manner of ways, by interposition of three several Media, as first of a Synchondrosis. Gristle, which kind of union the Greeks call Synchondrosis, after which manner the Sharebones grow together and also some Appendices in young bodies; secondly of a Ligament, and it is named by the Grecians Syneurosis, the name of a Nerve being taken in the largest sense, for sometimes it is used for a tendon, otherwhiles for a Ligament, otherwhiles for a Norve properly so called and which is Syneurosis. the author of sense and motion. But this Symphysis or union hath place by Syneurosis, or interposition of a Nerve in certain bones of the Sternon and Haunch. The things signified by word Nerve. Synsarcosis. Thirdly, the bones grow into one by interposition of flesh, called in Greek Synsarcosis; thus the flesh of the Gums fastens the teeth and makes them immovable. But if some be less pleased with this division, by reason of the obscurities, in which it seems to be involved, this following expression comes into my mind, which I was first admonished of by Germane Cortin Doctor of Physic, which if you well observe it, is both blameless and more easy for your understanding. The bones, which as pillars sustain the fabric of the whole body, are either, United mutually by Symphysis or union; by which they are so conjoined that there is no dissimular, nor heterogeneous body, at lest which may be discerned, interposed between them. Such union appears in the two bones of the lower jaw at the Chin, in the bones of the Sternon, the Haunch with the Hucklebones, and the Sharebones between themselves; of this union there are no more kinds, for by this it cometh to pass, that the bones, which were more and distinct meet together by interposition of one Medium, to wit, a Gristle, which now indeed is no Gristle, but is turned into a Bone. or Conjoined by that which they call Arthrodia, or Articulation, as when they so concur & are bound together, that some Heterogeneous substance may be noted betwixt them, but the bones thus composed are knit two manner of ways, that is, either more loosely as by Diarthrosis, that is a kind of Articulation not very straight, as by which it might have opportunity to preforme divers motions: of this composure or Articulation of bones there are three kinds, as Enarthrosis, when the head of a bone is wholly received in the cavity of another, & hid therein, as the Thighbone is joined with the Hucklebone. Arthrodia, when in a lightly engraven & not much depressed cavity, the head of another bone is not wholly hid, but only received in part thereof; so that unless nature had otherwise provided a sufficient receptacle for the head of this bone (as by the ligaments of the neighbouring Muscles) it would otherwise have been in perpetual danger of dislocation. Thus the Armebone is fastened to the shoulderblade. Gynglymos, when the bones mutually receive each other, such like composition hath the Cubit and Armebone. or more straight, as by synarthrosis, when the bones are more straight knit so that they can perform no motions in the body. Of this Articulation there are also 3, kinds, that is Gomphysis, as when one bone so receives another as a Pin is fastened in the hole made by a peircer, thus the teeth are fastened in the jaws. Sutura, like a Saw, or teeth of a comb, as the bones of the skull are mutually knit together, or as scales, or tiles are laid, after which manner the stony bones are fastened to these of the Synciput. Harmonis, which is by interposition of a simple line, which parts bones abutting one upon another, as the bones of the Nose. An Epitome or brief recital of all the Muscles of man's body. As I have formerly reckoned up the bones, so here I have decreed to recite the muscles of man's body. Wherefore in the face we first meet with the broad or skin muscle, arising from the flshy pannicle, & covering the whole neck & almost all the face. Then follow 4, pertaining to the upper eyelids. In the Orbs of the eyes lie 14, that is 7, in each Orb, of which 4 are called right, two oblique and one pyramidal. Then succeed 4 of the nose, two external on each side one, and two internal, these draw it together and the other open it. After these come the ten muscles of the lower jaw, of which two are called the Crotaphitae or Temporal; two Masseteres or Grinders; two round (which seem to me rather to pertain to the lips, than to this jaw;) two little ones hid in the mouth, arising from the winged process of the wedgebone; two openers of the mouth being nervous or tendinous in their midst. Then follow the 8 muscles of the lips, that is, 4 of the upper and as many of the lower, shutting and opening the mouth. The tongue with his ten muscles is hid as it were in the den of the mouth. Wherefore the; muscles of the whole face are 51. In the fore part of the neck are found the muscles of the bone Hyoides & throttle; now 8 muscles hold the bone Hyoides as equally balanced; of which there are 2 upper arising from the Chin; 2 on the sides from the process Styloides perforated in their midst, through which the 2 openers of the mouth in that part nervous do pass; 2 arise from the Sternon, & lastly 2 from the upper rib of the shoulderblade to the Coracoides, which also in their midst are nervous, in which place the two Mastoidei lie upon them. The Throttle composed of three gristles hath eighteen or twenty muscles, of The ●8. of the La●…x. which six or eight are common, and twelve proper; Of the common there are two above, two below, and two at the sides of the first gristle, to which we may add these two which serve for the opening of the Epiglottis, which are always found in great four footed beasts for to press down the Epiglottis. The proper are twelve which almost all of them come from the second gristle, so to be inserted into the first and third, of which some are before, others behind the Thyroides. Besides these, there are the Mastoidei which bend the head. The head is moved by 14. Muscles. But in the back part of the Neck there are twelve muscles also appointed for to move the head, so that in all there are fourteen muscles serving for the motion of the head, the two fore Mastoidei, and the twelve hind Muscles, that is to say, the two Splenij, two Complexi, four Right, and so many oblique which are very short, so that they pass not beyond the first and second Vertebra. The 8. Muscles of the neck. The Neck hath eight Muscles, of which two are called the long, lying before upon the bodies of the Vertebrae; the two Scaleni which are at the sides; the two Spinati which run alongst the Spine; the two transverse which go to the transverse processes of the Chest. The Muscles of the chest 18. The Chest hath 81 Muscles, of which some are on the fore part, some on the hind, others on the sides; they are all combined or coupled together except the Midriff. Now of these there are the two Subclavij; the two great Saw-muscles which proceed from the basis of the shoulderblade; the four little Rbomboides or square muscles, that is, two above and two below; the two Sacrolumbi; the two binder's of the Gristles within the Chest. Besides there are twenty and two external and as many internal intercostal muscles, twenty four Intercartilaginei, that is, twelve external and as many internal; so that the intercostal, and Intercartilaginei are 68, which with the twelve before mentioned make the number of 80 Muscles. Add to these the Midriff being without an associate, and you shall have the number formerly mentioned, to wit, 81. But also if you will add to these the Muscles of the lower belly, I will not much gainsay it, because by accident they help inspiration and expiration. The 8. muscles of the lower belly. Wherefore of the eight muscles of the Epigastrium, there are four Oblique, of which two are descendent and so many ascendent; two right, to which you may add the two Assisting or Pyramidal muscles which come from the share-bone, if it please you to separate them from the head of the right muscles: The 6. or 8. of the loins. There are six or eight Muscles of the Loins, of which two bend the loins which are the triangular; the two Semispinati; two Sacri; two are in the midst of the back, which for that cause we may call the Rachitae or Chine-muscles. Now, that hereafter we may severally and distinctly set down the muscles of the extreme parts, will we come to the privities. The two Cremasters of the Testicles. Where for the use of the Testicles there are two Muscles called the Cremasteres, or Hanging Muscles. At the root of the yard, or Perinaeum, there are four others, partly for the commodious passing of the urine and seed, and partly for erecting the yard. The Sphincter Muscle is seated at the Neck of the Bladder. At the end of the right Gut are three Muscles, two Levatores Any, or Lifters The three of the fundament. up of the fundament, and one Sphincter or shutting Muscle. Now let us prosecute the Muscles of the Extremities, or Limbs. But it will be sufficient to mention only the Muscles of one side, because seeing these parts of the body are double, those things which are said of the one may be applied to the other. Wherefore the muscles of the Arm, beginning with these of the shoulderblade, The muscles of the Arm 〈◊〉 general 32. at the least, are 42. for there are 4 of the shoulderblade: of the Arm properly or particularly so called, seven or eight; and there are three, four, or five proper muscles of the Cubite, that is, appointed for the performance of the motions thereof; in the inner part of the Cubite are seven, and as many in the outer; but those of the hand are reckoned thirteen at the least. The fourth of the shoulderblade are the Trapezius resembling a Monks Cowle, which moves it upwards and downwards, and draws it backwards; the second is the Levator, or Lifter-up; the third the great Rhomboides lying under the Trapezius. The fourth, the lesser saw muscle which is inserted into the Coracoides. The arm is moved forwards, backwards, upwards, downwards and circularly. The Pector all muscle arising from the Clavicle, Breastbone and neighbouring ribs, draws it forwards; the Humilis or low-muscle coming from the lower rib of the shoulderblade draws it backwards; the Deltoides upwards; and the Latissim●… downwards, and somewhat backwards. But the three seated about the shoulderblade move it about, or circularly. The Epomis or Scapularis upwards; the Supcascapularis, which may seem two, backwards and downwards; the Subscapularis which is in the cavity of the shoulder blade, forewards, so that by a certain vicissitude and succession of action they move it circularly. Two muscles bend the Cubite, the one named Biceps or Two-headed, and the other Brachiaeus or the Arme-muscle; but one, two, or three muscles extend it; for if you have respect to the original, this muscle hath two or three heads, but one only insertion. In the inside of the Cubite are seven muscles, one Palmaris, two wrest-benders; two pronatores, one square, another in some sort round; two fingerbenders, and one Abductor or Drawer aside. These fourteen internal and external muscles of the Cubite, do not indeed move the Cubite, but only seated there move the wand and with it the hand. These are the thirteen Muscles of the hand; the Theu which may not only be divided into two, but into six, not only by the divers actons it performs, but also by the branches divided by a manifest space between them; the second is called the Hypothenar, which lies under the little finger, as the Thenar doth under the Thumb; the third is the Abductor of the Thumb; then follow the four Lumbrici and six Interosses, although eight may be observed. The whole Leg hath at the least 50. Muscles, for we reckon there are fourteen muscles in the thigh; there are eleven made for the use of the Leg; there are nine The muscles of the leg in general 50. seated in the Leg, three before and six behind which serve for the use of the foot and toes; in the foot are seated sixteen. Therefore of the fourteen muscles serving the thigh two bend it, one called the Lumbaris, the other arising from the cavity of the Hanch-bone; but the three which make the Buttocks and the Triceps or Threeheaded muscle, (which if you please, you may divide into three) extend it. Besides these the 4. twin muscles, and two Obturators, of which the one is internal, the other external, turn the Thigh about. The Leg hath eleven, that is, the Long, the Membranous, the four Postici or Hind muscles (three of which come from the Hucklebone, but the other from the commissure of the Share-bone) the Right, the two vast, the Crureus or Legge-muscle, and the Poplitaeus, or Ham-muscle. These seated in the leg for the use of the foot and toes are three fore and six hind muscles: two of the fore bend the foot, one of which is called the Tibiaeus anticus, the other Peronaeus, which you may divide into two. The third the bender of the toes, although it also partly bend the foot, to which also the bender of the Thumb may be revoked. One of the hind is the Toe-bender, others extend the foot, and are in this order; Two twins, one Plantaris, one Soleus', one Tibiaeus posticus and the great bender of the Toes, to which may be revoked the bender of the Thumb. Of the sixteen seated in the foot, one is above, seated on the back of the foot, which we call the Abductor of the Toes; another in the sole of the foot, to wit, the little bender of the Toes, which goes to the second joint of the Toes alongst the inside of the foot; the other lends his help to the great Toe, which you may call the Abductor of the Thumb; another is seated on the outside for the use of the little Toe. To these are added the four Lumbrici, besides the eight Interosses; or if you had rather, ten. And thus much may suffice for the enumeration of the muscles. The Figure of the Muscles when the skin with its veins, the fat, and all the fleshy membrane are taken away, that part of the fleshy membrane excepted; which takes upon it the nature of a muscle, as being conjoined with the muscles. a, the muscle of the forehead. b, the temporal muscle. c, the muscle shutting the eyelid. d, the muscle opening the wings of the nose. e, the fore part of the yoake-bone. f, the muscle of the upper lip tending to the nose. g, the beginning of the masseter or grinding muscle. h, the broad muscle consisting of a fleshy membrane. i, k, the beginning thereof which rises immediately from the coller-bone & the top of the shoulder. l, that part thereof which bends forwards to l. m, the muscle which lifts up the arm. n, the pectoral muscle. o, the membranous part of this muscle which is joined to the nervous part of the first muscle of the Abdomen or belly. q, q, the fleshy portion thereof, from the 6. and 7. ribs, and the insertion thereof. r the muscle drawing down the arm. s, the oblique descending muscle of the lower belly. t, t, t, the insertion of the greater saw muscle. u u. the linea alba or white line, at which the two oblique descendent muscles meet, covering the whole belly. x, the yard, the skin being taken away. y, the vessels of seed. α, the testicles wrapped in the fleshy membrane. 〈◊〉, the fore muscle bending the cubite. γ, γ, the hind muscle bending the cubite. δ, the muscle extending the cubite. 〈◊〉, the two-headed muscle extending the wrist. 〈◊〉, the muscle producing the broad tendon on the back of the hand. ζ, his tendon. 〈◊〉, the muscle turning up the Wand. θ, the upper muscle flatting the Wand, 〈◊〉, the. second of the arme-benders, whose beginning is χ, and tendon λ, o, a portion of the muscle, whereof one part yields tendons to the wrist, the other to the thumb. 〈◊〉, the fleshless articulation of the thumb. ρ, a muscle inserted into the wrist, lying near to the following muscle. σ, a muscle divided into two tendons, the one whereof is inserted into the first joint of the thumb, the other into the following. τ, the first muscle of the thigh, whose head is at ν, and tendon at Φ, and insertion at χ. Ψ, the end of the second muscle of the thigh. ω the end of the third muscle of the thigh. 1, the sixth muscle of the leg; his beginning at 2. almost wholly membranous at 3. 4, the ninth muscle of the leg. 5, the eight of the leg. 6, a portion of the sixth and seventh of the thigh. 7, the Glandules of the groins. 8, the eight of the thigh. 9, the second of the leg. 11, the innermost of the ankle. 12, the sixth muscle of the foot, his original 13. end 14. 15, the seventh of the foot. 16, the tendon of the muscle lifting up the great toe. 17, the muscles extending the four other toes. 18, the abductor of the great toe. 19, a transverse ligament. 20, a tendon of the ninth muscle of the foot. 21, the first muscle. 22, the fourth muscle of the foot. 23, the tendon of the third muscle. 24. a muscle bending the third bone of the four lesser toes. THE SEVENTH BOOK Of tumors against Nature in General. CHAP. I. What a Tumour against Nature, vulgarly called an Impostume, is, and what be the differences thereof. AN Impostume, commonly so called, is an affect against nature, What an Impostume vulgarly so called is. The material causes of Impostumes, or unnatural tumours. composed and made of three kinds of diseases, Distemperature, ill Conformation, and Solution of continuity, concurring to the hindering or hurting of the Action. An humour, or any other matter, answering in proportion to a humour, abolishing, weakening, or depraving of the office or function of that part or body in which it resides, causeth it. The differences of Impostumes are commonly drawn from five things; quantity, matter, accidents, the nature of the part, which they affect or possess; and lastly, their efficient causes. I have thought good for the better understanding of them, to describe them in this following Scheme. A Table of the differences of Tumours. The differences of Impostumes are drawn principally from five things, that is, from their quantity, by reason whereof Impostumos are called— Great, which are comprehended under the general name of Phlegmons, which happen in the fleshy parts, by Galen, Lib de tumour contra naauram, & lib. 2, ad Glauconem. Indifferent, or of the middle sort, as Felons. Small, as those which Avicen calls Bothores, i Pushes and Pustules, all kind of Scabs and Leprosies, and lastly, all small break out. from their accidents, as Colour, from whence Impostumes are named white, red, pale, yellow, blue, or black, and so of any other colour. Pain, hardness, softness, and such like, from whence they are said to be painful, not painful, hard, soft, and so of the rest. from the matter, of which they are caused and made, which is either Natural or Hot, and that either, Sanguine, from whence a true Phlegmon. Choleric, from whence a true Erysipelas. Cold & that either Phlegmatic, from whence a true Oedema. Melancolick from whence a perfect Scyrrhus. Not natural, which hath, exceeded the limits of its natural goodness, from whence illegitimate tumours, therefore of a sanguine humour, of a choleric humour, Carbunckles, Gangrenes, eating ulcers, Sphaceles are caused. Of the grosser, the eating Herpes, of the subtler the Herpes miliaris is made. Watery and flatulent Impostumes, the King's-evil, knots & all phlegmatic swellings, & excrescenses. The exquisite or perfect Scyrrhus, hardnesses and all sorts of cancerous Tumours. of a phlegmatic humour, of a melancholic humour, From the condition and nature of the parts which they possess, from whence the Ophthalmia, is a Phlegmon of the eyes. Parotis a tumour near the ears. Paronychia or a whitlow at the roots of the nails; and so of the rest. From the efficient causes, or rather the manner of doing. For some impostumes are said to be made by defluxions, others by congestion, those are commonly hot, & the other commonly cold, as it shall more manifestly appear by the following chapter. CHAP. II. Of the general causes of Tumours. THere are two general causes of Impostumes, Fluxion, and Congestion. Defluxions are occasioned, either by the part sending, or receiving, the part After what manner tumors against nature are chiefly made. sending discharges itself of the humours, because the expulsive fa●…ltie resident in that part is provoked to expel them, moved thereto, either by the troublesomeness of their quantity or quality. The part receiving draws, and receives occasion of heat, pain, weakness (whether natural, or accidental) openness of the passages, and lower situation. The causes of heat, in what part soever it be, are commonly three, as all immoderate Three causes of heat. motion (under which frictions are also contained,) external heat, either from fire, or sun, and the use of acride meats and medicines. The causes of pain are four, the first, is a sudden and violent invasion of some Four causes of pain. untemperate thing, by means of the four first qualities; the second is solution of continuity, by a wound, luxation, fracture, contusion or distension; the third, is the exquisite sense of the part, for you feel no pain in cutting a bone, or exposing it to cold or heat; the fourth is, the attention, as it were of the animal faculty, for the mind diverted from the actual cause of pain, is less troubled, or sensible of it. A part is weak, either by its nature, or by some accident; by its nature as the Glandules and the Emunctories of the principal parts; by accident, as if some distemper, Two causes of weakness. bitter pain, or great defluxion have seized upon it, and wearied it, for so the strength is weakened, and the passages dilated. And the lowness of site yeeks opportunity for the falling down of humours. The causes of congestion are two principally, as the weakness of the concoctive Two causes of congestion. faculty, which resides in the part, (by which the assimulation into the substance of the part of the nourishment flowing to it is frustrated) and the weakness of the expulsive faculty; for whilst the part cannot expel superfluities, their quantity continually increases. And thus oftentimes cold impostumes have their original from a gross and tough humour, and so are more difficult to cure. Lastly, all the causes of Impostumes may be reduced to three, that is, the primitive, or external; the antecedent, or internal; and the conjuncte, or containing, as we will hereafter treat more at large. CHAP. III. The signs of Impostumes or Tumours in general. BEfore we undertake the cure of Tumours, it is expedient to know their kinds and differences, which knowledge must be drawn from their proper The principal signs of tumours are drawn from the essence of the part. signs, the same way, as in other diseases. But because the proper and principal signs of tumours are drawn from the essence of the part they possess, we must first know the parts, and then consider what their essence and composition are. We are taught both, by skill in Anatomy, and the observation of the deprived function, especially when the affected part is one of those which lie hid in the body; for we know whether or no, the external parts are affected with a tumour against nature, by comparing that with his natural which is contrary. For comparing the sound part with the diseased, we shall easily judge whether it be swollen, or no. But because it is not sufficient for a Chirurgeon only to know these general signs (which are known even to the vulgar) he must attentively observe such as are more proper and ne'er. And these are drawn from the difference of the matter and humours of which the tumours consist. For this Galen teaches, that all differences of tumours arise from the nature and condition of the matter which flows down and generates the tumour; also they are Lib. 2. ad glaive. & 13. method. known by such accidents as happen to them, as colour, heat, hardness, softness, pain, tension, resistance. Wherefore pain, heat, redness, and tension indicate a sanguine humour; coldness, The proper signs of a sanguine tumour, of a plegmaticke, of a melancholic, of a choleric. softness, and no great pain, phlegm; tension, hardness, the livide colour of the part, and a pricking pain by fits, melancholy; and yellowish and pale colour, biting pain without hardness of the part, choler. And besides, Impostumes have their periods and exacerbations following the nature and motion of the humours of which they are generated. Wherefore by the The knowledge of tumours by their motion and exacerbation. motion and fits it will be no difficult matter to know the kind of the humour; for as in the Spring, so in the morning the blood is in motion; as in the Summer, so in the midst of the day, choler; as in Autumn, so in the evening, melancholy; as in Winter, so on the night the exacerbations of phlegm are most predominante. For Hypocrates and Galen teach, that the year hath circuits of diseases, so that the same Lib. 2. Epidem. proportion of the excess and motion of humours which is in the four seasons of the year, is also in the four quarters of each day. Impostumes which are curable have four times, their beginning, increase, state, and declination, and we must alter our medicines, according to the variety of these times. We know the beginning by the first swelling, of the part; The increase when the swelling, pain, and other accidents do manifestly increase, and enlarge themselves; The beginning of an imposthume. The increase. The State. the state, when the foresaid symptoms increase no more, but each of them, because at their height, remain in their state immovable, unless the very matter of the tumour degenerate, and change itself into another kind of humour; The declination, when the swelling, pain, fever, restlessness are lessened. And from hence the Chirurgeon may presage what the end of the tumour may be; for tumours are commonly terminated four manner of ways, if so be that the motion of the humours causing them be not intercepted, or they without some manifest cause, do flow back into the body. Therefore first they are terminated by insensible transpiration, or resolution; secondly, by suppuration when the matter is digested and ripened; thirdly, by induration when it degenerates into a Scyrrhus, the thinner part of the humour being dissolved; the fourth, which is the worst of all, by a corruption and Gangrene of the part, which is, when overcome with the violence, or the abundance or quality of the humour, or both, it comes to that distemper, that it loses its proper action. It is best to terminate a tumour by resolution; and the worst by corruption; suppuration and induration are between both, although that is far better than this. The signs by which the Surgeons may presage that an Impostume may be terminated The signs of a tumour to be terminated by resolution. by resolving, are the remission, or flacking of the swelling, pain, pulsation, tension, heat, and all other accidents, and the unaccustomed liveliness and itching of the part; and hot Impostumes are commonly thus terminated, because the hot humour is easily resolved, by reason of its subtlety. Signs of suppuration are the intention or increase of pain, heat, swelling, pulsation, The signs of suppuration. and the fever; for according to Hypocrates, pain and the fever are greater when the matter is suppurating, then when it is suppurated. The Chirurgeon must be very attentive to know and observe when suppuration is made; for the purulent matter oft times lies hid (as Hypocrates saith) by reason of the thickness of the part lying above, or over it. The signs of an Impostume degenerating into a Scyrrhus hardness, are the diminution The signs and causes of a tumour terminated in a Scyrrhus. of the tumour, and hardness remaining in the part. The causes of the hardness not going away with the swelling, are the weakness of nature, the grossness and toughness of the humour, and unskilfulness of the Chirurgeon, who by too long using resolving things hath occasioned, that the more subtle part of the humour being dissolved, the rest of the grosser nature like earthy dreggs remains concrete in the part. For so potters vessels dried in the Sun grow hard. But the unskilful Chirurgeon may occasion a Scyrrhous hardness by another means, as by condensating the skin, and incrassating the humours by too much use of repercussives. But you may perceive an Impostume to degenerate into a Gangrene thus, if the accidents of heat, redness, The signs of a Gangrene at hand. pulsation and tension shall be more intense, than they are wont to be in suppuration; if the pain presently cease without any manifest cause, if the part wax livide or black; and lastly, if it stink. But we shall treat of this more at large when we come to treat of the Gangrene and Sphacelus. A sudden diminution of the tumour, and that without manifest cause, Of disappearance of a tumour, and the signs thereof. is a sign of the matter fallen back, and turned into the body again, which may be occasioned by the immoderate use of refrigerating thing. And sometimes much flatulency mixed with the matter, although there be no fault in those things which were applied. Fevers and many other malign Symptoms, as swound and convulsion, by translation of the matter to the noble parts, follow this flowing back of the humour into the body. CHAP. four Of the Prognostics in Impostumes. TVmors arising from a melancholy, phlegmatic, gross, tough, or viscors' humour, ask a longer time for their cure, than those which are of blood or Cold tumours require a longer cure. choler. And they are more difficultly cured which are of humours not natural, than those which are of humours yet contained in the bounds of nature. For those humours which are rebellious, offend rather in quality, than in quantity, and undergo the divers forms of things dissenting from nature, which are joined Tumours made of matter not natural, are more difficultly cured. by no similitude or affinity with things natural, as suet, poultis, honey, the dregs of oil, and wine; yea, and of solid bodies, as stone, sand, coal, straws, and sometimes of living things, as Worms, Serpents, and the like monsters. The tumours which possess the inner parts, and noble entrailes, are more dangerous and deadly, as also those which are in the joints, or near to them. And these tumours which seize upon great vessels, as veins, arteries, and nerves, for fear of great effusion of blood, wasting of the spirits and convulsion. So impostumes of a monstrous bigness are often deadly, by reason of the great resolution of the spirits caused by their opening. Those which degenerate into a Scyrrhus are of long continuance and Hippo. Aph. 8. sect. 6. hard to cure, as also those which are in hydropicke, leprous, scabby and corrupt bodies, for they often turn into malign and ill conditioned vulcers. CHAP. V. Of the general cure of Tumours against Nature. THere be three things to be observed in cure of impostumes. The first is the essence thereof; the second the quality of the humour causing the imposthume; What must be considered in undertaking the cure of tumours. the third the temper of the part affected. The first indication drawn from the essence, that is, from the greatness, or smallness of the tumour, varies the manner of curing, for the medicines must be increased or diminished according to the greatness of the tumour. The second, taken from the nature of the humour also changes our counsel, for a Phlegmon must be otherwise cured than an Erysypelas and an Oëdema than a Scyrrhus, and a simple tumour, otherwise than a compound. And also you must cure after another manner a tumour coming of an humour not natural, than that which is of a natural humour, and otherwise that which is made by congestion, than that which is made by defluxion. The third Indication is taken from the part in which the tumour resides; by the nature of the part we understand its What we must understand by the nature of the part. temperature, conformation, site, faculty, and function. The temperature indicateth that some medicines are convenient for the fleshy parts; as those which are more moist; others for the nervous, as more dry; for you must apply some things to the eye, and others to the throat; one sort of things to these parts which by reason of their rarity are easily subject to defluxion, another to those parts which by their density are not obnoxious to it. But we must have good regard to the site of the part, as if it have any connexion with the great vessels, and if it be fit to pour forth the matter and humour when it is suppurated. Galen by the name of faculty understands the use and sense of the part, This hath a What we must understand by the faculty of the part. manifold indication in curing, for some parts are principal, as the Brain, Heart, and Liver; for their virtue is communicated to the whole body, by the nerves, arteries, and veins. Others truly are not principal, but yet so necessary that none can live without them, as the Stomach. Some are endued with a most quick sense, as the eye, the membranes, nerves, and tendons; wherefore they cannor endure acrid and biting medicines. Having called to mind these indications, the indication will be perfected What we must consider in performing the cure. by these three following intentions, as if we consider the humour flowing down, or which is ready to flow; the conjunct matter, that is, the humour impact in the part; the correction of accidents; yet so that we always have care of that which is most urgent and of the cause. Therefore first repercussives must be applied for the antecedent matter, strong or weak, having regard to the tumour as it is then, only excepting six conditions of Tumours; the first is, if the matter of the Tumour be venenate: the second, if it be a critical abscess: the third, if the defluxion be near the noble What things dissuade us from using repercussives. parts: the fourth, if the matter be gross, tough, and viscide: the fifth, when the matter lies far in, that is, flows by the veins which lies more deep: the sixth, when it lies in the Gandules. But if the whole body be plethoric, a convenient diet, purging, and Phlebotomy must be appointed, frictions and baths must be used. Ill humours are amended by diet and purging. If the weakness of the part receiving draw on a defluxion, it must be strengthened. If the part be inferior in its site, let the patient be so seated, or laid, that the part receiving, as much as may be, may be the higher. If pain be the cause of defluxion, we must assuage it by things mitigating it. If the thinness, or lightness of the humour cause defluxion, it must be inspissate by meats and medicines. But for the matter contained in the part, because it is against nature, it requires to be evacuate by resolving things, as Cataplasms, ointments, somentations, cupping glasses; or by evacuation, as by scarifying, or by suppurating things, as by ripening and opening the Impostume. Lasty, for the conjunct accidents, as the Fever, pain and such like, they must be mitigated by assuaging, mollifying and malaxing medicines, as I shall show more at large hereafter. CHAP. VI Of the four principal and general Tumours, and of other Impostumes which may be reduced to them. THe principal and chief Tumours which the abundance of humours generate are four, A Phlegmon, Erysipelas, O●dema and Scyrrhus: innumerable others may be reduced to these, distinguished by divers names according What tumours may be reduced to a Phlegmon. to the various condition of the efficient cause and parts receiving. Wherefore a Phygethlum, Phyma, Felon, Carbuncle, inflammation of the eyes, Squincy, Bubo, & lastly all sorts of hot and moist tumours may be reduced to a Phlegmon. The Herpes Which to an Erysipelas. ●iliaris, the eating Herpes, Ringwormes and Tetters and all impostumes brought forth by choler, are contained under an Erysipelas. Atheromata, Ste●tomata, Meld●●rides, Which to an Oëdema. the Testudo, or Talpa, Ganglion, Knots, King's-evil, Wens, watery Ruptures the Ascites and Leucophlegmatia may be reduced to an Oëdema, as also all flarule●● tumours, which the abundance of corrupt Phlegm produces. In the kindred of the Scyrrhus are reckoned a Cancer, Leprosy, Warts, Corn● Which to a Scyrrhus. a Thymus, a Varix, Morphew, black and white, and other Impostumes arising from a melancholy humour. Now we will treat of these Tumours in particular beginning with a Phlegmon. CHAP. VII. Of a Phlegmon. APhlegmon is a general name for all Impostumes, which the abundance of inflamed blood produces. That is called a true Phlegmon, which is made of What a true Phlegmon is. laudable blood, offending only in quantity. But a bastard Phlegmon, or a Phlegmonous Impostume hath some other, and proper name; as a Carbuncle, Felon, A Phlegmon one thing, and a Phlegmonous tumour another. Gangrene, Sphacel, and the like malign Pustules. So when there is a conflu●e of divers humour into one tumour, divers kinds of phlegmonous Impostumes called by divers names, according to the more abundant humour, arise; as if a small portion of phlegm shall be mixed with a greater quantity of blood, it shall be called as Oëdematous Phlegmon; but if on the contrary, the quantity of phlegm be the greater, it shall be named a phlegmonous Oëdema, and so of the rest; always naming the tumour, from that which is most predominant in it. Therefore we must observe that all differences of such tumours arise from that, either because the blood causing it offends only in quantity; which if it do, it causes that tumour which is properly called a Phlegmon; if in quality, it makes a Phlegmonous tumour, because the matter thereof is much departed from the goodness of blood. But blood is said to offend in quantity, either by admixture of some other matter, as Phlegm, Choler, or melancholy, from whence proceeds Oëdematous, Erysipelas and Scyrrhous Phlegmons; or by corruption of its proper substance from whence Carbuncles, and all kinds of Gangrenes; or by concretion, and when nature is disappointed of its attempted and hoped for suppuration, either by default of the air, or patient, or by the error of the Physician; and hence oft times happen Atheroma's, Steatoma's, and Melicerides. Although these things be set down by the ancients, of the simple and simular matter of the true Phlegmon; yet you must know, that in truth there is no imposthume, whose matter exquisitely shows the nature of one, and that simple humour without all admixture of any other matter; for all humours are mixed together with the blood, yet from the plenty of blood prodominating, they are called Sanguine, as if they were of blood alone. Wherefore if any Tumours resemble the nature of one simple humour, truly they are not of any natural humour, but from some humour which is corrupt, vitiated and offending in quality; for so blood by adustion degenerates into choler and melancholy. Therefore a true Phlegmon is defined by Galen; A tumour against nature, of laudable Gal. lib. de tumoribus, & 2. add Glanc. blood flowing into any part in too great a quantity. This tumour though most commonly it be in the flesh, yet sometimes it happens in the bones, as Hypocrates and Galen witness. A Phlegmon is made and generated thus, when blood flows into any part, in too Hippoc. lib. de v●ln: cap. Gal. lib. de tumour. praeier naturam. great a quantity; first the greater veins and arteries of the affected part are filled, than the middle, & lastly, the smallest and capillary; so from those thus distended, the blood sweats out of the pores and small passages like dew; and with this the void spaces which are between the simular parts are first filled, & then with the same blood all the adjacent parts are filled, but especially the flesh, as that which is most fit to receive defluxions, by reason of the spongious rarity of its substance; but then the nerves, tendons, membranes, and ligaments, are likewise stuffed full; whereupon a Tumour must necessarily follow, by reason of the repletion which exceeds the bounds of nature; and from hence also are tension and resistance; and pain also happens at the same time, both by reason of the tension and preternatural heat. And there is a manifest pulsation in the part, specially whilst it suppurates, because The cause of a beating pain in a Phlegmon the veins, arteries, and nerves, are much pained, being they are not only heated within by the influx of the fervide humour, but pressed without by the adjacent parts. Therefore seeing the pain comes to all the foresaid parts because they are too immoderately heated and pressed, the arteries which are in the perpetual motion of their Systole & diastole, whilst they are dilated, strike upon the other inflamed parts, whereupon proceeds that beating pain. Hereunto add, the Arteries then filled with more copious and hot blood, have greater need to seek refrigeration by drawing in the encompassing Air; wherefore they must, as of necessity, have a conflict with the neighbouring parts which are swollen and pained. Therefore from hence is that pulsation in a Phlegmon which Comm. ad Aph. 21. sect. 7. is defined by Galen, an agitation of the arteries, painful, and sensible to the Patient himself; for otherwise as long as we are in health, we do not perceive the pulsation of the arteries. Wherefore these two causes of pulsation, or a pulsi●icke pain in a phlegmon are worthy to be observed, that is, the heat and abundance of blood, contained in the vessels and arteries (which more frequently than their wont incite the arteries to motion, that is, to their Systole and Diastole) and the compression and straightening of the said arteries, by reason of the repletion and distension of the adjacent parts, by whose occasion the parts afflicted and beaten by the trembling and frequent pulsation of arteries are in pain. Hence they commonly say, that in the part aflected with a Phlegmon, they feel as it were the sense or stroke of a Mallet or Hammer smiting upon it. But also besides Another kind of Pulsation in a phlegmon. this pulsation of the arteries, there is, as it were another pulsation with itching from the humours whilst they putrefy and suppurate, by the permixtion, motion, and agitation of vapours thereupon arising. The cause of heat in a Phlegmon is blood, which whilst it flows more plentifully into the part, is as it were trodden or thrust down, and causes obstruction, from whence necessarily follows alprohibition of transpiration, and a putrefaction of the blood, by reason of the preternatural heat. But the Phlegmon looks red by reason of the blood contained in it, because the humour predominant in the part shines through the skin. CHAP. VIII. Of the causes and signs of a Phlegmon. THe causes of a Plegmon are of three kinds; for some are primitive, some antecedent, The primitive causes of a Plegmon. and some conjunct. Primitive are falls, confusion's, strains, immoderate labour, frictions, application of acrid ointments, burnings, long staying or labouring in the hot Sun, a diet unconsiderate, and which breeds much The Antecedent and conjunct. The signs of a Phlegmon. blood. The antecedent causes are, the great abundance of blood, too plentifully flowing in the veins. The conjunct, the collection or gathering together of blood impact in any part. The signs of a Plegmon are swelling, tension, resistance, feverish heat, pain, pulsation, (especially while it suppurates) redness, and others, by which the abundance of blood is signified. And a little Phlegmon is often terminated by resolution; but a great one by suppuration; and sometimes it ends in a Scyrrhus, or a Tumour like a Scyrrhus; but otherwhiles in a Gangrene, that is, when the faculty, and native strength of the part affected, is overwhelmed by the greatness of the deflxion, as it is reported by Galen. The Chirurgeon ought to consider all these things, that he may apply and vary Gal. l. de Tum. such medicines as are convenient for the nature of the Patient, and for the time and condition of the part affected. CHAP. IX. Of the cure of a true Phlegmon. THe Chirurgeon in the cure of a true Phlegmon must propose to himself What kind of diet must be prescribed in a Plegmon. four intentions. The first of Diet; This, because the Plegmon is a hot affect and causes a fever, must be ordained of refrigerative and humecting things, with the convenient use of the six thingsnot natural, that is, air, meat, and drink, motion and rest, sleep and waking, repletion, and inanition, and lastly, the passions of the mind. Therefore let him make choice of that air which is pure and clear, not too moist, for fear of defluxion, but somewhat cool; let him command meats which are moderately cool and moist, shunning such as generate blood too plentifully; such will be broths not to fat, seasoned with a little Borage, Lettuce, Sorrell, and Succory, let him be forbidden the use of all spices, and also of Garlic, and Onions, and all things which heat the blood, as are all fatty and sweet things, as those which easily take fire. Let the Patient drink small wine, and much allayed with water: or if the fever be vehement, the water of the decoction of Licoris, Barley, and sweet almonds, or water and sugar; always having regard to the strength, age, and custom of the Patient. For if he be of that age, or have so led his life, that he cannot want the use of wine, let him use it, but altogether moderately. Rest must be commanded; for all bodies wax hot by motion, but let him chiefly have a care that he do not exercise the part possessed by the plegmon for fear of a new defluxion. Let his sleep be moderate, neither, if he have a full body, let him sleep by day, specially presently a●er meat. Let him have his belly soluble, if not by nature, then by art, as by the frequent use of glisters and suppositories. Let him avoid all vehement perturbations of mind, as hate, anger, brawling; let him wholly abstain from venery. This manner of diet thus prescribed, we must come to the second scope, that is, the diversion of the defluxion, which is performed by taking away its cause, that is, How to divert the defluxion of humours. the fullness and illness of the humours. Both which we may amend by purging and blood letting, if the strength and age of the patient permit. But if the part receiving be weak, it must be strengthened with those things which by their astriction amend the openness of the passages, the violence of the The pain must be assuaged. humour being drawn away by cupping glasses, frictions, ligatures. But if pain trouble the part, which is often the occasion of defluxion, it must be mitigated by medicines assuaging pain. The third scope is to overcome the conjunct cause. That we may attain to this, we must enter into the consideration of the tumour, according to its times, that is, the beginning, increase, state, and declination. For from hence the indications of variety of medicines must be drawn. For in the beginning we use repercussives to drive away the matter of the Phlegmon flowing down, as the white of an Egg, Oxicrate, When we must use repercussives. the juices or waters of Houseleek, Plantain, Roses; Cataplasms of Henbane, pomegranate, Pills, Balausties, Bole armenic, Terra sigillata, oil of Roses, Quinces, Myrtles, Poppies. Of these simples, variety of compound medicines arises. This may be the form, of a Cataplasm. ℞, far. hordei ℥ ij. succi sempervivi, plantag. an. ℥ iij. pal. malicorij, balaustiorum & rosar. an. ʒij ●l. mirtill. & rosar. an. ℥ j, fiat Cataplasma. Another, ℞, Plantag. solani, hyoscyam. an. m. ij. ca●da equin. tapsi barb. cintinodia an. m. i. coquantur perfect in oxicrato, pistentur, traijciantur, addendo p●lveris mirtill. nue. cupressi. & ros. rub. an. ʒiij. farin. fab.. ℥ jj, olei rosar. & cydon. a●. 〈◊〉▪ mix them and make a cataplasma to the form of a liquid pultis. And you may use this lineament, by dipping linen clothes in it, and applying to the part; ℞, ol. nymph. & rosar. an. ℥ iij, aq. ros. solani & plantag. an. ℥ ij, aceti ℥ iij, albumin. ov●r 'em n. iij, fiat linimentum. Also ung. rosatum & ●ng. Album, camphor. Rasis are good to apply to it, as in like manner, Emp. Diacalcitheos' dissolved in vinegar, and oil of Roses, and also Populeon may be used. In the increase you must have care of the humour flowing down, and of that which already impacted in the part, did formerly fall down. Therefore repercussives must be tempered & mixed with discussing medicines, but so that they may carry the chief sway, as ℞, fol. malvae, absinth. plantag. an. m. iij, coquantur What local medicines we must use in the increase. in oxicrat●, contundantur, trajectis add farinae fabarum & hordei an. ℥ j, pull. rosar. rub. & Absinth. an. ʒi, ol. rosar. & chamaem, an. ℥ j, fiat cataplasma od formam pultis satis liquidae. Another. ℞, farinae hord.. ℥ iij. farinae sem. lini & f●nugroeci, an. ℥ i. coquantur in aqua communi, addendo sub finem pull. mirtillorum, rosarum & chamaemeli an. ℥ ss, axungiae anseris & olei rosarum an. ℥ j, misce, fiat cataplasma. But in the state the repercussives, & discussives ought to be alike with some anodine, What in the state. or mitigating medicines, if it be painful, as ℞, rad. Altheae ℥ iiij, malvae, parietar. an. m. ij, coquantur sub cineribus, addendo farin. fabarum & lentium an ℥ ij, pulveris chamaem, & metiloti an. ℥ ss. olei chamaem. & rosar. an. ℥ i. axungiae gall. ℥ ij. fiat cataplasma. Another ℞, micae panis triticei aqua calida macerati lb ss, pulveris rosar. rub. & absinth. ana. ℥ vi. olei aneth. & mellis come. an. ℥ ij. misce omnia simul & fiat cataplasma ad formam pultis satis liquidae; which is of chief use when there is pain. But when the violence of pain and other symptoms are assuaged, it is likely that What in the declination. the plegmon is come to determination. Wherefore then we must use more powerful and strong discussives, and only then beginning with the more gentle, lest the subtler part of the humour being dissolved, the grosser, remaining in the part, should grow hard, as ℞, mal. bismal. an. m. iij. coquantur addendo furinae hordei ℥ ij, mellis come. ℥ j, ol. chamae. & melilot. an. ℥ ss, fiat cataplasma, Or ℞, radicum Brion. & cucumber. agrest. an. ℥ ij, florum chamam. & meliot. ana. m. iij. coquantur in hydromelite addendo farin●, sem. lini & faenugraec. an. ℥ ij. ol. aneth. axungiae Anser. & anat. an. ℥ i. fiat Cataplasma. And this plaster following may here find place. ℞, Diachyl. mag. ℥ ij, Empl. de melilot. ʒjs, olei aneth. & chamaemel. an. ℥ ss: dissolve them all together and make a medicine for your use. Or ℞, Empl. de mucag. & oxycro: an. ℥ ij. Empl. Diachyl. Ireat. ℥ i. olei liliorum & chamaemel. quantum satis est, and make thereof a soft emplaster. The fourth scope of curing a Phlegmon consists in correction of the accidents The correction of the accidents. which accompany it; of which pain is the principal. Wherefore the Chirurgeon must be diligent to assuage it, for besides, that it weakens the strength, and debilitates and depraves the function, it also causes defluxions by drawing the blood and spirits to the part affected. According to the variety of pain there must be variety of medicines, as ℞, micae The discommodities of pain. Medicines aswaging pain. panis albi in lacte tepido macerati lb ss, vitell. ovorum iij. ol. rosar. ℥ ij, croci ℈ ss, fiat cataplasma. Or ℞, florum chamaem. & melil. an. p. iij. farinae sem. lini. & fenugraec. an. ℥ i. fiat cataplasma pultis, satis liquidae. Or ℞, mucagin. rad. althaea & faenugraeci an. ℥ iij, ol. rosar. & aneth. an. ℥ i. farin. sem. lini. quantum satis, ut iude formetur cataplasma satis molle. But if the pain remain, and yield not to these remedies, we must fly to stronger, making use of narcoticks, or flupifactives, but with care lest we benumb, or dead the part; as ℞, fol. hyoscyani & papaver. sub. cineribus coctorum an. ℥ iij, adipis suillae, & ol. ros. an. ℥ j, croci. ℈ ij, fiat cataplasma: or, ℞, fol. cicutae & solani furiosi. an. ℥ iiij, coquantur Narcoticke medicine●. sub cineribus, pistentur, & traijciantur addendo. unguent. popul. & ol. rosar. an ℥ j, farin. faenugrac. quantum satis erit, ut inde formetur cataplasma ad form●m pultis liquidae. CHAP. X. The cure of an ulcerated Phlegmon. But it often happens, that the humour is so impactin the part, The signs of a Phlegmon turning to an Abscess. that it cannot be repressed, and so gross, that it cannot be discussed; which we may know by the greatness of the heat and swelling, by the bitterness of the pricking pain, the fever, and pulsation, and heaviness. Wherefore laying aside all hope of discussing, we must come to suppuratives. For which purpose Galen sorments the swollen part with water, or oil being Lib. 〈◊〉 ad Glau●. Cap. 7. warm, or with both of them; and then applies this following cataplasm. ℞, farinae tric. vel micae panis, ℥ iiij. ol. come. ℥ iij, aquae come. quantum sufficit, fiat cataplasma; or ℞, rad. lilior. alb. & altheae, an. ℥ iij, fol. malvae, parietar. & senecionis Suppurative medicines. ana. m. i. coquantur in hydromelite, pissentur, trajectis add farin. sem. lini ℥ ij, ●xungiae suillae, ol. liliorum an. ℥ iss, fiat cataplasma: Or ℞, malvae, bismalv. violar. an. m. i. caricarum ping. n. x. passul. ℥ ij, coquantur in aq. come. tusis, & traiectis, add n● else come. ℥ ij, ung. basilicon. & butyri recent. ana. ℥ j, fiat cataplasma. You may profitably use for the same purpose Empl. Diachylon magnum, or Basilicon. Or ℞, Empl. Dyachil. mag. ℥ iij. ung. basilicon. ℥ j, ol. liliorum ℥ ss. Of these mixed together make a a medicine for the foresaid use. When the heat, pain, fever, and other accidents shall remit, when the tumour hath a sharp head, when by the pressing of your finger you find the The signs of p●… or matter. humour to flow as it were to and fro, than you may know that it is ripe. Wherefore without any further delay the tumour must be opened, lest the matter too long shut up, corrode the adjacent parts, and the ulcer become sinuous and fistulous. For this usually happens, especially then, when the matter is venenate or malign, or when the swelling is near a joint, or at the fundament, or such like hot and moist places. For by the decree of Hypocrates we should anticipate the maturation of such tumours Hip. lib. de Fistul●. by opening. They may be opened with an incision knise or caustic, and that, either actual or potential. For if the patient shall be heartless and less confident, so that he either cannot, or will not endure any instrument, you must make way for the matter by a potential cautery. You may also do the business by another slight, as thus. Thrust the point of a sharp knife or lancet, through a brass counter that it may stand fast in the midst thereof; then cover it diligently with some Emplaster or Cataplasm, that neither the Patient nor standers by perceive the deceit: then laying on the plaster as that you would make a passage for the matter by that means, but when you have fitted the point to the part, where it is fit to open the tumour, so guide the Counter with your fingers, that you may presently make an impression into the Tumour, sufficient for excluding the matter. I have here expressed three deliniations of such Instruments, that you may use these, either bigger, lesser or indifferent, as occasion shall serve. Counters with the points of Knives or Lances put through them. A. shows the Counter or piece of Silver. B. shows the point of the Lancet. Other Instruments for opening Abscesses. Rings in which little knives lyebid, fit for to open Abscesses. The Deliniation of a Trunk or hollow justrument going with a spring. A. Shows the thicker pipe. B. Shows another which enters and is fastened in the other by a screw. C. The point of the Instrument, looking out. D. The spring which forces the Instrument. But there are seven things which must be diligently considered in opening all sorts of Impostumes. The first is, that you put your knife to that part of the Abscess which is the softer, and yields to the impression of your fingers, and where it rises into a head, or point. The second is, that you make choice of that place for dissection which is the lowest, that so the contained impurity may the more readily flow out, and not stay in the passage. The third is, that it be made according to the wrinkles of the skin, and the right fibers of the Muscles lying next under the skin. The fourth is, that you turn your knife from the larger vessels and Nerves worth speaking of. The fifth is, that the matter contained in them be not evacuated too abundantly at once in great Abscesses, lest thereby the strength be dejected, the spirits being much wasted together with the unprofitable humour. The sixth is, that the affected part be handled as gently as you can. The seventh is, that after the opening when the matter is evacuated, the Abscess be cleansed, filled with flesh, and lastly consolidated and cicatrized. But seeing that commonly after such sections some part of the Tumour What the cure must be after the opening of the Abscess remains, all the contained humour being not wholly suppurated, the Chiurgion may perceive that this is an implicit affect, that is a, Tumour and Ulcer. But the Cure thereof must be so, that you take away the Tumour before the ulcer; for the ulcer cannot be healed before the part be restored to its nature. Therefore the suppuratives formerly prescribed must be used, and the ulcer must be dressed for two or three days with this following Medicine. Detersive Medicines. ℞, Vitellum unius ovi, terebinth. Venetae, & ol. Rosar. an. ℥ ss, fiat medicamentum. Then you must seek to cleanse it by this following Medicine. ℞ Mellis rosar.. ℥ j, Syrupi rosar. & tereb. Venet. an. ℥ jss, far. hordei ℥ ij, fiat medicamentum Vng●entum de Appi●. ad usum. For this very purpose there is a singular Detersive made of Appium or Smallage of which this is the description. ℞ Succi appij, plantag. beton. an. ℥ j, Mellis common. ℥ v, terebint. Venet. ℥ iiij, farin. Hordei & Orobi, an. ℥ ij, anʒj. coquatur mel cum succis, quibus consumptis addantur sarinae & pulveres, & misceantur omnia ad formam unguenti. But if you would cleanse it more powerfully, you may use Vnguentum Apostolorum; or Vnguentum Aureum and Aeyptiacum mixed according to the scope you conceive in your minds, when the ulcer shall seem sufficiently cleansed, it shall be filled with flesh and cicatri●ed after the manner we shall declare in the proper treatise of the cure of Ulcers. CHAP. XI. Of seavers, and the cures of these ●eavers which accompany Plegmons. AMongst the Symptoms which most usually accompany Phlegmons, & afflict all the body of the patient, Fevers are the chief; that is hot, and dry distempers The ●eaver of a Phlegmon. What a Fever is. kindled in the heart, and thence by the Artery is sent over all the body; yet those which usually follow this kind of Tumours are Ephemerae, that is, Diary, unputrid Synochi or putrid Synochi; Of whose nature and order of cure I will here briefly relate what I have learned from my Masters, that is, Doctors of Physic, as I have been conversant with them in the practice of my Arte. The Ephemera, or Diary [that is of one day] is, a hot and dry distemperature What an Ephemera, or Diarye is. kindled in the vital spirits. It hath that name, because by its own nature it tarries not above the space of one day or twenty four hours, by reason it is kindled in a subtie easily dissipable matter. The efficient causes of this Fever are weariness, hunger, drunkenness, anger, fury, sorrow, watching, great and piercing cold, Adustion, Baths, and manner of living The causes thereof. inclining more to heat than ordinary, applying, using or drinking of acride medicines as Poisons, or of hot meats, and drinks; to conclude, all the efficient causes common to all Fevers, putrefaction only excepted which properly appertains to putrid fevers. For a Bubo also, which is a Phlegmon of the Glandules, causes a Diary, as Hypocrates shows. All fevers proceeding from the Tumours of the Glandules are evil, the Aphorism. 55. lib. 4. Diary excepted. Which Aphorism must be understood warily and with that distinction which Galen gives in his commentary, where he saith; It is only to be understood of Tumours risen in the Glandules without occasion, that is, without any evident and manifest cause; for otherwise Fevers that thence take their original, though not Diary, yet are not all evil, as we learn by Buboes in Children, and the venereous Buboes, which happen without inflammation, or corruption of the liver, for such commonly have no malign Fever accompanying them, which thing is worthy a Surgeon's observation. The common signs of a Diary are, a moderate and vaporous heat feeling gentle to the hand, a pulse swift and frequent, sometimes great and strong, as when the The signs of a Diary. Diary is caused by anger; sometimes little, if the Fever proceed from sorrow, hunger, cold, crudity; for other respects equal and ordinary. The most certain signs are, if the Fever come upon one not by little and little but suddenly and that from some external and evident cause, no loathing of meat, no causeless weariness, no deep sleep, yawning, great pain, restlessness, shaking nor cold going before, and lastly no other troublesome symptom preceding. We here make no mention of the urine, because most frequently they resemble the urines of sound bodies; for in so short a time as Diaryes endure, there cannot so great a perturbation Why in a Diarye the urines like to these in health. be raised in the blood that there may be signs thereof found in the urine. A Diary is ended in one fit, which by the proper nature of this Fever lasts but one day, although sometimes, otherwise it is extended to three, or four days space; and than it easily degenerates into a Putrid, especially any error of the Patient, Physician, or those which attend him concurring therewith, or if the external things be not rightly fitted. This Fever is terminated either by insensible transpiration, or by the moisture of the skin, or by a sweat natural, gentle, and not ill smelling; to this Diary we The unputride Synochus. may refer the unputride Synochus, generated of blood not putrid, but only heated beyond measure. For usually there arises a great heat over all the body, by means of the blood immoderately heated; whence the veins become more tumide, the face appears fiery, the Eyes red and burning, the breath hot, and to conclude, the whole habit of the body more full, by reason of that Ebullition of the blood, and the diffusion of the vapours thence arising over all the body: Whence it is, that this kind of Synochus may be called, a vapourous Fever. To this Children are incident as also all sanguine bodies, which have no ill humours. The cure of this and the Ephemera or Diary is the same; because it may scarce seem different from the Ephemera in any other thing, than that it may be prolonged for three or four days. Wherefore whatsoever we shall say for the cure of the Ephemera, may be all applied to the Synochus, blood-letting excepted, which in an unputrid Synochus is very necessary. Now the Cure of a Diary Fever consists in the decent use of things not natural, The cure of a Diary fever. contrary to the cause of the disease; wherefore baths of warm and natural water are very profitable; so that the Patient be not Plethoric, nor stuffed with excrements, nor obnoxious to catarrhs and defluxions, because a catarrh is easily caused and augmented by the humours diffused and dissolved by the heat of a bath; therefore in this case we must eschew frictions, and anointing with warm oil, which things notwithstanding are thought very useful in these kind of Fevers, especially when they have their original from extreme labour, by astriction of the skin or a Bubo. Let this be a general rule, that to every cause, whence this Fever proceeded, you oppose the contrary for a remedy; as to labour, rest; to watching; sleep; to anger and sorrow, the grateful society of friends, and all things replenished with pleasant good will; and to a Bubo, the proper cure thereof. Wine moderately tempered with water according to the custom of the sick patient, The use of wine in a Diarye. is good and profitable in all causes of this Fever, except he be pained in his head, or that the Fever drew its original from anger, or a Bubo; for in this last case especially, the patient must abstain wholly from wine, until the inflammation come to the state, and begins to decline. This kind of Fever often troubles infants; and than you must prescribe such medicines to their Nurses, as if they were sick, that so by this means their milk may become medicinable. Also it will be good to put the Infant himself into a bath of natural and warm water, and presently after the bath to anoint the ridge of the back and breast with oil of Violets. But if a Phlegmon possess any inward part, or otherwise by its nature be great, or seated near any principal Bowell, so that it may continually send from it either a putrid matter or exhalation to the heart, and not only affect it by a quality or preternatural heat by the continuity of the parts, thence will arise the Putrid Synochus, How a putrid Synochus is caused. if the blood by contagion putrifying in the greater vessels, consists of on equal mixture of the four humours. This Fever is chiefly thus known, it hath no exacerbations, or remissions, but much less intermissions; it is extended beyond the space of twenty four hours, neither doth it then end in vomit, sweat, moisture, or by little and little by insensible transpiration, after the manner of intermitting Fevers, or Agues; but remains constant, until it leaves the Patient for altogether; it commonly happens not unless to these of a good temper and complexion, which abound with much blood, and that tempered by an equal mixture of the four humours. It commonly endures not long, because the blood by power of some peculiar putrefaction degenerating into choler or Melancholy, will presently bring forth another kind of fever, to wit a Tertian or continued quartan. The cure of this Fever (as I have heard of most learned Physicians) chiefly consists in Phlebotomy necessary in a putrid S●●●chu●. Blood-letting. For by letting of blood the fullness is diminished, & therefore the obstruction is taken away, and lastly the putrefaction. And seeing that in this kind of Fever there is not only a fault of the matter, by the putrefaction of the blood, but also of the Temper by excess of heat; certainly Phlebotomy helps not only, as we said, the putrefaction, but also the hot distemper. For the blood in which all the heat of the creature is contained, whilst it is taken way, the acrid and fuliginous excrements exhale and vanish away with it, which kept in, increased the Feverish heat. Moreover, the veins, to shun emptiness, which nature abhors, are filled with much cold air instead of the hot blood which was drawn away, which follows a cooling of the habit of the whole body; yea and many by means of Phlebotomy have their bellyes loosed, and sweat, both which are much to be desired in this kind of Fever. This moved the ancient Physicians, to write, that we must draw blood in this disease, even to the fainting of the Patient. What benefit we may reap by drawing blood even to fainting. Yet because thus, not a few have poured out their lives together with their blood, it will be better and safer to divide the evacuations, and draw so much blood at several times, as the greatness of the disease shall require, and the strength of the Patient may bear. When you have drawn blood, forthwith inject an emollient and refrigerative Why we must give a clyster presently after bloods letting. clyster; lest that the veins emptied by Phlebotomy may draw into them the impurity of the Guts; but these clysters which cool too much, rather bindethe belly, than lose it. The following day the Morbi●icke matter must be partly evacuated by a gentle purge, as a bowl of Cassia, or Catholicon; then must you appoint Syrupes which have not only a refrigerative quality, but also to resist putrefaction, What Syrupes profitable in this case. such as the Syrup of Lemons, Berberries', of the jujce of Citrons, of Pomgranats, Sorrell and Vinegar; let his diet be absolutely cooling and humecting and also slender; for the native heat much debilitated by drawing of a great quantity Why a slender Diet must be used after letting much blood. of blood cannot equal a full diet. Therefore it shall suffice to feed the Patient with chicken and veal broths made with cooling herbs, as Sorrell, Lettuce and Purslane. Let his drink be Ba●ly water, Syrup of Violets mixed with some pretty quantity of boiled water, julepum Alexandrinum, especially if he be troubled with scouring, o● laske. But the Physician must chiefly have regard to the fourth day, for if then there appear any signs of concoction in the excrements, the Crisis must be expected on the seventh day and that either by a looseness of the belly, or an abundance of urine, by vomits, sweats, or bleeding. Therefore we must then do nothing, but commit the whole business to nature. When drinking of water is to be permitted in a putrid Synochus. But for drinking cold water, which is so much commended by Galen in this kind of Fever, it is not to be suffered beforethere appear signs of concoction; moreover in the declining of the disease the use of wine will not be unprofitable to help forwards sweats. CHAP. XII. Of an Erysipelas, or Inflammation. HAving declared the cure of a Phlegmon, caused by laudable blood, we must now treat of these tumours which acknowledge Choler the material cause of their generation, by reason of that affinity which intercedes between Choler and Blood. Therefore the tumours caussed by natural Choler, are called Erysipelata, or Inflammations; these contain a great heat in them, The definition of an Erysipelas. which chiefly possesses the skin, as also oftentimes some portion of the flesh lying under it. For they are made by most thin and subtle blood (which upon any occasion of inflammation easily becomes choleric) or by blood and choler, hotter than is requisite, and sometimes of choler mixed with an acride serous humour. That which is made by sincere and pure choler, is called by Galen, a true and perfect Erysipelas. But there arise three differences of Erysipelaes' by the admixture of Gal. Cap. 2. lib. 14 Meth. med. & 2. ad Glau. choler with the three other kinds of humours. For if it being predominant be mixed with blood, it shall be termed Erysipelas Phlegmonodes; if with phlegm, Erysipelas oedematodes; if with Melancholy, Erysipelas S●irrhodes. So that the former and substantive word shows the humour bearing dominion, but the latter or adjective that which is inferior in mixture. But if they concur in equal quantity, there will be thereupon made Erysipelas Phlegmone; Erysipelas oedema; Erysipelas scirrhus. Galen acknowledges two kinds of Erysipelaes', one simple and without an ulcer, Two kinds of Erysipelas. the other ulcerated. For Choler drawn and severed from the warmness of the blood, running by its subtlety and acrimony unto the skin, ulcerates it; but restrained by the gentle heat of the blood, as a bridle, it is hindered from piercing to the top of the skin, and makes a tumour without an ulcer. But of unnatural choler are caused many other kinds of choleric tumours, as the Herpes exedens, and Miliaris, and lastly all sorts of tumours which come between the Herpes and Cancer. You may know Erysipelaes' chiefly by three signs, as by their colour, which is a yellowish red; by their quick sliding back into the body at the least compression of the skin (the cause of which is the subtlety of the humour and the outward site of it under the skin, whereupon by some an Erysipelas is called a Disease of the skin) Lastly by the number of the Symptoms, as heat, pulsation, pain. The heat of an Erysipelas is far greater than that of a Phlegmon, but the pulsation is much less; for as the heat of the blood is not so great, as that of choler, so it far exceeds choler in quantity and thickness, which may cause compression and obstruction of the adjacent muscle. Gal. lib. 2. ad glaive. For Choler easily dissipable by reason of its subtlety quickly vanishes, neither doth it suffer itself to be long contained in the empty spaces between the muscles; neither doth an Erysipelas agree with a Phlegmon in the propriety of the pain. For that of an Erysipelas is pricking and biting without tension, or heaviness, yet the primitive, antecedent and conjunct causes are alike of both the tumours. Although Hip. Apho. 79 Sect. 7. Aph. 25 Sect. 6. Aph. 43. Sect. 3. an Erysipelas may be incident to all parts, yet principally it assails the face, by reason of the rarity of the skin of that place, and the lightness of the choleric humour flying upwards. It is ill when an Erysipelas comes upon a wound, or ulcer, and although it may come to suppuration, yet it is not good; for it shows that there is obstruction by the admixture of a gross humour, whence there is some danger of erosion in the parts next under the skin. It is good when an Erysipelas comes from within outwards; but ill when from without it retires inward. But if an Erysipelas possess the womb it is deadly, and in like manner if it spread too far over the face, by reason of the sympathy of the membranes of the brain. CHAP. XIII. Of the cure of an Erysipelas. FOr the cure of an Erysipelas we must procure two things, to wit, evacuation and Refrigeration. But because there is more need of cooling, than in a Phlegmon, the chief scope must be for refrigeration. Which being Gal: 〈◊〉▪ Method. done, the contained matter must be taken away and evacuated with moderately resolving medicines. We must do four things to attain unto these forementioned ends. First of all we must appoint a convenient manner of Diet, in 4 Things to be performed in curing an Erysipelas. the use of the six things not natural; that is, we must incrassate, refrigerate and moisten as much as the nature of the disease and patient will suffer, much more than in a Phlegmon; then we will evacuate the Antecedent matter, by opening a vein, and by medicines purging choler. And that by cutting the Cephalic vein, if there be a portion of the blood mixed with Choler, if the Erysipelas possess the face, In what Erysipelas it is convenient to let blood, in what not. and if it be spread much over it. But if it shall invade another part, although it shall proceed of pure choler, Phlebotomy will not be so necessary, because the blood which is as a bridle to the choler being taken away, there may be danger, lest it become more fierce; yet if the body be plethoric, it will be expedient to let blood, because this, as Galen teacheth, is oft times the cause of an Erysipelas. It will be expedient to give a clyster of refrigerating and hum●●ting things before you open a vein; but it belongs to a learned and prudent Physician to prescribe medicines, purging choler. The third care must be taken for Topick, or local medicines, which in the beginning What topicke medicines are fit to be used it the beginning of an Erysipelas and increase must be cold and moist, without any either dryness or astriction, because the more acride matter by use of astringent things being driven in, would ulcerate and fret the adjacent particle. Galen and Avicen much commend this kind of remedy; Take fair water ℥ uj, of the sharpest Vinegar ℥ j, make an Oxycrate, in which you may wet linen clothes and apply to the affected part and the circumjacent places, & renew them often. Or ℞, Succi solani, plan●ag. & sempervivi, an. ℥ ij, aceti ℥ ss, Mucaginis sem. Psylij ℥ ij, succi hyoscyami ℥ j, Misce. But if the Erysipelas be upon the face, you must use the medicine following. ℞. Unguent. Ros. ℥ iiij, succi plantagin. & sempervivi, an. ℥ i. Camphor●ʒss. aceti parum; let them be mixed together and make a lineament. But if the heat and pain be intolerable, we must come to narcoticke medicines. As, ℞ succi hyoscyami, solani, cicutae, an. ℥ i. album. ovorum n. ij. aceti ℥ ss, opij & Camphor. an. gr●. 4 croc● ℈ ss, Mucaginis sem. psill. & faenigr. extractae in aq. ros. & plantag. an ℥ j, ol. de papau. ℥ ij fiat linimentum, addendo ung, refrigerantis Gal. camphor q. satis sit. Yet we must not use such like medicines too long, lest they cause an extinction of the native heat and mortification of the part. Wherefore such Narcoticke medicines must be used with regard of place, time and such other circumstances. Therefore we may three manner of ways understand What caution must be had in the use of narcoticke medicines. when to desist from using Narcoticke or stupefactive medicines. The first is when the Patient in the affected part feels not so much heat, pricking and pain, as before; The second is when the part feels more gentle to the touch than before; The third when the fiery and pallid colour begins by little and little to wax livid and black; for than must we abstain from Narcoticke, and use resolving and strengthening things, whereby the part may be revived and strengthened by recalling Resolving and strengthening medicines. the Native heat; As ℞. ●arina hordei & Orobi, an. ℥ ij farina sem. lini ℥ jss. coquantur in Hydromelite vel oxycrato, addendo pulv. rosarum & chamaemael. an. ℥ ss. a●ethi & chamaem. an. ℥ j, fiat cataplasms. Or you may use this following fomentation ℞. Rad. Altheae ℥ ij, fol. malvae, bismal. pariet. absinthij, salviae, an. m. i. flor. chamaem. meliloti, rosar. rub. an. m. ij. coquantur in aequis partibus vini & aqu●, & fiat fotus cum spongia. After the fomentation you may apply an Emplaster of Diachylon Ireatum, or Diapalma dissolved in oil of chamomille and Melilote, and such other like. The fourth Intention which is of the correction of accidents, we will perform by these means which we mentioned in curing a Phlegmon, by varying the medicaments, according to the judgement of him which undertakes the cure. CHAP. XIIII. Of the Herpes; that is Teaters, or Ringwormes, or such like. HErpes is a tumour caused by pure choler separated from the rest of the humours, that is carried by its natural lightness and tenuitye even to the What a Herpes is, what be the kinds there of. Gal. 2. ad Glauronem. What the Herpes miltaris is. What the exedens. outer or scarf skin, and is diffused over the surface thereof. Galen makes three sorts of this tumour. For if perfect choler of an indifferent substance, that is, not very thick, cause this tumour, than the simple Herpes is generated, obtaining the name of the Genus; but if the humour be not so thin, but compounded with some small mixture of Phlegm, it will raise little blisters over the skin like to the seeds of Miller, whence it was that the Ancients called this Tumour the Herpes Miltaris. But if it have any admixture of Melancholy, if will be an Herpes exedens, terrible by reason of the erosion or eating into the skin and muscles lying under it. There are absolutely three intentions of curing; The first is to appoint a Diet just Three intentions in curing Herpes. like that we mentioned in the cure of an Erysipelas; The second is to evacuate the antecedent cause, by medicines purging the peccant humour, for which purpose ofttimes clysters will suffice, especially if the patient be somewhat easy by nature, and if the urine flow according to your desire; for by this a great part of the humour may be carried into the bladder; The third shall be to take away the conjunct cause by local medicines ordained for the swelling and ulcer. Therefore the Chirurgeon shall A rule for healing ulcers conjoined with tumours. have regard to two things, that is, the resolving of the tumour, and the drying up of the ulcer, for every ulcer requires drying, which can never be attained unto, unless the swelling be taken away. Therefore because the chiefest care must be to take away the Tumour, which unless it be performed there can be no hope to heal the ulcer, he shall lay this kind of medicine to dissolve and dry, as ℞. Cerusae & tuthiae praepar. an. ℥ i. ol. ros. & adipis capon. an. ℥ ij. corticis pini usti, & loci, ℥ ss cerae quantum satis, fiat unguentum. Or ℞. Farin. hordei & lent. an. ℥ ij, conquantur in decocto corticis mali granati, ballast. plantag. addendo pulveris rosar. ru●. absinth. an. ℥ ss. olei Myrtillor. & mellis come. an. ʒujs, fiat ungentum, ut artis est. But for an Herpes Miliaris these must chiefly be used, ℞. pulv. gallarum, malicorij, ballast, boli armeni an. ℥ i. aquae ros. ℥ iij, aceti acerrimi ℥ i. axungiae anser. & olei Myrtillor. an. ℥ jss, terebinth. ℥ j fiat unguentum ad usum. I have often The force of Vnguentum enulatum cum Mrcur●●. Medicines fit for restraining eating and spreading ulcers. sound most certain help in unguentum enulatum cum Mercurio, for it kills the pustules, and partly wastes the humour contained in them. Yet if the ulcer, not yet neither yields, but every day diffuse● itself further and further you shall touch the edges and lips thereof with some acride medicine, as Aqua fortis, oil of Vitriole, of such like, for by this kind of remedy, I have oft times healed fretting ulcers, which seemed altogether incurable. CHAP. XV. Of Fevers, which happen upon Erysipelous Tumours. AS Fevers sometimes happen upon Inflammations, and Erysipelaes', which A vulgar description of an intermitting Tertian fever. savour of the humour whereof they proceed, that is, Choler. Therefore seeing it is peculiar to Choler, to move every third day, it is no marvel if great Inflammations bring with them Tertian Fevers, or Agues, which have their fit every third day; for it is called anIntermitting Tertian which comes every other day. The Primitive causes in general are strong exercises, especially in the hot Sun, The causes of Tertian fevers. the use of heating, and drying either meats or medicines, great abstinence joined with great labour, care, sorrow; the antecedent causes are the plenty of choler in the body, an hot and dry distemperature either of the whole body, or of the liver only: the conjunct cause is the putrefaction of the Choleric humour lying in some plenty without the greater vessels, in the habit of the body. The signs, a shaking or shivering like as when we have made water in a cold winter The signs of an intermitting Tertian. morning, a great pricking, stretching, or stiffness, as if there were pins thrust into us over all our bodies, by reason of the acrimony of the choleric humour driven uncertainly & violently over all the body, & the sensible membranous & Nervousparticles at the beginning of the fit; then presently the heat becomes acride, the Fever kindled, like a fire in dry straw; the pulse is great, quick and equal; the tongue dry; the urine yellowish, red and thin. The Symptoms are watchings, thirst, talking idly, anger, disquietness The Symptoms. & tossing the body at the least noise or whispering. These Fevers are terminated by great sweats. They are incident to choleric young men, such as are lean, & in Summers; after the fit oft times follow choleric vomiting & yellowish stools. After the fit there follows an absolute intermission retaining no relics of the Fever, Why Tertians have an absolute cessation of the fever at the end of each fit. until the approach of the following fit, because all the choleric matter by the force of that fit & nature is easily cast out of the body, by reason of its natural levity & facility; whereas in Quotidians there is no such thing, as which after the fit always leave in the body a sense & ceiling of a certain inequality by reason of the stubborness of the Phlegmatic humour, & dulness to motion. The fit commonly uses to endure 4, 5, or 6 hours, although at sometime it may be extended to 8 or 10. This Fever is ended at 7 fits, and usually is not dangerous, unless there be some error committed by the Physician, Patient, or such as attend him. Tertians in summer are shorter, in winter longer. Wherefore the beginning of the fit is accompanied with stiffness, or stretching, the state with sweat, whereupon if the nose, lips of mouth break forth into pimples or scabs, it is a sign of the end of the Fever, and of the power of nature which is able to drive the conjunct cause of the disease from the centre to the habit of the body; yet these pimples appear not in the declining of all Tertians, but only then, when the Choleric humour causing the Fever shall reside in the stomach, or is driven thither from some other part of the first region of the Liver. For hence the subtler portion thereof carried by the continuation of the inner coat to the mouth and nose, by its acrimony easily causes pimples in these places. The cure is performed by Diet, and Pharmacy. Therefore let the Diet be so ordered for the six things not natural, that it may The Diet of such as have a Tertian. incline to refrigeration and humection, as much as the digestive faculty will permit, as Lettuce, Sorrell, Gourds, Cucumbers, Mallows, Barley Creames, Wine much a laid with water, thin, small, and that sparingly and not before signs of concoction When such as have a certain may use wine. shall appear in the urine; for at the beginning he may not use wine, nor in the declining, but with these conditions, which we have prescribed. But for the time of feeding the patient, on that day the fit is expected, The time of feeding the patient. he must eat nothing for three hours before the fit, lest the aguish heat lighting on such mea●s as yet crude, may corrupt and putrefy them; whence the matter of the Fever may be increased (because it is as proper to that heat to corrupt all things, as to the native to preserve and vindicate from putrefaction), the fit lengthened, and nature called away from the concoction and excretion of the Morbisicke humour; yet we may temper the severity of this law by having regard to the strength of the patient; for it will be convenient to feed a weak patient not only before the fit, but also in the fit itself, but that only sparingly, lest the strength should be too much impaired. Now for Pharmacy; It must be considered, whether the strength of the Patient be sufficient, if the humours abound; for than you may prescribe Diaprunum simplex, When to purge the patient. Cassia newly extracted, the decoction of Violets, of Citrine Myrobalanes; Syrupes of Violets, Roses, of Pomegranates and Vinager. But if the powers of the Patient languish, he must not only not be purged, but also must not draw blood too plenteously, because Choleric men soon faint, by reason of the facile and easy dissipation of the subtle humours and spirits; besides, such as are subject to tertian Fevers do not commonly abound with blood, unless it be with Choleticke blood, which must rather be renewed, or amended by cooling and humecting things, than evacuated. Yea verily, when it is both commodious and necessary to evacuate the body, it may be attempted with far more safety by such things as work by insensible transpiration, which provoke sweats, vomit or urine by reason of the subtlety of the Choleric humour, than by any other. Also the frequent use of emollient glisters made with a docoction of Prunes, jujubes, Violets, bran and Barley, will profit much; If the patient fall into a Delirium or talk idly by reason of the heat and dryness of the head, with a particular excess of the Choleric humour, the head must be cooled by applying to the Temples and forehead and putting into the nose oil of Violets, Roses, or woman's milk. Let the feet and legs be bathed in fair and warm water, and the soles of the feet be anointed with oil of Viols and such like. In the declining, a Bath made of the branches of Vines, the leaves of Willows, Lettuce and other refrigerating things boiled in fair water, may be profitablely used three hours after meat eaten sparingly. But I would have you so to understand the Declination or declining not of one When the time is fit to use a Bath. particular fit, but of the disease in general, that the humours already concocted, alured to the skin by the warmness of the bath, may more easily and readily breathe forth: he which otherwise ordains a bath at the beginning of the disease, will cause a constipation in the skin and habit of the body, by drawing thither the humours peradventure tough and gross, no evacuation going before. Also it will be good after general purgations to cause sweat by drinking What kinds of evacuations 〈◊〉 most fit in a Tertian. White wine thin and well tempered with water; but urine by decoction of Smallage and Dill; Certainly sweat is very laudable in every putrid Fever, because it evacuates the conjunct matter of the disease, but chiefly in a Tertian, by reason that choler by its inbred levity easily takes that way, and by its subtlety is easily resolved into sweat. But that the sweat may be laudable, it is fit it be upon a critical day, and be foreshowed by signs of concoction agreeable to the time and manner of the disease, Sweats when as they flow more Sudorifick●. slowly are forwarded by things taken inwardly and applied outwardly; by things taken inwardly, as with white wine, with a decoction of Figgs, Raisins stoned, grass roots and the like opening things; but by things outwardly applied, as sponges dipped in a decoction of hot herbs (as Rosmary, Time, Lavender, Marjerome and the like) applied to the Groins, Armholes, and ridge of the back. You may for the same purpose, fill two Swine's bladders with the same decoction, or else stone bottles, and put them to the feet, sides, and between the thighs. Then let this be the bound of sweeting, when the patient begins to wax cold, that is, when the sweat feels no more hot, but cold. But by the consent of all, blood must not be let after the third fit, but presently When blood must be lot. at the beginning of the Fever, according to the opinion and prescription of Galen; for seeing this Fever for the most part is terminated at seven fits, if you stay until the third fit be past, the Fever will now be comen to its state; but Hypocrates Aphor. 29. Sect. 2. forbid us to move any thing in the state, lest nature then busied in concocting the disease, be called from its begun enterprise. CHAP. XVI. Of an Oedema or cold Phlegmatic Tumour. HItherto we have treated of hot Tumours, now we must speak of cold; Cold Tumours are only two, on Oedema, and a Scirrhus; And Gal. lib. de tumo. praeter natures. for all that Hypocrates and the Ancients used the word Oedema for all sorts of Tumours in general; yet by Galen and these Physicians which succeeded him, it hath been drawn from that large and general signification, to a more straight and special, only to design a certain species, or kind of Tumour. Wherefore an Oedema is a soft, lax and painless Tumour, caused by collection What an Oedema is. of a fleg maticke humour. The Ancients made eight differences of Tumours proceeding of Phlegm. The first they termed a true and lawful Oedema proceeding from natural Phlegm; from The differentces of Oedemas unnatural Phlegm by admixtion of another humour they would have three sorts of Tumours to arise, as that by mixture of blood, should be made an Oedema Phlegmonodes, and so of the rest. Besides, when they perceived unnatural Phlegm either puffed up by flatulency, or to slow with a waterish moisture, they called some Oedemaes flatulent, others waterish; but also when they saw this same Phlegm often to turn into a certain Plaisterlike substance, they thought that hence proceeded another kind of Oedema, which they expressed one while by the name of Atheroma, another while by Steaetoma, and sometime by Melicerides, as lastly they called that kind of Oedema which is caused by putrid and corrupt phlegm, Scrophulae. For we must observe that Phlegm By how many ways Phlegm becomes not natural. sometimes is natural, and offends only in quantity, whence the true Oedema proceeds; other whiles it is not natural; and it becomes not natural, either by admixtion of a strange substance, as blood, Choler or Melancholy, whence arise the three kinds of Oedema's noted formerly by the way; or by the putrednesse and corruption of its proper substance, whence the Struma and Scrophulae proceed; or by concretion, whence kernels and all kinds of Wens, Ganglia and knots; or by resolution, whence all flatulent and waterish Tumours, as the Hydrocele, Pneumatocele and all kinds of Dropsies. The causes of all Oedema's are the defluxion of a Phlegmatic or flatulent The Causes. humour into any part, or the congestion of the same made by little & little in any part, by reason of the imbecility thereof in concocting the nourishment, and expelling the excrement. The signs are a colour whitish and like unto the skin, a soft Tumour, rare and lax by reason of the plentiful moisture with which it abounds, and without The signs. pain, by reason this humour infers no sense of heat nor manifest cold; when you press it with your finger the print thereof remains, because of the grossness of the humour and slowness to motion. Oedema's breed rather in winter The prognostics. than in the summer, because winter is fitter to heap up Phlegm; they chiefly possess the Nervous and Glandulous parts, because they are bloodless, and so cold and more fit by reason of their looseness to receive a defluxion; for the same cause bodies full of ill humours, ancient, and not exercised, are chiefly troubled with this kind of Tumour. An Oedema is terminated sometimes by resolution, but oftener by concretion, How Oedemas are terminated. seldomer by supputation, by reason of the small quantity of heat in that humour. A Symptomatical Oedema, as that which follows upon a Dropsy or Consumption, admits no cure unless the disease be first taken away. The general cure is placed in two things, that is, in evacuation of the conjunct matter, prohibiting the generation of the antecedent. We attain to both The intentions of curing Oedema's. chiefly by four means. The first truly by ordaining a fit manner of living and prescribing moderation in the use of the six things not natural. Wherefore we must make choice of The diet. such air as is hot, dry and subtle; we must prescribe wine of a middle nature for his drink; let the bread be well baked; let meats be appointed which may generate good blood, and these rather roasted than boiled. Let all fruits be forbidden, as also broths and milke-meates; let him eat such fish as are taken in stony rivers; the Patient shall observe mediocrity in feeding, but principally sobriety in drinking, for fear of crudities; After meat let him use digestive powders, or common drige powder; if his belly be not naturally loose let it be made so by art. Let the Patient use exercise before meat, so by little and little to spend this humour, and restore the native heat. Let him sleep little, because much fleepe Exercise. breedeth cold humours; let him avoid grief and sadness. And if he be of a weak body, let him abstain from venery, lest by another weakening by the use of venery added to his present infirmity, he fall into an uncureable coldness, from whence a greater measure of crudity will arise. Otherwise, if the body What to be observed in the use of venery. be strong and lusty, by such exercises and the moderate use of venery it will be the more dried and heated. For so that sentence of Hypocrates is to be understood; That venery is a cure 6. Epid. sect. 5● sen. 23. for Phlegmatic diseases, as Galen in his commentaries tells us. The Physician may perform the second intention by turning his counsel to that part, from whence the spring of this Phlegmatic humour flows. For if the infirmity arise from the stomach, or from any other part, the part from whence it comes must be strengthened; if from the whole habit of the body, let attenuating, penetrating and opening medicines be prescribed. We perform the third intention by evacuating the humour impact in the part with local medicines varied according to the four times of the Tumour. For Galen in the beginning and increase prescribeth a fomentation of Oxycratum Lib. 2. ad Glaus. cap. 3. A rowler. used with a sponge. But if so be that the Oedema be upon the Arm or Leg, a repelling rowler is very good, that is, such an one as is brought from below upwards. So these medicines following are very fit for the same purpose, ℞. Lixivij ex cineribus sarmentorum, & caulium, an. ℥ iiij. Tartari & Aluminis an. ℥ 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, aceti ℥ ij. mix all together and make a decoction, wherein wet sponges and foment the place. Also you may use the following Cataplasm, ℞, farinae hordei ℥ iiij. coquantur in Lixivio communi, addendo pulveris nuci● cupressi, corticum granatorum, balausti. an. ℥ i. Myrrhae, Aloes, alum. an● ℥ ss, olei Myrtill. ℥ ij, fiat Cataplasma. In the state and declination you must use drying and resolving medicines, as ℞. Nucum cupressi, granat. sumach, balausti, an. ℥ i. Salviae, origan. calament. Hyssopi, melissae an. in. i. an.ʒj. coquanter cum lixivio; foment it with a sponge, then presently apply this following Cataplasm. ℞, Rad. Brioniae ℥ ij. absinth. plantage. centinchamaem, meliloti, puleg. an. m. ss. coquantur in hydromelite, pistentur, traijciantur, addendo pulveris ros. rub. chamaem. melil. an. ℥ i. fiat Cataplasma. Lastly, you may here with good success use resolving emplasters and ointments, first heating or chase the part by friction or fomentations aswell moist as What caution to be had in application of Emplasters. dry; otherwise emplasters will scarcely do their duty, by reason of the great coldness of the part, being not sufficient of itself to assimilate the nourishment, or to expel the superfluous and unprofitable humour. Let a fomentation be made with white wine, in which Sage, Rosmary, Time, Lavender, Chamomile and Melilote flowers, red Roses, Orris roots, Staechos and such like have been boiled, with a little Vinegar added thereunto. Quench hot bricks in the same docoction, and apply them wrapped in linen clothes to the affected part, for so a vapour will breathe forth which hath an attenuating, piercing, resolving and strengthening faculty. But you may in stead of the bricks fitly apply Hogs or Ox bladders, filled half full with the foresaid decoction, and that hot. The frictions must be made with hot linen clothes, for so the native heat together with the blood and spirits is recalled to the part, and fuliginous humours contained under the skin are resolved, whereby the strength of the part is in some sort recovered. CHAP. XVII. Of the cure of flatulent and waterish Tumours. I Formerly declared that not only flatulent and waterish Tumours were comprehended under this word Oedema, but also such as are bred of congealed Phlegm, as Atheromata, Steatomata and Melicerides. Flatulent In what places flatulencies may be gathered. or windy Tumours are caused by vapour and wind kept in or contained sometimes under the skin, somewhiles under the membranes, as the Periostium and pericranium, whereupon ensues cruel torment by reason of the distension of these parts which are endued with most exquisite sense. Sometimes the Entrails, as the stomach and Guts are swollen and stretched out with wind, as in a Tympany. They in this differ from a true and legitimate Oedema, that when you lay your In what flatulent tumours differ from a true Oedema. finger upon them and take it off again, there remains no sign of the pressure thereof, because they are distent by vapour and not by humour, for the vapour being pressed returns speedily again, as you may perceive by balls or bladders filled with wind. The cause of such Tumours is the weakness of the native heat, not being able The causes of flatulent Tumours. easily to resolve and waste the Phlegm by which the windy Tumours are raised, for so the morning Sun (which in some sort resembles our native heat) cannot resolve the mists dipersed in the air; which at noon it easily resolves into pure air. Almost after the same manner our weaker heat stirs up vapours from that phlegm it could not dissolve, which vapours are the matter of inflations, or swellings. But oft times although the native heat be sufficiently powerful, yet because the humour lieth deep, or is kept in by the thickness of some membrane, tendon or Ligament, the stirred up vapour cannot exhale, whereby it comes to pass, that increased by little and little it causes a Tumour. The signs of such a Tumour are a certain renitency or resistance perceived The signs of such Tumours. by pressing it with your finger, and sometimes a noise as if you smit upon a drum, especially if much wind be contained therein, such as is often gathered together in the hollowness of the belly, and in the spaces between the larger muscles. The Tumour is neither red nor hot, but rather cold and white as in an Oëdema. It often possesseth the joints, and especially the knees, and it is very difficult to be resolved. If such flatulency be gathered together in the Guts, it causeth the wind Colic, in which sometimes the distension is so great that death ensues by reason of the renting or tearing the coats of the Guts. CHAP. XVIII. Of the cure of a flatulent and waterish Tumour. WE shall chiefly and principally cure flatulent and waterish tumours by three means. First by the same diet which we prescribed in an Oedema; then Diet. Things strengthening the parts. by strengthening the parts appointed for concoction, as the stomach & Liver, chiefly by the temperate use of Aromatic things as Diacuminum, Diacalamenthae, Aromaticum caryophyllatum, Aromaticum Rosatum, and the like, to be prescribed according to good liking of the Physician which oversees the cure; lastly by taking away of the conjunct matter by hot, drying and attenuating medicines which they call Carminative, that so the part being rarified the humour and flatulency therein contained may be discussed and dissipated. But remedies of this nature must Medicines evacuating the conjunct matter. be varied according to the variety of the parts; for some things are fit to be applied to the stomach, others to the Guts, others to the joints, and others to the fleshy parts; for the Colic you must inject carminative glisters, let resolving Sacculi or Baggs be applied, and cupping Glasses fastened to the Navel; if an outward part be affected, we use fomentations, liniments, chiefly if pain torment; as also Cataplasms and Emplasters, as ℞ Florum chamaem. melil. rorismarini, rosar. rub. an. p. j: absinth. hyssopi, an. m. ij. let them be boiled in Lie, adding a little vinegar for a fomentation to be used with sponges. Galen foments the part with Rose-vinegar and a little salt put thereto, and would have a sponge dipped therein to lie somewhat long upon the part. ℞. Olei chamaem. aneth. rut. Galens●omentation ●omentation. & liliorum, an. ℥ ss, cerae albae ℥ uj; aq. vitae ℥ j, let them all be mixed together and make a lineament, with which anoint the part after the fomentation. ℞. Farinae fabar. orobi, an. ℥ iij, coquantur in decocto pulegij, origani, calamenth. salviae, addita pulverum chamaem. & melilot. an. m. ss. fur●ur. sarinae fab. & orobi, an. ℥ ij, coquantur cum lixivio communi, addendo terebinth. ℥ iij, oleor. aneth. & rut. an. ℥ ij; make an emplaster for the foresaid use. The emplaster of Vigo with Mercury, and without is very good for the same purpose. But you must note, that such medicines must be applied to the part actually hot, and the same heat must be contained and renewed by putting about it linen clothes, bricks, bottles and such like hot things. The Humour and flatulency which were kept shut up in the part being resolved, the part must be strengthened, lest now and then it receive or generate the like Corrobotating medicines matter: That may be done by the following fomentation and cataplasm. ℞. Nucum cupressi, corticum granat. sumach. berberis, ballast. an. ʒjs, caudae equin. arnogloss. tupsi barb. absinth. salviae, rorism. lavendul. an. m. ss. flor. chamaem. melil. rosar. anthos, an. p. i. alum. salis come. an. ℥ j, bulliant omni● in aequis partibus aquae fabrorum & vini austeri, make bags for a fomentation, or use the decoction for the same purpose with a sponge. ℞, Farinae fab. hordei & lupin. an. ℥ ij. terebinth. come. ℥ iiij, pulver. r●dicis ireos, mastic. an. ℥ ss, mellis come. ℥ ijss, of the foresaid decoction as much as shall suffice, so to make a cataplasm to the form of a poultice liquid enough, let it be applied hot to the affected part having used the fomentation before. The signs of a waterish tumour are the same as of a flatulent; but over and besides it shines, and at the pressing with your fingers, there is hard a noise or murmur as of The signs of a waterish Tumour. a bladder half filled with water. Therefore the waterish tumour if it shall not yield to the forementioned resolving Why a wateterish tumour must be opened with an instrument: medicines, the way must be opened with an incision knife, after the same manner, as we mentioned in a Phlegmon. For often times this kind of remedy must be necessarily used, not only by reason of the contumacy of the humour which gives no place to the resolving medicines, but also because it is shut up in its proper cyst or bag, the thickness of which frustrates the force of the resolving medicines, neither suffers it to penetrate into the humour. As I some years ago found by experience A History. in a maid of 7. years old; which troubled with a Hydrocele or waterish rupture, to whom when I had rashly applied to dissolve it resolving medicines of all sorts, at length I was forced to open it with my knife; not only to evacuate the contained matter, but also that I might pluck out the bag, which unless it were cut up by the root, would be a mean to cause a relapse. john Altine doctor of Physic called me to this business. james Guilemeau the King's Chirurgeon oversaw the cure. CHAP. XIX. Of an Atheroma, Steatoma, and Meliceris. ALthough these Tumours may be thought comprehended under one genus with other Oëdematous tumours, yet they differ as thus; that is, their matter is shut up in its bladder or bag, as it were in a peculiar cell. But their In what an Atheroma, Steatoma, and Meliceris differ. difference amongst themselves is thus; the matter of the Steatoma as the name signifieth, is like unto Tallow [for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek signifieth Tallow, or seam] yet it oft times is found stuffed with other divers hard bodies, stony, bony or callous like unto the claws of an hen. For Philoxenus reports that he sometimes saw flies in a Steatoma at the opening thereof, and such other like things wholly dissenting from the common matter of Tumours. The matter contained in an Atheroma is like to pap, with which they feed little Children. A Meliceris contains matter resembling honey in colour and consistence; these Tumours appear and rise without any Inflammation going before them. Thus you shall know these Tumours; a Steatoma is harder than the other two, neither yields it to the pressure of your finger, but when it once yields, it doth not speedily and easily return to its former figure, because the matter is more gross; It is of the same colour as the skin, without pain, and of a longish figure. The Meliceris yeeds to the touch, as being a loose and soft body, and as it is easily disposed and diffused, so it quickly returns to its former place and Tumour. It differs from the Atheroma in figure and substance. For it is more globous and of a subtler and more shining matter, besides also it takes up a large space, and is more obsequious to the touch, and for the rest, without pain. As for the manual Of Surgery to be used to these Tumours. operation of the Chirurgeon in their cure, it seems to be of no great consequence of what sort the matter is, whether resembling tallow, honey, or pap, for there is one simple manner of operation, which is, that you pluck away the contained humour, as also the receptacle in which it is contained. Yet you must note such Tumours, sometimes as it were hanging in the surface of the skin, are easily to be moved this way and that way; but other some again deeper fastened firmly cohere with the adjacent bodies, and these require an exquisite hand and also industry for fear of a great flux of blood and convulsion by cutting a vein. There are many other kinds of Tumours, as the Testudo or Mole, the Nata, the Glandula, Nodus, Botium, Lupia, which as in matter (for they are all of a thick, clammy and viscous Phlegmatic humour) so also in kind they agree with an Atheroma, Steatoma and Meliceris. But also in these for the most part, when they are opened, you may see bodies of all sorts far different from the common matter of Tumours, as stones, chalk, sand, What the cause may be, that we sometimes finde infectae in these Tumours. coals, snails, straws, or awnes of Corn, hay, horn, hairs, flesh both hard and spongious, gristles, bones, whole creatures as well living as dead. The generation of which things (by the corruption & alteration of humours) shall not make us much to admire it, if we consider, that as nature of all the seeds & elements of the whole great world, hath made man the Microcosm or little world, that he might be, as it were, the lively Image of that greater world; so in him, it being never idle in us, would have all the kinds of all motions and actions to show themselves, as long as matter for generation is not wanting. But because there is little, or rather no mention of these tumours amongst the anicents, we will briefly show the opinions of the later Writers concerning them. Now they say, the Testudo is a rumour contrary to nature, soft, diffused, or vaulted, What the Testudo, or Talparia is. or arched like a Tortoise, sometimes it arises in the head in form of a Mole, and then it is called a Mole. The Nata is a great and fleshly tumour, not in shape unlike a Melon, or rather the What the Nata is. flesh of a man's buttocks, whence it may seem to have had the name, unless we had rather say it had it, because it more usually breeds upon the buttocks, than upon any other part of the body. The Glandula takes its denomination from an acorn, called Glans in Latin, the What a Gandula. which it somewhat resembles in the compass and form of the tumour; or else because it most commonly breeds in the Glandules, or Emunctories of man's body. The Nodus or knot, is a round tumour, hard and immovable, named from a rope What Nodus. tied on a knot. Guido Cauliacensis affirms knots commonly to grow in nervous bodies; but at this time they more usually arise on the bones of such as have the French disease. CHAP. XX. Of the cure of Lupiae, that is, Wens, or Ganglions. A Wen or Ganglion is a tumour sometimes hard, sometimes soft, yet always What a Glanglion is. round, using to breed in dry, hard, and nervous parts. And seeing that some of the tumours mentioned before in the former Chapter, stick immovable to the part to which they grow, because they are contained in no cyste, or bag; othersome are moved up and down by the touch of your fingers, because they are contained in a bag or bladder, it commonly comes to pass that Wens have their bladder wherein to contain them, and therefore we think fit, the rather more freely, and particularly to treat of their cure, because they are more difficultly cured, especially where they are inveterate and of long standing. The primitive causes of these are dull blows, fall from high places, strains, The causes. and other such like occasions. But the antecedent and conjunct causes are the same with those of an Atheroma, Meliceris and Steatoma. The description formerly set down, will furnish you with the signs by which Signs. you may know when they are present; certainly from very small beginnings they grow by little and little to a great bigness, in the space of six or seven years, some of them yield much to the touch, and almost all of them are without pain. You may hinder such as are beginning and first growing, from increase by somewhat a strong and frequent rubbing with your fingers. For so their bag or bladder, together with the skin wax thin, and the contained humour grows hot, is attenuated Their cure at the beginning. and resolved. But if so you nothing prevail, you must lie upon them with your whole hand, or a flatted piece of wood as heavy as you can, until such time as the cyste or bag be broken by your impression; Then apply and strongly bind unto it a plate of lead, rubbed over with Quicksilver; for I have many times found by Plates of lead rubbed with Quicksilver, experience, that it hath a wonderful force to resolve and waste the subject humour. But if the Wen be in such a place in which you can make no strong impression, as in the face, chest, belly, and throat, let there be applied an Emplaster which hath a resolving force, such as this following hath; ℞, gummi ammon. bdelij. galban. an. ℥ iij, A resolving plaster. liquefiant in aceto, & traijciantur per setaceum, addendo olei liliorum & lauri, an. ℥ j, anʒss; let them be all incorporated together, and make an Emplaster according to Art. But if the tumour cannot be thus resolved, it must be opened with a knife or cautery. And after Things to waist or consume the bag. the Eschar is removed, and the bag wasted by Aegyptiacum, Mercury, and the like, the ulcer must be cleansed, replenished with flesh, and cicatrized. Sometimes Wens grow to so great a mass, that they cannot be cured by the described remedies, wherefore they must be taken away by the root, by your hand and instrument, if so be that there be no danger by reason of their greatness, and so that they adhere not too closely to the adjacent parts, and if they be not too nigh to the greater veins and arteries; for it will be better in such a cause to let them alone. This shall be your way to cut them off, or take them away. A small incision must be made The manner to take away Wen●. even to the bladder, or bag, by which thrust in a probe of a finger's thickness, hollowed in the midst, round at the end, and as long as need shall require; then draw it many times about between the skin and the bag, even to theroote of the Wen, that so the skin may be divided long ways, than it will be requisite to make another incision overthwarte, so that they may intersect each other like a cross; then presently draw the skin from the bladder, from the corners of the Wen; towards the root, and that with your finger covered with a fine linen cloth, or else with a Razor if need require. But you must observe that in a Wen there are always certain vessels, which are small in the beginning, but much increased in process of time, according to the increase of the Wen, whereof they are as it were the roots; wherefore if any haemorrhagy or flux of blood happen, let it be stopped by binding the vessels at their heads and roots, or make a straight ligature at the roots of the Wen, with a piece of whipcord, or with a manytimes doubled thread, and let the ends hang forth until it fall away of its own accord. Neither will it be sufficient to have cut away all this tumour, but also it will be fit to cut away portion of the skin, wherewith the tumour was covered, and only to leave so much as shall suffice to cover the part, then with a needle and thread draw together the lips of the incision, but in the interim let tents be put into the bottom of the ulcer until it be perfectly cleansed, and the rest of the cure be workemanlike performed, even to the cicatrizing thereof. The Chirurgeon Collo and I using this method, in the presence of Master Dr. Violanius A History. the King's Physician, took away a Wen from Marshal Colard, the Major of Bourbon; it hanged at his neck, as big as a man's head, and it weighed eight pounds; which made it so troublesome and burdensome to him, that he was forced to carry it bound up in a towel, as in a scrip. Verily if these kind of tumours have a slender root and broad top, they must be What Wens to be cured by ligature. Which dangerous to cure. straight tied and so cut off. But it is very difficult and full of dangerous chance to take away such Wens as are seated in the neck, neareunto the jugular veins, these under the armholes, in the groins, and such as are under the ham; by reason of the deadly force of such symptoms, as may thence arise. We can only conjecture, not certainly say what kind of matter may be contained in them. We can only know of what sort it is, when by incision it is presented to our sight. Yet in such as are very hard and do much resist the touch, there are often found matters, which in consistence may be resembled to little stones, or pebbles. I being on a time called to open the body of a great Lady, found in one of her A History. breasts a body which might equal the bigness of an Hen's egg, hard, and compact like a rough pebble; it was held, whilst she lived, both by the Physicians and Surgeons The matter of a Wen is sometimes taken for a Cancer. Another History. to be a Cancer, because this hardness was very painful to her, when it was but gently pressed down. But also some few years agone, I being called to the cure of a very honest woman, which was troubled with the same disease, strongly withstood the Physicians and Surgeons affirming it to be a Cancer, for the tumour had taken no deep root, the habit of the part was not changed from the native colour, the veins about it were not fwollen, neither was there any other convincing sign of a Cancer. For this same woman had her courses at their due and usual time, and was well liking, and How you may know a Wen from a Cancer. had a good colour in her face and body, was free from all sort of pain, unless when you pressed down the part affected. Besides thenceforward the tumour grew not at all; no other evil accident befell her, yea verily shelives merrily, and well both in body and mind. CHAP. XXI. Of a Ganglion more particularly so called. THere are also certain small tumours of the kind of Lupiae or Wens, which What a Ganglion properly so called is. grow on divers parts of the body, but chiefly on the wrists of the hands, and ankles of the feet, being called by a more particular name Gangli●; they appear on the top of the skin, neither do they ever lie deep. The cause of The causes. them is either the imbecility of a Nerve or Tendon got by wresting, extension, a blow, labour, or other such like cause. Through which occasion the alimentary juice which flowed to these parts, seeing it can neither be concocted, nor assimulated into the proper substance, is converted into an humour of the like nature cold, and gross; which in continuance of time heaping itself up by little and little about the fibers, and the very substance of the tendon, concretes into a tumour. It is not fit to use any iron instrument to these Ganglia which possess the tendons What Ganglia may not be cured with iron Instruments. and joints, but only apply Ammoniacum and Galbanum dissolved in Vinegar and Aqua vitae: as ℞ gummi ammon. & sagapeni in aqua vitae dissolutorum, ana. ℥ i. coquantur super cineres calidos adformam emplastri, sub finem adde sulphuris vivi subtiliter pulverisatis. ℥ ss, fiat empl. ad usum. Also the Emplaster of Vigo with double Mercury would be good for the same purpose. The tumour softened by these remedies, must be wrought, rubbed, or pressed, so long, until the bladder or bag be broken under your fingers, which I have divers times done; than it will be expedient presently to apply and bind hard thereunto● plate of lead rubbed with Quicksilver, which may waste and consume the remainder of the tumour. Sometimes there are Ganglia seen hanging by a small root, as it were a string; wherefore they must be tied with a string at the root, and every day twitched harder and harder, till such time as they fall off. The rest of the cure may be easily performed by the common rules of Art. CHAP. XXII. Of the Strumae or Scrophulae, that is, the King's-evil. TThe Scrophulae are oedematous tumours arising in the glandulous parts, as What the Scrophulae or King's-evil is. the breasts, armholes, groins, but chiefly in the glandules of the neck. They appear either one or many, according to the quantity of that matter from whence they proceed, commonly contained in their proper cyste, or bag, as Atheromacs, Steatomaees, and Melicerides are. They are made of a gross, cold, viscide, and phlegmatic matter with some admixture Their material cause. How they differ from other glanduleus tumours. of melancholy. They differ from other glandulous tumours; first in number, for most usually there appear many of them united together, springing from somewhat a deeper root than glandulous tumours do; some of them are movable, othersome woven with the neighbouring nerves, remaining unremovable. Gangliae appear fewer in number, and are without pain; but Scrophulae oftentimes are painful, especially when they wax hot by putrefaction; so that sometimes they degenerate into cancerous ulcers, not to be touched by instruments, nor acride medicines. Phlegmatic, Melancholic, and gluttonous persons, and such as are accustomed to feed on cold and moist nourishments, as fish and cold water, and lead a sedentary and idle life, are subject to the Scrophulae. They are cured by a most slender Their cure by diet. diet, for so the native heat by want of nourishment turned upon the material cause of such like tumours, wastes it. And they are cured by purging of the superfluous humours, and also by application of emollient resolving, and suppuratine topicke medicines, after this following manner. ℞, Mucaginis ulth. faenugr. & ficuum ping. an. ℥ ij, olei liliorum, & chamaem. an. ℥ j, Emollient and resolving medicines. pinguedinis anseris & axungiae porct ℥ ss, Terebinth. Ven. ℥ iss, ammoniaci, & galbani in aeceto dissolutorum an. ℥ j, cerae novae quantum satis, fiat cerotum secundum artem ad modum d●achyli magni. The ointment for the French disease, and the Emplaster of Vigo with Mercury, are excellent for this purpose, especially if we continue so long, until the Patient come to Salivation, for so Nature will disburden itself of the humour, generating the Scrophulae, which I have sometimes tried with happy success, ℞, Emplastri diachyl. alb. & mag. cerotioesopis descriptionis Philagrij, ana. ℥ ij. Terebinth. clarae ℥ j, oleililiorum param, fiat emplastrum satis molle. But if the Scrophulae cannot by this means be resolved, but as it oft times happens, tend to suppuration, you must use suppuratives, as ℞, rad. alth. & liliorum, an. ℥ iij. coquantur in aqua communi, pistentur, trajectis Seppuratives. add capitum alliorum sub cineribus coctorum ℥ iij, olei liliorum, & ping. anseris & anat. an. ℥ iss, farinae seminis lini quantum satis, formetur cataplasma. Here we must admonish the Chirurgeon, that he open not the Scrophulae before A note to be observed in opening Scropulous tumours. that all the contained humour be fully and perfectly turned into pus or matter; otherwise the residue of the humour will remain crude, and will scarce in a long time be brought to maturation; which precept must be principally observed in the Scrophulae, and also sometimes in other abscesses, which come to suppuration. For we must not as soon as any portion of the contained humours appears converted into pus, procure and hasten the apertion. For that portion of the suppurated humour, causes the rest sooner to turn into pus, which you may observe in inanimate bodies. For fruits which begin to perish and rot, unless we presently cut away the putrifying part, the residue quickly becomes rotten; there is also another reason; The native heat is the Natural heats the cause of suppuration. efficient cause of suppuration; it therefore (the sore being opened) diminished and weakened by reason of the dissipation of the spirits, evacuated together with the humour, will cause the remaining portion of the humour, not to suppurate, or that very hardly, and with much difficulty. Yet if the tumified part be subject, by its own nature, to corruption and putrefaction, as the fundament; if the contained matter be malign, or critical, it will be far better to hasten the apertion. There is also another way of curing the Scrophulae, which is performed by the The chirurgical manner of cutting Scrophulae. hand. For such as are in the neck, and have no deep roots, by making incision through the skin, are pulled and cut away from these parts with which they were entangled. But in the performance of this work, we take special care, that we do not violate or hurt with our instrument, the jugular veins, the sleepy arteries, or recurrent nerves. If at any time there be danger of any great effluxe of blood, after they are plucked from the skn, they must be tied at their roots, by thrusting through a needle and thread, and then binding the thread straight on both sides, that so bound they fall off by themselves by little and little without any danger. The remainder of the cure may be performed according to the common rules of Art. CHAP. XXIII. Of the Fever which happens upon an oedematous Tumour. HAving showed all the differences of oedematous tumours, it remains that How an intermitting Quotidian haopens upon oedematous tumours. we briefly treat of the Symptomatical fever, which is sometimes seen to happen upon them. This therefore retaining the motion of the humour by which it is made, is commonly of their kind, which they name Intermitting Quotidians. Now the fit of a Quotidian comes every day, and in that repetition The cause of a Quotidian ●ea. continues the space of eighteen hours; the residue of the day it hath manifest intermission. The primitive causes of this fever are, the coldness and humitity of the air encompassing us, the long use of cold meats and drinks, and of all such things as are easily corrupted, as Summer fruits, crude fishes, and lastly, the omission of our accustomed exercise. The antecedent causes are a great repletion of tumours, and these especially phlegmatic. The conjunct cause, is phlegm putrefying in the habit of the body, and first region thereof without the greater veins. The signs of this fever are drawn from three things; as first natural; for this The Signs: Fever or Ague chiefly seizes upon these which which are of a cold and moist temper, as Old-men, Women, Children, eunuchs, because they have abundance of phlegm; and it invades Old-men by its own nature, because their native heat being weak, they cannot convert their meats, then taken in a small quantity, into laudable blood, and the substance of the parts. But it takes children by accident, not of its self, and the own nature, for children are hot and moist; but by reason of their How children come to be subject to Quotidian fevers. voracity, or greediness, and their violent, inordinate, and continual motion after their plentiful feeding, they heap up a great quantity of crude humours fit matter for this fever; whereby it comes to pass, that fat children are chiefly troubled with this kind of fever, because they have the passages of their bodies straight and stopped; or because they are subject to Worms, they are troubled with pain, by corruption of their meat; whence ariseth a hot distemper by putrefaction, and the elevation of putrid vapours, by which the heart being molested, is easily taken by this kind of fever. From things not natural, the signs of this fever are thus drawn. It chiefly takes one in Winter, and the Spring, in a cold and moist Region, in a sedentary and idle life, by the use of meats, not only cold and moist, but also hot and dry, if they be devoured in such plenty, that they over whelm the native heat. For thus wine, although it be by faculty and nature, hot and dry, yet taken How phlegmatic humours happen to be generated by hot and dry meats. too immoderately, it accumulates phlegmatic humours, and causes cold diseases. Therefore drunkenness, gluttony, crudity, baths, and exercises presently after meat, being they draw the meats as yet crude into the body and veins, and to conclude, all things causing much phlegm in us, may beget a Quotidian fever. But by things contrary to nature, because this fever usually follows cold diseases, the Centre, Circumference, and Habit of the body being refrigerated. The symptoms of this fever are, the pain of the mouth of the stomach, because The Symptoms of quptidians. that phlegm is commonly heaped up in this place, whence follows a vomiting, or casting up of phlegm; the face looks pale, and the mouth is moist without any thirst, often times in the fit itself; because the stomach flowing with phlegm, the watery and thinner portion thereof continually flows up into the mouth and tongue, by the continuity of the inner coat of the ventricle common to the gullet and mouth. It takes one with coldness of the extreme parts, a small and deep pulse, which The manner of the pulse and heat in a Quotidian. notwithstanding in the vigour of the fit, becomes more strong, great, full, and quick. Just after the same manner, as the heat of this fever at the first touch appears mild, gentle, moist, and vaporous; but at the length it is felt more acride, no otherwise than fire kindled in green wood, which is small, weak, and smoky at the first; but at the length when the moisture being overcome, doth no more hinder its action, it burns and flames freely. The Patients are freed from their fits with small sweats, which at the first fits break forth very sparingly, but more plentifully when the Crisis is at hand; the urine Critical sweats. at the first is pale and thick, and sometimes thin, that is, when there is obstruction. But when the matter is concoct, as in the state, it is red: if at the beginning of The urine. the fit they cast up any quantity of phlegm by vomit, and that fit be terminated in a plentiful sweat, it shows the fever will not long last; for it argues the strength of nature, the yielding and tenuity of the matter flying up, and the excretion of the conjunct cause of the fever. Why Quodidiansare oft times long. In to what diseases a quartan usually changes. A Quotidian fever is commonly long, because the phlegmatic humour being cold, and moist by nature, is heavy and unapt for motion; neither is it without fear of a greater disease, because oft times it changes into a burning, or quartan fever, especially if it be bred of salt Phlegm; for saltness hath affinity with bitterness, wherefore by adustion it easily degenerates into it, so that, it need not seem very strange, if salt Phlegm by adustion turn into choler, or Melancholy. Those who recover of a quotidian Fever, have their digestive faculty very weak; wherefore they must not be nourished with store of meats, nor with such as are hard to digest. In a quotidian the whole body is filled with crude humours, whereby it comes to pass that this Fever oft times lasts sixty days. But have a care, you be not deceived, How to distinguish a quotidian from a double tertian. and take a double tertian for a quotidian, because it takes the patient every day as a quotidian doth. Verily it will be very easy to distinguish these Fevers by the kind of the humour, and the propriety of the Symptoms and accidents; beside, quotidians commonly take one in the evening, or the midst of the night, as then when our bodies are refrigerated by the coldness of the air caused by the absence of the Sun. Wherefore then the cold humours are moved in us, which were bridled a little before by the presence and heat of the Sun. But on the contrary, double tertians take one about noon. The shortness and gentleness of the fit, the plentitifull sweat breaking forth, the matter being concocted, causes us to think the quotidian short and salutary. The Cure is performed by two means; to wit Diet and Pharmacy. Let the Diet Diet. be slender and attenuating, let the patient breath in a clear air moderately hot and dry; let his meats be bread well baked, cock or chicken broths in which have been boiled the roots of Parsley, Sorrell and the like. Neither at some times will the use of hot meats, as those which are spiced and salted, When the use of spiced and salted meats are fit. be unprofitable, especially to such as have their stomach & liver much cooled. Let him eat Chickens, Mutton, Partridge and small Birds, river fishes and such as live in stony waters fried or broiled, rear Eggs and such like. These fruits are also good for him, Raisins, stewed Prunes, Almonds and Dates. Let his drink be small white wine mixed with boiled water. Moderate exercises will be good, as also frictions of the whole body: sleep taken at a fitting time, and proportioned to waking, so that the time of sleep fall not upon the time of the fit; for than it hurts very When sleep it hurtful. much; for calling the heat to the inner parts, it doubles the raging of the feverish heat inwardly in the bowels. For the passions of the mind, the patient must be merry, and comforted with a hope shortly to recover his health. It seems not amiss to some, at the coming of the fit to put the feet and Legs into hot water, in which Chamomill, Dill, Melilote, Marjerome, Sage, and Rosemary have been boiled. The Medicines shall be such Syrupes as are called digestive and aperitive, as Syrup Medicines. of Wormwood, Mints, of the five opening roots, Oxymel with a decoction of Chamomill, Calamint, Melilot, Dill and the like, or with common decoctions. The Purgatives shall be Diaphaenicon, Electuarium Diacarthami, Hiera picra, Agaricke; Turbith; of which you shall make potions with the water of Mints, Balm, Hyssop, Sage, Fennell, Endive or the like, Pilluae aureae are also good. These purgatives shall sometimes be given in form of a bowl with Sugar, as the Physician being present shall think most fit and agreeable to the nature of the Patient. About the state of the disease, you must have a care of the stomach and principally Care must be had of the stomach. of the mouth thereof, as being the chief seat of Phlegm; wherefore it will be good to anoint it every other day with oil of Chamomill mixed with a little white wine, Vomits. as also to unlade it by taking a vomit of the juice of Radish, and much Oxymel, or with the decoction of the seeds and roots of Asarum and Chamomill; and Syrup of vinegar will be very good, especially at the beginning of the fit, when nature and the humours begin to move; for an inveterate quotidian, though you can cure it by no The use of Treacle in an inveterate quotidian. other remedy, nothing is thought to conduce so much as one dram of old Treacle taken with Sugar in form of a Bowl, or to drink it dissolved in Aqua vitae. CHAP. XXIIII. Of a Scirrhus, or an hard Tumour proceeding of Melancholy. HAving showed the nature of Tumours caused by blood, choler and Phlegm, it remains we speak of these, which are bred of a Melancholic humour; Of these there are said to be four differences. The first is What a true and legitimate Scirrhus, is. of a true and legitimate Scirrhus, that is, of an hard Tumour endued with little sense, and so commonly without pain, generated of a natural Melancholic humour. The second is, of an illegitimate Scirrhus, that is, of an hard Tumour What an illegitimate Scirrhus is. insensible, and without pain, of a Melancholic humour concrete by too much resolving and refrigerating. The third is of a cancrous Scirrhus bred by the corruption and adustion of the Melancholic humour. The fourth of a Phlegmonous, Erysipelous or Oedematous Scirrhus, caused by Melancholy mixed with some other humour. The cause of all these kinds of Tumours is a gross, tough and tenacious humour concrete, in any part. But the generation of such an humour in the body happens either of an ill and irregular diet, or of the unnatural affects of the liver or spleen, as obstruction; or by suppression of the Haemorr●oides or Courses. The signs are hardness, renitency, a blackish colour, and a dilatation of the veins The signs. of the affected part with blackishness, by reason of the abundance of the gross humour. The illegitimate or bastard Scirrhus which is wholly without pain and sense, Prognostics. and also the cancerous, admit no cure, and the true legitimate scarce yield to any. Those which are brought to suppuration, easily turn into cancers and fistulas; these tumours though in the beginning they appear little, yet in process of time they grow to a great bigness. CHAP. XXV. Of the Cure of a Scirrhus. THe Cure of a Sirrhus chiefly consists of three heads. First, the Physician shall prescribe a convenient diet, that is, sober and moderate in feeding, tending to humidity, and indifferent heat; for his manner of life, let it be Diet. quiet and free from all perturbation of anger, grief and sadness, as also abhorring the use of venery. The second is placed in the evacuation of the antecedent matter, as by Phlebotomy, if need require, and by purging, by procuring the haemorrhoids in men and the courses in women; let purgations be prescribed of Discatholicon, Hyera, diasenna, polipody, Epythymum according to the mind of the learned Physician. The third consists in the convenient use of Topicke medicines, that is, emollient at the beginning, and then presently resolving, or rather such as are mixed both of resolving & emollient faculties, as Galen teaches; for by the use of only emollient Lib. 2. Ad Gla●conem. things there is danger of putrefaction and a Cancer, and only of resolving there is fear of concretion the subtler part being resolved, and the grosser subsiding. The emollient shall be thus: ℞. Rad. alth. lib. s. rad. liliorum ℥ iij. conquantur in aqua come. pistentur, traijciantur per setaceum, addendo olei chamaem. & lilior. an. ℥ ij. oesipi humidae ℥ ss. emplastri diachyl. alb. cum oleo liliorum dissoluti ℥ iij, cerae albae quantum Emollients. fit satis, fiat cerotum. Or ℞. gummi ammoniaci, galb. bdellij, styracis liquidae in aceto dissolutorum, an. ℥ i. diachyl. mag. ℥ jss, olei liliorum, & axungiae anseris, an. ℥ i. ceroti oesip. descriptione Philagr. ℥ ij. liques●ant omnia simul, cerae quantum sit satis, ut iude fiat cerotum satis molle. When you have sufficiently used emollient things, fume the Tumour with strong Vinegar and Aqua vitae poured upon a piece of a Millstone, flint or brick heated very hot; for so the mollified humour will be rarified, attenuated, and resolved; then some while after renew your emollients, and then again apply your resolvers to waste that which remains, which could not be performed together and at once; for thus Galen healed a Scirrhus in Cercilius Lib. 2. ad Glau. his son. Goat's dung is very good to discuss Scirrhous tumours; but the Emplaster The efficacy of the Empl. of Vigo with Mercury. of Vigo with a double quantity of Mercury is effectual above the rest, as that which mollifies, resolves and wastes all tumours of this kind. CHAP. XXVI. Of a Cancer already generated. A Cancer is an hard Tumour, rough and unequal, round, immovable, of an What a Cancer is. ash, or livide colour, horrid by reason of the veins on every side, swollen with black blood, and spread abroad to the similitude of the stretched out legs and claws of a Crabb. It is a tumour hard to be known at the first, as that which scarce equals the bigness of a Chick, or Cicer, after a little time it will come to the greatness of a Hasell Nut, unless peradventure provoked by somewhat too acride medicines it suddenly increase; being grown bigger, according to the measure of the increase it torments the patient with pricking pain, with acride heat, the gross blood residing in the veins growing hot, and inferring a sense like the pricking of Needles, from which notwithstanding the Patient hath oft times some rest. But because this kind of Tumour by the veins extended & The nature of the pain. spread about it like claws and feet, being of a livide and ash colour, associated with a roughness of the skin and tenacity of the humour, represents, as it were, the toothed The reason of the name. claws of the Crab, therefore I thought it not amiss here to insert the Figure of the Crabb, that so the reason both of the name and thing might be more perspicuous. The figure of the Crabb, called Cancer in Latin. CHAP. XXVII. Of the causes, kinds, and prognostics of a Cancer. HEre we acknowledge two causes of a Cancer, the antecedent, and conjunct. The causes of a Cancer. The antecedent cause depends upon the default of irregular diet, generating and heaping up gross and feculent blood; by the morbificke affection of the Liver disposed to the generation of that blood; by the infirmity or weakness of the spleen in attracting and purging the blood; by the suppression of the Courses or Haemorrhoids, or any such accustomed evacuation. The conjunct cause is that gross and melancholic humour sticking and shut up in the affected part, as in a strait. That malancholicke blood which is more mild, and less malign, only The causes of a not ulcerated Cancer. increased by a degree of more fervide heat, breeds a not ulcerated Cancer, but the more malign and acride causes, an ulcerated. For so the humour which generated Carbuncles, when it hath acquired great heat, acrimony, and malignity, corrodes, and ulcerates the part upon which it alights. A Cancer is made more fierce and raging by meats inflaming the blood, by perturbations of the mind; anger, heat, and medicines too acride, oiely, and emplaisticke, unfitly applied, both for time and place. Amongst the sorts or kinds of Cancers, there be two chiefly eminent, that is, the The sorts and differences of Cancers. ulcerated or manifest Cancer, and the not ulcerated, or occult. But of Cancers some possess the internal parts, as the Guts, Womb, fundament; others the external, as the Breasts; also there is a recent, or late bred Cancer, and also an inveterate one. There is one small, another great; one raging and malign, another more mild. Every Cancer is held almost incurable, or very difficult to be cured, for it is a disease altogether malign, to wit, a particular Leprosy. Therefore saith Aëtius, a Cancer is not easily stayed until it hath eaten even to the innermost of the part which it possesses. Aetius lib. 16. It invades women more frequently than men, and those parts which are lax, rare, fungous, and glandulous, and therefore opportune to receive a defluxion of a The parts most subject to Cancers. gross humour, such are the Breasts and all the emunctories of the noble parts. When it possesses the Breasts, it often causes inflammation to the armholes, and sends the swelling ever to the glandules thereof; whereupon the Patients do complain that a pricking pain even pierces to their hearts. But this same pain also runs to the clavicles, and even to the inner side of the shoulderblades and shoulders. When it is increased, and covers the noble parts, it admits no cure but by the hand; but in decayed bodies, whose strength fail, especially if the Cancers be inveterate, we must not attempt the cure, neither with instrument, nor with fire, neither by too acride medicines, as potential Cauteries; but we must only seek to keep them from growing more violent, and from spreading further, by gentle medicines, and a palliative cure. What Cancers one must not undertake truly to cure. For thus many troubled with a Cancer, have attained even to old age. Therefore Hypocrates admonishes us, that it is better not to cure occult, or hidden Cancers; for the Patients cured (saith he) do quickly die, but such as are not cured live longer. CHAP. XXVIII. Of the Cure of a Cancer beginning, and not yet ulcerated. A Cancer beginning is oft hindered from increasing, before it fasten its roots, but when it hath once increased, it admits no cure but by iron, as that which contemns, by reason of the malignity & contumacy, the force of all Lib. 2. ad Glau. medicines. Galen affirms, he cured a Cancer not ulcerated. Now that cure is performed by medicines, purging melancholy, by Phlebotomy, when the strength and age of the Patient may well endure it, by shunning all things, which may breed ill and feculent blood. The distemper of the Liver must first be corrected, the Spleen strengthened, as also the part affected; in men the Haemorrhoides, in women their Courses must be procured. therefore thick and muddy wines, vinegar, brown bread, cold herbs, old cheese, old and salted flesh, Beef, Venison, goat, hare, garlic, Diet. onions and mustard, and lastly all acride, acide and other salt 〈◊〉▪ which may by any means incrassate the blood, and inflame the hum●… be eschewed. A cooling & humecting diet must be prescribed; fasting eschewed, as also watchings, immoderate labours, sorrow, cares, and mournings; let him use ptisans, and in his broths ●boile Mallows, Spinach, Lettuce, Sorrell, Purslane, Succory, Hops, Violets, Borradge, and the four cold seeds. But let him feed on Mutton, Veal, Kid, Capon, Pullet, young Hares, Partridges, Fishes of stony rivers, rear Eggs; and use white wine, but moderately for his drink. The part affected with the Cancer must be gently handled, and not overburdened How to handl● the cancorous part. by over hard, or heavy things, or by too solid, or fat emplasters; on the contrary gentle and mitigating medicines must be used; applying also at certain times such things as resist venom or poison, as Treacle and Mithridate. Asses milk is exceeding Antidotes. Asses milk. fit to assuage the acrimony of the cancorous humour. Therefore it must not only be taken inwardly, but also applied outwardly to the cancrous ulcer, making thereof a fomentation. CHAP. XXIX. Of the cure of an ulcerated Cancer. AN Ulcerated Cancer hath many signs common with that which is not The Signs. ulcerated, as the roundness of the tumour, the inequality, roughness, and pain; to the judgement of the eye, the tumour seems soft, but it is hard to the touch; the Ulcer is filthy, with lips thick, swollen, hard, knotty, turned out, and standing up, having a horrid aspect, and casting forth ichorous, filthy, and carionlike filth, sometimes black, sometimes mixed with rotten filth, and otherwhiles with much blood. This kind of ulcer is malign, rebellious, and untractable, as that which contemns mild remedies, and becomes more fierce, by acride and strong; the pain, fever, and all the symptoms being increased, from whence the powers are dejected, the wasting and consumption of the body follows, and lastly death. Yet if it be small, and in a part which may suffer amputation, the body How and where a Cancer may be cut away. What to be observed in cutting away a Cancer. being first purged, and blood drawn, the strength of the Patient not dissuading, it will be convenient to use the hand, and to take hold of, and cut away whatsoever is corrupt, even to the quick, that no fear of contagion may remain, or be left behind. The amputation finished, the blood must not be presently stopped, but permitted to flow out in some measure, yea verily pressed forth all about it, that so the veins swollne with black and melancholic blood may be disburdened. When you have The benefit of applying a cautery after amputation of the Cancer. taken a sufficient quantity of blood, the place must be scared with an actual cautery. For that will strengthen the part affected, draw forth the venenate quality, and also stay the defluxion. Then must you apply mitiga●… medicines, & procure the falling away of the Eschar. To conclude, that which rem●… must be performed according to the cure of other ulcers. Now we know and ●…stand that all the Cancer is cut away, Signs that a Cancer is well taken away: and all the malignity thereof extinct, when ●…lcer casts forth laudable matter, when that good flesh begins to grow●… little ●…ittle, like to the grains of a Pomeganate, the pricking pain, and ●…e symptoms being assuaged. Yet the cure of an ulcerated Cancer, which shall possess the lips may be more happily and mildly performed, no caustic medicine being applied after section, so also that scarce any deformity will be left, when it is cicatrized. Which new and never formerly tried, or written of way, as far as I know, I found and performed in a man of fifty years old. Doctor john Altine, a most learned Physician being called to Counsel, james Guillemea●…, and Master Eustachius, the King's Surgeons, and john Le jeune the Duke of Guise his most worthy Chirurgeon being present. The way is this; The Cancer must be thrust through the lips on both sides, above A new and observable way of taking away a Cancer from the lip. and below with a needle and thread, that so you may rule and govern the Cancer with your left hand, by the benefit of the thread (lest any portion thereof should scape the instrument in cutting) and then with your Scissors in the right hand, you ●…ut it off all at once, yet it must be so done, that some substance of the inner ●…the lip, which is next to the teeth, may remain, (if so be that the Cancer be not grown quite through) which may serve as it were for a foundation to generate flesh to fill up the hollowness again. Then when it hath bled sufficiently, the sides & brinks of the wound must be scarified on the right and lift sides, within, and without, with somewhat a deep scarification, that so (when we would draw together the sides and lips of the wound, by that manner of stitching, which is used in an hare-lippe) we may have the flesh more pliant and tractable to the needle and thread. The residue of the cure must be performed just after the same manner as we use in hare-lips; of which we shall treat hereafter. CHAP. XXX. Of the Topicke medicines to be applied to an unlcerated, and not ulcerated Cancer. WE at the beginning use repercussive medicines, such as are the juices of Nightshade, Plantain, Henbane, Lettuce, Sorrell, Houseleek, Water Lentill or Duckes-meate, Knotgrass, Pomegranates, and the like. Also Repelling medicines, Oleum rosarum omphacinum, the powders of Sumach, Berberies, lethargy, Ceruse, Burnt-lead, Tutia, Quicksilver, and the like. Of which you may compose Fomentations, Liniments, Ointments, Cataplasms, Emplasters. Emplastrum Diacalcitheos' dissolved with juice of Nightshade, and oil of Roses is very fit for not ulcerated Cancers. Pompholix, or Tutia, washed in juice of Nightshade, or Plantain, is very good for ulcerated Cancers. Besides this following medicine is very commendable. ℞, Lytharg. & cerus. an. ℥ j, terantur in mortario plumb. cum oleo rosar. donec reducantured consistentiam linimenti vel unguenti; and there may be use of a resolving and repercassive ointment, as ℞, plumbi usti loti, pomphol. thuris, an. ʒijss, absinth. pontic. ℥ ss, olei rosarum ℥ iij, ceraeʒuj, succi solani, quantum sufficit ad unguenti crassitudinem. They very much commend Theodorickes Emplaster to assuage the pain of ulcerated Cancers. ℞, Olei ros. cerae alb. an ℥ ijss, succigranat. & solani, an. ℥ ij, cerusae lotae ℥ j, plumbi usti, loti, Theodoricks' Emplaster. & tuthiae praepar. an. ℥ ss, thuris, mastic. an. ʒijs, fiat empl. molle. This following ointment I have often used with good success. ℞, Therciac. veter. ℥ j, succi cancrorum ℥ ss, succi lactucae & olei rosar. an. ℥ iss, vitel. ovorum sub cinerib. coct. ij, camphor. ʒss. pistentur omnia in mortario plumb. & fiat unguentun●. ℞, spum. argent. axungiae porei recentis, cerae alb. an lib. ss, olei boni ℥ viij, vitel. ovorum assat. iiij, fiat unguent. servetur usui. And when you will use it, mix it with a little ointment of Roses. I have also mitigated great pain by applying Leeches to an unulcerated Cancer, in that part where the torment was most vehement, by disburdening Leaches. the part of some portion of the malign humour; which same thing I have done The application of whelps. chickens, & 〈◊〉 by application of young Whelp●…, or Kitlings, or Pigeons, or Chickens cut long ways, and presently applied to the ulcer, and now and then changed, as soon as their heat seems dissolved; and ●…hers applied for the natural heat in an anodyne or mitigating medicine. john Ba●…●heodosius in his Epistles, writes, that a cataplasm Epist. 21. The estate of Erysimum. of the herb Erysimum, or C●…cke, being beaten, is very good to be applied to a Cancer not ulcerated; but if the Cancer●…cerated ●…cerated, he boiles this same herb in Hydromel, and so by injections and lotions ●…ses the ulcer, and mitigates the pain. If The signs of the Cancer in the womb. the Cancer affect the womb, the patient feels the pricking of the pain in the groins above the pecten, and in the Kidneys, & is often troubled with a difficulty of making water; but when it is ulcerated it pours forth filth or matter exceeding stinking & carion-like, and that in great plenty; the filthy vapour of which carried up to the heart and brain, causes often swooning. Now to mitigate the pains of such like places, the following medicines are of good use. ℞. Mucag. semin. lini, foenugr. extract. in aqua rosar. & plantaginis quod satis est; Of this being warm make a fomehtation. ℞. Rad. Atheae, lb ss. coquatur in hydromelite, pistetur, & traijciatur, addendo olei rosar. parum, fiat Cataplasma. Also you shall make divers pessaries according to the different kinds of pain; also make injections of the juice of Plantain, Knotgrass, Lettuce, Purslane, mixed together, and agitated or laboured in a leaden mortar wi●… oil of Roses; for this kind of medicine is commended by Galen, in every kind of ulcerated Cancer. Also this following water is very profitable, and often approved Lib. 9 Simpl. by me. ℞. Stercoris bubuli lb. iiij. herbae Roberti, plantag, sempervivi, hyoscyami, portulac. lactuc. endiu. an. m. i. cancros slu●iatiles, num. xij. let them be all beaten together and distilled in a leaden Alembicke, keep the liquor for use and with it make often injection into the part; or if the site of the part will permit, let the cancerous ulcers be washed therewith, and pledgets of lint steeped therein be applied and renewed ever and anon; for so the acrimony and force of the inflammation is retunded, and the pain assuaged. Galen beats into powder river Crabs burnt; the Lib. ●. decom●med. secundum gen. powder mixed with ointment of Roses is most profitably applied upon lint to cancerous ulcers. It will be very convenient to put into the neck of the womb the following instrument made of Gold, or Silver, whereby the cancerous filth may have free and safe passage forth, and the filthy and putredinous vapours may more easily breathe forth. Therefore let it be hollow quite through; some five or six fingers long, and about the bigness of ones Thumb, at the upper end, perforated with many holes whereby the filth may have passage forth. Let the outer or lower end be some two fingers thick in the circumference, make it with a neat springe, that may hold that end open more, or less according to the Physicians mind; let there be two strings, or laces put unto it, by which being tied before and behind to the rowler, with which the woman shall gift her loins, the Device may be kept from falling, as you may see in the following figure. A Vent made like a Pessary for the womb affected with a Cancerous ulcer. A. Shows the upper end perforated with five or six holes. B. The Lower end. C. That part of the end which is opened by the springe, which is marked with the letter D. E E. The strings, or laces. Neither is that remedy for not ulcerated cancers to be contemned, which consists of a plate of lead besmeared with quicksilver; for Galen himself testifies that lead is a Lib. 9 〈◊〉. good medicine for malign and inveterate ulcers. But Guido Cauliacensis is a witness Plates of Lead of ancient credit and learning, that such plates of lead rubbed over with quicksilver, to such malign ulcers as contemn the force of other medicines, are as it were Antidotes, to waste and overcome their malignity and evil nature. This kind of remedy, when it was prescribed by that most excellent Physician Hollerius, who commanded A History. me to apply it to the Lady of Montigni maid of Honour to the Queen mother, troubled with a Cancer in her left breast, which equalled the bigness of a Walnut, did not truly throughly heal it, yet notwithstanding kept it from further growth. Wherefore at the length growing weary of it, when she had committed herself to a certain Physician boldly promising her quick help, she tried with loss of her life, how dangerous, and disadvantageous that cure of a Cancer was, which is undertaken according to the manner of healing other ulcers; for this Physician, when he had cast away this our medicine, and had begun the cure with mollifying, heating and attractive thing, the pain, inflammation and all the other Symptoms increasing, the Tumour grew to that bigness; that being the humour drawn thither could not be contained in the part itself, it stretched the breast forth so much, that it broke it in the middle, just as a Pomegranate cleaves when it comes to its full maturity; whereupon an immoderate flux of blood following, for staying whereof he was forcte to strew caustic powders thereon; but by this means the inflammation and pain becoming more raging, and swound coming upon her, she poor Soul in steed of her promised health, yielded up her ghost in the Physicians bosom. CHAP. XXXI. Of the Fever which happeneth in Scirrhous Tumours. Such a Fever is a quartan, or certainly coming near unto the nature of a quartan, by reason of the nature of the Melancholic Why a quartan happens upon scirrhous tumours. humour of which it is bred. For this shut up in a certain seat in which it makes the tumour, by communication of putrid vapours heats the heart above measure, and inflames the humours contained therein, whence arises a Fever. Now therefore a quartan is a Fever coming every fourth day, and having two days intermission. The primitive causes thereof are, these things which increase Melancholic humours in the body, such as the long eating of pulse, ofcourse and burnt bread, of salt flesh and fish, of gross meats as Beese, Goat, Venison, old Hares, old Cheese, Cabbage, thick and muddy wines and other such things of the same kind. The antecedent causes are a heaped up plenty of Melancholic humours abounding over all the body. But the conjunct causes are Melancholic humours putrifying without the greater vessels, in the small veins and habit of the body. We may gather the signs of a quartan fever from things which they call natural, not natural, and against nature; from things natural, for a cold and dry The signs. temper, oldage, cold and fat men, having their veins small, and lying hid, their spleen swollen and weak, are usually troubled with quartan Fevers. Of things not natural; this Fever, or Ague is frequent in Autumn, not only because, for that it is cold and dry, it is fit to heap up Melancholic humours; but Why they are frequent in Autumn. chiefly by reason that the humours by the heat of the preceding Summer are easily converted into adust Melancholy, whence far worse and more dangerous quartaines arise, than of the simple Melancholic humour; to conclude, through any cold or dry season in a region cold and dry, men that have the like Temper easily fall into quartaines; if to these a painful kind of life full of danger and sorrow doth accrue. Of things contrary to nature; because the fits take one with painful shaking, inferring as it were the sense of breaking or shaking the bones; further it taketh one every fourth day with an it ch over the whole body, and oft times with a thin scurf and pustles especially on the legs; the pulse at the beginning is little, slow, and deep, and the urine also is then white and waterish, inclining to somewhat a dark colour. In the declination when the matter is concocted the urine becomes black, not occasioned by any malign Symptom or preternatural excess of heat, (for so it should be deadly) but by excretion of the conjunct matter. The fit of the quartan continues 24 hours, but the intermission is 48 hours. It often takes its original from an obstruction, pain, and Scirrhus of the Spleen, and the suppression of the courses and Haemorroides. Quartaines taken in the Summer are for the most part short, but in the Autumn Prognostics. long, especially such as continue till Winter. Those which come by succession of any disease of the Liver, Spleen, or any other precedent disease, are worse than such as are bred of themselves, and commonly end in a Dropsy. But those which happen without the fault of any bowels, and to such a patlent, as will be governed by the From what diseasses a quartain 〈◊〉 〈◊〉. Physician in his Diet, infer no greater harm, but free him from more grievous and long diseases, as Melancholy, the Falling sickness, Convulsions, Madness, because the Melancholy humour, the author of such diseases, is expelled every fourth day by the force of the fit of the quartan. A Quartane Fever, if there be no error committed, commonly exceeds not a year, for otherwise some quartans have been found to last to the twelfth year according to the opinion of Avicen: the Quartane beginning in Autumn is oft times ended in the following spring; the Quartane which is caused by adust blood or choler or Salt phlegm is more easily and sooner cured, than that which proceeds from an adust Melancholy humour; because the Melancholy humour, terrestrial of its own nature, and harder to be discussed than any other humour, is again made by adustion (the subtler parts being dissolved and the grosser subsiding) more stubborn, gross, malign and acride. The cure is wholly absolved by two means, that is, by Diet and medicines. The Diet ought to be prescribed, contrary to the Diet. cause of the Fever in the use of the six things not natural, as much as lies in our power. Wherefore the Patient shall eschew Swine's flesh, flatulent, viscide and glutinous meats, fenny fowls, salt meats and Venison, and all things of hard digestion. The use of white wine indifferent hot and thin is convenient to attenuate and incide the gross humour, and to move urine and sweat; yea verily at the beginning of the fit a draught of such wine will cause vomiting, which is athing of so great moment, How much vomiting prevails to cure ● quartan that by this one remedy many have been cured. Yet if we may take occasion and opportunity to provoke vomit, there is no time thought fitter for that purpose than presently after meat; for than it is the sooner provoked, the sibers of the Stomach being humected & relaxed, and the stomach is sooner turned to vomiting, whereupon follows a more plentiful, happy and easy evacuation of the Phlegmatic and Choleric humour, and less trouble some to nature: and of all the crudities with which the mouth of the ventricle abounds in a quartan, by reason of the more copious afflux of the Melancholic humour, which by his qualities cold and dry, disturbs all the actions and natural faculties. Moreover exercises and frictions are good before meat; such passions of the mind as are contrary to the cause from which this Fever takes his original, are fit to be cherished by the patient; as Laughter, jesting, Music, and all such like things full of pleasure and mirth. At the beginning the patient must be gently handled and dealt withal, and we must abstain from all very strong medicines until such time, as the disease hath been of some continuance. For this humour, contumacious at the beginning when as yet nature hath attempted nothing, is again made more stubborn, terrestrial and dry, by the almost fiery heat of acride medicines. If the body abound with blood, some part thereof must be taken away by opening the Median or Basilick vein of the left arm, with this caution, that if it appear more gross and black, we suffer it to flow more plentifully; if more thin, and tinctured with a laudable red Colour, that we presently stay it. The matter of this Fever must be ripened, concocted and diminished with the Syrups of Epithymum, of Scolopendrium, of Maiden hair, Agrimony, with the waters of Hopps, bugloss, Borage and the like. I sincerely protest, next unto God, I have Medicine. cured very many quartaines by giving a potion of a little Treacle dissolved in about some two ounces of Aqua vita; also sometimes by two or three grains of musk dissolved in Muskadine, given at the beginning of a particular fit towards the general declination of the disease, after general purgations the humour and body being prepared, and the powers strong; And certainly an inveterate quartan can scarce ever be discussed unless the body be much heated with meats and medicines. Therefore it is not altogether to be disproved which many say, that they have driven away a quartan by taking a draught of wine every day as soon as they came forth of their bed, in which some leaves of Sage had been infused all the night. Also it is good a little before the fit to anoint all the spin of the back with oils heating all the nervous parts, such as are the oil of Rue, walnuts, of the Peppers, mixing therewith a little Aqua vitae. but for this purpose the oil of Castoreum which hath been boiled in an apple of Coloquintida, the Kernels taken out, upon hot coals to the consumption of the half part, mixing therewith some little quantity of the powders of Pepper, Pelitory of Spain and Euphorbium, is excellent. Certainly such like Inunctions are good not only to mitigate the vehemency of the terrible shaking, but also to provoke sweats; for because by their humid heat they discuss this humour being dull and rebellious to the expulsive faculty, for the Melancholy is as it were the dross and mud of the blood. Therefore if on the contrary the quartan fever shall be caused by adust choler, we must hope for and expect a cure by refrigerating What quartaines must be cured with refrigerating things. and humective medicines, such as are Sorrel, Lettuce, Purflane, broths of the decoction of Cucumbers, Gourds, Melons and Pompions. For in this case if any use hot medicines, he shall make this humour most obstinate by the resolving of the subtler parts. Thus Trallianus boasts that he hath cured these kinds of Quartane Fever by the only use of refrigerating Epithemaes being often repeated a little before the beginning of the fit. And this is the sum of the Cure of true and legitimate intermitting Fevers. That is, of those which are caused by one simple humour, whereby the What bastard agues are and how they must be cured. Cure of those which they call bastard intermitting Fevers, may be easily gathered and understood; as which are bred by a humour impure and not of one kind, but mixed or composed by admixture of some other matter; for example, according to the mixture of divers humours Phlegmatic and choleric, the medicines must also be mixed, as if it were a confused kind of Fever of a Quotidian and tertian; it must be cured by a medicine composed of things evacuating phlegm and choler. CHAP. XXXII. Of an Aneurisma, that is, the dilatation, or springing of an Artery, vein, or Sinnew. AN Aneurisma is a soft tumour yielding to the touch, made by the blood and spirit poured forth under the flesh and Muscles, by the dilatation What it is. or relaxation of an Artery. Yet the author of the definitions seems to call any dilatation of any venous vessel by the name of an Aneurisma. Galen calls an Aneurisma an opening made of the Anastomasis of an Artery: Also an Aneurisma is made, when an Artery that is wounded closeth too slowly, the substance which is above it being in the mean time agglutinated, filled with flesh and cicatrized, which doth not seldom happen in opening of Arteries unskilfully performed and negligently cured; therefore Aneurismaes' are absolutely made by the Anastomasis, springing, breaking, Erosion, and wounding of the Arteries. These In what parts they chiefly happen. happen in all parts of the body, but more frequently in the throat, especially in women after a painful travail. For when as they more strongly strive to hold their breath, for the more powerful expulsion of the birth, it happens that the Artery is di ated and broken, whence follows an effusion of blood and spirits under the skin. The signs are, a swelling one while great, another small, with a pulsation and a colour not varying from the native constitution of the skin. It is a soft tumour, and so yielding to the impression of the fingers that if it peradventure be small, it wholly vanisheth, the Arterious blood and spirits flying back into the body of the Artery, but presently as soon as you take your fingers away, they return again with like celerity. Some Aneurismaes' do not only when they are pressed, but also of themselves make a sensible hissing, if you lay your ear near to them, by reason of the motion of the vital spirit rushing with great violence through the straitness of the passage. Wherefore in Aneurismaes' in which there is a great rupture of the Artery, such a Prognosticke. noise is not heard, because the spirit is carried through a larger passage. Great Ane●rismaes under the Arm pits, in the Groins and in other parts wherein there are large vessels, admit no cure, because so great an eruption of blood and spirit often follows upon such an incision, that death prevents both art and Cure. Which I A History. observed a few years ago in a certain priest of Saint Andrew's of the Arches, M. john Maillet dwelling with the chief Precedent Christopher de Thou. Who having an Aneurisma at the setting on of the shoulder about the bigness of a Walnut, I charged him, he should not let it be opened, for if it did, it would bring him into manifest Aneurismaes' must not rashly be opened. danger of his life, and that it would be more safe for him, to break the violence thereof with double clothes steeped in the juice of Nightshade and Houselike, with new and whayey cheese mixed therewith: Or with Vnguentum de Bolo or Emplastrum contra rupturam and such other refrigerating and astringent medicines, if he would lay upon it a thin plate of Lead, and would use shorter breeches that his doublet might serve to hold it too, to which he might fasten his breeches instead of a swath, and in the mean time he should eschew all things which attenuate and inflame the blood, but especially he should keep himself from all great straining of his voice. Although he had used this Diet for a year, yet he could not so handle the matter but that the tumour increased, which he observing goes to a Barber, who supposing the tumour to be of the kind of vulgar inpostumes, applies to it in the Evening a caustic causing an Eschar so to open it. In the Morning such an abundance of blood flowed forth from the tumour being opened, that he therewith astonished, implores all possible aid, and bids that I should be called to stay this his great bleeding, and he repented that he had not followed my directions. Wherefore I am called, but when I was scarce over the three should, he gave up his ghost with his blood. Wherefore I diligently admonish the young Chirurgeon that he do not rashly open How they must be cured. Aneurismas unless they be small in anignoble part, and not endued with large vessels, but rather let him perform the cure after this manner. Cut the skin which lies over it until the Artery appear, and then separate it with your knife from the particles about it, than thrust a blunt and crooked needle with a thread in it under it, bind it, then cut it off and so expect the falling off, of the thread of itself whiles nature covers the orifices of the cut Artery with new flesh, than the residue of the cure may be performed after the manner of simple wounds. The Aneurismaes' which happen in These of the inward parts incurable. the internal parts are uncurable. Such as frequently happen to those who have often had the unction and sweat for the cure of the French disease, because the blood, being so attenuated and heated therewith that it cannot be contained in the receptacles of the Artery, it distends it to that largeness as to hold a man's fist; Which I have observed in the dead body of a certain Tailor, who by an Aneurisma of the Arterious A History. vein suddenly whilst he was playing at Tennis fell down dead, the vessel being broken: his body being opened I found a great quantity of blood poured forth into the Capacity of the Chest, but the body of the Artery was dilated to that largeness I formerly mentioned, and the inner Coat thereof was bony. For which cause within a while after I showed it to the great admiration of the beholders in the Physicians School whilst I publicly dissected a body there; the whilst he lived said he felt a beating and a great heat over all his body by the force of the pulsation of all the Arteries, by occasion whereof he often swooned. Doctor Silvius the King's professor of Physic at that time forbade him the use of Wine, and wished him to use boiled water for his drink, and Crudds and new Cheeses for his meat, and to apply them in form of Cataplasms upon the grieved and swollen part. At night he used a ptisan of Barley meal and Poppy-seedes, and was purged now and then with a Clyster of refrigerating and emollient things, or with Cassia alone, by which medicines he said he found himself much better. The cause of such a bony constitution of the Arteries by Aneurismaes' is, for that the hot and fervid blood first dilates the Coats of an Artery, then breaks them; which when it happens, it than borrows from the neighbouring bodies a fit matter to restore the loosed continuity thereof. This matter whilst by little and little it is dried and hardened, it degenerats into a Gristely or else a bony substance, just by the force of the same material and efficient causes, by which stones are generated in the reins and bladder. For the more terrestrial portion of the blood is dried and condensed by the power of the unnatural heat contained in the part affected with an Aneurismae; whereby it comes to pass that the substance added to the dilated and broken Artery is turned into a body of a bony consistence. In which the singular providence of nature, the handmaid of God is showed, as that which, as it were by making and opposing a new wall or bank, would hinder and break the violence of the raging blood swelling with the abundance of the vital spirits; unless any had rather to refer the cause of that hardness to the continual application of refrigerating and astringent medicines. Which have power to condensate and harden, as may not obscurely be gathered by the writings of Galen. But beware you be not deceived by the forementioned signs; For Lib. 4. Cap. ●lt. de praes, expulse. sometimes in large Aneurismaes' you can perceive no pulsation, neither can you force the blood into the Artery by the pressure of your fingers, either because the quantity of such blood is greater than which can be contained in the ancient receptacles of the A Caution in the knowing of Aneurismaes' Artery, or because it is condensate and concrete into Clods, whereupon wanting the benefit of ventilation from the heart, it presently putrifies; Thence ensue great pain, a Gangrene, and mortification of the part, and lastly the death of the Creature. The End of the Seventh Book. OF PARTICULAR TUMOURS AGAINST NATURE. THE EIGHT BOOK. The Preface. BEcause the Cure of diseases must be varied according to the variety of the temper, not only of the body in general, but also of each part thereof; the strength, figure, form, site, and sense thereof being taken into consideration: I think it worth my pains, having already spoken of Tumours in General, if I shall treat of them in particular which affect each part of the body, beginning with those which assail the head. Therefore the Tumour either affects the whole head, or else only some particle thereof, as the Eyes, Ears, Nose, Gums and the like. Let the Hydrocephalos, and Physocephalos be examples of those tumours which possess the whole head. CHAP. I. Of an Hydrocephalos or watery tumour which commonly affects the heads of Infants. THe greeks call this disease Hydrocephalos, as it were a Dropsy of the What it is. Head, by a waterish humour; being a disease almost peculiar to Infants newly borne. It hath for an external cause the violent compression The causes. of the head by the hand of the Midwife or otherwise at the birth, or by a fall, contusion and the like. For hence comes a breaking of a vein or Artery, and an effusion of the blood under the skin. Which by corruption becoming whayish, lastly, degenerateth into a certain waterish humour. It hath also an inward cause, which is the abundance of serous and acride blood, which by its tenuity and heat sweats through the Pores of the vessels, sometimes between the Musculous skin of the head and the Pericranium, sometimes between the Pericranium Differences by reason of place and the skull, and sometimes between the skull and the membrane called Dura matter, and otherwhiles in the ventricles of the brain. The signs of it, contained in the space between the Musculous skin and the Signs. Pericranium, are a manifest tumour without pain, soft, and much yeeelding to the pressure of the fingers. The Signs, when it remaineth between the Pericranium and the skull, are for the most part like the forenamed, unless it be that the Tumour is a little harder, and not so yielding to the finger, by reason of the parts between it and the finger; And also there is somewhat more sense of pain. But when it is in the space between the skull and Dura matter, or in the ventricles of the Brain or the whole substance thereof, there is dullness of the senses as of the sight and hearing; the tumour doth not yield to the touch, unless you use strong impression, for than it sinketh somewhat down, especially in infants newly borne; who have their sculls almost as soft as wax, and the junctures of their Sutures lax, both by nature, as also by accident, by reason of the humour contained therein moistening and relaxing all the adjacent parts; the humour contained here lifts up the Scull somewhat more high, especially at the meetings of the Sutures, which you may thus know, because the Tumour being pressed, the humour flies back into the secret passages of the brain. To conclude, the pain is more vehement, the whole head more swollen, the forehead stands somewhat further out, the eye is fixed and immovable, and also weeps by reason of the serous humour sweeting out of the brain. Vesalius writes that he saw a girl of two years old, whose head was thicker than A History. any man's head by this kind of Tumour, and the Scull not bonny, but membranous, as it useth to be in abortive births, and that there was nine pound of water ran out of it. A●ucrasis tells that he saw a child whose head grew every day bigger by reason of the watery moisture contained therein, till at length the tumour became so great, that his neck could not bear it neither standing nor sitting, so that he died in a short time. I have observed and had in cure four children troubled with this disease, one of which being dissected after it died, had a brain no bigger than a Tennis Ball. But of a Tumour and humour contained within under the Cranium, or Scull, I have seen none recover; but they are easily healed of an external Tumour. Therefore whether the humour lie under the Pericranium, or under the musculous skin of the head, it must first be assailed with resolving medicines, but if it cannot be thus overcome, you must make an incision, taking heed of the Temporal Muscle, and thence press out all the humour, whether it resemble the washing of flesh newly killed, or blackish blood, or congealed or knotted blood, as when the tumour bathe been caused by contusion; then the wound must be filled with dry lint, and covered with double bolsters, and lastly bound with a fitting ligature. CHAP. II. Of a Polypus, being an eating disease in the Nose. THe Polypus is a Tumour of the Nose against nature, commonly arising from the Os Ethm●ides of spungye bone. It is so called, because it resembles the The reason of the name. feet of a Sea Polypus in figure, and the flesh thereof in consistence. This Tumour stops the Nose, intercepting and hindering the liberty of speaking and blowing the Nose. Celsus saith the Polypus is a caruncle or Excrescence one while white, another while reddish, which adheres to the bone of the Nose, and sometimes Lib. 6. Cap. 8. fills the Nostrils hanging towards the lips, sometimes it descends back through that hole, by which the spirit descends from the Nose to the throttle; it grows so that it may he seen behind the Wula, and often strangles a man by stopping his breath. There are five kinds thereof, the first is, a soft membrane, long and thin like the relaxed and depressed Wula, hanging from the middle gristle of the nose, being filled with a The differences thereof. Phlegmatic and viscide humour. This in expiration hangs out of the Nose, but is drawn in and hid by inspiration; it makes one snaffle in their speech and snort in their sleep. The second, hath hard flesh, bred of Melancholy blood without adustion, which obstructing the nostrils intercepts the respiration made by that part. The third, is flesh hanging from the Gristle, round, and soft, being the offspring of Phlegmatic blood. The fourth is an hard Tumour, like flesh, which when it is touched yields a sound like a stone; it is generated of Melancholic blood dried, being somewhat of the nature of a Scirrhus confirmed and without pain. The fifth is as it were composed of many cancrous ulcers spread over the transverse surface of the gristle. Of all these sorts of Polypi, some are not ulcerated, others ulcerated, which send forth a stinking and strong smelling filth. Such of them as are painful, hard, Which of them admit no manual operation. resisting, and which have a livide, or leaden colour, must not be touched with the hand, because they savour of the Nature of a Cancer, as into which they oft degenerate; yet by reason of the pain which oppresses more violently, you may use the Anodyne medicines formerly described in a Cancer, such as this following. ℞. Olei de vitell. ovorum ℥ ij, Lytharg. auri, & Tuthiae praep. an. ℥ i. succi plant. An Anodyne. & solani an. ℥ ssj. Lapid. haematit. & camphorae, an ℥ ss. Let them be wrought a long time in a leaden mortar, and so make a medicine to be put into the nosethrills. Those which are soft, loose and without pain, are sometimes curable, being plucked away with an instrument made for that purpose, or else wasted by actual cauteries put in through a pipe, so that they touch not the sound part; or by potential cauteries, as Agyptiacum composed of equal parts of all the simples with vitriol which hath a faculty to waste such like flesh. Aquafortis and oil of vitriol have the same faculty, for these take away a Polypus by the roots; for if any part thereof remain Why it must be taken clear away. it will breed again. But Cauteries and acride medicines must be put into the nostrils with this Caution, that in the mean time cold repelling and astringent medicines be applied to the nose and parts about it to assuage the pain, and hinder the inflammation. Such as are Vnguentum de bolo, and unguentum nutritum, whites of Eggs beat with Rose leaves, and many other things of the like nature. CHAP. III. Of the Parotides that is, Certain swellings about the Ears. THe Parotis is a Tumour against nature, affecting the Glandules and those What it is. parts seated behind and about the Ears, which are called the Emunctories of the brain; for these because they are loose and spongy, are fit to receive the excrements thereof. Of these some are critical, the matter of the disease somewhat digested being sent thither by the force of nature. The differences. Their signs and Symptoms. Others Symptomatical, the excrements of the brain increased in quantity or quality rushing thither of their own accord. Such abscesses often have great inflammation joined with them, because the biting humour which flows thither is more vitiated in quality than in quantity. Besides also they often cause great pain, by reason of the distension of the parts endued with most exquisite sense, as also by reason of a Nerve of the fifth Conjugation spread over these parts; as also of the neighbouring membranes of the brain, by which means the patient is troubled with the Headache and all his face becomes swollen. Yet many times this kind of Tumour useth to be raised by a tough, viscous, and gross humour. This disease doth more grievously afflict young men than old; it commonly Prognosticke. brings a Fever and watching. It is difficult to be cured, especially when it is caused by a gross, tough, and viscide humour, sent thither by the Crisis. The cure must be performed by diet, which must be contrary to the quality of the humour in the temper & consistence of the meats. If the inflammation & redness be great, The cure. which indicate abundance of blood, Phlebotomy will be profitable, yea very necessary. But here we must not use the like judgement in application of local medicines Lib. 3. de compmed. see. Locol. Hip. aph. 21 lib. 1. as we do in others tumours, as Galen admonisheth us; that is, we must not use repercussives at the beginning, especially if the abscess be critical; for so, we should infringe or foreflow the endeavours of nature forcibly freeing itself from the morbifique matter. But we must much less repel or drive it back if the matter which hath flowed thither be venenate, for so the reflow thereof to the noble parts would prove mortal. Wherefore the Chirurgeon shall rather assist nature in attracting and drawing forth that humour. Yet if the defluxion shall be so violent, if the pain so fierce that thence there may be fear of watchings and a Fever, which may deject the powers, Galen thinks it will be expedient with many resolving medicines to mix some repelling. Wherefore at the beginning let such a Cataplasm be applied. ℞. Far. hord. & sem. lin. ana. ℥ ij. coquantur cum mulsa aut decocto cham. addendo but. recen. & olei cham. ana ℥ j fiat Cataplasma. And the following ointment will also be good. ℞. But. recen. ℥ ij, oles cham. & lilior. an ℥ i. unguen. de Althaea ℥ ss. cerae parum: make an Gentle resolving medicines ointment to be applied with moist and greasy wool to mitigate the pain, also somewhat more strong discussing and resolving medicines will be profitable, as: ℞. Rad. altheae & bryon. an. ℥ ij. fol. rutae, puleg. orig. an. m. i. flo. chamaem. melil. an. p. i. Stronger resolvers. coquantur in hydromelite, pistentur, traijciantur, addendo farin. faenugraec. orobi, an. ℥ i. pal. Ireos, cham. melilot. an. ℥ ij. olet aneth. rutac. an. ℥ i. fiat cataplasma. But if you determine to resolve it any more, you may use Emplastrum Oxycroceum & Melilot-Plaister. If the humour doth there concrete and grow hard, you must betake you to the medicines which were prescribed in the Chapter of the Scirrhus; but if it tend to suppuration, you shall apply the following medicine. ℞. Rad. liliorum & ceparum sub cineribus coct. an. ℥ iij. Vitell. over. num. ij. axung. suilla & unguent. basilicon, an. ℥ i. far. sem. lini ℥ iss. fiat Cataplasma. But if the matter do A Ripening medicine. so require, let the tumour be opened as we have formerly prescribed. CHAP. four Of the Epulis, or overgrowing of the flesh of the Gums. THe Epulis is a fleshy excrescence of the Gums between the teeth, which is by little and little oft times increased to the bigness of an Egg, so that it both What it is. hinders the speech and eating; it casts forth salivous and stinking filth, and not seldom degenerates into a Cancer, which you may understand by the propriety of the colour, pain and other accidents; for than you must by no means touch it with your hand. But that which doth not torment the Patient with pain, may The Symputomes. be plucked away; and let this be the manner thereof. Let it be tied with a double thread, which must be straiter twitched until such time as it fall off; when it shall fall away, the place must be burnt with a cautery put through a trunk or pipe, or with Aqua fortis, or oil of Vitriol, but with great care The Chirutgicall cure. that the sound parts adjoining there to be not hurt, for if so be that it be not burnt, it usually returns. I have often by this means taken away such large tumours of this kind, that they hung out of the mouth in no small bigness, to the great dissiguring of the face, which when as no Chirurgeon durst touch, because the flesh looked livide, I ventured upon because they were free from pain; and by taking them away and cauterizing the place, I perfectly healed them; not truly suddenly and at once; for although I b●… the place after dissection; yet nevertheless they sprung up again, because a certain portion of the bone and sockets in which the Teeth stand fastened, were become rotten I have often observed such like flesh by continuance of time to have turned into a gristlely & bony substance. Wherefore the cure must be begun as speedily as may be; Why the eure must not be deferred. for being but little, and having fastened no deep roots, it is more easily taken away, being then only filled with a viscide humour, which in success of time is hardened, and makes the taking away thereof more difficult. CHAP. V. Of the Ranula. THere is ofttimes a tumour under the tongue, which takes away the liberty The Reason why it is so called. of pronunciation, or speech; wherefore the Greeks call it Batrachium, the Latins Ranula, because such as have this disease of the tongue, seem to express their minds by croaking rather than by speaking. It is caused by the falling down of a cold, moist, gross, tough The Cause. viscide and Phlegmatic matter, from the brain upon the tongue, which matter in colour and consistence resembles the white of an egg, yet sometimes it looks of a Citrine or yellowish colour. That you may safely perform the cure, you must open the Tumour rather with The Cute. a cautery or hot Iron, than with a Knife, for otherwise it will return again. The manner of opening of it must be thus. You shall get a bended hollow and perforated iron plate with a hole in the midst, and making the patient to hold open his mouth, you shall so fit it, that the hole may be upon the part which must be opened. Then there you must open it with an hot Iron, for so you shall hurt no part of the mouth which is whole; but when you are ready to burn it, by thrusting your thumb under the Patient's Chin, you may somewhat elevate the Tumour, whereby you may open it with more certainty; when it is opened you must thrust out the matter contained therein, and then wash the patient's mouth with some barley water, honey, and Sugar of Roses; for so the ulcer will be safely and quickly healed. The deliniation of the Iron plate and crooked actual Cautery. CHAP. VI Of the swelling of the Glandules, or Almonds of the Throate. NAture at the jaws near the roots of the Tongue, hath placed two Why the Glandules are called Almonds. Glandules opposite to one another; in figure and magnitude like to Almonds, whence also they have their name, Their office is to receive the spittle falling down from the brain, both least that the too Their use. violent falling down of the humour should hinder the tongue in speaking, as also that the tongue might always have moisture, as it were laid up in store, lest by continual speaking it should grow dry and fail. For thus this spittle being consumed by feverish heats, the patients are scarce able to speak, unless they first moisten their tongue by much washing of their mouth. These Glandules because they are seated in an hot and moist place, are very subject The Cause of their tumour. to inflammations; for there flows into these ofttimes together with the blood, a great quantity of crude, phlegmatic and viscous humours, whence arises a tumour; which is not seldom occasioned by drinking much and that vaporous wine, by too much Gluttony, and staying abroad in the open air. Swallowing is painful and trouble some to the Patient, and commonly he hath a Symptoms. Fever. Ofttimes the neighbouring Muscles of the Throttle and neck are so swollen together with these Glandules, that (as it usually happens in the Squinzye) the passage of the breath and air is stopped, and the Patient strangled. We resist this imminent danger by purging and blood-letting, by applying Cupping-Glasses Cure. to the Neck and shoulders, by frictions and ligatures of the extreme parts, and by washing and gargling the mouth and throat with astringent gargarisms. But if they come to suppuration, you must with your incision Knife make way for the evacuation of the Pus, or Matter; but if on the contrary, these things performed according to art, defluxion be increased, and there is present danger of death by stopping and intercepting the breath, for the shunning so great and imminent danger, the top or upper part of the Aspera arteria or Weazon must be opened, in that place Extreme diseases must have extreme remedies. where it uses to stand most out; & it may be done so much the safer, because the jugular veins, and arteries are furthest distant from this place, and for that this place hath commonly little flesh upon it. And that the incision may be the fitlyer made, the patient must be wished to bend his head back, that so the Artery may be the more easily come to by the instrument; than you shall make an incision overtwhart with a crooked knife between two rings (not hurting nor touching the Gristlely substance) that is to How you must open the Wearon. say, the membrane which ties together the Gristlely rings being only cut; you shall then judge that you have made the incision large enough, when you shall perceive the breath to break out by the wound; the wound must be kept open so long, until the danger of suffocation be past; and than it must be sowed up not touching the Gristle. But if the lips of the wound shall be hard and callous, they must be lightly scarified, that so they may become bloody for their easier agglutination and union, as we shall show more at large in the cure of Hare lips. I have had many in cure, who have recovered, that have had their Weazon together with the Gristlely rings thereof cut with a great wound, as we shall note when we shall come to treat of the cure of the wounds of that part. CHAP. VII. Of the inflammation and relaxation of the Wula, or Columella. THe Wula is a little body, spongy and somewhat sharpened to the form of a pine apple, hanging even down from the upper and inner part of the What the Wula is, and what the use thereof. The Cause of the swelling thereof. palate, so to break the force of the Air drawn in, in breathing and carried to the Lungs, and to be as a quill to form and tune the voice. It often grows above measure by receiving moisture falling down from the brain, becoming sharp by little and little from a broader and more swollen Basis. Which thing causes many Symptoms; for by the continual irritation of the distilling humour the Symptoms Cough is caused, which also hinders the sleep, and intercepts the liberty of speech; but also by hindering respiration the patients cannot sleep unless with open mouth: they are exercised with a vain endeavouring to swallow (having as it were a morsel sticking in their jaws) and are in danger of being strangled. This disease must be resisted and affailed by purging, bleeding, Cupping, taking of The Cure. chysters', using astringent Gargles, and a convenient diet; but if it cannot thus be overcome, the cure must be tried by a caustic of Aqua fortis, which I have divers times done with good success. But if it cannot be so done, it will be better to put to your hand, than through idleness to suffer the patient to remain in imminent and deadly The Cure by Chirurgery. danger of strangling; yet in this there must very great caution be used; for the Chirurgeon shall not judge the Wula fit to be touched with an instrument or caustick, which is swollen with much inflamed, or black blood after the manner of a Cancer; but he shall boldly put to his hand if it be longish, grow small by little and little into a sharp, loose & soft point; if it be neither exceeding red, neither swollen with too much blood but whitish and without pain. Therefore that you may more easily and safely cut away, that which redounds and is superfluous, desire the patient to sit in a light place, and hold his mouth open; then take hold of the top of the Wula with your scissors, and cut away as much thereof as shall be thought unprofitable. Otherwise you shall bind it with the instrument here under described; the invention of this instrument is to be ascribed to Honoratus Tastellanus that diligent and learned man, the King's Physician in ordinary, and the chief Physician of the Queen mother; Which also may be used in binding of Polypi and warts in the neck of the Womb. The Deliniation of constrictory rings fit to twitch, or bind the Columella, with a twisted thread. A. Shows the ring whose upper part is somewhat hollow. B. A double waxed thread, which is couched in the hollowness of the ring, and hath a running, or loose knot upon it. C. An iron rod, into the eye whereof the forementioned double thread is put, and it is to twitch the Columella when as much thereof is taken hold of, as is unprofitable, and so to take it away without any flux of blood. When you would straiten the thread, draw it again through this iron rod, and so strain it as much as you shall think good, letting the end of the thread, hang out of the mouth. But every day it must be twitched harder than other, until it fall away by means thereof, and so the part and patient be restored to health. I have delineated three of these instruments, that you may use which you will, as occasion shall be offered. A Figure of the Speculum oris, by which the mouth is held and kept open, whilst the Chirurgeon is busied in the cutting away or binding the Wula. But if an eating ulcer shall associate this relaxation of the Wula, together with a flux of blood, than it must be burnt and seared with an hot iron, so thrust into a Trunk, or Pipe with an hole in it, that no sound part of the mouth may be offended therewith. A hollow Trunk with a hole in the side, with the hot iron inserted, or put therein. CHAP. VIII. Of the Angina, or Squinzy. THe Squinancy, or Squinzy, is a swelling of the jaws, which hinders the entering of the ambient air into the weazon, and the vapours and spirit What it is. from passage forth, and the meat also from being swallowed. There are three differences thereof. The first torments the patient with great pain, no swelling being outwardly apparent, by reason the morbificke humour lies The differences. The first kind. hid behind the almonds or Glandules at the Vertebrae of the neck, so that it cannot be perceived, unless you hold down the tongue with a spatula or the Speculum oris, for so you may see the redness and tumour there lying hid. The patient cannot The Symptoms. draw his breath, nor swallow down meat, nor drink; his tongue, (likes Grayhounds after a course,) hangs out of his mouth, and he holds his mouth open that so he may the more easily draw his breath; to conclude, his voice is as it were drowned in his jaws and nose; he cannot lie upon his back, but lying is forced to fit, so to breathe more freely: and because the passage is stopped, the drink flies out at his nose; the eyes are fiery and swollen, and standing out of their orb. Those which are thus affected are often suddenly suffocated, a foam rising about their mouths. The second difference is said to be that, in which the tumour appears inwardly, The second kind. but little or scarce any thing at all outwardly, the tongue, Glandules, and jaws appearing some what swollen. The third being least dangerous of them all, causes a great swelling outwardly, but The third. little inwardly. The Causes are either internal, or external. The external are a stroke, splinter The Causes: or the like things sticking in the Throat, or the excess of extreme cold, or heat. The internal causes are a more plentiful defluxion of the humours either from the whole body or the brain, which participate of the nature either of blood, choler or phlegm, but seldom of Melancholy. The signs by which the kind and commixture may be known, have been declared in the general treatise of tumours. The Squincy is more dangerous, by how much the humour is less apparent within and without. That is less dangerous which shows itself outwardly, because such an one shuts not up the ways of the meat, nor breath. Some die of a Squincy in twelve hours others in two, four or seven days. Those (saith Hypocrates) Hip. sect. 3. prog. z. Aphor. ●0. sect. 5. which scape the Squincy, the disease passes to the lungs, and they dye within seven days; but if they scape these days, they are suppurated; but also often times this kind of disease is terminated by disappearing, that is, by an obscure reflux of the humour into some noble part, as into the Lungs (whence the Empyema proceeds) and into other principal parts, whose violating brings inevitable death; sometimes by resolution, otherwise by suppuration. The way of Resolution is the more to be desired; it happens when the matter is small, and that subtle, especially if the Physician shall draw blood by opening a vein, and the patient use fitting Gargarisms. A Critical Squincy divers times proves deadly by reason of the great falling down of the humour upon the throttle, by which the passage of the breath is suddenly shut up. Broths must be used made with Capons, and Veal, seasoned with Lettuce, Purslane, Sorrell, and the cold seeds. If the Patient shall be some what weak, let him have potched Eggs, and Barley Dict. Creames, the Barley being first boiled with Raisins in water and Sugar, and other meats of this kind. Let him be forbidden wine, in stead where of he may use Hydromelita, and Hydrosachara (that is, drinks made of water and Honey, or water and Sugar) as also the Syrupes of dried Roses, of Violets, Sorrell and Lemons, and others of this kind. Let him avoid too much sleep. But in the mean time the Physician must be careful of all, because this disease is of their kind, which brook no delays. Wherefore let the Basilica be presently opened, on that side the tumour is Cure. the greater; then within a short time after the same day, for evacuation of the conjunct matter, let the vein under the tongue be opened; let cupping-Glasses be applied, sometimes with scarification, sometimes without, to the neck and shoulders, and let frictions and painful Ligatures be used to the extreme parts. But let the humour impact in the part be drawn away by glisters and sharp suppositories. Whilst the matter is in defluxion, let the mouth without delay be washed with astringent gargarisms to hinder the defluxion of the humour, lest by its sudden falling down it kill the Patient, as it often happens, all the Physicians care and diligence Repelling Gargarisms. not withstanding. Therefore let the mouth be frequently washed with Oxycrate, or such a gargarism: ℞ Pomorum silvest. nu. iiij. sumach, Rosar. rub. an. m. ss. berber. ʒij. let them be all boiled with sufficient quantity of water to the consumption of the half, adding thereunto of the wine of sour Pomegranates ℥ iiij. of diamoron ℥ ij, let it be a little more boiled and make a gargoyle according to art. And there may be other Gargarisms made of the waters of Plantain, Nightshade, Verjuice, julep of Roses and the like. But if the matter of the defluxion shall be Phlegmatic, Alum, pomegranate pill, Cypress nuts, and a little Vinegar may be safely added. But on the contrary, repercussives must not be outwardly applied, but rather Lenitives, where by the external parts may be relaxed and rarified, and so the way be open either for the diffusing or resolving the portion of the humour. You shall know the humour to begin to be resolved, if the Fever leave the patient, if he swallow, speak and breathe more freely, if he sleep quietly, and the pain begin to be much assuaged. Therefore than nature's endeavour must be helped by applying resolving medicines, or else by using suppuratives inwardly and outwardly, if the matter seem to turn into Pus. Therefore let gargarisms be made of the roots Ripening Gargarisms. of March-Mallowes, Figgs, jujubes, damask Prunes, Dates, perfectly boiled in water. The like benefit may be had by Gargarisms of Cow's milk with Sugar, by oil of sweet Almonds, or Violets warm, for such things help forward suppuration and assuage pain; let suppurating cataplasms be applied outwardly to the neck and throat, and the parts be wrapped with wool moistened with oil of Lillies. When the Physician shall perceive that the humour is perfectly turned into pus, let the patient's mouth be opened with the Speculum oris, and the abscess opened with a crooked and long incision knife; then let the mouth be now and then washed with cleansing gargles; as ℞. Aquae hordej lib. ss. mellis ros. & syr. rosar. sic. an ℥ i. fiag gargarisma. Detergent Gargarisma. Also the use of aenomel, that is wine, and Honey will be fit for this purpose. The ulcer being cleansed by these means, let it be cicatrized with a little roch-Alume added to the former gargarisms. The Figure of an incision knife opened out of the haft, which serves for a sheath thereto. CHAP. IX. Of the Bronchocele, or Rupture of the throat. THat which the French call Goetra, that the Greeks call Bronchocele, the Latins The reason of the name. Gutturis Hernia, that is, the Rupture of the throat. For it is a round tumour of the throat, the matter whereof coming from within outwards, is contained between the skin and weazon; it proceeds in women from the same cause as an Aneurisma. But this general name of Bronchocele undergoes many differences, for sometimes The differences. it retains the nature of Melicerides, other while of Steatom'as, Atheroma's or Aneurisma's, in some there is found a fleshy substance having some small pain; some of these are small, others so great, that they seem almost to cover all the throatt; some have a Cyste, or bag, others have no such thing; all how many so ever they be, and what end they shall have, may be known by their proper signs; these which shall be curable, may be opened with an actual or potential cautery, or with The Care. an incision knife. Hence if it be possible, let the matter be presently evacuated, but if it cannot be done at once, let it be performeed at divers times, and discussed by fit remedies, and lastly let the ulcer be consolidated and cicatrized. CHAP. X. Of the Pleurisy. THe Pleurisy is an inflammation of the membrane, investing the ribs, What it is. caused by subtle and choleric blood, springing upwards with great violence from the hollow vein into the Axygos, and thence into the intercostal veins, & is at length poured forth into the empty spaces of the intercostal muscles, and the mentioned membrane. Being contained there, if it tend to suppuration, it commonly infers a pricking pain, a Fever and difficulty of breathing. This suppurated blood is purged and evacuated one while Of a Pleurisy coming to suppuration. by the mouth; the Lungs sucking it, and so casting it into the Weazon, and so into the mouth, otherwhiles by urine, and sometimes by stool. But if nature being too weak, cannot expectorate the purulent blood poured forth into the capacity of the Chest the disease is turned into an Empyema, wherefore the Chirurgeon must then be called, who beginning to reckon from below upwards, may Of the change there of into an Empyema. make a vent between the third and fourth true and legitimate ribs; & that must be done either with an actual or potential cautery, or with a sharp knife drawn upwards Of the apertion of the side in an Empyema towards the back, but not downwards, lest the vessels should be violated which are disseminated under the rib. This apertion may be safely and easily performed by this actual caurtry; it is perforated with four holes, through one whereof there is a pin put higher or lower according to the depth & manner of your incision: then the point thereof is thrust through a plate afiron perforated also in the midst, into the part designed by the Physician, lest the wavering hand might peradventure touch, and so hurt the other parts not to be meddled withal. This same plate must be somewhat hollowed, that so it might be more easily fitted to the gibbous side, and bound by the corners on the contrary side with four strings. Wherefore I have thought good here to express the figures thereof. The Figure of an actual cantery with its plate fit to be used in a pleurisy. But if the patient shall have a large body, Chest and ribs, you may divide and perforate the ribs themselves with a Trepan; howsoever the apertion be made, the pus or matter must be evacuated by little and little at several times; and the capacity of the Chest cleansed from the purulent matter by a detergent injection of uj ounces of Barley water, and ℥ ij honey of Roses, and other the like things mentioned at large in our cure of wounds. CHAP. XI. Of the Dropsy. THe Dropsy is a Tumour against nature by the abundance of a waterish What the Dropsy is. humour, of flatulencies, or Phlegm, gathered one while in all the habit of the body, otherwhiles in some part, and that especially in the capacity of the belly between the Peritonaeum and entrailes. From this distinction of places and matters there arise divers kinds of Dropses. First that Dropsy which fills that space of the belly, is either moist or dry. The The differences thereof. moist is called the Ascites, by reason of the similitude it hath with a leather bottle, or Borachio, because the waterish humour is contained in that capacity, as it were in such a vessel. The dry is called the Tympanites, or Timpany, by reason the belly swollen with wind, sounds like a (Tympanum) that is, a Drum. But when the whole habit of the body is distended with a Phlegmatic humour, it is called Anasarca or Leucophlegmatia. The Symptoms. In this last kind of Dropsy the lower parts first swell, as which by reason of their site are more subject to receive defluxions, and more remote from the fountain of the native heat; wherefore if you press them down, the print of your finger will remain sometime after; the patient's face will become pale and puffed up, whereby it may be distinguished from the two other kinds of Dropsy. For in them first the belly, then by a certain consequence the thighs and feet do swell. There are besides also particular Dropsies contained in the straight bounds of certain places, such are the Hydrocephalos in the head; the Bronchochele in the throat; the Pleurocele in the Chest; the Hydrocele in the Scrotum, or Cod; and so of the The Causes. rest. Yet they all arise from the same cause; that is, the weakness or defect of the altering or concocting faculties, especially of the liver, which hath been caused by a Scyrrbus, or any kind of great distemper, chiefly cold, whether it happen primarily, or secondarily by reason of some hot distemper dissipating the native and inbred heat, such a Dropsy is uncureable; or else it comes by consent of some other higher or lower part; for if in the Lungs, Midriff, or reins there be any distemper, or disease bred, it is easily communicated to the gibbous part of the Liver by the branches of the hollow vein, which run thither. But if the mischief proceed from the Spleen, Stomach, Mesentery, Guts, especially the jejunum and Ileum, it creeps into the hollow side of the Liver by the meseraicke veins, and How divers diseases turn into Dropsies. other branches of the Vena porta or Gate-veine. For thus such as are troubled with the Asthma, phthisic, Spleen, jaundice, and also the Frenzy, fall into a Dropsy. Lastly, all such as have the menstrual or haemorrhoidal blood suppressed or too immoderately flowing contrary to their custom, either overwhelmes, diminisheth or extinguisheth the native heat; no otherwise than fire, which is suffocated by too great a quantity of wood; or dieth and is extinguished for want thereof. We must look for the same from the excrements of the belly or bladder, cast forth either too sparingly or too immoderately: Or by too large quantity of meats too cold, and rashly devoured without any order; To conclude by every default of external causes, through which occasion, error may happen, in diet or exercise. The Ascites is distinguished from the two other kinds of Dropsies, both by the The signs of an Ascites. magnitude of the efficient cause, as also by the violence of the Symptoms, as the dejected appetite, thirst, and swelling of the Abdomen. And also when the body is moved or turned upon either side, you may hear a sound as of the jogging of water in a vessel half full. Lastly the humour is diversely driven upwards or downwards, according to the turning of the body and compression of the Abdomen; It also causeth The Symptoms. various Symptoms by pressure of the parts to which it floweth. For it causeth difficulty of breathing and the cough by pressing the Midriff; by sweeting through into the capacity of the Chest it causeth like Symptoms as the Empyema. Besides also the Patients often seem, as it were, by the ebbing and flowing of the waterish humour, one while to be carried to the skies, and another while to be drowned in the water; which I have learned not by reading of any author, but by the report of the patients themselves. But if these waterish humours be fallen down to the lower parts, they suppress the excrements of the Guts and bladder by pressing & straightening the passages. When the patient lies on his back the tumour seems less, because it is spread on both sides; On the contrary when he stands or sits, it seems greater, for that all the humour is forced or driven into the lower belly, whence he feels a heaviness in the Pecten or share. The upper parts of the body fall away by defect of the blood fit for nourishment in quality and consistence, but the lower parts swell by the flowing down of the Serous and waterish humour to them. The pulse is little, quick, and hard with tention. This disease is of the kind of chronical or long diseases; wherefore it is scarce, Prognostickes. or never cured, especially in those who have it from their mother's womb, who have the Action of their Stomach depraved, and those who are cachecticke, old, and lastly all such as have the natural faculty languishing and faulty. On the contrary young and strong men, especially if they have no Fever, and finally all who can endure labour and those exercises which are fit for curing this disease, easily recover, principally if they use a Physician before the water which is gathered together do putrify and infect the bowels by its contagion. CHAP. XII. Of the cure of the Dropsy. THe beginning of the cure must be with gentle and mild medicines; neither must we come to a Paracenteses, unless we have formerly used and tried these. Therefore it shall be the part of the Physician to prescribe a drying diet, and such medicines as carry away water, both by stool and Hip. lib. 4. de acut. & lib. de intern. urine. Hypocrates ordains this powder for Hydropicke persons. ℞, Canthar. ablatis capitib. & alis ℥ ss. Comburentur in furno, & fiat pulvis; of which administer two grains in white wine, for nature helped by this, and the like remedies hath not seldom been seen to have cured the dropsy. But that we may hasten the cure, it will be available to stir up the native heat of the part by application of those medicines which have a discussing force: as bags, baths, ointments, and emplasters. Bags. Let bags be made of dry and harsh Bran, Oates, Salt, Sulphur, being made hot, or for want of them, of Saunder, or Ashes often heated. The more effectual baths are salt, nitrous, and sulphurous waters, whether by Baths. Nature or Art, that is, prepared by the dissolution of Salt niter, and Sulphur; to which, if Rue, Marjarom, the leaves of Fennell, and tops of Dill, of Staechas, and the like be added, the business will go better forwards. Let the ointments be made Liniments of the oils of Rue, Dill, Bayss, and Squills, in which some Euphorbium, Pellitory of Spain, or Pepper have been boiled. Let plasters be made of Franckinsence, Emplasters. Myrrh, Turpentine, Costus, Baiberies', English galengall, honey, the dung of Oxen, Pigeons, Goats, Horses, and the like, which also may be applied by themselves. If the disease continue, we must come to Synapismes and Phoenigmes, that is, to rubrifying Vesicatories. and vesicatory medicines. When the blisters are raised, they must be anointed again, that so the water may by little and little flow so long until all the humour be exhausted, and the patient restored to health. Galen writes, the Husbandmen in Asia, when they carried wheat out of the country Gal. lib. defacul. nature. 〈◊〉. into the city in Cars, when they will steal away and not be taken, hid some stone juggs filled with water in the midst of the wheat; for that will draw the moisture through the juggs into itself, and increase both the quantity and weight. When certain pragmatical Physicians had read this, they thought that wheat had force to draw out the water, so that if any sick of the Dropsy should be buried in a heap of wheat, it would draw out all the water. But if the Physician shall profit nothing by these means, he must come to the exquisitely chief remedy, that is, to Paracenteses. Of which because the opinions of Divers opinions of Paracenteses, or opening of the belly. Reasons against it. the ancient Physicians have been divers, we will produce and explain them. Those therefore which disallow Paracenteses, conclude it dangerous for three reasons. The first is, because by pouring out the contained water, together with it, you dissipate and resolve the spirits, and consequently the natural, vital, and animal faculties; another opinion is, because the Liver wanting the water by which formerly it was borne up; thence forward hanging down by its weight, depresseth and draweth downwards the Midriff and the whole Chest, whence a dry cough, and a difficulty of breathing proceed. The third is, because the substance of the Peritonaeum, as that which is nervous, cannot be pricked or cut without danger, neither can that which is pricked or cut be easily agglutinated and united, by reason of the spermatique and bloodless nature thereof. Erasistratus moved by these reasons condemned Erasistratus his Reasons against it. Paracenteses as deadly: also he persuaded that it was unprofitable for these following reasons, viz. because the water poured forth, doth not take away with it the cause of the Dropsy, and the distemper and hardness of the Liver, and of the other bowels, whereby it comes to pass that by breeding new waters they may easily again fall into the Dropsy. And then the fever, thirst, the hot and dry distemper of the bowels, all which were mitigated by the touch of the included water, are aggravated by the absence thereof, being poured forth: which thing seemeth to have moved Avicen and Gordonius that he said none; the other said very few lived after the Paracenteses: but the refutation of all such reasons is very easy. For, for the first Galen infers, that harmful dissipation of spirits, and resolving Reasons for it. the faculties happens, when the Paracenteses is not diligently, and artificially performed. As in which the water is presently poured forth; truly if that reason have any validity, Phlebotomy must seem to be removed far from the number of wholesome remedies, as whereby the blood is poured forth, which hath far more pure and subtle spirits, than those which are said to be diffused and mixed with the Dropsie-waters. But that danger which the second reason threatens shall easily be avoided; the patient being desired to lie upon his back in his bed, for so the Liver will not hang down. But for the third reason, the fear of pricking the Peritonaeum, is childish: for those evils which follow upon wounds of the nervous parts, happen by reason of the exquisite sense of the part, which in the Peritonaeum ill affected and altered by the contained water, is either none or very small. But reason and experience teach, many nervous parts, also the very membranes themselves being far removed from a fleshy substance, being wounded, admit cure; certainly much more the Peritonaeum, as that which adheres so straight to the muscles of the Abdomen, that the dissector cannot separate it from the flesh, but with much labour. But the reason which seems to argue the unprofitableness of the Paracenteses is refelled by Lib. 3. Cap. 21. the authority of Celsus. ay, saith he, am nor ignorant that Erasistratus did not like Paracenteses; for he through the Dropsy to be a disease of the Liver, and so that it must be cured, and that the water was in vain let forth, which the Liver being vitiated, might grow again. But first this is not the fault of this bowel alone, and then although the water had his original from the Liver, yet unless the water which stayeth there contrary to nature being evacuated, it hurteth both the Liver, and the rest of the inner parts, whilst it either increaseth their hardness, or at the least keepeth it hard, and yet notwithstanding it is fit the body be cured. And although the once letting forth of the humour profit nothing, yet it make way for medicines, which while it was there contained, it hindered. But this serous, salt, and corrupt humour, is so far from being able to mitigate a Fever and thirst, that on the contrary, it increaseth them. And also it augmenteth the cold distemper, whilst by its abundance it overwhelmes and extinguisheth the native heat. But the authority of Caelius Aurelianus that most noble Physician, though a Methodicke, may satisfy Avicen and Gordonius. They, saith he, which dare avouch that all such as have the water let out by opening their belly have died, do lie; for we have seen many recover by this kind Lib. de morb. Ch. cap. de Hydrope. of remedy: but if any died, it happened either by the default of the slow or negligent administration of the Paracenteses. I will add this one thing which may take away all error of controversies: we unwisely doubt of the remedy when the patient is brought to that necessity, that we can only help him by that means. Now must we show how the belly ought to be opened. If the Dropsy happen by fault of the Liver, The places of the apertion must be divers, according to the parts chiefly affected. the section must be made on the left side; but if of the Spleen, in the right: for if the patient should lie upon the side which is opened, the pain of the wound would continually trouble him, and the water running into that part where the section is, would continually drop, whence would follow a dissolution of the faculties. The Section must be made three fingers breadth below the Navel, to wit, at the side of the right muscle, but not upon that which they call the Linea Alba; neither upon the nervous parts of the rest of the muscles of the Epigastrium; that so we may prevent pain and difficulty of healing. Therefore we must have a care that the patient lie upon his right side, if the incision be made in the left, or on the left, if on the right. Then the The manner of making apertion. Chirurgeon both with his own hand, as also with the hand of his servant assisting him, must take up the skin of the belly, with the fleshy pannicle lying under it, and separate them from the rest; then let him divide them so separated with a Section even to the flesh lying under them, which being done, let him force as much as he can the divided skin upwards towards the stomach, that when the wound, which must presently be made in the flesh lying there under, shall be consolidated, the skin by its falling therein, may serve for that purpose: then therefore let him divide the musculous flesh and Peritonaum with a small wound, not hurting the Kall or Guts. Then put into the wound a trunk, or golden, or silver crooked pipe, of the thickness of a Gooses-quill, and of the length of some half a finger. Let that part of it which goes into the capacity of the belly have something a broad head, and that perforated with two small holes, by which a string being fastened, it may be bound so about the body, that it cannot be moved, unless at the Surgeon's pleasure. Let a sponge be put into the pipe, which may receive the dropping humour: and let it be taken out when you would evacuate the water: but let it not be poured out all together, but by little and little, for fear of dissipation of the spirits, and resolution of the faculties, which I once saw happen to one sick of the Dropsy. He being impatient A History. of the disease and cure thereof, thrust a Bodkin into his belly, and did much rejoice at the pouring forth of the water, as if he had been freed from the humour and the disease, but died within a few hours, because the force of the water, running forth, could by no means be stayed, for the incision was not artificially made. But it will not be sufficient to have made way for the humour by the means aforementioned, but also the external orifice of the pipe must be stopped and strengthened by double clothes, and a strong ligature, lest any of the water flow forth against our wills. But A Caution for taking out the Pipe. we must note that the pipe is not to be drawn out of the wound, before as much water shall be issued forth as we desire, & the tumour requireth; for once drawn forth, it cannot easily be put in again, and without force & pain be fitted to the lips of the wound, because the skin and fleshy pannicle cover it by their falling into the wound of the flesh or muscle. But whilst the water is in evacuation, we must have a diligent care of feeding the Patient, as also of his strength, for if that fail, and he seem to be debilitated, the effusion of the water must be stayed for some days; which at the length performed according to our desire, the wound must be so consolidated that the Chirurgeon beware it degenerate not into a Fistula. The Figure of a Pipe inform of a Quill, to evacuate the water in Dropsies. Others perform this business after another Another manner of evacusting the water after the apertion. manner; for making an incision, they thrust through the lips of the wound with a needle and thread: but they take up much of the fleshy substance with the needle, lest that which is taken up should be rend and torn by the forcible drawing of the lips together. Then the thread itself is wrapped up and down over both ends of the needle, so thrust through, as is usually done in a hare-lippe, that so the lips of the wound may so closely cohere, that not a drop of water may get out against the Surgeons will. Sometimes such as are cured and healed of the Dropsy, fall into the jaundice, whom I usually cure after this manner. ℞, sterc. anser. ʒijs, dissolve it in ℥ iij, vini alb. coletur. A medicine for the jaundice. make a Potion, and let it be given two hours before meat. CHAP. XIII. Of the tumour and relaxation of the Navel. THe Exomphaloes or, swelling of the Navel, is caused by the Peritonaeum, either The diverse causes thereof. relaxed or broken: for by this occasion ofttimes the Guts, and ofttimes the Kall, fall into the seat of the Navel, and sometimes superfluous flesh is there generated; otherwise this tumour is as an Aneurisma by too great a quantity of blood poured forth in that place: otherwise by a flatulent matter, Signs hereof occasioned by the Kall. and sometimes by a waterish humour. If the humour be occasioned by the Kall, the part itself will retain his proper colour, that is, the colour of the skin; the tumour will be soft and almost without pain, and which will reside without noise, either by the pressure of your fingers, or of itself when the Patient lieth on his back; but the tumour caused by the guts, is more unequal, and when it is forced in by the pressure of your fingers, there is such a noise heard, as in the Enterocele; but if the tumour proceed By the guts: of superfluous flesh, it will be harder and more stubborn, not easily retiring By flesh. into the body, although the Patient lie upon his back, and you press it with your fingers. The tumour is softer which proceeds of wind, but which will not retire into the body, and sounds under your nail like a taber. If the swelling be caused by a waterish By wind. humour, it hath all things common with the flatuous tumour, except that it is not By a waterish humour. By bruised blood. Which may be cured by Chirurgery, which not. so visible, and without noise. If it be from effusion of blood, it is of a livid colour, but if the effused blood shall be arterial, then there are the signs of an Aneurisme. Wherefore when the tumour is caused by the Guts, Kall, Winde, or a waterish humour, it is cured by Chirurgery: but not if it proceed from a fleshy excrescence or suffusion of blood. The tumour of the Navel proceeding from the Kall, and Guts, the Patient must lie upon his back to be cured, and then the Kall, and Guts, must with your fingers be forced into their due place: then the skin with which the tumour The cure by Chirurgery. is circumscribed must be taken up with your fingers, and thrust through with a needle, drawing after it a double twined and strong thread; than it must be scatified about the sides, that so it may be the easier agglutinated. Then must it be thrust through with a needle, three or four times, according to the manner and condition of the distension and tumour. And so twitch it strongly with a thread, that the skin which is so bound may at length fall off together with the ligatures. But also you may cut off the skin so distended even to the ligature, and then cicatrise it, as shall be fit. A flatulent tumour of the Navel shall be cured with the same remedies, as we shall hereafter mention in the cure of a windy rupture, but the watery may be poured forth by making a small incision. And the wound shall be kept open, so long, until all the water be drained forth. CHAP. XIIII. Of the Tumours of the Groins and Cod's, called Herniae, that is, Ruptures. THe ancient Physicians have made many kinds of Ruptures, yet indeed There are only 3. sorts of Ruptures. there are only three to be called by that name, that is, the Intestinalis, or that of the guts, the Zirbalis, or that of the kall, and that which is mixed of them both. The other kinds of Ruptures have come into this order, rather by similitude, than any truth of the thing: for in them the Gut, or Kall do not forsake their places. The greeks have given to all these several names, both from the seat of the tumour, as also from their matter. For thus they have called an unperfect rupture which descends not beyond the Groins, nor falls down into the Cod's, Bubo●ocele: but Bubo●ocele. the complete which penetrates into the Cod, if it be by falling down of the Gut, Enterocele: if from the Kall, Epiplocele; if from them both together, they name it Enteroepiplocele: Enterocele and Epiplocele. but if the tumour proceed from a waterish humour, they term it Hydrocele; if from wind, Physocele, if from both, Hydrophydocele; if a fleshy excrescence Hydrocele. Physocele. shall grow about the testicle, or in the substance thereof, it is named Sarcocele. If the veins interwoven, and divaricated divers ways shall be swollen in the Cod and Sarcocele. Testicles, the tumour obtains the name of a Cirsocele. But if the humours shall be Cirsocele. shut up, or sent thither, the name is imposed upon the tumour, from the predominant humour, as we have noted in the beginning of our Tractate of tumours. The causes are The Causes. many, as all too violent motions, a stroke, a fall from a high place, vomiting, a cough, leaping, riding upon a trotting horse, the sounding of trumpets, or sackbuts, the carrying, or lifting up of a heavy burden, racking, also the too immoderate use of viscide and flatulent meats; for all such things may either relax or break the jertonaeum, as that which is a thin and extended membrane. The signs of a Bubo●ocele are a round tumour in the Groin, which pressed, is easily forced in. The signs of Thesignes. an Enterocele, are a hard tumour in the Cod, which forced, returneth back and departeth with a certain murmur and pain; but the tumour proceeding of the Kall, is lax and feels soft like Wool, and which is more difficultly forced in, than that which proceeds from the Guts, but yet without murmuring and pain: for the substance of the Guts, seeing it is one, and continued to itself, they do not only mutually succeed each other, but by a certain consequence do, as in a dance draw each other; so to avoid distension, which in their/ membranous body cannot be without pain, by reason of their change of place from that which is natural, into that against nature: none of all which can be fall the Kall, seeing it is a stupid body; and almost without sense, heavy, dull, and immovable. The signs that the Peritonaeum is broken, are the sudden increase of the tumour, and a sharp and cutting pain; for when the Peritonaeum is only relaxed, the tumour groweth by little and little, and so consequently with small pain; yet such pain returns so often, as the tumour is renewed by the falling down of the Gut, or Kall, which happens not the Peritonaeum being broken: for the way being once open, and passable to the falling body, the tumour is renewed without any distension, and so without any pain to speak of. The rest of the signs shall be handled in their places. Sometimes it happens that the Guts, and Kall, do so firmly adhere to the process of the Peritonaeum, that they cannot be driven back into their proper seat. This stubborn adhesion happens by the intervention of the viscide matter, or by means of some excotiation caused by the rude hand of a Chirurgeon, in too violently forcing of the Gut, or Kall, into their place. But also, too long stay of the gut in the cod, and the neglect of wearing a Truss, may give occasion to such adhesion. A perfect and inveterate rupture by the breaking of the process of the Peritonaeum in men of full growth, never, or very seldom admits of cure. But What rupture is uncurable. you must note, that by great ruptures of the Peritonaeum, the Guts may fall into the cod, to the bigness of a man's head, without much pain and danger of life, because the excrements, as they may easily enter, by reason of the largeness of the place and rupture, so also they may easily return. CHAP. XV. Of the cure of Ruptures. BEcause children are very subject to Ruptures, but those truly not fleshy To what ruptures children are subject. or varicous, but watery, windy, and especially of the Guts, by reason of continual and painful crying and coughing: Therefore in the first place we will treat of their cure. Wherefore the Chirurgeon, called to restore the Gut which is fallen down, shall place the child, either or table, or in a bed, so that his head shall be low, but his buttocks, and thighs higher; the● shall he force with his hands by little and little, and gently, the Gut into its proper place; and shall foment the Groin with the astringent fomentation, described in the falling down of the womb. Then let him apply this remedy. ℞, Prescript decoctionis quantum An astringent cataplasm. sufficit, farinae hordei & fabarum, an. ℥ j, pulver. Aloes, Mastiches, Myrtyll. & Sarcoco. an. ℥ ss, Boli Armeni ℥ ij. Let them be incorporated and made a cataplasm according to Art. For the same purpose he may apply Emplastrum contra Rupturam: but the chief of the cure consists in folded clothes, and Trusses, and ligatures artificially made, that the restored gut may be contained in its place, for which purpose he shall keep the child seated in his cradle for 30. or 40. days, as we mentioned before; and keep him from crying, shouting, and coughing. Aetius bids steep paper 3. days in water, and Ser. 1. Cap. 24. apply it made into a ball to the groin, the gut being first put up; for that remedy by 3. days adhesion will keep it from falling down. But it will be, as I suppose more effectual, if the paper be steeped not in common, but in the astringent water, described in the falling down of the womb. Truly I have healed many by the help of such remedies, and have delivered them from the hands of Gelder's, which are greedy o● The craft and coveto usuesse of Gelder's. children's testicles, by reason of the great gain they receive from thence. They by a crafty cozenage, persuade the Parents, that the falling down of the Gut into the Cod, is uncurable: which thing notwithstanding, experience convinceth to be false, if so be the cure be performed according to the forementioned manner, when the Peritonaum is only relaxed, and not broken: for the process thereof by which the Gut doth fall as in a steep way, in progress of time and age is straitened and knit together, whilst also in the mean time the guts grow thicker. Another way to cure Ruptures. A certain Chirurgeon who deserveth credit, hath told me that he hath cured many children as thus: He beats a loadstone into fine powder, and gives it in pap, and then he annointes with honey the Groin, by which the gut came out, and then strewed it over with fine filings of iron. He administered this kind of remedy for ten or twelve days: The part, for other things, being bound up with a ligature and truss as was fitting. The efficacy of this remedy seemeth to consist in this; that the loadstone by a natural desire of drawing the iron which is strewed upon the The reason of this cure. Groin, joins to it the fleshy and fatty particles interposed between them, by a certain violent impetuosity, which on every side pressing and bending the looseness of the Peritonaeum, yea verily adjoining themselves to it, in process of time by a firm adhesion intercept the passage and falling down of the Gut or Kall; which may seem no more abhorring from reason, than that we behold the loadstone itself through the thickness of a table, to draw iron after it any way. The same Chirurgeon affirmed, that he frequently and happily used the following medicine. He burned into ashes in an Oven red Snails, shut up in an earthen pot, and gave the powder Another medicine. of them to little children in pap, but to those which were bigger, in broth. But we must despair of nothing in this disease, for the cure may happily proceed in men of full growth, as of forty year old, who have filled the three dimensions of the body, as this following relation testifies. There was a certain Priest in the Parish of Saint Andrew's, called john M●ret, A notable History. whose office it was to sing an Epistle with a loud voice as often as the solemnity of the day, and the thing required. Wherefore seeing he was troubled with the Enterocele, he came to me, requiring help, saying, he was troubled with a grievous pain, especially then, when he stretched his voice in the Epistle. The Figure of a man broken on the side, wearing a Truss, whose bolster must have three Tuberosities, two on the upper, and one on the lower part; and there must be a hollowness between them in the midst, that they may not too straight press the sharchone, and so cause pain. The manner of such a Truss, I found out not long ago, and it seemed better and safer than the rest for to hinder the falling aowne of the Gut and Kall. A. Shows the shoulder band which is tied before and behind to the girdle of the Truss. B. The Truss. C. The cavity left in the midst of the Tuberosities. When I had seen the bigness of the Enterocele, I persuaded him to get another to serve in his place; so having gotten leave of M. Curio Clerk, and Deacon of Divinity, he committed himself unto me: I handled him according unto Art, and commanded him he should never go without a Truss; and he followed my directions. When I met him some five or six years after, I asked him how he did, he answered very well, for he was wholly freed from the disease with which he was formerly troubled; which I could not persuade myself of, before that I had found that he had told me the truth, by the diligent observation of his genitals. But some six months after, he dying of a Pleurisy. I came to Curio's house where he died, and desired leave to open his body, that I might observe whether nature had done any thing at all in the passage through which the gut fell down. I call God to witness, that I found a certain fatty substance about the process of the Peritonaeum about the bigness of a little egg, and it did stick so hard to that place, that I could scarce pull it away without the rending of the neighbouring parts. And this was the speedy cause of his cure. But it is most worthy of observation, and We must never despair in disseases if so be nature be associated by Art. admiration, that Nature but a little helped by Art, healeth diseases which are thought incurable. The chief of the cure consists in this, that we firmerly stay the gut in its place, after the same manner as these two Figures show. Another Figure of a man having a Rupture on both sides, showing by what means, what kind of Truss, and what shoulder-band he must be bound on each groin. A. showeth the shoulder-band divided in the midst for the putting through of the head. B. The Truss, with two bolsters, between which is a hole for putting through the yard. The form of both bolsters aught to be the same with the former. In the mean time we must not omit diet. We must forbid the use of all things, which may either relax, dilate, or break the process of the Peritonaeum, of which I have already treated sufficiently. Sometimes, but especially in old men, the guts cannot be restored into their place by reason of the quantity of the excrements hardened in them: In this case they must not be too violently forced, but the Patient must be kept in his bed, and lying with his head low, and his knees higher up; let the following Cataplasms be applied. ℞. rad. alth. & lil. ana. ℥ ij. seminis lini. & foenug. an. ℥ ss, sol. malva, viol. & parietan. A Cataplasma to soften the excrements. m. ss. Let them be boiled in fair water, afterwards beaten, and drawn through a searse, adding thereto of new Butter without fault, and oil of Lilies, as much as shall suffice. Make a Cataplasm in the form of a liquid pultis. Let it be applied hot to the Cod, and bottom of the belly; by the help of this remedy when it had been applied all night, the guts have not seldom been seen of themselves, without the hand of a Chirurgeon, to have returned into their proper place. The windiness being resolved, which hindered the going back of the excrements into another gut, whereby they might be evacuated and expelled. But if the excrements will not go back thus, the flatulencies, yet resisting and undiscussed, an emollient and carminative Clyster is to be admitted with a little Chemical oil of Turpentine, Dill, juniper or Fennill. Clysters of Muscadine, oil of walnuts and Chemical oil. Aqua vitae, and a small quantity of any the aforesaid oils, are good for the same purpose. It often happens that the guts cannot yet be restored, because the process of the Peritonaeum is not wide enough. For when the excrements are fallen down with the gut into the cod; they grow hard by little and little, and increase by the access of flatulencies caused by resolution, which cause such a tumour as cannot be put up through that hole, by which a little before it fell down: whereby it happens that by putrefaction of the matter there contained, come inflammations, and a new access of pain; and lastly, a vomiting and evacuation of the excrements by the mouth being hindered from the other passage of the fundament. They vulgarly call this affect Miscrere mei. That you may help this symptom, you must rather assay extreme remedies, than suffer the Patient to die by so filthy and loathsome a death. And we must cure it by Chirurgery after this manner following. We will bind the Patient lying on his back, upon a Table or Bench; then presently make an incision in the upper pard of the cod, not touching the substance of the guts; then we must have a silver Cane or Pipe, of the thickness of a Goose quill, round, and gibbous in one part thereof, but somewhat hollowed in the other, as is showed by this following Figure. The Figure of the Pipe or Cane. We must put it into the place of the incision, and put it under the production of the Peritonaeum being cut together with the cod, all the length of the production; that so with a sharp knife we may divide the process of the Peritonaeum, according to that cavity separated from the guts there contained, by the benefit of the Cane in a right line not hurting the guts. When you have made an indifferent incision, the guts must gently be put up into the belly with your fingers, and then so much of the cut Peritonaeum must be sowed up, as shall seem sufficient, that by that passage made more strait, nothing may fall into the Cod, after it is cicatrized. But if there be such abundance of excrements hardened, either by the stay or heat of inflammation, that that incision is not sufficient to force the excrements into their place, the incision must be made longer, your Cane being thrust up towards the belly: so that it may be sufficient for the free regress of the guts into the belly. Then sow it up as is fit, and the way will be shut up against the falling down of the guts or kall; the process of the Peritonaeum being made more strait, by reason of the future; for the rest, the wound shall be cured according to Art. But before you undertake this work, consider diligenly whether the strength of the Patient be sufficient, neither attempt any thing before you have foretold, and declared the danger to the Patient's friends. CHAP. XVI. Of the golden Ligature, or the Punctus Aureus; as they call it. IF the Rupture will not be cured by all these means, by reason of the The chirurgical cure by the golden Tye. great solution of the continuity of the relaxt, or broken Peritonaeum, and the Patient by the consent of his friends there present, is ready to undergo the danger in hope of recovery; the cure shall be attempted by that which they call the Punctus Aureus, or Golden tie. For which purpose a Chirurgeon which hath a skilful and sure hand, is to be employed. He shall make an incision about the share bone, into which he shall thrust a Probe like to the Cane, a little before described; and thrust it long ways under the process of the Peritonaeum, and by lifting it up, separate it from the the adjoining fibrous, and nervous bodies, to which it adheres; then presently draw aside the spermatique vessels, with the Cremaster, or hanging muscle of the testicle; which being done, he shall draw aside the process itself, alone by itself: And he shall take as much thereof, as is too lax, with small and gentle mullets, perforated in the midst, and shall with a needle, having five or six threads, thrust it through as near as he can to the spermaticke vessels, and cremaster muscles. But the needle also must be drawn again into the midst of the remnant of the process, taking up with it the lips of the wound; then the thread must be tied on a straight knot, and so much thereof must be left after the section, as may be sufficient to hang out of the wound. This thread will of itself be dissolved by little and little by putrefaction: neither must it be drawn out before that nature shall regenerate and restore flesh into the place of the ligature, otherwise all our labour shall be spent in vain. And lastly, let the wound be cleansed, filled with fiesh, and cicatrized, whose callous hardness may withstand the falling of the gut, or kall. There are some Chirurgeons who would perform this golden Ligature after anoothe manner. They cut the skin above the share-bone where the falling down Another manner thereof. commonly is, even to the process of the Peritonaeum, and they wrap once or twice about it, being uncovered, a small golden wire, and only straiten the passage as much as may suffice, to amend the looseness of this process, leaving the spermatique vessels at liberty. Then they twist the ends of the wire twice or thrice with small mullets, and cut off the remnant thereof; that which remains after the cutting, they turn in, least with the sharpness it should prick the flesh growing upon it. Then leaving the golden wire there, they cure the wound like to other simple wounds, and they keep the Patient some fifteen or twenty day in his bed, with his knees some thing higher, and his head some thing lower. Many are healed by this means; others have fallen again into the disease by reason of the ill twisting of the wire. A. Shows a crooked needle, having an eye not far from the point, through which you may put the golden wire. B. B: The golden wire put through the eye of the needle. C. The mullets or Pincers, to cut away the waist or superfluous ends of the wire. D. The springe of the mullets. E The mullets to twist the ends of the wire together. Another more easy and safe way to restore the Gut and Kall. THeodoricke and Guido have invented another way of performing this operation. Lib. 3, Cap. 33. They put back into their places the Gut and Kall being fallen down, the Patient being so placed, that his thighs are high and his head is somewhat low; then they draw aside the lower portion of the production of the Peritonaeum; and also the spermaticke vessels, and cremaster muscle to the Ischium; then by applying a caustic fitted to the age and disease, they burn the other part of the process, directly perpendicular to the share-bone, where the Gut did fall down. Then they pull off the eschar thus made with a knife even to the quick, than they apply another caustic in the same place, which may go even to the bone, then procure the falling of this Eschar made on the foresaid process. And afterwards they heal the ulcer which remains, which presently contracting somewhat a thick Callus, so keeps up the Guts and Kall, that it binds them from falling down into the Cod. This way of restoring the Gut and Kall, though it be safer and more facile; yet the Chirurgeon must not attempt it, if the Guts or Kall stick so fast, agglutinated to the process of the Peritonaeum, that they cannot be severed, nor put back into their places (for from the guts so burnt and violated, greater mischief would ensue) if by the broken and too much dilated process, the bodies thereby restrained, make an exceeding great tumour by their falling down; if the testicle yet lying in the groin as in a Bubonocele, a kind of Enterocele, being not yet descended into the Scrotum or Cod; if the Patients be not come to such age as they can keep themselves from stirring, or hold their excrements whiles the operation is performed. CHAP. XVII. Of the cure of other kinds of Ruptures. EPiplocele is the falling down of the Kall into the Groin, or Cod, it hath the same causes as an Enterocele. The signs have been explained. It is not so dangerous, nor infers a consequence of so many evil symptoms, as the Enterocele doth, yet the cure is the same with the other. Hydrocele is a waterish tumour in the Cod, which is gathered by little and little what a Hydrocele is. between the membranes encompassing the testicles, especially the Dartos and Erythroides; it may be called a particular dropsy, for it proceeds from the same causes, but chiefly from the defect of native heat. The signs are a tumour increasing slowly The signs. without much pain, heavy, and almost of a glassy clearness, which you may perceive by holding a candle on the other side, by pressing the Cod above, the water flows down, and by pressing it below, it rises upwards, unless peradventure in too great a quantity it fills up the whole capacity of the Cod, yet it can never be forced or put up into the belly as the Kall or Guts may, for oft times it is contained in a Cyste, or bag; it is distinguished from a Saycocele, by the smoothness and equality thereof. The cure must first be tried with resolving, drying, and discussing medicines, The cure. repeated often before, and in the Chapter of the Dropsy; this which follows I have often tried and with good success. ℞, Vng. comitissa, & desiccat. rub. an. ℥ ij. malaxentur simul; and make a medicine for A medicine 〈◊〉 draw forth the contained matter. your ease. The water by this kind of remedy is digested and resolved, or rather dried up, especially if it be not in too great quantity. But if the swelling, by reason of the great quantity of water will not yield to those remedies, there is need of Chirurgery; the Cod and membranes wherein the water is contained, must be thrust through with a Seton, that is, with a large three square pointed needle, thread with a skein of silk; you must thrust your needle presently through the holes of the mullets made for that purpose, not touching the substance of the Testicles. The skean of thread must be left there, or removed twice or thrice a day, that the humour may drop down, and be evacuated by little and little. But if the pain be more vehement by reason of the Seton, and inflammation come upon it, it must be taken away, and neglecting the proper cure of the disease, we must resist the symptoms. Some Practitioners use not a Seton, but with a Razor, or incision knife, they open the lower part of the Cod, making an incision some half finger's breadth long, penetrating even to the contained water; always leaving untouched the substance of the Testicles and vessels, and they keep the wound open, until all the water seems evacuated; truly by this only way the cure of a watery rupture whose matter is contained in a Cyste, is safe, and to be expected; as we have said in our Treatise of Tumours in general. The Pneumatocele, is a flatulent tumour in the Cod, generated by the imbecility of heat residing in the part. What a Pneumatocele is. It is known by the roundness, lenity, renitency and shining. It is cured by prescribing a convenient diet, by the application of medicines which resolve and discuss The Cure. flatulencies, as the seeds of Annis, Fennell, Faenugreeke, Agnus Castus, Rue, Origanum, other things set down by Avicen in his Treatise of Ruptures. I have often used with good success for this purpose, Emplastrum Vigonis cum mercurio; and Emplastrum Diacalcitheos', dissolved in some good wine, as Muscadine, with oil of Bays. A Sarcocele is a tumour against nature, which is generated about the stones by a schyrrhus flesh. Gross and viscide humours breed such kind of flesh, which the part What a Sarcocele is. could not overcome and assimilate to itself; whence this overabundance of flesh proceeds, like as Warts do. Varices, or swollen veins often associate this tumour; and it increases with pain. It is known by the hardness, asperity, inequality, and roughness. It cannot be cured but by amputation or cutting it away; but you must The signs. Prognostics. diligently observe, that the flesh be not grown too high, and have already seized upon the Groin, for so nothing can be attempted without the danger of life. But if any may think, that he in such a case may somewhat ease the patient by the cutting away of some portion of this same soft flesh, he is deceived. For a Fungt will grow, if the least portion thereof be but left, being an evil sure worse than the former; but if the tumour be either small or indifferent, the Chirurgeon taking the whole tumour, that is, the testicle, tumefied through the whole substance, with the The signs. process encompassing it, and adhering thereto on every side, and make an incision in the Cod, even to the tumour; then separate all the tumid body, that is, the testicle from the Cod: then let him thrust a needle with a strong thread in it, through the midst of the process above the region of the swollen testicle; and then presently let him thrust it the second time through the same part of the process; then shall both the ends of the thread be tied on a knot, the other middle portion of the Peritonaeum being comprehended in the same knot. This being done, he must cut away the whole process with the testicle comprehended therein. But the ends of the thread, with which the upper part of the process was bound, must be suffered to hang some length out of the wound, or incision of the Cod. Then a repercussive medicine shall be applied to the wound, and the neighbouring parts with a convenient ligature. And the cure must be performed as we have formely mentioned. The Cirsocele is a tumour of veins dilated, and woven with a various and mutual implication about the testicle and cod, and swelling with a gross and melancholy What a Cirsocele is. blood. The causes are the same as those of the Varices. But the signs are manifest. To heal this tumour, you must make an incision in the cod, the breadth of two The Cure. fingers to the Varix. Then you must put under the varicous vein, a needle having a double thread in it, as high as you can, that you may bind the roots thereof: then let the needle be again put after the same manner about the lower part of the same vein, leaving the space of two fingers between the Ligatures. But before you bind the thread of this lowest Ligature, the Varix must be opened in the midst; almost after the same manner as you open a vein in the arm to let blood; That so this gross blood causing a tumour in the Cod, may be evacuated as is usually done in the Cure of the varices. The wound that remains shall be cured by the rules of Art after the manner of other wounds: Leaving the threads in it, which will presently fall away of themselves. To conclude then, it being grown callous especially in the upper part thereof; where the vein was bound, it must be Cicatrized, for so afterwards the blood cannot be strained, or run that way. Hernia Humoralis is a tumour generated by the confused mixture of many humours Hernia Humoralis. in the Cod or between the tunicles which involve the testicles, often also in the proper substance of the testicles. It hath like causes, signs and cure as other tumours. While the cure is in hand, rest, trusses, and fit rulers to sustain and bear up the testicles are to be used. CHAP. XVIII. Of the falling down of the Fundament. WHen the muscle called the Sphincter which ingirts the Fundament is relaxed, than it comes to pass that it cannot sustain the right gut. This disease is very frequent to Children by reason of the too much The causes. humidity of the belly; which falling down upon that muscle mollifieth and relaxeth it or presseth it down by an unaccustomed weight, so that the muscles called Levatores Any or the lifters up of the Fundament, are not sufficient to bear up any longer. A great bloody flux gives occasion to this effect. A strong endeavour to expel hard excrements, the Haemorrhoides, which suppressed do overloade the right gut, but flowing relax it: Cold as in those which go without breeches in winter, or sit a long time upon a cold stone, a stroke or fall upon the Holybone: a palfie of nerves which go from the Holybone to the Muscles the lifters up of the fundament: the weight of the stone being in the bladder. That this disease may be healed, we must forbid the Patient too much drinking, The cure. too often eating of broth, and from feeding on cold fruits. For local medicines the part must be fomented with an astringent decoction made of the rinds of Pomegranetts, galls, myrtles, knotgrass, shepherd's purse, Cypress nuts, Alum, and common salt boiled in smith's water or red wine. After the fomentation, the gut be anointed with oil of Roses or myrtles, and then let it be gently put by little and little into its place, charging the child if he can understand your meaning, to hold his breath. When the gut shall be restored, the part must be diligently wiped lest the gut fall down again by reason of the slipperiness of the unction. Then let the powder prescribed for the falling down of the womb be put into the fundament as far as you can: Then you must straight bind the loins with a swath, to the midst whereof behind let another be fastened which may be tied at the Pubes coming along the Perinaeum, so to hold up to the fundament; the better to contain it in its place, a sponge dipped in the astringent decoction. The Patient if he be of sufficient age to have care of himself, shall be wished when he goes to stool that he sit upon two pieces of wood being set some inch a sunder, least by his straining he thrust forth the gut together with the excrement; but if he can do it standing, he shall never by straining thrust forth the gut. But if the gut cannot by the prescribed means be restored to its place, Hypocrates bids that the Patient hanging by the heels be shaken, for so the gut by that shaking will return to his place: but the same Hypocrates wisheth to anoint Hypocrates his cure. the fundament, because that remedy having a drying faculty, hath also power to resolve the flatulent humours without any acrimony, by reason of which the gut was the less able to be contained in his place. CHAP. XIX. Of the Paronychia. THe Paronychia or Panaris is a tumour in the ends of the fingers, with great inflammation, coming of a malign and venomous humour, What the Paronychia is. which from the bones by the Periostium is communicated to the tendons and nerves of that part which it affecteth, whereof cruel symptoms do follow, as pulsifique pain, a fever, restlessness, so that the affected through impatiency of the pain are variously agitated like those tormented with Carbuncles: for which cause Guide and johannes de Vigo judge this disease to be mortal; wherefore you must provide a skilful Physician for the cure of this disease, which may appoint convenient diet, purging and Blood letting. In the mean time the Surgeon, shall make way for the virulent and venenate matter, by making incision in the inner part of the finger, even to the bone alongst the first joint thereof; for Vigo saith there is not a presenter remedy, if so be that it be quickly done Lib. 2. cap. 4. tract. 8. and before the maturation of the matter; for it vindicates the finger from the corruption of the bone and nerves, and assuages pain, which I have often and happily tried immediately at the beginning, before the perfect impression of the viruleacie. But the wound being made you must suffer it to bleed well, then presently let him dip his finger in strong and warm vinegar, in which some treacle being dissolved may draw forth the virulency. But to appease the Pain, the same remedies must be applied to the affected part as are used in Carbuncles, as the leaves of Sorrell, Henbane, Hemlock, Mandrake roasted under the Embers and beaten in a Mortar with new Vnguentum Populeon, or oil of Roses or new butter without salt: for such like medicines also help forward suppuration, whilst by their coldness, they repress the extraneous heat affecting the part; and so strengthen the native heat being the author of suppuration: which reason moved the ancient Physicians to use such medicines in a Carbuncle: but if by reason of the fearfulness of the patient, or unskilfulness of the Surgeon, no incision being made, a Gangrene and Sphacel shall possess the part, it remains that you cut off with your cutting mulletts as much of the part as shall be corrupt, and perform the rest of the cure according to Art. Yet it doth not seldom happen that there may be no need to cut off such a finger, because it being corrupted together with the bone doth by little and little dissolve into a purulent or rather sanious and much stinking filth. But in this affect there is often caused an Eschar by the adustion of putredinous heat, and superfluous flesh endued with most exquisite sense groweth underneath it, which must in like manner be cut off with the Mulletts that the part may receive comfort, the pain being assuaged by the copious effusion of blood. CHAP. XX. Of the swelling of the knees. AFter long and dangerous diseases there oftentimes arise Tumours in the knees, and also in plethoric bodies and such as have evil juice after Gal. comm. ad sent. 1. ser. 4. lib. 6 E●●. Gal. Com ad sect, 67. sect. 2. prog. labours and exercise. This kind of disease is frequent because the humour easily falls into the part which hath been heated by Labour. But if such tumours follow long diseases, they are dangerous and difficult to cure, and therefore not to be neglected; for bitter pain accompanieth them, because the humour falling thither distends the Membranes, which being many involve the part; besides that this humour participateth of a certain virulent and malign quality whether it be cold or hot, when it hath settled into those parts, being such as we find in the pains of the joints, and in the bitings of venomous creatures. For the cure, if the tumour be caused by blood, let a slender and refrigerating The cure. diet be appointed, and phlebotomy for the revulsion of the antecedent cause; divers local medicines shall be used according to the variety of the four times. But for to assuage the pain, Anodyne or mitigating medicines shall be appointed: of all which we have sufficiently treated in the Chapter of the cure of a Phlegmon. And because these parts are of exact sense, if there be necessity to open the tumour, yet must we not do it rashly or unconsiderately, for fear of pain and evil accidents. This kind of tumour is oft times raised by wind contained there; in which case the Chirurgeon must be very provident, that he be not deceived with the show of flowing of the humour; which he seems to perceive by the pressure of his fingers, as if there were matter and humour contained therein, and so be brought to open the tumour. For the wind breaking forth in stead of the humour, causeth evil symptoms by reason of the section rashly made in a part so sensible. But if waterish humours shall tumify the part, the body shall first be purged with medicines purging phlegm: And then inciding, attenuating, rarifying, discussing and very drying local medicines shall be used. Of which we have abundantly spoken in the Chapter of the Oedema. Yet this humour, divers times lies deep between the whirl bone and the joint, which causeth it that it cannot be discussed and resolved by reason of the weakness of the part and defect of heat, so that the adventitious humour often moves and excludes the bones from their seat. As I have observed it to have happened to many. In which cause Irrigations of red wine falling something high, whereby the force of the medicine may enter and more easily penetrate, are much commended. CHAP. XXI. Of the Dracunculus. ICannot choose, but explain in this place those things which may be It is not as yet sufficiently known what Dracunculs are. spoken of that kind of tumour against nature, which by the ancients is called Dracunculus. The matter and reason of these hath been variously handled by divers Authors, so that hitherto we have nothing written of them to which we may by right and with good reason adhere as a firm foundation of their essence. For first for Galens' opinion, Lib. 6. de Loc. affect cap. 3. The generation, saith he, of those hairs which are evacuated by the Urine is worthy no less admiration than the Dracunculi, which as they say, in a certain place of Arabia breed in the legs of men being of a nervous nature and like worms in colour and thickness. Therefore seeing I have heard many who have said they have seen them, but I myself never saw them, I cannot conjecture any thing exactly neither of their origiginall nor essence. Paulus Aegineta writes that the Dracunculi are bred in India and the higher parts of Egypt, like worms in the musculous parts of man's body, that is, the arms, Lib. 4. cap. ult. thighs and legs, and also creep by the intercostal muscles in children with a manifest motion. But whether they by creatures indeed, or only have the shape of creatures, they must be cured with a hot fomentation, by which the Dracunculus raised to a just tumour, may put forth itself, and be plucked away piece meal with the fingers: The cure out of Egineta. also suppurating Cataplasms may be applied, composed of water, honey, wheat and barley meal. Avicen being various, having no certainty whereon to rest, inclineth one while to this, and another while to that opinion: for now he speaketh of the Dracunculi as Cap 21. lib. 4. sent. 3 tract. 3. of creatures, then presently of a matter and humour shut up in a certain place; for the rest he rightly delivers the cure and essence of this disease, as we shall afterwards show. Actius saith, the Dracunculi are like worms, and that they are found sometimes Lib. 14. cap. ult. great, sometimes small, and that their generation is not unlike to that of flat worms, which are bred in the guts, for they move under the skin without any trouble, but in process of time, the place becomes suppurate about the end of the Dracunculus. The skin openeth, and the head thereof is thrust forth. But if the Dracunculus be pulled, it causeth great grief; especially if it be broken by too violent pulling. For that which is left causeth most vehement pain. Where fore that the creature may not run back, the arm must be bound with a strong thread, and this must be done every day, that the Dracunculus going forward The cure out of Aetius by little and little, may be intercepted by this binding, but not broken off. The place must be bathed with Aqua Mulsa and oil in which wormwood or southernewood hath been boiled, or some other of those medicines which are prescribed for the worms of the belly. But if the Dracunculus going forward of its own accord, may be easily drawn forth, we must do nothing else: but if it be turned to suppuration we must not leave off the Cataplasms, the Aqua Mulsa and anointing with oil: It was usual with him after the taking away of the Cataplasms, to apply Emplaslrum E Ba●●is Lauri: but when it is come to suppuration the skin must be opened long ways, and the Dracunculus so laid open must be taken away, but the skin must be filled with lint, and the rest of the suppurative cure used, so that the creature being suppurated and drawn forth, the wound may be incarnated and cicatrised. Rhasis writeth, that when the part is lifted up into a blister, and the vein hasteneth its egress, it is good for the patient to drink the first day half a dram Tract. at 〈◊〉. cap. 31. The cure our of Rhasis. of Aloys, the next day a whole dram, the third day two dams; and in like manner the place affected must be fomented with Aloes, for so that which lies hid will break forth: that which shall come forth must be rolled in a pipe of lead, which may equal the weight of a dram so that it may hang down, for the vein drawn by the weight will come more forth; and when that which shall come forth is grown much and long, it must be cut off, but not by the root, but so that a portion thereof may remain and hand forth, to which the leaden pipe may be fastened, for otherwise it would withdraw itself into its skin and its lurking hole, and so cause a putrid and malign ulcer. Therefore we must gently meet with this disease, and the vein must be drawn by little and little out of the body until it be all come forth that no worse thing happen: but if by chance it shall happen that as much of the vein as shall be come forth shall be cut off by the roots, than the ulcer must be opened long ways with an incision knife, and that so that whatsoever remains thereof may be wholly taken away. Then for some days the part must be anointed with butter until whatsoever of such a substance adheres, being consumed with putrefaction shall flow away. Then the ulcer must be cured with sarcoticke things. Therefore Rhasis thus in the same text expresseth the same thing by divers names, and armed with Iron and Lead, he comes to the cure thereof, as if he meant to His opinion of them. encounter with some fierce beast. Soranus the Physician, who lived in the times of Galen, was of a quite contrary opinion, Soranus his opinion. as Paulus Aegineta in the place being before cited, relates of him; as who denies the Dracunculus to be a living creature, but only a condensation of a certain small nerve, which seems both to the Physicians and Patients to have some motion under the skin. Wherefore Soranus seems to have come nearer the truth than the rest, but yet not so, as throughly to understand, and know the essence of this disease, as we shall demonstrate hereafter. Manardus writes, that the Dracunculi are generated of evil and unlaudable blood, Epist. 2. lib. 7. gross, hot, and melanckolicke, or of adust phlegm very much dried. Gorraeus a most learned Physician of our time, Lib. de Definitionib. medic. denies any of our Physicians to be able to say anything of the Dracunculi, because it is a disease so unfrequent in these our regions, that it is scarce ever met withal in practice. The Author of the Introduction, and Medicinal definitions, defines the Dracunculus to be a disease very like the Varices; then causing great pain, when increasing by little, and little, it begins to be moved: Therefore to be cured after the same manner, and by the same method of Section and incision, as the varices are. Which thing chiefly seems to have moved Guido to refer this kind of disease to the Varices in his Tractate of Impostumes, because it hath the same cause, and is healed with the same remedy as the varices. But seeing that divers names have been imposed upon this disease by several writers, yet they all have expressed it by the name of a vein: for it is called by Avicen and Guido, Vena Meden, because it is a disease frequent in the City Medina: by Albucrasis, vena civilis. Haliabbas hath called it vena famosa; others have called it Vena Cruris or the leg vein. Truly the contrariety of so many opinions repugnant not only amongst themselves, but also with themselves, easily argueth how little certainty they had of the essence of this disease, who have written of it unto us: To which also this may be added, that none of the latter Physicians have written any things thereof. For although jacobus Dalechamphius a man most conversant in every part of Physic, hath written much of this matter in his book of the French Surgery which he set forth some years ago: Yet he hath left us no amplier testimony of his industry, than that he was very diligent in collecting the writings of the Ancients concerning this thing, interposing no judgement of his own, the better to assure us of a thing so controverted. But my modesty cannot so contain me, but that I shall choose rather to undergo the censure of being thought too daring, than (as much as in me lieth,) to suffer this question of the Dracunculi to remain longer ambiguous and undecided. Therefore for the present, I will thus order it, that refuting the opinions of the Ancients I may strengthen by certain reasons, my opinion of the essence and cure of this disease. For first, that Dracunculi are no living things, nor like unto worms, nor of like generation Aetius opinion confuted. Tract. 3. serme. 1. cap. 40. as the flat worms of the belly, which was the opinion of Aetius, is easy to disprove both by his writings, as also by reason itself. For he writes that the broad worm which he calls Tania, is as it were a certain Metamorphosis or transmutation of the inner tunicle of the small guts, into a quick living and movable body. But no man ever said, neither will he confess that the Dracunculi have the material causes of their beginning from the tunicle of the vein, in which they are closed, or from the fibers of a nervous body, to which often they are adjoined; but much less from the skin under which they lie, may they draw their material causes of their original. Moreover, neither can there be any generation of worms, nor of any other living creatures whatsoever, who have their original from putrefaction, unless by the Corruption of some matter, of whose better and more benign part, nature by the force of the vital heat, produceth some animate body, as Aristotle teacheth. Wherefore to produce this effect, it is fit the matter should have such a 4. Meteorolog. disposition to putrefaction as is required for the generation of such a creature as they would make the Dracunculus to be: It is fit the helping causes should concur as assistants to the principals in the action. And it is meet the place should be opportune or fit. But there may be many causes found which may give life to the Dracunculi, for by the common consent of all those who have written of them, their generation proceeds from an humour melancholic, terrestrial and gross, which by its qualities both by the first coldness and dryness, as also by the second, that is acidity, is not only thought most unfit of all others for putrefaction, but also is judged Natural Melancholic humour is most unapt to putrify. to resist putrefaction, as that which is caused by heat and superfluous heat humidity. Besides, if the material cause of this disease should be from an humour putrifying and turning by putrefaction into some living creature, it was fit there should be stench also, as being an unseparable accident of putrefaction, for thus the excrements Stink an unseparable companion to putrefaction. in the guts of which the worms are generated, do smell or stink. Therefore that which exhales from their bodies which are troubled with the Dracunculi, should be stinking, as it happens to those sick of the Pthiriasis or Lewsie-evill. But none of those who have delivered the accidents or symptoms of the Dracunculi are found to have made mention hereof. But for the efficient cause whereby so great heat may be raised in the places next under the skin, by the efficacy whereof such a creature may be form of a matter melancholic and most unapt to putrify, as they make the Dracunculus to be who fain our bodies to be fruitful monsters; especially seeing the surface of the body is continually ventilated by the small Arteries spread under the skin, as also by the benefit of insensible transpiration, and breathed with the coolness of the Air encompassing us. But now the material and efficient causes being defective, or certainly very weak, for the generation of so laborious an effect; what coadjutory cause, can yield assistance? Can the humidity of meats? for those bodies which are fed with warm and moist meats, What things usually breed worms. as milk, Cheese, Summer fruits, usually breed worms, as we are taught by experience in Children. But on the Contrary, Avicen in the place before cited writeth, that meats of a hot and dry temper chiefly breed this kind of disease, and that it is not so frequent to moist bodies and such as are accustomed to the Bath, moist meats and wine moderately taken. But whether may the condition of the Air of those regions in which it is as it were, an Endemiall disease, confer any thing to the generation of such creatures? Certainly for this purpose a cloudy warm and thick air, such as useth to be at the beginning of the Spring when all places resound with frogs, toads and the like creatures bred of putrefaction. But on the Contrary jacobus Dalechampius by the opinion of all the Physicians that Cap. 83. Chir. Gallic. have written of the Dracunculi, writes that this disease breeds in the dry and Sun burnt regions of India and Arabia; but if at the least that part of our body which is next under the skin should have any opportunity to engender and nourish such creatures, they may be judged to have written that the Dracuuculus is a living creature with some probability, But if there be no opportunity for generation in that place, nor capacity for the nourishment of such like creatures as in the guts, if that region of the body be breathed upon with no warmness and smothering heat, if it be defiled with none of the gross excrements, as the guts usually are, but only by the subtler exhalation, which have an easy and insensible transpiration by the pores of the skin, which may seem to be a just cause of so monstrous and prodigious an effect: but we shall little profit with these engines of reason unless we cast down at once all the Bulwarks, with which this old opinion of the Dracunculi may stand and be defended. For first they say, why have the ancients expressed this kind of disease by the name of a living thing, that is, of a Dracunculus or little Serpent? I answer, because in Physic names are often imposed upon diseases rather by similitude than from the truth of the thing; for the confirmation whereof, the examples of three diseases may suffice, that of the Cancer, Polypus, and Elephas. For these have those names not because any Crabb, Polypus, or living Elephant may breed in the Body by such like diseases, but because this by its propagation into the adjacent parts represents the feet and claws of a Crab: the other represents the flesh of the Sea-Polypus in its substance; and the third because such as have the Leprosy have their skin wrinkled, rough, and horrid with scales and knots, as the skin of a living Elephant. So truly this disease of which we now inquire seems by good right to have deserved the name Dracunculus, because in its whole conformation, colour, quality and production Why they are called Dacunculi. into length and thickness it expresseth the image of a Serpent. But whence, will they say (if it be without life) is that manifest motion in the matter? We reply that the humour the cause of this disease is subtle and hot, and so runs with violence into the part whence it may seem to move. But when the Dracunculi are separated, why do they put their heads as it were out of their holes? we answer, in this the ancients have been very much deceived, because after the suppuration the ulcer being opened, some nervous body being laid bare, thrust forth and subjected itself to the sight, which by the convulsive and shaking motion might express the crooked creeping of a Serpent. But they will say, pain happens not unless to things endued with sense and life, but this Dacunculus when he is drawn too violently especially if he be broken, thereby will cause extreme pain: we do answer, that the conclusion doth not follow and is of no consequence, for these pains happen not unless when the unprovident Surgeon draws or pulls instead of the Dracunculus some nervous or membranous body swollen and replete with an adust humour, whence there cannot but be great pain that part being pulled which is the author ofsence. But it is childish to say that the Dracunculus feels, for that it causeth sharp pains to the living body in which it is. Therefore that at last we may determine something of the nature, essence and generation of these Dracunculi, I dare boldly affirm it is nothing else but a tumour and abscess bred from the heat of the blood in a venenate kind. Such blood driven by the expulsive faculty through the veins to the external parts, especially the limits, that is the Arms and Legs, causeth a tumour round and long often stretched from the joint of the shoulder even to the wrist, or from the groin even to one of the Ankles with tension, heat, renitency, pricking pain, and a fever. But this tumour is some whiles stretched forth strait, otherwhiles into oblique and crooked tumours, which hath been the cause that many taken with this kind of disease, and having their limbs so enfolded as with the twine of a Serpent would say they had a Serpent. I have thus much to say of the Dracunculi, especially of those of our own country. For the cure, it is not unlike to the cure of a Phlegmon arising from a defluxion, The Cure. for here also in like manner the remedies must be varied according to the four times of the disease, and the same rule of diet, phlebotomy and purging must be observed which is before prescribed in the cure of a Plegmon. The mention of the Dracunculi calls to my memory another kind of Abscess, So the Malu●pilate in Aristotle cap. 11. lib. 7. hist. animal. altogether as rare. This our French men name Cridones, I think a Crinib us. i. from hairs: it chiefly troubles children and pricks their backs like thorns. They toss up & down being not able to take any rest. This disease ariseth from small hairs which are scarce of a pin's length, but those thick and strong. It is cured with a fomentation of water more than warm, after which you must presently apply an ointment made of honey and wheaten flower; for so these hairs lying under the skin are alured and drawn forth; and being thus drawn, they must be plucked out with small mullets. I imagine this kind of disease was not known to the ancient Physicians. The End of the Eighth Book. OF WOUNDS IN GENERAL. THE NINTH BOOK. CHAP. I. What a Wound is, what the kinds and differences thereof are, and from whence they may be drawn, or derived. A Wound is a solution of Continuity, caused by a stroke, fall, or What a Wound properly is. bite, newly done, bloody, and with putrefaction, and filth. They also call it a new simple ulcer; for the solution of continuity happens to all parts of the body; but according to the diversity of the parts, it hath divers names amongst the greeks. For in the flesh it is called Helcos, in the bone Catagma, in the nerve Spasma, in the Divers appellations of wounds according to the varieties of the parts. ligament Thlsma, in the vessels Apospasma, in the Muscles Regma: and that solution of continuity, which happens in the vessels, their mouths being open, is termed Anastomasis, that which happens by erosion, Anaurosis; that which is generated by sweeting out and transcolation, Diapedeses. That these may be the more easily understood, I have thought good to describe them in the following table. A Table of the differences of Wounds. The differences of wounds are drawn or taken, From the nature of the parts in which they are made or happen. But these parts are Either similar and these, Either soft as the Glandules, Flesh, Fat, Marrow. Or hard as A Bone, A Gristle. Or of a middle consistence, as the Membranes, Ligaments, Fibers, Vessels, Nerves, Veins, Arteries. Principal as the Brain, Heart, Liver, to which some add the womb and Testicles. Or Organical and these either. Or serving the principal, as The Weasand, Lungs, gullet, Stomach, Guts, Bladder. Or neither The Ears, Nose, Feet, Hands, and other of the same kind. From their proper essence, from whence they are called, Simple wounds When there is no complication of any other disease or symptom besides. Or compound, When there is a complication of some one or more diseases, which unless they be taken away, we must not hope for to cure the wound. From their quantity according to which they are called, Great, Long, Broad, Deep. Indifferent, Little, Short, Narrow, Super ficiarie. From their figure, according to which they are named, Strait, Oblique, Cornered. CHAP. II. Of the causes of Wounds. ALL things which may outwardly assail the body with force and violence, may be counted the causes of wounds; which are called green, and properly Divers denominations from their causes. bloody. These things are either animate, or inanimate. The animate, as the bitings, and prickings of beasts. The Inanimate, as the stroke of an arrow, sword, club, gun, stone, a dagger, and all such like things. From the variety of such like causes, they have divers names: for those which are made by sharp and pricking things are called punctures: those caused by cutting things, are called wounds or gashes: and those which are made by heavy and obtuse things are named Contusions, or wounds with Contusions. CHAP. III. Of the signs of Wounds. WOunds are first known by sight, and by the signs drawn from thence. The Chirurgeon ought first and chiefly, to consider, what wounds are curable, A caution for making reports of Wounds. and what not; what wounds will scarce admit of cure, and what may be easily cured; for it is not the part of a prudent Chirurgeon, to promise cure in a deadly or dangerous and difficult wound; Lest he may seem to have killed him, whom not the unsufficiency of the Art, but the greatness of the wound hath slain. But when the wound is dangerous, but yet without despair of recovery, it belongs to him to admonish the Patient's friends which are by, of the present danger, and doubtful state of the wound; that if Art shall be overcome by the greatness thereof, he shall not be thought ignorant of the Art, neither to have deceived them. But as this is the part and duty of a good and prudent Chirurgeon, so it is the trick of a cheating and juggling knave, to enlarge small wounds, that so he may seem A juggling cheating Chirurgeon. to have done a great cure, when it is nothing so. But it is agreeable to reason, that the Chirurgeon professing the disease easy to be cured, will think himself in credit bound by such promises and his duty, and therefore seek all means for the quick recovery of the patient; le●t that which was of its own nature small, may by his negligence become great. Therefore it is expedient, he should know what wounds are to be accounted great. This (as Galen saith) is three ways to be known; The first is by the magnitude Lib. 4. Meth. cap. 6. 1. and principality of the part affected; for thus the wounds of the Brain, Heart, and of the greater vessels, though small of themselves, yet are thought great. Then from the greatness of the solution of continuity; for which cause wounds may be judged Wounds are called great out of three respects. great, in which much of the substance of the part is lost in every dimension, though the part be one of these which are accounted servile. Then from the malignity; through which occasion the wounds of the joints are accounted great, because for the most part, they are ill conditioned. CHAP. four Of Prognostickes to be made in Wounds. THose Wounds are thought dangerous, wherein any large Nerve, Vein, What wounds are dangerous. or Artery are hurt. From the first there is fear of convulsion, but from the other large effusion of the veinous, or arterious blood, whence the powers are debilitated; also these are judged evil, which are upon the arm pits, groins, leskes, joints and between the fingers; and likewise those which hurt the head or tail of a Muscle. They are least dangerous of all other which wound only the fleshy substance. But they are deadly which are inflicted upon the Bladder, Brain, Heart, Liver, Lungs, Stomach and small guts. But if any Bone, Gristle, What least dangerous. What deadly. Hip. aphor. 19 Lib. 6. Nerve or portion of the cheek or prepuce, shall be cut away, they cannot be restored. Contused wounds are more difficult to cure, than those which are only from a simple solution of continuity; for before you must think to heal them up, you must suppurate and cleanse them; which cannot be done in a short time. Wounds which are round and circular are so much the worse; for there can be no unity unless by an angle, that is, a meeting together of two lines, which can have no place in Why round Wounds are difficult to heals. round wounds, because a circular figure consists of one oblique line. Besides, wounds are by so much thought the greater, by how much their extremes and lips are the further disjoined, which happens to round Wounds. Contrary to these are cornered wounds or such as are made alongst the fibers, as such as may be easily healed. Wounds may be more easily healed in young men, than in old, because in them nature is more vigorous, and there is a greater plenty of fruitful, or good blood, by which the loss of the flesh may be the better and more readily restored, which is slowlier done in an old body, by reason their blood is smaller in quantity and more dry, and the strength of nature more languide. Wounds received in the Spring, are not altogether so difficult to heal as those Hip. lib. de ulcer. Hip. aph. 66. lib. 5. taken in Winter or Summer. For all excess of heat and cold is hurtful to them; it is ill for a convulsion to happen upon a Wound, for it is a sign that some Nervous body is hurt; the brain suffering together therewith, as that which is the original of the Nerves. A Tumour coming upon great Wounds is good; for it shows the force of nature is able to expel that which is harmful, and to ease the wounded part. The organical parts wholly cut off cannot again be united: because a vital part once severed and plucked from the trunk of the body cannot any more receive influence from the heart as from a root without which there can be no life. The loosed continuity of the Nerves, Veins, Arteries, and also the bones, is sometimes restored, not truly, and as they say, according to the first intention, but by the second, that is, by reposition of the like, but not of the same substance. The first intention takes place in the fleshy parts by converting the Alimentary blood into the proper substance of the wounded part. But the second, in the spermatique parts in which the lost substance may be repaired by interposition of some heterogeneous body, which nature, diligent for its own preservation, substitutes in place of What a Callus is and whence it proceeds. that which is lost: for thus the body, which restores and agglutinats, is no bone but a Callus, whose original matter is from an humour somewhat grosser than that, from whence the bones have their original and beginning. This humour, when it shall come to the place of the fracture, agglutinateth the ends of the bones together, which otherwise could never be so knit by reason of their hardness. The bones of children are more easily and speedily united by reason of the pliantness of their soft and tender substance. Lastly we must here admonish Small and contemptible. Wounds often prove mortal the Chirurgeon, that small Wounds and such as no Artisan will judge deadly, do divers times kill by reason of a certain occult and ill disposition of the wounded, and encompassing bodies; for which cause we read it observed by Hypocrates, that it is not sufficient for the Physician to perform his duty, but also external things Aphor. 1, sect. 1 must be rightly prepared, and fitted. CHAP. V. Of the Cure of Wounds in general. THe Chirurgeon ought for the right cure of wounds to propose unto himself The General Indication of Wounds. the common and general indication: that is, the uniting of the divided parts, which indication in such a case is thought upon and known even by the vulgar: for that which is disjoined desires to be united, because union is contrary to division. But by what means such union may be procured, is only known to the skilful Artisan. Therefore we attain unto this chief and principal Indication by the benefit of nature as it were the chief Agent, and the work of the Chirurgeon as the servant of nature. And unless nature shall be strong the Chirurgeon shall never attain to his conceived, and wished for end: therefore that he may attain hereto, he must perform five things; the first is, that if there be Five things necessary for uniting wounds. any strange bodies, as pieces of Wood, Iron, Bones, bruised flesh, congealed blood, or the like, whether they have come from without, or from within the body, and shall be by accident fastened or stuck in the wound, he must take them away, for otherwise there is no union to be expected. Another is, that he join together the lips of the Wound; for they cannot otherwise be agglutinated and united. The third is, that he keep close together the joined lips. The fourth, that he preserve the temper of the wounded part, for the distemper remaining, it is impossible to restore it to its unity. The fifth is, that he correct the accidents, if any shall happen, because these urging, the Physician is often forced to change the order of the cure. All strange and external bodies must be taken away, as speedily as is possible, because they hinder the action of nature intending unity, especially if they press or prick any Nervous body, or Tendon, whence pain or an Abscess may breed in any principal part, or other serving the principal. Yet if by the quick and too hasty taking forth of such like bodies there be fear of cruel pain or great effusion of blood, it will be far better to commit the whole work to nature than to exasperate the Wound by too violent hastening. For nature by little and little will exclude, as contrary to it, or else together with the Pus, what strange body soever shall be contained in the wounded part. But if there shall be danger in delay, it will be fit the Chirurgeon fall to work quickly, safely, and as mildly as the thing will suffer: for effusion of blood, swooning, convulsion and other horrid symptoms, follow upon the too rough and boisterous handling of Wounds, whereby the patient shall be brought into greater danger than by the wound itself. Therefore he may pull out the strange bodies, either with his fingers, or with instruments, fit for that purpose: but they are sometimes more easily and sometimes more hardly pulled forth, according as the body infixed is either hard or easy to be found or pulled out. Which thing happens according to the variety of the figure of such like bodies; according to the condition of the part itself, soft, hard, or deep, in which these bodies are fastened more straight or more loosely; and then for fear of inferring any worse harm, as the breaking of some Vessel; but how we may perform this first intention, and also the expression of the instruments necessary for this purpose, shall be shown in the particular treaties of wounds made by Gun-shot, Arrows and the like. But the Surgeon shall attain to the second and third scope of curing wounds by Ligatures and Sutures for to conjoin and hold together the lips of wounds. two and the same means, that is, by ligatures and sutures: which notwithstanding before he use, he must well observe whether there be any great flux of blood present, for he shall stop it if it be too violent; but provoke it, if too slow, (unless by chance it shall be poured out into any capacity or belly) that so the part freed from the superfluous quantity of blood may be less subject to inflammation. Therefore the lips of the wounds shall be put together, and shall be kept so joined by suture and ligatures: Not truly of all, but only of those which both by their nature, and magnitude, as also by the condition of the parts in which they are, are worthy and capable of both the remedies. For a simple and small solution of continuity, stands only in need of the Ligature which we call incarnative, especially, if it be in the Arms or Legs; but that which divides the Muscles transversly, stands in need of both Suture and Ligature; that so the Lips which are somewhat far distant from each other, and as it were drawn towards their beginnings, and ends, may be conjoined. If any portion of a fleshy substance by reason of some great cut shall hang down, it must necessarily be adjoined and kept in the place by suture. The more notable and large Wounds of all the parts, stand in need of Suture, which do not easily admit a Ligature, by reason of the figure and site of the part in which they are, as the Ears, Nose, Hairy-scalpe, Eyelids, Lips, Belly and Throat. There are three sorts of Ligatures, by the joint consent of all the Ancients. They Three sorts of Ligatures: commonly call the first, a Glutinative or Incarnative; the second Expulsive, the third Retentive. The Glutinative or Incarnative is fit for simple, green, and yet What an incarnative Ligature is. bloody wounds. This consists of two ends, and must so be drawn, that beginning on the contrary part of the wound, we may so go upwards, partly crossing it, and going downwards again, we may closely join together the lips of the Wound. But let the Ligature be neither too straight, lest it may cause inflammation or pain; nor too loose, lest it be of no use, and may not well contain it. The Expulsive Ligature is fit for sanious and fistulous ulcers, to press out the filth What an expulsive. contained in them. This is performed with one Rowler, having one simple head; the beginning of binding must be taken from the bottom of the Sinus, or bosom thereof; and there it must be bound more straightly, and so by little and little going higher, you must remit something of that rigour, even to the mouth of the Ulcer. That so (as we have said) the sanious matter may be pressed forth. The Retentive Ligature is fit for such parts as cannot suffer strait binding, such What the retentive. are the Throat, Belly, as also all parts oppressed with pain; For the part vexed with pain, abhorreth binding. The use thereof, is to hold to local Medicines. It is performed with a Rowler, which consists some while of one, some while of more heads. All these Rulers ought to be of linen, and such as is neither too new, nor What the rulers must be made of. too old; neither too course, nor too fine. Their breadth must be proportionable to the parts to which they shall be applied; the indication of their largeness being taken from their magnitude, figure and site. As we shall show more at large in our Tractates of Fractures and Dislocations. Why and how the temper of the wounded part must he preserved. The Chirurgeon shall perform the first scope of curing Wounds, which is of preserving the temper of the Wounded part, by appointing a good order of Diet by the Prescript of a Physician, by using universal and local Medicines. A slender, cold, and moist Diet must be observed, until that time be passed, wherein the patient may be safe and free from accidents which are usually feared. Therefore let him be fed sparingly, especially if he be plethoric; he shall abstain from salt and spiced flesh, and also from wine; If he shall be of a Choleric or Sanguine nature: In steed of wine he shall use the decoction of Barley or Liquerice, or Water and Sugar. He shall keep himself quiet; for rest is (in Celsus opinion) the very best Medicine. He shall avoid Venery, Contentions, Brawls, Anger, and other perturbations of the mind. When he shall seem to be past danger, it will be time to fall by little and little to his accustomed manner of diet and life. Universal remedies are Phlebotomies and purging, which have force to divert and hinder defluxion, whereby the temper of the part might be in danger of change. For Phlebotomy it is not always necessary, as in small wounds and bodies, which In what wounds blood letting is not necessary. are neither troubled with ill humours, nor plethoric: But it is only required in great wounds, where there is fear of defluxion, pain, Delirium, Raving and unquietness; and lastly in a body that is Plethoric, and when the joints, tendons, or nerves are wounded. Gentle purgations must be appointed, because the humours are moved and enraged by stronger; whence there is danger of defluxion and inflammation: wherefore nothing is to be attempted in this case, without the advice of a Physician. The Topick and particular Medicines are Agglutinative, which ought to be endued What medicines are to be judged agglutinative. with a drying and astrictive quality, whereby they may hold together the lips of the wound, and drive away defluxion, having always regard to the nature of the part and the greatness of the disease. The Simple Medicines are Glibanum, Al●es, Sarcocolla, Bole-Armenick, Terra sigillata, Sanguis Draconis, Common and Venice Turpentine, Gum Elemni, Plantain, Horsetayle, the greater Comfery, Farina Volatilis, and many other things of this kind, which we shall speak of hereafter in our Antidotary. The fifth scope of healing wounds, is the Correction of those Symptoms or Accidents which are accustomed to follow wounds, which thing verily makes the Chirurgeon have much to do; For he is often forced to omit the proper cure of the disease, so to resist the accidents and symptoms, as bleeding, pain, inflammation, a fever, convulsion, palsy, talking idly, or distraction, and the like. Of which we shall treat briefly and particularly, after we have first spoken of Sutures as much as we shall think fitting for this place. CHAP. VI Of Sutures. WHen Wounds are made alongst the thighs, Legs, and arms, they may easily want Sutures, because the solution of continuity is easily restored What wounds stand in no need of a suture by Ligatures, but when they are made overthwart, they require a Suture, because the flesh and all such like parts, being cut are drawn towards the sound parts; whereby it comes to pass that they part the further each from other; wherefore that they may be joined and so kept, they must be sowed, and if the wound be deep, you must take up much flesh with your needle; for if you only take hold of the upper part, the wound is only superficially healed: but the matter shut up, and gathered together in the bottom of the wound, will cause abscesses and hollow Ulcers: Wherefore now we must treat of making of Sutures. The first, called Interpunctus, leaves the distance of a finger's breadth, and therefore The first manner of suture. is fit for the green wounds of the fleshy parts, which cannot be cured with a Ligature, and in which no heterogeneous or strange body remains; It is performed after this manner. You must have a smooth needle with a thread in it, having a three The form of your needle. square point, that so it may the better enter the skin, with the head of it some what hollowed, that the thread may lie therein; for so the needle will the better go through. You must also have alittle pipe with a hole or window in the end, which you must hold and thrust against the lip of the wound, that it be not moved to the The form of the pipe. with a window in it. one side or other, whilst you thrust through the needle: And that we may see through that window when the needle is thrust through, and also draw it together with the thread, and withal hold the lip of the wound in more firmly, that it follow not at the drawing forth of the needle and thread. Having thus pierced the lips of the wound, tie a knot, near to which cut off the thread; lest that if any of it be left below the knot, it may so stick to the Emplasters that it cannot be plucked and separated from them without pain, when they are taken off. But you must note, the first stitch must be thrust through the midst of the wound, and then the second must be in that space which is between the midst and one of the ends; but when you have made your stitches, the lips of the wound must not be too closely joined, but a little space must be left open between them, that the matter may have free passage forth, and the inflammation and pain may be avoided: otherwise if they shall be closely joined together without any distance between, a tumour after arising when the matter shall come to suppuration, the lips will be so much distended that they may easily be broken by the stiffness of the thread. But you must neither take hold of too much nor too little flesh with your needle, for too little will not hold, and too much causeth pain and inflammation. And besides leaves an ill favoured scar. Yet in deep wounds, such as are those which are made in the thicker Muscles, the needle must be thrust home, that so it may comprehend more of the fleshy substance; lest the thread drawn away by the weight of the flesh not taken hold of, may be broken. But oft times wounds are seen made in such places as it will be needful, the Chirurgeon should have a crooked needle and pipe, otherwise the Suture will not succeed according to his desire. Wherefore I have thought good to set forth both their figures, that you may use either as occasion shall serve. The Figure of Pipes with fenestels in them, and Needles fit for Sutures. The second Suture is made just after the same manner as the Skinners sow their The 2. manner of Suture. ●els or forrs. And the guts must be sowed with this kind of Suture, (if they shall be at any time wounded) that the excrements come not forth by the wound. The third Suture is made by one or more needles having thread in them, thrust The third manner of Suture. through the wound, the thread being wrapped to and again at the head and the point of the needle, as boys use to fasten their needle, for fear of losing it, in their caps, or clothes. This kind of Suture is fit in the curing and healing of Hare-lips, as we shall show you hereafter expressed by a Figure. The fourth kind of Suture is termed Gastroraphia, invented for the restoring and The 4. kind of Suture termed Gastroraphia. uniting the great Muscles of the Epigastrium, or lower belly, cut with a great wound together with the Peritonaeum lying under them. The manner whereof we will show in due place. The fifth kind is called the Dry Suture, which we use only in the wounds of the The 5. kind called the Dry Suture. face, which also we will describe in its proper place. CHAP. VII. Of the Flux of blood, which usually happens in wounds. OFt times great bleeding follows upon wounds, by reason of some vessel The signs of blood flowing from an artery cut, broken, or torn, which there is need to heal and help diligently, because the blood is the treasure of nature, without which life cannot consist. The Blood which floweth from an Artery, is thus known. It is more subtle, it runs forth as it were leaping, by reason of the vital spirit contained together with it in the Arteries. On the contrary that which floweth from a Vein is more gross, black, and slow. Now there are many ways of staunching blood. The first and most usual is that, by which the lips of the wound are closed, and The first way of staying bleeding. unless it be somewhat deep, are contained by Medicines which have an astringent, cooling, drying, and glutinous faculty; As terrae sigil. Boli Armeni, ana. ℥. ss. thuris, Mastichis, Myr hae, Aloes, ana. ʒ. ij. Farinae volat. molend. ℥. i. Fiat pulvis qui albumine ovi excipiatur. r Or ℞. Thuris & Aloes, ana. parts aequales. Let them be mixed with the white of an Egg, and the down of a hare, and let the pledgets be dipped in these Medicines, as well those which are put unto the wound as those which are applied about it. Then let the wound be bound up with a double clop and fit Ligature, and the part be so seated as may seem the least troublesome and most free from pain. But if the blood cannot be stayed by this means, when you have taken off all that covereth it, you shall press the wound and the orifice of the Vessel with your The 2. manner of staunching is. thumb, so long until the blood shall be concrete about it, into so thick a clott as may stop the passage. But if it cannot be thus stayed, than the Suture (if any be) must be opened, and the The 3. way by binding of the vessels. mouth of the Vessel towards the original or root, must be taken hold of, and bound with your needle and thread, with as great a portion of the flesh as the condition of the part will permit. For thus I have stayed great bleedings, even in the amputation of members, as I shall show in fit place. To perform this work, we are often forced to divide the skin which covereth the wounded Vessel. For if the jugular vein, or Artery be cut, it will contract and withdraw itself upwards and downwards. Then the skin itself must be laid open under which it lieth, and thrusting a needle and thread under it, it must be bound as I have offen done. But before An admonition you lose the knot, it is fit the flesh be grown up, that it may stop the mouth of the Vessel, lest it should then bleed. But if the condition of the part shall be such as may forbid this comprehension, and binding of the Vessel, we must come to Escharoticks, such as are the powder of The 4. way die Escharoticks. burnt Vitriol, the powder of Mercury, with a small quantity of burnt Allume; and Cawsticks which cause an Escar. The falling away of which must be left to Nature, and not procured by art, lest it should fall away before that the orifice of the Vessel shall be stopped with the flesh, or clotted blood. But some times it happens that the Chirurgeon is forced wholly to cut off the vessel The 5. way by cutting off the vessels. itself, that thus the ends of the cut vessel withdrawing themselves, and shrincking upwards and downwards, being hidden by the quantity of the adjacent and encompassing parts, the flux of blood, which was before not to be stayed, may be stopped with less labour. Yet this is an extreme remedy and not to be used, unless you have in vain attempted the former. CHAP. VIII. Of the pain which happens upon wounds. THe pains which follows upon wounds ought to be quickly assuaged, because Paines weakens the body, and causes defluxious. nothing so quickly dejects the powers; and it always causes a defluxion, of how good soever a habit and temper the body be of; for Nature ready to yield assistance to the wounded part, always sends more humours to it, than are needful for the nourishment thereof, whereby it comes to pass that the defluxion is easily increased, either by the quantity, or quality, or by both. Therefore to take away this pain the author of defluxion, let such Medicines be applied to the part as have a repelling and mitigating faculty; as ℞. Olei Myrtini. Divers anodynes or medicines to assuage pain. & Rosarum, ana. ℥. ij. Cerae alb. ℥. i. Farinae hordei, ℥. ss. Boli armeni, & terra sigillat. ana. ʒ. vi. Melt the Wax in the Oils, then incorporate all the rest, and according to Art, make a Medicine to be applied about the part, or ℞. Emplast. Diacalcith. ℥. iv. Ole. Rosar. & aceti, ana. ℥. ss. liquefiant simul, and let a Medicine be made for the fore mentioned use. Irrigations of oil of Roses and Mirtiles, with the white of an Egg, or a whole Egg added thereto, may serve for lenitives, if there be no great inflammation; Rulers and double clothes moistened in Oxycrate, will be also convenient for the same purpose. But the force of such Medicines must be often renewed, for when they are dried, they augment the pain. But if the pain yield not to these, we must come to narcoticke Medicines, such as are the Oil of Poppy, of Mandrake, a Caraplasme of Henbane and Sorrel, adding thereto Mallows and Marsh-mallows, of which we spoke formerly in treating of a Phlegmon. Lastly, we must give heed to the cause of the pain, to the kind and nature of the humour that flows down, and to the way which Nature affects: for according to the variety of these things, the Medicines must be varied, as if heat cause pain, it will be assuaged by application of cooling things; and the like reason observed in the contrary; if Nature intent suppuration, you must help forwards its endeavours with suppurating Medicines. CHAP. IX. Of Convulsion by reason of a wound. A Convulsion is an unvoluntary contraction of the Muscles (as of parts What a Convulsion is. movable at our pleasure, towards their original, that is, the Brain and spinal Marrow, for by this the Convulsed member or the whole body (if the Convulsion be universal) cannot be moved at our pleasure. Yet motion is not lost in a Convulsion as it is in a Palsy, but it is only depraved: and because sometimes the Convulsion possesseth the whole body, otherwhiles some part thereof, you must note that there are three kinds of Convulsions in General. The first is called by the greeks, Tetanoes, when as the whole body grows stiff Three kinds of an universal Convulsion. like a stake that it cannot be moved any way. The second is called Opisthotanoes, which is when as the whole body is drawn backwards. The third is termed Emprosthotonos, which is when the whole body is bended or crooked forwards. A particular Convulsion is, when as the Muscle of the Eye, Tongue, and the like parts which is furnished with a Nerve, is taken with a Convulsion. Repletion or Inanition, Sympathy or consent of pain cause a Convulsion. Abundance Three causes of a convulsion Causes of Repletion. of humours cause Repletion, dulling the body by immoderate eating and drinking, and omission of exercise, or any accustomed evacuation, as suppression of the Hemorrhoids and Courses: for hence are such like excrementions humours drawn into the Nerves, with which they being replete and filled, are dilated more than is fit, whence necessarily becoming more short, they suffer Convulsion. Examples whereof appear in Leather and Lute or Viol-strings, which swollen with moisture in a wet season are broken by repletion. Immoderate vomitings, fluxes, bleedings, cause Inanition or Emptiness, wherefore a Convulsion caused by a wound, is deadly: as also by burning fevers. For by Causes of Inanition. these and the like causes, the inbred and primigeneous humidity of the Nerves is wasted, so that they are contracted like leather which is shrunk up, by being held too near the fire, or as fiddle strings which dried with Summer's heat, are broken with violence, such a Convulsion is incurable: For it is better a Fever follow a Convulsion, than a Convulsion a Fever; as we are taught by Hypocrates, so that Aph. 26. sec. 2. such a Fever be proportional to the strength of the convulsifique cause, and the Convulsion proceed from Repletion; for the abundant and gross humour causing the Convulsion is digested and wasted by the feverish heat. The causes of a Convulsion by reason of pain, are either the puncture of a Nerve, Causes of convulsion by consent of pain. whether it be by a thing animal, as by the biting of a venomous beast; or by a thing inanimate, as by the prick of a needle, thorn, or penknife: or great and piercing cold, which is hurtful to the wounds, principally of the nervous parts; whereby it comes to pass, that by causing great and bitter pain in the nerves they are contracted towards their original, that is, the Brain, as if they would crave succour from their parents in their distressed estate. Besides also, an ill vapour carried to the brain from some putrefaction so vellicateth it, that contracting itself, it also contracteth together with it all the Nerves and Muscles, as we see it happeneth in those which have the falling sickness. By which it appears that not only the brain itself suffereth together with the Nerves, but also the Nerves with the Brain. The signs Signs of a convulsion. of a Convulsion are difficult, painful and depraved motions, either of some part or of the whole body, turning aside of the Eyes and whole Face, a Contraction of the Lips, a drawing in of the Cheeks as if one laughed, and an Universal sweat. CHAP. X. The cure of a Convulsion. THe cure of a Convulsion, is to be varied according to the variety of the Convulsive cause, for that which proceeds from Repletion must be otherwise cured, than that which is caused by Inanition, and that which proceeds The cause of a Convulsion by Repletion. of pain, otherwise than either of them. For that which is caused by Repletion is cured by discussing and evacuating Medicines: as by diet conveniently appointed, by purging, bleeding, digestive local Medicines, exercise, frictions, sulphurous Baths and other things appointed by the prescription of some learned Physician which shall oversee the cure, which may consume the superfluous and excrementitious humours that possess the substance of the Nerves, and habit of the body. The local remedies are Oils, Unguents and Liniments, with which the Neck, Backbone and all the contracted parts shall be anointed. The Oils are, the Oil of Foxes, Bays, Camomile, Worms, Turpentine, of Costus, of Castorcum: The Ointments are Vnguentum Arragon, Agrippae, de Althaea, Martiatum. This may be the form of a Lineament; ℞. Olei Chamaem. & Laurin. ana. ℥. ij. Olei Vulp. ℥. i. Vnguenti de Althaea & Marti. an. ℥. ss. Axungiae vulpis, ℥. i. Aquae vitae, ℥. i. ss. Cerae quantum sufficit. Make a Lineament for your use, or ℞. Olei Lumbric. de Spica & de Castoreo, ana. ℥. iij. Axng. hum. ℥ i. Sulphuris vivi, ℥. ss. Cerae quantum sufficit. Make a Lineament, or ℞. Vnguenti Martiati, & Agrip. an. ℥. iij. Olei de Terebinth. ℥. i. ss. Olei Salvia, ℥. ss. Aquae vitae ℥. i. Cerae ℥. i. ss. fiat linimentum. But this disease is cured by slender diet, and sweeting with the Decoctions of Guiacum, because by these remedies the gross, tough, and viscide excrements, which are in fault, are digested. A Convulsion proceeding of Inanition is to be cured by the use of those things, which do wholesomly and moderately nourish. And therefore you must prescribe a diet consisting of meats full of good nourishment, as broths and culliss of Capons, The cure of a Convulsion caused by inanition. Pigeons, Veal, and Mutton, boiling therein Violet and Mallow leaves. Conserves must be ordained, which may strengthen the debilitated powers, and humect the habit of the body, such as are, the Conserves of bugloss, Violets, Borage and water Lilies. The following broth will be profitable, ℞. Lactucae, Buglos. & portul. ana. M. i. quatuor seminum frigid. major. an. ℥ ss. seminis Barberis, ʒ. i. Let them all be boiled with a Chicken, and let him take the broth every morning. If thirst oppress him, the following julep will be good. ℞. Aquae rosar. ℥. iv. Aquae viol. lb. ss. Saccari albissimi ℥. vi. fiat juiep, utatur in siti. If the patient be bound in his body, emollient and humecting Clysters shall be appointed, made of the decoction of a sheep's head and feet, Mallows, Marsh Mallows, Pellitory of the wall, Violet leaves, and other things of the like faculty; or that the remedy may be more ready and quickly made: let the Clysters be of Oil and Milk. Topick remedies shall be Liniments and Baths. Let this be the example of a Lineament. ℞. Olei Viol. & Amygdal. dulc. ana. ℥ ij. Olei Lilior. & An Emolient Lineament for any Convulsion. Lumbric. ana. ℥. i. Axungiae porci recentis, ℥. iij. Cerae novae quantum sufficit, fiat Linimentum, with which let the whole spin and part affected be anointed: This shall be the form of an emollient and humecting Bath. ℞. Fol. Malvae, Bis Malvae, Pariet. ana. An Emolient and humecting Bath. M. vi. Seminis Lini & foenug. ana. lb. ss. Coquantur in Aqua communi, addendo Olei Lillior. lb. viij. Make a Bath: Into which let the patient enter when it is warm. When he shall come forth of the Bath, let him be dried with warm Clothes, or rest in his bed avoiding sweat. But if the patient be able to undergo the charge, it will be good to ordain a Bath of Milk, or Oil alone, or of them equally mixed together. CHAP. XI. Of the cure of a Convulsion, by sympathy and pain. A Convulsion which is caused both by consent of pain and Communication of the affect, is cured by remedies which are contrary to the dolorifique The cure of a Convulsion by a puncture, or bite. cause. For thus if it proceed from a puncture or venomous bite, the wound must be dilated and enlarged by cutting the skin, that so the venenate matter may flow forth more freely, for which purpose, also Medicines which are of a thin and liquid consistence, but of a drying and digestive faculty shall be poured in, to call forth & dissolve the virulency, as Treacle & Mithridate, dissolved in Aqua vitae, with a little of some Mercurial powder for this is a noble A worthy Alex●pharmac●… or Antidote. Antidote. Also cupping glasses and scarrifications will be good. Lastly the condition of all dolorifique causes, shall be oppugned by the opposition of contrary remedies, as if pain by reason of a pricked Nerve or Tendon, shall cause a Convulsion, it must presently be resisted by proper remedies, as Oil of Turpentine, of Euphorbium, mixed with Aqua vitae, and also with other remedies appropriated to punctures of the Nerves. If the pain proceed from excess of cold, because cold is hurtful to the Brain, the spinal marrow, and Nerves; the patient shall be placed in a hot air, such as that of a Hothouse or Stoave, all the Spine of his back and Convulsed parts, must be anointed with the hot Liniments above mentioned: For that is much better, than suddenly to expose him from the conceived convulcifique, cause to a most hot fire or warm Bath. In the mean time the Chirurgeon must take diligent heed, You must hinder the locking of the teeth. that as soon as the signs of the Convulsion to come, or already present, or at hand, do show themselves, that he put a stick between the patient's teeth, lest they be fast locked by the pertinacious contraction of the jaws: for many in such a case have bit off their tongues, for which purpose he shall be provided of an instrument called Speculum Oris, which may be dilated and contracted according to your mind by the means of a screw, as the figures underneath demonstrate, the one presenting it open and somewhat twined up, and the other as it is shut. The Figure of a Speculum Oris, to open the teeth when they are locked or held fast together. CHAP. XII. Of the Palsy. THe Palsy is the resolving or mollification of the Nerves, with privation of sense and motion, not truly of the whole body, but of the one part thereof, as of the right or left side. And such is properly named the Palsy: What a Palsy is. for otherwise and less properly the resolution of some one member is also called the Palsy: For when the whole body is resolved, it is an Apoplexy. Therefore The differences thereof. the Palsy sometimes takes half the body, otherwhiles the uper parts which are between the navel and the head, otherwhiles the lower which are from the navel to the feet; sometimes the tongue, gullet, bladder, yard, eyes, and lastly any of the panicles of the body. It differs from a Convulsion in its whole nature. For in a Convulsion, there is a contention and contraction of the part, but in this a resolving and relaxation thereof: besides, it commonly happeneth that the sense is either abolished or very dull, which usually remains perfect in a Convulsion. There are some which have a pricking, How it differs from a Convulsion. and as it were great pain in the part. The causes are internal or external, the internal are humours obstructing one of the ventricles of the brain, or one side of the spinal marrow, so that the Animal faculty, the worker of sense and motion, cannot by the Nerves come to the part to The causes. perform its action. The external causes are a fall, blow, and the like injuries, by which oft times the joints are dislocated, the spinal marrow wrested aside, and constrictions and compressions of the Vertebrae arise, which are causes that the Animal spirit cannot come to the Organs in its whole substance. But it is easy by skill in Anatomy perfectly to understand by the resolved part the seat of the morbifique cause, for when there is a Palsy properly so called, that is when the right, or left side is wholly feized upon, than you may know that the obstruction is in the brain, or spinal marrow; but if the parts of the head being untouched, either of the sides being wholly resolved, the fault remains in the Original of the spinal marrow; if the arms be taken with this disease, we may certainly think that the matter of the disease lies hid in the 5. 6. and 7. Vertebra of the neck. But if the lower members languish, we must judge the Paralytic cause to be contained in the Vertebra of the loins and holy bone. Which thing the Chirurgeon must diligently observe that he may always have recourse to the original of the disease. The Palsy which proceeds from a Nerve cut, or exceedingly bruised, is incurable, because the way to the part by that means is shut against the Animal spirit. Old men scarce or never recover of the palsy, because their native heat is languid, and they are oppressed with abundance of excrementitious humours, neither doth an inveterat palsy which hath long possessed the part, neither that which succeeds an Apoplexy, yeeldus any better hope of cure. It is good for a It is good for a fever to happen upon a Palsy. fever to come upon a Palsy, for it makes the dissipation of the resoloving and relaxing humour, to be hoped for. When the member affected with the palsy, is much wasted, and the opposite on the contrary, much increased in quantity, heat and colour, it is ill: For this is a sign of the extreme weakness of the afflicted part, which suffers itself to be defrauded of its nourishment, all the provision flowing to the sound or opposite side. CHAP. XIII. Of the cure of the Palsy. IN the cure of the Palsy we must not attempt any thing, unless we have first used general remedies, diet and purging; all which care lieth upon the learned and prudent Physician. The Decoction of Guaiacum is very fit for this The decoction of Guaiacumis good for a Palsy. purpose, for it procures sweat and attenuates, digests and drieth up all the humidity which relaxeth the nerves: but when sweat doth not flow it shall not be unprofitable to put about the resolved members, bricks heated red hot in the fire and quenchedin a decoction of Wine, Vinegar, and resolving herbs, or also stone bottles, or Ox and Swine's bladders, half filled with the same decoction; for such heat which is actual Things actually hotegood for to be applied to paraliticke membera. resuscitateth & strengtheneth the heat of the part, which in this disease is commonly very languid: Then the Patient shall go into a Bathing-tub, which is vailed or covered over just as we have described in our Treatise of Baths, that so he may receive the vapour of the following Decoction. ℞. Fol. Salviae, Lavend. Lauri. major. Absinth. Thym. Angelicae, Rutae. ana. M. ss. Florum Chamaem. Melil Anethi, Anthos. ana. P. ij. Baccar. Laur. & juniper. Conquassatar. ana. ℥. i. Caryophyl. ʒ. ij. Aquae fontanae & Vini albi, ana. lb. iv. Let them be all put in the Vessel mentioned in the Treatise lately described for use. The patient shall keep himself in that Bathing-tub, as long as his strength will give him leave, then let him be put into his bed well covered, where he shall sweat again, be dried and rest. Then let him be presently anointed with the following ointment, which Leonellus Faventinus much commends, ℞. Olei Laurini & de Terebinth. ana ℥. iij. Olei Leon. Faventi. his ointment. Nardini & petrolei, ana. ℥ j Vini malvatici, ℥ iv. Aqua vitae, ℥. ij. Pyrethri, Piperis, Synap. Granor. lunip. Gummi hederae, anacard. Ladani puri, an. ℥ i. ss. Terantur & misceantur omnia cum Olets & Vino: bulliant in vasi duplici usque ad Vini consumptionem, facta forti expressione, add Galbani, Bdillit, Euphorbil. Myrrhae, Castorei, adipis ursi, Anatis, Ciconiae, an. ʒij. Make an ointment in form of a lineament, adding a little wax if need shall require. Or you shall use the following remedy approved by many Physicians, ℞ Myrrhae & aloes, An approved ointment for the Palsy. Spicaenardi, Sanguinis draconis, thuris, opopanacis, Bdellii. Carpobalsami, amemi, sarcocollae, eroci, mastio. gumml arabici, styrac. liquidae, ladani, castorei, ana ℥. ij. Moschi, ʒ. i. aquae vitae, ℥. i. Terebinthinae venetae, ad pondus omnium, pulverabuntur pulverisanda & gummi eliquabuntur cum aqua vitae & aceti tantillo. And let them all be put in fit vessels, that they may be distilled in Balneo Mariae, and let the spin of the back, and paralytic limbs be anointed with the liquor which comes from thence. I have often tried the force of this following Medicine. ℞. rad. Angel. Ireos, florens. gentian. cyperi, ana. ℥. i. Calami aromat. A distilled water good to wash them outwardly, & to drink inwardly, Cinam, Caryophil. nucis Mosch. macis, ana. ʒ. ij. Salviae, major. juae arthriticae, Lavend. rorism. satureiae, puleg. calament. mentastri, ana. M. ss. florum chamaem. melil. hyperic. anthos, staechad. ana. P. i. Concisa omnia contundantur, & in Aqua vit. & Vini malvat. an. lb. ij. infundantur. And let them be distilled in Balneo Mariae, like the former, let the affected parts be moistened with the distilled liquor, of which also you may give the patient a spoon full to drink in the morning with some Sugar. For thus the stomach will be heated, and much phlegm contained therein as the fuel of this disease, will be consumed. You must also appoint exercises of the affected parts and frequent and hard frictions, with hot linen clothes, that the native heat may be recalled and the excrements Exercises and frictions. contained in the parts digested: You may also use the Chemical oils of Rosemary, Time, Lavender, Cloves, Nutmegs, and lastly of all spices, the manner of extracting, Chemical oils. whereof we shall hereafter declare in a peculiar Treatise. CHAP. XIV. Of Swooning. Swooning is a sudden and pertinacious defect of all the powers, but especially the Vital; In this the Patients lie without motion and sense, so that the Ancients thought that it differed from death only in continuance of time. What Swooning is. The cause of swooning, which happens to those that are wounded, is bleeding, which causeth a dissipation of the spirits: or fear which causeth a Three causes of swooning. sudden and joint retirement of the spirits to the heart. Whence follows an intermission of the proper duty as also of the rest of the faculties, whilst they being thus troubled, are at a stand. Also Swooning happens by a putrid and venenate vapour, carried to the heart by the Arteries, and to the Brain by the Nerves; by which you may gather that all swooning happens by three causes. The first is, by dissipation of the spirits and native heat, as in great bleeding. And then by the oppression of these spirits by obstruction, or compression as in a fear, or tumult; For thus the spirits fly back hastily from the surface and habit of the body, unto the heart and centre. Lastly, by corruption, as in bodies filled with ill humours, and in poisonous wounds. The signs of Swooning are Paleness, a dewy and sudden sweat arising, the failing of the pulse, a sudden falling of the body upon the ground without sense & motion, a coldness possessing the whole body, so that the Patient may seem rather dead, than alive. For many of these who fall into a swoon dye unless they have present help. Therefore you shall help them, if when they are ready to fall, you sprinkle much The cure of swooning caused by dissipation of spirits. cold water in their face, if that the swooning happen by dissipation of the spirits, or if they shall be set with their faces upwards, upon a bed or on the ground, as gently as may be; and if you give them bread dipped in wine to hold and chew in their mouths. But if it be caused by a putrid vapour and poisonous air, you shall give them a little The cure of swooning caused by a venenate air. The cure of Swooning caused by oppression and obstruction. Mithridat or Treacle in Aqua vitae with a spoon, as I usually do to those which have the plague, or any part affected with a Gangrene, or sphacell. But if the patients cannot be raised out of their sows, by reason of the pertinatious oppression and compression of the spirits about the heart, you must give them all such things as have power to diffuse, callforth and resuscitat the spirits, such as are, strong wines to drink, sweet perfumes to smell: You must call them by their own name, loud in their ear, and you must pluck them somewhat hard by the hairs of the Temples, and neck. Also rub the temples, nostrils, wrists and palms of the Hands with Aquavitae, wherein Cloves, Nutmegs, and Ginger have been steeped. CHAP. XV. Of Delirium (i) Raving, Talking idly or Doting. DOting, or talking idly, here is used for a symptom which commonly happeneth in fevers caused by a wound, and inflammation; and it is a perturbation What a Symptomatical Delirium is. The causes thereof. of the fantasy, and function of the mind, not long enduring. Wherefore such a doting happens upon wounds, by reason of vehement pain, and a fever, when as the nervous parts as the joints, stomach, and midriff shall be violated. For the Ancients did therefore call the Midriff Phrenae, because when this is hurt Why the brain suffers with the midriff. as if the mind itself were hurt, a certain frenzy ensues, that is, a perturbation of the Animal faculty, which is employed in ratiocination; by reason of the community which the Diaphragma hath with the Brain, by the nerves, sent from the sixth Conjugation, which are carried to the stomach. Therefore doting happens by too much bleeding, which causeth a dissipation of the spirits, whereby it happens that the motions and thoughts of the mind err, as we see it happens to those who have bled much in the Amputation of a member. And it happens by the puncture of a venomous beast, or from seed retained or corrupted in the womb, or from a Gangreen or Sphacel, from a venenate and putrid air carried up to the brain, or from a sudden tumult and fear. Lastly, what things soever with any distemper especially hot, do hurt and debilitate the mind. These may cause doting by the afflux of humours, specially choleric, by dissipation, oppression or corruption of the spirits. Therefore if it shall The Cure proceed from the inflammation of the brain, and Meninges or Membranes thereof; after purging and blood letting by the prescription of a Physician, the hair being shaved or cut off, the head shall be fomented with rose vinegar, and then an Emplaster of Diacalcitheos' dissolved in oil and vinegar of Roses, shall be laid thereupon. Sleep shall be procured with Barley creames, wherein the seeds of white Poppy have been boiled, with broths made of the Decoction of the cold seeds of Lettuce, Purslane, Sorrell and such like. Cold things shall be applied to his nostrils, as the seeds of Poppy gently beaten with Rose-water and a little vinegar. Let him have merry and pleasant Companions that may divert his mind from all cogitation of sorrowful things, and may ease and free him of cares, and with their sweet entreaties may bring him to himself again. But if it happen by default of the spirits, you must seek remedy from these things which have been set down in the Chapter of Swooning. The End of the Ninth Book. OF THE GREEN AND BLOODY WOUNDS OF EACH PART. THE TENTH BOOK. CHAP. I. Of the kinds or differences of a broken Scull. NOw that we have briefly treated of wounds in general, that is, of their differences, signs, causes, prognostics and cure, and also showed the reason of the accidents and symptoms which usually follow and accompany them; it remains that we treat of them as trey are incident to each part, because the cure of wounds must be diversely performed according to the diversity of the parts. Now we will begin with the The differences of a broken head. wounds of the head. Therefore the head hath the hairy scalp lightly bruised without any wound, otherwhiles it is wounded without a Contusion, and sometimes it is both contused and wounded: but a fracture made in the Scull, is sometimes superficiary, sometimes it descends even to the Diploe, sometimes it penetrats through the 2. Tables, and the Meninges into the very substance of the Brain; besides, the brain is oft times moved and shaken with breaking of the internal veins, and divers symptoms happen when there appears no wound at all in the head: of all, and every of which we will speak in order, and add their cure, especially according to the opinion of the divine Hypocrates. He in his Book of the wounds of the head, seems to have The kinds of a broken Skull out of Hypocrates. made 4. or 5. kinds of fractures of the Scull. The first is called a fissure or fracture, the 2. a contusion or collision, the 3. is termed Effractura, the 4. is named Sedes, or a seat; the 5. (if you please to add it) you may call a Counterfissure, or as the interpreter of Paulus calls it, a Resonitus. As when the bone is cleft on the contrary side, to that which received the stroke. There are many differences of these 5. kinds of a broken Scull. For some fractures are great, some small, and others indifferent; some run out to a Differences from their quantity. greater length or breadth; others are more contracted; some reside only in the superficies; others descend to the Diploe, or else pierce through both the Tables of the Scull; some run in a right line, others in an oblique and circular; some are complicated Differences from their figure. From their complication. amongst themselves, as a fissure is necessarily and always accompanied with a Collision or Contusion; and others are associated with divers accidents, as pain, heat, swelling, bleeding and the like. Sometimes the Scull is so broken, that the membrane lying under it, is pressed with shivers of the bone, as with pricking needles. Somewhiles none of the bones falls off. All which differences are diligently to be observed, because they force us to vary the cure, and therefore for the help of memory, I have thought good to describe them in the following Table. A Table of the fractures of the Scull. A fracture, or solution of continuity in the Scull is caused either, by Contusion, that is, a collision of a thing bruising, hard, heavy and obtuse, which shall fall or be smitten against the head, or against which the head shall be knocked, so that the broken bones are divided, or Keep their natural figure and site, touching each other, whence proceeds that fracture of the Scull which is called a fissure, which is Either manifest, & apparent, that is To your sight, To your feeling, Or instrument. Or obscure and not manifest, when as not the part which received the blow is wounded, but the contrary thereto; and that happens either. In the same bone, and that 2 manner of ways as On the side, as side example, than the right side of the bone of the forehead is strucken, the left is cleft. Or from above to below, as when not the first Table which received the blow is cleft, but that which is under it. In divers bones to wit in such men as want sutures, or have them very close, or disposed otherways then is fit, and this opposition is, either From the right side to the left, and so on the contrary, as when the right Bregma is struck, and the left cleft. From before to behind and the emtrary, as when the forehead is smitten, the noll is cleft. Or between both, that is, the obscure & manifest, as that which is termed a Capillary fissure, and is manifested by smearing it over with oil, and writing ink. Or lose that site, and that either Wholly so that the particles of the broken bone removed from their seat, and falling down, press the membrane, whence proceeds that kind of effracture which retains a kind of attrition, when as the bone struck upon is broken as it were into many fragments, shivers and scailes, either apparent, or hid in the sound bone, so that it is pressed down. Or in some sort; as when the broken bone is in some part separated, but in others adheres to the whole bone, whence another kind of effracture arises; you may call it Arched, when as the bone so swells up, that it leaves an empty space below. Or by incision of a sharp, or cutting thing, but that incision is made, either by Succision, when the bone is so cut, that in some part it yet adheres to the sound bone. Rescission, when the fragment falls down wholly broken off. Or Seat, when the mark of the weapon remains imprinted in the wound, that the wound is of no more length, nor breadth than the weapon fell upon. Another Table of the differences of a fractured Scull. The differences of fractures common to these of all other parts are drawn, either from Their nature, according to which fractures are called, Simple, as when they are found solitary and by themselves. Compound and that either Mutually with themselves, as a contusion, or collision with incision, a fissure with an effracture. Or with other symptoms, as swelling, pain, heat, bleeding, convulsion and the like. Their Quantity whence they are called, great, indifferent and small, according to the triple dimension of length, breadth and profundity. Their figure, from whence they are called. Right, Oblique, Transverse, Round, Triangular. Their site, whence they are termed on the fore or back, or the right or left, or the upper or lower part; or superficiary and profound. The part, whence it is called a Fracture of the Forehead, Noll, Bregma, and Stony bones; and hence it is judged, what may be deadly, or hopeful of recovery, easy or difficult to cure. CHAP. II. Of the causes and signs of a broken Scull. THe causes of a broken Scull are external, as a fall, a blow or stroke with any kind of weapon, sharp, obtuse, heavy, hard, the bitings of The external causes. Beasts, and many other things of the like kind. But the signs by which we come to know that the Scull is broken, are of two kinds; for some of them are found out by the reasoning and discourse of the mind, other by the sense, as those which lay open the wound to the eye and hand. The Rational signs show by these things which have happened upon the thing it Rational causes. self, whether it be, and of what sort it is. For you may know the Scull is broken, if the patient shall fall down with the stroke, or if he shall fall headlong from a high place upon some hard thing. If for some time after the stroke, he shall lie without speaking, sight, and hearing, if he shall have felt and feel much pain, so that he is often forced to put his hand to the wound. But also the weapon is to be considered, that is, whether it be heavy, obtuse, pricking or sharp. Also we must consider with what & how great strength the stroke was given, and with how great anger and from what distance the weapon fell. Also he must consider whether the patient received the blow with his head unarmed and naked; whether he fell into a swoon presently after the blow; whether when he came to himself, he was in his right senses; whether his eyes were blinded, whether he was troubled with a giddiness or dizines, and whether he bled at the nose, mouth, ears, or eyes, and lastly whether he vomited. For Hypocrates writes, that Aphor. 50. sec. 6. those who have their brain cut, must necessarily have a fever and vomiting of choler to ensue thereupon, which Galen confirming in his Commentary saith, that the same happens also when the wound comes to the Membranes of the brain. Also a dull sound as from a broken vessel coming from the skull, (the hairy sealpe and Pericranium being taken off) and it being lightly smitten upon with an Iron probe, is said to be a sign of a fracture thereof, as it is recorded by Paulns Lib. 8, cap. 4. Aegineta. Truly all these signs make a great conjecture or rather assuredness that the skull is wounded, and the brain hurt, as which cannot happen unless the bone be broken, as Celsus hath written. Yet many have had their skulls broken, who had no such sign immediately after the blow; but this is very seldom. But I do not think fit amongst so many signs, here to omit that which is set down by Guido. If any (faith he) will know in what place the scull is broke, let the patient hold fast between his foreteenth, one end of a lute string or thread, and the Chirurgeon hold the other in his hand; then let him lightly touch or play upon the string with his fingers; for in the very instant of the sound or stroke, the patient will be certainly admonished, or perfectly perceive the part of the scull that is broken, and as o'ercome and forest by this sense of pain, will by lifting up his hand make demonstration thereof. As yet I have not beeneable to find the truth hereof by experience, although I have made trial of it in many. Wherefore I cannot say any thing certainly of this sign, as neither of that which is mentioned by Hypocrates in Coais Pras. Hypocrates and Guidoes' conjectural fignes of a broken scull. In such as you doubt, whether the bones of the scull be broken, or not, you must judge by giving them the stalk of Asphodill, to chaw on both sides of their jaws, but so that you bid them withal observe, whether they perceive any bone to crackle, or make a noise in their heads, for these which are broken seem to make a noise. But passing over these things, now let us come to these signs, which may be obvious to our senses. CHAP. III. Of the signs of a broken skull, which are manifest to our sense. THese signs are here said to be manifest to sense, which when the bone is bared, manifest the wound to our eyes, fingers and probe. But if the Sensible signs of a broken scull before the dividing of the skin. hairs stand upon one end in the wound, you may know the bone is broke, because the hair which yields to the violence of the blow, cannot be so cut, the bone which resists the stroke being not violated, as it is observed by Hypocrates; wherefore we may by the sight of this one thing, before any inspection of the wound itself, suspect by a probable conjecture, that Lib. de vuluere cap. the Scull is broken, and persuade the beholders or standers by so much. Moreover we may, before we have cut the skin across, or baid lare the bone, give a guess by our feeling, whether the scull be broken, or no, if we by pressing down our fingers near the wound shall perceive the bone either to stand up, or be pressed down otherwise than it should naturally be. The skin being cut crosswise and the bone laid bare, if the fracture be not obvious to the eye, you must try with your probe, which must neither be too thin What a probe must be used in searching for a fracture. nor to sharp, least by falling into some natural cranyes, it may cause us to suspect without any cause that the bone is broken; neither let it betoo thick, lest the little cliffs may deceive you. If when your probe comes to the bone, it meets with nothing but that which is smooth and slippery, it is a sign that it is whole. But on the contrary, if you find it any thing rough, specially where there is no suture, it shows the bone is broken. But let the Chirurgeon consider, that the fractures are not seldom upon the future's; and that the future's have not always one and their natural site; as also it often comes to pass that the broken clefte, or cut bone can neither be perceived by your sight, nor instrument; wherefore if you think there is any such thing, by the rational signs above mentioned, anoint the place with writing Ink, and oil, and so you shall find the crack or cleft, by the means we shall show you hereafter. When you are certain of the fracture, than you must diligently consider the greatness of the disease, and apply medicines speedily. Verily when a fracture chances to light upon any future, the disease is hard to be known, unless the fracture be very Lib. 5. Epid. in Autonomus of Omsium Hipcrates was deceized by the future's. great, because the future's by their cliffs and roughness resemble fractures; wherefore Hypocrates faith that he was deceived by them. Now having briefly delivered the differences and signs of a broken scull, it is time to come to the several kinds thereof, with a Fissure. CHAP. four Of a Fissure, being the first kind of a broken scull. IF the Chirurgeon by the forementioned signs shall know that the scull is Upon what occasion the hairy sealpe must be cut. broken, or cracked, and if the Wound made in the musculous skin shall not be thought sufficient for ordering the fissure, then must he shave off the hair, and cut with a razor, or incision knife, the musculous skin with the Pericranium lying under it, in a triangular or quadrangular figure to a proportionable bigness, always shunning, as much as in him lies, the future's and temples; neither must the fear any harm to ensue hereof; for it is far better to bare Celsus. the bone by cutting the skin, then to suffer the kind and nature of the fracture to remain unknown, by a too religious preservation of the skin; for the skin is cured without any great ado, though plucked off to no purpose. For it is much more expedient (in Hypocrates opinion) to cure diseases safely and Hippocrater. securely though not speedily; than to do it in a shorter time with fear of relapse and greater inconveniencies. Let this dissection be made with a razor, or sharp knife, and if there be any Wound made in the skin by the weapon, let one of your incisions be made agreeable thereto. A Razor, or Incision knife. Now therefore the Musculous skin together with the Pericranium must be divided and cut with a sharp razor pressed and guided with a strong and steady hand; The manner how to pull the hairiesealp from the broken scull. then must it be so plucked from the bone, or scull lying under it, that none thereof remain upon the bone; for if it should be rend or torn with the Trepane, it would cause vehement fevers with inflammation. You must begin to pull it back at the corners of the lines crossing each other with right angles, with this chisel whose figure you see here expressed. A chisel or Instrument to pull back or separate the Pericranium from the Scull. Then you must fill all the wound with bolsters of fine soft lint, that so the lips may be kept further a sunder. But you shall apply upon it medicines fit to staunch blood. But if it come so to pass that the blood flows forth so violently, that it can be stayed by no means, the vessel itself must be bound, after this manner First thrust through the musculous skin on the outside with a needle and The manner to bind a vessel in case of too much bleeding. thread, than thrust the needle back again; then tie the thread on a knot on the outside, but first put some lint rolled up to the bigness of a Goose quill between the thread and the hairy scalp on both sides thereof, lest the straight twitching of the thread which may serve to stay the bleeding, may cut and tear the skin, or cause pain: then must you raise his head somewhat higher. I have lately tried, and performed this upon a certain Coachman, who thrown A History. from the Coach upon his head on a pavement of freestone, exceedingly bruised the hind part of the Bregma, for which cause it was fit to open the Musculous skin, with a cross incision, both that the congealed blood might be pressed out, as also that the fracture (if there were any) might be observed. But an Artery being cut in performance hereof, when as the Chirurgeon who was there present could not stay the blood leaping out with violence; and the Coachman already had lost so great a quantity thereof, that his strength was so much decayed, that he could not stir himself in his bed, or scarce speak: I being called, showed them by experience, that whereas a stringent medicines were used before to no purpose, it was better to stay the bleeding by binding the vessel, than to let the patient die for a childish fear of pricking him. But that we may return to our former matter, the Chirurgeon shall the next day consider with what kind of fracture the bone is hurt; and if no signs of hurt appear to the eyes, nor be perceived with your fingers and probe, yet some of the rational signs may cause one to have a conjecture that there is a fracture: Then you A way to find a fracture in the scull, when it presents not itself to the view at the first. must anoint as we told you before, the bared bone with writing Ink, and a little oil of Roses; that the cleft or crack may be died or coloured therewith, if that therebe any there. Then the next dressing you must dry the bone with a linen cloth, and scrape off the Ink, and oil, with scraping Instruments made for the purpose: if any part thereof, shall be sunk into the bone; for if there be any crack, it will be black; Wherefore you must continue scraping until no sign of the fissure remain, or else until you come even to the Dura Mater. But that he may be more certain whether the fissure pierce through both the Tables of the scull, he must bid the Patient, that stopping his nose & mouth, he strive to breathe with a great endeavour. For than bloody matter or sanies will sweat through the fissure: For the breath driven forth A sign that both the Tables are broken. of the chest, and prohibited passage forth, swells and lifts up the substance of the brain, and the Meninges, wherereupon that frothy humidity and Sanies sweats forth. Therefore than the bone must be cut even to the Dura Mater, with Radule and other scraping Instruments, fit for that purpose, yet so as you hurt not the membrane; but if the fissure shall be somewhat long, it will not be convenient to follow it all the extent thereof: for nature will repair and restore the remnant of the fissure by generating a Callus, besides also the Chirurgeon according to Celsus opinion must take away as little of the bone as he can, because there is nothing so fit to cover the brain, as the scull. Therefore it shall suffice to make a passage, whereby the blood and Sanies may pass and be drawn forth, lest that matter being suppressed may corrupt the bone, and cause an inflammation in the brain. But the broken bone must be taken forth within three days if it be possible, especially in Summer for fear of inflammation. Yet I have oftentimes taken forth with a Trepan and with Scrapers the bones You may use the Trepan after the tenth day. of the skull, after the seaventeenth day, both in Winter & Summer; and that with happy success. Which I have the rather noted, lest any should, at any time, suffer the wounded to be left destitute of remedy: for it is better to try a doubtful remedy than none: Yet the Bystanders shall be admonished and told of the danger, for many more die who have not the broken bones of the scull taken out, than those that have. But the Instruments, with which the wounded or cleft bones may be cut out are called Scalpri or Radulae, of which I have caused divers sorts to be here deciphered, that every one might take his choice, according to his mind, and as shall be best for his purpose. But all of them may be screwed into one handle, the figure whereof I have here exhibited. Radulae or Scalpri ay Shavers or Scrapers. Radulae of another form, for the better cutting of the greater bones. To conclude, when the scull shall be wounded or broken with a simpleifissure, the It it sufficient in a simple fissure to dilate it with your Scalpri only and not to Trepan it. Chirurgeon must think he hath done sufficient to the patient; and in his Art, if he shall divide the bone and dilate the fissure or cleft with the described Instruments, though he have used no Trepan, although the fissure pierce through both the Tables. But if it doth not exceed the first Table, you must stay your scrapers as soon as you come to the second, according to the opinion of Paulus: but if the bone shall be broken, and shivered into many pieces, they shall be taken forth with fit Instruments, using also a Trepan if need shall require, after the same manner as we shall show you hereafter. CHAP. V. Of a Contusion, which is the second sort of fracture. AN Ecchymosis, that is, an effusion of blood, presently concreating under the What an Ecchymosis is. musculous skin, without any wound, is oft caused by a violent Contusion. This Contusion if it shall be great, so that the skin be divided from the scull, it is expedient, that you make an incision, whereby the blood may be evacuated and emptied. For in this case you must wholly desist from suppurative medicines, How 〈◊〉 contusion of the scull must be cured. (which otherwise would be of good use in a fleshy part) by reason that all moust things are hurtful to the bones, as shall be shown hereafter. But if the bone shall be too strong, thick, and dense, so that this Instrument will not serve to pluck it forth; than you must perforate the scull, in the very centre of the depression; and with this threefold Instrument, or Levatory put into the hole, lift up and restore the bone to its natural site; for this same Instrument is of strength sufficient for that purpose. It is made with three feet, that so it may be applied to any part of the head which is round; but divers heads may be fitted to the end thereof according as the business shall require, as the figure here placed doth show. A three footed levatory. A deliniation of other Levatories. A A. Shows the point or tongue of the Levatory, which must be somewhat dull, that so it may be the more gently and easily put between the Dura Mater and the scull, and this part thereof may be lifted up so much by the head or handle taken in your hand, as the necessity of the present operation shall require. B. Intimates the body of the Levatory, which must be four square, lest the point or tongue put thereon should not stand fast, but the end of this Body must rest upon the sound bone, as on a sure foundation. The use thereof is, thus; put the point or tongue under the broken or depressed bone, then lift the handle up with your hand, that so the depressed bone may be elevated. C. Shows the first Arm of the other Levatory, whose crooked end must be gently put under the depressed bone. D. Shows the other Arm, which must rest on the sound bone, that by the firm standing thereof, it may life up the depressed bone. But if at any time it comes to pass, that the bone is not totally broken or depressed, but only on one side; it will be fit, so to lift it up, as also to make a vent for the issuing out of the filth, to divide the scull with little saws like these, which ye see here expressed, for thus so much of the bone, as shall be thought needful, may be cut off without compression, neither will there be any danger of hurting the brain or membrane with the broken bone. The Figures of Saws fit to divide the scull. But if by such signs as are present, and shall appear, we perceive or judge that the contusion goes but to the second Table, or scarce so far; the bearing or taking away of the bone, must go no further than the contusion reaches; for that will be sufficient to eschew and divert Inflammation and divers other symptoms. And this shall be done with a scaling or Desquamatory Trepan (as they term it) with which, you may easily take up as much of the bone, as you shall think expedient: And I have here given you the figure thereof. A Desquamatorie or Scaling Trepan. CHAP. VI Of an Effracture, depression of the bone, being the third kind of Fracture. BEfore I come to speak of an Effracture, I think it not amiss to crave pardon of the courteous and understanding Reader, for this reason especially, that as in the former Chapter, when I had determined and appointed to speak of a Contusion. I inserted many things of a Depression; so also in this chapter of an Effracture, I intent to intermix something of a Contusion; we do not this through any ignorance of the thing itself; for we What a contusion is. know that it is called a contusion, when the bone is depressed and crushed, but falls not down. But an Effracture is when the bone falls down and is broken by a most violent blow. But it can scarce come so to pass, but that the things themselves must be What an Effracture is. confounded and mixed, both as they are done; and also when they are spoken of: so that you shall scarce see a Contusion without an Effracture, or this without that. Therefore the bones are often broken off and driven down with great and forcible blows, with clubs whether round or square, or by falling from a high place directly The causes of Effractures. down, more or less according to the force of the blow, kind of weapon, and condition of the part receiving the same: Wherefore you must be provided with diversity of remedies and Instruments to encounter therewith. Wherefore admit the bone is pressed down, and shivered into many pieces, now for that these splinters need not be taken out with a Trepan: you may do the business with Levatories The cure. made and neatly fashioned for that purpose; such as these, which are here expressed. A levatory. But we must have special care, lest that in pulling and taking out of these scales and splinters, we hurt the membranes. These scales are sometimes very rough & prickly, so that they cannot touch the Meninges without offence; but somewhiles the business is so intricate, that they cannot be taken out unless by enlarging the fracture. Wherefore in this case, if there be a space so large, as that the ends of these mullets may enter you may easily shear off so much of the bone, as shall be necessary ●…equisite for the taking away of these scales, without any assistance of the Trepan, which I have done very often and with good success; for the operation performed by these mullets is far more speedy and safe, than that with the Trepan; and in the performance of every operation, the chief commendation is given to safeness and celerity. Cutting Mullets, commonly called, Rostra Psittaci, or Parrots-beakes. Moreover I have thought good here to give you the figures of chissells, scrapers, and Pincers, together with a leaden mallet, because such Instruments are not only very necessary to take forth the scales of bones which are broken, but also to plain, and smooth those which remain whole. The Figures of Scrapers, Pincers, a Leaden Mallet, etc. But here you must note, that a Trepan nor levatory must never be applied to a bone quite broken, lest the membranes lying under it be hurt by the compression thereof. Therefore you must apply them to a sound bone, but as near as you can to the fracture, so that you take away as little of the scull as is possible, lest the brain despoiled of its bonny cover, take some harm thereby. Neither Effractures, nor yet fissures if they be of some length, must be followed to their ends, but think yourself well, if you have made a passage for the issuing forth of the Sanies or filth, and have drawn forth that bone, which pricked the membranes. For nature is accustomed by generating a Callus to souder, or unite the bones of the scull, as it also doth these of the other parts; as we have read it written by Hypocrates and Galen; for which purpose it hath by singular providence Hip. lib. do ●ul●. cap. Gal. sib. 6. meth. cap. 〈◊〉. replenished both the Tables of the scull, with a certain alimentarie and bloody matter, that with this, as with marrow it might repair the loss and defect of the bone. The truth hereof was lately manifested in the servant of Master Grol●, who had an A History. Effracture on the coronal bone, by a grievous blow, given him with the foot of a Mule; which when I understood, I divided the musculous skin with a three cornered section in that place, with an intent to apply a Trepan there; wherefore the day following, the bone being bored, and when I thought to draw it forth, yea verily endeavoured to pluck it forth, being already divided with the Trepan; I perceived a fearful production of an Effracture; by the movableness of the bone shaking under my hand; for it reached from the midst of the forehead, to the lesser corner of the eye. Wherefore omitting both my determination and endeavour to pull it forth, I thought I should do sufficiently for the patient●… if I should only raise up the bone which was depressed; for so it did not trouble the Crass●meninx by pressing it, and the matter, and filth, were let forth by a passage made with a saw. So that in conclusion, he recovered perfectly, but that he lost one of his eyes which was adjoining to the fracture. CHAP. VII. Of a Seat, being the fourth kind of a broken Scull. HIppocrates calls a seat that kind of Fracture of the scull, when the weapon What a seat is. so falls upon the scull, that the fracture retaining the print thereof is neither stretched forth any further, nor contracted to any less space. And seeing there be many forms hereof, they all whether they shall be superficiary, or shall pierce even to the Diploe, or else pass through both the 〈◊〉, The cure. whether it be with any loss of the bonny substance, whether it run long ways, or else be but short, or otherwise are dilated to some breadth, or else be but narrow; whether they shall be done with a cut, or with a prick with a dagger, stelletto, la●ce or other kind of weapon, whether they shall have this or that accident joined with them, I say all of them, how many and various soever they be, aught and must be cured by some of the formerly described Instuments and means. Yet this must be noted, which as yet we have not remembered, that if it happen by a violent stroke, and great wound, that a portion of the bone is wholly so cut off, that it is clean severed from the rest of the scull, and hang only by the Pericranium and musculous skin; yet you must not pluck it from the Pericranium, and cast it away as unprofitable, but restore it to its proper seat and plaoe, so by the force of nature, to be glued by a Callus, as Celsus hath observed. Lib. 8. cap. 4. I have tried the truth of this experiment, in captain Hydron not very long ago. He had the middle part of the Os Coronale, of the breadth, and length of three fingers, A History. so cut with a sharp sword, that it stuck not to the rest of the bone; but scarce adhering to the Pericranium and musculous skin; but lay turned down over his face, so that the Dura Mater was plainly seen; wherefore I prepared to pluck it from the skin, and cast it away, but that I remembered Hypocrates precept, where he bids, that the Brain should not be robbed of its cover and left bare. Wherefore first of all I wiped away the blood which was fallen upon the Dura Mater, whose motion you might plainly see, than I restored the portion of the bone, to its place, and fastened it on the upper side with a suture consisting of three slitches; and that the residue of the matter might have passage forth, I filled the places between each stitch with lint; by this means, he by the mercy of God, recovered, though at the same time he received many other large wounds in his body; which is a certain experiment, that we must cast away no part of the scull, nor of the Pericranium, no not of the musculous skin, unless necessity urge; therefore much less to leave the brain naked and despoiled of its cover. CHAP. VIII. Of a Resonitus, or Counterfissure, being the fifth kind of Fracture. SOmetimes the fracture is made in the part opposite to that which received the blow; as if the right side be struck, the left is cloven; this kind What a Resonitus, is. of fracture is very dangerous, because we cannot find it out by any certain sign, as it is written by Hypocrates Lib. de vulu. Capitis. Wherefore if at any time the patient die of such a fracture, the Chirurgeon must be pardoned. And although Paulus Aegineta laugh at this kind of fracture and thinks that it Lib. 6. cap. 90. cannot happen to a man's head, as that which is hard and full, as it happens in empty glass bottles, yet I have sometimes seen and observed it. Neither is their reason of any validity, who think nature therefore to have framed the head of many bones knit together by sutures, left the fracture of the one In whom this fracture may take place in divers bones of the scull. side, should be stretched to the other. For peradventure this may take place, in such as have express sutures, seated and framed according to nature. But it takes no place in such as either want them, or have them not seated according to nature, or have them very close and so defaced that it may seem one bone grown together of many; This shall be made manifest by recital of the following History. A servant of Massus the Poste-master had a grievous blow with a stone, upon the A History. right Bregma, which made but a small wound, yet a great contusion and Tumour: Wherefore that it might more plainly appear, whether the bone had received any harm, and also that the congealed blood might be pressed forth, the wound was dilated, the skin being opened by Theodore Hereus the Chirurgeon, who as he was a skilful workman and an honest man, omitted nothing which Art might do for his cure. When he had divided the skin, the bone was found whole, although it was much to be feared, that it was broken, because he fell presently to the ground with the blow, vomited and showed other signs of a fractured scull; so it happened that he died on the one & twentieth day of his sickness. But I being called to learn, & search how he came by his death, deviding the skull with a saw, found in the part opposite to the blow, a great quantity of Sanies or bloody matter, and an Abscess in the Crassae meninx, and also in the substance of the very brain, but no sutures, but the two scaly ones. Therefore that is certain which is now confirmed by the authority of Hypocrates; as also by reason and experience, that a blow may be received on the one side, and the bone may be fractured on the opposite, especially in such as have either no sutures, or else so firmly united and closed, that they are scarce apparent. Neither is it absured, that the part, opposite to that which received the stroke, of The Resonitus may be in the same bone of the scull. the same bone and not of divers bones may be cloven, and in those men who have their sculls well made, and naturally distinguished and composed with sutures; and this both was and is, the true meaning of Hypocrates. That this may be the better understood, we must note that the opposite part of the same bone may be understood two manner of ways. First, when the fracture is in the same surface of the smitten bone, as if that part of one of the bones of the Bregma which is next to the Lambdall future be smitten, and the other part next to the coronal suture be cloven. Secondly, when as not the same superficies and table which receives the blow, but that which lies under it is cleft, which kind of fracture I observed, in a certain Gentleman A History. a Horsman of Captain Stempans' troop; He in defending the breach of the wall of the Castle of Hisdin was struck with a Musket bullet upon the Bregma, but had his helmet on his head; the bullet dented in the Helmet but did not break it, no nor the musculous skin, nor scull, for as much a could be discerned, yet notwithstanding he died apoplecticke upon the sixth day after. But I being very desirous to know, what might be the true cause of his death, dividing his scull, observed that the second table was broken, and cast off scales and splinters, wherewith as with needles the substance of the brain was continually pricked, the first and upper table being whole, for all this: I afterwards showed the like example to Capellanus and Castellanus the King and Queen's chief Physicians in the expedition of Roan. Why Hypocrates set down no way to cure a Resonitus. But Hypocrates prescribes no method of curing this fifth kind of fracture, by reason he thinks it cannot be found out by any circumstance, whence it happens that it is for the most part deadly. Yet must we endeavour to have some knowledge & conjecture of such a fracture; if it shall at any time happen. Wherefore having first diligently shaved away the hair, we must apply an Emplaster of Pitch, Tar, Wax, Turpentine, The manner to know when the scull is fractured by a Resonitus. the powder of Iris, or flower deluce roots, and mastic; now if any place of the head shall appear more moist, soft and swollne, it is somewhat likely that the bone is cleft in that place, so that the patient, though thinking of no such thing, is now & then forest to put his hand to that part of the scull. Confirmed with these and other signs formerly mentioned, let him call a counsel of learned Physicians; and foretell the danger to the Patient's friends which are there present, that there may no occasion of calumny remain, then let him boldly perforate the scull; for that is far better, than forsake the patient ready to yield to the greatness of the hidden disease, and so consequently to dye within a short while after. There are four sorts, or conditions of fractures, by which the Chirurgeon may be so deceived, that when the scull is broken indeed, yet he may think there is no fracture. The first is when the bone is so depressed, that it presently rises up into its true place, and native equability. The second is when the fissure is only capillary, The third is when the bone is shaken on the inside, the utter surface nevertheless remaining whole, forasmuch as can be dediscerned. The fourth is, when the bone is stricken on the one side and cleft on the other. CHAP. IX. Of the moving, or Concussion, of the Brain. BEsides the mentioned kinds of fractures by which the brain also suffers; there is another kind of affect besides nature, which also assails it by the Gal. lib. 2. de comp. medic. cap. 6. & Com. ad Aph. 58, sect. 7. violent incursion of a cause, in like manner, external; they call it the Commotion or shaking of the brain, whence Symptoms like those of a broken scull ensue. Falling from aloft upon a solid and hard body, dull and heavy blows, as with stones, clubs, staves, the report of a piece of Ordinance, or crack of Thunder, and also a blow with ones hand. Thus as Hypocrates tells, that beautiful damosel the daughter of Nerius, when she was twenty years old, was smitten by a woman, a friend of hers, playing with her, Lib. 5. Epidem. with her flat hand upon the fore part of the head, and then she was taken with a giddiness, and lay without breathing, & when she came home, she fell presently into a great Fever, her head ached, and her face grew red. The seaventh day after there came forth some two or three Ounces of stinking and bloody matter about her right ear, and she seemed some what better and to be at somewhat more ease. The fever increased again, and she fell into a heavy sleepiness, and lost her speech, and the right side of her face, was drawn up, and she breathed with difficulty, she had also a convulsion and trembling; both her tongue failed her, and her eyes grew dull, on the ninth day she died. But you must note, that though the head be armed with a helmet, yet by the violence of a blow, the Veins, and Arteries may be The vessels of the brain broken by the commotion thereof. broken, not only these which pass through the sutures, but also those which are dispersed between the two tables in the Diploe, both that they might bind the Crassa Meninx to the scull, that so the brain might move more freely, as also that they might carry the alimentary juice to the brain wanting marrow, that is, blood to nourish it, as we have formerly showed in our Anatomy. But from hence proceeds the effluxe of blood running between the scull, and signs. membraines, or else between the membraines and brain; the blood congealing there, causeth vehement pain, and the eyes become blind, vomiting is caused, the Celsus. mouth of the stomach suffering together with the brain, by reason of the Nerves of the sixth conjugation, which run from the brain thither, and from thence are The cause of vomiting when the head is wounded. spread over all the capacity of the ventricle; whence becoming a partaker of the offence it contracts itself, and is presently as it were overturned; whence first, these things that are contained therein are expelled, and then such as may flow, or come thither from the neighbouring and communne parts, as the Liver and Gall; from all which choler, by reason of its natural levity and velocity, is first expelled and that in greatest plenty; and this is the true reason of that vomiting, which is caused and usually follows upon fractures of the scull and concussions of the Brain. Within a short while after inflammation seizes upon the membranes and brain itself, which is caused by corrupt and putrid blood proceeding from the vessels broken by by the violence of the blow, and so spread over the substance of the brain. Such inflammation communicated to the heart, and whole body by the continuation of the parts, causes a fever. But a fever, by altering the brain causes Doting; to which if stupidity succeed; the Patient is in very ill case, according to that of Hypocrates; Stupidity, and doting, are ill in a wound, or blow upon the head. But if Aphor. 14, sect. 7 to these evils, a sphacel, and corruption of the brain ensue, together with a 〈◊〉 difficulty of breathing, by reason of the disturbance of the Animal fac●…, which from the brain imparts the power of moving to the muscles of the Chest, the instruments of respiration, than death must necessarily follow. A great part of these accidents appeared in King Henry of happy memory, a little A History▪ before he died. He having set in order the affairs of France, and entered into amity with the neighbouring Princes, desirous to honour the marriages of his daughter, and sister, with the famous and noble exercise of Tilting, and he himself running in the Tiltyard, with a blunt lance received so great a stroke upon his breast, that with the violence of the blow, the visor of his helmet flew up, and the truncheon of the broken Lance, hit him above the left eyebrow, and the musculous skin of the forehead was torn even to the lesser corner of the left eye, many splinters of the same truncheon being struck into the substance of the fore mentioned eye, the bones being not touched or broken; but the brain was so moved and shaken, that he died What was the necessary cause of the death of King Henry the second of France. the eleaventh day after the hurt. His scull being opened after his death, there was a great deal of blood found between the Dura, and Pia Mater, poured forth in the part opposite to the blow, at the middle of the suture of the hind part of the head; and there appeared signs by the native colour turned yellow, that the substance of the brain was corrupted, as much as one might cover with ones thumb. Which things caused the death, of the most Christian King, and not only the wounding of the eye, as many have falsely thought. For we have seen many others, who have not died of far more grievous wounds in the eye. A History. The history of the Lord Saint john's is of late memory: he in the Tiltyarde, made for that time before the Duke of Guise's house, was wounded with a splinter of a broken Lance, of a finger's length and thickness, through the visor of his Helmet, it entering into the Orb under the eye, and piercing some three fingers breadth deep into the head; by my help and God's favour he recovered, Valeranus and Duretus the King's Physicians and james the King's Chirurgeon assisting me. What shall I say of that great and very memorable wound of Prancis of Lorraine the A History▪ Duke of Guise? He in the sight of the City of Bologne had his head so thrust thorough with a Lance, that the point entering under his right eye by his nose, came out at his neck between his ear and the vertebrae, the head or Iron being broken and left in by the violence of the stroke, which stuck there so firmly, that it could not be drawn or plucked forth, without a pair of Smith's pincers. But although the strength & violence of the blow was so great, that it could not be without a fracture of the bones, a tearing and breaking of the Nerves, Veins, Arteries and other parts; yet the generous Prince by the favour of God recovered. By which you may learn, that many die of small wounds; and other recover of Why some die of small wounds and others recover of great. great, yea very large and desperate ones. The cause of which events is chiefly and primarily to be attributed to God, the author and preserver of mankind; but secondarily to the variety and condition of temperaments. And thus much of the commotion or conclussion of the brain; whereby it happens that although all the bone remains perfectly whole, yet some veins broken within by the stroke, may cast forth some blood upon the membranes of the brain, which being there concreate may cause great pain, by reason whereof it blinds the eyes; if so be that the place can be found against which the pain is, and when the skin is opened, the bone look pale, it must presently be cut out, as Celsus hath written. Now it remains, that we tell you how to make your prognostickes, in all the forementioned fractures of the scull. CHAP. X. Of Prognostickes to be made, in fractures of the scull. WE must not neglect any wounds in the head, no not these which cut or bruise but only the hairy scalp; but certainly much less, these Hippoc. de vul. cap. which are accompanied by a fracture in the scull; for oft times all horrid symptoms follow upon them, and consequently death itself, especially in bodies full of ill humours, or of an ill habit, such as are these which are affected with the Lues venerea, leprosy, dropsy, Pthisicke and consumption; for in these, simple wounds are hardly or never cured; for union in the cure of wounds, but this is not performed, unless by strength of nature, and sufficient store of laudable blood: but those which are sick of hectic fevers and consumptions, want store of blood and those bodies which are replete with ill humours, and of an ill habit have no afflux or plenty of laudable blood: but all of them want the strength of nature; the reason is almost the same in those also which are lately recovered of some disease. Those wounds which are bruised are more difficult to cure, than those which are cut, When the skull is broken, than the continuity of the flesh lying over it must necessarily be hurt & broken, unless it be in a Reso●itus. The bones of children are more soft, thin Whether the wounds of children, or old people are better to heal. and replenished with a sanguine humidity, than those of old men, and therefore more subject to putrefaction; Wherefore the wounds which happen to the bones of children, though of themselves, and their own nature they may be more easily healed, (because they are more soft, whereby it comes to pass, that they may be more easily agglutinated, neither is there fit matter wanting for their agglutination by reason of the plenty of blood laudable both in consistence and quality) than in old men, whose bones are drier and harder, and so resist union, which comes by mixture, and their blood is serous, and consequently a more unfit bond of unity and agglutination; yet oft times through occasion of the symptoms which follow upon them, that is putrefaction and corruption, which sooner arise in a hot and moist body, and are more speedily increased in a soft and tender, they usually are more suspected and difficult to heal. The Patient lives longer of a deadly fracture in the scull, in Winter than in Summer, for that the native heat is more vigorous in that time than in this; besides, also the humours putrify sooner in Summer, because unnatural heat is then easily inflamed and more predominant, as many have observed out of Hypocrates. The Wounds of the brain and of the Meninges or membranes thereof are most Aph. 15. sect. 1. commonly deadly, because the action of the muscles of the chest, and others serving for respiration, is divers times disturbed & intercepted, whence death ensues. If a swelling happening upon a wound of the head presently vanish away, it is an ill sign, unless there be some good reason therefore, as blood-letting, purging, or the use of resolving local medicines, as may be gathered by Hypocrates in his Aphorisms. If a fever ensue presently after the beginning of a wound of the head, that is, upon the Aphor. 65, sect. 5 fourth or seaventh day, which usually happens, you must judge it to be occasioned by the generating of Pus or Matter, as it is recited by Hypocrates. Neither is such a fever so much to be feared, as that which happens after the seaventh day, in which Aph. 47, sect. 2. time it ought to be determinated; but if it happen upon the tenth or foureteenth day with cold or shaking, it is dangerous, because it makes us conjecture that there is putrefaction in the brain, the Meninges, or scull, through which occasion it may arise, chiefly if other signs shall also concur, which may show any putrefaction, as if the wound shall be pallid and of a faint yellowish colour, as flesh looks after it is washed. For, as it is in Hypocrates Aphoris. 2. sect. 7. It is an ill sign if the flesh look livide, Wounds which are dry, rough, livide and black are evil. when the bone is affected; for that colour portends the extinction of the heat, through which occasion, the lively, or indifferently red colour of the part, faints and dies, and the flesh there abouts is dissolved into a viscide Pus or filth. Commonly another worse affect follows hereon, wherein the wound becoming withered and dry, looks like salted flesh, sends forth no matter, is livide and black, whence you may conjecture, that the bone is corrupted, especially if it become rough, whereas it was formerly smooth and plain; for it is made rough when Caries or corruption invades it; but as the Caries increases, it becomes livide and black, sanious matter withal sweeting out of the Diploe, as I have observed in many: all which are signs that the native heat is decayed, and therefore death at hand; but if such a fever be occasioned from an Erysipelos which is either present or at hand, it is usually less terrible. But you shall know by these signs, that the fever is caused by an Erysipelas The signs of a fever caused by an Erysipelas. & confluxe of choleric matter; if it keep the form of a Tertian, if the fit take them with coldness and end in a sweat; if it be not terminated before the choleric matter is either converted into Pus or else resolved; if the lips of the wound be somewhat swollne, as also all the face; if the eyes be red and fiery; if the neck and chaps be so stiff, that he can scarce bend the one, or open the other; if there be great excess of biting and pricking pain, and heat, and that far greater than in a Phlegmon. For such an Erysipelous disposition generated of thin and hot blood, chiefly assails the face, and that for two causes. The first is, by reason of the natural levity of the choleric humour; the other because Why an Erysipelas chiefly assails the face. The cure of an Erysipelas on the face. of the rarity of the skin of these parts. The cure of such an affect must be performed by two means, that is, evacuation, and cooling with humectation. If choler alone cause this tumour, we must easily be induced to let blood, but we must purge him with medicines evacuating choler. If it be an Erisipelas phlegmonodes, you must draw blood from the Cephalic vein of that side, which is most affected, always using advice of a physician. Having used these general means, you must apply refrigerating and humecting things, such as are the juice of Nightshade, Houseleek, Purslane, Lettuce, Navel wort, Water Lentill, or Ducksmeate, Gourds; a lineament made of two handfuls of Sorrel boiled in fair water, then beaten and drawn through a searse, with ointment of Roses, or some unguent. Populeon added thereto, will be very commodious. Such and the like remedies must be often and so long renewed until the unnatural heat be extinguished. But we must be careful to abstain from all unctuous and oily thing, because Why oily things must not be used in an Erysipelas of the face. they may easily be inflamed, and so increase the disease. Next we must come to resolving medicines; but it is good when anything comes from within, to without; but on the contrary it is ill, when it returns from without inwards, as experience and the Authority of Hypocrates testify: If when the bone shall become purulent, pustles Aph. 25. sect. 6 shall break out on the tongue, by the dropping down of the acride filth or matter by the holes of the palate upon the tongue, which lies under. Now when this symptom appears, few escape. Also it is deadly when one becomes dumb and stupid, that is, Apolecticke by a stroke or wound on the head; for it is a sign that not only the bone, but also the brain itself is hurt. But oft times the hurt of the Brain proceeds Deadly signs in wounds of the head. so far, that from corruption it turns to a sphacel, in which case, they all have not only pustles on their tongues, but some of them dye stupid and mute, othersome with a convulsion of the opposite part; neither as yet have I observed any which have died with either of these symptoms, by reason of a wound in the head, who have not had the substance of their brain tainted with a sphacel, as it hath appeared when their sculls have been opened after their death. CHAP. XI. Why, when the brain is hurt by a wound of the head, there may follow a Convulsion of the opposite part. MAny have to this day enquired, but as yet as far as I know it hath not A convulsion is caused by dryness. been sufficiently explained, why a convulsion in wounds of the head seizes on the part opposite to the blow. Therefore I have thought good to end that controversy in this place. My reason is this, that kind of Symptom happens in the sound part by reason of emptiness and dryness; but there is a twofold cause, and that wholly in the wounded part, of this emptiness and dryness of the sound or opposite part; to wit, pain; and the concourse A twofold cause of convulsisieke dryness. of the spirits and humours thither by the occasion of the wound, and by reason of the pains drawing and natures violently sending help to the afflicted part. The sound part exhausted by this means both of the spirits and humours, easily falls into a Convulsion. For thus Galen writes; God the creator of nature, hath so knit together, the triple spirituous substance of our bodies, with that tie, and league of concord, by the productions Lib. 4. de usu partium. of the passages; to wit of Nerves, Veins, and Arteries, that if one of these forsake any part, the rest presently neglect it, whereby it languisheth, and by little, and little dyes, through defect of nourishment. But if any object that nature hath made the body double, for this purpose, that when one part is hurt, the other remaining safe and sound, might suffice for life and necessity: but I say, this axiom hath no truth in the vessels and passages of the body. For it hath not every where doubled the vessels, for there is but one only vein, appointed for the nourishment of the brain, and the membranes thereof, which is that they call the Torcular, by which when the left part is wounded, it may exhaust the nourishment of the right and sound part, and though that occasion cause it to have a convulsion, by too much dryness; Verily it is true, that when in the opposite parts, the muscles of one kind are equal in magnitude, strength, and number, the resolution of one part, makes the convulsion of the other by accident; but it is not so in the brain. For the two parts of the brain, the right and left, each by its self performs that which belongs thereto, without the consent, conspiratiou, or commerce of the opposite part; for otherwise it should follow, that the Palsy properly so called, that is of half the body, which happens by resolution, caused either by mollification or obstruction residing in either part of the brain, should infer together with it a Convulsion of the opposite part. Which notwithstanding daily experience convinces as false. Wherefore we must certainly think, that in wounds of the head wherein the brain is hurt, that inanition and want of nourishment are the causes, that the sound and opposite part suffers a convulsion. Francis Dalechampius in his French Chirurgiry renders another reason of this question; That, (saith he) the truth of this proposition may stand firm and ratified, we Opinion of Champhius. must suppose, that the convulsion of the opposite part mentioned by Hypocrates, doth then only happen, when by reason of the greatness of the inflammation in the hurt part of the brain, which hath already inferred corruption; and a Gangraene to the brain and membranes thereof, and within a short time is ready to cause a sphacel in the scull, so that the disease must be terminated by death; for in this defined state of the disease, and these conditions, the sense and motion must necessarily perish in the affected part, as we see it happens in other Gangraenes, through the extinction of the native heat. Besides, the passages of the animal spirit must necessarily be so obstructed by the greatness of such an inflammation or phlegmon, that it cannot flow from thence to the parts of the same side lying there under, and to the neighbouring parts of the brain; and if it should flow thither, it will be unprofitable to carry the strength and faculty of sense and motion, as that which is infected and changed by admixture of putrid and Gangraenous vapours. Whereby it cometh to pass, that the wounded part destitute of sense, is not stirred up to expel that which would be troublesome to it, if it had sense; wherefore neither are the Nerves thence arising seized upon, or contracted by a Convulsion. It further more comes to pass, that because these same nerves are deprived of the presence and comfort of the animal spirit, and in like manner the parts of the same side, drawing from thence their sense and motion are possessed with a palsy; for a palsy is caused either by cutting or obstruction of a Nerve, or the madefaction, or mollification thereof by a thin and watery humour, or so affected by some vehement distemper, that it cannot receive the Animal spirit. But for the opposite part and the convulsion thereof, it is known and granted by all, that a convulsion is caused either by repletion which shortens the Nerves by distending them into breadth, or by inanition, when as the native and primitive heat of the Nerves being wasted, their proper substance becoming dry is wrinkled up and contracted; or else it proceeds from the vellication, and acrimony of some vapour, or sanious and biting humour, or from vehemency of pain. So we have known the falling sickness caused by a venenate exhalation carried from the foot to the brain. Also we know that a convulsion, is caused in the puncture of the Nerves, when as any acride and sanious humour is shut up therein, the orifice thereof being closed; but in wounds of the Nerves when any Nerve is half cut, there happens a convulsion by the bitterness of the pain. But verily in the opposite part, there are manifestly two of these causes of a convulsion; that is to say, a putrid and carionlike vapour, exhaling from the hurt, and Gangraenate part of the brain; and also a virulent acride and biting Savies, or filth, sweeting into the opposite sound part, from the affected and Gangraenous; the malignity of which Sanies, Hypocrates desirous to decipher, in reckoning up the deadly signs of a wounded head, hath expressed it by the word Ichor; and in his book of fractures he hath called this humour Dacryodes et non Pyon. [that is, weeping and not digested.] Therefore it is no marvel if the opposite and sound part endued with exquisite and perfect sense, and offended by the flowing thereto of both the vaporours' and sanious matter, using its own force, contend and labour as much as it can, for the expulsion of that which is trouble somethereto. This labouring or concussion is followed (as we see in the falling sickness) by a convulsion, as that which is undertaken in vain, death being now at hand; and nature overruled by the disease. Thus (saith Dalechampius) must we in my judgement determine of that proposition of Hypocrates and Avicen. But he adds further, in wounds of the head, which are not deadly, practitioners observe that sometimes the hurt part is taken with the palsy, and the sound with a convulsion; otherwhiles on the contrary, the wounded part is seized by a Convulsion and the sound by a Palsy; otherwhiles both of them by a convulsion or Palsy; and somewhiles the one of them by a convulsion or Palsy, the other being free from both affects; the causes of all which belong not to this place to explain. Thus much Dalechampius. CHAP. XII. A Conclusion of the deadly signs in the Wounds of the head. NOw that we may return to our former discourse; you may certainly foretell The signs of a deadly wound from the depraved faculties of the mind. the patient will dye; when his reason and judgement being perverted, he shall talk idly, when his memory fails him; when he cannot govern his tongue, when his sight grows dark and dim, his ears deaf, when he would cast himself headlong from his bed, or else lies therein without any motion; when he hath a continnuall fever with a delirium, when the tongue breaks out in pustles, when it is chopped, and become black, by reason of too much dryness; when the wound From habit of the body. grows dry, and casts forth little or no matter, when as the colour of the wound which was formerly fresh, is now become like salted flesh yellow and pale; when the Urine, and other excrements are suppressed; when the Palsy, convulsion, apoplexy; and lastly often swooning, with a small and unequal pulse, invade him. All such signs sometimes From the time that such signs appears. appear presently after the wound, otherwhiles some few days after; therefore when as the brain is hurt and wounded by the violence of the incision, or fissure, of the contusion, compression, puncture, concussion or any other fracture, the forementioned signs appear presently in the first days; but when they do not appear till many days after the blow, you may know that they rise and appear, by reason of an inflammation and phlegmon in the brain, occasioned by the putrefaction of the blood poured forth upon it. But we must observe this by the way, which also belongs to the prognostickes, that Celsus lib. 8. c●. 4. flesh is easily regenerated, and restored in all parts of the head, except in that part of the forehead, which is a little above that which lies between the eyebrows, so that it will be ulcerated ever after, and must be covered with a plaster. I believe that, in that place there is an internal cavity in the bone, full of air which goes to the sieve-like bones of the nose, by which the growth of flesh may be hindered; or else that the bone is very dense or compact in that place, so that there can scarce sufficient juice sweat forth, which may suffice for the regeneration of flesh; add hereunto a great confluxe of excrements flowing to this ulcer, which should otherwise be evacuated by the eyes and nose, which hinder by that means the dryness of the ulcer, and consequently the healing thereof. Hence certainly it comes to pass, that if you desire the patient thus affected to breathe, shutting his mouth and nose, the air or breath will come forth of the ulcer with such force, as it will easily blow forth a lighted candle of an indifferent bigness held thereto. Which thing I protest, I observed in a certain man, whom I was forced to trepan in that place, by reason the bone of the forehead was broken and depressed. CHAP. XIII. Of salutary signs in wounds of the head. But on the contrary these are salutary signs, when the patient hath no fever, is in his right mind, is well at the application or taking of any thing, sleeps well, hath his belly soluble, the wound looks with a fresh and lively colour, casts forth digested and laudable matter, the Crassa Meniux hath its motion free and no way hindered. Yet we must note, which also is observed by the Ancients and confirmed by experience; When the patients are out of danger. that we must think none past danger, and free from all chance, until the hundreth day be past. Wherefore the Physician ought so long to have a care of his patient, that is, to consider how he behaves and governs himself in meat, drink, sleep, venery and other things. But let the Patient diligently avoid and shun cold, for many when they have The patient must beware of cold. been cured of wounds of the head, by careless taking could have been brought into danger of their lives. Also you must know that the Callus whereby the bones of the scull are knit together, requires almost the space of forty or fifty days to its perfect coagmentation and concretion. Though in very deed one cannot set down a certain number of days, by reason of the variety of bodies, or tempers. For it is sooner finished in young men, and more slowly in old; And thus much may serve for prognostickes. Now will we treat as briefly and perspicuously as we can of the cure both in general and particular; wherefore beginning with the general we will first prescribe a convenient diet by the moderate use of the six things not natural. CHAP. XIIII. Of the general cure of a broken scull, and of the Symptoms usually happening thereupon. THe first cure must be, to keep the patient in a temperate air; and if so be, that it be not such of itself and its own proper How the air ought to be. nature, it must be corrected by Art. As in winter he must have a clear fire made in his chamber, lest the smoke cause sneesing and other accidents; and the windows and doors must be kept shut to hinder the approach of the cold air and wind. All the time the wound is kept open to be dressed, some body standing by shall hold a chafendish full of coals or a heated Iron bar over the wound, at such a distance, that a moderate heat may pass thence to the wound; and the frigidity of the encompassing air may be corrected by the breathing of the diffused heat. For cold according to the opinion of Hypocrates, Aphor. 18. sect. 〈◊〉. is an enemy to the Brain, Bones, Nerves, and spinal marrow; it is also hurtful to ulcers, by suppressing their excrements, which suppressed do not only hinder suppuration, but also by corrosion makes them sinuous. Therefore Galen rightly admonisheth us, to keep cold from the brain, not only in the time Lib. 2, de us● part. ca 2. of Trepaning, but also afterwards. For there can no greater, nor more certain harm befall the fractured scull, than by admitting the air, by such as are unskilful. For if the air should be hotter than the brain, than it could not thence be refrigerated; The Air though in summer is colder than the brain. but if the brain should be laid open to the air, in the midst of Summer, when it is at the hottest, yet would it be refrigerated, and unless it were relieved with hot things, take harm: this is the opinion of Galen, whereby you may understand that many who have their sculls broken, die more through default of skill in the curing, than by the greatness of the fracture. But (when the wound is bound up with the pledgets, clothes, and rulers as is fit) if the air chance to be more hot, than the patient can well endure, let it be amended by sprinkling, and strawing the chamber with cold water, oxycrate, the branches of Willows and Vine. Neither is it sufficient to shun the too cold air, unless also you take heed of the over light, chiefly until such time as the most feared and malign symptoms are past. For a too great light dissipates the spirits, increases pain, strengthens the fever and The discommodities of too much light. symptoms. Hypocrates wholly forbids wine, therefore the patient in steed thereof must drink, Barley water, fair water boiled and tempered with julep of Roses, What his drink must be. syrup of Violets, vinegar and the like: water wherein bread crumbs have been steeped, water and sugar, with a little juice of Lemons, or pomecitron added thereto, and such like as the ability and taste of the patient shall require. Let him continue such drinks, until he be free from malign symptoms, which usually happen within fourteen days. His meat shall be pap, ptisan, shunning Almond milks; (for Almonds are said Almonds increase the pain of the head. to fill the head with vapours and cause pain) stewed damask Prunes, Raisins and Currants, seasoned with sugar, and a little cinnamon (which hath a wonderful power to comfort the stomach, and revive and exhilarate the spirits) Chickens, Pigeons, Veal, Kid, Leverets, birds of the fields, Pheasons, blackbirds, Turtles, Partridges, Thrushes, Larks and such like meats of good digestion, boiled with lettuce, purslane, sorrel, borage, bugloss, succory, endive and the like, are thought very convenient in this case. If he desire at any time to feed on these meats roasted, he may, only dipping them in verjuice, in the acide juices of Oranges, Citrons, Lemons, or Pomegranates, sometimes in one, and sometimes in another, according to his taste and ability. If any have a desire to eat fish, he must make choice of Trout, Gudgeons, What fish he may eat. Pikes and the like, which live in running and clear waters, and not in muddy; he shall eschew all cold salads and pulse, because they fly up and trouble the head: it will be convenient after meat to use common drige powder; or Aniseed, Fennell-seed or Coriander comfits, also conserve of Roses, or Marmilate of Quinces to shut up the orifice of the Ventricle, lest the head should be offended with vapours arising from thence. Children must eat often, but sparingly; for children cannot fast so long as those Aphor 13. & 14 sect. 1. which are elder, because their natural heat is more strong, wherefore they stand in need of more nourishment; so also in winter all sorts of people require more plentiful nourishment, for that than their stomaches are more hot than in Summer. When the foureteenth day is past, if neither a fever, nor any thing else forbid, he Aphor. 15, sect. 2 may drink wine moderately, and by little and little, increase his diet, but that respectively to each one's nature, strength and custom. He shall shun, as much as in him lies, sleep on the day time, unless it happen that a Phlegmon seize upon the brain or Meninges. For in this case it will be expedient to sleep on the day time, Why sleep upon the daytime is good for the brain being inflamed. Lib. 2. Epidem. especially from morning till noon, for in this season of the day, as also in the spring blood is predominant in the body, according to the opinion of Hypocrates. For it is so vulgarly known, that it need not be spoken, that the blood when we are awake is carried into the habit and surface of the body; but on the contrary by sleep it is called into the noble parts, the Heart and Liver. Wherefore if that the blood by the force of the Sun casting his beams upon the earth, at his rising is carried into the habit of the body, should again be more and more diffused by the strength and motion of watching, the inflammation in the brain and Meninges would be much increased. Wherefore it will be better, especially then to stay by sleep the violence of the blood running into the habit of the body, when it shall seem to rage and more violently to affect that way. Watching must in like manner The discommodities ensuing immoderate Watching. be moderate; for too much depraves the temper of the brain and of the habit of the whole body; it causes crudities, pains and heaviness of the head, and makes the wounds dry and malign. But if the patient cannot sleep by reason of the vehemency of the inflammation of the brain and Meninges, Galen wishes, to wash, besmear and anoint the head, nose, Gal. Meth. 13. temples and ears with refrigerating and humecting things, for these stupefy, and make drowsy the Brain and membranes thereof, being more hot than they ought to be. Wherefore for this purpose let the temples be anointed with Vnguentum populeon, or Vnguentum Rosatum with a little rose vinegar, or oxycrate; Let a sponge Medicines procuring sleep. moistened in the decoction of white or black poppy seed, of the rinds of the roots of Mandrages, of the seeds of Henbane, lettuce, purslane, plantain, nightshade and the like. He may also have a broth or barley cream, into which you may put an emulsion made of the seeds of white poppy, or let him have a potion made with ℥ i. or ℥ iss. of the syrup of poppy, with ℥ ij. of lettuce water; Let the patient use these things 4 hours after meat, to procure sleep. For sleep doth much help concoction, it repairs the effluxe of the triple substance caused by watching, assuageth The commodities of sleep. pain, refresheth the weary, mitigates anger and sorrow, restores the depraved reason, so that for these respects it is absolutely necessary that the patient take his natural rest. If the patient shall be plethoric, let the plenitude be lessened by blood-letting, purging and a slender diet, according to the discretion of the Physician who shall oversee the cure. But we must take heed of strong purgations, in these kinds of wounds, especially at the beginning, lest the fever, inflammation, pain, and other such like symptoms be increased by stirring up the humours. Phlebotomy according to Galens' opinion, must not only be made respectively to Lib. 4. Meth. the plenty of blood, but also agreeable to the greatness of the present disease, or that which is to come, to divert, and draw back that humour which flows down, by a way contrary to that which is impact in the part; and which must be there evacuated, or drawn to the next. Wherefore for example, if the right side of the head be wounded, the Cephalic vein of the right arm shall be opened, unless a great Plethora or plenitude cause us to open the Basilica, or Median, yet if neither of them can be fitly opened, the Basilica may be opened, although the body is not plethoric. The like course must be observed in wounds of the left side of the head; for that is far better by reason of the straightness of the fibers, than to draw blood on the opposite side; in performance whereof you must have diligent care of the strength of the patient, still feeling his pulse, unless a Physician be present, to whose judgement you must then commit all that business. For the pulse is, in Galens' opinion, the certainest shower of the strength. Wherefore we must consider the changes and inequalities thereof, for as soon as we find it to become lesser and more slow, when Lib. de cur. per sangu●… Miss. the forehead begins to sweat a little, when he feels a pain at his heart, when he is taken with a desire to vomit, or go to stool, or with yawning, and when he shall change his colour and his lips look pale, than you must stop the blood as speedily as you can; otherwise there will be danger lest he pour forth his life together with his blood. Then he must be refreshed with bread steeped in wine, and put into his mouth, and by rubbing his temples and nostrils with strong vinegar, and by lying upon his back. But the part shall be eased and freed from some portion of the impact and conjunct humour by gently scarifying the lips of the wound, or applying of Leaches. But it shall be diverted, by opening these veins which are nighest to the wounded part, as the Vena Puppis, or that in the midst of the forehead, or of the temples, or these which are under the tongue; besides also cupping-glasses shall be applied to the shoulders sometimes, with scarification, sometimes without; neither The use of Fractures. must strong, and long frictions with course clothes, of all the whole body, the head excepted, be omitted during the whole time of the cure, for these will be available, though but for this, that is; to draw back and dissipate by insensible transpiration the vapours which otherwise would ascend into the head, which matters certainly in a body that lies still and wants both the use and benefit of accustomed exercise, are much increased. But it shall be made manifest by this following and notable example, how powerful A History. blood-letting is, to lessen and mitigate the inflammation of the Brain, or the membranes thereof in wounds of the head. I was lately called into the suburbs of Saint German, there to visit a young man twenty eight years old, who lodged there in the house of john Marshal, at the sign of Saint Michael. This young man, was one of the household servants of Master Doucador, the steward of the Lady Admiral of Brion. He fell down headlong upon the left Bregma, upon a marble pavement, whence he received a contused wound, without any fracture of the scull, and being he was of a sanguine temperature, by occasion of this wound, a fever took him on the seaventh day with a continual delirium and inflammation of phlegmonous tumour of the wounded Pericranium. This same tumour possessing his whole head and neck by continuation and sympathy of the parts, was grown to such a bigness, that his visage was so much altered, that his friends knew him not; neither could he speak, hear, or swallow any thing but what was very liquid. Which I observing, although I knew, that the day past, which was the eight day of his disease, he had four saucers of blood taken from him by german Agace Barbersurgion of the same suburbs; yet considering the integrity and constancy of the strength of the patient, I thought good to bleed him again; wherefore I drew from him fourteen saucers at that one time; when I came to him the day after, and saw that neither the fever, nor any of the fore mentioned symptoms were any whit remitted, or assuaged, I forthwith took from him four saucers more, which in all made two & twenty; the day following when I had observed, that the symptoms were no whit lessened, I durst not presume by my own only advice, to let him the fourth time blood as I desired. Wherefore I brought unto him, that most famous Physician Doctor Violene, who as soon as he felt his pulse, knowing by the vehemency thereof, the strength of the Patient, and moreover considering the greatness of the inflammation and tumour which offered its self to his sight, he bid me presently take out my Lancet and open a vein. But I lingered on set purpose, and told him, that he had already twenty two saucers of blood taken from him: Then said he, Grant it be so, and though more have been drawn, yet must we not therefore desist from our enterprise, especially seeing the two chief Indications of blood-letting yet remain, The two chief Indications in blood letting. that is, the greatness of the disease, and the constant strength of the Patient. I being glad of this, took three saucers more of blood, he standing by, and was ready to take more but that he wished me to differ it until the after noon; wherefore returning after dinner I filled two saucers more, so that in all, this young man to his great benefit, lost twenty seven saucers of blood at five times, within the space of four days. Now the ensuing night was very pleasing to him, the fever left him about noon, the tumour grew much less, the heat of the inflammation was assuaged in all parts, except in his eyelids, and the laps of his ears, which being ulcerated cast forth a great quantity of Pus or matter. I have recited this history purposely, to take away the childish fear which many have to draw blood in the constant strength of the patient, and that it might appear how speedy and certain a remedy it is in inflammations of the head and brain. Now to return from whence we digressed, you must note that nothing is so hurtful The discommoditis of venery in wounds of the head. in factures and wounds of the head, as venery; not only at that time the disease is present, but also long after the cure thereof. For great plenty of spirits are contained in a small quantity of seed, & the greatest part thereof flows from the brain; hence therefore all the faculties, but chiefly the Animal, are resolved, whence I have divers times observed death to ensue in small wounds of the head, yea when they have been agglutinated and united. All passions of the mind must in like sort be avoided, because they by contraction and dissipation of the spirits cause great trouble in the body and mind. Let a place be chosen for the Patient as far from noise as can be, as from the ringing of bells, beat and knockings of Smiths, Cooper's, and Carpenters, and from highways How hurtful noise is to the fractures of the scull. through which they use to drive Coaches; for noise increases pain, causes a fever, and brings many other symptoms. I remember when I was at Hisdin at the time that it was besieged by the forces of Charles the fifth, that when the wall beaten with the Cannon, the noise of the Ordinance A History. caused grievous torment to all those which were sick, but especially those that were wounded on their heads, so that they would say, that they thought at the discharging of every Cannon that they were cruelly strucken with staves on that part which was wounded; and verily their wounds were so angered herewith, that they bled much, and by their pain and fevers increased, were forced with much sighing to breathe their last. Thus much may serve to be spoken of the cure in general, now we will out of the monuments of the ancients, treat of the particular. CHAP. XV. Of the particular cure of Wounds of the head, and of the musculous skin. LEt us begin with a simple wound, for whose cure the Chirurgeon must Of a simple wound of the flesh and the skin. propose one only scope, to wit, Union; for unless the wound pierce to the scull, it is cured like other wounds of the fleshy parts of our bodies. But if it be compound, as many ways as it is complicate, so many indications show themselves. In these the chiefest care must be had of the more urgent order and cause. Therefore if the wound shall be simple and superficiary, than the hair must first be shaved away, than aplaister applied made of the white of an egg, bowl Armenicke and Aloes. The following day you must apply Emplastrum de janua, or else the gratia Dei, until the wound be perfectly healed. But if it be deeper and penetrate even to the Pericranium, the Chirurgeon shall not do amiss, if at the second dressing he apply a digestive medicine (as they call it) which may be made of Venice Turpentine, the A degestive medicine. yolkes of eggs, oil of Roses and a little saffron, and that shall be used so long, until the wound come to maturation; for than you must add honey of Roses and Barley flower to the digestive. Hence must we pass to these medicines, into whose composition no oily, or unctuous bodies enters, such as this; ℞ Terebinth. venetae ℥ ij. syrupi rosar. ℥ i. anʒss. Let them all be incorporated and made into A sarcoticke Medicine. an unguent, which shall be perfectly regenerated; then it must be cicatrised with this following powder. ℞ an.ʒj. Misceantur simul & fiat puluis: but if the wound be so large that it require a suture, it An Epuloticke. shall have so many stitches with a needle, as need shall seem to require. Whilst I was at Hisdin, a certain soldier, by falling of the earth whilst he undermined, A History. had the Hairy scalp so pressed down even to the Pericranium, and so wholly separated from the beginning of the hind part of his head, even to his forehead, that it hung over his face. I went about the cure in this manner; I first washed all the wound with wine, a little warmed, that so I might wash away the congealed blood mixed with the earth; then I dried it with a soft linen cloth, and laid upon it Venice Turpentine mixed with a little Aqua Vitae wherein I had dissolved some Sanguis Draeconis, Mastich and Aloes; then I restored the hanging skin to its former place, and there stayed it with some stitches being neither too straight, 〈◊〉 nor too close together, for fear of pain and inflammation, (which two chiefly happen whilst the wound What things we must observe in soweing. comes to suppuration) but only as much as should serve to stay it on every side, and to keep forth the air, which by its entrance doth much harm to wounds: the lower sides of the wound, I filled with somewhat long and broad tents, that the matter might have passage forth. Then I applied this following cataplasm to all the head. ℞, farinae board. & fabarum an ℥ vi. rosatiʒiij, aceti quantum sufficit, fiat cataplasma ad formam pultis; this hath a faculty to dry, cool, repel mitigate pain and inflammation, and stay bleeding. When we must not let blood in wounds. I did not let him bood, because he had bled much, especially at certain arteries which were broken near his temples; he being dressed after this manner grew well in a short time. But if the wound be made by the biting of a wild beast, it must be handled A History. after another manner, as shall appear by this following history. As many people on a time stood looking upon the King's Lions, who were kept in the Tiltyard at Paris for the delight of King Henry the second, and at his charges: it happened that one of the feircest of them broke the things wherein he was tied, and leaping amongst the company, he with his paws threw to the ground a Girl of some twelve years old, and taking her head in his mouth, with his teeth wounded the musculous skin in many places, yet hurt not the scull. She scarce at length delivered by the Master of the Lions from the jaws of Death and the Lion, was committed to the cure of Rowland Claret Chirurgeon; who was there present by chance at the sametime; some few days after, I was was called to visit her; she was in a fever, her head, shoulders, breast and all the places where the Lion had set his teeth, or nails, were swollen, all the edges of the wounds were livide, and did flow with a waterish, acride, virulent, cadaverous, dark green and stinking matter, so that I could scarce endure the smell thereof; she was also oppressed with pricking, biting and very great pain; which I observing, that old saying came into my mind which is: That all wounds made by the bitings of beasts, or of men also, do The bitings of man and beasts are venenate. somewhat participate of poison. Wherefore there must principally great care be had of the venenate impression left in the wounds by the nails and teeth, and therefore such things must be applied, as have power to o'ercome poison. Wherefore I scarrifyed the lips of the wounds in divers places, and applied Leeches to suck out the venenate blood, and ease the inflammation of the parts, than I made a Lotion of Aegyptiacum, Treacle and Mithridate after the following manner. ℞. Mithrid. ℥ j theriac. ℥ ij. agyptiac. ℥ ss dissolvantur omnia cum aqua vitae, & Cardui theriacal 〈…〉 pick Medicines. been. Let the wounds be fomented and washed with it warm; besides also Treacle and Mithridate were put in all the medicines which were either applied or put into the wound; and also of the same with the conserveses of Roses and bugloss dissolved in the water of Sorrell and Carduus benedictus, potions were made to strengthen the heart and vindicate it from malign vapours. For which purpose also this following Epithema was applied to the region of her A Cordial Epithema. heart. ℞. aquae rosar. & nenuphar, an. ℥ iiij. aceti scillitici ℥ i. corallorum, santalorum alborum & rubrorum, rosar rub. pulveris spodij. an. ℥ i. Mithridatij, theriacae, an. ʒij. ijcrociʒ, i. dissolve them altogether, make an Epitheme and apply it to the heart with a scarlet cloth or sponge, and let it be often renewed. Verily she dressed after this manner, and the former remedies but once used, pain, inflammation and all the malign symptoms were much lessened; to conclude she recovered, but lingered and was lean some two years after, yet at length she was perfectly restored to her health and former nature. By which you may understand, that simple wounds must be handled after another manner, than these which have any touch of poison. But now that we may prosecute the other affects of the hairy scalp; say that it is The cure of the Hairy scalp when it is contused. contused with a blow without a wound, that which must be first and always done, (that so the affect may better appear, and the remedies which are applied may take more effect) the hair must be shaved away, and at the first dressing a repelling medicine applied, such as is this following Oxyrhodinum. ℞. ol. ros. ℥ iij. album. ovorum nu. ij. an.ʒj. Let them be all incorporated, A repelling medicine. and make a medicine for the formeruse, or in steed thereof, you may apply the cataplasm prescribed before consisting of Farina hordei, sabaru●, aceto & oleo rosaceo. But such medicines must be often renewed. When the pain and defluxion are appeased, we must use discussing medicines for the dissipation of that humour which remains impacted in the part; ℞ Emplastri de mucilagin. ʒij. oxicrocei, & emp. de meliloto, an. ℥ i. olei chamaem. & anethi, an. ℥ ss. malaxentur simul & fiat emplastrum ad A discussing Fomentation. usum dictum. Such a fomentation will also be good. ℞ vini rub. lib. iiij. lixivij. come. lib. ij. nuces cupressi contus. nu. x. pull. myrtillorum ℥ i. rosar rub. absinth. fol. salviae, majoranae, staechados, florum chamaem. melil. an. M. ss. aluminis rochae, radicis cyperi, calami aromatici an. ℥ ss. bulliant omnia simul, and make a decoction to foment the grieved part. After somewhat a long fomenting it, whereby it may the better discuss, dry and exhaust the concrete humour; the head must be dried & more discussing things applied such as the Cerate described by Vigo called de minio, which hath an emollient and digestive faculty in this form. ℞ Olei chamam. lilior. an. ℥ x. olei mastic. ℥ ij. pinguedinis Ceratum de Minio. vervecis lib. i. litharg. auri, ℥ viij. minij ℥ ij. vini boni cyathum unum, bulliant omnia simul baculo agitando, primum quidem lento igne, mox verò luculentiore, donectot● massa colorem nigrum vel subnigrum contrahat; add in fine cocturae Terebinth. lib. s. pulveris mastic. ℥ ij. gum. elemi. ℥ i. cerae quantum sufficit, bulliant rursus una ebullitione & fiat empl. molle. But if the humour be not thus discussed, but only grow soft, than the tumour must be quickly opened, for when the flesh is inflamed and putrified through occasion of the contained humour, the bone under it putrifies also by the contagion of the inflammation and the actimony of the matter falling upon the bone. When you have opened it, wash away the filth of the ulcer with this following detersive medicine. ℞ syrupi ros. & absinth. an. ℥ i. terebinth. ℥ iss. pull. ireos, aloes, mastich●, Detersive or cleansing medicines. myrrhae, farinae, hordei an. ʒss. In steed here of if there be great putrefaction Aegyp●●a. either by itself, or mixed with an equal quantity of Vnguenium apostolorum may be put into the ulcer. When the ulcer is cleansed it will be time to use scarcotike and cicatrizing medicines. CHAP. XVI. Of the particular cure of a fractured or broken scull. IF the scull be be broken, so that it be needful to trepan it, or to elevate and lift it up, or scrape it away, the musculous skin being cut as we formerly noted, the Pericranium shall be plucked from the scull, as we Why the Pericranium. hath such exquisite sense. said before; which because it can hardly be done without great pain, by reason of its exquisite sense and connexion with the membranes of the brain, we must labour to mitigate the pain for fear of inflammation and other accidents. Therefore the first dressing ended and the corners of the wound drawn each from other; at the second dressing put to the wound, a digestive (as they term it) made of the yolk of an egg, and oil of Roses, but you must apply no humid thing to the bone, because we desire to keep it sound and whole. For Galens' opinion is, that bared bones must not be touched with unctuous things, but rather on the contrary Gal. 6. Meth. all dry things must be applied to them, which may consume the superfluous The bones are offended with the application of humid things. humidity. Therefore we must lay some lint and the cephalic powders which we shall hereafter describe, upon the bone we intent to preserve, and must ha●e diligent care that it be not offended either by the the air, or touch of humid medicines. You must in Trepaning have a special care of the Crassa Meniux. For I have often observed a great quantity of blood to have flowed from some broken vessel, which adhered to the second Table: neither must we presently and forthwith stay such bleeding, but suffer it to flow according to the plenitude and strength of the patient; for thus the fever, and together therewith the rest of the symptoms are diminished. For in the opinion of Hypocrates, in every green wound it is good to cause often bleeding, except in the bellies; for thus the vehemency of pain, inflammation and Lib. dei ulcer▪ other accidents will be less troublesome; also it is not amiss too for old ulcers to bleed much, for so they are freed from the burden of the impact humours. When you think it hath bled sufficiently, it may be staunched with this following medicine described by Galen. ℞ Aloesʒij, thuris, mastiches an. ʒiss. albuminua overum nu. ij. 〈◊〉. 6. Math. agitentur simul cum pilis leporinis minutim incisis, fiat medicamentum. When the bleeding is stayed, you shall for the aswaging of pain, drop upon the Meniux some Pigeons blood, yet warm by opening a Vein under the wing, than it shall be strewed over with this following powder, ℞ an.ʒj. Misce, fiat pulvis subtilis. Also you may make an irrigation with Rose Vinegar, or some repelling medicine; such as is a cataplasm ex farinis, & olc● rosacco. Which may be applied until the fourth day to assuage and mitigate pain. Vigoes' Cerate will be of good use in this case, as that which in my opinion is most Vigoes Cerate good for a broken scull. fit for fractures of the scull, because it draws powerfully, resolves and dries moderately, and by reason of the smell refreshes the animal spirits, and strengthens the brain and membranes thereof, as you may easily perceive by things which enter into the composition thereof. ℞ Oleiros. Omph. resinaepini, gummi Elemi. an ℥ ij. Mastiches ℥ iss. pinguedinis vervecis castrati ℥ ijss. foliorum beton. caprifol. anthos an. M. i. ammoniaciʒss. tinctorumʒx. liquata pinguedine terenda terantur, & ammoniacum simul cum aceto fcillitico, eliquetur; deinde bulliant omnia simul in lib. ij. vini boni, lento igne usque ad consumptionem vini, deinde exprimantur; cum expressione addantur terebinth, Ven. ℥ iiij. cerae albae quantum susficit, fiat cerotum molle ad usum praedictum. Also let the neck, and all the spin of the back be anointed with a lineament, which hath force of mollifing the Nerves, lest they should suffer convulsion; such is this. ℞ Rutae, marrubij, rorismar. ebulor, saluia, herb. paralies. an. M. s. rad. Ireos, cyperi, A lineament good against convulsions. baccarum lauri. an. ℥ i. florum chamae. melil. hyperici, an. M. i. pistentur & macerentur omnia in vino albo per noctem, deinàe coquantur in vase duplici cum olei lumbricorum, liliorum, de terebinthina, axungiae, anseris & hum. an. ℥ ij usque ad consumptionem vini, postea colentur & in colatura add terebinth. venet. ℥ iij. vitaeʒss. cerae quantum sufficit fiat linimentum secundum artem. But when the pain is assuaged, we must abstain from all such unctuous things, lest they make the wound become sordid and malign, and putrify the adjacent parts, and; consequently the Crassa Meninx and scull; for the integrity of all parts may be preserved by their like, and such are dry things in a fracture of the scull. Wherefore all humid and oyely things must be shunned in the cure thereof, unless peradventure there shall be some need to mitigate pain and bring the humour to suppuration. For according to Galen, we are oft forest for a time to omit the proper cure of Gal. 4. Meth. the disease, so to resist the symptoms; furthermore Hypocrates would have us not How far humid things are good for a fractured scull. to foment the scull, no not with wine, but if we do, to let it be but with very little. Vidius interprets that little to be, when there is fear of inflammation; for wine if it be red, tart and astringent, hath a repressing refrigerating and drying faculty: for otherwise all wine although it heats and dries by its faculty, yet it actually humects and cools, both which are very hurtful in wounds of the head, or a fractured scull, especially when the bone is bare; for from too much cooling of the brain there is fear of a convulsion, or some other evil symptom. Wherefore let this be ratified, that is, We must not use humid and unctuous medicines in wounds of the head, except for curing of an inflammation, or the mitigation of pain caused thereby. Therefore let the bared scull be strewed with catagmaticke and cephalic powders, (being so called by the ancients, for that they are convenient and good in fractures of the scull & the rest of the bones) for by Why Cephalic or Catagmaticke powders are good. their dryness they consume the superfluous humidity, and by that means help nature in the separating of the broken bones, and the regenerating of flesh. Such powders usually consist of such things as these ensuing. Thus, radix Iridos florent. farina Hordei, & Ervi, pulvis Aloes Hepatica, sanguis Draconis, mastiche, Myrrah, rad. Aristolochiae, Gentianae: and generally all such simples as have a drying and an abstergent faculty without biting; but you must not use these things before the pain, inflammation and apostumation be past; that is then, when the membranes must be cleansed, the bones scaled, and the flesh generated. When to used. For the scull by how much it is the dryer, by so much it requires and more easily endures more powerful and drier medicines, than the Dura Mater or Pericranium, as that which in quickness of sense comes far short of these two. Wherefore when you would apply the forementioned cephalic powders to the Meninges, they must How to be mixed when trey are to be applied to the Meninges. be associated and mixed with honey, syrup of roses or of wormwood and such other like, that so their too violently drying faculty may be allayed and tempered. CHAP. XVII. Why we use Trepaning, in the Fractures of the scull. THere are four causes of this remedy. The first is, to raise up the depressed bones, and take forth their fragments, which press upon the Meninges, or also upon the substance of the brain. The second is, that the Sanies or matter may be evacuated, cleansed, wasted, and dried up, which by the breaking of any vessel is poured forth upon the Membraines, whereby they are, and not they only, but the Brain also is in great danger of corruption. The third is, for the fitter application of medicines, convenient for the wound and fracture. The fourth is, that so we may have something whereby we may supply the defect of a Repelling Ligature, and such an one as may hinder defluxions; for such a Ligature cannot take place here as it may Why a repelling Ligature cannot be used in fractures of the Scull. in the other parts of the body, by reason of the Spherical or Round figure of the head, which doth not easily admit binding; and then the density and hardness of the interposed scull is a means that the vessels lying under it (by which usually the defluxion comes) cannot easily be bound with a rowler sufficiently to repel the running blood. And the external vessels, (to whom the force of the Ligature may come) cannot be bound without great pain, and danger of Inflammation. For by such a compression the pulsation of the Arteries would be intercepted, and the effluxe of the suliginous excrements which useth to pass through the sutures of the scull, would be suppressed, by reason of the constriction of these sutures. Besides also, the blood would thus be forced from the wounded part without, to within into the Membranes and Brain; whence pain, Inflammation, a Fever, Abscess, Convulsion, Palsy, Apoplexy, and lastly death itself would ensue. And these are the chief causes, that Trepaning is necessary in fractures of the scull, and not so in the fractures of other bones. But before you apply or put to your Trepan, the Patient must be fitly placed How the patient must be placed when you Trepan him. or seated, and a double cloth must be many times wrapped about his head, and then his head must be so laid, or pressed upon a Cushion or pillow, that when you come to your operation, it may not sink down any further, but remain firm and steady. Then you must stop the patient's cares with cotton-wool, that so he may not hear the noise made by the Trepan, or any other Instrument. But before you put to your Trepan the bone must be pierced with an Instrument, having a three square point, that so it may be the more speedily and certainly perforated What to be done before the application of the Trepan. The point thereof must be no bigger than the pin of the Trepan, that so the Trepan which is forthwith to be applied may stand the more firmer, and not play to and again in too wide a hole. The shape of this Instrument is not much different from a Gimlet, but that the point is threesquare, and not twined like a screw; as you may perceive, by this following figure. A Gimlet or peircer to perforate the scull, before the setting too of the Trepan. A. Shows the handle. B. The points which may be screwed and fitted into the handle. CHAP. XVIII. A description of Trepans. TRepans are round saws, which cut the bone circularly more or less according to their greatness; they must have a pin standing in the middle a little further out than their teeth, so to stay and hold fast the Trepan that it stir neither to this side nor that, until it be entered and you have cut through the first table at the least: than you must take forth the pin, lest going quite through the bone, it may prick or hurt the Crassa Meninx. Wherefore when you have taken forth the pin, you may safely turn it about until you have cut through both the tables; Your Trepans must also have a cap, or some what to engirt or encompass them, lest no way hindered they cut more of the bone than we would, and in conclusion run into the Meninx. They must also be anointed with oil, that so they may cut the more readily and gently; for thus Carpenters use to grease their saws. But you must, during the time of the operation, often dip them in cold water, lest the bone by attrition become The harm the bone receives by being heated with the Trepan. too hot: for all hard solid bodies by quick and often turning about, become hot; but the bone made more hot and dry, is altered and changeth its nature, so that after it is cut, more of it scailes and falls away. Now you must know that the bone, which is touched with the Trepan, or the Air, always casts off scailes, for the speedier helping forwards whereof, you must strew upon it powders made of Rocket, Briony, wild cucumber and Aristolochia roots. When the bone is sufficiently scaled let this following powder be put upon it, which What things hasten these ailing of the bone. hath a faculty to cover the bone with flesh, and to harden it with dryness convenient to its kind. ℞ an.ʒj. Flesh being by this means generated, let it be cicatrized by strewing upon it the rinds of Pomegranates and Alum burnt. The bone must not be forcibly scailed. Neither shall the Chirurgeon forcibly take away these scales, but commit that whole work to nature, which useth not to cast them off before that it hath generated flesh under them. For otherwise if he do any thing rashly, he brings new corruption to the bone; as we shall more at large declare, when we come to treat of the Caries or Rottenness of bones. He which useth the Trepan, must consider this, that the head is of a round figure, and also the Trepan cuts circularly, and therefore it is impossible to cut the bone so equally A caution in Trepaning. on every side, as if it were performed upon a plane body. Furthermore the thickness of the scull is not alike in all places; wherefore you must look, and mark whether the Trepan go not more deep on one side than on the other, which you may do by measuring it now and then with a pin or needle; and if ye find that it is cut deeper on one side, than on the other, you must press down the Trepan more powerfully upon the opposite part. But seeing there are many sorts of Trepans invented and expressed by many men, A safe and convenient Trepan. yet if you weigh and rightly consider them all, you shall find none more safe, than that I invented, and have here delineated. For it cannot pierce one jot further into the scull, than he pleases that useth it, and therefore it cannot hurt either the Meninges or the Brain. An Iron head or cover stays it as a bar, that it can penetrate no further than you shall think it requisite. This head or Cover is to be drawn up and down, and set higher and lower, as he which uses it shall think good, and so it will stay the Trepan that it shall not go a hair's breadth beyond your intended depth. So that hence forwards there shall be no Chirurgeon, howsoever ignorant in the performance of his Art, which by the benefit of such a Trepan may not perform this operation without any danger or fear of danger of touching the Dura Mater; the hurting whereof, puts the life in jeopardy. The figure of our Trepan opened and taken in pieces. A. Shows the whole handle or Brace of the Trepan. B. The Cover or Cap of the Trepan. C The ferule. D. D. The screw pins which hold and stay the ferule and Trepan. E. The Trepan without his pin. F. The Trepan furnished with its pin. The figure of the same Trepan fitted and put together. A. Shows the Brace and Trepan fitted in every point. B. The place into which the Trepan is put and fitted. C. C. C. The upper end of the Trepan which is to be fitted and put into the Brain. D. The Trepan with its cover or cap upon it. E. The ferule. F. A screw pin by the twining whereof the Trepan is fastened in the Brace. G. Another screw pin which fastness the ferule closer to the Trepan. H. The Three square point. In stead of the other Trepan set forth by the Author, I have thought fit to give you the figure of that Trepan that is here most in use, and the fittest therefore, as it is set forth by Mr. Doctor Crook. All these particulars of the Trepan taken in sunder, you may see united and fitted together in the other figure. But when you cannot bring out the bone which you have cut off with your Trepan; than you may take it forth with the Terebellum or Gimlet here expressed, that is, screwing the point thereof into the hole made by the three square pin; the handle of this Instrument may also serve in steed of a levatory. A Terebellum or Gimlet consisting of three branches. When with the Gimlet you have drawn or taken forth that part of the scull which was cut away by the Trepan; if there shall be any sharp splinters in the second table, which may hurt and prick the Meninx, when it is heaved up by the motion of the brain, they must be shaved away and planed with this lentil fashioned scraper, being so called, because it hath the head thereof fashioned and smooth like a lentil, lest being sharp it should hurt and prick the membrane in the smoothing thereof. A Lentill-like cutting Scraper. But if by reason of the thickness, the scull cannot be cut with this Lentill-like The use of a Leaden Mallet. scraper, you may use the cutting scrapers and a mallet. The mallet must be of lead, that so it may shake the brain as little as may be. But you must diligently with your mullets take forth the sharp splinters, and pieces of the bone. But if the fractured part of the scull be such, that it will not admit that section which is requisite for the bared bone, as when the fracture is upon the temporal muscle, or at the sutures; Why a Trepan must not be applied to the sutures. then in the steed of one Trepan, two or three must be applied, if the necessity of the present case so require, and that within a very small compass; but they must not be applied to the fractured part, but nigh thereto, as we shall show more at large in the following chapter. But the Trepans shall be applied so near to each other, that the ring of the second may be joined with the ring of the first and third. But if a fracture shall happen to Why two Trepans are to be used to a fractured suture. light upon a suture, than you must not apply a Trepan to it, but use two thereto on each side; he that shall do otherwise, shall tear in sunder the nervous and membranous fibers, and also the veins and arteries by which the Dura Mater is fastened to the scull, and yields matter to the Pericranium. He which shall apply one Trepan, that is, but upon one side of the suture, he shall not be able to get forth all the Sanies which is fallen down on both sides by reason of the partition of the Crassa Meninx which lies between, and rises up by the sutures of the scull. To conclude, when for what cause soever we cannot make use of a Trepan, we may employ this instrument, if so be as much of the bone be bared as is needful. It is made in form of a pair of Compasses, and by means of a screw may be opened more or less as you please. You as need shall require may change the points, and put other in their places, for they may be fitted to one side of the compass with a screw. Apaire of cutting Compasses to cut forth the scull. A. Shows the one leg of the cutting compasses, which as you carry it about cuts the scull. B. The screw which fastens the point to the leg of the compasses. C. C. Two different points which may be screwed to the leg of the Compasses, as need shall require. D. A great screw which fastens upon an Iron string, alongst which the one of the legs of the Compass running, may be widened and straitened as you please. Moreover it is fit that the one leg of such cutting compasses should stand firm and steady, whilst the other is drawn circularly to cut. Wherefore it is fit you have an Iron plate made full of little holes, wherein you may firmly stay that leg of the compass, lest it waver against your will; it is requisite that this plate be crooked, (because the head is round) that so it may be fitted to any part thereof. A crooked Iron Plate fit to sustain and hold steady one leg of the Compass upon the head. Another pair of Commpasses of the like nature and use, which may be widened and straightened by a screw. CHAP. XIX. Of the places of the scull whereto you may not apply a Trepan. FIrst of all, you shall not apply a Trepan, to a bone that is so broken that it is A bone almost severed from the scull must not be Trepaned. wholly, or in the greater part thereof divided from the scull by the violence of the stroke, least by your weight and pressing of the Trepan, you force it down upon Membrane. Secondly, you must not apply one to the fractured Sutures, for the reasons mentioned in the former chapter. Thirdly, nor to that part of the forehead which is a little above the eyebrows, A notable cavity in the forehead bone. for these reasons we gave you before in the twelfth chapter. For there is in that place under the first table of the scull itself, a large cavity replenished with a certain white and tough humour, as also with a certain spirituous and airy substance, placed there by nature, to prepare the air which ascends to the brain by the Nosethrills: unless the Chirurgeon observe and be mindful hereof, he may be deceived, supposing this cavity to be an Effracture of the bone and a depression thereof. Fourthly, neither in the lowest parts of the scull, lest the marrowy substance of the Brain, by reason of its weight, should slide through the hole made by the Trepan. Fifthly, neither to the Bregma bones of Children, as those which as yet have not acquired just solidity, to endure the impression of a Trepan. Sixtly, nor to the temples by reason of the Temporal muscle, the cutting whereof in the opinion of Hypocrates causes convulsson of the opposite part. For being cut Lib. de ●ul. c●. athwart it loses its proper action, that is, to move and lift up the lower jaw; but then the opposite Temporal muscle being whole and perfect, using its strength, (his Antagoniste suffering it, and not resisting or labouring any thing at all to the contrary) it draws the same jaw to it, whereupon the mouth and all the parts of the face are drawn awry, and suffer a Convulsion towards the sound part, the other being resolved according to Hypocrates his rule. For as often as the muscles of one kind are equal in number, magnitude and A rule out of Hypocrates. strength on each side, the resolution of the one part, causes the Convulsion of the other. What discommodities arise from cutting the temporal muscle. Neither doth this danger alone arise from the cutting of the Temporal muscle, but also another, which is, that this muscle when we eat and speak, is in perpetual motion, whereby it comes to pass, that being once cut, it is scarce ever united again, besides also the commissure or joining together of the stony bones lie under it. But by the second caution we are forbid to Trepan upon the sutures; moreover also many Veins, Arteries and Nerves are spread over the substance thereof, so that by cutting of them, there is danger of many and malign symptoms, as pain, inflammation, a fever, a convulsion not only of the part itself, but also of the whole body, whence lastly death ensues. Wherefore let no Chirurgeon be so fool hardy, as to attempt the cutting of this muscle, so to Trepan the bone which lies under it; rather let him apply his Trepan above it, or on the side thereof, or as near to the affected part as he can, as I did in a Gentleman called Monsieur de la Bretesche. He in the triumphant entrance of King Henry the second, into the City of Paris; was so hurt with a stone, that the Os Petrosum or scaly bone, was broken with the A history. violence of the blow, and the temporal muscle was vehemently contused, yet without any wound. I being called the next day (viewing the manner of the hurt, and the condition of the wounded part) thought good to bring some Physicians, and Surgeons with me to consult hereof, of whom when some thought it expedient presently to divide the Temporal muscle, that bearing the bone we might apply a Trepan, and so take forth the broken bones: I on the contrary begun earnestly to withstand that opinion, citing that saying of Hypocrates, ex libr● de vulneribus Capitis, wherein Surgeons are forbidden to cut such muscles, for fear of the forementioned symptoms; also I cited experience, how that I had often observed all those which had this muscle cut, died with a convulsion; but that it should be far better, that near above the fracture the bone should be Trepaned, not touching the Temporal muscle at all if he could. When all of them at the last had inclined to my opinion, I presently divided the musculous skin which was over the upper part of the fracture with a three cornered section: the day following which was the third of his disease I Trepaned him, and after I had done, some few days after, I took out some four splinters of the broken bone; and I put in a plain leaden pipe, by which (I wishing the patient ever when I dressed him to hold down his head, to stop his mouth and his nose, and then strive as much as in him lay to put forth his breath) much sanious matter came forth, which was gathered between the scull and Crassa Meniux. Other filth which stuck more fast, I washed out with a detergent decoction, injected with such a syringe as is here expressed; And I did so much, God blessing my endeavours, that at length he recovered. A Plane leaden pipe for to carry forth the Sanies gathered under the scull. A little syringe fit to make injections withal. The like chance and fortune befell Monsieur de Pi●nne at the siege of Mets. For he as he fought at the breach of the wall, had the bone of his Temples broken with a stone struck out of the adjacent wall, by a piece of Ordinance shot from the A history. Emperor's camp; he presently fell down with the blow, and cast blood out of his mouth, nose and ears, with much vomiting, and remained dumb & as it were senseless almost fourteen days, so that he knew none of the bystanders. He had often palpitations, and convulsive twitchings, and his face was swollne. His forehead bone was Trepaned at the side of the Temporal muscle by the hand of Peter Aubert the King's Chirurgeon: and although on the 25. day, soft flesh, endued with exquisite sense grew out of the hole made with the Trepan, whose growth could not be hindered by Cathaereticke powders, yet at the length he recovered. The Ancients called this kind of growing flesh a Fungus [i. a Mushroom] for that it is soft, and grows with a small root and broad top like a mushroom: but it increases and decreases, according to the plenty of the flowing matter, and industry of the Chirurgeon hindering by art the growth thereof. This flesh stinks exceedingly, they commonly call it ●icus sancti ●icarij [i. the Fig of S. Fiacrye.] This disease commonly hath its original after this manner. Even as in the bodies of Trees from the excrements of nourishment, a certain half putrid The generation of a Fungus. gross and viscous humour sweats through the bark, and gathered together by little and little grows into a Mushroom, so blood melancholy both in temper and consistence, springs from the broken vessels of the scull and Crassa Meninx, which also is sent sometimes by nature for the necessary repairing of the flesh in these parts, whereupon a certain fungus breeds, which in Galens' opinion, savours or partakes of the nature and condition of the parts to which it grows; though in general it be of the nature of malign warts, or excrescences. But for to take away such Fungi, you must apply medicines which have a specific faculty to waste superfluous flesh; such are these which strongly dry, and gently waste and eat, such as this which follows. ℞ Sabinaeʒij. ocraeʒj. pulverisentur simul, aspergatur caro excrescens. or else. ℞ Hermodsctylorum combustorum ℥ ss. make a powder for the same use. But if so be that this fungous' flesh come to such growth, (as it often happens,) as to equal the bigness of an egg, it must be tied and straight twitched, close to the root with a silken thread; and when it shall fall away by reason of this binding, the place must be strewed with the forementioned powders, for so it will be more certainly cured, than with more acride cathaeretickes. CHAP. XX. Of the corruption and Caries, or rottenness of the bones of the Head. THere sometimes follows a corruption and sphacel of the fractured Why when the scull is broken the bones sometimes become foul or rotten. bones of the scull upon wounds of the head; which happens either because they are touched by the air, which they are not sensible of; or for that the Sanies putrifying and detained under them, hath infected them with like putrefaction; or by the cure unskillfully handled, they by the rash application of suppurating and oily medicines becoming more moist, and so undergoing an unnatural change of their proper complexion and native temper, as we shall show more at large when we shall treat of the reason of the Caries in the Lues venerea. We shall know this unnatural change and corruption, partly The signs of foulness of the bone. by sight, that is, when from white they become to be yellowish, livide and black; partly also by putting down a probe; when as it meets with nothing smooth and slippery, but feels rough in many places, and besides also when it enters and easily penetrates with a small thrusting down into their substance, as if it were fungous. Yet this last sign may often deceive you, for I have divers times observed rotten bones, Corrupt bones are sometimes hard. which being bare had long suffered the injury of the air, to become so hard that a Trepan would scarce pierce them; for it is putrid humidity which makes the bones soft and fungous; but the air by drying them exhausts this humidity and lastly dries it, whence follows such contumacious hardness. This sign will be far more certain, if the flesh which is grown upon the bone be more soft than is fit, loose and have little or no sense or feeling. You may correct and amend this corruption of the bone with cauteries aswell actual, as potential, or with the powders of Aloes, Gentian, Aristolochia, centaury, cortex pini, as, ℞ an.ʒj. centaur. ʒij. pi●iʒss. Misce & fiat pulvis subtilissimus ossi inspergendus. But if it be much corrupted, it must be scraped forth with your Scalpra. And you must expect the falling or scailing of the corrupt bone from the sound, and not forciblely procure it; for otherwise the sound bone, which lies under it, being as yet covered with no flesh growing over it, would be corrupted by the appulse, or touch of the air. Yet you shall by little and little gently move and shake rotten bones with your probe, that so they may more easily scaile and with less trouble to nature. But note by the way, that the scailing of the bone which hath environed the Trepan, is commonly performed in the space of forty or fifty days. So long also will that caused by the unusual appulse or touch of the air, or application of a Cautery, or the aspersion of Cephalic powders; besides also in the same number of days broken bones may be united and joined together by a Callus, which is to them as a scar, yet sometimes sooner, somewhiles latter according to the variety of the ages, tempers and habits of divers men. But if the Caries or Rottenness can neither by these fore mentioned remedies be o'ercome and amended, neither the loosed continuity agglutinated nor united, you must give the patient a vulnerary potion, for hence I have found happy success The benefit of a vulnerary potion. in many. But sometimes not only a certain portion of the bone, is taken with a Caries, but also the whole is often seized upon with sphacel, and all falls out. For in Hypocrates opinion, Lib. de vulneribus capitis, the bone of the scull being broken falls from the sound more or less, according to the violence of the blow; which also is confirmed by experience. For which purpose I think good in this place to recite a History, whereof I was A History. an eye witness, whilst I served as Chirurgeon in Piedmont under the Marshal de Montejan (who was the King's Lieutenant there.) It happened that a Lackey of Monsieur de Goulaines came to me to be cured; he had the Bregma bone of the left side broken with a sword, neither yet did the fracture come to the second Table; a few days after his recovery the bone being agglutinated and united, it came to pass that a company of Gascoine soldiers his countrymen came to ●urin, with whom one morning he eat plentifully Tripe fried with Onions and spices, & drunk a great quantity of strong wine. Whereupon he presently fell into a continual Fever, and lost his speech and understanding; his head swelled, his eyes looked red and fiery and as though they would have started out of his head. Which things being considered, I let him blood, having first (by the Physicians advice) given him a Glister, and applied to his head such things as were fit, and also I laboured with Frictions and Ligatures of the extreme parts to draw the humours downwards; yet for all this the part of the head which was formerly affected begun to impostumate; which being opened, there came forth a great quantity of matter, and at the length the musculous skin and Pericranium sinking down, both the Tables of the scull became putrified and rotten, as you might know by their blackness and stench. Now to take away this corruption, I applied at certain times actual cauteries, both to amend the corruption and separate that which was altered: but mark, after some month's space, a great number of worms came forth by the holes of the rot, ten bones from underneath the putrified scull; which moved me to hasten the separation and falling away of the putrid bones. Which being done, upon the very Crassa Meniux, which is more strange, in that place which nature had covered with flesh, I observed three cavities of the largeness of ones thumb filled with worms A great falling away of a corrupt bone. about the bigness of a points tag, with black heads, diversely wrapped amongst themselves. The bone which nature separated was of the bigness of the palm of ones hand, so that it was strange that so large a portion of the scull should be cast off by nature, and yet the patient not dye thereof; for he recovered yet beyond all men's expectation, but after the agglutination of the wound the scar remained very Aph. 45. Sect. 6 hollow according to the decree of Hypocrates. For flesh doth not easily grow upon a Callus, because it is a thing strange and supposititious by nature; besides, as a scar is a thing more dense than the skin, so is a Callus than the bone, so that through the more compact substance thereof, the blood can neither freely, nor plentifully sweat through for matter to regenerate flesh. Hence it is, that wheresoever any portion of the scull is wanting, you may there by putting too of your hand perceive and feel the beating of the Brain, wherefore the scull must needs be much weaker in that place. Now to help this infirmity, I wished this Lackey to wear a Cap made of thick leather, so more easily to withstand external injuries, The cevetous craft of impo●tore. and verily thereby he grew much better. Now I think good in this place to lay open the deceit and craft of some Impostors falsely styling themselves Surgeons, who when they are called to cure wounds of the head, wherein any part of the scull is lost, persuade the patient and his friends, that they must put a plate of gold in the place of the scull which is wanting. Wherefore they hammer it, in the presence of the patient, and turn it divers ways and apply it to the part, the better to fit it; but presently after they slily convey it into their purses, and so leave the patient thus cozened. Others brag that they are able to put the dried rind of a gourd into the place of the lost bone, and fasten it on to defend the part; and thus they grossly abuse those which are ignorant in the Art. For this is so far from being done that nature will not suffer nor endure so much as an hair, or any other small body to be shut up in a wound when it is cicatrized; neither is the reason alike of a leaden bullet which shot into the body lies there for many years without any harm to the patient; for although lead have a certain familiarity with man's body, yet is it at length (unless the density of the opposed flesh, ligament, tendon, or some other such like substance hinder) thrust forth by nature impatient of all strange bodies. And thus much of the rottenness and corruption of fractured bones; now must we speak of the discommodities which befall the Meninges by wounds whereby the scull is broken. CHAP. XXI. Of the discommodities which happen to the Crassa Meninx by fractures of the scull. MAny discommodities chiefly happen to the Crassa Meninx by a fracture of the scull and rash Trepaning thereof; for it sometimes chances to be cut and torn. Agglutination is a remedy for this disease, which Hypocrates wishes to be procured with the juice of Nepeta [that is, of that calamint, which smells like Pennyroyal.] mixed with barley flower. In steed whereof this following powder having the like faculty may take place. Remedies for the lace● and Meniux. ℞ Colophon. ʒiij. an.ʒj. anʒss. misce & fiat pulvis subtilis. But to purge the blood and matter which is gathered and lies between the Crassa Meninx and scull, you shall put in a Tent made of a rag twined up some four or five double, and steeped in syrup of Roses or wormwood and a little aqua vita; for thus you shall press down both the Crassa Meninx, lest lifted up by the accustomed and native pulsation of the brain, it should be hurt by the edges of the scull yet rough by reason of the sharp splinters of the bone lately Trepaned, and give freer passage forth for the matter there contained. But as oft as you shall dress the patient, you shall renew the forementioned Tent, until all the matter be purged forth. And so often also you shall press down with the following instrument the Dura Mater, and bid the patient to strive to put forth his breath, stopping his mouth and nose, that so the matter may more easily be evacuated. This Instument wherewith you shall hold down the Dura Mater, must have the end round, polished and smooth as it is here expressed. A fit Instrument to press and hold down the Dura Mater, so to make way for the passage forth of the Sanies or Matter. And let there be laid upon the Dura Mater strewed over with the formerly mentioned powder, a sponge moistened and wrung forth of a drying decoction made of aromatic and cephalic things, such as this which follows. ℞, Fol. salviae, majoran. betonica, rosar. rub. absinth. Myrtil. florum chamam. melil. stoechad. utriusque an. M. iij. ss. rad. cyperi, calam. aromat. ireos, caryophyllatn; angelic●, an. ℥ ss. bulliant omnia secundum artem cum aqua fabrorum & vino rubro, fiat decoctio ad usum dictum. And in stead hereof you may use claret with a little aqua vita, that so the contained matter may be evacuated and dried up. A sponge is fitter for this purpose to draw than a linen rag or any other thing, both because it is good A sponge fit to 〈◊〉 with all. of its self to draw forth the humidity, as also for that by its softness it yields to the pulsation of the Brain. Then apply to the wound and all the adjoining parts, an emplaster of Diacalcitheos' dissolved with vinegar, or wine, or oil of Roses, that so the plaster may be the more cold and foft. For in Hypocrates opinion, Lib. de 〈◊〉. cap. nothing which is any thing heavy or hard must be applied to wounds of the head, neither must it be bound with too straight, or hard a ligature, for fear of pain and inflammation. For Galen tells (as he had it from Mantias) that a certain man lost his eyes by inflammation and impostumation arising, for that an Apothecary had used too Lib. de fasc●js. straight a ligature to his head and face; for this straight ligature so pressed the sutures, that the fuliginous vapours, which used to pass through them and the pores of The discommodities of too straight binding of the head. the scull, were stopped from passing that way; besides, the beating of the Arteries was intercepted and hindered; by which means the pain and inflammation so increased, that his eyes were rend and broke in sunder and fell forth of their orb. Wherefore Hypocrates rightly commends an indifferent ligature, also he fitly wisheth us to let the emplasters be soft which are applied to the head, as also What clothes we must use. the clothes wherewith it is bound up, to be of soft and thin linen, or of Cotton, or wool. When the patient is in dressing, if there come much matter out of the wound, you shall wish him if he can, to lie upon the wound, and now and then by fits to strive to breathe, stopping his mouth and nose, that so the brain How the patient must lie in his bed. lifted and swollne upwards, the matter may be the more readily cast forth; otherwise suffer him to lie so in his bed, as he shall best like of, and shall be least troublesome to him. You may with good success put upon the Crassa Meninx oil of Turpentine with a small quantity of aqua vitae and a little Aloes and Saffron finely powdered, to cleanse or draw forth the Sanies, or matter. Or else, ℞. Mellis rosar. ℥ ij. sarinae hord. pulver. aloes, Mastic. & Ireos Florent. an. ʒss. aqu● vitae parum; let them be incorporated together and make a detersive medicine for the foresaid use. Sometimes also the Crassa Meninx is inflamed after Trepaning, and swollen by a Phlegmon, that impatient of its place, it rises out of the hole made by the Trepan, Paulus lib. 6. cap. 90. and lifts its self much higher than the scull, whence grievous symptoms follow. Wherefore to prevent death, of which then we ought to be afraid, we must enlarge the former hole with our cutting mullets, that the matter contained under the scull, by reason of whose quantity the membraine swells, may the more freely breathe and pass forth; and then we must go about by the prescript of the Physician to let him bleed again, to purge and diet him. The inflammation shall be resisted by the application of contrary remedies, as this following fomentation. ℞ Sem. lini, althae, soen. psillij, ros. rub. an. ℥ i. solani, plantag. an. M. i. bulliant in aqua tepida communi, ex qua fiat fotus. Anodyne and repelling medicines shall be Remedies for the inflammation of the Crass. Meninx. dropped into his ears; when it is exceedingly swollen, that the tumour may subside, you shall cast upon it the meal or flower of lentils, or vine leaves beaten with Goose grease. With all which remedies if the tumour do not vanish, and withal you conjecture that there is Pus or matter contained therein, than you must open the Dura Mater with your incision knife, holding the point upwards and outwards, for so How we must open the Crassa Meninx when it is impostumate the matter will be poured forth and the substance of the brain not hurt nor touched. Many other Surgeons, and I myself have done this in many patients with various success. For it is better in desperate causes to try a doubtful remedy than none at all; also it oft times happens whither by the violence of the contusion and blow, or concretion or clotting of the blood which is shed, or the appulse of the cold air, or the rash application of medicines agreeing neither in temper nor complexion with the The causes and remedies of the blackness of the Dura Mater. Crassa Meninx, or also by the putrefaction of the proper substance, that the Dura Mater itself becomes black. Of which symptom the Chirurgeon must have a great and special care. Therefore that thou mayst take away the blackness, caused by the vehemency of the contusion, you shall put upon it oil of eggs with a little Aqua Vitae, Remedies for contusion. and a small quantity of Saffron and Orris roots in fine powder; you shall also make a fomentation of discussing and aromatic things boiled in water and wine; and Vigoes' Cerat formerly described shall be applied. But if the harm come from congealed blood, you shall withstand it with this following remedy. ℞ Aquae Vitae ℥ ij. tritorumʒiiss. croci, ℈ 1. For congealed blood. Mellis rosat. ʒjss. sarcocol. ʒiij. Leviter & simul bulliant omnia, & de colatura infundatur, quousque nigrities fuerit obliterata. If this affect come by the touch of the air, it shall be helped with this following remedy. ℞ Tereb. ven. ℥ iij. Mellis ros. ℥ ij. hordeiʒiij. creci. ℈ i. For the hurt received by the air. sarcocol. ʒij. vitaeʒij. Incorporentur simul, & bulliant paululum. This remedy shall be used until the blackness be taken away, and the membrane recover its pristine colour. But if this affect proceeds from the rash use of medicines, it must be helped by application of things contrary. For thus the offence caused by the too long use of What medicines make the Crassa Meniux black. moist and oily medicines, maybe amended by using catagmaticke & cephalick powders; but the heat and biting of acride medicines, shall be mitigated by the contrary use of gentle things; for both humid and acride things somewhat long used make the part look black; that truly by generating and heaping up filth, but this by the burning and hardening heat. But when such blackness proceeds from putrefaction, john de Vigo commends the following remedy. ℞ aquae vitae ℥ ij mellis rosat. ℥ ss. But if the affect be grown so contumacious that Medicines against that putrefaction of the Meniux. it will not yield to this gentle remedy, than this following will be convenient. R Aq. vitae ℥ iij. mellis ros. ℥ j pulver. Mercur. ʒij. unica ebullitione bulliant simul ad usum dictum. Or ℞ aquae vit. ℥ iss. syrup. absinth & mellis ro (at. an. ʒij. aegyptiaciʒijss. an.ʒj. vini albi boni & odoriferi, ℥ i. bulliant leviter omnia simul, colentur ad usum dictum. But if the force of the putrefaction be so stubborn, that it will not yield to these remedies, it will be helped with Agyptiacum (made with plantain water in steed of Vinegar) used alone by its self, or with the powder of Mercury alone by itself, or mixed with the powder of Alum. Neither must we be afraid to use such remedies especially in this extreme disease of the Dura Mater; for in Galens' opinion the Crassa Meninx after the scull is Trepaned delights in medicines that are acride, that is, strong and very drying, especially if it Why the Crassa Meninx easily endures acrid medicines. have no Phlegmon; and this for two reasons; the first is, for that hard and dry bodies, such as membranous bodies are, be not easily affected unless by strong medicines; the other is, which must be the chief and prime care of the Physician, to preserve and restore the native temper of the part by things of like temper to it. But if the auditory passage not only reaching to the hard membranes of the Brain, but also touching the Nerve which descends into it from the brain, suffer most vehement medicines, though it be placed so near; certainly the Crassa Meninx will endure them far more easily and without harm. But if by these means the putrefaction be not restrained, and the tumour be increased so much, that the Dura Mater rising far above the scull, remains unmoveable, black and dry, and the patient's eyes look fiery, stand forth of his head and roll up and down with unquietness and a frenzy, and these so many ill accidents Signs of death at hand. be not sugitive, but constant; then know that death is at hand, both by reason of the corruption of the gangraene of a noble part, as also by extinction of the native heat. CHAP. XXII. Of the cure of the Brain being shaken, or moved. We have formerly declared the causes, signs and symptoms of the concussion, or shaking of the Brain, without any wound of the musculous What the concussion of the brain is. skin, or fracture of the bone; wherefore for the present I will treat of the cure. Therefore in this case, for that there is fear that some vessel is broken under the scull, it is fit presently to open the cephalic vein. And let blood be plentifully taken according to the strength of the patient, as also respectively to the disease both which is present, and like to ensue, taking the advice of a Physician. Then when you have shaved away the hair, you shall apply to the whole head and often renew the forementioned cataplasm, Ex farinis, ale● rosacea, oxymelite, and other like cold and moist repelling medicines. But you must eschew dry, and too astringent medicines must be shunned, such as are Vnguentum de bolo and the like; for they obstruct too vehemently, and hinder the passage forth of the vapours both by the sutures and the hidden pores of the scull. Wherefore they do not only not hinder the inflammation, but fetch it when it is absent, or increase it, when present. The belly shall be loosed with a glister, and the acride vapours drawn from the head; for which purpose also it will be good, to make frictions from above downwards, to make strait ligatures on the extreme parts, to fasten large cupping-glasses with much flame to the shoulders and the original of the spinal marrow, that so the revulsion of the blood running violently upwards to the brain, and ready to cause a phlegmon, may be the greater. The following day it will be convenient to open the Vena Puppis, which is seated upon the Lambdall suture, by reason of the community it hath with the veins of the brain, and shutting The opening of the Vena Puppis. the mouth and nose to strive powerfully to breathe. For thus the membranes swell up, and the blood gathered between them and the scull is thrust forth; but not that which is shut up in the brain and membranes, of which if there be any great quantity, the case is almost desperate, unless nature assisted with stronger force, cast it forth turned into Pus. But also after a few days the vena frontis or forehead vein may be opened, as also the Temporal Arteries and Veins under the tongue, that the conjunct matter may be drawn forth by so many open passages. In the mean spare the Patient must keep a spare diet, and abstain from wine, especially until the fourteenth day, for that until that time the fearful symptoms commonly reign. But repelling medicines must be used until the fourteenth day be past, than we must come to discussing medicines, beginning with the more mild, such as is this following decoction. ℞. rad. Alth. ℥ vi. ireos, cyperi, calami arom. an. ℥ ij. fol. salviae, Majoran, betonic. flor. chamaem. me●il. ros. rub. s●oechad. an. M. ss. salis come. ℥ iij bulliant omnia simul secundum A discussing ●omentatior. artem cum vino rub. & aqua fabrorum, fiat decictio. Let the head be washed therewith twice a day with a sponge. But yet when you do this, see that the head A caution in somenting the head. be not to much heated by such a fomentation, or any such like thing, for fear of pain and inflammation. Then you shall apply the cerate of Vigo which hath power to discuss indifferently, to dry, and draw forth the humours which are under the scull, and by its aromatic force and power to confirm and strengthen the brain; it is thus described. ℞. Furfuris bene triturati ℥ iij. farin. lentium ℥ ij. ros. myrtillor. foliorum & granorum A description of V. goes Cerate. ejus, an. ℥ i. cal●m. aromat. ℥ iss. chamaemel. melil. an. M. ss. nuces cupres●● num. vi. olei rosacei, & chamaem. an. ℥ iij. ceraealbae ℥ iiss, thuris, mastichiss, an. ʒiij. myrrhaeʒij. Inpulverem quae redigi debent redactis, & liquefactis oleis cum cera, omnis misceantur simul, & fiat mixtura, quae erit inter formam emplastri & ceroti. Vigo saith, that one of the Duke of Urbin's Gentlemen found the virtue hereof A History. to his great good. He fell from his horse with his head downwards upon hard Marble, he lay as if he had been dead, the blood gushed out of his nose, mouth and ears, and all his face was swollen and of a livide colour; he remained dumb twenty days, taking no meat but dissolved jellies, and Chicken, and Capon broths with sugar; yet he recovered, but lost his memory, and saultered in his speech all his life after. To which purpose is that Aphorism of Hypocrates; Those Aph. 58 sect. 7. which have their Brain shaken by what cause soever, must of necessity become dumb; yea also, as Galen observes in his commentary, lose both their sense and motion. That Cerat is not of small efficacy, but of marvellous and admirable force, which could hinder the generating of an abscess, which was incident to the brain by reason of the fall. Yet there be many men so far from yielding to reason, that they stiffly deny, that any impostumation can be in the brain, and augmenting this error with another, That there may be an abscess in the brain. they deny that any who have a portion of the brain cut off can recover, or rise again; but the authority of ancient writers and experience do abundantly refel the vanity of the reasons whereon they rely. Now for the first in the opinion of Hypocrates; If those which have great pain in their heads have either pus, water or blood flowing Aph, 10. sect. 6. from their Nose, mouth or ears, it helps their disease. Gal. lib. deign aqual. ●…temp. Rhas'. cap. 4. continent. Av●cen. cap. de exit. se●. 3. lib, 4. cap. 20. A History. But Galen, Rhasis and Avicen affirm that Sanies generated in the brain disburdens its self by the nose, mouth or ears; and I myself have observed many who had the like happen to them. I was told by Prethais Coulen Chirurgeon to Monsieur de Langey, that he saw a certain young man in the town of Man's, who often used to ring a great bell; he once hanging in sport upon the rope, was snatch up therewith and fell with his head full upon the pavement: he lay mute, was depriyed of his senses and understanding, and was besides hard bound in his belly. Wherefore presently a fever and delirium with other horrid symptoms assailed him, for he was not Trepaned because there appeared no sign of fracture in the scull: on the seaventh day he fell into a great sweat with often sneesing, by the violence whereof a great quantity of matter and Pus flowed forth of his ears, mouth and nose, than he was eased of all his symptoms, and recovered his health. Now for the second, Galen affirms that he saw a Boy in Smirna of jonia that recovered of a great wound of the brain, but yet such an one as did not penetrate to Lib. 8. de. us● part. & come. ad aph. 18. sect. 6. any of the ventricles. But Guido of Caulias saith, he saw one which lived and recovered after a great portion of the brain fell out by reason of a wound received on the hind part of his head. In the year of our Lord 1538. while I was Chirurgeon to the Marshal of Montejan at Turin, I had one of his Pages in cure, who playing at quoites received a wound with a stone upon the right Bregnia with a fracture, and so great an effracture of the bone, that the quantity of half a hazel Nut of the brain came forth thereat. Which I observing, presently pronounced the wound to be deadly; a Physician which was present contradicted my opinion, affirming that substance was no portion of the brain, but a certain fatty body. But I with reason and experience in presence of a great company of Gentlemen, convinced the pertinacy of the Man; with reason; for that fat cannot be generated under the scull, for although the parts Why fat cannot be generated under the scull. there contained be cold, yet because they are heated by the abundance of the most hot and subtle animal spirits, and the heat of vapours rising thither from all the body, they do not suffer fat to concreate about them. But with experience, for that in the dissecting of dead bodies, there was never any fat observed there; besides also fat will swim on the top of water; but this substance as marrowie, cast into the water presently sunk to the bottom. Signs of a fa●●y substance. Lastly, fat put to the fire becomes liquid and melts; but this substance being laid upon a hot Iron, became dry, shrunk up and contracted itself like a piece of leather; but dissolved not at all. Wherefore all those which were present cried out, that my judgement was right of that substance that came forth of the scull. Yet though it was cut away, Page recovered perfectly, but that he continued deaf all his life after. CHAP. XXIII. Of the wounds of the face. HAving treated of the wonnds of the head by their causes, signs and cure, it follows that we now speak of the wounds of the face, if but for this, Why we treat in particular of wounds of the face. that when they are carelessly handled, they leave deformed scars in the most specious and beautiful part of the body. The causes are the same which are incident to the scull, that is, external. But this may be added to the kinds and differences of the wounds, that the life may be out of danger though any one whole part of the face, (as the ear, eye, nose, lip) may be cut away by a wound, but not so in the head or scull. Wherefore beginning at the wounds of the eye brows, we will prosecute in order the wounds of the other parts of the face. This is chiefly to be observed in wounds of the eyebrows, that they are oft A thing to be observed in wounds of the eyebrows. times cut so overtwhart, that the muscles, and fleshy pannicle which move and lift them up, are wholly rend and torn. In which case the eye lids cannot be opened, and the eyes remain covered, and as it were shut up in the cases of their lids; so that even after the agglutination of the wound, if the patient would look upon any thing, he is forced to hold up the eyelids with his hand; with which insirmity I have seen many troubled, yet oft times not so much by the violence of the wound, as by the unskilfulness of the Chirurgeon who cured them; that is, by the negligent application of bolsters, an unfit ligature and more unfit suture. In this case the skilful Chirurgeon which is called to the patient shall cut off as much of the skin and fleshy pannicle as shall serve the eyelids, that so they may by their own strength hold and keep open, without the help of the hand: then he shall sow the wound as is fit, with such a stitch as the Furriers, and Glover's use; and then he shall pour thereon some of the balsam of my description, and shall lay such a medicine to the neighbouring parts. R Olei rosar. ℥ ss. album. o●●r. nu. ij. anʒj. agitentur simul, fiat medicamentum. Then let the part be bound with a fitting ligature. Afterwards you shall use Emplast. degratia Dei, Empl. de Betonica, Diacalcitheos', or some other like, until the wound be cicatrized. But such like and all other wounds of the face may be easily healed, unless they either be associated with some malign symptoms, or the patient body be replete with ill humours. There sometimes happens a quite contrary accident in wounds of the eyebrows, Lagophthal●i● is a quite contrary to the falling down of the eyelids. that is, when the eyelids stand so up that the patient is forced to sleep with his eyes open, wherefore those which are so aflected are called by the Greeks Lagophthal●i. The cause of this affect is often internal, as a carbuncle or other kind of abscess, as a blow or stroke. It shall be cured by a crooked or semicircular incision made above the eyelids, but so that the extremes of the semicircle bend downwards, that they may be pressed down and joined as much as is needful to amend the stiffness of the eyelid. But you must not violate the gristle with your Instrument, for so they could no more be lifted up; the residue of the cure must be performed as is fit. CHAP. XXIIII. Of the wounds of the eyes. WOunds of the eyes are made by the violence of things prickings cutting, bruising, or otherwise losing the continuity. But the cure must always be varied according to the variety of the causes and differences. The first head of the cure is, that if any strange and heterogeneous body shall be fallen into the eyes, let it be taken forth as soon as you can, lifting and turning up the eyelid with the end of a spatula. But if you cannot discern this moat or little body, than put three or four seeds of Clary, or Oculus Christi into the pained eye. For these seeds are thought to have a faculty to cleanse the eyes and take out the moats, which are not fastened deep in, nor do too stubbornly adhere to the membranes. For in this case, you shall use this following instrument, for herewith we open the eyelids the further, putting it between them and the eye, and also keep the eye steady by gently pressing it, that so with our mullets we may pull out the extraneous body; this is the figure of such an Instrument. The deliniation of a Speculum oculi, fit to dilate and hold asunder the eyelids, and keep the eye steady; it is so made, that it may be dilated and contracted according to the greatness of the eyes. All strange bodies taken out, let this medicine be put into the eye. Take the strains A repercussive to be put into the eye. of a dozen eggs, let them be beaten in a lead Mortar with a little Rose water, and so put into the eye; but let this repercussive be laid upon the eye and the neighboving parts. ℞. albumin. ovor. nu. iiij. combustiʒij. Draconisʒj. aquae rosar. & plantag. an. ℥ ij. agitentur simul, make a repercussive, which you Divers repercusaives to be applied to the eye. may frequently use. Or else apply cheese curds well wrung, mixed with Rosewater, the white of an Egg, and as much acacia as shall suffice. This which followeth doth more powerfully stay the flowing humour. ℞. gum▪ arab & tragac. an. ʒij psilij. cydon. semin. portul. plant. sumach. an. ʒij fiat mucag. cum aqua plantag. solan. & rosar. concinnetur collyrium, of which you may drop some both within and about the eye. But note, that all such remedies must be applied warm, both that they may the Things actually cold are hurtful to the eyes. better penetrate by their moderate heat, as also for that all actual cold things are hurtful to the eyes and sight, because they dull the sight by incrustating the visive spirits. For I have known many who have become dull of sight by the frequent using of medicines actually cold to the eyes. I have on the contrary seen not a few, who have recovered with the fit use of such like medicines, who have had any part of their eye (so it were not the pupilla or Apple of the eye) so pricked with a needle or bodkin, that much of the waterish humour ran forth thereat. The milk of a woman which suckles a girl (for that is reputed the cooler) mitigates Anodyne medicines for the eyes. pain and cleanses, if it be milked out of the Dug into the eye; to which purpose also the blood of Turtles, Pigeons or Chickens much conduces, being dropped into the eye by opening a vein under their wings. Also this following cataplasm assuageth pain and inflammation, and hinders defluxion, being applied to the eye and the adjacent parts. ℞ Carnis pomorum sub cinere calido decoctorum ℥ v. vitellos ●vorum num. iij, cassiae fistulae recenter extractae ℥ ss, macaginis psilij, altheae & cydon. an. ℥ i. farin. hordeiparum, incorporentur omnia simul, fiat cataplasma. Also sheep's lungs boiled in milk and applied warm, and changed as they grow cold, are good to assuage pain. But if the too violent heat and pain shall not yield to such medicines, but require more vehement, then Foliorum Hyoscyami, m. i. Narcotickes. sub cineribus coquatur, atque in mortario cum mucagine seminis psilij, & cydonier, extract in aquis solani & plantag. pistetur: then let this medicine be wrapped in a linen cloth and applied to the eyes and temples. The mucilages of Psilium, or Flea-wort, and Quince seeds extracted in a decoction of Poppy heads and mixed with a little Opium and Rose water, are used for the same purpose. But when there is need of detergent and sarcoticke medicines, than R syrup. rosar. siccar. ℥ i. aq faenic. & ruta an. ʒijs, aloes l●…e, olibani an. ℥ ss. mix them for the foresaid use. The galls of Scates, Hares, and Detergent medicices. Partridges dissolved in eye-bright and fennel water, are fit for cleansing such wounds; as also this following Collyrium. R Aquae hordei ℥ i. despumatiʒiij. aloes ter lotae in aqua plantaginis and anʒj. fiat collyrium. Also this ensuing medicine is very sarcoticke. R mucagin. gummi olibani, arabici, tragacanth. & sarcocol. in aq. hordei extract. an. A sarcoti ●●e ●d●ane for the eyes. ʒiij. rosarumʒj. cerus. ustae & lotae, tutia prapar. an. ʒss fiat collyrium. But here you must note, that the coat Adnata often swells so much by reason of a wound or some other injury, and stands so forth by the falling down of humotes, access and mixture of flatulencies, that it hides the whole Pupilla, and hangs forth of the eyelids, like as if it were an unnatural fleshy excrescence, and it loses the native colour, and looks very red; so that the eye can neither be shut nor opened. Wherewith a young Chirurgeon being deceived, determined to cut away this protuberancie of the Adnata, as though it had been some superfluous flesh, and then to waste it with cathaereticke powders, had I not forbidden him, telling him of the certain danger of blindness which would thereupon befall the patient. Wherefore I prescribed a fomentation of chamomile, melilote, Rose leaves, wormwood, rue, fennel, and aniseedes boiled in milk with the roots of Orris and marigolds. Then I presently added this following fomentation, being more powerful and drying. R Nucis cupressi, gallar. ballast. an. ℥ i. plantag. absinth. hippuris, flo. chamaem. ros. rub. A drying fomentation. an. M. ss. bulliant simul cum aqua fabrorum, & fiat decoctum pro fotu cum spongia. Besides also you may apply a cataplasm made of barley and bean flower, the powders of Mastic, Myrrh, and Aloes, and some of the last described decoction. The tumour beginning to decline; I dropped the flowing liquor into the eye, which hath a very astringent, drying and strengthening faculty. Roast a new laid egg in Embers until it be hard, then pill off the shell, take forth the yolk, and in place thereof put a scruple of Roman Vitriol in fine powder, than put it in a linen cloth and wring it hard forth into some clean thing, and drop thereof for some days into the eye, with a little smith's water wherein Sumach and Rose leaves have been boiled. I have found by experience the certain force of this remedy; but if notwithstanding there be a true fleshy excrescence upon the coat Adnata, it may be taken away by this following powder. R Ossis sepiae, & testae ovorum calcinatae an. ʒjs, fiat pulvis. Calcined Vitriole, burnt A medicine to consume a fleshvex croscence without biaing. Alum and the like may be commodiously used to this purpose. Yet you must warily make use of all such things, and always lay repercussives about the eye, that no harm ensue thereof. For divers times acride humours fall down into the eye with such violence, that they break the Horny coat, whereupon the humours of the eye are poured out. Remember also, that in diseases of the eyes, the Patient lie with his head somewhat high, and that he keep shut not only the pained, but also the sound eye, because rest is always necessary for the grieved part. But one eye cannot be moved without some motion of the other by reason of the connexion they have by their optic and moving nerves, both the Meninges, the Pericranium; Veins, and Arteries; which is the cause that when the one suffers, the other in some sort partakes therewith. But if we cannot prevail by all these formerly prescribed medicines fit to stay A Seton a good remedy against inveterate defluxions into the eyes. the defluxion, than it remains, that we apply a Seton to the neck; for it is a singular remedy against inveterate defluxions into the eyes. For we know by daily experience, that many who have had their sight dulled by a long and great defluxion, so that they were almost blind, have by little and little recovered their former splendour and sharpness of sight, when matter once begun to be evacuated by the Seton. The truth hereof appeared in Paul the Italian Goldsmith, who dwelled near the A History. Austin Friars. For he having used many medicines of divers Physicians, and Surgeons in vain, when he was almost blind, he applying a Seton, by mine advice, began by little and little to see better according to the quantity of the matter which was evacuated, until at length he perfectly recovered his sight. But at last growing weary of the Seton which he had worn for a year (although matter came daily forth thereof) yet he would have it taken forth, and healed up; but this way of evacuation being shut up, and the humour again beginning to flow into his eyes, so that he was in danger to become blind, he called me and made me again to apply the Seton in his neck. Whereby recovering his former soundness and perfection of sight, he yet wears the Seton. I also once freed by this kind of remedy, by the appointment of the most learned A Seton good against the falling sickness. Physician Hollerius, a certain young man of twenty years old, from the falling sickness, who before had many fits thereof; the Ichorous humours the feeders of this disease being by this means, as it is most probable, drawn away and evacuated. Wherefore seeing a Seton is of this use, I have thought good in this place to set The manner of making a Seton. down in writing and by figure, the manner of making thereof, for the behoof of young practitioners. Wish the patient to sit on a low stool, and to bend down his head, that so the skin and fleshy pannicle may be relaxed; then must you with your fingers pluck up and sever the skin from the muscles, and take hold of as much hereof as you can with your pincers, not touching the muscles of the neck for fear of a convulsion and other symptoms; you shall then twitch the skin which is held in the pincers, most hard, when you shall thrust the hot Iron through the holes made in the midst of them; that also the nerves being so twitched, the dolorificke sense may the less come to the part. The wound must be made or burnt in long ways and not twharting, that so the matters may be the better evacuated by the strait fibers. But the cautery or hot Iron must have a three or else a fouresquare point and that sharp, that so it may the more easily and speedily enter. Then keeping the pincers immovable, let him draw through the passage made by the cautery a needle thread with a three or four doubled thread of Cotton [or rather a skein of silk] moistened in the white of an egg and oil of Roses; then after you have applied pledgets dipped in the same medicine, bind up the part with a convenient ligature. The day following the neck must be anointed with oil of Roses, and the pledgets dipped in the former medicine applied for some days after. But it will be convenient to moisten the Seton with a digestive made of the yolk of an Egg and oil of Roses, until the ulcer cast forth much matter; than you shall anoint the Cotton thread with this following remedy. ℞. terebinthinae ven. ℥ iiij. syrupirosat. & absinthij. an. ℥ ss. pulveris Ireos, diacrydij, agarici trochiscati, & Rhei, an. ℥ ss. incorporentur omnia simul & siat medicamentum. Which you shall use so long, as you intent to keep open the ulcer. For it hath a faculty to draw the humours from the face, and cleanse without biting. A figure of the Pincers, actual Cautery and Needle used in making a Seten. I have found not long since by experience, that the apertion made with a long thick Triangular needle of a good length like to a large Pack-needle, is less painful, than that which is performed with the actual cautery, which I formerly mentioned. Wherefore I would advise the young Chirurgeon, that he no more use the foresaid actual cautery. I have here given you the figure of the Needle. The Figure of a Triangular Needle. CHAP. XXV. Of Wounds of the Cheek. SEeing a wound of the cheek seems to require a suture, it must have a The use of a dry suture. dry suture (as they term it) lest that the scar should become deformed. For that deformity is very grievous to many, as to women who are highly pleased with their beauties. Therefore you shall spread two pieces of new cloth of an indifferent fineness, and proportionable bigness with this ensuing medicine. ℞. pulveris mastichini, sanguinis Draconis, thuris, farinae volatilis, tragacantha contusae, gypsi, picis, sarcocollae an. ʒij. nigraʒiss. albumina ovorum quae sufficiant, fiat How to make a dry suture. medicamentum. Apply the pieces of cloth spread with this on each side of the wound one, some finger's breadth asunder, and let it alone till it be hard dried to the skin. Then you shall so draw them together with your needle and thread, that the flesh by their sticking may also follow, and be mutually adjoined, as you may see it here expressed. The wound shall be agglutinated by this means, together with the use of fit medicines, pledgets, ligatures. But all the ligatures and stays which shall be used for that purpose must be fastened to the patient's night-lappe. But when the wound is great and deep, and the lips thereof are much distant the on from the other, there can be no use of such a dry suture. Wherefore you must use a A Suture fit for hare-lips. three or four square needle (that so it may the more readily and easily enter into the flesh) being thread with a waxed thread; and with this you must thrust through The manner thereof. the lips of the wound, and leave the needle sticking in the wound, and then wrap the thread to and again over the ends thereof eight or ten times, just after that manner which women use to fasten a needle with thread in it, upon their sleeves, or Tailors to their hats or caps, that they may not lose them. The needle thus fastened, shall be there until the perfect agglutination of the What hare-lips are wound; this kind of suture is used in the wounds of the lips, as also in hare-lips, for so we commonly call lips which are cleft from the first conformation in the womb by the error of the forming faculty. But such a suture will help nothing to agglutination, if there lie or remain any skin between the lips of the wound; Wherefore you shall cut away whatsoever thereof shall be there, otherwise you must expect no union. Other kind of sutures are of no great use in wounds of these parts, for out of the necessity of eating and speaking, they are in perpetual motion; wherefore a third would cut the flesh; for which reason you shall take up much flesh with such Needles mentioned in this last described kind of Suture, as this following figure shows. The figure of the suture fit for cloven or Hare lips, as also the dilineation of the Needle about whose ends the third is wrapped over and under, to and again. To this purpose I will recite a history, to the end, that if any such thing happen . to come to your hands, you may do the like. A certain Gascoine in the battle at Saint Laurence had his upper jaw cut overthwart even to his mouth, to the great disfiguring of his face. The wound had many worms in it, and stanke exceedingly, because he could get no Chirurgeon until three days after he was hurt. Wherefore I washed it with a decoction of wormwood, Aloes and a little Aegyptiacum, A decoction good to wash away putridematter. both to kill the worms, and to fetch away all the putrid matter; I discussed the tumour with a dissolving fomentation and cataplasime, I joined together the lips of the wound with the last described suture. But I applied this following medicine to the whole part. ℞ Terebinth. venet a ℥ vi. gumml elemi. ℥ ij. pulver is boli armeni, san. drac. Mastiches, myrrhae, aloes an. ʒss. incorporentur simul, fiat medicamentum. The wound was agglutinated within a few days, but that there remained a certain little whole at the joining A small hole remaining after the cure of great wound. of the lower jaw with the upper, wherein you could scarce put the head of a pin; out whereof nevertheless much serous and thin moisture flowed, especially when he either eat or spoke; which I have also observed in many others. But for staying of this waterish humidity I dropped Aqua fortis into the bottom of the ulcer, and divers times put therein a little of the powder of burnt vitriol. Thus by God's grace he recovered and became whole. CHAP. XXVI. Of the wounds of the Nose. THe Nose many ways suffers solution of continuity; as by a wound, fracture and contusion, and it is sometimes battered and broken on the How many ways the nose may be ●urt. upper part; which when it happens, you shall restore the depressed bones to their native seat and figure, with the end of a spatula or fit stick wrapped about with tow, cotton or a linen rag. Then with pledgets dipped in an astringent medicine composed ex albumine ovi, mastic, bowl armeno, sanguine drac. & Alumine ufto, and applied to the side of the nose, he shall The cure of a broken nose. labour to strengthen the restored bones, and then bind them with a convenient ligature, which may not press them too much, lest the nose should become flat, as it happens to many through the unskilfulness of Surgeons. Then must you put little pipes into the nosethrills, and these not exactly round, but somewhat flat and depressed, The use of pipes in broken nose: tied to the nightcap on each side with a thread, lest they should fall out. By the help of these pipes the bones of the nose will be kept in their place, and there will be pastage forth for the matter, and for inspiration and expiration. But if all the nose, or some portion thereof shall be wholly cut off, we must not hope to restore it. But if the Nose be so cut, that as yet it adheres to much of the adjacent flesh, from whence it may receive life and nourishment, then sow it up. For the lower part of the nose it may be shaken, depressed and wrested aside, seeing it is gristly; but it cannot be broken as the other which is of a bony nature. The Figure of pipes to be put into the Nosethrills. CHAP. XXVII. Of the Wounds of the tongue. THe tongue may be so wounded, that either it may be wholly cut off and deprived of some portion of the substance, or onelyslit long ways How many ways the continuity of the tongue may be loosed. or atwhart. The loss of the substance cannot be rapaired, because every part separated and plucked from the living body, from whence it had life, spirit and blood, presently dies. For as the Philosophers say, A privatione ad habitum non est regressus. But when it is cut or slit longwayes or sidewayes, it is easily restored by suture, if so be that the cloven part yet adhere to the living body from whence it may draw both matter and form of life. Therefore The cure of a cloven tongue. a careful servant shall straight hold with a soft and clean linen cloth the body of the tongue, lest it should slip away by reason of its slipperiness, whilst the Chirurgeon stitch it above and below; when he thinks he hath sufficiently sowed it, let him cut off the thread as near to the knot as he can, least being left too long it might be tangled with the teeth as he eats, and so cause a hurtful laceration or rending of the sowed parts. In the mean time let the patient eat barley creames, almond milks, Gelleyes, cullisses and broths, and the yolkes of eggs; and let him often hold in his mouth Sugar of Roses and syrup of Quinces; for such things besides their nourishing faculty, perform the part of an aggluttinating and detergent medicine. I have learned these things I have here set down, neither from my Masters whom I have heard with attention, nor by reading of books, but they have been such as I have tried with happy success in many; as in the son of Monsieur de Marigny precedent of the Inquisition, in john Piet a Carpenter dwelling in the suburbs of Saint German. But most apparently in a child of three years old, the son of the great Lawyer A History. monsieur Covet, who fell with his chin upon a stone, and so cut off a large piece of the end of his tongue, which chanced to be between his teeth, it hung but at a very small fiber of flesh, so that I had very little or no hope to agglutinate and unite it, which thing almost made me to pluck it quit away; yet I changed that determination by considering the loss of the most noble action of speaking, which would thereupon ensue, and weighing the providence of nature often working wonders and such things as exceed the expectation of the physician in curing diseases. I also thought thus with myself, the flesh of the tongue is soft, loose, 〈◊〉 and spongy, neither is it altogether obvious to the external injuries of the air, wherefore Nature oft doth strange things in the cures of diseases. after that I had once or twice thrust through the needle and thread upwards and downwards, and for the rest ordered the child to be used and after the manner I lately mentioned, he grew well within a short time, and yet remains so, speaking well and distinctly. CHAP. XXVIII. Of the Wounds of the Ears. THe ears are sometimes wholly cut off, sometimes but in part, otherwhiles they are only slit, so that the rend portion as yet adhering to the rest, is How many ways the unity of ears may be violated. How to sow a wounded Ears. joined with it in communion of life. In this last case it is fit to use a suture; but yet so that you touch not the gristle with your needle; for thence there would be in danger of a gangraene which happens to many by foolish curing; therefore you shall take up and comprehend with your needle only the skin, and that little flesh which encompasses the gristle. You shall perform the rest of the cure with pledgets and ligatures artificially fitted, and shall resist inflammation and other symptoms with fit medicines. But you must take special care that no superfluous flesh grow in the auditory passage, which may hinder the hearing; wherefore you shall keep that passage free by stopping it with a piece of sponge. But you shall procure agglutination and consolidation of the gristly part (and therefore next to a bone most dry) with dry medicines. But those who have their ears quite cut off, can do nothing but hide the deformity of their mishap with a cap, stuffed with Cotton on that side. CHAP. XXIX. Of the Wounds of the neck and throat. THe Wounds of the neck and throat are somewhiles simple, as those which only use the continuity of the muscles; other whiles compound, The differences of wounds of the neck and throat. such as those which have conjoined with them a fracture of the bones, as of the Vertebrae, or hurt of the internal and external jugular Veins, or sleepy Arteries; sometimes the Trachea Arteria, or Weazon, and the oesophagus or gullet are wounded; sometimes wholly cut off, whence present death casues. Wherefore let not the Chirurgeon meddle with such wounds, unless he first foretell the danger of death, or the loss of some motion to those that are present. For it often happens that some notable nerve or tendon is violated by a wound in the neck, whence a palsy ensues, and that absolutely incurable, if the wound shall penetrate to the spinal marrow, also hurt therewith. Wounds of the gullet and Weazon are The palsy follows upon wounds of the neck. difficultly cured because they are in perpetual motion; and chiesely of the latter by reason it is grisly and without blood. The wounds of the gullet are known, by spitting of blood, by the breaking forth of meat and drink by the wound; but if the Signs that the gullet is wounded. gullet be quite cut asunder, the patient cannot swallow at all. For the cut parts are both contracted in themselves, the one upwards, and the other downwards. But we know the weazon is hurt, by casting up blood at the mouth with a continual cough, and by the coming forth of the breath or wind by the Wound. The Wounds of the jugular Veins and sleepy Arteries, if they be great, are usually deadly, The wounds of the iugular veins and fleepy Arteries are deadly by accident. because they cannot be straitely bound up; for you cannot bind the throat hard without danger of choking or strangling the patient. But for defect of a straight ligature in this case the flux of blood proves deadly. If the recurrent Nerve of either side be cut, it makes the voice hoarse; if cut on both sides, it takes away the use of speech, by hurting these instruments which impart motion to the muscles of the Larinx. By hurting the recurrent Nerve the voice is hurt. For the cure if the wound be small, & not associated with the hurt of any notable vessel, nor of the Weazon and gullet, it is speedily and easily cured; and if there shall be need you shall use a suture, than you shall put therein a sufficient quantity of Venice Turpentine mixed with bolearmenicke; or else some of my Balsam of which this is the receipt. ℞. Terebinth. venetae lb ss. gum. elemi ℥ iiij. olei hypericon is ℥ iij. The description of the Author's Balsam. boli armeni, & sang. draconis an. ℥ i. aqua vita ℥ ij. an.ʒj. I have done wonders with this Balsam in the agglutination of simple wounds, wherein no strange body hath been. Now when you have put it in, lay upon it a plaster of Diacalcitheas dissolved in oil of Roses and vinegar, as that which hath power to repress the flowing down The faculty of Diacalcitheas of humours, and hinder inflammation, or in steed thereof you may apply Emp. de Gratia, Dei, or Emp. de janua. But if the jugular veins and sleepy Arteries be cut, let the bleeding be stayed, as we have showed in a chapter, treating thereof. When the Weazon or Gullet are wounded, the Chirurgeon shall sow them up as neatly as he can; and the patient The cure of the wounded Weazon and gullet. shall not endeavour to swallow any hard thing, but be content to be fed with jellies and broths. When a gargarism is needful, this following is very good. R. hordei M. i. florum rosar. p. i. passul. mund. jujubarum an. ℥ ss, glycyrhizae ℥ i. bulliant A gargarism omnia simul, addendomellis ros. & julep. ros. an. ℥ ij. fiat gargarisma, ut artis est. With which being warm the Patient shall moisten his mouth, and throat, for it will mitigate the harshness of the part, assuage pain, cleanse and agglutinate, and The manifold use thereof. make him breathe more freely. But that the Chirurgeon may not despair of, or leave any thing unattempted in such like wounds, I have thought good to demonstrate by some examples, how wonderful the works of nature are, if they be assisted by Art. A certain servant of Monsieur de Champagne, a gentleman of Anjou, was wounded A History. in the throat with a sword, whereby one of the jugular veins was cut together with his Weazon. He bled much and could not speak, and these symptoms remained, until such time as the wound was sowed up, and covered with medicines, But if the medicines at any time were more liquid, he as it were sucked them by the wound and spaces between the stitches, and presently put forth at his mouth that which he had sucked or drawn in. Wherefore more exactly confidering with myself, the greatness of the Wound, the spermaticke, and therefore dry and bloodless nature unapt to agglutination, of the affected part, but chiefly of the Weazon & jugular vein; as also for that the rough Artery is obnoxions to these motions which the gullet performs in swallowing, by reason of the inner coat, which is continued to the coat of the gullet, by which means these parts mutually serve each other with a reciprocal motion, even as the ropes which run to the wheel of a pulley; further more weighing that the Artery was necessary for the breathing, and tempering the heat of the heart, as the jugular veins served for the nourishment of the upper parts; and lastly weighing with myself the great quantity of blood he had lost, which is as it were the treasure of nature, I told those which were present, that death was near and certainly at hand. And yet beyond expectation, rather by divine favour than our Art, he recevered his health. Equally admirable is this history following. Two Englishmen walked out of the City of Paris for their recreation to the wood of Vincenne; but one of them A strange History. lying in wait to rob the other of his money and a massy chain of gold which he wore, set upon him at unawares, cut his throat and robbed him, and so left him amongst the Vines which were in the way, supposing he had killed him having with his dagger cut the Weasand and gullet. This murderer came back to the city; the other half dead, crawled with much ado to a certain Peasant's house, and being dressed with such medicines as were present and at hand, he was brought to the City, and by his acquaintance committed to my cure to be cured. I at the first, as diligently as I could, sowed up the Weasand which was cut quite asunder, and put the lips of the wound as close together as I could; I could not get hold of the gullet because it was fallen down into the stomach, than I bound up the wound with medicines, pledgets and fit ligatures. After he was thus dressed he begun to speak, and tell the name of the villain the author of this fact, so that he was taken and fastened to the wheel, and having his limbs broken lost his wretched life, for the life of the innocent wounded man who died the fourth day after he was hurt. The like hurt befell a certain german; who lay at the house of one Perots' in Another History. the street of Nuts; hebeing frantic in the night cut his throat with a sword: I being called in the morning by his friends who went to see him, dressed him just after the same manner as I dressed the Englishman. Wherefore he presently recovering his speech, which before could not utter one syllable, freed from suspicion of the caime and prison the servant who lying in the same chamber with him, was upon suspicion committed to prison, and confessing the thing as it was done, living four days after the wound, being nourished with broths put into his fundament like clysters, and with the grateful vapour of comfortable things, as bread newly drawn out of the Oven and soaked in strong wine. Having thus by the Art of Chirurgery made the dumb speak for the space of four days. CHAP. XXX. Of the Wounds of the Chest. SOme wounds of the Chest are on the fore side, some behind, somepenetiatc more deep, others enter not into the capacity thereof, other The differences of wounds of the Chest. some pierce even to the parts contained therein, as the Mediastinum, Lungs, heart, midriff, hollow vein, and ascendent artery; Other some paste quite through the body; whereby it happens that some are deadly, some not. You shall thus know that the wound penetrates into the capacity of the Chest, if The signs. that when the patient's mouth and nose be shut, the breath, or wind breaks through the wound with noise, so that it may dissipate, or blow out a lighted candle being held necre it. If the patient can scarce either draw, or put forth his breath, which also is a sign that there is some blood fallen down upon the Diaphragma. By these signs you may know that the heart is wounded: If agreat quantity of Signs that the heart is wounded. blood gush out, if a trembling possess all the members of the body; if the pulse be little and faint, if the colour become pale, if a cold sweat and frequent swooning assail him, and the extreme parts become cold, than death's at hand. Yet when I was at Turin I saw a certain Gentleman who fight a Duel with A History. another, received a wound under his left breast which pierced into the substance of his heart, yet for all that he struck some blows afterwards, and followed his flying Enemy, some two hundred paces until he fell down dead upon the ground; having opened his body, I found a wound in the substance of the heart, so large as would contain one's finger; there was only much blood poured forth upon the midriff. These are the signs that the Lungs are wounded, for the blood comes soamie Signs that the Lungs are wounded. or frothy out of the wounds the patient is troubled with a cough, he is also troubled with a great difficulty of breathing and a pain in his side, which he formerly had not; he lies most at ease when he lies upon the wound, and sometimes it comes so to pass, that lying so he speaks more freely and easily, but turned on the contrary side, he presently cannot speak. When the Diphragma or midriff is wounded, the party affected is troubled with a weight or heaviness in that place, he is taken with a Delirium, or raving by reason Signs that the midriff is wounded. of the sympathy of the Nerves of the sixth conjugation which are spread over the midriff; difficulty of breathing, a cough and sharp pain trouble the patient, the Guts are drawn upwards; so that it sometimes happens by the vehemency of breathing, that the stomach and guts are drawn through the wound in to the capacity of the, Chest; which thing I observed in two. The on of these was a Maison, who was thrust though the midst of the midriff, where it is Nervous, and died the third day following. I opening his lower belly, and no A History. finding his stomach, thought it a monstrous thing; but at length searching diligently, I found it was drawn into the Chest, though the wound which was scarce an inch broad. But the stomach was full of wind, but little humidity in it. The other was called captain Francis d' Alon a Native of Xantoigne, who before Another History. Roshell was shot with a musket bullet, entering by the breastbone near to the sword-like. Gristle, and passing through the fleshy part of the midriff, went out at the space between the fifth and sixth bastard ribs. The wound was healed up on the out side, yet for all that there remained a weakness of the stomach, whereupon a pain of the guts like to the colic took him especially in the Evening, and on the night; for which cause he durst not sup but very sparingly. But on the eighth month after, the pain raging more violently in his belly than it was accustomed, he died; though for the mitigating of the vehemency thereof Simon Malmedy and Anthony du Val both learned Physicians, omitted no kind of remedy. The body of the diseased was opened by the skilful Chirurgeon, james Guillemeau, who found a great portion of the colic gut swelled with much wind gotten into the Chest, through the wound of the Diaphragma, for all it was so small that you could scarce put your little finger in thereat, But now let us return from whence we digressed. Signs that there is blood poured into the capacity of the Chest. We understand that there is blood poured forth into the capacity of the Chest by the difficulty of breathing, the vehemency of the increasing fever, the stinking of the breath, the casting up of blood at the mouth, and other symptoms which usually happen to these who have putrified and clotted blood poured out of the vessels into the belly, infecting with the filthy vapour of the corrupt substance, the partato which it shall come. But also, unless the patient cannot lie upon his back, he is troubled with a desire to vomit, and covets now and then to rise, whence he often falls into a swoon, the vital faculty which fusteines the body being broken and debilitated both by reason of the wound, and concreate or clotted blood; for so putting on the quality of poison, it greatly dissipates and dissolves the strength of the heart. Signs that the spin is wounded. It is a sign the spinal marrow is hurt, when a convulsion or Palsy, that is, a sudden loss of sense and motion in the parts thereunder, an unvoluntary excretion of the Urine and other excrements, or a total suppression of them, seizes upon the Patient. When the hollow vein and great Artery are wounded, the patient will dye in a short time, by reason of the sudden and abundant effusion of the blood and spirits, which intercepts the motion of the lungs and heart, whence the party dies sufforaced. CHAP. XXX. Of the cure of the Wounds of the Chest. WE have read in john de Vigo, that it is disputed amongst Surgeons Vigo tract. de vul. thereat, cap. 10. concerning the consolidation of wounds of the Chest. For some think that such wounds must be closed up, and cicatrized with all possible speed, lest the cold air come to the heart, and the vital spirits fly away and be dissipated. Others on the contrary think that such wounds ought to be long kept open; and also if they be not sufficiently large of themselves, that then they must be enlarged by Chirurgery, that so the blood poured forth into the capacity of the Chest may have passage forth, which otherwise by delay would putrefy, whence wound ensue an increase of the fever, a fistulous ulcer, and other pernicious accidents. The first opinion is grounded upon reason and truth, if so be that there is little or no blood poured forth into the capacity of the Chest; But the latter takes place where there is much more blood contained in the empty spaces of the Chest. Which lest I may seem rashly to determine, I think it not amiss to ratify each opinion with a history thereto agrecable. Whilst I was at Turin, Chirurgeon to the Marshal of Montejan, the King of France A History. his General, I had in cure a soldier of Paris, whose name was L'evesque, he served under captain Renovart. He had three wounds, but one more grievous than the rest, went under the right breast, some what deep into the capacity of the Chest, whence much blood was poured forth upon the midriff, which caused such difficulty of breathing, that it even took away the liberty of his speech; besides, though this occasion he had a vehement fever, coughed up blood, and a sharp pain on the wounded side. The Chirurgeon which first dressed him, had so bound up the wound with a strait and thick suture, that nothing could flow out thereat. But I being called the day after, and weighing the present symptoms which threatened speedy death, judged that the sowing of the wound must strait be loosed; which being done, there instantly appeared a clot of blood at the orifice thereof; which made me to cause the patient to lie half out of his bed, with his head downwards, and to stay his hands on a settle which was lower than the bed, and keeping himself in this posture, to shut his mouth and nose that so his lungs should swell; the midriff be stretched forth, and the intercostal muscles and those of the Abdomen should be compressed, that the blood poured into the Chest might be evacuated by the wound; but also that this excrestion might succeed more happily, I thrust my finger somewhat deep into the wound, that so I might open the Orifice thereof being stopped up with the congealed blood; and certainly I drew out some seven or eight ounces of putrified and stinking blood by this means. When he was laid in his bed, I caused frequent injections to be made into the wound of a decoction of Barley with honey of Roses and red Sugar, which being injected I wished him to turn first on the one, and then on the other side and then, again to lie out of his bed as before: for thus he evacuated small, but very many clots of blood, together with the liquor lately injected; which being done, the symptoms were mitigated, and left him by little and little. The next day I made another more detergent injection, adding thereto wormwood, Why bitter things must not be cast in to the Chest. centaury, and Aloes; but such a bitterness did rise up to his mouth together with a desire to cast, that he could not longer endure it. Then it came into my mind that formerly I had observed the like effect of the like remedy in the Hospital of Paris, in one who had a fistulous ulcer in his Chest. Therefore when I had considered with myself that such bitter things may easily pass into the Lungs, and so may from thence rise into the Weazon and mouth, I determined that thence forwards I would never use such bitter things to my patients, for the use of them is much more troublesome than any way good and advantageous. But at the length this patient by this and the like means recovered his health beyond my expectation. Read the History of Maryllus in Galen, lib. 7. de Anatom. admismistra. But on the contrary, I was called on a time to a certain german gentleman who was run with a sword into the capacity of his Chest; the neighbouring Chirurgeon had put a great tent into the wound at the first dressing, which I made to be taken forth, for that I certainly understood there was no blood poured forth into the capacity of the Chest because the patient had no fever, no weight upon the diaphragma, nor spitted forth any blood. Wherefore I cured him in few days by only dropping in some of my balsam and laying a plaster of Diacalcitheos' upon the wound. What harm ensues the too long use of tents. The like cure I have happily performed in many others. To conclude, this I ear boldly affirm, that wounds of the Chest by the too long use of tents degenerate into Fistula's. Wherefore if you at any time shall undertake the cure of wounds which penetrate into the capacity of the Chest, you shall not presently shut them up at the first dressing, but keep them open for two or three days; but when you shall find that the patient is troubled with no or very little pain, and that the midriff is pressed down with no weight, and that he breathes freely, then let the tent be taken forth, and the wound healed up as speedily as you can by covering it only with lint dipped No liniments must be used in wounds of the Chest. in some balsam which hath a glutinative faculty, and laid some what broader than the wound; never apply liniments to wounds of this kind, lest the patient by breathing draw them into the capacity of the Chest. Wherefore also you must have a care that the tent put into those kinds of wounds may be fastened to the Pledgets, and also have somewhat a large head, lest they should be drawn as we said into the capacity of the Chest, for if they fall in, they will cause putrefaction and death. Let Emplast. Diacalcitheos' or some such like be applied to the wound. But if, on the contrary, you know by proper, and certain signs, that there is much blood fallen into the spaces of the Chest, then let the orifice of the wound be kept open with larger tents, until all the Sanies or bloody matter, wherein the blood hath degenerated, shall be exhausted. But if it happen at any time, as assuredly it sometimes doth, that notwithstanding the Art and care of the Physician, the wound degenerates into a Fistula, than the former evil is become much worse. For Fistula's of the Wounds of the Chest easily degenerate into a Fistula. Chest, are scarce cured at any time, and that for divers causes. The first is, for that the muscles of the Chest are in perpetual motion; Another is, because they on the contrary inside are covered only with the membrane investing the ribs, which is without blood. The third is, for that the wound hath no stay, by means whereof it may be compressed, sowed, and bound, whereby the lips being joined together, the wound may at length be replenished with flesh, and cicatrized. But the reason why wounds of the Chest do every day heap up and pour forth Why there flows such planty of matter out of wounds of the Chest. so great a quantity of matter, seems to be their vicinity to the heart, which being the fountain of blood, there is a perpetual effluxe there eof from thence to the part affected. For this is nature's care in preserving the affected parts, that continually and abundantly without measure or mean it sends all its supplies, that is, blood and spirits, to the aid. Ad hereto, that the affected parts by pain, heat and continual motion of the Lungs and midriff, draw and allure much blood to themselves. Such like blood defiled by the malignity and filth of the wound, is speedily corrupted; whence it is that from the perpetual afflux of blood, there is a continual effluxe of matter or filth, which at the last brings a man to a consumption; because the ulcerated partlike a ravenous wolf consumes more blood by the pain, heat and motion than can be ministered thereto by the heart. Yet if there be any hope to cure and heal the Fistula, it shall be performed, (after the use of diet, phlebotomy, and according to the prescript of the Physician) by a vulnerary potion, which you shall find described when we treat of the Caries or rottenness of the bones. Wherefore The cure ofa Fistula in the Chest. you shall make frequent injections therewith into the Fistula, adding and mixing with it syruput de rosts ficcis and mell rosarum. Neither doc ay, if the putrefaction be great, fear to mix therewith Aegyptiacum. But you must have a care to remember When Aegyptiacum must be put into the injections. and observe the quantity of the injected liquor, that you may know whether it all come forth again after it hath performed its detergent office. For if any thereof remain behind in the corners and crooked passages, it hurts the part, as corrupted with the contagion thereof. The for me of a Syringe fit to make injection, when a great quantity of liquor is to be injected into any part. After the injected liquor is come forth, a pipe of gold, silver or lead, shall be put into the fistulous ulcer; and it must have many holes in it, that so the filth may pass forth at them; it must be fast tied with strings, that it may not fall into the capacity of the Chest. A great sponge steeped in aqua vita and wrung forth again, shall be laid hot to the end or orifice thereof, both to hinder the entrance of theayre into the Fistulous ulcer, as also to draw forth the filth thereof by its gentle heat, the which thing the Patient shall much further if often times both day and night he hold his breath, stopping his mouth and nose, and lying upon the diseased side, that so the Sanies may be the more forcibly evacuated; neither must we leave putting in the pipe, before that this fistulous ulcer shall be almost dry, that is, whole, as when it yields little, or no matter at all; than it must be cicatrized. But if the orifice of this fistulous ulcer being in the upper part hinder the healing thereof, then by a chirurgical Section a passage shall be made in the bottom, as we said before in an Empyema. The delineation of the pipes with their strings and sponges. The reader must note that the pipes which are fit for this use, need not have so many holes as these here expressed; but only two or three in their ends: for the flesh growing and getting into the rest, make them that they cannot be plucked forth without much pain. A wound made in the Lungs admits cure, unless it be very large; if it be without inflammation; if it be on the skirts of the Lungs, and not on What wounds of the Lungs curable. their upper parts; if the patient contain himself from coughing much, and contentious speaking, and great breathing: for the wound is enlarged by coughing, and thence also arises inflammation; the Pus and Sanies whereof, whilst the lungs again endeavour to expel by coughing, by which means they are only able to expel that which is hurtful and troublesome to them, the ulcer is dilated, the inflammation The harm that ensues upon coughing in wounds of the Lungs. augmented, the Patient wastes away, and the disease becomes incurable. There have been many Eclegmas described by Physicians for to cleanse the ulcer; which when the patient useth, he shall lie on his back, to keep them long in his mouth, so to relax the muscles of the Larinx; for thus the medicine will fall by How Eclegmas must be swallowed. little and little alongst the coats of the Weazon, for if it should fall down in great quantity, it would be in danger to cause coughing. Cows, Asses, or Goat's milk with a little honey, lest they should corrupt in the stomach, are very fit remedies for this purpose; but woman's milk exceeds the rest. But Sugar of Roses is to be preferred before all other medicines, in the opinion of Avicen, for that it hath a detergent, and also an astrictive and strengthening faculty, The utility of Sugar of roses in ulcerated or wounded Lungs. than which nothing is more to be desired in curing of ulcers. When you shall think it time to agglutinate the cleansed ulcer, you must command the patient to use emplastic, austere, and asttringent medicines, such as are Terra sigillata, bolus armenus, hypocystis, plantain, knotgrass, Sumach, acacia and the like, which the patient shall use in hisbrothes and Eclegmas, mixing therewith honey of roses, which serving for a vehicle to the rest, may carry away the impacted filth which hinders agglutination. But seeing an hectic fever easily follows upon these kinds of wounds, and also upon the affects of the Chest and lungs, it will not be amiss to set down somewhat concerning the cure thereof, that so the Chirurgeon may know to administer some help to his patient, whilst a Physician is sent for, to overcome this disease with more powerful and certain remedies. CHAP. XXXII. Of the differences, causes, signs and cure of an Hectic fever. A Hectic fever is so called; either for that it is stubborn and hard to eure and loose, as things which have contracted a habit; for Hexis in The reason of the name. Greek signifies a habit; or else for that it seizes upon the solid parts of our bodies called by the greeks Hexeiss; both which the Latin word Habitus doth signify. There are three kinds, or rather degrees of this fever. The first is when the hectic The differences theroof. heat consumes the humidity of the solid parts. The second is, when it feeds upon the fleshy substance. The third and uncureable is, when it destroys the solid parts themselves. For thus the flame of a lamp first wastes the oil, than the proper moisture of the week. Which being done there is no hope of lighting it again what store of oil soever you pour upon it. This fever very seldom breeds of its self, but commonly follows after some other. Wherefore the causes of a hectic fever are, sharp and burning fevers not well The causes, cured, especially if their heat were not repressed with cooling epithemes applied to the heart and Hypochondria. If cold water was not fitly drunk. If may also succeed a Diary fever which hath been caused and begun by some long, great and vehement or anger, or some too violent labour, which any of a slender and dry body hath performed in the hot sun. It is also oft time caused by an ulcer or inflammation of the Lungs, an empyema of the Chest, by any great and long continuing Phlegmon of the liver, stomach, mesentery, womb, kidneys, Bladder, of the guts jejunam and Colon, and also of the other Guts, of if the Phlegmon succeed some long Diarrhoea; Lienteria or bloody flix; whence a consumption of the whole body, and at last a hectic fever, the heat becoming more acride, the moisture of the body being consumed. This kind of fever as it is most easily to be known, so is it most difficulty to The Signs. cure; the pulse in this fever is hard, by reason of the dryness of the Artery which is a solid part; and it is weak by reason of the debility of the vital faculty, the substance of the heart being assaulted. But it is little and frequent because of the distemper and heat of the heart, which for that it cannot by reason of its weakness cause a great pulse to cool its self, it labours by the oftenness to supply that defect But for the pulse, it is a proper sign of this fever, that one or two hours after meat the pulse feels stronger than usual; and then also there is a more acride heat Why in hectickes the heat is more acride after meat. over all the patient's body. The heat of this flame lasts until the nourishment be distributed over all the patient's body; in which time the dryness of the heart in some sort tempered and recreated by the appulse of moist nourishment, the heat increases no otherwise than lime which a little before seemed cold to the touch, but sprinkled and moistened with water grows so hot, as it smokes and boiled up. At other times there is a perpetual equality of heat and pulse in smallness, faintness; obscurity, frequency, and hardness, without any excerbation, so that the patient cannot think himself to have a fever, yea he cannot complain of any thing, he feels no no pain, which is another proper sign of an hectic fever. The cause that the heat doth not show its self is, it doth not possess the surface of the body, that is, the spirits and humours, but lies as buried in the earthy grossness of the solid parts. Yet if you hold your hand somewhat, you shall at length perceive The signs of a hectic joined with a putrid fever. the heat more acride and biting, the way being opened thereto by the skin rarifyed by the gentle touch of the warm and temperate hand. Wherefore if at any time in these kind of fevers the Patient feel any pain, and perceive himself troubled with an inequality and excess of heat, it is a sign that the hectic fever is not simple, but conjoined with a putrid fever, which causeth such inequality, as the heat doth more or less seance upon matter subject to putrefaction; for a hectic fever of its self is void of all equality unless it proceed from some external cause, as from meat; Certainly if an Hippocratique face may be found in any disease, it may in this, by reason of the colliquation, or wasting away the triple substance. In the cure of this disease, you must diligently observe with what affects it is entangled, The cure. and whence it was caused. Wherefore first you must know whether this fever be a disease; or else a symptom. For if it be symptom aticall it cannot be cured, as long as the disease the cause thereof, remains uncured; as if an ulcer of the guts occasioned by a bloody flux shall have caused it, or else a fistulous ulcer in the Chest A symptomatical hectic. caused by some wound received on that part; it will never admit of cure, unless first the fistulous or dysenterick ulcer shall be cured; because the disease feeds the symptoms, as the cause the effect. But if it be a simple and essential hectic fever, for that it hath its essence consisting in an hot and dry distemper, which is not fixed An essential hectic. in the humours, but in the solid parts, all the counsel of the Physician must be to renew the body, but not to purge it; for only the humours require purging, and not the defaults of the solid parts. Therefore the solid parts must be refrigerated and humected; which we may do by medicines taken inwardly and applied out-wardly. The things which may with good success be taken inwardly into the body for Things to be taken inwardly. this purpose, are medicinal nourishments. For hence we shall find more certain and manifest good, than from altering medicines, that is, wholly refrigerating and humecting without any manner of nourishment. For by reason of that portion fit for nutriment which is therewith mixed, they are drawn and carried more powerfully to the parts, and also converted into their substance: The benefit of medicinal nourishments. whereby it comes to pass that they do not humect and cool them lightly and superficially, like the medicines which have only power to alter and change the body, but they carry their qualities more throughly even into the innermost substance. Of these things some are herbs, as violets, purssaine, bugloss, endive, ducksmeat, or water lentil, mallows, especially when the belly shall be bound. Some are fruits, as gourds, cucumbers, apples, prunes, raisins, sweet almonds, and fresh or new pineapple kernels. In the number of seeds are the four greater and lesser cold seeds, and these new, for their native humidity, the seeds of poppyes, berberries, quinces. The flowers of bugloss, violets, water lilies, are also convenient; of all these things let broth be made with a chicken, to be taken in the morning for eight or nine days, after the first concoction. For meats; in the beginning of the disease, when the faculties are not too much The choice of meats. debilitated, he shall use such as nourish much and long, though of hard digestion; such as the extreme parts of beasts, as the feet of Calves, Hogs feet not salted, the flesh of a Tortoise, which hath lived so long in a garden, as may suffice to digest the excrementitious humidity; the flesh of white Snails, and such as have been gathered in a vineyard, of frogs, river Crabs, Eels taken in clear waters and; welcooked, hard eggs eaten with the juice of Sorrel without spices; Whiting and stockfish. For all such things because they have a tough and glutivons juice, are easily put & gluti, nated to the parts of our body, neither are they so easily dissipated by the feverish heat. But when the patient languisheth of a long hectic, he must feed upon meats of easy digestion, and these boiled rather than roasted; for boiled meats humect more, and roasted more easily turn into choler. Wherefore he may use to eat Veal, Kid, Capon, Pullet, boiled with refrigerating and humecting herbs; he may also use Barley creames, Almond milks, as also bread crumbed and moistened with rose water and boiled in a decoction of the four cold seeds with sugar of roses; for such a Panada cools the liver, and the habit of the whole body, and nourisheth withal. The Testicles, wings, and livers of young cocks, as also figs and raisins. But if the patient at length begin to loathe and grow weary of boiled meats, then let him use roast, but so that he cut away the burnt and dried part thereof, and feed only on the inner part thereof, and that moistened in rose water, the juice of Citrons, Oranges or Pomegranates. Let him abstainefrom salt and dry fishes, and choose such fishes as live in stony waters, for the exercise they are forced to undergo in shunning the rocks beaten upon by the waves. Asses milk newly milked and seasoned with a little salt, sugar, honey, or fennel, that it may not corrupt, nor grow sour in thestomacke; How Asses milk must be used in a hectic. or woman's milk sucked from the dug by the patient, to the quantity of half a pint is much commended; verily woman's milk is the more wholesome, as that which is more sweet and familiar to our substance, if so be that the nurse be of a good remper and habit of body. For so it is very good against the gnawing of the stomach, and Woman's milk more wholesome than Asses. ulcers of the Lungs, from whence a Consumption often proceeds. Let your milch Ass be fed with barley, oats, oakeleaves; but if the patient chance to be troubled with the flux of the belly, you shall make the milk somewhat astringent, by gently boiling it, and quenching there in pebble stones heated red hot. But for that all natures cannot away with Asses milk, such shall abstain from it, as it makes to have acrid belchings, difficulty of breathing, a heat and rumbling in the Hypochondria, and pain of the head. Let the patient temper his wine with a little of the waters of Lettuce, purslane and waterlillies, but with much bugloss water, both for that it moistens very much; as also for that it hath a specific power to recreate the heart, whose solid substance in this kind of disease is greivously afflicted. And thus much of things to be taken inwardly. These things which are to be outwardly applied, are inunctious, baths, epithemes, Things to be outwardly applied. clysters. Inunctions are divers, according to the various indication of the parts whereto they are applied. For Galen anoints all the spin with cooling & moderate astringent things, as which may suffice to strengthen the parts, and hinder their wasting, and not let the transpiration; for if it should be letted, the heat would become more acride, by suppressing the vapours. Oil of roses, water lilies, Quinces, the mucilages of Gum tragacanth and arabic extracted in water of night shade, with some small quantity of camphire, and a little wax if need require; but on the contrary, the parts of the breast must be anointed with refrigerating and relaxing things; by refrigerating I mean things which moderately cool, for cold is hurtful to the breast. But astringent things would hinder the motion of the muscles of the chest, and cause a difficulty of breathing. Such inunctions may be made of oil of Violets, willows, of the seeds of lettuce, poppyes, water-lillyes, mixing with them the oil of sweet almonds to temper the astriction which they may have by their coldness. But you must have great care that the Apothecary for A caution in the choice of Oils. covetousness in steed of these oils newly made give you not old, rancide and salted oils, for so in steed of refrigerating, you shall heat the part; for wine, honey and oil acquire more heat by age; in defect of convenient oils, we may use butter well washed in violet and nightshade water. The use of such inunctions, is to cool, humect and comfort the parts whereto they are used; they must be used evening and morning, chiefly after a bath. Now for Baths, we prescribe them either only to moisten, and then plain warm The differences of baths. water wherein the flowers of Violets and water lilies, willow leaves and barley have been boiled, will be sufficient; or else not only to moisten, but also to acquire them a fairer and fuller habit, and then you may add to your bath the decoction of a sheep's head and Gather, with some butter. But the patient shall not enter into the bath fasting, but after the first concoction of the stomach, that so the nourishment Why the patients must not enter the Bath fasting. may be drawn by the warmness of the bath into the whole habit of the body, for otherwise he which is sick of a consumption and shall enter the bath with his stomach empty, shall suffer a greater dissipation of the triple substance, by the heat of the bath, than his strength is well able to endure. Wherefore it is fit thus to prepare the body, before you put it into the bath. The day before in the morning let him take How to prepare the body for the Bath. an emollient clyster, to evacuate the excrements backed in the guts by the hectic dryness; then let him eat to his dinner some solid meats about nine of the clock; and let him about four of the clock eat somewhat sparingly, meats of easy digestion to his supper. A little after midnight let him sup of some chicken broth or barley cream, or else two rear eggs tempered with some rose water and sugar of roses in steed of salt. Some 4. or 5. hours after, let him enter into the bath, these things which I have set down, being observed. When he comes out of the ●ath, let him be dried and gently rubbed, with soft linen clothes, and anointed as I formerly prescribed, then let him sleep it he can for two or three hours in his bed: when he wakes let him take some Prisan, or some such like thing, and then repeat his bath after the foresaid manner. He shall use this bath thrice in ten days; But if the patient be subject to crudities of the stomach, so that he cannot sit in the bath Things strengthening the ventricle. without fear of swooning and such symptoms, his stomach must be strengthened with oil of Quinces, Wormwood and Mastic, or else with a crust of bread toasted, and steeped in muskedine, and strewed over with the powders of Roses, Sanders, and so laid to the stomach, or behind near to the thirteenth vertebra of the back, under which place, Anatomy teaches, that the mouth of the stomach Epithemes. lies. Epithemes shall be applied to the liver and heart, to temper the too acride heat of these parts, and correct the immoderate dryness by their moderate humidity. Now they shall be made of refrigerating and humecting things, but chiefly humecting; for too great coldness would hinder the penetration of the humidity into the part lying within. The waters of Bug loss, and Violets, of each a quartern with a little white wine is convenient for this purpose. But that which is made of French barley, the seeds of gourds, pompions, or Cucumbers of each three drams in the decoction, and mixed with much tempering with oil of Violets, or of sweet almonds, is most excellent of all other. Let clothes be dipped and steeped in such epithemes, and laid upon the part, and renewed as oft as they become hot by the heat of the part. And because in hectic bodies, by reason of the weakness of the digestive faculty, many excrements are usually heaped up, and dried in the guts, it will be convenient, all the time of the discase to use frequently glisters made of the decoction of cooling and humecting herbs, flowers, and seeds wherein you shall dissolve Cassia with sugar and oil of Violets, or waterlillies. But because there often happen very dangerous fluxes in a confirmed hectic fever, which show the decay What a flux happening in a hectic fever indicateth. of all the faculties of the body, and wasting of the corporaell substance, you shall resist them with refrigerating and assisting medicines; and meats of grosser nourishment, as Rice, and Cicers; and application of astringent and strengthening remedies; and using the decoction of Oats or parched barley for drink. Let the patient be kept How children be cured. quiet and sleeping as much as may be, especially if he be a child. For this fever frequently invades children by anger, great and long fear, or the too hot milk of the nurse, overheating in the Sun, the use of wine and other such like causes; they shall be kept in a ho● and moystayre, have another Nurse, and be anointed with oil of violets; to conclude, you shall apply medicines which are contrary to the morbificke cause. CHAP. XXXIII. Of the Wounds of the Epigastrium and of the whole lower belly. THe wounds of the lowerbelly are sometimes before, sometimes behind, Their differences. some only touch the surface thereof, others enter in; some pass quite through the body, so that they often leave the weapon therein, some happen without hurting the contained parts; others grievously offend these parts, the liver, spleen, stomach, guts, kidneys, womb, bladder, Signs of a wounded liver. ureters, and great vessels, so that oft times a great portion of the Kall falls forth. We know the Liver is wounded, when a great quantity of blood comes forth of the wound, when a pricking pain reaches even to the swordlike gristle, to which the Liver adheares. Oft times morecholer is cast up by vomit, and the patient lies on his belly with more case, and content. Signs that the stomach and smaller guts are wounded. When the stomach or any of the small guts are wounded, the meat and drink break out at the wound, the Ilia or flanks swell and become hard the hicker troubles the patient, and oft times he casts up more choler, and grievous pain wrings Signs to know when the greater guts are wounded. his belly, and he is taken with cold sweats, and his extreme parts wax cold. If any of the greater guts shall be hurt, the excrements come forth at the wound: When the Spleen is wounded, there flows out thick and black blood, the patient is oppressed with thirst, and there are also the other signs, which we said use to accompany the wounded Liver. A difficulty of making water troubles the patient whose reins are wounded, blood is pissed forth with the Urine, and he hath a pain Signs that the Kidneys are hurt. stretched to his groins and the regions of the Bladder and Testicles. The Bladder or ureters being wounded, the flanks are pained, and there is a Tension Signs that the Bladder is wounded. of the Pecten or share, blood is made in stead of urine, or else the urine is very bloody, which also divers times comes forth at the wound. When the womb is wounded, the blood breaks forth by the privities, and the Symptoms are like Signs that the womb is wounded. those of the Bladder. The wounds of the liver are deadly, for this part is the work house of the blood, Prognostics. wherefore necessary for life; besides by wounds of the liver the branches of the Gateor Hollow veins are cut, whence ensues a great flux of blood not only inwardly, but also outwardly, and consequently a dissipation of the spirits and strength. But the blood which is shed inwardly amongst the bowels putrefies and corrupts, whence follows pain, a fever, inflammation, and lastly death. Yet Paulus Aegineta Lib. 6. cap. 88 writes, that the lobe of the Liver may be cut away without necessary consequence of death. Also the wounds of the Ventricle and of the small Guts, but chiefly of the jejunum are deadly; for many vessels run to the jejunum or empty Gut, and it is of a very nervous and slender substance, and besides it receives the choleric humour from the bladder of the Gall. So also the wounds of the Spleen, Kidneys, ureters, Bladder, Womb and Gall, are commonly deadly, but always ill, for that the actions of such parts are necessary for life; besides, divers of these are without blood and nervous, others of them receive the moist excrements of the whole body, and lie in the innermost part of the body, so that they do not easily admit of medicines. Furthermore, all wounds which penetrate into the capacity of the belly, are judged very dangerous, though they do not touch the contained bowels; for the encompassing and new air entering in amongst the bowels, greatly hurts them, as never used to the feeling thereof; add hereto the dissipation of the spirits which much weakens the strength. Neither can the filth of such wounds be wasted away according to the mind of the Chirurgeon, whereby it happens, they divers times turn into Fistula's, as we said of wounds of the Chest, and so at length by collection of matter cause death. Yet I have dressed many who by God's assistance and favour have recovered of wounds passing quite through their bodies. I can bring as a witness the steward of the Portugal Ambassador, whom I A History. cured at Melun, of a wound made with a sword so running through his body, that a great quantity of excrements came forth of the wounded Guts, as he was a dressing, yet he recovered. Not long agone Giles le Maistre a Gentleman of Paris was run quite through Another History. the body with a Rapier, so that he voided much blood at his mouth and fundament divers days together, whereby you know the Guts were wounded; and yet he was healed in twenty days. In like sort the wounds of the greater vessels are mortal, by reason of the great effusion of blood and spirits which ensues thereupon. CHAP. XXXIIII. The cure of wounds of the lower belly. THe first cogitation in curing of these wounds ought to be whether they pierce into the capacity of the Belly; for those which pass no further than to the Peritonaeum shall be cured like simple wounds which only requre union. But those which enter into the capacity must be cured after another manner. For oft times the Kall or Guts, or both fall forth at them. A gut which is wounded must be sowed up with such a seam as Furriers or Glover's The cure of a wounded Gut. use, as we formerly told you; and than you must put upon it a powder made of Mastich, Myrrh, Aloes and Bole. Being sowed up, it must not be put up boisterously together and at once into its place, but by little and little, the Patient lying on the side opposite to the wound. As for example, the right side of the Guts being wounded and falling out by the wound, the Patient shall lie on his left side, for the more easy restoring of the fallen down Gut, and so on the contrary. If the lower part of the Guts being wounded slide through the wound, than the Patient shall lie with his head low down, and his buttocks raised up by putting a pillow under them; If the upper part be hurt, then must he lie quite contrary, that the Guts falling downwards by such a site, may give way to these which are fallen out through the wound. But often in this case, the Guts having taken cold by the encompassing air, swell up & are distended with wind, the which you must discuss before you put them into their place, with a fomentation of the decoction of camomile, melilote, aniseeds and fennel applied with a sponge or contained in a bladder; or else with chickens, or whelps cut alive in the midst and laid upon the swelling; for thus they do not only discuss the flatulency, but also comfort the afflicted part. But if the inflation cannot thus be discussed, the wound shall be dilated, that so the Guts may return the more freely to their place. If the Kall shall fall out, it must be speedily restored to its place, for it is very subject The cure when the Kall falls out. to putrify; for the fat, whereof for the most part it consists, being exposed to the air, easily loses its native heat, which is small and weak, whence a mortification ensues. Hence is that of Hypocrates; If the Kall fall out, it necessarily putrifies. The Chirurgeon shall know whether it putrify, or not, by the blackness and the coldness Hip. Aph. 58. sect. 6. you may perceive by touching it; neither must you when it putrifies presently restore it to its place, for so the contagion of the putrefaction would spread to the rest of the parts: but what soever thereof is putrefied shall be twitched and bound hard with a string and so cut off, and the rest restored to his proper place: but its good after cutting of it away to leave the string still hanging thereat, that so you may pluck and draw forth whatsoever thereof may by being too strait bound fall away into the capacity of the belly. Some think it to be better to let the Kall thus bound to hang forth until that portion thereof which is putrified fall away of itself, and not to cut it off. But they are much deceived, for it hanging thus would not cover the guts, which is the proper place. The Guts and Kall being put up, if the wound be great and worth speaking of, it must be sowed with that future which is termed Gastroraphia; but this kind of future is thus made. The needle at the first putting in must only take hold of the peritonaeum, & then on the opposite side only of the flesh, letting the peritonaeum alone, and so go along putting the needle from without inwards, and from within outwards, but so that you only take the musculous flesh and skin over it, and then only the peritonaeum, until you have sowed up all the wound. He which doth otherwise shall undergo this danger, that whereas the coat peritonaeum is of itself without blood, it being divided, or wounded cannot of itself be united to itself, therefore it requires an intercourse of flesh: otherwise unless it be thus united by the benefit of the flesh intermixed therewith, there would remain an uncurable Tumour after the wound is cicatrized on the outside. But that which we said before according to Galens' mind, that all the wounds must be sowed, it is not Lib. 6. Metb. cap. 4. so to be taken as if that the wound must be sowed up to the very end; for in the lower part of the wound there must be left a certain small vent by which the quitture may pass forth, which being wholly cleansed and exhausted, the wound must be quite healed up. But the wounds which shall penetrate into the substance of the liver, spleen, ventricles, and other bowels, the Chirurgeon shall not suffer them to be without medicines as if they were desperate, but here shall spare neither labour nor care to dress them diligently. For doubtful hope is better than certain despair. The bladder, womb, and right gut being wounded, detergent and agglutinative injections shall be put up by their proper passages. I have read nothing as yet in any author of the wounds of the Fat, for all of them refer the cure thereof to the wounds of the Muscles. Yet I will say this by the way, that wounds of the fat how deep soever they The cure of the wounded fat. be, if they be only simple, may be dressed without putting in of any Tent, but only dropping in some of my balsam, and then laying upon it a plaster of Cratia Dei, or some such like, for so they will heal in a short time. CHAP. XXXV. Of the Wounds of the Groins, Yard and Testicles. WHen the Groins and neighbouring parts are wounded, we must first consider whether they pierce to within: and if they do penetrate, to what inward parts the come, whether to the bladder, the womb, or right gut: for these parts are such near neighbours that oft times they are all wounded with one blow. But for the wounds of the Testicles, and genital parts, because they are necessary instruments for the preserving the species by generation, or a succession of individuals, and to keep all things quiet at home, therefore the Chirurgeon ought to be very diligent and careful for their preservation. Wherefore if they should chance at any time to be wounded, they shall be dressed as we have formerly delivered, the medicines being varied according to the state of the wound, and the appearing and happening symptoms; for it would be a thing of immense labour to handle all things in particular. CHAP. XXXVI. Of the Wounds of the Thighs and Legs. WOunds which have been received on the inside of the Thighs, have often Why wounds of the inside of the Thigh are oft times deadly. caused sudden death, if they have come to the vein Saphena, or the great Artery, or the Nerves the associates of these vessels. But when they are simple, there is nothing which may alter the usual manner of cure. Yet the patient must be careful to lie in his bed: for the vulgar Italian proverb is true. La mano all petto, la gamba all letto, [that is, the hand on the breast, and the leg on the bed.] But when they penetrate more deeply into the substance of the part, they bring horrid and fearful symptoms, as an inflammation, an abscess, from whence oft times such abundance of matter issues forth, that the Patient falls into an Atrophia and consumption. Wherefore such wounds and ulcers require a careful and industrious Chirurgeon, who may fitly make incisions necessary for the corrupt parts, and callosity of the fistulous ulcer. Some Surgeons have been so bold as to sow together the end of the Tendons of the Ham, and of other joints, when they have been quite cut asunder. But I durst never attempt it for fear of pain, convulsions and the like horrid symptoms. For the wounds of that large Tendon which is composed in the calf of the Leg by the concourse of three The large Tendon of the he'll hard to consolidate. muscles, and goes to the heel, I have observed that when it hath been cut with a sword, that the wounds have been long and hard to cure; and besides when at the last they have been healed, as soon as the Patient hath got out of his bed, and endeavoured to go, they have grown ill and broke open again. Wherefore in such like wounds let the Patient have a care that he begin not to go, or too boldly to use his hurt leg before it be perfectly cicatrized and the scar grown hard. Therefore that the patient may be in more safety, I judge it altogether necessary, that he use to go with Crutches, for a good while after the wound is perfectly healed up. CHAP. XXXVII. Of the Wounds of the Nerves, and nervous parts. THe continuity of the nervous parts is divers ways loosed by the violent incursion of external things; as by things which contuse, batter and grind in Differences drawn from things wounded. sunder, as by the blow of a stone, cudgel, hammer, lance, bullet out of a gun, or crossbow; by the biting of greater teeth; or the pricking of some sharp thing, as a needle, bodkin, penknife, arrow, splinter; or the puncture of some venomous thing, as of a Sea Dragon; or the edge of some cutting thing, as a sword or Rapier; or of stretching things which violently tear asunder the nervous bodies. Hence therefore it is, that of such wounds some are simple, others compound, and the compound, some more compound than other. For of these some are superficiary and short, others deep and long; some run alongst the nervous body, others run broadwayes; some cut the part quite asunder, others only a portion thereof. The symptoms which follow upon such wounds are, vehement pain, and Their symptoms. de fluxion, inflammation, abscess, fever, delirium, swooning, convulsion, gangrene, sphacel; whence often death ensues by reason of that sympathy, which all the nervous parts have with the brain. Amongst all the wounds of the nervous parts, there Why a puncture of a nerve is deadly. is none more to be feared than a puncture, or prick, nor any which causeth more cruel and dangerous symptoms. For by reason of the straightness of the wound, medicines can neither be put in, nor the sanious matter pass forth: now the sanious matter by long stay acquires virulency, whereby the nervous parts are tainted and swollne, suffer pain, inflammation, convulsions and infinite other symptoms; of these the wounds are most dangerous, by which the nervous and membranous bodies are but half cut asunder. For the portion whereof which remains whole, by its drawing and contracting its self towards the original, causeth great pain and convulsion by sympathy. The truth hereof is evident in wounds of the head, as when the pericranium is half cut, or when it is cut to apply a Trepan. For the cutting thereof infers far greater pain, than when it is cut quite asunder. Wherefore it is safer, to have the nervous body cut quite off, for so it hath no community, nor consent with the upper parts, neither doth it labour, or strive to resist the contraction of its self; now this contrariety, and as it were fight, is the cause of pain; yet there arises another misery from such a wound, for the part whereinto the nerve which is thus cut insunder passes, thence forwards looseth its action. CHAP. XXXVIII. Of the cure of wounds of the nervous parts. IT is the ancient doctrine of the ancient Physicians, that the wounds of the nervous A wound of the nervous parts indicateth contrary to the general cure of wounds. parts should not presently be agglutinated (which notwithstanding the general and first indication usually taken from the solution of continuity requires) but rather, chiefly if they be too straight, that the punctures should be dilated, by cutting the parts which are above them, and let them be kept long open that the fifth may pass freely forth and the medicine enter well in. Yet I in many cures have not followed this counsel, but rather that which the common indication requires. That cure is in fresh memory which I performed upon Monsieur le Cocque a Proctor A History. of the spiritual court, who dwelled in our Lady's street; he gathering and binding up some loose papers, run a penknife which was hid amongst them, through his hand. Also one of his neighbours who went to spit a piece of beef, thrust the spit through the midst of his hand; But I presently agglutinated both their wounds, without any danger, dropping presently in at the first dressing a little of my balsam warm, & putting about it a repelling & astringent medicine, & by this means they were both of them healed in a short time, no symptom thereupon happening. Yet I would not have the young Chirurgeon to run this hazard, for first he must be well practised and accustomed to know the tempers and ha● its of men; for this manner of curing would not do well in a plethoric body, or in a body replete with ill humours, or endued with exquisite sense. Therefore in such a case it will be safer to follow the course here set down. For wounds of the nerves do not only differ from other wounds, but also among themselves in manner of curing. For although all medicines which draw from far, and waste sanious humours, may be reputed good for the wounds of the nerves; yet those which must be applied to punctures and to those nerves which are not wholly laid open, aught to be far more powerful, sharp and drying, yet so that they be not without biting, that so penetrating more deep they may draw forth the matter, or else consume and discuss that which either lies about the nerves, or moistens their substance. On the contrary when the sinews are bared from flesh and the Medecines fit for wounds of the nerves. adjoining particles, they stand in need but of medicines, which may only dry. Here you may furnish yourselves with sufficient store of medicines good for the nerves howsoever pricked. As ℞. Terebinth. ven. & olei veteris an. ℥ i. aquae vitae parum. Or ℞. olei Terebinth. ℥ i. vitaeʒj. euphorb. ʒss. Or ℞. radices Dracotia, Brionia, valeriana, & gentiana exsiccatas, & in pulverem redactas, misce cum decocto centaurij, aut oleo, aut exungia veteri; drop hereof warm into the wound as much as shall suffice. Or else put some Hogs, Goose, Capons, or Bear's grease, old oil, oil of Lillies or the like, to Galbanum, pure Rozin, opopanax dissolved in aqua vitae and strong vinegar. Or ℞. olei hypericonis, sambuci, & de euphorbio an. ℥ i. sutphuris vivi subtiliter pulverisatis ℥ ss. gummi ammoniaci, bdellij, an. ʒij. aceti boni ℥ ij. vermium terrest. praeparat. ℥ i. bulliant omnia simul ad consumptionem aceti. Let as much hereof as shall suffice be dropped into the wound; then apply this following cerate, which draws very powerfully. ℞. olei suprà scripti ℥ i. terebinth. venet. ℥ ss. diachylonis albi cum gummi, ʒx. ammoniac. bdellij in aceto dissolutorum an. ʒij. resin. pint, gum. elemi, picis navalis an. ʒv. cerae quod sufficit, fiat ceracum satis molle. We must use somewhiles one, somewhiles another of these medicines in punctures of the Nerves with choice and judgement, according to their conditions, manner, depth, and the temperaments and habit of the wounded bodies. But if the pain yield not to such remedies, but rather increase, what wound of the Nerves must be burnt. with the inflammation of the affected part, a swelling of the lips of the wound, and sweeting forth of a serous, thin and virulent matter or filth, than you shall pour into it scalding oil, and shall touch three or four times not only the surface of the wound but the bottom thereof with a rag dipped therein and tied to the end of a spatula. For this will take away the sense from the Nerve, Tendon, or Membrane, like as if they were burnt with a cautery, and so the pain will be eased. So in the A certain Anodyne in pain of the teeth. most grievous pains of rotten teeth, the thrusting of an hot iron into their roots, or stopping them with cotton dipped in oil of Vitriol, or aqua vitae, gives most certain ease; for by burning the Nerve which is inserted into their roots, the sense and so consequently the pain is taken away. So also in malignant, gnawing, eating, Why Escharoticks must be used to spreading ulcers. and spreading ulcers, which are always associated with much pain, the pain ceases by applying an Escharoticke, as the powder of Alum, or Mercury, or aegyptiacum made somewhat more strong than usual. That the young Chirurgeon may be more ready for this practice and the use of the former remedies, I have thought good to insert the following History both for the lateness of the thing and the pleasing memory of the most iaudible Prince. Charles the ninth the French King being sick of a fever, Monsieur Chapellan and A famous history. Castellan his Physicians thought it fit he should be let blood; for the performance whereof, there was called a Chirurgeon wondrous famous for that business; but when as he by chance had pricked a nerve in stead of a vein, the King cried out, that he felt a mighty pain in that place. Then I bid, that the ligature should strait ways be loosed, otherwise the arm would presently be much swelled. But he going slowly about it, behold the arm begun to swell with such contraction, that he could not bend it, nor put it forth, and cruel pain molested not only the pricked particle, but all the whole member besides. I forthwith laid upon the wound a plaster of Basilicon, to hinder the agglutination thereof, & then I wrapped all the arm in a double linen clothe dipped in oxycrate, putting upon it an expulsive ligature, which beginning at the wrist & ending at the top of the shoulder, might keep the blood and spirits from fear of defluxion and inflammation. This being thus performed, we went aside to consult what was necessary to be done, both to assuage the pain, as also to divert the other symptoms, which usually happen upon punctures of the nerves. I being desired, thus delivered my opinion, that in my mind, there were nothing better, than presently to drop into the wound some oil of Turpentine warmed and mixed with a little aqua vitae. And then all the arm should be covered with a plaster of Diacalcitheos' dissolved in vinegar and oil of Roses, bound over and besides with the expulsive ligature, which we formerly mentioned. For the oil and aqua vitae have a faculty to penetrate into the bottom of the wound, & to exhaust and dry up, the serous and virulent humour, which sweats from the substance of the pricked nerve; and also to mitigate the pain by its actual heat. Furthermore the emplaster Diacalcitheos' hath a faculty to dissolve the humour which hath already fallen down into the arm, and to hinder the entrance and defluxion of any new matter. And the ligature is such as by its moderate astriction would serve to strengthen the muscles, and to press out and repel the humours which were fallen down into the upper part, and to prohibit that which is ready to fall down. Mine advice being approved of the Physicians both in word and deed, the pain was mitigated. But the humour stayed in the part, for the dissolving and drying whereof, this following remedy was used. ℞ far. hordei & orobi, an. ʒij. flor. chamaem. & melilot. an. p. ij butyr. recentis sine sale ℥ jss. lixivij barbitonsoris quod sufficit, fiat cataplasma ad formam pultis. By these remedies A discussing and drying cataplasm. the King at the last after three months' space was perfectly healed, so that there remained no sign of the depraved action in the part. But if at any time there shall be so great contumacy, that it will not yield to these means, but that there is imminent danger of a convulsion; it will be better to cut it in sunder whether Nerve, Tendon or Membrane, than to expose the patient to the danger of a deadly convulsion; for thus indeed the peculiar action of that part will be lost, but the whole body preserved thereby; for so we had determined by common consent, that if the pain which afflicted the King would not yield to the prescribed remedies, either to pour inscalding oil, or else to cut the sinew quite asunder. For the late and sad memory of Mistress Courtin dwelling in the street of the holy-Crosse A History. was in our minds, who of a vein not well opened in her arm fell into a Gangraene and total mortification of that whole part, of which she died, because she was not dressed with the formerly mentioned medicines. Yet we must abstain from these too powerful remedies, when the pricked nerve shall lie bare, for else the pain would be increased, and more grievous symptoms follow. Wherefore as I have formerly wished, more mild medicines must be applied, which may dry up the serous humour without biting or acrimonye, as ℞. terebinth. venet. in aq. ros. lotae ℥ ij. boli armen. subtiliter pulverisatis, ʒij. incorporentur simul. Our Balsam also is excellent in this case, and this of Vigoes which follows. ℞. olei. rosar. omphacini ℥ jss. olei de terebinth. ʒiij. succiplaniag. ℥ ss. semin. hypericonis aliquantulii contriti. m. ss. tutiaepraepar. ʒiij. calcis decies lotae cum aqua plantagin. ʒij. antimonij An anodyne and Sarcotick Balsam. ʒi. anʒv. vermium terrestrium cum vino lotorum ℥ jss. bulliant omnia simul dempta tutia in cyatho decoctionis hordei, ad comsumptionem aquae & vini, colentur, rursumque igni admoveantur, addendo tutiam, & fiat linimentum cum cera alba, & ʒss. croci. This lineament assuages pains, and covers the bared nerves with flesh. This cure of punctured nerves, may with choice and judgement and observing the proportion of the parts be transferred to the pricked Tendons and membranes. But take this as a general and common rule, that all nervous bodies how soever hurt, are A general rule for all wounds of all Nervous parts. to be comforted by anointing them with hot oils, such as the oils of Bays, Lilies, of Worms, Sage, or some other such like remedy being applied to their originals and more notable passages; as to the original of the spinal marrow, the armpits and groins. Neither do I think it fit in this place to omit an affect which sometimes happens to the large Tendon of the heel, of which we formerly made mention. For it oft times is rend or torn by a small occasion without any sign of injury or solution of continuity apparent on the outside as by a little jump, the slipping aside of the foot, the too nimble getting on horseback, or the slipping of the foot out of the stirrup in mounting into the sadlde. When this chance happens it will give a crack like a Coachman's whip; above the heel, where the tendon is broken, the depressed cavity may be felt with your finger, there is great pain in the part, & the party is not able to go. This mischance may be amended by long lying and resting in bed, and repelling medicines applied to the part affected in the beginning of the disease, for fear of more grievous symptoms; & then applying the Black plaster, or Diacalcitheos' or some other such, as need shall require; neither must we hereupon promise to ourselves or the patient certain or absolute health. But on the contrary at the beginning of the disease we must foretell, that it will never be so cured but that some relics may remain, as the depression of the part affected and depravation of the action and going; for the ends of this broken or relaxed Tendon by reason of its thickness and contumacy cannot easily be adjoined, nor being adjoined, united. CHAP. XXXIX. Of the wounds of the joints. BEcause the wounds of the joints have something proper and peculiar to Why wounds of the joints are malignant. themselves, besides the common nature of wounds of the Nerves, therefore I intent to treat of them in particular. Indeed they are always very dangerous, and for the most part deadly, by reason of the nervous productions and membranous Tendons wherewith they are bound and engirt, and into which the Nerves are inserted: whereby it comes to pass, that the exquisite sense of such like parts will easily bring malign symptoms, especially if the wound possess an internal, or as they term it, a domestic part of them; as for example, the armpits, the bending of the arm, the inner part of the wrist, and ham, by reason of the notable Veins, Arteries and Nerves of these parts, the loosed continuity of all which brings a great flux of blood, sharp pain and other malignant symptoms, all which we must resist according to their nature and condition, as a flux of blood with things staying bleeding; pain with anodynes. If the wound be large and wide, the severed The cure. parts shall be joined with a future, leaving an orifice in the lower part, by which the quitture may pass forth. This following powder of Vigoes' description must be strewed upon the future. ℞. thuris, sang. draconis, boli armen. terrae sigil. an. ʒij. an.ʒj. fiat pulvis subtilis. And then the joint must be wrapped about with a repercussive medicine composed of the whites of eggs, a little oil of Roses, Bole, Mastich, and barley flower. If it be needful to use a Tent, let it be short and according to the wound thick, lest it cause pain: and moreover let it be anointed with the yolk of an egg, oil of Roses, washed turpenetine and a little saffron. But if the wound be more short and narrow, it shall be dilated, if there be occasion, that so the humour may pass away more freely. You must rest the part, and beware of using cold, relaxing mollifying, humecting, and unctuous medicines, unless peradventure the sharpness of the pain must be mitigated. For on the contrary, astringent and desiccant medicines are good, as this following cataplasm. ℞. furtur, macri, farin. hordei, & fabarum. an. ℥ iiij. florum cham ae. & melil. an m. ss. terebinth. An astringent and drying cataplasm. ℥ iij. mellis communis ℥ ij. ol. myrtini ℥ j oxymelitis, vel oxycrat. vellixivij come. quantum sufficit, fiat cataplasma ad formam pultis. Or you may compose one of the Lees of wine, Wheat bran, the powder of Oaken bark, cypressenuts, galls and Turpentine and such like, that have an astringent, strengthening and drying quality, and thereby asswaging pain, and hindering the defluxion of humours. This following medicine is astringent and agglutinative. ℞. Terebinth. venet. ℥ ij. aq. vitaeparum, pulveris mastic. aloes, myrrhae, boli armen. an. ℈ ij. And also our balsam will be good in this case, if so be that, you add hereto so much powder which dries without acrimony as occasion shall serve. I admonished you before to take heed of cold, and now again; for it is hurtful to all wounds and ulcers, but especially to these of the nervous parts; hence it is that many dye of small wounds in the winter, who might recover of the same wounds though greater in the Summer. For cold according to Hypocrates is nipping to ulcers, hardens the skin, Aphor. 20. sect. 5. and hinders them from suppuration, extinguisheth natural heat, causes blackness, cold aguish fits, convulsions and distentions. Now divers excrements are cast forth of wounds of the joints, but chiefly albugineous, that is, resembling the white of an egg, and mucous, and sometime a very thin water, all which favour of the nature What matter usually flows from wounds of the joints. of that humour which nourisheth these parts. For to every part there is appropriate for his nourishment and conservation, a peculiar Balsam, which by the wound flows out of the same part, as out of the branches of the Vine. when they are pruned, their radical moisture or juice flows; whence also a Callus. proceeds in broken bones. Now this same mucous and albugineous humour, slow and as it were frozen flowing from the wounded joints, shows the cold distemper of the parts, which causes pain, not to be o'ercome by medicines only potentially hot. Wherefore to correct that, we must apply things actually hot, as beasts and swine's bladders half full of a discussing decoction, or hot bricks quenched in wine. Such actual heat helps nature to concoct and discuss the superfluous humour impact in the joints, and strengthens them; both which are very necessary, because the natural heat of the Why things actually hot must be applied to the wounded joints. Of the site and posture of wounded joints. joints is so insirme that it can scarce actuate the medicine unless it be helped with medicines actually hot. Neither must the Chirurgeon have the least care of the figure and posture of the part, for a vicious posture increases ill symptoms, uses to bring to the very part though the wound be cured, distortion, numbness, incurable contraction; which fault lest he should run into, let him observe what I shall now say; If the forepart of the shoulder be wounded, a great bolster must be under the armepit, and you must carry your arm in a scarf, so that it may bear up the lower part of the arm, that so the top of the shoulder may be elevated some what higher, and that so it may be thereby more speedily and happily agglutinated and consolidated. If the lower part be wounded, when flesh begins to be generated and the lips of the wound to meet, you must bid the patient to move and stir his arms divers ways ever and anon, for if that be omitted or negligently done, when it is cicatrized then it will be more stiff and less pliable to every motion; and yet there is a further danger lest the arm should totally lose its motion. If the wound be upon the joint of the elbow, the arm shall be placed and swathed in a middle posture, that is, which neither too straight bows it, nor holds it too stiffly out; for otherwise when it is cicatrized, there will be an impediment either in the contraction or extension. When the wound is in the wrist, or joints of the fingers either externally or internally, the hand must be kept half shut, continually moving a ball therein. For if the fingers be held strait stretched forth, after it is cicatrized, they will be unapt to take up or hold any thing, which is their proper faculty. But if after it is healed, it remain half shut, no great inconvenience will follow thereon; for so he may use his hand divers ways to his sword, pike, bridle and in any thing else. If the joints of the Hip be wounded, you must so place the patient that the thigh bone may be kept in the cavity of the hucklebone, & may not part a hair's breadth therefrom, which shall be done with linen bolsters and ligatures applied as is fitting, and lying full upon his back. When the wound shall begin to cicatrise, the patient shall use to move his thigh every way, lest the head of the Thighbone stick in the cavity of the hucklebone without motion. In a wound of the knee, the leg must be placed strait out, if the patient desire not to be lame. When the joints of the feet and toes are wounded, these parts shall neither be bended in nor out, for otherwise he will not be able to go. To conclude, the site of the foot and leg, is quite contrary to that of the arm and hand. CHAP. XL. Of the wounds of the Ligaments. THe wounds of the Ligaments, besides the common manner of curing these Ligaments more dry than Nerves, and without sense. of the Nerves, have nothing peculiar, but that they require more powerful medicines, for their agglutination, desiccation and consolidating; both because the ligamental parts are harder, and dryer, and also for that they are void of sense. Therefore the foresaid cure of Nerves and joints may be used for these wounds: for the medicines in both are of the same kind, but here they ought to be stronger and more powerfully drying. The Theory and cure of all the symptoms which shall happen thereupon have been expressed in the Chapter of curing the wounds of the nervous parts, so that here we shall need to speak nothing of them, for there you may find as much as you will. Wherefore here let us make an end of wounds, and give thanks to God the author and giver of all good for the happy process of our labours, and let us pray that, that which remains may be brought to a happy end, and secure for the health and safety of good people. The end of the tenth Book. OF WOUNDS MADE BY GUN SHOT, OTHER FIERY ENGEINES, AND ALL SORTS OF WEAPONS. THE ELEVENTH BOOK. The Preface. I Have thought good here to premise my opinion of the original, increase, and hurt of fiery Engines, for that, I hope it will be an ornament and grace to this my whole treatise: as also to entice my Reader, as it were with these junkets, to our following Banquet so much savouring of Gunpowder. For thus it shall be known to all whence Guns had their original, and how many habits and shapes they have acquired from poor and obscure beginnings; and lastly how hurtful to mankind the use of them is. Polydore Virgil writes that a German of obscure birth and condition was the inventor Lib. 2. inventor 〈◊〉. of this new engine which we term a Gun, being induced thereto by this occasion. He kept in a mortar covered with a tile, or slate, for some other certain uses a powder (which since that time for its chief and new known faculty, is named Gunpowder.) Now it chanced as he struck fire with a steel and flint, a spark thereof by accident fell into the mortar, where upon the powder suddenly catching fire, casts the stone or tile which covered the mortar, up on high; he stood amazed at the novelty and strange effect of the thing, and withal observed the formerly unknown faculty of the powder; so that he thought good to make experiment thereof in a small Iron trunk framed for that purpose according to the intention of his mind. When all things were correspondent to his expectation, he first showed the use of his engine to the Venetians, when they warred with the Genoveses about Fossa Clodia, in the year of our Lord 1380. Yet in the opinion of Peter Messias, their invention must have been of greater antiquity; for it is read in the Chronicles of Cap. 8. prim. par. ●ar. lect. Alphónsus the eleaventh King of Castille, who subdued the Isles Argezires, that when he besieged the chief Town in the year of our Lord 1343. the besieged moors shot as it were thunder against the assailants, out of Iron mortars. But we have read in the Chronicles written by Peter Bishop of Leon's, of that Alphonsus who conquered Toledo, that in a certain sea fight fought by the King of Tunis, against the Moorish King of Seville, whose part King Alphonsus favoured, the Tunetans cast lightning out of certain hollow Engines or Trunks with much noise. Which could be no other, than our Guns, though not attained to that perfection of art and execution which they now have. I think the deviser of this deadly Engine hath this for his recompense, that his name should be hidden by the darkness of perpetual ignorance, as not meriting for this his most pernicious invention, any mention from posterity. Yet Andrew Thevet in his Cosmography published some few years agone, when he comes to treat of the Suevi, the inhabitants of Germany, brings upon the authority & credit of a certain old Manuscript, that the German the inventor of this warlike Engine was by profession a monk and Philosopher or Alchemist, borne at Friburge, Who the inventor of Guns. and named Constantine Anclzen. Howsoever it was, this kind of Engine was called Bombarda (ay) a Gun, from that noise it makes, which the greeks and Latins according to the sound call Bombus: then in the following ages, time, art and man's maliciousness The reason of the name. added much to this rude and unpolisht invention. For first for the matter, Brass and Copper, metals far more tractable, fusible and less subject to rust, came as supplies to Iron. Then for the form, that rude and undigested barrel, or mortar-like mass, hath undergone many forms and fashions, even so far as it is gotten upon wheels, that so it might run not only from the higher ground, but also with more rapide violence to the ruin of mankind; when as the first and rude mortars seemed not to be so nimbly traversed, nor sufficiently cruel for our destruction by the only casting forth of Iron & fire. Hence sprung these horrible monsters of Canons, double Canons, Bastards, Musquits, field pieces; hence these cruel and furious beasts, Culverines, Serpentines, Basilisques, Sackers, Falcons, Falconets, and divers other names not only drawn from their figure and making, but also from the effects of their cruelty. Wherefore certainly I cannot sufficiently admire the wisdom of our Ancestors, who have so rightly accommodated them with names agreeable to their natures; as those who have not only taken them from the swiftest birds of prey, as Falcons; but also from things most harmful and hateful to mankind, such as Serpents, Snakes, and Basilisks. That so we might clearly discern, that these engines were made for no other purpose, nor with other intent, but only to be employed for the speedy and cruel slaughter of men; and that by only hearing them named we might detest and abhor them, as pernicious enemies of our lives. I let pass other engines of this offspring, being for their quantity small, but so much the more pernicious and harmful, for that they nearer assail our lives, and may traitorously and forthwith seize upon us not thinking nor fearing any such thing; so that we can scarce have any means of escape; such are Pistols and other small handguns, which for shortness you may carry in your pocket, and so privily The danger of Pistols. and suddenly taking them forth oppress the careless and secure. Fowling pieces which men usually carry upon their shoulders, are of the middle rank of these engines, as also Muskets and Caleevers, which you cannot well discharge unless lying upon a Rest, which therefore may be called Breast-guns for that they are not laid to the cheek, but against the Breast by reason of their weight and shortness; All which have been invented for the commodity of footmen, and light horsemen. This middle sort of engine we call in Latin by a general name Sclopus, in imitation of the sound, and the Italians who term it Sclopetere; the French call it Harquebuse, a word likewise borrowed from the Italians, by reason of the touchhole by which you give fire to the piece, for the Italians call a hole Buzio. It is termed, Arcus (ay) a Bow, for that at this present it holds the same place in martial affairs, as the Bow did of old; and as the Archers formerly, so at this day the Musquetiers are placed in front. From the same wretched shop and magazine of cruelty, are all sorts of Mines, Countermines, pots of fire, trains, fiery Arrows, Lances, Crossbows, barrels, balls of fire, burning faggots, Granats, and all such fiery engines and Inventions, which closely stuffed with fuel and matter for fire, and cast by the defendants upon the bodies and Tents of the assailants, easily take fire by the violence of their motion. Certainly a most miserable and pernicious kind of invention, whereby we often see a thousand of heedless men blown up with a mine by the force of gunpowder; otherwhiles in the very heat of the conflict you may see the stoutest soldiers seized upon with some of these fiery Engines, to burn in their harness, no waters being sufficiently powerful to restrain and quench the raging and wasting violence of such fire cruelly spreading over the body and bowels. So it was not sufficient to have arms, Iron and fire to man's destruction, unless also that the stroke might be more speedy, we had furnished them, as it were with wings, so to fly more hastily to our own perdition, furnishing sithe-bearing death with wings so more speedily to oppress man, for whose preservation, all things contained in the world were created by God. Verily when I consider with myself all the sorts of warlike Engines, which the ancients used, whether in the field in set battles, as Bows, Darts, Crossbows, A comparison of the ancient weapons with the modern. Slings; or in the assault of Cities, and shaking or overturning their walls, as Rams, Horses, wooden towers, slings and such like; they seem to me certain childish sports and games made only in imitation of the former. For these modern inventions are such as easily exceed all the best appointed and cruel Engines which can be mentioned or thought upon, in the shape, cruelty and appearance of their operations. For what in the world is thought more horrid or fearful than thunder and lightning? and yet the hurtfulness of thunder is almost nothing to the cruelty of these infernal Engines; which may easily appear by comparing together both their effects. Man alone of all creatures is not always killed by being touched Plin. Lib. 2. Cap. 54. with thunder; but it immediately killeth all other things which are subject to be touched therewith. Nature bestowing this honour upon him, seeing so many creatures exceed him in strength: For all things lie contrary to man; and man, unless he be overthrown with it, doth not dye thereof. But these fire-spitting Engines do no more spare man, than they do other creatures, and kill without difference from whence soever they come, whither soever they are carried, and howsoever they touch. There are many, but more are said to be the remedies against thunder; for beside the charms whereby Plin. Lib. 2. Cap. 55. the ancient Romans did suppose they might be driven away, they never penetrate deeper into ground than five foot, therefore such as were fearful thought the deeper Caves most safe. Of those things which grow out of the earth they do not touch the Bay tree, and that was the cause that it was counted a sign of victory both in ancient and modern times. Wherefore Tiberius Caesar otherwise a contemner S●●ton, in Tiberio. of God and religion, as he who endued with the Mathematical sciences thought all things governed by fate, yet because he exceedingly feared thunder, he always carried a Laurel wreath about his neck when the air was troubled, for that this kind of leaf is reported not to be touched by thunder. Some report that he made him tents or Seals skins, because it toucheth not this kind of creature of all these things that live in the Sea, as neither the Eagle amongst birds, which for that is feigned to be joves' squire. But on the contrary, charms, the victorious Bay, the Seal or Sea-calf, the Eagle or any such thing profits nothing against the violence The wondrous force of great Ordinance. of these fiery Engines: no not a wall of ten foot thick will advantage. Lastly, this argues the immense violence of brazen Cannons above thunder, for that thunder may be dispersed and driven away with the noise and ringing of Bells, the sounding of Trumpets, the tinkling of brazen kettles, yea also by the shooting of such great Ordinance; to wit, the clouds, by whose collision and fight the Thunder is caused, being dispersed by this violent agitation of the air, or else driven further to more remote parts of the skies. But their fury once provoked, is stayed by no opposition, appeased by no remedy. As there are certain seasons of the year, so also there are certain Regions of the earth, wherein Thunder is seldom or never heard. Thunders are rare in Winter and Summer, and that for contrary causes; for that in Winter the dense air is thickened with a thicker coat of clouds, and the frosty and cold exhalation of the earth extinguisheth what fiery vapours soever it receives; which thing keeps Scythia and the cold countries about it free from Thunder. And on the contrary, too much heat preserves Egypt. For hot and dry exhalations Plin. Lib. 21 Cap. 50. of the earth are condensed into very thin, subtle and weak clouds. But as the invention, so also the harm and tempest of great Ordinance, like a contagious pestilence is spread and rages over all the earth, and the skies at all times sound again with their reports. The Thunder and Lightning commonly gives but one blow, or stroke, and that commonly strikes but one man of a multitude; But one great Cannon at one shot may spoil and kill an hundred men. Thunder, as a thing natural falls by chance, one while upon an high oak, another while upon the top of a mountain, and some while on some lofty tower, but seldom upon man. But this hellish Engine tempered by the malice and guidance of man, assails man only, and takes him for his only mark, and directs his bullets against him. The Thunder by its noise as a messenger sent before, foretells the storm at hand; but, which is the chief mischief, this infernal Engine roars as it strikes, and strikes as it roars, sending at one and the same time the deadly bullet into the breast, and the horrible noise into the ear. Wherefore we all of us rightfully curse the author of so pernicious an Engine; on the contrary praise those to the skies, who endeavour by words and pious exhortations to dehort Kings from their use, or else labour by writing and operation to apply fit medicines to wounds made by these Engines. Which hath moved me, that I have written hereof almost with the first of the French. But before I shall do this, it seemeth not amiss, so to facilitate the way to the treatise I intent to write of wounds made by Gunshot, to premise two Discourses, by which I may confute and take away certain erroneous opinions which have possessed the minds of divers; for that unless these be taken away, the essence and nature of the whole disease cannot be understood, nor a fitting remedy applied by him which is ignorant of the disease. The first Discourse which is dedicated to the Reader, refells and condemns by The arguments of the following discourses. reasons and examples the method of curing prescribed by john de Vigo, whereby he cauterizes the wounds made by Gunshot, supposing them venenate; and on the contrary proves that order of curing with is performed by suppuratives, to be so salutary and gentle, as that prescribed by Vigo is full of error and cruelty. The second dedicated to the King, teaches that the same wounds, are of themselves void of all poison, and therefore that all their malignity depends upon the fault of the air, and ill humours predominant in the bodies of the patients. THE FIRST DISCOURSE, WHEREIN WOUNDS MADE BY GUNSHOT, ARE FREED FROM BEING BURNED, OR CAUTERISED ACCORding to Vigoes' Method. IN the year of our Lord 1536. Francis the French King, for his acts in war and peace styled the Great, sent a puissant Army beyond the Alpes, under the government and leading of Annas of Mommorancie high Constable of France, both that he might relieve Turin with victuals, soldiers, and all things needful, as also to recover the Cities of that Province taken by the Marquis of Guast General of the Emperor's forces. I was in the King's Army the Chirurgeon of Monsieur of Montejan General of the foot. The Imperialists had taken the straits of Suze, the Castle of Villain, and all the other passages; so that the King's army was not able to drive them from their fortifications but by fight. In this conflict there were many wounded on both sides with all sorts of weapons, but chiefly with bullets. I will tell the truth, I was not very expert at that time in matters of Chirurgery; neither was I used to dress wounds made by Gunshot. Now I had read in john de Vigo that wounds made by Gunshot were venenate or poisoned, and that Lib. 1. de ●… ner. Cap. 8. by reason of the Gunpowder; Wherefore for their cure, it was expedient to burn or cauterise them with oil of Elders scalding hot, with a little Treacle mixed therewith. But for that I gave no great credit neither to the author, nor remedy, because I knew that cau sticks could not be poured into wounds, without excessive pain; I, before I would run a hazard, determined to see whether the Surgeons, who went with me in the army, used any other manner of dressing to these wounds. I observed and saw that all of them used that Method of dressing which Vigo prescribes; and that they filled as full as they could, the wounds made by Gun-shot with Tents and pledgets dipped in this scalding Oil, at the first dress; which encouraged me to do the like to those, who came to be dressed of me. It chanced What chance may do in finding out of remedies. on a time, that by reason of the multitude that were hurt, I wanted this Oil. Now because there were some few left to be dressed, I was forced, that I might seem to want nothing, and that I might not leave the ●… undressed, to apply a digestive made of the yolk of an egg, oil of Roses, and Turpentine. I could not sleep all that night, for I was troubled in mind, and the dressing of the precedent day, (which I judged unfit) troubled my thoughts; and I feared that the next day I should find them dead, or at the point of death by the poison of the wound, whom I had not dressed with the scalding oil. Therefore I rose early in the morning, I visited my patients, and beyond expectation, I found such as I had dressed with a digestive only, free from vehemency of pain to have had gooodrest, and that their wounds were not inflamed, nor tumifyed; but on the contrary the others that were burnt with the scalding oil were feverish, tormented with much pain, and the parts about their wounds were swollen. When I had many times tried this in divers others, I thought thus much, that neither I nor any other should ever cauterise any wounded with Gun-shot. When we first came to Turin, there was there a Chirurgeon far more famous than all the rest in artificially and happily curing wounds made by Gun shot; wherefore I laboured with all diligence for two years' time to gain his favour and love, that so at the length, I might learn of him, what kind of Medicine that was, which he honoured with the glorious tittle of Balsam, which was so highly esteemed by him, and so happy and successful to his patients; yet could I not obtain it. It fell out a small while after that the Marshal of Montejan the King's Lieutenant, General there in Piedmont died, wherefore I went unto my Chirurgeon, and told him that I could take no pleasure in living there, the favourer and Macenas of my studies being taken away; and that I intended forthwith to return to Paris, and that it would neither hinder, nor discredit him to teach his remedy to me, who should be so far remote from him. When he heard this, he made no delay, but presently wished me to provide two Whelps, I pound of earthworms, The description of oil of Whelps. 2 pounds of oil of Lillies, six ounces of Venice Turpentine, and one ounce of aqua vitae. In my presence he boiled the Whelps put alive into that oil, until the flesh came from the bones, then presently he put in the Worms, which he had first killed in white wine, that they might so be cleused from the earthy dross wherewith they are usually replete, and then he boiled them in the same oil so long, till they became dry, and had spent all their juice therein: then he strained it through a towel without much pressing; and added the Turpentine to it, and lastly the aqua vitae. Calling God to witness, that he had no other Balsam, wherewith to cure wounds made with Gunshot, and bring them to suppuration. Thus he sent me away as rewarded with a most precious gift, requesting me to keep it as a great secret, and not to reveal it to any. When I came to Paris, I went to visit Silvius the King's professor of Physic well known by name to all scholars for his great learning; he kept me long that so I might dine with him, and diligently inquires of me, if I had observed any new Method of curing wounds made by Gun-shot, and combustions occasioned by Gunpowder. Then I affirmed to him that Gunpowder did not participate any thing of Gunpowder not poisonous. poison, for that none of these things, whereof it is compounded are poisonous; which reason ought to free the whole composition from suspicion of poison. And that experience confirmed this reason, for I had seen many soldiers, who would drink a great quantity of this powder with wine, because they were persuaded, that this drink would free them from malign symptoms when they were wounded, yet I give no credit to this persuasion; and lastly for that many without any harm, strew this powder upon rebellious ulcers. For the Bullets, I affirm, that they cannot conceive such heat, as to become caustic. For if you shoot them out of a Gun against a hard stone, yet you may presently take them up without any Bullets shot out of a Gun do not burn. harm in your hands, though by striking upon the stone, they should become more hot. For the combustions caused by Gunpowder, I observed no special nor peculiar remedy, which might make their cure different from other combustions. To which purpose I related this ensuing history. One of the Marshal of Montejan his Kitchen boys, fell by chance into a Cauldron of Oil being even almost boiling hot; I being called to dress him, went A History. to the next Apothecaries to fetch refrigerating medicines commonly used in this case: there was present by chance a certain old country woman, who hearing that I desired medicines for a burn, persuaded me at the first dressing, that I should lay to raw Onions beaten with a little salt; for so I should hinder the breaking out of blisters or pustules, as she had found by certain and frequent experience. Wherefore I thought good to try the force of her Medicine upon A medicine hindering blistering in burns, or scalds. this greasy scullion. I the next day found those places of his body whereto the Onions lay, to be free from blisters, but the other parts which they had not touched, to be all blistered. It fell out a while after, that a Germane of Montejan his guard had his flasque full of Gunpowder set on fire, whereby his hands and face were grievously burnt: I A History. being called, laid the Onions beaten as I formerly told you, to the middle of his face, and to the rest I laid medicines usually applied to burns. At the second dressing I observed the part dressed with the Onions quite free from blisters and excoriation, the other being troubled with both; whereby I gave credit to the Medicine. Besides also, I lastly told him this, that I had observed, that that was the readiest to draw forth bullets shot into the body, which sets the patients in the same posture and site, as he was when he received his hurt. Which things when I had told him, together with many other handled at large in this work, the good old man requested me to publish in print my opinions concerning these things, that so the erroneous and hurtful opinion of Vigo might be taken out of men's minds. To whose earnest entreaty when I had assented, I first of all caused to be drawn and carved many Instruments fit to draw forth Bullets and other strange bodies; then a short while after I first published this work in the year of our Lord 1545. which when I found to be well liked and approved by many, I thought good to set it forth the second time somewhat amended in the year 1552. And the third time augmented in many particulars in the year 1564. For I having followed many wars, and detained as Chirurgeon in besieged Cities, as Mets and Hesdin, had observed many things under five Kings, whom I served with diligence and content. I had learned many things from most expert Surgeons, but more from all learned Physicians, whose familiarity and favour for that purpose I always laboured to acquire with all diligence and honest Arts; that so I might become more learned and skilful by their familiarity and discourse, if there was any thing especially in this matter and kind of wounds, which was hid from me, or whereof I was not well assured. Of which number I have known Wounds made by Gunshot must be dressed with suppuratives. very few, who any thing seen in this kind of operation either by study, or experience in Wars, who have not thought that wounds made by Gunshot ought to be dressed at the first with suppurative medicines, and not with scalding and caustic Oil. For this I affirm, which then also I testified to this good man, that I have found very many wounds made in the fleshy parts by Gunshot, as easily cured as other wounds, which be made by contusing things. But in the parts of the The causes of difficulty in this cure. body where the bullet meets with bones and nervous particles, both because it tears and rents into small pieces those things which resist, not only where it touches, but further also, through the violence of the blow, therefore it causeth many and grievous symptoms, which are stubborn and difficult, and oft times impossible to cure, especially in bodies replete with ill humours, in an ill constitution of the heaven and air, such as is hot, moist and foggy weather, which therefore is subject to putrefaction; and in like manner a freezing and cold season, which uses to mortify the wounded parts not only of those that are hurt with Bullets, but in like sort with any other weapon; nor only in bony and nervous particles, but also in musculous. Whereby you may understand, that the difficulty of curing proceeds not from the venenate quality of the wounds, nor the combustion made by the Gunpowder, but the foulness of the patient's bodies, and the unseasonableness of the air. For proof whereof, I will set down, that which I not long agone observed in a A History. Scottish Nobleman the Earl of Gordon, Lord of Achindon, whom I cured at the appointment of the Queen Mother. He was shot through both his thighs with a Pistoil, the bone being not hurt nor touched; and yet the 32. day after the wound he was perfectly healed, so that he had neither fever nor any other symptom which came upon the wound. Whereof there are worthy witnesses, the Archbishop of Glasco, the Scottish Ambassador, Francis Brigart and john Altine, Doctors of Physic, as also james Guillemeau the King's Chirurgeon, and Giles Buzet a Scottish Chirurgeon, who all of them wondered that this Gentleman was so soon healed, no acride medicine being applied. This I have thought good to recite and set down, that the Readers may understand, that I for 30. years ago had found the way to cure wounds made by Gunshot, without scalding oil or any other, more acrid medicine; unless by accident the illness of the patient's bodies and of the air caused What makes Surgeons sometimes use cau●… curing wound● made by Gunshot. any malign symptoms, which might require such remedies besides the regular and ordinary way of curing, which shall be more amply treated of in the following discourse. ANOTHER DISCOURSE OF THESE THINGS, WHICH KING CHARLES' THE NINTH, REturning from the expedition and taking of Rouën, enquired of me concerning wounds made by Gunshot. FOr that it pleased your Majesty one day, together with the The occasion of writing this discourse. Queen Mother, the Prince of the Rock upon Yon, and many other Noblemen and Gentlemen, to inquire of me, what was the cause that the far greater part of the Gentlemen and common Soldiers which were wounded with Guns, and other warlike Engines, all remedies used in vain, either died, or scarce and that with much difficulty recovered of their hurts, though in appearance they were not very great, and though the Surgeons diligently performed all things requisite in their Art; I have made bold to premise this Discourse to that Tractate which I determine to publish concerning wounds made by Gunshot; both to satisfy the desires of the Princes and of many Gentlemen, as also the expectation they have of me, as being the King's chief Chirurgeon, (which place being given me by Henry the second, Charles' the ninth, a son most worthy of such a father, had confirmed) neither make I any question, but that many who too much insist upon their own judgement, and not throughly consider the things themselves, will marvel, and think it far from reason; that I departing from the steps of my ancestors, and dissenting wholly from the formerly received opinions, am far The argument of this discourse. from their Tenants, who lay the cause of the malignity of wounds made by Gun-shot, upon the poison brought into the body by the Gunpowder, or mixed with the Bullets whilst they are tempered or cast. Yet for all this, if they will courteously and patiently weigh my reasons, they shall either think as I do, or at least shall judge this my endeavour and pains taken for the public good, not to be condemned nor contemned. For I shall make it evident by most strong reasons drawn out of the writings of the Ancient both Philosophers and Physicians, and also by certain experiments of mine own, and other Surgeons, that the malignity and contumacy which we frequently meet withal in curing wounds made by Gunshot, is not to be attributed either to the poison carried into the body by the Gunpowder or Bullet, nor to burning imprinted in the wounded part by the Gunpowder. Wherefore to come to our purpose, that opinion must first be confuted, which accuseth wounds made by Gunshot of poison; and we must teach, that there is neither Gunpowder is not poison nous. any venenate substance, nor quality in Gunpowder, neither if there should be any, could it empoison the bodies of such as are wounded. Which that we may the more easily perform, we must examine the composition of such powder, and make a particular enquiry of each of the simples, whereof this composition consists, what essence they have, what strength and faculties, and lastly what effects they may produce. For thus by knowing the simples, the whole nature of the composition consisting of them, will be apparently manifest. Of what it is made. The simples which enter the composition of Gunpowder are only three, Charcoals of Sallow or Willow, or of Hemp stalks, Brimstone, and salt Peter, and sometimes a little aqua vitae. You shall find each of these, if considered in particular, void of all poison and venenate quality. For first, in the Charcoal you shall observe nothing but dryness, and a certain subtlety of substance, by means whereof it fires so suddenly, even as Tinder. Sulphur or Brimstone is hot and dry, but not in the highest degree, it is of an oily and viscide substance, yet so that it doth not so speedily catch fire as the coal, though it retain it longer being once kindled, neither may it be so speedily extinguished. Salt Peter is such, that many use it for Salt, whereby it is evidently apparent that the nature of such simples is absolutely free from all poison; but chiefly the Brimstone, (which notwithstanding is more Lib. 5. Cap. 73. Lib. 9 simple. Cap 36. suspected than the rest.) For Dioscorides gives Brimstone to be drunk, or supped out of a rear Egg to such as are Asthmaticke, troubled with the Cough, (spit up purulent matter, and are troubled with the yellow jaundice.) But Galen applies it outwardly to such as are bitten by venomous Beasts, to scabs, teaters, and leprosyes. For the aqua vitae, it is of so tenuious a substance that it presently vanisheth into air, and also very many drink it, and it is without any harm used in frictions of the exterior parts of the body. Whence you may gather, that this powder is free from all manner of poison, seeing these things whereof it consists and is composed, want all suspicion thereof. Therefore the german horsemen, when they are wounded with shot, fear not to drink off cheerfully half an ounce of Gunpowder dissolved in wine; hence persuading themselves freed from such malign symptoms as usually happen upon such wounds; wherein whether they do right or wrong I do not here determine; the same thing many French Soldiers forced by no necessity, but only to show themselves more courageous, also do without any harm; but divers with good success use to strew it upon ulcers, so to dry them. Now to come to these, who think that the venenate quality of wounds made by Gun-shot, springs not from the powder, but from the Bullet wherewith some poison Bullets cannot be poisoned. hath been commixed or joined, or which hath been tempered or steeped in some poisonous liquor. This may sufficiently serve for a reply; that the fire is abundantly powerful to dissipate all the strength of the Poison, if any should be poured upon or added to the Bullet. This much confirms mine opinion, which every one knows; The Bullets which the King's soldiers used to shoot against the Townsemen in the siege of Rovenn, were free from all poison; and yet for all that they of the Town thought that they were all poisoned, when they found the wounds made by them, to be uncurable and deadly. Now on the other side the Townsemen were falsely suspected guilty of the same crime by the King's Army, when as they perceived all the Surgeons labour in curing the wounds made by the Bullets shot from Rouën, to be frustrated by their contumacy and malign nature; each side judging of the magnitude and malignity of the cause from the unhappy success of the effect in curing. Even as amongst Physicians according to Hypocrates, all diseases are termed As Galen notes adsent, 20. et 21. sect. 3. lib. 3. Epid. pestilent, which arising from whatsoever common cause, kill many people; so also wounds made by Gunshot, may in some respect be called pestilent, for that they are more refractory, and difficult to cure than others, and not because they partake of any poisonous quality, but by default of some common cause, as the ill complexions of the patients, the infection of the air, and the corruption of meats and drinks. For by these causes wounds acquire an evil nature and become less yielding to medicines. Now we have by these reasons convinced of error that opinion which held wounds made by Gunshot for poisonous; let us now come to overthrow that which is held concerning their combustion. First it can scarce be understood how bullets which are commonly made of Lead, Wounds made by Gunshot are not burnt can attain to such heat, but that they must be melted; and yet they are so far from melting, that being shot out of a Musket they will pierce through an armour and the whole body besides, yet remain whole, or but a little diminished. Besides also if you shoot them against a stone wall, you may presently take them up in your hand without any harm, and also without any manifest sense of heat; though their heat by the striking upon the stone should be rather increased, if they had any. Furthermore, a Bullet shot into a barrel of Gunpowder, would presently set it all on fire, if the Bullet should acquire such heat by the shooting, but it is not so. For if at any time the powder be fired by such an accident, we must not imagine that it is done by the bullet bringing fire with it, but by the striking and collision thereof against some Iron, or stone that opposes or meets therewith, whence sparks of fire proceeding as from a flint, the powder is fired in a moment. The like opinion we have of thatched houses, for they are not fired by the bullet which is shot, but rather by some other thing as linen rags, brown paper, and the like, which rogues and wicked persons fasten to their Bullets. There is another thing which more confirms me in this opinion, which is; take a bullet of Wax, and keep it from the fire, for otherwise it would melt, and shoot it against an inch board, and it will go through it; whereby you may understand that Bullets cannot become so hot by shooting, to burn like a cautery. But the Orifices The reason why wounds made by Gun-shot look black. (may some say) of such wounds are always black. This indeed is true, but it is not from the effect of heat brought thither by the Bullet, but the force of the contusion. Now the contusion is exceeding great, both because the Bullet is round, and enters the body with incredible violence. Of which those that are wounded will give you sufficient testimony, for there is none of them, which thinks not presently upon the blow, that as it were some post, or thing of the like weight, falls upon the affected member, whence great pain and stupidity possess the part, whereby the native hair and spirits are so much dissipated, that a Gangreen may follow. But for the Eschar which they affirm is made by the blow, and falls away afterwards, they are much mistaken. For certain particles of the membranes and flesh contused and torn by the violence of the Bullet beguiles them; which presently putrifying are severed from the sound parts by the power of nature and the separating heat, which thing usually happens in all great Contusions. But for all that these so many and weighty reasons may free the Powder from all suspicion of Poison, and the Bullet from all, thought of burning; yet there are many who insisting upon Philosophical arguments, raise new stirs. For (say they) the discharging a piece of Ordinance is absolutely like Thunder and Lightning, which the rent and torn clouds cast from the middle region, upon the earth; wherefore the Iron bullet which is shot out of the Cannon must needs have a venenate and burning faculty. I am not ignorant that Lightnings generated of a gross and viscous exhalation, breaking the cloud wherewith it is encompassed, The reasons of our adversaries refelled. never falls upon the earth, but brings fire with it, one while more subtle, another while more gross, according to the various condition of the matter whence the exhalation hath arisen. For Seneca writes that there are three several kinds of Lightning Quaest. nat. lib. 2. cap. 49. differing in burning, condition and plenty. One of them penetrates or rather perforates by the tenuity of the matter of the objects which it touches. The other with a violent impetuosity breaks insunder and dissipates the objects, by reason it hath a more dense, compact and forcible matter, like as Whirlwinds have. The third, for that it consists of a more terrestrial matter, burns what it touches, leaving behind it the impression of the burning. Also I know that Lightning is of a pestilent The stinking smell of lightning. and stinking nature, occasioned by the grossness and viscidity of the matter whereof it is; which matter taking fire sends forth so loathsome and odious a smell that the very wilde-beasts cannot endure it; but leave their Dens, if they chance to be touched with such a lightning. Besides also, we have read in the northern history of Olaus Magnus, that in some places after a Lightning, you shall find a whole plain spread over with Brimstone, which Brimstone notwithstanding is extinguished, unprofitable & of no efficacy. But grant these things be thus, yet must we not therefore conclude, that the Bullets of the great Ordinance carry poison and fire with them into the wounds. For though there be many things like in Lightning and discharging great Ordinance, yet they have no similitude either in matter or substance, but only in effects whereby they shake, break insunder and disperse the bodies which withstand them; For Lightning and Thunder do it by means of fire, and oft times of a stone generated in them, which is therefore termed, a Thunderbolt; But Ordinance by the bullet carried by the force of the air, more violently driving and forcing it forwards; Neither if any should by more powerful arguments force me to yield that the matter of Lightning and shooting of Ordinance are like, yet will I not therefore be forced to confess that wounds made by Gunshot are combust. For according to Pliny, there are some Lightnings which Quaest. 2. cap 51. consisting of a most dry matter, do shatter in sunder all that withstands them, but do not burn at all; others which are of somewhat a more humid nature, burn no more than the former, but only black such things as they touch; Lastly othersome of a more subtle and tenuous matter, whose nature (as Seneca saith) we must The wonderful nature of some lightning. not doubt to be divine, if but for this reason, that they will melt gold and silver, not harming the purse; a sword, not hurting the scabbard; the head of a Lance, not burning the wood, and shed wine not breaking the vessel. According to which decree I can grant, that these Lightnings which break in sunder, melt and dissipate, and perform other effects so full of admiration, are like in substance to the shot of great Ordinance; but not these which carry with them fire and flame. In proof whereof there comes into my mind the history of a certain Soldier, out of whose thigh I remember I drew forth a Bullet wrapped in the taffata of his A History. breeches, which had not any sign of tearing or burning. Besides, I have seen many who not wounded, nor so much as touched, yet notwithstanding have with the very report & wind of a Cannon bullet, sliding close by their ears, fallen down for dead, so that their members becoming livid & black, they have died by a Gangrene ensuing thereupon. These and such effects are like the effects of Lightnings which we lately mentioned, and yet they bear no sign nor mark of poison. From whence I dare now boldly conclude, that wounds made by Gunshot are neither poisoned, nor burnt. But seeing the danger of such wounds in these last civil wars hath been so great, universal and deadly to so many worthy personages and valiant Why the wounds made by Gunshot some few years agone were so deadly. men, what then may have been the cause thereof, if it were neither combustion, nor the venenate quality of the wound? This must we therefore now insist upon and somewhat hardily explain. Those who have spent all their time in the learning and searching out the mysteries of Natural Philosophy, would have all men think and believe, that the four Elements have such mutual sympathy, that they may be changed each into other; so that they not only undergo the alterations of the first qualities which are heat, coldness, dryness and moisture, but also the mutation of their proper substances by rarefaction and condensation. For thus the fire is frequently changed into air, the air into water, the water into air, and the water into earth; and on the contrary, the earth into water, the water into air, the air into fire; because these 4. first bodies The cause of the transmutation of the Elements. have in their common matter enjoyed the contrary and fight, yet first and principal qualities of all. Whereof we have an example in the * These bellowes here mentioned by the Author, are Balls made of Brass in form of a pear, with a very small hole in their lesser ends: when you would fill them with water you must heat them very hot, and so the air which is contained in them will be exceedingly rarified, which by putting them presently into water will be condensate as much, and so will draw in the water to supply the place, ne detur Gacuum. The● put them into the fire, and it again rarifying the water into air will make them yield a strong continued and forcible blast. The cause of the report and blow of a Cannon. A History. The cause of an Earthquake. Ball-bellowes brought out of Germany, which are made of brass, hollow and round; and have a very small hole in them, whereby the water is put in, and so put to the fire; the water by the action thereof is rarified into air, and so they send forth wind with a great noise, and blow strongly as soon as they grow throughly hot. You may try the same with Chestnuts, which cast whole and undivided into the fire, presently fly asunder with a great crack; because the watery and innate humidity turned into wind by the force of the fire, forcibly breaks his passage forth. For the air or wind raised from the water by rarifaction, requires a larger place, neither can it now be contained in the narrow films, or skins of the Chestnut, wherein it was formerly kept. Just after the same manner Gunpowder being fired, turns into a far greater proportion of air, according to the truth of that Philosophical proposition, which saith, Of one part of earth, there are made ten of water; of one of water, ten of air; and of one of air are made ten of fire. Now this fire not possible to be ●ent in the narrow space of the piece, wherein the powder was formerly contained, endeavours to force its passage with violence, and so casts forth the Bullet lying in the way, yet so that it presently vanishes into air, and doth not accompany the Bullet to the mark, or object, which it batters, spoils and breaks asunder. Yet the Bullet may drive the obvious air with such violence, that men are often sooner touched therewith than with the bullet, and dye by having their bones shattered and broken without any hurt on the flesh which covers them; which as we formerly noted, it hath common with Lightning. We find the like in Mines, when the powder is once fired, it remooves and shakes even mountains of earth. In the year of our Lord 1562 a quantity of this powder which was not very great, taking fire by accident in the Arsenal of Paris, caused such a tempest, that the whole City shaken therewith, but it quite overturned divers of the neighbouring houses, and shook off the tiles and broke the windows of those which were further off; and to conclude, like a storm of Lightning it laid many here and there for dead, some lost their sight, others their hearing, and othersome had their limbs torn asunder, as if they had been rend with wild horses; and all this was done by the only agitation of the air into which the fired Gunpowder was turned; Just after the same manner as winds penned up in hollow places of the earth which want vents. For in seeking passage forth, they vehemently shake the sides of the Earth, and raging with a great noise about the cavities, they make all the surface thereof to tremble; so that by the various agitation one while up, another down, it overturnes or carries it to another place. For thus we have read that Megara and Aegina anciently most famous Cities of Greece, were swallowed up and quite overturned by an earthquake; I omit the great blusterings of the winds striving in the cavities of the earth, which represent to such as hear them at some distance, the fierce assailing of Cities, the bellowing of Bulls, the horrid roar of Lions, neither are they much unlike to the roaring reports of Cannons. These things being thus premised let us come to the thing we have in hand. Amongst things necessary for life, there is none causes greater changes in us than the air; which is continually drawn into the Bowels appointed by nature, and whether we sleep, wake, or what else soever we do, we continually draw in, and breath it out. Through which occasion Hypocrates calls it Divine, for that breathing through this mundane Orb, it embraces, nourishes, defends and keeps in quiet peace all things contained therein, friendly conspiring with the stars from whom a divine virtue is infused therein. For the air diversely changed and affected by the stars, doth in like manner produce various changes in these lower mundane bodies. And hence it is that Philosophers and Physicians do so seriously wish us to behold and consider the culture and habit of places, and constitution of the air, when they treat of preserving of health, or curing diseases. For in these the great power and dominion of the air is very apparent, as you may gather by the four seasons of the year; for in summer the air being hot and dry, heats and dries our bodies; but in winter it produceth in us the effects of winter's qualities, that is, of cold and moisture; yet by such order and providence of nature, that although according to the varieties of seasons our bodies may be variously altered, yet shall they receive no detriment thereby, if so be that the seasons retain their seasonableness; from whence How the air becomes hurtful. if they happen to digress, they raise and stir up great perturbations both in our bodies and minds; whose malice we can scarce shun, because they encompass us on every hand, and by the law of nature enter together with the air into the secret cabinets of our bodies both by occult and manifest passages. For who is he, that doth not by experience find both for the commodity and discommodity of his health, the various effects of winds, (wherewith the air is commixed) according as they blow from this or that Region, or Quarter of the world. Wherefore seeing that the South wind is hot and moist; the North wind cold and dry; the East wind clear and fresh; the West winde cloudy; it is no doubt but that the air which we draw in by inspiration carries together therewith into the bowels the qualities of that wind which is then prevalent. When we read in Hypocrates, that changes Aphor. 17. sect. 3. of times, whether they happen by different winds, or vicissitude of seasons, chiefly bring diseases; For northerly winds do condense, and strengthen our bodies, and makes them active well coloured and daring, by resuscitating and vigorating the native hear. But southern winds resolve and moisten our bodies, make us heavy headed, dull the hearing, cause giddiness, and make the eyes and body less agile; as the Inhabitants of Narbon find to their great harm, who are otherwise ranked among the most active people of France. But if we would make a comparison of the seasons and constitutions of a year, by Hypocrates decree Droughts are more wholesome and less deadly than rain; I judge for that too much humidity is the mother of putrefaction, as you learn by these countries which are blown upon Flesh quickly putrifies in maritime places. by a wind from Sea: For in these flesh which is kept for food, putrefies in the space of an hour; and such ulcers as in other places are easily and quickly healed, do there by the conflux and collection of matter become inveterate and contumacious. Therefore as when the seasons of the year successively fall out agreeable to their nature, and when each season is seasonable, then either we are not sick at all, or assuredly with less danger. So on the contrary the perfect constitution and health of our bodies becomes worse and decays, when the seasons of the year are depraved and perverted in time and temper. Now seeing that these many years the four seasons of the year have wanted their seasonableness, the summer wanting his usual heat, and the winter its cold, and all things by moisture and the dominion of the southern winds have been humid and languide; I think there is none so ignorant in natural Philosophy and Astrology, who will not think that the causes of the malignity and contumacy of those diseases which have so long afflicted all France, are not to be attributed to the air and Heavens. For otherwise, whence have so many pestilent and contagious diseases tirannized over so many people of every age, sex and condition? whence have so many catarrhs, coughs and heavinesses of the head, so many pleurisies, tumours, small pox, meazells, and Itches not admitting of digestion and remedies prescribed by Art? Whence have we had so many venomous creatures, as Toads, Grasshoppers, Caterpillars, Spiders, Wasps, Hornets, Beetles, Snails, Vipers, Snakes, Lizards, Scorpions and Efts or nuts, unless from excessive putrefaction which the humidity of the air, our native heat being liquid and dull, hath caused in us, and the whole kingdom of France? Hence also proceeds the infirmity of our native heat, and the corruption of the blood and humours whereof we consist, which the rainy Southwind hath caused with its sultry heat. Wherefore in these last years I have drawn little blood, which hath not presently showed the corruption of its substance by the black or greenish colour, as I have diligently observed in all such as I have bled, by the direction of Physicians, either for prevention of future, or cure of present diseases. Whence it comes to pass that the fleshy substance of our bodies could not but be faulty both in temper and consistence; seeing that the blood whence it is generated had drawn the seeds of corruption from the defiled air. Whence it fell out, that the wounds which happened with loss of substance, could be scarce healed or united, because of the depraved nature of the blood. For so the wounds and ulcers of these which are troubled with the Dropsy, whose blood is more cold or wholly waterish; so of Leprous persons, whose blood is In what bodies 〈◊〉 and wounds are not easily cured. corrupt, and lastly of all such as have their bodies replete with ill juice, or else are Cachecticke, will not easily admit of cure. Yea assuredly if but the very part which is hurt swerve from its native temper, the wound will not easily be cured. Therefore seeing all these things, both the putrefaction of the Air, and depraved humours of the body, and also the distemper of the affected parts conspired together to the destruction of the wounded, what marvel was it, if in these late civil wars, the wounds which were for their quantity small, for the condition of the wounded parts but little, have caused so many and grievous accidents and lastly death itself? Especially, seeing that the Air which encompasseth us, tainted with putrefaction corrupts and defiles the wounds by inspiration and expiration, the body and humours being already disposed, or inclined to putrefaction. Now there came such a stink, which is a most assured sign of putresaction, from these wounds when they were dressed, that such as stood by could scarce endure it, neither could this stink be attributed to the want of dressing, or fault of the Chirurgeon; for the wounds of the Princes and Nobility stunk as ill as these of the common Soldiers. And the corruption was such, that if any chanced to be undressed An argument of great putrefaction of the humours. for one day, which sometimes happened amongst such a multitude of wounded persons, the next day the wound would be full of worms. Besides also, which furthermore argues a great putrefaction of humours, many had Abscesses in parts opposite to their wounds, as in the left knee, when as the right shoulder was wounded; in the left arm, when as the right Leg was hurt. Which I remember befell the King of Navarre, the Duke of Nevers, the Lord Rendan and divers others. For all men had nature so overcharged with abundance of vicious humours, that if it expelled not part thereof by impostumes to the habit of the body, it certainly otherwise disposed of it amongst the inner parts of the body; for in dissecting dead bodies, we observed that the Spleen, Liver, Lungs, and other Bowels were purulent, and hence it was that the patients by reason of vapours sent from them to the heart were troubled with continual fevers. But the Liver and all the veinous parts being polluted, and so the generation of the laudable blood hindered, they languished for want of fitting nourishment. But when the Brain by vapours was drawn in to sympathise with the rest, they were molested with Rave and Convulsions. Wherefore if any thing succeeded unprosperously in so great malignancy of wounds, the Chirurgeon was not to be blamed, for that it were a crime to fight against God and the Air, wherein the hidden scourges of the divine justice lie hid. Therefore, if according to the mind of the great Hypocrates, who commands to bring all contused wounds to suppuration, that so they may be healed, we endeavoured to cure with such medicines wounds made with Gunshot, and therefore contused; who can rightly be angry with us, if we performed it not so well, by reason of these putrefactions, All contused wounds must be brought to suppuration. gangrenes and mortifications which proceeded from the corrupt Air, for all that we used not only suppuratives, but were oft times forced to use other medicines; so long turning aside from the cure of the disease, until we had o'ercome the symptoms which much endanger the patient and customarily happen upon such wounds, as also upon those which are made with a sword or any other kind of weapon; As shall plainly appear in the following treatise, to which it now seems high time that we betake ourselves. CHAP. I. A division of wounds drawn from the variety of the wounded parts, and the Bullets which wound. ALl wounds which are made in man's body by Gunshot, whether simple or compound, are accompanied with contusion, dilaceration, distemper and A division of wounds ●on the variety of the Wounded parts. swelling. I say, all these possess either the noble parts, or ignoble, the fleshy, nervous or bony, some while with rending and tearing asunder the larger vessels, sometimes without harming them. Now these wounds are only superficiary, or else pierce deep and pass quite through the body. But there is also another division of these wounds taken from the variety of the Bullets wherewith they are made. For some bullets are bigger, some less, some between both, they are From the difference of Bullets. usually made of Lead, yet sometimes of Steel, Iron, Brass, Tin, scarce any of Silver much less of Gold. There arises no difference from their figure; for almost all kinds of wounds of this nature are round. From these differences, the Chirurgeon Wounds made by 〈◊〉 shot 〈…〉 〈◊〉. must take his Indications what to do, and what medicines to apply. The first care must be, that he think not these horrid and malign symptoms, which usually happen upon these kinds of wounds, to arise from combustion, or poison carried with the Bullet into the wounded part, and that for these reasons we have formerly handled at large. But rather let him judge they proceed from the vehemency of the contusion, dilaceration and fracture, caused by the Bullets too violent entry into the nervous and bony bodies. For if at any time the bullet shall only light upon the fleshy parts, the wounds will be as easily cured, as any other wound usually is, which is made with a contusing and round kind of weapon, as I have often found by frequent experience, whilst I have followed the wars, and performed the part of a Chirurgeon to many Noblemen and common Soldiers, according to the counsel of such Physicians as were there overseers of the cure. CHAP. II. Of the signs of wounds made by Gunshot. WOunds made by Gunshot are known by their figure, which is usually round; by their colour, as when the native colour of the part decays, and Signs of Wounds from their figure. From their colour. From the feeling the blow. in stead thereof a livid, greenish, violet or other colour succeeds; by the feeling or sense of the stroke, when in the very instant of the receiving thereof, he feels a heavy sense as if some great stone, or piece of Timber, or some such other weightything had fall'n upon it; by the small quantity of blood which issues out thereat, for when the parts are contused, within some small while after the stroke From the bleeding. they swell up, so that they will scarce admit a Tent, whence it is that the blood is stopped, which otherwise would flow forth of the orifice of the wound; by heat, From the heats of the Wound. which happens either by the violentnesse of the motion, or the vehement impulsion of the air, or the attrition of the contused parts, as the flesh and nerves. Also you may conjecture that the wounds have been made by Gunshot, if the bones shall be broken, and the splinters thereof by pricking the neighbouring bodies cause defluxion and inflammation. But the cause that the Bullet makes so great a contusion is, for that it enters the body not with any points or corners, but Whence these wounds are so much confused. with its round and spherical body, which cannot penetrate but with mighty force; whence it cometh to pass that the wound looks black, and the adjacent parts livid. Hence also proceed so many grievous symptoms, as pain, Defluxion, Inflammation, Apostumation, Convulsion, Frenzy, Palsy, Gangreen and mortification, whence lastly death ensues. Now the wounds do often cast forth virulent and very much stinking filth, by reason of the great contusion, and the rending and tearing of the neighbouring particles. A great abundance of humours flow from the whole body, and fall down upon the affected parts, which the native heat thereof being diminished forsakes, and presently an unnatural heat seizes upon it. Hither also tend an universal or particular repletion of ill humours, chiefly if the wounds possess the nervous parts as the joints. Verily neither a Stag with his horn, nor a flint out of a sling can give so great a blow, or make so large a wound, as a Leaden or Iron Bullet shot out of a Gun, as that which going with mighty violence, pierces the body like a Thunderbolt. CHAP. III. How these wounds must be ordered at the first dressing. THe wound must forthwith be enlarged, unless the condition of the part Strange bodies must first be pulled forth. resist, that so there may be free passage forth both for the Sanies, or matter, as also for such things as are farced, or otherwise contained therein; such as are pieces of their clothes, bombast, linen, paper, pieces of Mail or Armour, Bullets, Hailshot, splinters of bones, bruised flesh and the like, all which must be plucked forth with as must celerity and gentleness as may be. For presently after the receiving of the wound the pain and inflammation are not so great, as they will be within a short time after. This is the principal thing in performance of this work, that you place the patient just in such a posture as he was in The manner how to draw them forth. at the receiving of the wound; for otherwise the various motion and turning of the Muscles will either hinder or straiten the passage forth of the contained bodies. You shall if it be possible, search for these bodies with your finger, that so you may the more certainly and exactly perceive them. Yet if the Bullet be entered somewhat deep in, than you shall search for it with a round and blunt probe, lest you put the patient to pain; yet often times you shall scarce by this means find the Bullet. As it happened to the Marshal of Brissac in the siege of Parpignan, who was wounded in his right shoulder with a Bullet, which the Surgeons thought to have entered into the capacity of his body. But I, wishing the patient to stand just in the same manner as he did when he received the wound, found at length the place where the Bullet lay, by gently pressing with my fingers, the parts near the wound, and the rest which I suspected; as also by the swelling, hardness, pain and blackness of the part, which was in the lower part of the shoulder near unto the eight or ninth spondyl of the back. Wherefore the bullet being taken forth by making incision in the place, the wound was quickly healed and the Gentleman recovered. You shall well observe this, and rather believe the judgement of your fingers, than of your probe. CHAP. four A description of fit Instruments to draw forth Bullets and other strange bodies. BOth the magnitude and figure of Instruments fit for drawing forth of Bullets and other strange bodies, are various according to the diversity of the incident occasions. For some are toothed, others smooth, others of another figure and bigness; of all which sorts the Chirurgeon must have divers in a readiness, that he may fit them to the bodies and wound, and not the wounds and bodies to his Instruments. The Deliniation of such like Instruments. A toothed Crowesbill. The crooked Cranes-bill, with teeth like a Saw. The strait Cranes-bill being also toothed, fit for drawing forth hailshot, pieces of armour, splinters of bones, and such things as lie deep within. The Ducks-bill. This Duck's bill hath a large round and toothed cavity in the end, for so it more easily taketh hold of the Bullet when it lies amongst much Flesh. Another Instrument fit for drawing forth of Bullets, which may be termed, a Catch-bullet. A. Shows the Trunk. B. Shows the rod, or string, which opens & shuts the joint. C. The joint. Another Catch-bullet called a Lizards-nose, made for drawing out of bullets which are somewhat flatted, by striking upon a bone. The Parrots-beake is made for drawing forth pieces of mail thrust into the flesh, flesh, or bones; and this is the figure thereof. A. Shows the screw-pin. B. The hollowed part which receives, the round part noted with. C. Which is opened and shut by the screw. D. D. falls, or stays, which govern the running branch. The Swan's bill opens with a screw: you may with this dilate the wounds, and so put in a straight Cranes-bill, as pincers to pluck forth strange bodies. The figure of both are here expressed. But if these strange bodies, especially bullets and hail shot, be not too deep in the wound, they may be taken forth with your levatory, or else by the help of these Gimlets. These Gimlets are screwed into their pipes, or canes, and enter with their screwed points into the Bullets, if that they be of Lead or Tin, and of no harder mettle; and so being fastened in them, bring them out with them. The figure of the Gimlet with his pipe, or can. Besides the Swans-bill which we lately mentioned, there are also other Instruments fit to dilate and open the wounds; therefore called Dilaters, by whose help the wound may be held open, that so the hidden bodies may be seen; for when you press together the two ends of this Instrument, the other two open and dilate themselves. You may also use them in dilating divers other parts of the body, as the Nostrils, fundament, and such like. Dilaters. The Instruments which follow are called Seton needles, or Probes; whose use is, to draw through a flamula, so to keep the wound open, that you may the better take forth any strange body. Besides also we use the same needles, to search, or as it were to sound the deepness of wounds, and to find out the Bullets. For they cannot put one to much pain because they have smooth and round ends. So also all Probes wherewith we search for Bullets, must have somewhat large, smooth and round ends. For seeing that the verges of the wound meet together presently after What probes fit search these wounds. the hurt, if the Probes be too small or slender, they will stick in the inequality of the flesh, neither will they be able to come to the Bullet. But if they be sharp and pointed, they will cause and renew the pain by pricking the flesh they melt withal, and so hinder your intention of finding the Bullet; Now you must be furnished with these Instruments of a different length, according to the various thickness of the parts; for you cannot put any through the thigh but such as are of good length. Probes for to put slamulaes through a wound withal. CHAP. IX. What dressing must first be used, after the strange bodies are plucked or drawn out of the wound. WHen the strange bodies are drawn or plucked out of the wound, by these means we have formerly recited, the chief of the cure must be to heal the contusion, and amend the distemper of the air if it be hot and moist, that is, subject to putrefaction. This shall be done by medicines taken inwardly, applied outwardly and put into the wound. Things to be inwardly used in diet and pharmacy I leave to the judgement of learned Physicians; for the particular and topicke medicines, (unless from the present constitution of the air, the condition of the wounded part, or from some other cause there be danger of a Gangrene) you must use suppuratives, as you usually do in contusions; such as are oil of Whelps A Caution in the use of suppuratives. and that which we call a digestive; you must chiefly forbear suppuratives, when as the wounded part is of a nervous nature. For all nervous parts requre drier medicines than fleshy, as we have formerly delivered speaking of wounds of the joints; wherefore in wounds of the joints and nervous parts you shall use more venice Turpentine than oil. Laurentius jobertus the Kings Physician and Chancellor of the University Why Escharotickes must be eschewed in these kinds, if they be simple. of Mompelier, in a treatise which he writ of wounds made with Gunshot, forbids the use of Escharotickes both actual and potential, in these wounds, if simple; for that they induce pain, inflammation, a fever, Gangraene and other deadly symptoms. Besides also an eschar will hinder suppuration, which is to be desired in this kind of wounds, that so the contused flesh may be severed from the sound, lest it be drawn to putrefaction by contagion. Which easily happens when an How an Eschar may cause putrefaction. Eschar is drawn, as a bar over it, for then the excrementitious humour remains longer in the part, and the putridinous vapours hindered from passing forth, are increased, and carried from the lesser vessels to the bigger, and so over all the body. Wherefore, when you suspect putrefaction, letting alone suppuratives, use in the first place such things as resist putrefaction, as this following ointment. ℞. pulver. alumin. The description of an Egyptiacum. rochae, viridisaeris, Vitrioli, romani, mellis rosat. an. ℥ ij. aceti boni quantum sufficit, bulliant omnia simul secundum artem, & fiat medicamentum ad formam meliis. This by reason of the heat and subtlety of the substance, hath a faculty to induce and attenuate the humours, as also to call forth the native heat drawn in and dissipated by the violent and forcible entrance of the Bullet into the body; furthermore also it corrects the venomous contagion of the virulent humour. Now this medicine shall be used, dissolved in Venegar or aqua vitae, and be put into the wound with tents, or pledgets. The tents which shall be used at the first dressing must be somewhat long and thick, that by dilating the wound, they may make way for application of other remedies; otherwise you may make injection with a syringe, that so it may penetrate the more powerfully. But this described Egyptiacum shall be tempered according to the condition of the affected parts, for the nervous parts will be offended with it as being How and when to temper this Egyptiacum. too acride; but it may be qualified by admixture of oil of Turpentine and Saint john-wort. Also we may well be without this Egyptiacum when there is no such pestilent constitution of the air, as was seen in the late Civil wars. After the use of Egyptiacum you shall with emollient and lenitive medicines procure the falling away of the Eschar, and such a medicine is this following oil, being somewhat more than warm. ℞. Olei violati lib. iiij. in quibus coquantur catelli duo nuper nati, usque ad dissolutionem ossium, addendo vermium terrestrium, ut decet praeparato●um, lb. i. coquantur simul lente The oil of Whelps a digestive, anodyne, and fit medicine to procure the falling away of an Eschar. igne, deinde fiat expressio ad usum, addendo terebinth. venet. ℥ iij. aquae vitae ℥ i. This oil hath a wonderful force to assuage pain, to bring the wound to suppuration, & cause the falling away of the Eschar. This ensuing oil is made more easily. ℞. olei seminis lini, & lilior. an. ℥ iij. unguent. basilic. ℥ i. lique fiant simul & fiat medicamentum, put of this a sufficient quality into the wound; for this being applied indifferent hot, hath power to assuage pain, to foften and humect the orifice of the wound, and help forwards suppuration, which is the true manner of curing these kind of wounds, according to the rule of Hypocrates, which wishes every contused wound to be presently brought to suppuration, for so it will be less subject to a Phlegmon; and besides, all Lib de ulter. the rent and bruised flesh must putrify, dissolve and turn to quitture, that new and good flesh may be generated in steed thereof. La●rentius joubertus much commends this following medicine, of whose efficacy, as yet, I have made no trial. ℞. pulver. mercur. bis calcinati, ℥ j, adipis porcirecentis, vel butyrs recentis, ℥ viij. Camphorae in aqua vitae dissolutae, ʒij. misce omnia simul, addende tantillum olei liliorum, aut lini. Experience taught him, and reason also shows, that The faculties of the powder of Mercury. this kind of remedy is very commendable; for the powder of Mercury, if mixed with a gross and humecting matter, doth in a short space turn the bruised flesh into pus, without causing any great pain. For the Camphire, whether it be hot or cold, in temper, it much conduces to that purpose, by reason of the subtlety of the parts, whereof it consists. For by means of this quality the medicines enter with more facility into the affected bodies, and perform their parts; besides also Camphire refists putrefaction. Some drop into the wound aqua vitae, wherein they have dissolved some calcined vitriol. Which kind of remedy is not suppurative, but yet much resists The force of ealcined vitriol. putrefaction, so that we may use it with good success, when the weather is hot, moist, and foggy. But when the wound is made very near at hand, it cannot but be burnt by the flame of the powder; in which remedies used for burns, will be useful, How wounds made by Gun-shot may be combait. not omitting such as are fit for contusions. But for these parts which lie next the wound, you shall not, unless at the first dressing apply, refrigerating and astringent things, but rather emollient and suppurative. For those things which have a refrigerating faculty, weaken the part, and hinder suppuration. For astringents constipate the skin, which is the cause, that the putrid vapours shut up and hindered from transpiration Scarification. and passage forth, a gangrene and mortification easily seize upon the part. But if the contusion be great and diffuse itself more largely over the flesh; the part must be much scarified; that so the contused and concreat blood, and therefore subject to putrefaction, may be evacuated. But for these parts, which somewhat further distant from the wound encompass the contused flesh, they require refrigerating and strengthening medicines, so to hinder the falling down and settling of the humour in that part; such is this ensuing medicine. ℞. Pul. boli. armen. sauguin. Dracon. Myrrhae. an. ℥ j succi solan. sempervivi, portulac. an. ℥ iss. album iiij. ovorum. oxyrhodin. quantum An Astringent repelling medicine. sufficit; fiat linimentum, ut decet. You may use this, and the like until the suspected symptom, be past fear. Neither must you have less care, of binding up and rolling the part, than of your medicines; for it doth not a little conduce to the cure, to bind The binding up. it so fitly up as it may be without pain. The wound at the beginning of the cure, must be dressed but once in 24. hours, that is, until the wound come to suppuration; How oft the wound must be dressed in a day. but when the quitture begins to flow from it, and consequently the pain and fever are increased, it shall be dressed twice a day, that is every twelve hours. And when the quitture flows more abundantly than usual, so that the collection thereof is very troublesome to the Patient, it will be requisite to dress it every 8 hours; that is thrice a day. Now when as this abundant effluxe is somewhat slaked, and begins to decrease, it will suffice to dress it twice a day. But when the ulcer is filled with flesh, and consequently casts forth but little matter, it will serve to dress it once a day, as you did at the first. CHAP. VI How you shall order it at the second dressing. AT the second and following dress, unless you suspect putrefaction, and a Gangrene, you shall only put into the wound some of the oils formerly described, adding to them the yolkes of some eggs and a little saffron; and use this medicine, until the wound come to perfect suppuration. Here you must note Why wounds made by Gun-shot are so long before they come to suppuration. this, that these kinds of wounds are longer before they come to suppuration, than other wounds made by any other sort of weapon; both for that the bullet, as also the air which it violently carries before it, by much bruising the flesh, on every side, dissipates the native heat, and exhausts the spirits of the part. Which things hinder digestion, and often cause the matter to stink, as also many other pernicious symptoms. Yet most usually pus or quitture appears within three or four days, sooner and later according to the various complexion, and temperament of the patient's bodies, and the condition of the ambient air in heat and cold. Then by little and little you must come to detersives, adding to the former medicine some Turpentine washed in Rose, Barley, or some other such like water, which may Why Turpentine must be washed. wash away the biting thereof. If the encompassing air be very cold, you may to good purpose add some aqua vitae; for by Galens' prescript, we must use hot medicines in winter, and less hot in summer. Then in the next place use detersives, as Gal. lib. 3. Meth. ℞. aquae decoctionis hordei quantum sufficit, succi plantaginis, appij, agrimon. centaurei A detergent medicine. minoris, an. ℥ j, bulliant omnia simul; in fine decoctionis adde terebinthinae venetae ℥ iij. mellis rosat. ℥ ij. farin. hordei. ℥ iij. croci ℈ i. Let them be all well mixed together and make a Mundificative of an indifferent confistence. Or ℞. succi clymeni, plantag. absinth. appijs, an. ℥ ij. tereb. venet. ℥ 4. syrup. absinth. & mellis ros. an. ℥ ij. bulliant omnia secundum artem, postea colentur, in colatura add pulver. aloes, mastiches, Ireos Florent. far. hord. an. ℥ i. fiat Mundificatiwm ad usum dictum. Or else ℞. terebinth. venet. lotae in aq. ros. ℥ v. olei ros. ℥ i. mellis ros. ℥ iij. myrrhae, aloes, mastic. aristoloch. rotundae, an. ʒiss. far. hord, ʒiij. misce. Make a Mundificative, which you may put into the wound Why tents must be neither too long, nor thick. with tents, but such as are neither too long, nor thick, lest they hinder the evacuation of the quitture and vapours, whence the wounded part will be troubled with erosion, pain, defluxion, inflammation, abscess, putrefaction; all which severally of themselves, as also by infecting the noble parts, are troublesome both to the part affected, as also to the whole body besides. Wherefore you shall put into the wound no tents, unless small ones, and of an indifferent consistence; lest (as I said) you hinder the passing forth of the matter, or by their hard pressing of the part, cause pain, and so draw on malign symptoms. But seeing tents are used both to keep open a wound so long, until all the strange bodies be taken forth, as also to carry the medicines, wherewithal they are anointed: even to the bottom of the wound. Now if the wound be sinuous and deep, that so the medicine cannot by that means arrive at the bottom and all the parts thereof, you must do you business When you must use injections. by injections made of the following decoction. ℞. aq. hord.. lib. 4. agrimon. centaur. minor. pimpinellae, absinth. plantag. an. M. ss. rad. aristoloch. rotund. ʒss. fiat decoctio An Injection. hepaticaeʒiij. mellis ros. ℥ ij. bulliant modicum. Inject some of this decoction, three or four times into the wound, as often as you dress the patient; and if this shall not be sufficient to cleanse the filth, and waste the spongious, putrid and dead flesh, you shall dissolve therein as much Aegyptiacum as you shall think fit for the present necessity; but commonly you shall dissolve an ounce of Aegyptiacum in a pint of the decoction. Verily Aegyptiacum doth powerfully The quantity of Egyptiacum to be used in an injection. consume the proud flesh which lies in the capacity of the wound; besides also it only works upon such kind of flesh. For this purpose, I have also made trial of the powder of Mercury, and burnt Alum equally mixed together, and found them very powerful, even almost as sublimate, or Arsenic, (but that these cause not such pain in their operation.) I certainly much wonder at the largeness of the Eschar which arises by the aspersion of these powders. Many Practitioners would have a great Why none of of the iniection must beleft in the wound. quantity of the injection to be left in the cavityes of sinuous ulcers, or wounds; which thing I could never allow of. For this contained humour causeth an unnatural tension in these parts, and taints them with superfluous moisture, whereby the regeneration of flesh is hindered; for that every ulcer as it is an ulcer, requires to be dried, in Hypocrates opinion. Many also offend in the too frequent use of Tents; for as they change them every hour, they touch the sides of the wound, cause pain, & renew other malign symptoms; wherefore such ulcers as cast forth more abundance of matter, I Hollow tents or pipes could wish rather to be dressed with hollow tents, like those I formerly described to be put into wounds of the Chest. You shall also press a linen bolster to the bottom of the wound, that so the parts themselves may be mutually condensed by that pressure The manner of binding up the wound. and the quitture thrust forth; neither will it be amiss to let this bolster have a large hole fitted to the orifice of the wound & end of the hollow tent and pipe, that so you may apply a sponge for to receive the quitture, for so the matter will be more speedily evacuated and spent, especially if it be bound up with an expulsive ligature, beginning at the bottom of the ulcer, and so wrapping it up to the top. All the bolsters and rulers, which shall be applied to these kinds of wounds, shall be dipped in Oxycrate, or red wine, so to strengthen the part, and hinder defluxion. But you must have a special care, that you do not bind the wound too hard, for hence will arisen pain, hindering the passage forth of the putredinous vapours and excrements, which the contused flesh casts forth; and also fear of an Atrophia, or want of nonrishment, the alimentary juices being hindered from coming to the part. CHAP. VII. By what means strange bodies, left in at the first dressing, may be drawn forth. IT divers times happens, that certain splinters of bones, broken and shattered asunder by the violence of the stroke, cannot be pulled forth at the Two causes that make strange bodies hard to he taken forth. first dressing, for that they either do not yield or fall away, or else cannot be found by the formerly described instruments. For which purpose this is an approved medicine to draw forth that which is left behind. ℞. radic. Ireos' Florent. panac. & cappar. an. ʒiij. an.ʒj. in pollinem redacta incorporentur cum melle rosar. & terebinth. venet. an. ℥ ij. or ℞. resin. pini siccae ℥ iij. pumicis combusti & extincti in vino albo, radic. Ireos, aristolochiae, an. ʒss. thurisʒj. squamae aris, ʒij. in pollinem redigantur, incorporentur cum melle rosato, fiat medicamentum. CHAP. VIII. Of Indications to be observed in this kind of wounds. THe ulcer being cleansed and purged, and all strange bodies taken forth; natures endeavours to regenerate flesh, and cicatrise it, must be helped forwards with convenient remedies, both taken inwardly, and applied out-wardly. To which things we may be easily and safely carried by indications drawn, first from the essence of the disease, then from the cause; if as yet present it nourish the disease. For that which Galen says, Lib. 3. Meth. that no indication may be taken from the primitive cause and time; must be understood of the time past, and the cause which is absent. And then from the principal times of the disease, the beginning, increase, state, and declination; for each of these four require their remedies. Others are taken from the temperament of the patient, so that no Chirurgeon need doubt, that some medicines are fit for choleric, othersome for phlegmatic bodies. Hither refer the indication taken from the age of the patient; also it is drawn from his diet, for no man must prescribe any slender diet to one who is always feeding, as to him who is accustomed to eate but once, or twice a day. Hence it is that a diet consisting only of Panada's is more fit for Italians, than for French men; for we must give somewhat to custom, which is as it were another nature. Vocations and daily exercises, are referred to diet, for other things besit husband men and labours, whose flesh is dense and skin hardened by much labour, than idle and delicate persons. But of all other, have diligent regard of that indication which is drawn from the strength of the patient; for we must presently, (all else The Indication which is drawn from the strength of the patient is the chiefest of all other. being neglected) secure the fainting, or decaying strength; wherefore if it be needful to cut off a member that is putrified, the operation must be deferred if the strength of the patient be so dejected, that he cannot have it performed without manifest danger of his life. Also indication may be drawn from the encompassing air, under which also is comprehended that, which is taken from the season of the year, region, the state of the air and soil, and the particular condition of the present and lately bypast time. Hence it is we read in Guido, that wounds of the head are cured with far more difficulty at Paris, than at Avignion; where notwithstanding on the Why wounds of the head at Paris, and of the legs at Avignion are hard to be cured. contrary, the wounds of the legs are cured with more trouble, than at Paris; The cause is, the air is cold and moist at Paris; which constitution seeing it is hurtful to the brain and head, it cannot, but must be offensive to the wounds of these parts. But the heat of the ambient air at Avignion, attenuates and dissolves the humours, and makes them flow from above downwards. But if any object that experience contradicts this opinion of Guide, & say, that wounds of the head are more frequently deadly in hot countries; let him understand that this must not be attributed to the manifest & natural heat of the air, but to a certain malign & venenate humour, or vapour dispersed through the air, and raised out of the Seas; as you may easily observe in those places of France & Italy which border upon the Mediterranean Sea. An indication may also be drawn from the peculiar temper of the wounded parts, for the musculous parts must be dressed after one, and the bony parts after another manner. The different sense of the parts, indicateth and requires the like variety of remedies; An indication to be drawn from the quick and 〈◊〉 of the wounded parts for you shall not apply so acride medicines to the Nerves and Tendons, as to the ligaments which are destitute of sense. The like reason also, for the dignity and function of the parts needful for the preservation of life; for oft times wounds of the brain, or of some other of the natural and vital parts, for this very reason that they are defixed in these parts, divert the whole manner of the cure, which is usually and generally performed in wounds. Neither that without good cause, for oft times from the condition of the parts, we may certainly pronounce the whole success of the disease; for wounds which penetrate into the ventricles of the brain, into the heart, the large vessels, the chest, the nervous part of the midriff, the Liver, ventricle, small guts, bladder, if somewhat large are deadly; as also these which light upon a joint in a body replete with ill humours, as we have formerly noted. Neither must you neglect that indication which is drawn from the situation of the part, and the commerce it hath with the adjacent parts, or from the figure thereof; seeing that Galen himself would not have it neglected. But we must consider in taking these Gal. lib. 7. Meth. et 2. add Glauc. forementioned Indications, whether there be a composition, or complication of the diseases; for as there is one and that a simple indication, of one & that a simple disease, so must the indication be various of a compound and complicate disease. But there is observed to be a triple composition, or complication of affects besides nature; for either a disease is compounded with a disease, as a wound, or a phlegmon with a fracture of a bone; or a disease with a cause, as an ulcer with a defluxion; or a disease with a symptom, as a wound with pain, or bleeding. It sometimes comes to pass, that these three, the disease, cause, and symprome, concur in one case or affect. In artificially Gal. lib. 7. Meth. handling of which, we must follow Galens' counsel, who wishes in complicated and compounded affects, that we resist the more urgent; then let us withstand the cause of the disease, and lastly that affect, without which the rest cannot be cured. Which counsel must well be observed; for in this composure of affects, which distracts the Empiric; But on the contrary the rational Physician hath a way prescribed in a few and these excellent words, which if he follow in his order of cure, he can scarce miss to heal the patient. Symptoms truly as they are symptoms, yield no indication of curing, neither change the order of the cure; for when the disease is healed, the symptom vanishes, as that which follows the disease, as a shadow follows the body. But symptoms do often times so urge and press, that perverting the whole order of the cure, we are forced to resist them in the first How and when we must take indication of curing from a symptom. place, as those which would otherwise increase the disease. Now all the formerly mentioned indications may be drawn to two heads; the first is, to restore the part to its native temper; the other is that the blood offend not either in quantity or quality; for when those two are present, there is nothing which may hinder the repletion, nor union of wounds or Ulcers. CHAP. IX. What remains for the Chirurgeon to do in this kind of wounds. THe Chirurgeon must first of all be skilful and labour to assuage pain, hinder defluxions, prescribe a diet in these six things we call Not natural, forbidding the use of hot and acrid things, as also of wine; for such attenuate the humours and make them more apt for defluxion. Therefore at Why such as are wounded must keep a slender Diet, the first let his diet be slender, that so the course of the humours may be diverted from the affected part; for the stomach being empty and not well filled, draws from the parts about it, whereby it consequently follows, that the utmost and remotest parts are at the length evacuated; which is the cause, that such as are wounded, must keep so spare a diet for the next days following. Venery is very pernicious, for that it inflames the spirits and humours far beyond other motions; whereby it happens that the humours waxing hot, are too plentifully carried to the wounded and overheated part. The bleeding must not be staunched presently upon the receiving of the wound, for by the more plentiful effluxe thereof the part is freed from danger of inflammation and fullness. Wherefore if the wound bleed not Why we must open a vein in such as are wounded by Gunshot. sufficiently at the first, you shall the next day open a vein, and take blood according to the strength and plenitude of the patient; for there usually flows no great store of blood from wounds of this nature; for that by the greatness of the contusion and vehemency of the moved air, the spirits are forced in, as also I have observed in those who have one of their limbs taken away with a Cannon bullet. For in the time when the wound is received, there flows no great quantity of blood, although there be large veins and arteries torn in sunder thereby. But on the 4, 5, 6. or some more days after, the blood flows in greater abundance, and with more violence, the native heat and spirits returning into the part. The belly must be so qualified, that he may have at the least one stool a day, either by nature, or Art; and if by Art, than rather with a glister than purging medicines taken by the mouth, for that the agitation of humours, chiefly in the first days of the disease, is to be susspected, lest we increase the defluxion falling down upon the wounded part. Yet Galen writes that both the evacuations are here needful, that is, blood-letting and Gal. Lib. 4. Meth. cap. 6. purging, though the Patient be neither phethoricke, nor replete with ill humours. But the care hereof must be committed to the judgement of the learned Physician. Pain if joined with inflammation shall be mitigated, by anointing the parts near unto the wound with Unguent. nutritum, composed with the juice of Plantain, Houseleek, Nightshade and the like. Vnguentum Diacalcitheos' described by Galen Gal. Lib. 1 de comp. Med. secund. gen. c. 〈◊〉. dissolved with vinegar, oil of Poppyes and Roses is of no less efficacy; nor unguent. de bolo, nor divers other things of the same faculty, though properly no anodynes, as those which are not hot and moist in the first degree, but rather cold, but yet not so as to have any narcoticke faculty. Now these forementioned things assuage pain for that they correct the hot distemper, and stay the acride and choleric defluxions, whose violence is more than cold. After the use of repercussives, it will be good to apply this following cataplasm. ℞ Micae panis infusae in lacte vaccino lb. i. ss. bulliant parum addendo olei violacei, & rosar. an. ℥ iij. vitellos ovorum nu. iiij. An Anodyne and ripening Cataplasm pulver. rosar. rub. flor. chamaem. & meliloti, an. ℥ ij. farin. fabar. & hordei, an. ℥ i. misce, fiat cataplasma secundum artom. Also in this case you may easily make a medicine, of bread crumbs boiled in Oxycrate and oil of Roses. The cure of Tumours, if any associate the wound, may be found in their proper place. Nature's motion, whether to suppuration, or any such thing, must still be observed, and helped by the Physician and Chirurgeon, as the ministers or servants thereof. CHAP. X. Of Bullets which remain in the body, for a long time after the wound is healed up. LEaden Bullets lie in some parts of the body some while seven, eight or more years, so that they neither hinder the agglutination of the wound, neither doth any other symptom happen thereupon, as I have divers Why Leaden Bullets lie in the body so many years without doing any harm. times observed; until at length by the strength of nature forcing them, and their proper weightiness bearing them downwards, they show themselves in some lower part, by their swelling or bunching forth, and so must be taken forth by the hand of the Chirurgeon. For they say Lead hath a certain sympathy and familiarity with man's body, chiefly the fleshy parts thereof. Wherefore it neither putrifies its self, nor causeth the flesh to putrify; besides it hath an excellent faculty in cicatrizing old ulcers. But bullets of stone, Iron and of any other mettle, are of another nature, for they cannot remain any long time in the body without hurt; for Iron will grow rusty, and so corrode the neighbouring bodies, and bring other malign symptoms. Yet a Leaden bullet cannot remain any long time in nervous, or noble parts without danger. CHAP. XI. How to correct the constitution of the air, so that the noble parts may be strengthened, and the whole body besides. But because as we have formerly told you, there are some times wherein even small wounds made by Gunshot prove deadly, not by their own fault, but the fault of the air; therefore also the Chirurgeon must have this care, that Cordials to strengthen the noble parts. he correct the air with all diligence, and reduce it to a certain quality and moderation of substance, and strengthen the noble parts and whole body besides, which may be performed, by the following medicines, which are to be taken inwardly and applied outwardly. In the morning three hours before meat let the Patient take some certain quantity as the Physician shall think fit of the electuary Diarbodon Abbatis, or Aromaticum rosatum, triasantalon, biamoschum, laetificans Galeni, or some such other like. And you shall apply some such Epitheme as is here described to the heart and Liver. ℞ aquae rosar. ℥ iiij, aquae buglossae, aceti boni, an. ℥ ij. coriandri praeparati ℥ ss. A cordial Epithem. an.ʒj. saint. rub. ʒss. utriusqueʒss. camphorae ℈ i. croci ℈ ss. pulver. diarhod. Abbot. ʒij theriacae & Mithridatij an. ℥ ss. pull. flo. chamaem & melil. an. ʒiij. misce, fiat epithema. Let it be applied warm by dipping a scarlet cloth therein. You shall frequently put odorifferous and refrigerating things to the patient's nose, to strengthen the animal faculty, as, ℞. aquaerosar. & aceti boni. an. ℥ iij. an.ʒj. Let a linen rag dipped herein, be now and then put to the patient's nose; for the same purpose he shall carry a Pomander about him, and often smell thereto. As ℞ Pomandera. ros. rub. violar. an. ʒiij. baccarum myrti, juniperi, santal. rub. an. ʒijss. styracis calamit. ʒij. aq. rosarum, quantum satis est: lique fiat simul cum cerae albae quod sufficit, fiat ceratum ad comprehendendos supradictos pulvers cum pillillo calido, & ducatur in pomum. Or, ℞. rad. Ireos' Florent. majoran. calam. aromat. ladani, ●enzoini, rad. cyperi, caryophll. an. ʒij. Moschi, gra. 4. fiat pulvis cum gummi tragacanth. quod sufficit. Or else. ℞. ladani puri ℥ i. Benzoini ℥ ss, styracis calamit. ʒuj. ireos Flor. ℥ ss caryophyll. ʒiij. majoran. ros. rub. calami aromat. an. ʒss, in pollinem redigantur omnia, & bulliant cum aqua ros. quantum sufficit; colentur, colata liquefiant cum justa cerae albae quantitate, styracis liquidae, ℥ j, fiat ad modum cerati, & frontals to cause rest, and strengthen the animal faculty. moschiʒj. Also you may corroborate the animal faculty by application of frontals, as also procure sleep, and ease the pain of the head; as, ℞. aq. ros ℥ ij. olei ros. & papav. an. ℥ iss. aceti boni, ℥ i. trochis. de camphora, ʒss. fiat from tale. Linen rags dipped herein may be applied to the temples of the forehead, and often renewed; otherwise by their heat, dryness, and hardness, they will cause watching in steed of sleep. Neither must you in the mean time bind the head too hard, lest by intercepting and hindering the pulsation of the temporal Artery, you increase the pain of the head. You shall make a fire, in the patient's chamber of oderifferous woods, as juniper, Bay-tree, the prune or cuttings of Vines, Rosemary, and Orris roots. For the same purpose, you may sprinkle the floor with sweet water, if the patient be able to undergo such cost. As, ℞. majoranae, menthae, radic. cyperi, calami aromat. salviae, lavendulae, faenicul. thymi, staechad. flor. chamam. A sweet water. melilot. satureiae, baccarum lauri, & juniperi, an. M. iij. pulv. caryophyll. nucis Moschat. an. ℥ i. aquae rosar. & vitae, an. lib. ij. vini albi boni & odorifici. lb. x. bulliant omnia in balneo Mariae ad usum dictum. You may also make perfumes to burn in his chamber, as thus, ℞. carbonis salicis ℥ viij. ladani puri ℥ ij. thuris masculi, ligni & baccarum Perfumes to burn. juniperi, an. ℥ i. xyloaloes, benjoini, styracis calamit. an. ℥ ss. Nucis moschatae, santal. citrin. an. ʒiij. caryophill▪ styracis liquidae, an. ʒij. an.ʒj. gummi tragacanth. aqua rosar. soluti, quod sit satis; Make hereof perfumes in what fashion you please. For the rottenness and corruption of bones we will treat thereof hereafter in its due place. CHAP. XII. Certain memorable Histories. HEre I think good for the benefit of young practitioners, to illustrate by examples the formerly prescribed Method of curing wounds made by Gunshot. The famous and most valiant Count of Mansfelt, Governor of the Duchy of Luxembourge, Knight of the order of Burgundy, coming to the aid of the French King, was at the battle of Moncontour, where in the conflict, he received so great a wound at the joint of the left arm with a Pistol bullet, that the bones were shivered and broken in so many pieces, as if they had been laid upon an Anvil and struck with an hammer: hence proceeded many The malign symptoms which usually happens upon wounds made by Gunshot. malign symptoms, as cruel & tormenting pain, inflammation, a fever, an oedematous and flatulent tumour of the whole arm even to the finger's end, and a certain inclination to a Gangraene: which to resist, Nicolas Lambert, & Richard Hubert the King's Surgeons, had made many and deep scarifications. But when I came to visit and dress him, by the King's appointment, and had observed the great stinch, and putrefaction, I wished that they would use lotions of Aegyptiacum made somewhat stronger than ordinary, & dissolved in venegar & aqua vitae, and do other things more largely spoken of in the chapter of a Gangrene. For the patient had also a Diarrhaea or flux, whereby he evacuated the purulent, and stinking filth which flowed from his wound. Which how it might come to pass we will show at large when we come to treat Matter may flow from the wounded jimbes into the belly. of the suppression of the Urine. For this seemed very absurd to many, because that if this purulent humour flowed out of the arm into the belly, it must needs flow back into the veins, be mixed with the blood, and by its pernicious and contagious passage through the heart and liver, cause exceeding ill symptoms, and lastly death. Indeed he often swooned by the ascent of the filthy vapours raised from the ulcers to the noble parts; which to resist, I wished him to take a spoonful of aqua vitae with some Treacle dissolved therein. I endeavoured to repress the oedematous and flatulent Tumour possessing all the arm with stoups dipped in oxycrate, to which was put a little salt and aqua vitae; these stoups I stayed & held to the part with double clothes, sowed as straight as I could. Such a compression held the broken bones in their places, pressed their Sanies from the ulcers, and forced back the humours flowing to the part into the centre of the body. If at any time I omitted this compression, the tumour was so increased, that I was in a great deal of fear, lest the native heat of the part should be suffocated. Neither could I otherwise bind up the arm by reason of the excessive pain which molested the patient upon the least stirring of the Arme. There were also many Abscesses about his elbow and over all his arm bessdes. For the letting forth of whose matter I was forced, to make new incisions; which he endured very stoutly. At length I cured him with using a vulnerary potion, and by cleansing the ulcers, and correcting the putrefaction with Aegyptiacum dissolved in wine or honey of roses, and so poured A brief recid tall of the manner of the cure. into the ulcers, and repressing the growth of proud flesh, with the powder of burnt Alum, drying it after the detersion with liniments. Now this I can truly affirm and profess, that during the time of the cure, I took out above threescore splinters of bones, and those necessarily, amongst which there was one of the length of ones finger; yet by God's assistance at length he became sound in all things, but that he could not put forth, or draw in his arm. Not long after by the Kings command I went to see Charles Philip of Croy, Lord of Auret, the Duke of Aschos brother, not far from Mounis a City of Henalt. He kept his bed seven months by reason of a wound made by a Bullet the space of three fingers above his knee. When I came to him, he was afflicted with these symptoms, intolerable pain, a continual fever, cold sweats, watchings, excoriation Horrid symptoms occasioned by a wound made by Gun-shot. of the hips by reason of his long lying upon them, his appetite dejected with much thirst. He oft sunk down as if he had the falling sickness, had a desire to vomit, and a continual trembing or shaking so that he could not put one hand to his mouth without the assistance of the other: he swooned frequently by reason of the vapours ascending to the noble parts. For the thighbone was broken long ways and sidewayes with many splinters of bones, whereof some were plucked out and others remained sticking fast in. He besides also had an ulcer in his groin which reached to the midst of his thigh, and many other sinuous ulcers about his knee. All the muscles of his thigh and leg were swollen with a phlegmatic, cold and flatulent humour, so that almost all the native heat of those parts seemed extinct. All which things being considered, I had scarce any hope to recover him, so that I repented my coming thither. Yet at length putting some confidence in his strength, and prime of youth, I began to have better hopes. Therefore with his Incisions wherefore made. good liking, first of all I make two incisions, so to let forth the matter, which lying about the bone did humect the substance of the muscles. This had happy success, and drew out a great quantity of matter; then I with a syringe injected much Aegyptiacum dissolved in wine, and a little aqua vitae into these incisions, so to restrain and amend the purrifaction, repress the spongy, loose and soft flesh, resolve the oedematous and flatulent tumour, assuage the pain, and stir up and strengthen the native heat almost oppressed by the abundance of excrementitious humours, so that it could scarcely assimilate any nourishment and adjoin it to the parts. Then I fomented the affected part with Sage, Rosemary, Time, Lavender, Chamomile and Melilot Wherefore I used fomentations. flowers and red-rose leaves boiled in white wine, and lie made of Oake-ashes, adding thereto as much salt and vinegar as I judged requisite. This fomentation did attenuate and draw forth the morbificke humour. Now we used them long and often, so to waste the humour more by drying up and breathing thorough the passages of the skin, more thereof than fell into the part. For this same purpose, we ordained that Mixed or round frictions, as they term them. he should use frictions with hot linen clothes, and that these should be made from above downwards, from below upwards, and so on every side, and somewhat long withal: For a short friction draws more humour into the part than it can resolve: I wished that each other day they should lay bricks heated hot in the fire about his leg, thigh, & sole of his foot; but they were to besomewhat quenched, & sprinkeld with wine and vinegar, with a small quantity of aqua vitae. Much waterish moisture by this moist heat, did sweat out of these parts, the tumour was leslened, and the native heat A medicated Lye. by little and little restored. Then shoupes dipped in lie made of Oake-ashes, wherein Sage, Rosemary, Lavender, salt, and cloaves, were boiled, some aqua vitae added, were applied thereto; but the rulers were so gently, and artificially wrapped about, that he did easily endure them without any pain, and that with such happy success, that if they were omitted but for one day, the tumour became very great. But thick linen bolsters were laid upon the lower cavities of the ulcers; that so the sanies or filth might be more easily pressed forth. But I had always a special care that the orifices of the ulcers should be kept open with hollow Tents or pipes put therein: and sometimes this following cataplasm was applied to resolve the tumour. ℞. Far. hord. fabar. & orobi, an ℥ vi. mellis come. & tereb. an. ℥ ij. flo. chamam. melil. & ros. rub. A discussing Cataplasm. an. ℥ ss. pulv. rad. Ireos, Flor. cyper. Mast. an. ʒiij. oxymel. simp. quantum sufficit; fiat cataplasma ad formam pultis satis liquidae. And Emplastrum de Vigo without mercury was applied thereto, whereby the pain was much assuaged, and the tumour lessened: yet were they not applied before the parts were throughly heated by the fomentation, frictions, and evaporations; for otherways this Emplaster could never have been activated, by reason of the excessive coldness of the affected parts. Neither did we omit catagmaticke powders, fit for the taking, and drawing forth of broken bones. He used a vulnerary potion for 15, days. Also besides the particular frictions of the affected parts, I appointed other general frictions of the whole body, which was become very lean; for by these, blood together with the spirit was drawn to the parts, and the acride, and fuliginous vapours were breathed forth. To conclude, his fever and pains being assuaged, his appetite restored, by feeding plentifully upon good meats according to his strength, he in a short time became more lusty; and lastly by the singular mercy of God, recovered his health perfectly, but that he could not very well bend his knee. I thought good to recite these things, not to glory or brag of the happy success of those patients, which have recovered by my means, and the favour of God; but that thus I may more fully and perfectly by familiar examples instruct young practitioners in the operations of Chirurgery. CHAP. XIII. An Apology concerning Wounds made by Gunshot. THere lately came to my hands a book written by a certain Physician, whereby he endeavours to disproove and overthrow, that which I The occasion of writing this Apology. have hitherto writ, of the cure of wounds made by Gunshot. Assuredly if there were no other harm, but the loss of my credit ensuing thereon, I would willingly hold my peace, and stop his mouth by modest silence. But seeing the safety of so many men, lies upon the judgement of this point, I have thought good to withstand this error, lest it, to the great destruction of mankind, spread and diffuse itself any further. The use (saith he) of suppurative medicines, have killed many who have been but lightly wounded with The chief heads of our adversaries Treatise. Gunshot, but acride medicines, as Aegyptiacum have killed more. Neither is the counsel of Hypocrates to be observed in curing this sort of wounds, who bids that every contused wound be brought to suppuration. For seeing this is a new kind of wound, it requires new, and not anciently used medicines. Now the temper of the air changed from the natural constitution ought not to indicate change of medicines; but much less must thunder and lightning be compared to the shooting of Great Ordinance. These are the chief heads of this his book, which because they descent from the truth, & these things I have formerly delivered, I have thought good here to confute. First, seeing Leaden bullets which are usually shot out of Guns are round, obtuse and weighty, they cannot wound the body without contusion and attrition; All wounds made by Gun-shot are contused. Now no contusion can be cured without suppuration, not only according to the opinion of Hypocrates, but also of Galen and all others who have written of Physic. Neither must we invent new remedies, for these new kinds of wounds; for the laws of the sacred and divine Art of Physic are nor obnoxious to change, nor subject to the humour of men or times, as the decrees of Kings and Emperors are. For these are established with immutable necessity, which constancy neither consuming time, nor age, nor tyranny can pervert. Wherefore neither these who with great praise are Physicians to Kings and Princes, I mean joubert and Botallus, think it lawful for them to depart from the rule of Hypocrates. And this they not only do and follow in curing and doing the works of Art, but much and highly commend, confirm and propound to be diligently observed by all, in their books which they have published concerning the cure of these kinds of wounds. And yet these Physicians are such, as daily conversant in Armies and Kings houses have healed and daily cure as many wounded by Gunshot as this Physician our Antagonist hath seen in all his life. Neither only do these whom I have named thus cure these wounds, but almost all that dress such kind of wounds do the like, so that if there be nothing which may hinder, or indicate to the contrary they presently apply suppuratives. And I wonder that he hath not observed how his neighbour Doublet the Empiric cures desperate wounds of this nature, with A suppurative medicine of tried efficacy. no other than a suppurative medicine, composed of Lard, the yolk of an Egg, Turpentine and a little Saffron. In the year 1538. There was at Turin whilst I was Chirurgeon there to the Marshal of Montjan the King's Lieutenant General in Piedmont, a certain Chirurgeon wondrous famous for curing these wounds, and yet he used nothing else but the oil of Whelps, (the description whereof I at length obtained of him with much entreaty and expense) and he used it not scalding hot, as some have imagined, but poured it scarce warm into their wounds, and so did mitigate their pain, and happily bring them to suppuration. Which afterwards almost all Surgeons, after they had got the description hereof, when I first published this Work, have used and daily do use with happy success. But in contemning and condemning Aegyptiacum, I think he hath no partaker; The force of Egyptiacum against putrefaction. seeing there as yet hath been found no medicine more speedy and powerful to hinder putrefaction, if beginning; or correct it if present. Now these wounds often degenerate into virulent, eating, spreading, and malign ulcers, which cast forth a stinking and carion-like filth, whence the part Gangrenates, unless you withstand them with Aegyptiacum and other acrid medicines, being greatly approved by the formerly named Physicians and all Surgeons. But (saith he) this unguent is poisonous, and therefore hath been the death of many who have been wounded by Gunshot. Verily if any diligently inquire into the composition of this ointment, and consider the nature of all and every the ingredients thereof, he shall understand that this kind of Unguent is so far from poison, that on the contrary it directly opposes and resists all poison and putrefaction which may happen to a fleshy part, through occasion of any wound. It is most false and dissonant from the doctrine of Hypocrates to affirm, that the seasons of the year swerving from the Law of nature, and the air, not truly The force of the air in breeding and augmenting diseases. the simple and elementary, but that which is defiled and polluted by the various mixture of putrid and pestilent vapours, either raised from the earth, or sent from above, make not wounds more malign and hard to cure at some times than they are at othersome. For the air either very hot, or cold, drawn into the body by inspiration or transpiration, generates a condition in us like its qualities. Therefore why may it not, when defiled with the putredinous vapours of bodies lying unburied after great battles, and shipwrecks of great Armadas, infect with the like quality our bodies and wounds? In the year 1562. when the civil wars concerning Religion first begun A History. in France, at Pene a Castle lying upon the River Lot, many slain bodies were cast into a Well, some hundred Cubits deep, so stinking and pestilent a vapour arose from hence some two months after, that many thousand of people died all over the Provence of Agenois, as if the Plague had been amongst them, the pernicious contagion being spread twenty miles in compass; which none ought to think strange, especially seeing the putrid exhalations by the force of the winds may be driven and carried into divers and most remote regions, dispersed like the seeds of the Pestilence; whence proceeds a deadly corruption of the spirits, humours and wounds, not to be attributed to the proper malignity, or perverse cure of wounds, but to be the fault of the air. Therefore Francis Daleschampe in his French Chirurgery, in reckoning up these things which hinder the healing of Ulcers, hath not omitted that common cause which proceeds from the air defiled or tainted with the seeds of the pestilence. For he had learned from his Master Hypocrates that the mutations Hip. Aph. 1. sect. 3. of times chiefly bring diseases, and he had read in Guide, that this was the chief occasion, that wounds of the head at Paris, and of the legs at Avignion, were more difficultly healed. Lastly even Barbers and such as have least skill in Chirurgery know, that wounds easily turn into a Gangrene in hot and moist constitutions of the air. Wherefore when the wind is southerly, the Butchers will kill no more flesh than to serve them for one day. I have formerly declared the malignity of the In our second discourse. wounds occasioned by the air in the siege of Roüen, which spared none, no not the Princes of the blood, who had all things which were requisite for their health. Which caused me, made at length more skilful by experience, to use Vnguentum Aegyptiacum and medicines of the like faculty in steed of suppuratives, to wounds during all that season, that so I might withstand the putrefaction and Gangrene which so commonly assailed them. But if the various motion of the stars, can by their influx send a Plague into the air, why then may it not by depravation of their The power of the stars upon the Air and our bodies. qualities infect, and as by poisoning corrupt both wounds and wounded bodies obnoxious to their changes and that of the air? We learned long since by experience, that all pains but principally of wounds, grow worse in a rainy and moist season, specially because in that southerly constitution the air replete with thick and foggy vapours, causes the humours to abound in the body, which forthwith easily fall upon the affected parts, and cause increase of pain. But (saith our Adversary) in the battle at Dreux and at S. Dennis which were fought in winter, there died a great number of men who were wounded by Gunshot: This I confess is true; but yet I deny, that it was occasioned by applying suppuratives, or corrosives, but rather by the vehemency and largeness of their wounds, and the spoil the Bullet made in their members, but above all by reason of the cold. For cold is most hurtful to wounds and ulcers (as Hypocrates testifies) it hardens Aoho. 20. sect. 5. the skin and causes a Gangrene. If this my Gentleman had been with me in the siege of Metz, he might have seen the Legs of many soldiers to have rotten, and presently taken with a Gangrene to have fallen away, by the only extremity of cold; If he will not believe me, let him make trial himself; and go in winter to the Chapel at Mount Senis one of the Alpine hills, where the bodies of such as were frozen to death in passing that way are buried, and he shall learn and feel how true I speak. In the mean time I think it fit to confute the last point of his reprehension. He cavils for that I compared Thunder and Lightning with the discharging pieces The similitude between Thunder and great Ordinance, maintained. of Ordinance. First he cannot deny but that they are alike in effects. For it is certain that the flame arising from Gunpowder set on fire, resembles Lightning; in this also that you may see it before you hear the crack or reporr. I judge for that the eye almost in a moment perceives its object; but the ear cannot but in some certain space of time, and by distinct gradations. But the rumbling noise is like in both, and certainly the report of great Ordinance may be heard sometimes at forty miles' distance, whilst they make any great battery in the beseiging of Cities. Besides also, Iron Bullets cast forth with incredible celerity by the fired Gunpowder, throw down all things with a horrid force, and that more speedily and violently by how much they resist the more powerfully by their hardness. They report that Lightning melts the money not hurting the purse; Now many by the only violence of the air agitated and vehemently moved by shooting a piece of Ordinance, as touched with Lightning, have died in a moment, their bones being shivered and broken, no sign of hurt appearing in the skin. The smell of Gunpowder when it is fired, is hurtful, fiery and sulphurous, just like that which exhales or comes from bodies killed with Lightning. For men do not only shun this smell, but also wild Beasts leave their Dens if touched with Lightnings. Now the cruelty of great Ordinance makes no less spoil amongst buildings, nor slaughter amongst men and beasts, than Lightnings do, as we have formerly shown by examples, not only horrid to see, but even to hear reported, as of Mines, the Arsenal of Paris, the City of Maligns. These may seem sufficient to reach, that Thunder and Lightning have a great similitude with the shooting of great Ordinance, which notwithstanding I would not have alike in all things. For they neither agree in substance, nor matter, but only in the manner of violent breaking asunder the objects. Now let us see and examine what manner of cure of wounds made by Gunshot Our adversaries method, and manner of cure, reproved. our adversary substitutes for ours. For he would have suppuratives used and applied, yet such as should not be hot and most in quality, or of an Emplastic consistence, but hot and dry things. For (saith he) here is not the same reason as in Abscesses, where the Physician intends nothing but suppuration. But here because a contusion is present with the wound, this requires to be ripened with suppuratives, but the wound to be dried. Now to answer this objection, I will refer him to Galen, who will teach him the nature of suppuratives; from whom also he may learn that great regard is to be Gal. lib. 9 simple. 10. Method. had of the cause and more urgent order in the cure of compound diseases; then would I willingly learn of him, whether he can heal a wound made by Gunshot, not first bringing that which is contused to perfect maturity. If he affirm he can, I will be judged by whatsoever Practitioners he will, to judge how obscure these things are. Whereby you may the better understand there is nothing more commodious than our Basilicon and oil of Whelps to ripen wounds made by Gunshot, if so be that putrefaction, corruption, a Gangreen or some other thing do not hinder. Then would he have Oxycrate poured into these wounds to stay their bleeding, which if it cannot so be stayed, he would have a medicine applied consisting of the white of an Egg, Bowl Armenicke, oil of Roses and salt. But I leave it to other men's judgement, whether these medicines have power to stay bleeding if put into the wound; certainly they will make it bleed the more. Vinegar put into a wound doth not stay but causes bleeding. A History. For Vinegar seeing it is of a tenuious substance and biting, it is no doubt but that it will cause pain, defluxion and inflammation. To which purpose I remember I put to staunch bleeding, for want of another remedy, a medicine wherein was some Vinegar, into a wound received by a Moor, an attendant of the Earl of Roissy, hurt with a Lance, run through his arm before Bologne by an English horseman. But he comes again to me a little after, complaining and crying out that all his arm burnt like fire; wherefore I was glad to dress him again, and put another medicine into his wound, and laid an astringent medicine upon the wound, but poured it not therein. And then above all other remedies he extols his Balsam composed of Oil of Wax, and Myrrh beaten together with the white of an Egg; which he saith is equal in operation to the natural Balsam of Peru. For he affirms that this hath a faculty to consume the excrementitious humidity of wounds, and so strengthens the parts that no symptom afterwards troubles them. Yet he saith, this doth not so well heal and agglutinate these wounds, as it doth others which are cut. Balms are fit to heal simple but not contused wounds. Verily it is ridiculous to think that contused wounds can be healed after the same manner as simple wounds may, which only require the uniting of the loosed continuity. Therefore neither can these Balsams be fit remedies to heal wounds made by Gunshot, seeing by reason of their dryness they hinder suppuration, which unless it be procured the patient cannot be healed. Wherefore such things ought not to be put into wounds of this nature, before they be ripened, washed and cleansed from their filth. Yet can I scarce conceive, where we shall be able to find out so many Chemists which may furnish us with these things sufficiently to dress so many wounded soldiers as usually are in an Army, or whence the soldiers shall have sufficient means to bear the charge thereof. Also that which he saith is absurd, that these Balsams must be put into the wounds without Tents; and presently forgetting himself, he saith, It will not be amiss, if there be a little and slender Tent put into the wound, which may only serve to hinder the agglutination thereof. But how can these Balsams come to the bottoms of wounds without Tents, when as it is their chief property to carry medicines even to the innermost parts of the wounds, and always keep open a free passage for the evacuation of the quitture? But it is note worthy, that after he hath rejected unguentum Aegyptiacum, he nevertheless bids to apply it, from the beginning until the contusion come to perfect maturation, dissolving it in a decoction of the tops of wormwood, S. john Wurt, the lesser Centory and Plantain, and so injecting it Egyptiacum howsoever made is a cleanser not a suppurative. into the wound. Besides also a little after he gives another way of using it, which is, to boil a quantity of Honey of Roses in plantain water, carefully sciming it, until it be boiled to the consistence of Honey, and then to add as much Aegyptiacum thereto, and so to make an ointment most fit to bring these wounds to supputation. But I leave it for any skilful in Chirurgery to judge, whether such medicines can be suppuratives, or whether they be not rather detersives. Last of all he writes, that these wounds must be dressed but every fourth day. And if there be a fracture of the bone joined with the wound, then to move nothing after the first dressing until the eighth day after; then presently in another place he faith, it will be good, and expedient, to drop ten or twelve drops of the formerly described Balsam every day into the wound. Verily such doctrine which neither agrees with its self nor the truth, cannot but much puzzle a Novice and young Practitioner in Chirurgery, who is not yet versed in the Art, or the operations thereof. CHAP. XIIII. Another Apology, against those who have laboured with new reasons to prove, that wounds made by Gunshot are poisoned. SOme few months agone, I visited a patient together with some learned Physicians and skilful Surgeons. Now they, as it oft times The occasion of this Apology. happens, in way of discourse, begun to argue of the condition and quality of wounds made by Gunshot, and endeavoured to prove that they might be poisoned, by five reasons. Not truly through the occasion of the Gunpowder, for they all confessed that it was free from poison, whether you have regard to its essence, or to its composition; but by the Bullet, into which the poison may be transfused and incorporated. The first reason is, that The reasons of our adversaries that the Bullets may be poisoned, set down and confuted. Led seeing it is of a rare and spongious nature, which the easiness of melting and softness argues, is very fit to drink and soak in what liquors so ever you please. But me thinks this conclusion is very weak; for in all mixtures made by Art, such as this is whereof we speak, there are two things to be considered; that is to say, the matter of the things which enter into the mixture, and the form: for the matter, such bodies must be either liquid, or soft or friable; and lastly such as may be broken and divided into small particles, that so they may easily in all parts concur and be conjoined and united. But for their form, there ought to be a certain affinity, consent and sympathy. You may perceive this by water and oil; for each of them though of a liquid substance, and such as may easily be mixed with divers other things, yet cannot they be mixed the one with the other by reason of their antipathy of forms. For thus gold and silver are so agreeing with Lead, that as oft as they are molten, Lead is mixed with them. But Brass shuns Led as much as gold and silver fly Tin and white Lead. If therefore Brass and Lead being melted cannot be mixed together, though contained under the same Genus, and common nature of Metals; how then can it be commixed with another thing distinct in the whole kind, much more in species, and form, to wit, poison? Their second reason is this; Iron, say they, which is more dense, solid, and less porous, may receive some venenate substance and quality, as the Arrows of the Ancients which were dipped in poison, testify; therefore must Led much more be capable thereof. I answer, that the surface of Iron may be poisoned, but not the inner part or substance by mixture therewith. But here the question is of union, but not of anointing or inunction. The third reason is thus framed; Though (say they) Lead casts off and purges itself from the dross and unpure parts, yet that is no argument, that it will not commix, or soak its self in some strange liquor or body; for thus Steel, being the most solid Iron, receives the temper which hardens it by the artificial pouring upon it or quenching it in liquors contrary thereto in their whole kind. I answer, that Steel admits into it by that quenching and tempering, none of the juices or liquors wherewith it is watered or quenched. For if that were necessary, it might be better and more easily performed, when the mettle is first cast, than when it is beaten into plates, or bars; which answer shall serve to confute their fourth reason; wherein they say, that bullets may be made so poisonous by the commixture of the juices of Muncks-hood, Oleander, Crowefoote, and other such like things which in their whole substance are contrary to ours, that the wound which is made with them cannot but be poisoned. But I on the contrary affirm, that mixture is only of these things, which may not only be put, but also stick thereto, and be mutually united; but how can water, or any other liquid juice so much as only stick to Led, as that which is a solid and firm body, it is so far from being united therewith? You may give more certain judgement hereof by experience, than by reason; wherefore let melted Led be put into the foresaid juices or the like; then when the lead is cold, weigh each of them severally, and you shall find, that both of them retain the same weight they formerly had. Which is a most certain argument that neither the Lead hath mixed or united itself with the juices, nor the juices lost any part of their substance. Their fifth reason is thus; A Bullet shot out of a Gun against some hard stone, grows not so hot, but that you may presently without any harm take it up in your hand. Therefore it is false, that the poison commixed and united with the Bullet can be dissipated by the fire and flash of Gunpowder. The answer to this objection is easily. For when we say, that although the Bullet may be infected by poison perfectly commixed with the Lead, yet all the force of the poison would be dissipated by the fire; we would have you thus to understand us, that we do not mean this of that fire which is made by the powder at the discharging of the Piece, but of that by force whereof the molten head is mixed and conjoined with the venenate juice, so to make one of many. For this fire exercising its force upon the venenate juices, hindered by the intercourse of no Medium, and that for some space of time, and not for an instant, it may, if not consume, yet much weaken their strength. If there be any, who will not be satisfied by these reasons, let him consult, and read Matthiolus. There are (saith he) some of these latter times wholly ignorant of things, who (if we may say the truth) have been so madly foolish, that they said it was fit and requisite to put Treacle and Mithidate and such like Antidotes In praefat. 〈◊〉 6. Diascor. amongst Gold and Silver that was melted to make Cups, that so receiving the faculties of the Antidote they might resist poison. But how absurd and ridiculous their opinion is, let them judge (for it needs no clearer reproof) who have but a little knowledge in natural things, but chiefly in Metals. These are my reasons, these the authorities of men excelling in learning and judgement, that confirm me in my ancient and former opinion, that wounds made by Gunshot do not partake of any venenate quality. CHAP. XV. How wounds made by Arrows differ from such as are made by Gunshot. WOunds made by Arrows and Bolts shot out of Crossbows and such Wounds made with Arrows and such like things, are often without contufion. But are ofttimes poisoned. like things, differ chiefly in two things, from these which are made by Gunshot. The first is, for that they are oft times without contusion, which the other never are. The other is, for that they oft times are poisoned. In both these respects, their cure is different from the other. But the cure of these wounds made by Arrows is different in itself, by reason of the variety and divers sorts of Darts or Arrows. CHAP. XVI. Of the diversities of Arrows and Darts. Arrows and Darts are different amongst themselves both in matter and in form or figure, in number, making, faculty or strength; In matter, for that The differences of Arrows. In matter. In sign. some of them are of wood, some of Reeds, some are blunt headed, others have piles or heads of Iron, Brass, Led, Tin, Horn, Glass, Bone. In figure, for that some are round, others cornered, some are sharp pointed, some barbed, with the barbs standing either to the point, or shafts, or else across, or both ways; but some are broad and cut like a chisel. For their bigness, some are three foot long, some less. For their number, they differ in that, because some have one In bigness. In number, In making. head, others more. But they vary in making, for that some of them have the shaft put into the head, others the head into the shaft; some have their heads nailed to the shaft, others not, but have their heads so loosely set on, that by gentle plucking the shaft, they leave their heads behind them, whence dangerous wounds proceed. But they differ in force, for that some hurt by their Iron only, others In force. besides that, by poison, wherewith they are infected. You may see the other various shapes here represented to you in the following Figure. The Figures of divers sorts of Arrows. CHAP. XVII. Of the difference of the wounded parts. THe Wounded parts are either fleshy or bony; some are near the joints, others seated upon the very joints; some are principal, others serve them; some are external, others internal. Now in wounds where deadly signs appear, its fit you give an absolute judgement to that effect; lest you make the Art to be scandalled by the ignorant. But it is an inhuman part, and much digressing from Art, to leave the Iron in the wound; it is sometimes difficult to take it out, You must not leave the weapon in the wound. yet a charitable and artificial work. For it is much better to try a doubtful remedy, than none at all. CHAP. XVIII. Of drawing forth Arrows. YOu must in drawing forth Arrows shun incisions and dilacerations of Veins and Arteries, Nerves and Tendons. For it is a shameful and The manner of drawing forth 〈◊〉 and such weapons. bungling part to do more harm with your hand, than the Iron hath done. Now Arrows are drawn forth two ways, that is, either by extraction, or impulsion. Now you must presently at the first dressing pull forth all strange bodies, which that you may more easily and happily perform, you shall set the Patient in the same posture, as he stood when he received his wound; and he must also have his Instruments in a readiness, chiefly that which hath a slit pipe and toothed without, into which there is put a sharp iron style, like the Gimlets we formerly mentioned for the taking forth of Bullets; but that it hath no screw at the end, but is larger and thicker, so to widen the pipe, that so widened it may fill up the hole of the Arrows head where into the shaft was put, and so bring it forth with it, both out of the fleshy as also out of the bony parts, if so be that the end of the shaft be not broken, and left in the hole of the head. That also is a fit Instrument for this purpose, which opens the other end toothed on the outside, by pressing together of the handle. You shall find the Iron or head that lies hid by these signs, there will be a certain roughness and inequality observable on that part if you feel it up and down with your hand; the flesh there will be bruised, livid, or black, and there is heaviness and pain felt by the patient both there and in the wound. A deliniation of Instruments fit to draw forth the heads of Arrows and Darts, which are left in the wound without their shafts. A hooked Instrument fit for to draw forth strange bodies, as pieces of Mail, and such other things as it can catch hold of, which may also be used in wounds made by Gunshot. But if by chance either Arrows, Darts or Lances, or any winged head of any other weapon, be run through and left sticking in any part of the body, as the Thigh, with a portion of the shaft or staff slivered in pieces, or broken off; than it is fit the Chirurgeon with his cutting mullets should cut off the end of the staff or shaft, and then with his other mullets pluck forth the head, as you may see by this Figure. CHAP. XIX. How Arrows broken in a wound may be drawn forth. But if it chance that the weapon is so broken in the wound, that it cannot be taken hold on by the formerly mentioned Mullets, then must you draw, or pluck it out with your Crane, or Crow's bill, and other formerly described Instruments. But if the shaft be broken near the head, so that you cannot take hold thereof with your Crane's bill, than When to draw forth the weapon on the coutrary side. you shall draw it forth with your Gimlet which we described before to draw forth bullets; for if such a Gimlet can be fastened in Bullets, it may far better take hold of wood. But if the head be barbed, as usually, the English arrows are, then if it may be conveniently done, it will be very fitting to thrust them through the parts. For if they should be drawn out the same way they went in, there would be no small danger of breaking or tearing the Vessels and Nerves by these hooked barbes. Wherefore it is better to make a section on the other side whither the head tended, and so give it passage forth if it may be easily done; for so the wound will be the more easily cleansed and consolidated. But on the the contrary, if the point tend to When by the same way it went in. any bone, or have many muscles or thick flesh against the head thereof, as it happens sometimes in the Thighs, Legs and Arms; than you must not thrust the head through, but rather draw it out the same way it came in, dilating the wound with fit Instruments, and by skill in Anatomy shunning the larger Nerves and Vessels. Therefore for this purpose put a hollow Dilater into the wound, and therewith take hold of both the barbes or wings of the head; and then take fast hold of the head with your Cranes-bill, and so draw them forth all three together. A Dilater hollowed on the inside, with a Cranes-bill to take hold of the barbed head. CHAP. XX. What to be done, when an Arrow is left fastened or sticking in a bone. But if the weapon be so depact and fastened in a bone that you cannot drive it forth on the other side, neither get it forth by any other way than that it entered in by; you must first gently move it up and down, if it stick A Caution. very fast in, but have a special care that you do not break it, and so leave some fragment thereof in the bone; then take it forth with your Crow's bill, or some other fit Instrument formerly described. Then press forth the blood, and The benefit of bleeding in wounds. suffer it to bleed somewhat largely, yet according to the strength of the Patient and nature of the wounded part. For thus the part shall be eased of the fullness and illness of humours, and less molested with inflammation, putrefaction and other symptoms which are customarily feared. When the weapon is drawn forth, and the wound once dressed, handle it, if simple, as you do simple wounds; if compound, then according to the condition and manner of the complication of the effects; Certainly the Oil of Whelps formerly described is very good to assuage pain. To conclude, you shall cure the rest of the Symptoms according to the method prescribed in our Treatise of wounds in general, and to that we have formerly delivered concerning wounds made by Gunshot. CHAP. XXI. Of poisoned wounds. IF these wounds at any time prove poisoned, they have it from their primitive The signs of poisoned wounds. cause, to wit, the empoisoned Arrows, or Darts of their enemies. You may find it out both by the property of the pain; if that it be great and pricking, as if continually stung with Bees, for such pain usually ensues in wounds poisoned with hot poison, as Arrows usually are; Also you shall know it by the condition of the wounded flesh; for it will become pale and grow livid, with some signs of mortification. To conclude, there happen many and malign symptoms upon wounds which are empoisoned, being such as happen not in the common nature of usual wounds. Therefore presently after you have plucked forth the strange bodies, encompass the wound with many and deep scarrifications, Remedies in poisoned wounds. apply ventoses with much flame, that so the poison may be more powerfully drawn forth; to which purpose the sucking of the wound, performed by one whose mouth hath no soreness therein, but is filled with oil, that so the poison which he sucks may not stick, nor adhere to the part, will much conduce. Lastly, it must be drawn forth by rubefying, vesicatory and caustick medicines, and assailed by ointments, cataplasms, emplasters, and all sorts of local medicines. The end of the Eleventh Book. OF CONTUSIONS AND GANGRENES. THE TWELFTH BOOK. CHAP. I. A Contusion, according to Galen, is a solution of Continuity in the flesh or bone, caused by the stroke of some heavy and Gal. Lib. de artis const●●●t. obtuse thing, or a fall from an high. The symptom of this disease is by Hypocrates called Peliosis, and Melasma, that Sect. 2. lib. de fracturis. is to say, blackness & blueness; the Latins tear me it Sugillatum. There are divers sorts of these Sugillations or blacknesses, according as the blood is poured forth into the more inward or outward part of the body. The blood is poured forth into the body, when any (for example) falls from an high, or hath any heavy Causes of Bruises and Sugillations. weight falls upon him, as it often happens to such as work in Mines, or are extremely racked or tortured; and sometimes by too loud and forcible exclamation. Besides also by a Bullet shot through the body, blood is poured forth into the bellies, and so often evacuated by the passages of the Guts and bladder. The same may happen by the more violent and obtuse blows of a hard Truncheon, Club, Stone, and all things which may bruise and press the blood out of the vessels either by extending or breaking them. For which causes also the exterior parts are contused, or bruised sometimes with a wound, sometimes without, so that the skin being whole, and as far as one can discern, untouched, the blood pours itself forth into the empty spaces of the muscles, and between the skin and muscles; which affect the Ancients have termed Ecchymosis; Hypocrates calls it by a peculiar name Nausiosis, for that in this affect the swollne veins seem as it were to vomit, Sect. 2. lib. de fract. and verily do vomit or cast forth the superfluous blood which is contained in them. From these differences of Contusions are drawn the indications of curing, as shall appear by the ensuing discourse. CHAP. II. Of the general cure of great and enormous Ccontusions. THe blood poured forth into the body, must be evacuated by visible and not visible evacuation. The visible evacuation may be performed by blood-letting, Cupping-glasses, horns, scarification, horeseleeches and fit purgative medicines; if so be the patient have not a strong and continual fever; The not visible evacuation is performed by resolving and sudorificke potions, baths, & a slender diet. Concerning Blood-letting Galens' opinion is plain, where he bids, in a fall from an high place, and generally Ad sentent. 62. sect. 3. lib. de Articulit. for bruises upon what part soever they be, to open a vein, though the parties affected are not of a full constitution; for that unless you draw blood by opening a vein, there may inflammations arise from the concreate blood, from whence without doubt evil accidents may ensue. After you have drawn blood give him four ounces of Oxycrate to drink; for that by the tenuity of its substance hinders the coagulation of the blood in the belly, or in stead thereof you may use this following potion. ℞. Gentianaeʒiij; bulliant in Oxycrato; in colatura dissolve A potion to dissolve and evacuate clotted blood. electiʒj. fiat potio. These Medicines dissolve, and cast forth by spitting and vomit the congealed blood, if any thereof be contained in the ventricle or lungs; it will be expedient to wrap the patient presently in a sheep's skin, being hot and newly taken from the sheep, and sprinkled over with a little myrrh, cresses and fault, A hot sheep's skin. and so to put him presently in his bed, and then cover him so that he may sweat plentifully. The next day take away the sheeps-skinne, and anoint the body with the following anodyne and resolving unguent. ℞. unguent. de althaea ℥ vi. olei Lumbrie. chamaem. anethi. an ℥ ij. terchinth. venetae ℥ iiij. farinae foenugrae. rosar. rub. pulverisat. pull. A discussing ointment. myrtillorum, an ℥ i. fiat litus ut dictum est. Then give this potion which is sudorificke and dissolves the congealed blood. ℞. Ligni guaiaci ℥ viij. radicis enulae camp. consolid. A sudorificke potion to dissolve congealed blood. majoris, ireos Florent. polypod. querni, seminis coriandri, anisi, an ℥ ss. glycyrhiz. ℥ ij. nepeta, centaurcae, caryophyl. cardui ben. verbena, an, m. s. aquae fortanae lib. xij. Let them be all beaten and infused for the space of twelve hours, then let them boil over a gentle fire until the one half be consumed; let the patient drink some half pint of this drink in the morning, and then sweat some hour upon it in his bed, and do this for seven or eight days. If any poor man light upon such a mischance, who for want of means cannot be at such cost, it will be good, having wrapped him in a sheet, to bury him up to the chin in Dung mixed with some hay or straw, and there to keep him, until he have sweat sufficiently. I have done thus to many with very good success. You shall also give the patient potions made with syrups which have power to hinder the coagulation and putrefaction of the blood; such as syrup of Vinegar, or Lemons, of the juice of Citrons and such others to the quantity of an ounce dissolved in scabious, or Carduus water. You may also presently Surupe hindering putrefaction and congealing of blood. after the fall give this drink, which hath power to hinder the coagulation of the blood, and strengthen the bowels. ℞. redactiʒjs, aquae rubiae majoris, & plantagin. an. ℥ i. theriacaeʒss. syrupi de rosis siccis, ℥ ss, fiat potus. Let him take it in the morning for four or five A drink for the same purpose. days. In steed hereof you may make a potion of one dram of Sperma ceti dissolved in bugloss or some other of the waters formerly mentioned, and half an ounce of syrup of Maidenhair; if the disease yield not at all to these formerly prescribed medicines, it will be good to give the patient for nine days, three or four hours before meat some of the following powder. ℞. rhei torrefacti, rad. rub. majoris, centaurei, gentianae, aristolo. rotundae, an. ℥ ss. give ʒj. hereof with syrup of Venegar A powder for the same. and Carduus water. They say that the water of green Walnuts, distilled by an Alembicke, The distilled water of green Walnuts. Baths. is good to dissolve congealed and knotted blood. Also you may use baths made of the decoction of the roots of Orris, Elecampane, Sorrell, Fennell, Marshmallows, Waterferne, or Osmund the waterman, the greater Comfery; the seeds of Faenugreeke; the leaves of Sage, Marjerome; the flowers of Camaemile, Melilore and the like. For a warm bath hath power to rarify the skin, to dissolved the clotted blood, by cutting the tough & mitigating the acride humours, by calling them forth into the surface of the body, and relaxing the passages thereof; so that the rebellious qualities being o'ercome, there ensues an easy evacuation of the matter by vomit, or expectoration, if it float in the stomach, or be contained in the chest; but by stool & Urine, if it lie in the lower parts; by sweats and transpiration if it lie next under the skin. Wherefore baths are good for those who have a Peripneumonia or inflammation of their Lungs, or a Pleurisy, according to the mind of Hypocrates, if so be that they be used, when the fever begins to be assuaged; for so they mitigate pain, Lib. 3. de vict. deut. & lib. 3. de morb. help forwards suppuration, and hasten the spitting up of the purulent matter. But we would not have the patient enter into the bath, unless he have first used general remedies, as blood-letting and purging; for otherwise there will be no small danger, lest the humours diffused by the heat of the bath, cause a new defluxion into the parts affected. Wherefore do not thou by any means attempt, to use this or the like remedy, having not first had the advice of a Physician. CHAP. III. How we must handle Contusions, when they are joined with a wound. EVery great Contusion forthwith requires blood-letting, or purging, or both; and these either for evacuation, or revulsion. For thus Hypocrates in a contusion of the Heel, gives a vomitory potion, the same day, or else Sect. 2. lib. fract. the next day after the heel is broken. And then if the Contusion have a wound associating it, the defluxion must be stayed at the beginning, with an ointment made of Bole Armenicke, the whites of eggs, and oil of roses, and smyrtles, with the powders of red roses, Allome and mastic. At the second dressing apply a digestive made of the yolk of an egg, oil of violets and Turpentine. This folfowing Cataplasm shall be applied to the near parts to help forwards suppuration. ℞. A suppurative Cataplasm. rad althaes, & lilio. an. ℥ iiij. sol. malu. violar. senecionis, an. M. ss. coquantur complete, & passentur per setaceum, addendo butyrirecentis & olei viol. an. ℥ iij. farinae volatilis quant. sufficit; fiat cataplasma ad formam pultis liquidae. Yet have a care in using of Cataplasms, that A caution to be observed. you do not too much exceed; for too frequent and immoderate use of them makes wounds plegmonous, sordid and putrid. Wherefore the wound after it is come to suppuration must be cleansed, filled with flesh and cicatrized; unless haply the contused flesh shall be very much torn, so that the native heat forsake it, for than it How contused wounds must be sowed must be cut away. But if there be any hope to agglutinate it, let it be sowed, and other things performed according to Art; but the stitches must not be made so close together, as when the wound is simple, and without contusion; for such wounds are easily inflamed and swell up, which would occasion either the breaking of the thread or flesh, or tearing of the skin. CHAP. IU. Of these Contusions which are without a wound. IF the skin being whole and not hurt, as far as can be discerned, the flesh which lies under it be contused, and the blood poured forth under the skin make an Ecchymosis, than the patient must be governed according to Art Phlebotomy. until the malign symptoms, which commonly happen, be no more to be feared. Wherefore in the beginning draw blood on the opposite side, both for evacuation and revulsion. The contused part shall be scarified with equal scarifications; then shall Scarifying. Cupping glasses. you apply cupping-glasses or horns, both for evacuation of the blood which causes the tumour and Tension in the part; as also to ventilate and refrigerate the heat of the part, lest it turn into an Abscess. Neither must we in the mean while omit gentle purging of the belly. The first topicke medicines ought to be astrictives Astrictives how good in Contusions. which must lie some short while upon the part, that so the Veins, and Arteries may be as it were straitened and closed up, and so the defluxion hindered; as also that the part itself may be strengthened. This may be the form of such a remedy, ℞. Albumina everum nu. iij. olei myrtini & rosacei, an. ℥ i. boli armeni, & sanguine. dracon. an. After astrictives must follow discussives. ℥ ss. nucum cupress. gallarum, pull. aluminis usti, an. ʒij. incorporentur omnia addendo aceti parum, fiat medicamentum. Then you shall resolve it with a fomentation, Cataplasm, and discussing emplasters. CHAP. V. By what means the contused part may be freed from the fear and imminent danger of a Gangrene. GReat Contusions are dangerous even for this cause, for that a Gangrene Sect. 2. lib. de fract. and mortification sometimes follows them; which Hypocrates teacheth to happen, when as the affected part is grown very hard and liquid. Wherefore when the part grows livide and black, and the native colour The cause of a Gangrene. thereof, by reason of the afflux of the concreate blood, is almost extinct; chiefly, to ease the part of that burden, cupping glasses and horns shall be applied to the part itself being first scarified with a Lancet, or else the following Instrument termed a Scarificator, which hath 18 little wheels sharp and cutting like a razor, which The use of a Scarificator. may be straitened and slacked by the pins noted by D. and P. This instrument is to be commended for that it performs the operation quickly and gently, for it makes 18 incisiones in the space that you make one with a Lancet or knife. A Scarificator. A. Shows the cover. B. The Box, or Case. Then shall you foment the part with strong Venegar wherein the roootes of radish or of Dragons, Cuckowpint, Saelomons' Seal, Auripigmentum and the like have been boiled; for such acride things do powerfully heat, resolve and draw the A fomentation to discuss and draw to the skin. concreate blood from the inner part of the body unto the skin, which by its settling in the part affected, prohibits the entrance of the vital spirits, the preservers of its integrity; yea also extinguisheth the native heat of the same part. Now we must not use these things but with great discretion, lest so we draw not only that blood which is poured forth of the vessels, but also the other which is contained in the vessels. Moreover also we must not use them, unless when the defluxion is stayed. For small contusions (which Galen judgeth by the softness of the contused part) it will be sufficient to apply to discuss them, Virgins wax dissolved and In sect. 2. lib. de fiactur. mixed with Cummim seeds, Cloves, the root of black Briony, (which hath a wonderful faculty to discuss all blackenesses and sugillations) for the same purpose, you may also apply wormwood bruised and so warmed in a dish and sprinkled over with a little white wine. Also fry wormwood with oil of camomile, bran, the powder of Cloves, and Nutmegs, adding thereto a little aqua vitae, then put it all in a linen cloth and apply it hot to the part. The following emplaster doth powerfully discuss congealed blood. ℞. Picis nigrae ℥ ij. Gum. Elemi. ℥ ij. styracis A discussing plaster. liquidae & terebinth. come. an. ℥ ss. pull. sulphuris vivi. ℥ i. Liquefiant simul, fiat Emplastrum; and let be spread upon leather and so applied. CHAP. VI Of that strange kind of symptom which happens upon contusions of the ribs. THe flesh contused sometimes by great violence becomes mucous and swollen, or puffed up like Veal, which the butchers blow up, the skin Hip. sect. 3. lib. de art. sent, 58. & 65. remaining whole. This is seen and happens chiefly in that flesh which is about the ribs; for this being bruised either by a blow, or fall, or resitencie, or any other such like cause; if you press it with your hand, a certain windiness goeth out thereof with a small whyzzing, which may be heard, and the print of your finges will remain as in oedemas. Unless you quickly make fit provision against this symptom, there is gathered in that space which the flesh departing from the bones, leaves empty, a certain purulent sanies, which divers times fowls and corrupts the ribs. It will be cured, if the mucous tumour be presently pressed, and straightly bound with ligatures, yet so that you hinder not the breathing, when as the affect happens upon the ribs and parts of the Chest. Then apply to the Remedies for a mucous and flatulent tumour of the ribs. The cause. part a plaster of Oxycroceum or diachylon Ireatum with the emplaster de meliloto; also discussing fomentaions shall be used. The cause of such a tumour is a certain mucous phlegm; seeing that nature is so weak that it cannot well digest the nourishment, and assimilate it to the part: but leaves fomething as it were half concocted. No otherwise than the conjunctive coat of the eye is sometime so lifted up and swollen by a stroke, that it starts as it were out of the orb of the eye, leaving such filth or matter as we see those which are bleared eye to be troubled withal; because the force and natural strength of the eyes is become more weak, either by the fault of the proper distemperature, or the abundance of moisture which flows thither, as it happens in those tumours which are against nature. For flatulencies are easily raised from a waterish and phlegmatic humours wrought upon by weak heat, which mixed with the rest of the humour, the tumour becomes higher. CHAP. VII. A discourse of Mumia, or Mummy. PEradventure it may seem strange what may be the cause, why in this Treatise of curing contusions, or bruises, I have made no mention of giving Mummy either in bowl, or potion to such as have fall'n from high places, or have been otherwise bruised, especially seeing it is so common Mummy a frequent and usual medicine in contusions. and usual, yea the very first and last medicine of almost all our practitioners at this day in such a case. But seeing I understood, and had learned from learned Physicians, that in using remedies, the indication must always be taken from that which is contrary to the disease, how could I? how can any other give Mummy in this kind of disease, seeing we cannot as yet know what Mummy is, or what is the The reason that the Author makes no mention thereof amongst his medicines. nature and essence thereof? So that it cannot certainly be judged, whether it have a certain property contrary to the nature and effects of contusions. This how it may have, I have thought good to relate somewhat at large; neither do the Physicians who prescribe Mummy, nor the Authors that have written of it, nor the Apothecaries that fell it, know any certainty thereof. For if you read the more ancient, Serapio and Avicen, to the modern Matthiolus and Thevet, you shall find quite different opinions. Ask the Merchants who bring it to us, ask the Apothecaries who buy it of them, to fell it to us, and you shall hear them speak diversely hereof, The opinion of the Arabians concerning it. that in such variety of opinions, there is nothing certain and manifest. Serapio and Avicen have judged Mummy to be nothing else but Pissasphalthum; now Pissasphaltum is a certain forth or foam rising from the Sea, or Sea, waters; this same foam as long as it swims upon the water is soft and in some sort liquid: but being driven upon the shore by force of tempest, and working of the sea, and sticking in the cavityes of the rocks, it concreates into somewhat a harder substance than dried pitch, as Dioscorides faith. Belonius saith, that Mummy is only known to Egypt and Greece. Others write that it is man's flesh, taken from the carcases of such as are dead, and covered over in the Lib. 4. cap. 84. sands in the deserts of Arabia; in which Country they say the sands are sometimes carried and raised up with such force and violence of the winds, that they Another opinion of Mummy. overthrow and suffocate such passengers as they meet withal; the flesh of these dried by the sand and wind they affirm to be Mummy. Mathiolus following the more usual and common opinion, writes that Mummy is nothing else than a liquor flowing from the Aromatic embalments of dead bodies, which becomes dry and hard. For understanding whereof you must know Another. from all manner of antiquity, that the Egyptians have been most studious in burying and embalming their dead; not for that end that they should become medicines for such as live, for they did not so much as respect or imagine so horrid a wickedness. But either for that they held an opinion of the general resurrection, or that in these monuments they might have something, whereby they might keep their dead friends in perpetual remembrance. Thevet not much dissenting from his own opinion, writes that the true Mummy is taken from the monuments and stony tombs of the anciently dead in Egypt, the chinks of which tombs were closed, and cemented with such diligence; but the enclosed bodies embalmed with precious spices with such art for eternity, that the linen vestures which were wrapped about them presently after their death, may be seen whole even to this day; but the bodies themselves, are so fresh that you would judge them scarce to have been three days buried. And yet in those Sepulchers and Vaults from whence these bodies are taken, there have been some corpses of two thousand years old. The same, or their broken members are brought to Venice from Syria and Egypt, and thence dispersed over all Christendom. But according to the different condition of men, the matter of their embalments were divers; for the bodies of the Nobility or Gentry are embalmed with Myrrh, Aloes, Saffron, and other precious spices, and Drugs; but the bodies of the common sort whose poverty and want of means could not undergo such cost, were embalmed with asphaltum or piss asphaltum. Now Mathiolus saith that all the Mummy which is brought into these parts is of this last kind and condition. For the Noble men and chief of the province so What our Mummy usually is. religiously addicted to the monuments of their ancestors, would never suffer the bodies of their friends, and kindred to be transported hither for filthy gain, and such detested use, as we shall show more at large at the end of this work. Which thing sometimes moved certain of our French Apothecaries, men wondrous audacious, and covetous, to steal by night the bodies of such as were hanged, and embalming them with salt and Drugs they dried them in an Oven, so to sell them thus adulterated in steed of true Mummy. Wherefore we are thus compelled both foolishly and cruelly to devour the mangied and putrid particles of the carcases of the basest people of Egypt, or of such as are hanged, as though there were no other way to help or recover one bruised with a fall from a high place, than to bury man by an horrid insertion in their, that is, in man's guts. Now if this Drugge were any way powerful for that they require, they might perhaps have some pretence, for this their more than barbarous inhumanity. But the case stands thus, that this wieked kind of Drugge, doth nothing help the diseased, in that case, wherefore and wherein it is administered, as I have tried Mummy is no way good for contusions, an hundred times, and as Thevet witnesses, he tried in himself, when as he took some thereof by the advice of a certain jewish Physician in Egypt, from whence it is brought; but it also infers many troublesome symptoms, as the pain of the heart or stomach, vomiting and stink of the mouth. I persuaded by these reasons, do not only myself prescribe any hereof But hurtful, and how? to my patients, but also in consultations, endeavour what I may, that it be not prescribed by others. It is far better according to Galens' opinion in Method. med. to drink some oxycrate, which by its frigidity restrains the flowing blood, and by its tenuity of substance dissolves and discusses the congealed clotts The effects of oxycrate in Contusions. thereof. Many reasons of learned Physicians (from whom I have learned this history of Mummy) drawn from Philosophy, whereby they make it apparent, that there can be no use of this or that Mummy in contusions, or against flowing or congeased blood, I willingly omit, for that I think it not much beneficial to Surgeons to insert them here. Wherefore I judge it better to begin to treat of Combustions, or Burnes. CHAP. VIII. Of Combustions and their differences. ALL Combustions whether occasioned by Gunpowder, or by scalding oil, water, some mettle or what things soever else, differ only in The reason and syptomes of Combustions. magnitude. These first cause pain in the part, and imprint in it an unnatural heat. Which savouring of the fire, leaves that impression, which the greeks call Empyreuma. There are more or less signs of this impression, according to the efficacy of the thing burning, the condition of the part burned, and stay upon the same. If the Combustion be superficiary, the skin rises into pustles and blisters, unless it be speedily prevented. If it below or deep in, it is covered with an Eschar or crust, the burnt flesh by the force of the fire turning into that crusty hardness. The burning force of the fire, upon whatsoever part it falls, leaves a hot distemper therein, condensates, contracts, and thickens the skin, The cause of the blisters rising upon burns. whence pain proceeds; from pain there comes an attraction of humours, from the adjacent and remote parts. These humours presently turned into waterish or serous moisture, whilst they seek to pass forth, and are hindered thereof by the skin condensated by the action of the fire, they lift it up higher, and raise the blisters which we see. Hence divers Indications are drawn, whence proceeds the variety of medicines for burns. For some take away the Empyreuma, that is, the heat of the fire (as we term it) and assuage the pain; other hinder the rising of blisters; othersome are fit, to cure the ulcer, first to procure the falling away of the Eschar, then to cleanse, generate flesh and cicatrise it. remedies fit to assuage pain, and take away Variety of medicines to take away the heat and assuage the pain. the fiery heat, are of two kinds; for some do it by a cooling faculty, by which they extinguish the preternatural heat, and repress or keep back the blood and humours, which flow into the parts by reason of heat & pain. Others endued with contrary faculties, are hot and attractive; as which by relaxing the skin, and opening the pores, resolve and dissipate the serous humours, which yield both beginning, and matter to the pustles, and so by accident assuage the pain and heat. Refrigerating things, are cold water, the water of Plantain, Nightshade, Henbane, Hemlock; the juices of cooling herbs, as Purslane, Lettuce, Plantain, Houseleek, poppy, Mandrake and the like. Of these some may be compounded, as some of the forenamed juices beaten with the white of an egg; Clay beaten and dissolved in strong Venegar; roch Alum dissolved in water, with the whites of eggs beaten therein; writing ink mixed with Venegar and a little Camphire; Vnguentum nutritum, and also Populeon newly made. These and the like shall be now and then renewed chiefly at the first, until the heat and pain be gone. But these same remedies must be applied warm, for if they should be laid, or put to cold, they would cause pain, and consequently defluxion; besides also their strength could not pass, or enter into the part, or be brought into action; but so applied they assuage pain, hinder inflammation and the rising of blisters. CHAP. IX. Of hot and attractive medicines to be applied to burns. AMongst the hot and attractive things which by rarifying, drawing out, and dissolving, assuage the pain and heat of combustions, the fire challenges How fire may assuage the pain of burning. the first place, especially when the burning is but small. For the very common people know and find by daily experience, that the heat of the lightly burnt part vanishes away, and the pain is assuaged, if they hold the part which is burnt some pretty while to the heat of a lighted candle, or burning coals; for the similitude causeth attraction. Thus the external fire whilst it draws forth the fire which is internal and inust into the part, is a remedy against the disease it caused and bred. It is also an easily made and approved remedy, if they presently after the burn apply to the grieved part raw Onions beaten with some salt. Now you must note, that this medicine takes no place, if it be once gone into an Beaten Onions good for burns and how. ulcer, for it would increase the pain and inflammation; but if it be applied when the skin is yet whole and not excoriated, it doth no such thing, but hinders the rising of pustles and blisters. Hypocrates for this cause also uses this kind of remedy in procuring the fall of the Eschar. If any endeavour to gainsay the use of this remedy by that principle in Physic, which says, that contraries are cured by contraries, and therefore affirm that Onions according to the authority of Galen, being hot in the fourth degree, are not good for combustions; let him know that Onions Lib. 5. simple. are indeed potentially hot, and actually moist, therefore they rarify by their hot quality, and soften the skin by their actual moisture, whereby it comes to pass that they attract, draw forth, and dissipate the imprinted heat, and so hinder the breaking forth of pustles; To conclude, the fire as we formerly noted, is a remedy against the fire. But neither are diseases always healed by their contraries (saith Galen) but sometimes by their like; although all healing proceed from the contrary, this word contrary, being more largely and strictly taken; for so also a Phlegmon is often cured by resolving medicines, which healeth it by dissipating the matter thereof. Therefore Onions are very profitable for the burnt parts, which are not yet exulcerated or excoriated: But there are also many other medicines good to hinder the rising of blisters; such is new horse-dung fried in oil of walnuts or Roses, and applied to the parts. In like manner the leaves of Elder or Dane-wort boiled in oil of nuts, and beaten with a little salt. Also quinched lime powdered and mixed with Vnguentum Rosatum. Or else the leaves of Cuckowpint and Sage beaten together with a little salt. Also Carpenters Glue dissolved in water and anointed upon the part with a feather, is good for the same purpose. Also thick Varnish which pollishers or sword cutlers use, But if the pain be more vehement, these medicines must be renewed 3 or 4 times in a day and a night, so to mitigate the bitterness How often in a day these must be dressed. of this pain. But if so be we cannot by these remedies hinder the rising of blisters, than we must presently cut them as soon as they rise, for that the humour contained in them, not having passage forth, acquires such acrimony that it eats the flesh which lieth under it, & so causeth hollow ulcers: So by the multitude of causes & increase of matter the inflammation groweth greater, not only for nine days (as the common people prattle) but for far longer time; also some while for less time, if the body be neither replete with ill humours, nor plethoric, and you have speedily resisted the pain and heat by fit remedies. When the combustion shall be so great Medicines for an Eschar. as to cause an Eschar, the falling away must be procured by the use of emollient and hamective medicines, as of greases, oils, butter, with a little basilicon, or the following ointment. ℞. Mucagin. psillij. & cydon. an. ℥ iiij. gummi, trag. ℥ ij. extrahantur cum aqua parietariae, olei lilliorum ℥ iiss. cerae novae q. s. fiat unguentum molle. For ulcers and excoriations you shall apply fit remedies, which are those that are without acrimony, such as unguentum album camphoratum, desiccativum rubrum, unguentum rosatum, made without Venegar, or nutritum composed after this manner. ℞. lethargy auri ℥ iiij. A description of Nutritum. ol. rosat. ℥ iij. ol. depapaver. ℥ iiss. ung. populeon. ℥ iiij. camphoraeʒj. fiat unguentum in mortario plumbeo secundum artem. Or oil of Eggs tempered in a Leaden mortar. Also unquenched lime many times washed and mixed with unguentum rosatum, or fresh butter without salt, and some yolkes of eggs hard roasted. Or. ℞. Butyri recent. fine sale, ustulati, & colati ℥ vi. vitell. over. iiij. cerus. lotae in aqualplantag. vel rosar. ℥ ss. tutkiae similiter lotae, ʒiij. plumbi usti, & loti, ʒij. Misceantur omnia simul, fiat linimentum ut decet. Or else, ℞. cort. sambuc. viridis, & olei rosat. an. lib. i. bulliant simul lento igne, postea colentur, & add olei ovorum ℥ iiij. pull. ceruse. & tuthiae praepar. an. ℥ i. cerae albae quantum sufficit, fiat unguent. molle secundum artem. But the quantity of drying medicines may always be increased or diminished according as the condition of the ulcer shall seem to require. The following remedies, are fit to assuage pain, as the mucilages of Line seeds, of the seeds of Psilium, or Flea-wort, and quinces extracted in rose-water, or fair water, with the addition of a little camphire; and lest that it dry too speedily, add thereto some oil of Roses. Also five or six yoalkes of eggs mixed with the mucilages of Line seed, the seed of Psilium, and quinces often renewed, are very powerful to assuage pain, The women which attend upon the people in the Hospital in Paris, do happily use this medicine against burns. ℞. Lard. conscisilibram unam; let it be dissolved in Rosewater, then A remedy for burns commonlyumed in the Hospital of Parts. strained through a linen cloth, then wash it four times with the water of hen-bane or some other of that kind, then let it be incorporated with eight yolkes of new laid egg, and so make an ointment. If the smart be great, as usually it is in these kinds of wounds, the ulcer or sores shall be covered over with a piece of Tiffany, lest you hurt them, by wiping them with somewhat a course cloth, and so also the matter may easily come forth, and the medicines easily enter in. Also you must have a care when the eyelids, lips, sides of the fingers, neck, the armpits, hams, and bending of the elbow are burnt, that you suffer not the parts to touch one the other, without the interposition of some thing; otherwise in continuance of time they would grow and stick together. Therefore you shall provide for this, by fit placing the parts, and putting soft linen rags between them. But you must note, that deep combustions, and such as cause a thicker Eschar, are less painful, than such as are but only superficiary. The truth hereof you may perceive by the example Why deep combustions are less painful than superficiary. of such as have their limbs cut off, and seared or cauterised with an hot Iron; for presently after the cauterising is performed they feel little pain. For this great combustion takes away the sense, the vehemency of the sensory or thing affecting the sense, depriving the sensitive parts of their sense; As we have formerly noted when we treated of wounds and pains of the Nerves. The falling away of such Eschars shall be procured by somewhat a deep scarification which may pierce even to the quick, that so the humours which lie under it may enjoy freer perspiration, and emollient medicines may the freelier enter in, so to soak, moisten and soften the Eschar that it may at length fall away. The rest of the cure shall be performed by detergent and sarcoticke medicines, adding to the former ointments mettalline powders, when the present necessity shall seem so to requre. But we cannot justly say in what proportion and quantity each of these may be mixed, by reason of that variety which is in the temper and consistence of bodies, and the stubborness and gentleness of diseases. After a burn the scar which remaineth is commonly rough, unequal, and ill favoured: therefore we will tell you in our treatise of the plague how it must be smoothed, and made even. I must not here omit to tell you, that Gunpowder set on fire doth often so penetrate Marks or spots made in the face by corns of Gunpowder cannot be taken away. into the flesh, not ulcerating nor taking off the skin, and so insinuate and throughly fasten itself into the flesh by its tenuity, that it cannot be taken or drawn out thence by any remedies, no not by Phoenigmes nor vesicatoryes, nor scarification, nor ventoses, nor horns, so that the prints thereof always remain, no otherwise than the marks which the Barbarians burn in their slaves which cannot afterwards be taken away or destroyed by any Art. CHAP. X. Of a Gangrene and Mortification. Certainly the malign symptoms which happen upon wounds, and the solutions of Continuity are many, caused either by the ignorance or negligence of the Chirurgeon; or by the Patient, or such as are about him; or by the malignity and violence of the disease: but there can happen no greater than a Gangrene, as that which may cause the mortification and death of the part, and oft times of the whole body; wherefore I have thought good in this place to treat of a Gangrene, first giving you the definition, then showing you the causes, signs, prognostickes, & lastly the manner of cure. Now a Gangrene is a certain disposition, and way to the mortification of the part, which it seizeth upon, dying by little and little. For when there is a perfect mortification, it is called by the greeks Sphacelos, by the Latins Syderatio, our countrymen Gal. 2. ad Glauconem. term it the fire of Saint Anthony or Saint Marcellus. CHAP. XI. Of the general and particular causes of a Gangrene. THe most general cause of a Gangrene is, when by the dissolution of the harmony and joint temper of the four first qualities, the part is made The general cause of a Gangrene. unapt to receive the faculties, the Natural, Vital, and Animal spirits, by which it is nourished, lives, feels, and moves. For a part deprived by any chance of these, as of the light, languishes and presently dies. Now the particular causes are many: and these either primitive, or antecedent. The primitive or external are combustions, caused by things either actually or potentially burning; The particular causes. actually as by fire, scalding oil or water, gunpowder fired and the like. But potentially by acride medicines; as Sublimate, vitriol, potential cauteries and other things of the same nature: for all these cause a great inflmmation in the part. But the ambient air may cause great refrigerations, and also a Gangrene, which caused Cold causeth a Gangrene. Hypocrates lib. de Aer. to call great refrigerations of the brain Sphacelisme. Therefore the unadvised and unfit application of cold and narcoticke things, a fracture, luxation and great confusion, too straight bandages, the biting of beasts, especially of such as are venomous; a puncture of the Nerves and Tendons, the wounds of the nervous parts and joints, especially in bodies which are plethorike and replete with ill humours, great wounds whereby the vessels which carry life are much cut, whence an aneurisma, and lastly many other causes, which perturb that harmony of the four prime qualities which we formerly mentioned, and so infer a Gangrene. CHAP. XII. Of the Antecedent causes of a Gangrene. NOw the antecedent or internal and corporeal causes of a Gangrene, are plentiful and abundant defluxions of humours hot or cold, falling into How defluxions cause a Gangrene. any part. For seeing the faculty of the part is unapt and unable to sustain and govern such plenty of humours, it comes to pass that the native heat of the part is suffocated and extinct for want of transpiration. For the Arteries are hereby so shut or penned up in a straight, that they cannot perform their motions of contraction and dilatation, by which their native heat is preserved and tempered. But then the Gangrene is chiefly uncureable when the influx of humours An untureable Gangrene. first takes hold of the bones, and inflammation hath its beginning from them. For in the opinion of Galen; all these kind of affects which may befall the flesh, are also incident to the bones. Neither only a Phlegmon or inflammation, but also Lib. de tumour. prater nature. a rottenness and corruption doth oft times first invade and begin at the bones; for thus you may see many who are troubled with the Leprosy and French disease, to have their skin and flesh whole and fair to look on, whose bones notwithstanding are corrupt and rotten, and oft times are much decayed in their proper substance. This mischief is caused by a venomous matter, whose occult quality we can scarce express by any other name than poison inwardly generated. Oft times also there is a certain acrid and stinking filth generated in flesh with a malign and old ulcer, with which if the bones chance to be moistened they become foul and at length mortified: of which this saying of Hypocrates is extant, Ulcers of a Aph. 5, sect. 6. years continuance or longer, must necessarily foul the bone, and make the scars hollow. Whither also belongs this saying of the same party; An Erysipelas is ill in the laying bare of a bone. But this flowing venenate and gangrenous matter is somewhiles hot, as in pestilent Carbuncles, which in the space of four and twenty hours by causing an escharre, bring the part to mortification: otherwhiles cold, as we see it divers times happens in parts which are possessed with a Gangrene, A Gangrene by effluxe of a cold matter. no pain, tumour, blackness, nor any other precedent sign of a Gangrene going before. For john de Vigo saith, that happened to a certain gentlewoman of Genoa under his cure. I remember the same happened to a certain man in Paris, who supping merrily A notable History. and without any sense of pain, went to bed, and suddenly on the night time a Gangrene seized on both his legs, caused a mortification without tumour, without inflammation; only his legs were in some places spread over with livid, black and green spots, the rest of the substance retaining his native colour: yet the sense of these parts was quite dead, they felt cold to the touch, and if you thrust your lancet into the skin no blood came forth. A Council of Physicians being called, they thought good to cut the skin, and flesh lying under it, with many deep scarifications; which when I had done, there came forth a little black, thick and as it were congealed blood; wherefore this remedy as also divers other, proved to no purpose, for in conclusion a blackish colour coming into his face, and the rest of his body, he died frantic. I leave it to the Readers judgement, whether so speedy, and suddenly cruel a mischief could proceed from any other than a venenate matter; yet the hurt of this venenate matter is not peculiar, or by its self. For oft times the force of cold, whether of the encompassing air, or the too immoderate Simple cold may cause a Gangrene. use of Narcoticke medicines, is so great, that in a few hours it takes away life from some of the members, and divers times from the whole body, as we may learn by their example, who travel in great snows, and over mountains congealed, and horrd with frost & ice. Hence also is the extinction of the native heat and the spirits residing in the part, and the shutting forth of that which is sent by nature to aid or defend it. For when as the part is bound with rigid cold, and as it were frozen, they cannot get nor enter therein. Neither if they should enter into the part, can they stay long there, because they can there find no fit habitation, the whole frame and government of nature being spoilt, and the harmony of the four prime qualities destroyed, by the offensive dominion of predominant cold their enemy. whereby it cometh to pass, that flying back from whence they first came, they leave the part destitute and deprived of the benefit of nourishment, life, sense and motion. A certain Briton an Ostler in Paris, having drunk sound after supper, cast A History. himself upon a bed; the cold air coming in at a window left open, so took hold upon one of his legs, that when he waked forth of his sleep, he could neither stand nor go. Wherefore thinking only that his leg was numb, they made him stand to the fire; but putting it very nigh, he burned the sole of his foot without any sense of pain, some finger's thickness, for a mortification had already possessed more than half his leg. Wherefore after he was carried to the Hospital, the Chirurgeon who belonged thereto, endeavoured by cutting away of the mortified leg to deliver the rest of the body from imminent death; but it proved in vain; for the mortification taking hold upon the upper parts, he died within three days, with thoublesome belching and hicketting, raving, cold sweat, and often swooning. Verily all that same winter, the cold was so vehement that many in the Hospital of Paris lost the wings or sides of their nosethrills, seized upon by a mortification without any putrefaction. But you must note, that the Gangrene which is caused by cold, doth first and principally seize upon the parts most distant from the heart, the fountain of heat, What parts are usually taken by a Gangrene occasioned by cold. to wit, the feet and legs; as also such as are cold by nature, as gristly parts, such as the nose and ears. CHAP. XIII. Of the signs of a Gangrene. THe signs of a Gangrene which inflammation or a phlegmon hath caused, are pain and pulsation without manifest cause, the sudden Sect. 2. lib. de fract. changing of the fiery and red colour into a livid or black, as Hypocrates shows where he speaks of the Gangrene of a broken heel. I would have you here to understand the pulsificke pain not only to be that which is caused by the quicker motion of the Arteries, but that heavy and What a pulsificke pain is. pricking which the contention of the unnatural heat doth produce by raising a thick cloud of vapours from these humours which the Gangrene sets upon. The signs of a Gangrene caused by cold, are, if suddenly a sharp pricking and burning pain assaileth the part; for penetrabile frigus adurit (i) piercing cold doth burn: if a Sgnes of a Gangrene proceeding of cold. shining redness as if you had handled snow, presently turn into a livid colour; if in stead of the accidental heat which was in the part, presently cold and numbenesse shall possess it, as if it were shaken with a quartain fever. Such cold if it shall proceed so far as to extinguish the native heat, bringeth a mortification upon the Gangrene; also oft times convulsions and violent shaking of the whole body, wondrous troublesome to the brain and the fountains of life. But you shall know Signs of Gangreenes' proceeding from straight bandages, or ligatures, etc. Gangreenes caused by too straight bandages, by fracture, luxation, and contufion, by the hardness which the attraction and flowing down of the humours hath caused; little pimples or blisters spreading or rising upon the skin by reason of the great heat, as in a combustion; by the weight of the part occasioned through the defect of the spirits not now sustaining the burden of the member; and lastly from this, the pressing of your finger upon the part, it will leave the print thereof as in an aedema; and also from this, that the skin cometh from the flesh without any manifest cause. Now you shall know Gangreenes' arising from a bite, puncture, aneurisma, or wound in plethoric and ill bodies, and in a part endued with most Signs of a Gangrene occasioned by a bite, puncture, etc. exquisite sense, almost by the same signs as that which was caused by inflammation. For by these and the like causes, there is a far greater defluxion and attraction of the humours than is fit, when the perspiration being intercepted and the passages stopped, the native heat is oppressed and suffocated. But this I would admonish the young Chirurgeon, that when by the forementioned signs he shall find the Gangrene present, that he do not defer the amputation for that he finds some sense, or small motion yet residing in the part. For oft times the affected parts are in this case moved not by the motion of the whole muscle, but only by means, that the head of the muscle is not yet taken with the Gangrene: with moving itself by its own strength, also moves its proper and continued tendon and tail though dead already; wherefore it is ill to make any delay in such causes. CHAP. XIIII. Of the Prognostickes in Gangreenes. HAving given you the signs and causes to know a Gangrene; it is fit we also give you the prognosticke. The fierceness and malignity thereof is so great, that unless it be most speedily withstood the part itself will dye, and also take hold of the neighbouring parts by the contagion of its mortification: which hath been the cause that a Gangrene by many hath been termed an Esthiomenos. For such corruption creeps out like poison, and like fire Why a Gangrene is called Esshiomenos. eats gnaws and destroys all the neighbouring parts, until it hath spread over the whole body. For as Hypocrates writes, Lib. de vulner. capitis; Mortui & viventis nulla est proportio (i) There is no proportion between the dead and living. Wherefore it is fit presently to separate the dead from the living; for unless that be done, the living will dye, by the contagion of the dead. In such as are at the point of death The quick impatient of the dead. a cold sweat flows over all their bodies: they are troubled with rave, and watchings, belchings, and hicketing molest them; and often swound invade them, by reason of the vapours abundantly and continually raised from the corruption of the humours and flesh, and so carried to the bowels and principal parts, by the Veins, Nerves, and Arteries. Wherefore when you have foretold these things to the friends of the patient; then make haste to fall to your work. CHAP. XV. Of the general cure of a Gangrene. THe Indications of curing Gangreenes are to be drawn from their differences, Various Indications of curing of a Gangrene. for the cure must be diversely instituted according to the essence and magnitude. For some Gangreenes possess the whole member; others only some portion thereof; some are deep; othersome superficial only. Also you must have regard to the temper of the body. For soft and delicate bodies, as of children, women, eunuchs, and idle persons, require much milder medicines, than those who by nature and custom, or vocation of life, are more strong and hardy, such as husbandmen, labourers, mariners, huntsmen, potters, and men of the like nature who live sparingly and hardly. Neither must you have respect to the body in general, but also to the parts affected; for the fleshy and musculous parts, are different from the solid, as the Nerves and joints, What parts soon taken hold of by a Gangrene. or more solid, as the Vertebrae. Now the hot and moist parts, as the Privities, mouth, womb, and fundament, are easilyer and sooner taken hold of by putrefaction; wherefore we must use more speedy means to help them. Wherefore if the Gangrene be chiefly occasioned from an internal cause, he must have a diet prescribed for the decent and fitting use of the six things not natural. If the body be plethoric, or full of ill humours; you must purge, or let blood by the advice of a Physician. Against the ascending up of vapours to the noble parts, the heart must chiefly be strengthened with Treacle dissolved in Sorrell, or Carduus water; with a bowl of Mithridate, the conserveses of Roses & bugloss; and with Opiates made for the present purpose according to Art; this following Apozem shall be outwardly applied to the region of the A cordial Epithemae. heart. ℞. aquae rosar. & nenuphar. an. ℥ iiij. aceti scillitici ℥ i. corallorum, santalorum alborum & rubrorum, rosar. rub. inpulver. radactarum, & spodij, an. ℥ i. mithrid. & theriacae, an. ʒijss. trochiscorum de Caphura, ʒij. crociʒj. ex omnibus in pollinem redactis, fiat epithema. Which may be applied upon the region of the heart with a scarlet clot or sponge. These are usually such as happen in the cure of every Gangrene. CHAP. XVI. Of the particular cure of a Gangrene. THe cure of a Gangrene, caused by the too plentiful and violent defluxion of humours suffocating the native heat, by reason of great Plegmons, is performed by evacuating and drying up the humours, which putrify by The cure of a Gangrene made by inflammation. delay and collection in the part. For this purpose scarifications and incisions, great, indifferent, small, deep and superficiary according to the condition of the Gangrene, are much commended; that so the burdened part may enjoy the benefit of perspiration; and the contained humours, of difflation, or evacuation of their footy excrements. Let incisions be made when the affect is great, deep in, and near to mortification. But scarifications may be used when the part first begins to putrefy; for the greatness of the remedy must answer in proportion to that of the disease. Wherefore if it penetrate to the bones, it will be fit, to cut the skin and flesh with many and deep incisions, with an incision knife made for that purpose, yet take heed of cutting the larger nerves and vessels, unless they be wholly putrified, for if they be not yet putrified, you shall make your incisions in the spaces between them; if the Gangrene be less, we must rest satisfied with only scarifying it. When the scarifications and incisions are made, we must suffer much blood to flow forth, that so the conjunct matter may be evacuated. Then must we apply and put upon it such medicines as may by heating, drying, resolving, cleansing and opening, amend and correct the putrefaction, and by piercing to the bottom may have power to overcome the virulency already impact in the part. For this purpose Lotions made of the lie of the Ashes of figtree, or Oak wherein Lupins have been throughly boiled are good. Or you may with less trouble make a medicine with salt water, wherein you may dissolve Aloes and Aegyptiacum, adding in the conclusion a little Aqua vitae; for aqua vitae and calcined vitriol are singular medicines for a Gangrene. Or, ℞. acet. opimi lb. i. mell. ros. ℥ iiij. syrup. acetosi ℥ iij. salis come. ℥ v. bulliant simul, add aq. vitae. lb. s. Let the part be frequently washed with this medicine, for The description of an Egyptiacum. it hath much force to repress Gangreenes. After your Lotion, lay Aegyptiacum for a Lineament and put it into the incisions; for there is no medicine, more powerful against putrefaction, for by causing an Eschar, it separates the putrid flesh from the sound. But we must not in this kind of affect expect that the putrid flesh may of itself fall from the sound; but rather cut off with your incision knife or sissers, whatsoever thereof you can, & then put to it Egyptiacum as oft as need shall require. The knowledge hereof may be acquired from the colour, smell, and sensibleness of the flesh its self. The description of the Egyptiacum, whose wondrous effects I have often tried in these causes, is this. ℞. floris aris, aluminis roch. mellis come. an. ℥ iij. aceti acerrimi ℥ v. salis come. ℥ i. vitrioli rom. ℥ ss. sublimatipul. ʒij bulliant omnia simul ad ignem, fiat unguent. If the force of the putrefaction in the part be not so great, a weaker Aegyptiacum may serve. When you have put in the Aegyptiacum, then presently lay the following Cataplasm thereupon. For it hinders putrefaction, resolves, cleanses & dries up the virulent sanies, and by the dry subtlety of the parts penetrates into the member, strengthens it, and assuages the pain. ℞. farin. fabar. hor dei orobi, lent. lupin. an. lb. s. sal. come. mellis rosat. an. ℥ iiij. succi absinth. marrub. an. ℥ iiss. aloes, mastiches, myrrhae, & aqua A strigents that may be used in cure of a Gangrene. vit. an. ℥ ij, oxymelitises simple. quantum sufficit; fiat Cataplasma molle secundum artem; Somewhat higher than the part affected, apply this following astringent, or defensitive, to hinder the flowing down of the humours into the part, and the rising up of the vapours from the putrid part into the whole body. ℞. oleirosatis, & myrtill. an ℥ 4. succi plantag. solani, sempervivi, an. ℥ ij. album ovorum 5. boli armeni, te●rae sigillata subtiliter pulver●satorum, an. ℥ i. oxycrati quantum sufficit, misce ad usum dictum. But these medicines must be often renewed. If the grief be so stubborn that it will not yield to the described remedies, we must come to stronger, to wit, Cauteries, after whose application, Galen bids to put upon it the juice of a Leek with Gal. 2. ad Glauconem. salt beaten and dissolved therewith, for that this medicine hath a piercing and drying faculty, and consequently to hinder putrefaction. But if you prevail nothing with Cauteries, then must you come to the last remedy and refuge, that is, the amputation of the part; For according to Hypocrates, to extreme diseases exquisitely Aphor. 6. sect. 11. extreme remedies are best to be applied. Yet first be certain of the mortification of the part; for it is no little or small matter to cut off a member without a cause. Therefore I have thought it fit to set down the signs, whereby you may know a perfect and absolute mortification. CHAP. XVII. The signs of a perfect Necrosis or Mortification. YOu shall certainly know that a Gangrene is turned into a sphacel, or mortification, and that the part is wholly and throughly dead, if it look of a black colour, and be colder than stone to your touch, the cause of which coldness is not occasioned by the frigidity of the air; if there be a great softness of the part, so that if you press it with your finger it rises not again, but retains the print of the impression. If the skin come from the flesh lying under it; if so great and strong a smell exhale (especially in an ulcerated sphacel) that the standers by cannot endure or suffer it; if a sanious moisture, viscide, green or blackish flow from thence; if it be quite destitute of sense and motion, whether it be pulled, beaten, crushed, pricked, burnt, or cut off. Here I must admonish the young Chirurgeon, that he be not deceived concerning the loss or privation of the sense of the part. For I know very many deceived as thus; the patients pricked on that part would say they felt much pain there. But that feeling is oft deceitful, as that which A note concerning the unsensiblenes of the part. proceeds rather from the strong apprehension of great pain which formerly reigned in the part, than from any faculty of feeling as yet remaining. A most clear and manifest argument of this false and deceitful sense appears after the amputation of the member; for a long while after they will complain of the part which is cut away. Verily it is a thing wondrous strange and prodigious, and which will scarce be A wondrous symptom. credited, unless by such as have seen with their eyes, and heard with their ears the patients who have many months after the cutting away of the Leg, grievous, lie complained that they yet felt exceeding great pain of that Leg so cut of. Wherefore have a special care lest this hinder your intended amputation; a thing pitiful, yet absolutely necessary for to preserve the life of the patient and all the rest of his body, by cutting away of that member which hath all the signs of a sphacel and perfect mortification; for otherwise the neglected fire will in a moment spread over all the body, and take away all hope of remedy; for thus Hypocrates wisheth: Sect. 7. Lib. 6. Epidem. That Sections, Vstions, and Terebrations must be performed as soon as need requires. CHAP. XVIII. Where Amputation must be made. IT is not sufficient to know that Amputation is necessary; but also you must learn in what place of the dead part, it must be done, and herein the The controversy decided. wisdom and judgement of the Chirurgeon is most apparent. Art bids to take hold of the quick, and to cut off the member in the sound flesh; but the same art wisheth us, to preserve whole that which is sound, as much as in us lies. I will show thee by a familiar example how thou mayst carry thyself in these difficulties. Let us suppose, that the foot is mortified even to the ankle; here you must attentively mark in what place you must cut it off. For unless you take hold of the quick flesh in the amputation, or if you leave any putrefaction, you profit nothing by amputation, for it will creep and spread over the rest of the body. It befits Physic ordained for the preservation of mankind, to defend from the iron or instrument and all manner of injury, that which enjoys life and health. Wherefore you shall cut off as little of that which is sound as you possibly can; yet so that you rather cut away that which is quick, than leave behind any thing that is perished, according to the advice of Celsus. Yet oft times the commodity of the action of the Lib. 7. Cap. 33. rest of the part, and as it were a certain ornament thereof, changes this counsel. For if you take these two things into your consideration they will induce you in this propounded case and example, to cut off the Leg some five fingers breadth under the knee. For so the patient may more fitly use the rest of his Leg and with less trouble, that is, he may the better go on a wooden Leg; for otherwise, if according to the common rules of Art, you cut it off close to that which is perished, the patient will be forced with trouble to use three Legs in stead or two. For I so knew Captain Francis Clerk, when as his foot was strucken off with an An observable History. iron bullet shot forth of a man of war, and afterwards recovered and healed up, he was much troubled and wearied with the heavy and unprofitable burden of the rest of his Leg. wherefore though whole and sound he caused the rest thereof to be cut off, some five fingers breadth below his knee; and verily he useth it with much more ease and facility than before in performance of any motion. We must do otherwise if any such thing happen in the Arm; that is, you must cut off a little of the sound part as you can. For the actions of the Legs much differ from these of the arms, and chiefly in this that the body restsnot, neither is carried upon the arms, as it is upon the feet and Legs. CHAP. XIX. How the section or amputation must be performed. THe first care must be of the patient's strength, wherefore let him be nourished with meats of good nutriment, easy digestion, and such as generate many spirits; as with the yolkes of Eggs, and bread toasted and dipped in Sack or Muskedine. Then let him be placed, as is fit, and drawing the muscles upwards toward the sound parts, let them be tied with a straight ligature a little above that place of the member which is to be cut off, with a strong and broad fillet like that which women usually bind up their hair withal; This ligature hath a The Ligature of the part. threefold use; the first is, that it hold the muscles drawn up together with the skin, so that retiring back presently after the performance of the work, they may cover the ends of the cut bones, and serve them in stead of bolsters or pillows when they are healed up, and so suffer with less pain the compression in sustaining the rest of the body; besides also by this means the wounds are the sooner healed and cicatrized; for by how much more flesh or skin is left upon the ends of the boner, by so much they are the sooner healed and cicatrized. The second is, for that it prohibits the flux of blood by pressing and shutting up the veins and arteries. The third is, for that it much dulls the sense of the part by stupefying it; the animal spirits by the straight compression being hindered from passing in by the Nerves: Wherefore when you have made your ligature, cut the flesh even to the bone with a sharp and well cutting incision knife, or with a crooked knife, such as is here expressed. A crooked knife fit for dismembering; or a dismembering knife. Now you must note, that there usually lies between the bones, a portion of certain muscles, which you cannot easily cut with a large incision or dismembering A caution to be observed. knife; wherefore you must carefully divide it and separate it wholly from the bone, with an instrument made neatly like a crooked incision knife. I thought good to advertise thee hereof; for if thou shouldest leave any thing besides the bone to be divided by the saw, you would put the patient to excessive pain in the performance thereof; for soft things as flesh tendons and membranes, cannot be easily cut with a saw. Therefore when you shall come to the bared bone, all the other parts being wholly cut asunder and divided, you shall nimbly divide it with a little saw about some foot and three inches long, and that as near to the sound flesh as you can. And then you must smooth the front of the bone which the saw hath made rough. The Figure of such a Saw. CHAP. XX. How to staunch the bleeding when the member is taken off. WHen you have cut off and taken away the member, let it bleed a little according to the strength of the patient, that so the rest of the part may afterwards be less obnoxious to inflammation and other symptoms; Then let the Veins and Arteries be bound up as speedily and straight as you can; that so the course of the flowing blood may be stopped and wholly stayed. Which may be done by taking hold of the vessels with your Crow's beak, whereof this is the figure. The Crow's beak fit for to draw the vessels forth of the flesh wherein they lie hid, that so they may be tied or bound fast. The ends of the vessels lying hid in the flesh, must be taken hold of & drawn with this How to draw forth the vessels and bind them. instrument forth of the muscles whereinto they presently after the amputation withdrew themselves, as all parts are still used to withdraw themselves towards their originals. In performance of this work, you need take no great care, if you together with the vessels comprehend some portion of the neighbouring parts, as of the flesh, for hereof will ensue no harm; but the vessels will so be consolidated with the more ease, than if they being bloodless parts should grow together by themselves. To conclude, when you have so drawn them forth, bind them with a strong double thread. CHAP. XXI. How after the blood is staunched, you must dress the wounded member. WHen you have tied the Vessels, lose you Ligature which you made above the place of amputation; then draw together the lips of the How the lips of the dismembered part are to be joined together. wound with four stitches made across, having taken good hold of the flesh; for thus you shall draw over the bones that part of the skin and cut muscles drawn upwards before the amputation, and cover them as close as you can, that so the air may the less come at them, and that so the wound may be the more speedily agglutinated. But when we say, draw together the lips of the wound with four stitches, you must not so understand it, as that you must endeavour, to draw them so close as to touch each other, for that is impossible; for the stitches would sooner break out, and so the part would lie bare. Wherefore it will be sufficient to draw them indifferent close together, that so you may suffer the skin and flesh thereunder to enjoy its former liberty which it possessed before the drawing up, and so in fine by nature's assistance, the wound may be the more easily agglutinated. CHAP. XXII. How you must stop the bleeding, if any of the bound up vessels chance to get loose. THe business hitherto being performed as we said, if peradventure it happen that any bandage of any of the vessels be unloosed; then must you again bind the member with that kind of Ligature which you did before the amputation thereof. Or else, which is better, more easily and less painful, let your servant taking hold of the member with both his hands, pressing his fingers straight, stop the passage of the loosed vessel, for so he may staunch the bleeding. Then let the workemaster take a needle some four fingers long, square, and having sharp edges, drawing after it a three or four doubled strong thread. With this let him bind the vessel after the following manner. Let him thrust his needle on the outside into the flesh, some half finger's breadth from the loosed vessel until he come to the end thereof, then let him put it about it, and bring it back again, but so that there be no more than the space of a finger's breadth between the going in, and coming forth of the needle. In this, space let him put a linen rag three or four times doubled, and thereupon bind some what straight the two ends of the thread together. For so he shall hinder the knot from hurting the flesh which lies under it in the bindings, and also add strength thereto. For so the bound up orifice of the vessel will in short space be agglutinated to the adjoining flesh, and The Heamorrhagie of small vessels is not to be regarded that so firmly, that there hath never been seen, any one drop of blood to have flowed from a vessel so bound up. But if the blood which flows forth proceed from any small vessel, you must not use this suture and ligature, nor make any such great matter thereof; for it will quickly be staunched by the only application of Astringents presently to be mentioned. CHAP. XXIII. How to perform the residue of the cure of the amputated member. NOw must we show what medicines are fitting to be applied after the amputation of a member; which are emplastics, as these which exceedingly conduce to green wounds. As ℞. boli arm. ℥ iiij. farin. vol. ℥ iij. An emplastic medicine. picis, resinae, an. ℥ ij. pulverisentur omnia subtiliss. & simul mixtis fiat pulvis; herewith let the wound be strewed, and lay thereupon dry Lint; but let the following repercussive or defensitive be applied to the member. ℞. Album ovorum vi. boli arm. sang. drac. gypsi, terrae sigil. aloës, mastiches, gallar. combust. A repercussive. an. ℥ ij. in pollinem redigantur omnia, & bene agitentur, addendo olei rosarum & myrtil. an. ℥ i. fiat defensitivum ad formam mellis. This ointment must be applied upon stoops dipped in Oxycrate, and that so that it may not only cover the cut member, but also be spread further and cover the neighbouring parts; as when the Leg is cut off, it must be laid upon the joint, and spread higher than the knee, some four fingers upon the thigh; for it hath not only a repercussive faculty, but it also strengthens the part, hinders defluxion by tempering the blood, aswaging pain, and hindering inflammation. It will also be good to moisten your double clothes and bandages in Oxycrate; then must you place the member in an indifferent posture upon a pillow stuffed with oaten husks or chaff, Stag's hair, or wheat bran. How to place the member and how often to dress it. It must not be stirred after the first dressing (unless great necessity urge) for four days in winter, but somewhat sooner in summer. For the ligatures wherewith the vessels are bound, they must not be loosed, or otherwise taken away, before the mouths of the vessels are covered with their glue or flesh, lest by too much haste you cause a new flux of blood. This agglutination will be performed by applying refrigerating, astringent, and emplastic medicines, such as this following powder. ℞. boli arm. farin. hord. picis. res. gypsi, an. ℥ iiij. Aloës, nucum cup. cort. granat. an. ℥ i. An emplastic powder. incorporentur omnia simul, fiat pulvis subtilis: herewith let the whole ulcer be strewed over for three or four days space; which being ended, let only the seats of the vessels be powdered therewith, and that for eight or ten days, so that we need no further doubt of the agglutination of the vessels. In the mean space let the digestive be applied to the rest of the Ulcer until it be come to suppuration; for than you shall give over your digestive, and betake you to detersive and mundificative medicines: As ℞. terebinth. ven. lotae in aqua vitae ℥ vi. mellis ros. colati ℥ iiij. succi plan●ag. Apij, Detersives. centaur, minoris, an. ℥ ij. bulliant omnia simul usque ad consumptionem succorum auferantur abigne, addendo farinae fab. & hord. an. ℥ i. theriac. Gal. ℥ ss. aloes, myrrhae, aristoloch. an. ℥ iij. croci ℈ i. fiat mundificativum. But seeing the case stands so that the Patients imagine they have their members yet entire, and yet do complain thereof (which I imagine to come to pass, for Why after dismembering the patients complain of pain as if the part were yet remaining on. that, the cut nerves retire themselves towards their original, and thereby cause a pain like to convulsions; for as Galen writes in his book, De motu musculorum, That contraction is the true and proper action of a nerve and muscle: and again, extension is not so much an action as a motion:) now we must endeavour to give remedy to this symptom. Which may be done by anointing the spin of the back and all the affected part with the following Lineament, which is very powerful against Convulsions, the Palsy, numbness, and all cold affects of the nervous bodies. ℞ salviae, chamaepytheos, majoranae, rorismar. menth. rutae, lavendulae, an. m. i. flor. cham●mel. An ointment for the spin of the back against all affects of the nerves. melilot. summit. aneth. & hyperici, an. p. ij. baccarum lauri & juniperi an. ℥ ij. pyrethriʒij. mastic. assae odorat. an. ℥ iss. terebinth. venet lb. i. olei lumbr. aneth. cattles, an. ℥ vi. olei terebinth. ℥ iij. axung. hum. ℥ ij. crociʒj. vini albi ●doriferi lib. i. cerae quantum sufficit, contundenda contundantur pulverisanda pulverisentur, deinde macerentur omnia in vino per noctem, postea coquantur cum oleis & axungia praedictis in vase duplici, fiat linimentum secundum artem, in fine add aquae vitae ℥ iiij. Besides, in dressing these wounds, the Chirurgeon must use diligence to procure the falling away of the ends or scalls of the How to procure the falling away of the ends of the bones. bones, which the saw and the appulse of the air never before coming hereto, have tainted; which may be done by applying to their ends actual cauteries, that is, hot irons, in using of which you must have a special care that you touch not the sensible parts with fire; neither must the bones themselves be forcibly plucked off, but gently moved by little and little, so that you shall think you and the patient have exceedingly well performed your parts if they fall away at the thirtyeth day after the Amputation. All these things being performed, you shall hinder the growth of proud flesh with the cathaereticks, such as are burnt vitriol, the powder of Mercury, Cathaereticks. and other things, amongst which is Alum burnt and powdered, which is excellent in these kind of wounds whether by its self or mixed with others. You shall use these and such like, even unto the perfect agglutination and cicatrisation of the wound, and you may of yourself devise other things, such as these, as occasion shall offer its self. CHAP. XXIIII. What just occasion moved the Author to devise this new form of remedy, to staunch the blood after the amputation of a member; and to forsake the common way used almost by all Surgeons; which is, by application of actual cauteries. VErily I confess, I formerly have used to staunch the bleeding of members after amputation, after another manner than that I have a little before mentioned. Whereof I am ashamed, and aggrieved; But what should I do? I had observed my masters whose method I intended to follow, always to do the like; who thought themselves singularly well appointed to staunch a flux of blood, when they were furnished with various store of hot Irons and caustic medicines, Hot Irons not to be used. which they would use to the dismembered part, now one, than another, as they themselves thought meet. Which thing cannot be spoken, or but thought upon without great horror, much less acted. For this kind of remedy could not but bring great and tormenting pain to the patient, seeing such fresh wounds made in the quick and sound flesh are endued with exquisite sense. Neither can any caustic be applied to nervous bodies, but that this horrid impression of the fire will be presently communicated to the inward parts, whence horrid symptoms ensue, and oft times death itself. And verily of such as were burnt, the third part scarce ever recovered, and that with much ado, for that combust wounds difficultly come to cicatrisation; for by this burning are caused cruel pains, whence a Fever, Convulsion, and oft times other accidents worse than these. Add hereunto, that when the eschar fell away, oft times a new haemorrhagye ensued, for staunching whereof they were forced to use other caustic and burning Instruments. Neither did these good men know any other course; so by this repetition there was great loss and waste made of the fleshy and nervous substance of the part. Through which occasion the bones were laid bare, whence many were out of hope of cicatrisation, being forced for the remainder of their wretched life to carry about an ulcer upon that part which was dismembered; which also took away the opportunity of fitting or putting too of an artificial leg or arm in stead of that which was taken off. Wherefore I must earnestly entreat all Surgeons, that leaving this old, and too too cruel way of healing, they would embrace this new, which I think was taught me by the special favour of the sacred Deity; for I learned it not of my masters, nor of any other, neither have I at any time found it used by any. Only I have read in Galen, that there was no speedier remedy for staunching of blood, than Lib. 5. Meth. to bind the vessels through which it flowed towards their roots, to wit, the Liver and Heart. This precept of Galen, of binding and sowing the Veins and Arteries in the new wounds, when as I thought it might be drawn to these which are made by the amputation of members, I attempted it in many; yet so that at first in my budding practice thereof, I always had my cauteries and hot Irons in a readiness, that if any thing happened otherwise then I expected in this my new work, I might fetch succour from the ancient practice, until at length confirmed by the happy experience of almost an infinite number of particulars, I bid eternally adieu, to all hot Irons and cauteries which were commonly used in this work. And I think it fit that Surgeons do the like. For antiquity and custom in such things as are performed by Art, ought not to have any sway, authority or place contrary to reason, as they oft times have in civil affairs; wherefore let no man say unto us, that the Ancients have always done thus. CHAP. XXV. The practice of the former precepts is declared, together with a memorable history of a certain soldier, whose arm was taken off at the Elbow. I Think it fit to confirm by an example the prescribed method of curing a Gangrene and Mortification. Whilst I was Chirurgeon to the A History: Marshal of Montejan at Turin, a certain common soldier received a wound on his wrist with a musket bullet, by which the bones and tendons being much broken, and the nervous bodies cruelly torue, there followed a Gangreen, & at length a mortification even to the Elbow; besides also an inflammation seized upon the middle part of his Chest, and there was as it were a certain disposition to a Gangrene, whereby it followed that he was painfully and dangerously troubled with belchings, hicketting, watchings, unquietness and frequent swound, which occasioned many Surgeons to leave him as desperate. But it so it fell out, that I o'ercome by his friend's entreaty, undertook the cure of this wretched person, destitute of all humane help. Wherefore knowing the mortification by its signs, I cut off the arm by the elbow as speedily as I could, making first the ligature, where of I made mention; I say I took it off not with a saw, but only Dismembering at a joint. with an incision knife, cutting in sunder the ligaments which held the bones together, because the sphacel was not passed the joint of the Elbow. Neither ought this section to be accounted strange, which is made in a joint; for Hypocrates Sect. 4. lib. de Art. much commends it, and saith that it is easily healed, and that there is nothing to be feared therein besides swooning, by reason of the pain caused by cutting the common tendons and ligaments. But such incision being made, the former Ligature could not hinder, but much blood must flow from thence, by reason of the large vessels that run that way. Wherefore I let the blood to flow plentifully so to disburden the part, and so afterwards to free it from the danger and fear of inflammation and a Gangrene; then presently I staunched the blood with an hot Iron, for as yet I knew no other course. Then gently losing the Ligature I scarify that part of the brawn of the Arm which was Gangreenated, with many and deep incisions, shunning and not touching the inner part, by reason of the multitude of the large vessels and Nerves which run that way; then I presently applied a cautery to some of the incisions, both to staunch the bleeding, and draw forth the virulent sanies which remained in the part. And then I assailed and overcame the spreading putrefaction by putting and applying the formerly prescribed medicines; I used all sorts of restrictive medicines, to stay the inflammation of the Chest; I also applied Epithema's to the region of the heart, and gave him cordial potions and boles, neither did I desist from using them until such time as his belching, hicketting and swound had left him. Whilst I more attentively intended these things, another mischief assails my patient, to wit, Convulsions, and that not through any fault of him or me, but by the naughtiness of the place wherein he lay, which was in a Barn every where full of chinks and open on every side, and then also it was in the midst of winter raging with frost and snow and all sorts of cold; neither had he any fire or other thing necessary for preservation of life, to lessen these injuries of the Air and place; Now his joints were contracted, his teeth set, and his mouth and face were drawn awry, when as I pitying his case made him to be carried into the neighbouring Stable which smoked withmuch horse dung, and bringing in fire in two chafendishes, I presently anointed his neck and all the spin of his back, shunning the parts of the Chest, with liniments formerly described for convulsions; then strait way I wrapped him in a warm linen cloth, and buried him even to the neck in hot dung, putting a little fresh straw about him; when he Burying in hot horse dung helps Convulsions. had stayed there some three days, having at length a gentle scouring or flux of his belly, and plentiful sweat, he begun by little and little to open his mouth and teeth which before were set and close shut. Having got by this means some opportunity better to do my business, I opened his mouth as much as I pleased, by putting this following Instrument between his Teeth. A Dilater made for to open the mouth and Teeth by the means of a screw in the end thereof. Now drawing out the Instrument I kept his mouth open by putting in a willow stick on each side thereof, that so I might the more easily feed him with meats soon made, as with Cow's milk and rear eggs, until he had recovered power to eat, the convulsion having left him. He by this means freed from the Convulsion, I then again begun the cure of his arm, and with an actual cautery sear the end of the bone, so to dry up the perpetual afflux of corrupt matter. It is not altogether unworthy of your knowledge, that he said, how that he was wondrously delighted by the application of such actual cauteries, a certain tickling running the whole length of the arm by reason of the gentle diffusion of the heat by applying the caustic; which same thing I have observed in many others; especially in such as lay upon the like occasion in the Hospital of Paris. After this cauterizing there fell away many and large scales of the bone, the freer appulse of the air than was fit making much thereto; besides when there was place for fomentation, with the decoction of red Rose leaves, A fomentation for a Convulsion. Wormwood, Sage, Bay leaves, flowers of Chamomile, Melilote, Dill▪ I so comforted the part that I also at the same time by the same means drew and took away the virulent Sanies, which firmly adhered to the flesh and bones. Lastly, it came to pass, that by God's assistance, these means I used, and my careful diligence, he at length recovered. Wherefore I would admonish the young Chirurgeon, that he never account any so desperate, as to give him for lost, content to have let him go with prognostics; for as an ancient Doctor writes; That as in Monsters or miracles in diseases. Nature, so in diseases there are also Monsters. The end of the Twelfth Book. OF ULCERS, FISTVLA'S, AND Haemorrhoides. THE THIRTEENTH BOOK. CHAP. I. Of the nature, causes, and differences of Ulcers. HAving already handled and treated of the nature, difference, causes, signs and cure of fresh and blood wounds, reason & The divers acceptions of an Ulcer. order seem to require that we now speak of Ulcers; taking our beginning from the ambiguity of the name. For according to Hypocrates, the name of Ulcer most generally taken Sent. 34. sect. 3. lib. defract. may signify all or any solution of Continuity; In which sense it is read, that all pain is an Ulcer. Generally, for a wound and Ulcer properly so called; as appears by his Book, de Vlceribus. Properly, as when he saith, it is a sign of death when an Ulcer is dried up through an Atrophia, or defect of nourishment. We Sect. 1. pr●g. have here determined to speak of an Ulcer in this last and proper signification. And according thereto we define an Ulcer to be the solution of Continuity in a soft What an Ulcer properly is. part, and that not bloody, but sordid and unpure, flowing with quitture, Savies or any such like corruption, associated with one or more affects against nature, which hinder the healing and agglutination thereof; or that we may give you it in fewer words according to Galens' opinion; An ulcer is a solution of Continuity, caused by Lib. de conflict Artis●ap. 6. The internal causes. Erosion. The causes of Ulcers are either internal or external. The internal are through the default of humours peccant in quality rather than in quantity, or else in both, and so making erosion in the skin and softer parts by their acrimony and malignity; Now these things happen either by naughty and irregular diet, or by the ill disposition of the entrailes, sending forth and emptying into the habit of the body this their ill disposure. The external causes are, the excess of cold seizing upon any part, especially more remote from the fountain of heat, whence follows pain, The external causes. whereunto succeeds an attraction of humours and spirits into the part, and the corruption of these so drawn thither by reason of the debility or extinction of the native heat in that part, whence lastly ulceration proceeds. In this number of external causes may be ranged, a stroke, contusion, the application of sharp and acrid medicines, as caustics, burns; as also impure contagion, as appears by the virulent ulcers acquired by the filthy copulation or too familiar conversation of such as have the French disease. How many and what the differences of Ulcers are, you may see here described in this following Scheme. A Table of the differences of Ulcers. An Ulcer is an impure solution of continuity in a soft part, flowing with filth and matter or other corruption, whereof there are two chief differences, for one Is simple and solitary without complication of any other affect against nature and this varies in differences, either Proper which are usually drawn from three things, to wit figure. whence one Ulcer is called Round or circular. Sinuous, and variously spread. Right or oblique. Cornered, as triangular Quantity, & that either according to their Length; whence an Ulcer is long, short, in different. Breadth; whence an Ulcer is broad, narrow indifferent. Profundity; whence an Ulcer is deep, superficiary, indifferent. Equality or inequality, which consists, In those differences of dimensions whereof we last treated, I say in length, breadth and profundity, wherein they are either alike or of the same manner, or else unlike and so of a different manner. Or common and accidental, & these drawn, either From their time; whence an Ulcer is termed new, old, of short or long cure and ●uration. From their appearance; whence one is called an apparent Ulcer; another a hidden and occult Ulcer. From their manner of generation; as if it be made by a heavy, bruising, cutting, pricking or corroding thing; whence a cut, torn and mixed Ulcer. From their site; whence an Ulcer before, behind, above, below, in the head, tail, or belly of a Muscle. From that part it seizes upon, whence an ulcer in the flesh and skin, or feeding upon the gristles or bones, such as these of the nose, the palate of the mouth, and ears. From other common accidents; whence a Telephian Ulcer; that is, such an Ulcer as Telephus had. A Chironian, which needs the hand and art of Chiron. A Canckrous which resembles a Cancer. Is compound and many and various ways complicated, as With the cause, whence an Ulcer Is Cacochymicke, Catarrhoicke or venenate, that is, with a Cachochymia or Repletion of ill humours, a Catarrh, or poison cherishes or feeds. With the disease, as from Distemper, whether simple or compound, whence an Ulcer is, Hot. Cold. Day. M●…st. Mixt. Swelling or Tumour, whence a Phlegmonous, Erysipelous. Oedematous. Scirrhous, Cancrous Ulcer. Solution of continuity, or any other discommodity, whence a rough, callous, fistulous, cavernous, sinuous Ulcer, with luxation, facture, etc. With the Symptom, whence, According, eating, painful, sordid and virulent Ulcer. With the cause and disease, With the cause and Symptom, Examples whereof may be taken from that we have formerly delivered. With the disease and Symptom, With the cause, disease and Symptom. CHAP. II. O● the signs of Ulcers. THere are various signs of Ulcers according to their differences. For it is the sign of a putrid Ulcer, if it exhale a noy some, grievous, stinking and The signs of a putr●d Ulcer. carion-like vapour, together with filthy matter. An eating Ulcer is known by the eating in, hollowness and wearing away of the part wherein it resides, together with the adjoining parts. A sordid Ulcer may be known by the grossness and viscidity of the excrements it sends forth, and by the loose and spongy softness, or the crusted inequality of the flesh which grows over it. A cavernous Ulcer, by the streghtnesse of the orifice, and largeness and deepness of the windings within. A fistulous Ulcer, if to the last mentioned signs there accrue a callous hardness of the lips or sides of the Ulcer. A cancrous Ulcer is horrible to behold with the lips turned back, hard and swollne, flowing with virulent and stinking corruption, and sometimes also with bloody matter, together with the swelling and lifting up of the adjacent veins. An untemperate, or as they term it, a distempered Ulcer, is such as is nourished by some great distemper whether hot or cold, moist or dry, or compounded of these. An ill * Vlc●● cacoethes. natured or malign Ulcer is Gal. cap. 5. lib. 4. Meth. known by the difficulty of curing and rebellious contumacy to remedies appointed according to art and reason. We know a catarrhous Ulcer, if the matter which feeds it flow to it from some varices thereunto adjoining, or dilated, swollne and broken-veines, or from some entrail, or from the whole body being ill affected. An Apostumatous Ulcer is perceived by the presence of any tumour against nature, whose kind may be found out by sight and handling. Telephian Ulcers, are such as affected Telephus, and Chironian (in whose cure Chiron excelled) are Ulcers which may be known by their magnitude not much putrid, and consequently not sending forth any ill smell, not eating, not tormenting with pain, but having their lips swollne and hard, and therefore ill to be healed. For although they may be sometimes cicatrized, yet it being but slender may easily be broken, and the Ulcer renewed. They are almost like an ulcerated Cancer, but that they are accompanied with swelling in the adjacent parts; they are also worse than these which are termed Cacoëthe, that is, ill natured or malign; whence it is that Fernelius thought they had a hidden cause of malignity, besides the common default of the humour, and that such as can scarce be driven away; such commonly are left after the plague. Com. ad a●hor. 22. sect. 5. Wherefore Galen thinks such to be malign as will not suppurate or yield any quitture. CHAP. III. Of the prognostics of Ulcers. THe bone must necessarily scaill, and hollow scars be left by malign Ulcers of a years continuance or longer, and rebellious to medicines fitly Aph. 45. sect. 6. applied. The bone must scaill by reason of the continual afflux, and wearing by the acrimony of the humour, which loses the composure and glue by which the parts thereof are joined together. But the scars must become hollow, for that the bone (whence all the flesh takes its first original) or some portion thereof, being taken from under the flesh, as the foundation thereof, so much of the bulcke of the flesh must necessarily sink down, as the magnitude of the portion of the wasted bone comes unto. You may know that death is at hand, when the Ulcers that arise in or before diseases, are suddenly either livid or dried, or pale and withered. For such dryness Hip. progn. lib. 1. cap. 8. Aph. 65. sect. 5. showeth the defect of nature, which is not able to send the familiar and accustomed nutriment to the part ulcerated. But the livid or pale colour is not only an argument of the overabundance of choler and melancholy, but also of the extinction of the native heat. In Ulcers where tumours appear, the patients suffer no convulsions, neither are frantic; for the tumour being in the habit of the body possessed with an Ulcer, argues that the nervous parts and their original are free from the noxious humours. But these tumours suddenly vanishing and without manifest cause, as without application of a discussing medicine, or bleeding, those who have them on their backs have convulsions and distensions, for that the spin of the back is almost wholly nervous; but such as have them on their fore parts, become either frantic, or have a sharp pain of their side, or pleurisy, or else a dysentery if the tumours be reddish; for the forepart of the body is replenished and overspread with many and large vessels, into whose passages the morbificke matter being translated, is presently carried to these parts which are the seats of such diseases. Soft and loose tumours in Ulcers are good, for they show a mildness and gentleness Aph. 67. sect. 5. of the humours, but crude and hard swellings are naught; for all digestion in some measure resembles elixation. Ulcers which are smooth and shining are ill, for they show that there resides an humour malign by its acrimony, which frets asunder the roots of the hairs, and depraves the natural construction of the pores of the skin; whence it is that such as are troubled with quartan agues, the Leprosy or Aph. 4. sect. 5. Lues venerea, have their hair fall off. A livid flesh is ill in Ulcers which cause a rottenness or corruption of the bones lying under the flesh; for it is an argument of the dying hear and corruption of the bone, whence the flesh hath its original and integrity. These Ulcers which happen by occasion of any disease, as a Dropsy, are hard to be Hip. lib. de 〈◊〉. Gal. cap. 2. & 5. lib. Meth. 4. cured; as also those whereinto a varix or swollne vessel continually casts in matter; which a present distemper ●oments; which have swollne, hard and callous lips; and such as are circular or round. An Hypersarcosis, or fleshy excrescence usually happens to Ulcers not diligently mundified; and if they possess the arms or Legs they cause a Phlegmon or some other tumour in the groins, chiefly if the body be full of ill humours, as Avicen hath noted. For these parts by reason of their rarity and weakness are fit and subject to defluxions. Albucrasis writes that for nine causes Ulcers are difficultly replenished with flesh and cicatrized. The first for want of For what causes Ulcers are ●aid to heal. blood, in a bloodless body; the second by reason of ill humours and the impurity of the blood; the third by the unfit application of unconvenient medicines; the fourth by reason of the sordidness of the Ulcer; the fifth by the putrefaction of the soft and carionlike flesh encompassing the Ulcer; the sixth when they take their original from a common cause which every where ●ages with fury, such as are those which are left by the pestilence; the seaventh by reason of the callous hardness of the lips of the Ulcer. The eighth when the heavens and air are of such condition as ministers fuel to the continuance of the Ulcer, as at Sarogoza in Arragon; the ninth when the bones which lie under it are wasted by rottenness. An Ulcer that casts forth white, smooth, equal quitture, and little or no stinking, is easily healed; for it argues the victory of the native heat, and the integrity of the solid parts. We term that smooth quitture which is absolutely concocted, neither What pu● or matter is 〈…〉, equal and white. yields any asperity to the touch, whereby we might suspect that as yet any portion of the humour remains crude; we call that equal wherein you can note no diversity of parts; and white not that which is perfectly so, but that which is of an ash colour, as Galen observes. But it is ill, if when the cure is indifferently forward, a flux Ad sustent. 32 sect▪ 2. de fract. of blood suddenly break forth in those Ulcers which beat strongly by reason of the great inflammation adjoined therewith. For as Hypocrates observes, an effusion Aph. 21. sect. 7. of blood happening upon a strong pulsation in Ulcers is evil; for the blood breaking out of an Artery cannot be stayed but by force; and also this blood is so furious by reason of the heat and inflammation the nourishers of this Ulcer, that it breaks its receptacles, and hence ensues the extinction of the native heat, whence the defect of suppuration and a Gangrene ensues. Now for that there flows two Two sorts of excrements flow from a malign Ulcer. sorts of excrements from malign Ulcers, the more thin is termed Ichor or sanies, but the more gross is named sordes; that is virulent and flows from pricked nerves, and the Periostia when they are evil affected; but the other usually flows from the Ulcers of the joints, and it is the worse if it be black, reddish, ashcoloured, if muddy or unaequall like wine Lees, if it stink. Sanies is like the water wherein flesh hath been washed, it argues the preternatural heat of the part, but when it is pale coloured, it is said to show the extinction of the heat. CHAP. four Of the general cure of Ulcers. AN Ulcer is either simple or compound. A simple Ulcer, as an Ulcer hath one and that a simple indication, that is, exsiccation; and that more than in a The curing of a simple Ulcer consists in exsiccation. wound, by how much an Ulcer is moister than a wound. There are many indications proposed for the cure of a compound Ulcer, in respect of which Galen would have us to keep this order, that we have the first regard of the most urgent, then Gal. 7. Meth. cap. 12. of the cause, then of that, which unless it be taken away, the Ulcer cannot be healed. By giving you an example you may easily understand the meaning hereof. Imagine on the inside of the Leg a little above the ankle, an Ulcer very painful, hollow, putrid, associated with the rottenness of the bone, circular, having hard and swollen Lips, and engirt with the inflammation and varices of the neighbouring parts. If you take this to cure before you do any thing about the Ulcer, unless you be called upon by that which urges, as by vehemency of pain, you must first use general means by calling and advising with a Physician; For in Galens' opinion, if the Gal Lib. 4. de companed. secund. gen. whole body require a preparation, then must that be done in the first place; for in some Ulcers purgation only will be sufficient; in some blood-letting; others are better by using both means, which is as the cause of the Ulcer proceeds from a repletion or illness of humours. Now by these means having taken away the cause of the Ulcer, you must come to the particular cure thereof, beginning with that which is most urgent. Wherefore you must first assuage the pain by application of things contrary to the cause thereof, as if it proceed from a Phlegmonous distemper, which hath long possessed, distended and hardened the part, it must be eased by evacuation. First, bathing it with warm water, to mollify and relax the skin, that so you may the more easily evacuate the contained humours; then shall you draw away portion of the matter causing the swelling and pain by scarification, if the patient shall be of sufficient courage, or else by application of hose-leaches if he be more faint hearted; and than you shall temper the heat there of by applying Vnguentum refrigerans Galeni. To conclude, you shall attempt all things which we have formerly delivered (in our treatise of Tumours) to take away the swelling thereof. When you have brought this to that pass you desire, you shall come to those which are such, that it cannot be taken away or healed without them, which shall be done by orderly helping the defects against nature which were conjoined with the Ulcer, to wit, the rottenness of the bone, which you shall help by actual cauteries; and in the mean while you shall draw the Ulcer into another form, to wit, cornered, and you shall cut away the callous hardness, and help the rottenness. Then must you procure the falling away of the Eschar, and then provide for the scailing of the bone by the means formerly prescribed, lastly the mundified Ulcer must be filled with flesh. For generating of flesh two causes must concur, the efficient and material; The The things conducing to the generating of flesh. efficient is, the good temper both of the whole body, as also of the Ulcerated part. For this prevailing, there will be an attraction, digestion, apposition and assimulation of the laudable juice to the part affected; verily the laudable temper is preserved by like things, but the vicious is amended by contraries. The matter to be spent upon flesh, is laudable blood, which offends neither in quality, nor quantity. In this regeneration of the flesh there appear two kinds of excrements, the one more thin and humid called Sanies, the other more gross termed Sordes. Both of these for that they are contrary to nature, do therefore hinder the regeneration of flesh, and therefore must be taken away by applying their contraries, as by things drying in the first degree, and more strongly or weakly detergent according to the complexion of the part and the whole body, and the plenty and quality of the excrementitious humour, and the uncleanness of the Ulcer. For the part must be preserved by the use of the like, but the ulcer o'ercome by application of things contrary thereto. After that by nature's endeavour and the Surgeons help the Ulcer is replete with flesh, it must be cicatrized, that is, covered with a callous skin What a scar is. in stead of the true and native skin. It may be cicatrized by strewing of very drying powders having very little or no acrimony. Thus Alum and vitriol being burnt and made into powder, and thinly strewed upon the part do quickly cicatrise the former fleshy work. To this purpose also serve, the root of Aristolochia, Aloes, Things causing cicatrisation. burnt Lead, Pomegranate pills burnt, lethargy, Tutia, and also plates of Lead besmeared with quicksilver, whose efficacy for this purpose Surgeons sometimes find more certain and powerful than any other remedies. CHAP. V. Of a distempered Ulcer. BEfore we speak of a distempered Ulcer, it is meet; lest that the Chirurgeon Signs of a distempered Ulcer. take one distemper for another, briefly to relate the signs of each. You may know that an Ulcer is associated with a dry distemper by your sight, as if the Ulcer be as it were wrinkled, if it send forth little or no moisture; also it is known by touch, if it feel rough and hard. You shall correct Remedies for a dry distempered Ulcer. this distemper by humecting medicines, as fomenting it with warm water according to Galens' opinion, or else with Hydraelaeum (i) Oil and water mixed, but always you must first purge, if the body shall abound with ill humours, or use Phlebotomy if the body be plethoric; otherwise you shall draw more humours into the part than it can bear. Now you shall so long ●oment it, until the flesh which is about it begin to look red, wax soft and moist, and the part itself be a little swollne. If you proceed further, you will resolve all the humour which you have drawn thither, and so your labour is in vain. After the fomentation apply such a remedy to the ulcerated part. ℞. cremoris hordei ℥ ij. fol. malva in aq. coct. ℥ i. pingued. porci ℥ iss. mellis come. ℥ ss. mis●e in mortario & fiat unguentum. You shall know a moist distemper associates the Ulcer by the plenty of the excrementitious Signs of to● moist an Ulcer. humour, which the Ulcer sends forth; by the spongy and fungous softness and growth of the flesh about it. You shall amend this by drying remedies, such as these are, which we term sarcotics, having always regard to the plenty of the humour, the proper temper of the part, and other indications formerly mentioned. Amongst other remedies Galen much commends Alum water, for it dries, Gal. lib, 1●… simp, cap 7. cleanses and corroborates the affected part. Also this ensuing fomentation may be applied to good purpose. rum rosar. rub. absinth. beton. tapsi barbati, an. m. i. gallarum, nucum cupressi, an. ʒij. rochaeʒj. fiat decoctio in vino ansiero, instituatur fotus; Then let Empl. de cerussa or De minio be applied to the Ulcer. Also I have found by experience that the powder of burnt alum lightly strewed upon the Ulcer is very effectual in this case. You shall know that an hot distemper associates the Ulcer by Signs of a hot distempered Ulcer. redness, or yellowness thereof, by the heat manifest to your touch, and the propriety of the pain. Then must you have recourse to refrigerating things, such as ●ng. Rosatum Mes. Refrigerans Gal. Populeon; stoops and clothed dipped in plantain water, Nightshade water, or Oxycrate. I have oft found by experience that scarification, or Leaches being applied, did more conduce than any other remedy. For so the chafed blood, which by that means is apt to corrupt, is drawn away, and the part its self is also freed of that burden. We know a cold distemper by the whitish or pale colour, by the touch of the Chirurgeon, Signs of a cold distempered Ulcer. and speech of the patient complaining of the coldness of the ulcerated part. You shall correct this by applying and putting bottles filled with water about the part, or else Swine's bladders half filled with the following decoction. rum origani, pulegij, chamaem. meliloti, an. m. i. absinth. majoranae, salviae, rorismar. an. m ss. fiat decoctio in vino generoso, addendo aquae vitae quod sufficit. Also the Ulcer may conveniently be fomented with sponges dipped in the same decoction, and let there be applied thereto Empl. Oxycroccum; emp. de meliloto; de Vigo cum mercuris, and sine mercurio. But if a mixed and compound distemper be joined to the Ulcer, the medicines must in like manner be mixed & composed. The residue of the Surgeon's care and pains must be spent upon the proper and peculiar cure of the Ulcer, as it is an Ulcer; which we said in the former Chapter was contained in detersion, regenerating flesh and cicatrisation thereof. CHAP. VI Of an Ulcer with pain. THere oft times so great pain accompanieth Ulcers, that it calls thereto the counsel of the Physician. Wherefore if it proceed from any distemper, it shall be taken away by remedies proper against that distemper, such as we mentioned in the former Chapter. But if it do not so cease, we must go on to Narcoticks. Such are cataplasms of the leaves of Mandrakes, water lilies, Hen-bane, Nightshade, Hemlock, the seeds of Poppy and Oils of the same; to which also may be added Opium, Populeon, and other things of like faculties. But if a malign The matter of Narcoticke cataplasms. acrimony and virulency of an humour corroding and eating the flesh lying under it and the lips about it, cause and make the pain, you shall neither assuage it by anodynes, nor Narcoticks; for by application of gentle medicines it will become worse and worse. Wherefore you must betake you to Cathaereticks; For strong medicines Catheraeticks have power to assuage pain. are fittest for strong diseases. Wherefore let a pledget dipped in strong and more than ordinarily powerful Aegyptiacum, or in a little oil of Vitriol, be applied to the Ulcer; for these have power to tame this raging pain, and virulent humours. In the mean season let refrigerating things be put about the Ulcer, lest the vehemency of acrid medicines cause a defluxion. CHAP. VII. Of Ulcers with overgrowing or proudness of flesh. Ulcers have oft times proud or overgrowing flesh in them, either by the negligence of the Chirurgeon, or fault of the patient. Against this, Things wasting superfluous flesh. drying and gently eating or consuming medicines must be applied; such as are Galls, cortex thuris, Aloes, T●tia, Antimony, Pompholix, Vitriol, Led, all of them burnt and washed if need require. Of these powders you may also make ointments with a little oil and wax; but if the proud flesh, as that which is hard and dense yield not to these remedies, we must come to caustics, or else to iron, so to cut it off. For in Galens' opinion, the taking away of proud flesh is no work of nature, (as the generating, restoring and agglutinating of the flesh is) but Lib. 〈◊〉. Meth. cap. 6. it is performed by medicines which dry vehemently, or else by the hand of the Chirurgeon; wherefore amongst the remedies fit for this operation, the powder of mercury with some small quantity of burnt Alum, or burnt Vitriol alone, seem very effectual to me. Now for the hard and callous lips of the Ulcer, they must be For the callous lips of Ulcers. mollified with medicines which have such a faculty, as with Calves, Goose, Capons or Duck's grease, the oils of Lilies, sweet Almonds, Worms, Whelps, Oesipus, the mucilages of Marshmallows, linseed, faenugreeke seed, Gum Ammoniacum, Galbanum, Bdellium, of which being mixed may be made Emplasters, unguents, and liniments, or you shall use Empl. Diachylon, or de Mucaginibus, De Vigo cum mercurio. To conclude, after we have for some few days used such like remedies, you may apply to the Ulcer a plate of Lead rubbed over with Quick silver; for this is very effectual to smooth an Ulcer and depress the lips; if you shall prevail nothing by this means, you must come to the caustics, by which if you still prevail nothing, for that the lips of the Ulcer are so callous that the caustics cannot pierce into them, you must cleave them with a gentle scarification, or else cut them to the quick, so to make way, or as it were open a window for the medicine to enter in, according to Galen. Neither in the interim must you omit Hypocrates his advice, which is, that by the same Lib. 4. Meth. cap. 2. operation we reduce the ulcer if round, into another figure, to wit, long or triangular. CHAP. VIII. Of an Ulcer putrid and breeding worms. Worms are divers times bred in ulcers, whence they are called wormie ulcers; the cause hereof is the too great excrementitious humidity prepared The cause of worms breeding in Ulcers. to putrefy by unnatural and immoderate heat. Which happens, either for that the ulcer is neglected, or else by reason of the distemper and depraved humours of all the body, or the affected part; or else for that the excrementitious humour collected in the ulcer, hath not open and free passage forth; as it happens to the ulcers of the ears, nose, fundament, neck of the womb, and lastly to all sinuous and cuniculous ulcers. Yet it doth not necessarily follow that all putrid ulcers must have worms in them; as you may perceive by the definition of a putrid ulcer which we gave you before. For the cure of such ulcers after general means, the worms must first be taken forth, than the excrementitious humour must be drawn away, whence they take their original. Therefore you shall foment the ulcer with the ensuing decoction, which is of force to kill them; for if any labour to take forth all that are quick he will be much deceived; for they oft times do so tenaciously adhere to the ulcerated part, that you cannot pluck them away without much force and pain. ℞. absinth. centaur. majoris, marrub ij, an. M. i. fiat decoctio ad lb. ss. in qu● dissolve A fomentation to kill the worms. aloes ℥ ss. unguenti agyptia●i ℥ i. Let the ulcer be fomented and washed with this medicine, and let pledgets dipped herein be put into the ulcer; or else if the ulcer be cuniculous or full of windings, make injection therewith which may go into all parts thereof. Archigenes much commends this following medicine. ℞. Cerusae, poli j montani, an. Gal. 4. comp. med. ℥ ss. picis navalis liquidae quantum sufficit, misce in mortario pro linimento. If the putrefaction be such that these medicines will not suffice for the amendment thereof, you must come to more powerful, or to cauteries also, or hot Irons, or to section; yet you must still begin with the more gentle, such as this of Galens' description. ℞. cerae. ℥ ij. cerusae ℥ i. olei ros. ℥ ij. salis amnon. ℥ ss arisʒij. an.ʒj. fiat emplastrum. Or ℞. terebinth. lotae ℥ ij. cer● albae ℥ ss liquefiant simul addendo sublimati, ʒss. salis torrefacti, & vitrioli calcinati, an. ℥ i. fiat mundificativum. Or you must use our Aegyptiacum alone, which hath Sublimate entering into the composition thereof; but in the interim the circuit of the Ulcer must be defended with refrigerating, and defensative things for fear of pain. CHAP. IX. Of a sordid Ulcer. ASordide Ulcer after the cure of the body in general, shall be healed with detergent medicines; the indication being drawn from the gross and tough excrement, which with the excrementious Sanies, as it were besieging, and blocking up the ulcerated parts, weakens and as it were dulls the force of medicines though powerful, which causeth us to begin the cure with fomentations and lotions as thus. ℞. Lixivij come. lb. i. absinth. marr●…. appij. centaur. utriusque, hypericonis, an. M. ss. A detergent lotion. coquantur, colaturae, quae sufficiat, add mellis rosatis ℥ i. ungunti aegyptiaci ℥ ss. fiat fo●us. Then use the following detersive medicine: ℞. succi appij, & plantag. an. ℥ ij. mellis come. ℥ i. terebinth. ℥ iss. pull. ●reos Florent. & aloes. an. ℥ ss. fiat medicamentum. The Chirurgeon must well consider, at how many dress he shall be able to wash away the gross sordes or filth sticking close to the Ulcer, and dry up the excrementitious sanies. For oft times these things may be done at one dressing; but in others who have more quick sense or feeling, not so soon. But when the Ulcer is freed of such gross Sordes or filth, you must forbear to use more acride things for fear of pain, defluxion, inflammation, and erosion, whereby the Ulcer would become more hollow. Wherefore then we shall be content to apply remedies which dry and cleanse without acrimony, that we may so help nature's endeavours in generating Detergent medicines without acrimony. flesh. Such remedies are the powders of Aloes, Mastic, Myrrh, Orris, lethargy, Antimony, roots of Gentian, Barley flower, and the like, which being strewed upon the Ulcer, you shall cover it with Lint, and put over that a plate of Lead, rubbed over with quicksilver; and you shall put on these detersives and desiccatives more or less strong, as you shall find it requisite and necessary. For the too plentiful A caution very observable in use of detergent things. use of drying and detersive things, doth in time hollow the Ulcers, whereby it comes to pass that in short time in like sort, a greater quantity of Sanies flows from the Ulcer, the proper substance of the flesh being dissolved by the force or acrimony of the detersive medicine; as also the proper alimentary humour, which flowed to the part, being in like sort, a greater quantity of Sanies flowed from the Ulcer, the proper substance of the flesh being dissolved by the force or acrimony of the detersive medicine, as also the proper alimentary humour, which flowed to the part, being in like sort defiled: which thing beguiles the unskilful Chirurgeon. For by how much he sees the Ulcer flow more plentifully with sanies, he endeavours by so much the more to exhaust and dry up with more acrid medicines these humidities as if they were excrementitious; But Galen hath long ago admonished us to take heed hereof, setting forth a History of a certain Empiric who dressing a sordid Ulcer with a green, acrid and eating medicine, dissolved the flesh, and so consequently made the Ulcer more hollow, and caused more pain and defluxion; whereby it happened that continually adding more acrid medicines, he continually by his ignorance and unskilfulness increased the colliquation of the flesh, the largeness of the ulcer and excrementitious humidity. Wherefore we A distinction to be observed concerning the impurity of ulcers. must take special care, whether the sordid Ulcer grow each day worse, by its proper fault and the impurity of the whole body besides, or else by the colliquation of the flesh and corruption of the benign and alimentary humour sent thither for the nutrition of the part, by the too frequent and unskilful use of too acrid a medicine. You may conjecture this by the increase of the pain without reason, and by Diligent regard must be had of the patient's bodies and the affected parts. the heat and redness of the lips of the Ulcer. Therefore you must principally have regard to this, that you give each of your patients his fit measure, that is, a convenient and agreeable medicine to each of their strengths, taking indication from the strength, distemper, and consistence of the whole body and affected part; for there is a great deal of difference whether you apply a medicine to a ploughman or labourer, or to an Eunuch and woman, or whether to the Leg, or eyes. For these medicines which to a dense and hard body and part are only detergent and drying, the same are to delicate and tender bodies and parts cathaereticke and eating, by colliquation of the flesh, and corruption of the nourishment, making an increase of Sordes or filth; on the contrary those things which do laudibly and sufficiently cleanse the flesh in a soft body and dry up the sanies, these same things applied to a hard body increase the sordes and sanies by suffering them to breed, neither are they of sufficient power to wash away the tenacious impurity of a dense body. Wherefore the skilful Chirurgeon will see when he must be take himself from too strongly cleansing and eating medicines, to these which are more mild. CHAP. X. Of a virulent, eating & malign Ulcer which is termed Cacoëthes, & of a Chironian Ulcer. VIrulent and eating Ulcers differ not unless in magis and minus, for we term How virulent and eating ulcers differ. it a virulent Ulcer which sends forth a virulent sanies, which is properly called Virus. This Virus, or virulency, when it becomes more malign, gnaws and feeds upon the parts which lie under, and are adjoining to the Ulcer, and makes an eating Ulcer. Such Ulcers are by Galen called Dysepulotica, that is, Gal. Lib. 4 de comp. mod. sec. genera. difficultly to be cicatrized; for, saith he, it happens that the Ulcer is Dysepuloticke, either for that the part affected may be vitiated either in the habit or temper thereof, so that it may corrupt the humour which flows thither; such an Ulcer is by a particular name termed Cacoethes; or for that by reason of the evil quality of the blood flowing thither and eating the part, the part affected being too moist cannot How a chironian ulcer differs from an eating, see before, Cap, 2. heal up. He further adds that a Chironian Ulcer is far more malign than these Ulcers which are termed Cacoethe. For the cure; by reason that all these Ulcers have a large extent, for some are more malign and ill to be cicatrized than othersome; it is also necessary to have divers medicines ready and at hand distinct both in their faculties and the degrees thereof; so that it is no marvel if they oft fail of their purpose, who with the same medicine dress and think they shall heal all malign Ulcers. This following medicine described by Asclepiades is much commended by Galen. ℞. squamae aeris, aeruginis rasae, an. ℥ i. cera lb. ss. resinae laricis. ℥ jss. quae liquari possunt Gal, lib, 4. sec; gen, Cap, 5. aridis affundantur, and make an emplaster to be laid only upon the Ulcer; for you must lay a defensative about the Ulcer for fear of inflammation. But Galen saith, that the following Epuloticke of Primion excels the rest, as that which to desperate Ulcers, (which many have taken in hand and left as uncurable,) was of certain and approved use. ℞ soreos ℥ iij aluminis scissilis, calcis vivae, an ℥ ij. thuris, gallarum, an. ℥ iiij. cerae, lb. j Gal, lib, a, de comp, med, sec▪ gen. Cap, 6. & ℥ iij. sevi vitulini lb. i. & ℥ seven. olei veteris quantum sufficit, fiat emplastrum. CHAP. XI. An advertisement to the young Chirurgeon touching the distance of times wherein malign Ulcers are to be dressed. TO show the use of Asclepiades his medicine described in the former Chapter, Gal, lib, 4, de comp, med: sec. gen: Cap. 5. and convince the error of these Surgeons, who think they do well for their patients, if they twice or thrice on a day dress malign Ulcers, I have here thought good to digress a little from my purpose and to interpose Galens' authority. Rightly (saith Galen) hath Asclepiades added these words to the formerly described medicine: And lose this after three days, and foment the Ulcer, and fasten the same emplaster being washed, and apply it again; for unless the medicine adhere long to the skin, it will do no good. Which thing notwithstanding many Physicians have been ignorant of, thinking if they wiped away the Sanies from the Ulcer thrice on a day, they should do better than those who did the save but twice a day. But those who dress it but once a day, are reproved by the patients as negligent. But they are much mistaken; for you must remember, as we have delivered in most of our writings, that the qualities of all neighbouring bodies do mutual actuate and affect each other in some degree, although the one thereof be much more powerful; for by this reason in space of time they become somewhat alike, though they otherwise differ much; But when the quality of the medicine shall be like in species to the body to be cured, there follows the better success. Wherefore he which moved by these reasons first appointed to use the emplaster formerly applied, is worthy of commendations; and we ought to follow him much the rather, seeing that which he found out by reason, is approved by experience. Neither did he unadvisedly command to foment the wound every third day, that is, at every dressing; for seeing it is a powerful medicine, therefore it stands in need of mitigation. Thus much Galen, whose opinion grounded Galens' reason further explained. on reason, he can again confirm with another reason. It is already sufficiently known, that medicines can do nothing in us unless by the force of the native heat, which stirs up the faculty of the medicine to operation. But in Ulcers which are absolutely malign, the native heat of the affected part is very languid, being broken and debilitated by the presence of the preternatural heat; so that it stands in need of a great space of time to actuate the virtue and faculty of the medicine. Wherefore, if in that time, when as the native heat hath much moved and stirred up the faculty of the medicine, the ulcer be loosed or opened, and that emplaster cast away which was laid upon the part, and a fresh one laid in steed thereof; the heat implanted in the part is either dissipated by the contact of the air, or is weakened and driven in; and that endeavour which was made by the emplaster was to no purpose, being as it were stopped in the midst of the course. But a new emplaster being laid on, the heat of the part must undergo a new labour, so to stir up the faculty to bring it to act. For all medicines are, what they are, in faculty. Equal to this is their error, who by too oft renewing their emplasters on the same day, do too powerfully Medicines are only such in faculty. cleanse; for so they do not only take away the excrementitious humours, both Sordes and Sanies, but also the alimentary juice; to wit, the Rob, Cambium, and Gluten, which are the next matter for procreating of laudable flesh. Wherefore it is not good to dress Ulcers so often in one day, and to lose them to apply new emplasters, unless some grievous symptom (as pain) force us to do it, which requires to be assuaged and mitigated by the often changing and renewing of Anodyne medicines. CHAP. XII. How to bind up Ulcers. FOr the binding up of Ulcers, you must always begin your bandage at the Ulcer. Now the Rowler must be so large that it may not only cover The beginning of your binding must be at the Ulcer. and comprehend the Ulcer, but also some portion of the adjacent parts above and below; and let it press the Ulcer with that moderation, that it may only press out the excrementitious humours. For so the ulcer will become dry, and consequently more near to healing, as it is observed by Hypocrates. Let this be the measure of your binding, that it be neither too straight for hence would ensue Hip. lib. de ulc. pain and defluxion; nor too lax, for such is of no use. You may moisten your bolsters and Rulers in oxycrate or in red and astringent wine, especially in Summer; when you have bound it up the part must be kept quiet. For according to Hypocrates, those who have an ulcer in the leg, ought neither to stand, nor sit, but to lie on a bed. Wherefore when the legs are ulcerated the arms must be exercised, by handling, lifting up and casting down of divers things. But on the contrary if Revulsion into contrary parts. the arms be ulcerated, the legs must be exercised with walking, or frictions from above downwards, if the patient cannotendure to walk. So the humours and spirits which with more violence and greater plenty run down to the part affected, may be drawn back and diverted. CHAP. XIII. Of the cure of particular ulcers, and first of those of the eyes. FOr that (in Galens' opinion) the divers indication in curing diseases is drawn from the condition of the part, to wit, the temper, complexion, site, figure, 4. Methodi. use, dull or quick sense; Therefore having briefly handled the general cure both of simple and compound and implicit ulcers, I think it fit to treat of them now as they are distinguished by the parts, beginning with these of the eyes. These according to Celsus, are sometimes caused by pustules, or a sharp defluxion which frets or eats in sunder the coats thereof, or else by a stroke. Paulus sets down these differences of the ulcers of the eyes; If (saith he) a small, little and hollow ulcer be upon the horny coat, it is by the greeks termed Botryon; Lib. 6. cap. 6. lib. 3. Botryon. Caloma. but if it be broader and less deep, it is termed Caloma; about the circle of the Iris or Rainbow, it is called Argemon. If it be crusty and sordid, it is termed Epicauma. Argomon. Ep●cauma. The cure. These in general require the same cure as the former, that is, to be mundified, incarnated, dried and cicatrized; but the part affected indicateth more gentle medicines. Wherefore having purged the patient and taken some blood both from his arm, as also from his veins and temporal Arteries, and bathed him if it be needful; to divert the defluxion you shall to his shoulders apply cupping glasses with scarification; or else bread newly drawn out of the oven, and sprinkled with aqua vitae or some good wine shall be applied to the original of the spinal marrow. But you shall apply to the forehead and temples an astringent emplaster made of emplastrum contra rupturam, ung. Comitissae, and Resiccativum rubrum mixed together. But this ensuing Collyrium described by Celsus and approved by Hollerius, shall be dropped into the eye. ℞. aeris usti, cadmiae ustae & lotae, an. ℥ i. ex aqua ●ingatur collyrium quod liquore ovi dissolvatur. But in the mean time you must diligently observe whether you put the A Collyrium to cleanse the Ulcers of the eyes. eye to any great pain. Wherefore now and then by putting anodyne medicines thereto, it will be good to comfort it. Also you may make collyria of the decoction of Plantain, faenugreeke, wormwood, with a little quantity of Sugar Candy, tutia, gum tragacanth, myrrh and vitriol dissolved therein. When the ulcer i● mundified, the following sarcoticke will be of good use. ℞. sarcocollae in lacte muliebri nutritae, ʒiij. pull. diaireos simplicis, gum. arabici, tragacanth. A sarcoricke Collyrium. an. ʒss. mucilaginis faenugraeci quantum sufficit ut inde fiat collyrium. But you must note that for moist Ulcers, powders are more convenient than Collyria. When the ulcer is plained or filled with its proper flesh, it may be cicatrized with the following collyrium. ℞. tutiae, cadmiae ut decet praeparatae, cerusae, antimonij, olibani, an. ʒss. myrrhae, sarcocollae, sanguinis Draconis, aloes, opij, an. ℈ ss. cum aqua planta. An ●pulotick Collyrium. ginis fiat collyrium; or the powder only may be conveniently strewed thereon. Celsus hath noted that the cicatrizing of the eyes is incident to two dangers, that is, Lib. 6. cap. 6. lest they be too hollow, or else too thick. If too hollow, they must be filled by the following remedy, ℞. Papaveris lachrimae, ʒss. sagapeni, opopanacis, an. ʒss. aruginisʒj. A Collyrium for hollow scars. cuminiʒiij. piperisʒij. cadmiae lotae & cerusa, an. ʒiss. cum aqua pluviali fiat collirium. But if the scars be thick or gross, the following remedy will extenuate them. ℞ cinnamon. acaciae, an. ʒss. an.ʒj. piperis albi, thuris, an. ℥ iss. aris combusti, ʒiij. cum aqua pluviali fiat collyrium. But The scars of the Horny coa● are white and these of the Adnata red. if the scar be upon the cornea or horny coat, so that it cover the pupilla or sight, the sight will be intercepted by the densenesse of the membrane. Here you must also observe, that the scars that are on the Cornea are white, but these on the Adnata are red, because this is spread over with more little veins than that. CHAP. XIIII. Of the Ozaena and Ulcers of the Nose. THe Ozaena is a deep and stinking Ulcer in the inside of the nose, sending forth many crusty and stinking excrements. Celsus saith that such ulcers Lib. 6. cap. 8. Ga. Lib. 3. de comp. med. secund. locos cap. 3. The cure. can scarcely be healed. It is caused (as Galen saith) by the distillation of acride and putrid humours from the head into the nosethrills about the mammillary processes. For the cure, the patient must eat sparingly, and his meat must neither be sharp nor strong; the humour being prepared must be purged; the head dried and strengthened, that so it may neither admit the excrementitious humours, nor send them down; then must we come to the part affected with the Ulcer. The Ulcer must be dried with a repelling medicine, such as is the juice of Pomegranates boiled to the half in a brass vessel; the powder of Calamint, Cresses, white Hellebore, the juice of Cresses with Alum and other things which you may read in Celsus. Galen out of Archigenes wishes, to draw up into the nosethrills the juice of Calamint, or that the Calamint itself being dried, and made into powder, may be blown with a quill into the nose. Others use this following powder. ℞. ros. rub. mint. calam. arom. rad. angelica, gentian, macis, caryop. an. ʒss. camph. ambrae, an. gr. iiij. mosch. gr. vi. fiat pulvis subtilissimus. Manardus writes that the Urine of an Ass, though a nasty Lib. 20. epist. 5. medicine, is an excellent remedy in this affect. But if the inveterate and contumacious evil do not yield to these remedies, than you must have recourse to Coprose, Verdigreece, sal ammoniacum, and Alum with Vinegar. It divers times happens that the Ulcer spreading on, comes to take hold of the Ossa ethmoidea or sieve-like bones; in which case you must not forcibly pluck them out; but refer the whole business An injection when the Ozaena shall come to the Oss● Ethmoideae. to nature, and expect when they shall come away of themselves, making in the mean while injections into the nostrils of aqua vitae, wherein Cephalic powders have been steeped for the greater drying. CHAP. XV. Of the Ulcers of the mouth. OF this tribe are the Aphthae, Ulcers familiar to little children, according to Hypocrates. They oft times begin at the gums, and by the palate of Aph. 24, sect: 3 Celsus lib, 6, cap, 11. Gal come, ad 〈◊〉, lib. ep●●●m. the mouth creep into the uvula, throttle, and over all the mouth, as Celsus saith. Galen makes two kinds of Aphtha's; the one of easy cure, such as that which usually troubles children by reason of the acrimony of the nurse's milk; the other is malign by reason of an afflux of an evil humour (that is, venenate and malign) into the mouth. For the cure, it shall be good to abstain from all acride things, and if it be a sucking The cure. child, it will not be amiss to temper the nurse's milk with refrigerating meats, bathing the whole body, and fomenting the dugs with warm water; for all the members in children are most tender, and as it were mucous, and their mouths are unaccustomed to meats and drinks. For topicke medicines, you must make choice of such which may quickly and readily work the effect; for here the condition of the affected part is such, that they cannot long remain and adheere thereto. Therefore if the Ulcer be malign, it must be lightly touched with aqua fortis which hath been used in separating metals and which besides is tempered with six parts of common water. You may for the same purpose use the oils of Vitriol, Sulphur, Antimony, Mercury water and the like. Aetius wishes you to touch and correct such Ulcers with a lock of wool dipped in scalding oil, and so fastened to the end of a probe, until they wax white and become smooth or plain. For so their eating and spreading force will at length be bridled, and laudable flesh grow up in place of that which is eaten. After such burning it will be good to wash the mouth with the following gargarism, which also of its self alone will serve to cure Aphtha's, which are not malign. A gargatisme for the Aphthaes. ℞. hordei integri p. i. plantag. ceterach, pilosellae, agrimonia, an. M. i. fiat decoctio ad lb. i. in qua dissolve mellis rosatis ℥ i. diamoron, ℥ ss. fiat gargarisma. You may also make other gargles, of Pomegranate pills, Balausties, Sumach, Berberies, red roses being Lib. 6. meth. Cap. 10. boiled, and dissolving in the strained liquor Diamoro● and Dianucum with a little Alum. For Galen writes, that simple Ulcers of the mouth are healed with things which dry with moderation; now Diamoron and Dianucum are such. But others Ulcers of the palate must be quickly aed carefully dressed. stand in need of strong medicines, with such like. If the palate be seized upon, we must use the more diligence and care; for there is danger, least being the part is hot and moist, the bone which lies under which is rare and humid, may be corrupted by the contagion and fall away, and the voice or speech be spoilt. If the Ulcer be pocky, omitting the common remedies of Ulcers, you must speedily be●ake yourself to the proper antidote of that disease, to wit, quicksilver. Fistulous Ulcers often take hold on the Gums, whence the root of the next tooth becomes rotten, and so far that the acrimony of the Sanies oft time's makes its self a passage forth on the outside under the chin; which thing puts many into Aetius lib. 6. cap. 3. Celsus lib. 6. cap. 13. a false conceit of the scrophulae or King's evil, and consequently of an uncurable disease. In such a case Aetius, and Celsus counsel is, to take out the rotten tooth, for so the Fistula will be taken away, the Gum pressing and thrusting its self into the place of the tooth which was taken forth; and so the cause nourishing the putrefaction being taken away, (that is, the tooth) the rest of the cure will be more easy. The Ulcers of the tongue may be cured by the same remedies by which the rest of the mouth; yet those which breed on the side thereof endure very long, and you must look whether or no there be not some sharp tooth over against it, which will not suffer the Ulcer in that place to heal; which if there be, then must you take it away with a file. CHAP. XVI. Of the Ulcers of the Ears. Ulcers are bred in the auditory passage both by an external cause, as a stroke, or fall, as also by an internal, as an abscess there generated. They Their causes oft times flow with much matter, not there generated, for such Ulcers are usually but small and besides in a spermaticke part, but for that the brain doth that way disburden its self. For the cure, the chief regard must be had of the antecedent cause, which feeds The cure. the Ulcer, and it must be diverted by purging medicines, Masticatories and Errhines. This is the form of a Masticatory. rum. Mastic. ʒj. staphisagr. & pyreth. an. ℈ i. cinam. A masticatory & caryoph. an. ʒss. fiant Masticatoria, utatur manè & vesperi. But this is the form of an Errhine. rum succi betonic. mercurial: & melissa, an ℥ ss. vini albi ℥ j, misce & frequenter An Errhine. naribus attrahatur. For topicke medicines we must shun all fatty and oily things, as Galen sets down in Method. medendi, where he finds fault with a certain follower of Thessalus who by using Tetrapharmacum, made the Ulcer in the ear grow each day more filthy than other, which Galen healed with the Trochisces of Andronius dissolved in Vinegar, whose composure is as followeth. rum ballast. ʒijs, alumin. The composition of Andronius his trochisces. ʒj. atrament. suitor. ʒijs, myrrhae. ʒjs, thur. aristoloch. gallarum, an. ʒijs, salis Ammon. ʒjs, excipiantur omnia melicrato, & ●…t trochisci. Galen in the same place witnesseth, that he hath healed inveterate Ulcers and of two years old of this kind, with the scailes of Iron made into powder, and then boiled in sharp Vinegar until it acquired the Scailes of Iron. consistence of Honey: Moreover an Ox's gall dissolved in strong Vinegar, and dropped in warm, amends and dries up the putrefaction wherewith these Ulcers flow. Also the scailes of Iron made into powder boiled in sharp Vinegar, dried and strewed upon them. But if the straightness of the passages should not give leave to the matter contained in the windings of the ears to pass forth, then must it be drawn out with an Instrument thereupon called a Pyoulcos, or matter-drawer, Of the Pyoulcos Galen makes mention 2 add Gia●… con●…. whereof this is the figure. The figure of a Pyoulcos, or matter-drawer. CHAP. XVII. Of the Ulcers of the Windpipe, Weasand, stomach and Guts. THese parts are ulcerated either by an external cause as an acride medicine, or poison swallowed down; or by an internal cause, as a malign The Causes. fretting humour which may equal the force of poison generated in the body, and restrained in these parts. If the pain be increased by swallowing or breathing, it is the sign of an Ulcer in the weazon, or windepipe joining thereto; But the pain is most sensibly felt when as that which is swallowed is either Signs. sour or acride, or the air breathed in, is more hot or cold than ordinary. But if the cause of pain lie fastened in the stomach, more grievous symptoms urge; for sometimes they swoon, have a nauseous disposition and vomiting, convulsions, gnawing, and pain almost intolerable, and the coldness of the extreme parts; all which when present at once, few escape unless such as are young, and have very strong bodies. The same affect may befall the whole stomach, but because both for the bitterness of pain, and greatness of danger, that Ulcer is far more grievous which takes hold of the mouth of the Ventricle, honoured by the Ancients with the name of the heart; therefore Physicians do not make so great a reckoning of that Gal. lib. 5. de loc. affect. cap. 5. which happens in the lower part of the stomach. Now we know that the Guts are ulcerated if Pus, or much purulent matter come forth by stool; if blood come that way with much griping; for by the Pus staying and as it were gathered together in that place, there is as it were a certain continual Tenesmus, or desire to go to stool. Now all such Ulcers are cured by meats and drinks, rather than by medicines, according to Galen. Therefore you must make choice of all such meats and drinks Lib. 4. & 5. Method. as are gentle, and have a lenitive faculty, shunning acride things; for Tutia, Lytharge, Ceruse, Verdigreece and the like, have no place here, as they have in other Ulcers. But when as the Ulcer shall be in the Gullet or Weazon, you must have a care that The cure. such things may have some viscidity or toughness, and be swallowed by little, and little, and at divers times; otherwise they will not m●●h avail, because they cannot make any stay, in these common ways of breath and meat; therefore they presently slip down and flow away; wherefore all such things shall be used in form of an How to take medicines for Ulcers of the throat. Eglegma, to be taken lying on the back, and swallowed down by little and little, opening the muscles of the throat, lest the medicine passing down suddenly and in great quantity, cause a cough, a thing exceeding hurtful to these kinds of Ulcers. When they must be cleansed, you shall have crude honey, which hath a singular faculty, above all other detergent things, in these kind of Ulcers. But when they can conveniently swallow, you shall mix Gum Tragacanth dissolved in some astringent decoction. In Ulcers of the stomach all acride things (as I have formerly advised) Why acride things must be shunned in these Ulcers. must be shunned, as those which may cause pain, inflammation and vomit, and besides hinder the digestion of the meat. Therefore let them frequently use a ptisan, and sugared jellies wherein Gum Tragacanth, and bowl Armenicke have been put, the decoction of Prunes, Dates, Figs, Raisins, Honey, Cow's milk boiled with the yoalkes of eggs, and a little common honey. When they are to be agglutinated, it will be convenient to make use of austere, astringent, and agglutinative things which want all acrimony, and ungrateful taste, such as are Hypocistis, Pomegranate flowers and pills, terra sigillata, sumach, acacia a decoction of quinces, the Lentisk wood, the tops of Vines, of brambles, myrtles, made in astringent wine, unless there be fear of inflammation. Their drink shall be Hydromel water with Sugar, syrup of Violets and jujubes. Honey mixed with other medicines is a very How powerful Honey is to cure such kind of Ulcers. fitting remedy for Ulcers of the guts and other parts more remote from the stomach; for if you shall use astringent medicines alone of themselves, they will stick to the stomach; neither will they carry their strength any further; but honey mixed with them, besides that it distributes them to the rest of the body, and helps them forwards to the affected parts; also cleanses the Ulcers themselves. Here also Asses milk may with good success be used in stead of Goats or Cow's milk. The use of a valnerary potion is almost commendable, if so be that it be made of such herbs and simples, as by a certain tacit familiartiy have respect to the parts affected. But the Ulcers of the Guts have this difference amongst themselves, that if the greater guts be affected, you may heal them with a clyster and injections, made also sharp to correct the putrefaction; such as are those which are made of Barley Egyptiacum good for the Ulcers of the greater guts. Lib. 5. meth.. water, or wine with Aegyptiacum. But if the small guts be ulcerated, they must be rather healed by potions and other things taken at the mouth, for that (as Galen saith) these things which are put up into the body by the Fundament, do not commonly ascend, to the small or slender guts, but such as are taken at the mouth cannot come unless with the loss of their faculty, so far as the great guts. CHAP. XVIII. Of the Ulcers of the Kidneys and Bladder. Ulcers are caused in the Kidneys and Bladder, either by the use of acride meats, drinks, or medicines, as Cantharideses; or else by the collection of an acride humour bred in that place, sent or fall'n thither; or else by the rupture Causes. of some vessel, or an abscess broken and degenerated into an Ulcer, as it sometimes comes to pass. They are discerned by their site, for the pain and heaviness of Ulcers of the reins comes to the Loins, and the Pus or matter is evacuated well and Signs. throughly mixed with the Urine. Neither doth the Pus which flows from the renies stink so ill, as that which is cast Hip. Aphor. 81 sect 4. forth of the bladder; the reason is, for that the bladder being a bloodless, fleshless & membranous part hath not such power to resist putrefaction; that pus which flows Aphor. 76. sect. 4. from the Kidneys never flows without water; and although by long keeping in an Urinal, it at length subsides or falls to the bottom, and may be seen separated; yet when it is first made, you may see it perfectly mixed with the Urine; but that Pus which Ap●●or. 77. sect. 4. flows from the bladder is oft times made alone without Urine; & usually it comes to pass that the Pus, or matter which flows from the ulcerated Kidneys, hath in it certain caruncles, or as it were hairs, according to the rule of Hypocrates. Those who in a thick Urine have little ca●uncles, and as it were hairs come forth together therewith, they come from their Kidneys; but on the contrary those who have certain branlike scailes come from them in a thick Urine, their bladder is scabby or troubled with a scabby Ulcer. For the cure; it is expedient that the belly be soluble either by nature; or Art and The cure. the use of mollifying Glisters. And it is good to vomit sometimes, so to draw back the humours by whose confluxe into the affected part the Ulcer might be seed and made more sordid and filthy. You must beware of strong purgations, lest the humours Why we must shun strong purges. being moved and too much agitated, the matter fit to nourish the Ulcer may fall down upon the Kidneys or bladder. The ensuing potion is very effectual to mundify those kind of Ulcers. ℞. Hordei integri, M. ij. glycyrrhizae ras. & contus. ℥ ss. rad. acetosae & petrosel. an. Things to cleanse these Ulcers. ʒuj. fiat decoctio ad lb. i. in colatura dissolve mellis dispum. ℥ ij. Let him take every morning the quantity of four Ounces. Gordonius exceedingly commends the following Trochisces. ℞. quator sem. frig. maj. mundatorum, sem. papaveris albi, sem. malvae, portul. cydon. baccarum myrti, tragacanth. gum. arab. nucum pinearum mund. Trochisces for the Ulcers of the Kidneys and bladder. pistach. glycyrrhizae mund. ●ucaginis sem. psilij, amygd. dulc. hordei mund, an. ʒij. bol. armeni, sang. drac●spodij, rosarum, myrrhae an. ℥ ss. ponderisʒij. Let him take one thereof in the morning dissolved in Barley water or Goat's milk. Galen bids to mix honey and diuretic things with medicines made for the Ulcers of the reins and bladder, for that they gently move 4. Method. Urine, and are as vehicles to carry the medicines to the part affected. Ulcers of the bladder are either in the bottom thereof, or at the neck and urinary passage. If they be in the bottom, the pain is almost continual; if in the neck, the pain Signs to know what part of the ●ladder is ulcerated. than pricks and is most terrible when they make water and presently after. The Ulcer which is is the bottom sends forth certain scaly or skinny excrements together with the Urine; but that which is in the neck, causes almost a continual Tentigo. Those which are in the bottom are for the most part incurable, both by reason of the bloodless and nervous nature of the part, as also for that the Ulcer is Why ulcers in the bottom of the bladder are uncureable. continually chased and troubled by the acrimony of the Urine, so that it can hardly be cicatrized. For even after making of water some relics of the Urine always remain in the bottom of the bladder, which could not therefore pass forth together with the rest of the Urine, for that for the passing forth of the Urine, the bladder being distended before, falls and is complicated in its self. Ulcers of the bladder are healed with the same medicines as those of the reins are; but these not only taken by the mouth but also injected by the urinary passage. These injections may be made of Gordonius his Trochisces formerly prescribed, being dissolved in some convenient liquor; but because Ulcers of the bladder cause greater and more sharp pain than those of the Kidneys, therefore the Chirurgeon must be more diligent in using Anodynes. For this purpose, I have often by experience found, that the oil of hen-bane made by expression gives certain help. He shall do the same with Caraplasmes and liniments applied to the parts about the Pecten and all the lower belly and perinaeum, as also by casting in of Glisters. If that they stink, it will not be amiss to make injection of a little Aegyptiacum dissolved in wine, plaintaine Egyptiacum for the ulcers of the bladder. or rose water. For I have often used this remedy in such a case with very prosperous success. CHAP. XIX. Of the Ulcers of the womb. Ulcers are bred in the womb either by the confluxe of an acride, or biting humour, fretting the coats thereof, or by a tumour against nature degenerating into an Absesse, or by a difficult and hard labour; The causes. they are known by pain at the perinaeum, and the effluxe of Pus and San●es by the privity All of them in the opinion of Avicen are either putrid, when as the Sanies breaking forth is of a stinking smell, and in colour resembles Lib. 3. sect. 12. tract. 2, cap. 5. Signs. the water wherein flesh hath been washed; or else sordid, when as they flow with many virulent and crude humours; or else are eating or spreading Ulcers, when as they cast forth black Sanies, and have pulsation joined with much pain. Besides they differ amongst themselves in site, for either they possess the neck and are known by the sight, by putting in a speculum; or else are in the bottom, and are manifested by the condition of the more liquid and serous excrements, and the site of the pain. They are cured with the same remedies wherewith the ulcers of the mouth to wit, with aqua fortis, the oil of Vitriol and antimony, and other things made The cure. somewhat more mild, and corrected with that moderation, that the ulcerated parts of the womb may be safely touched with them; it is requisite that the remedies which are applied to the Ulcers of the womb, do in a moment that which is expected of them, for they cannot long adhere or stick in the womb, as neither to the mouth. Galen saith that very drying medicines are exceeding fit for the Ulcers of the womb, that so the putrefaction may be hindered or restrained, whereto this Why strongly drying things are good for Ulcers of the womb. part as being hot and moist is very subject; besides that the whole body unto this part as unto a sink sends down its excrements. If an ulcer take hold of the bottom of the womb, it shall be cleansed and the part also strengthened by making this following injection. ℞ hordei integri p. ij. guajaci. ℥ i. rad. Ireos. ℥ ss. absinth. plant. centaur. utriusque, an. M. j fiat decoct. in aqua fabrorum ad lb. ij. in quibus dissolve mellis vosatis, & An in●ection for an Ulcer in the bottom of the womb. syrupi de absinthio, an. ℥ iij. fiat injectio. For amending the stinking smell I have often had certain experience of this ensuing remedy. ℞. vinirub. lb. i. unguent. agyptiaci ℥ ij. bulliant parum. Thus the putrefaction may be corrected and the painful maliciousness An injection hindering putrefaction. of the humour abated. Ulcers when they are cleansed must presently be cicatrized; that may be done with Alum water, the water of plantain wherein a little vitriol or Alum have been dissolved. Lastly, if remedies nothing availing, the Ulcer turn into a Cancer, it must be dressed with anodynes and remedies proper for a Cancer, which you may find set down in the proper treatise of Cancers. The cure of Ulcers of the fundament was to be joined to the cure of these of the womb; but I have thought good to refer it to the treatise of Fistula's, as I do the cure of these of the urinary passage to the Treatise of the Lues venerea. CHAP. XX. Of the Varices and their cure by cutting. AVarix is the dilatation of a Vein, some while of one and that a simple branch, otherwhiles of many. Every Varix is either strait or crooked, What a Varix is and what be the differences thereof. and as it were enfolded into certain windings within its self. Many parts of the body are subject to Varices, as the temples, the region of the belly under the Navel, the testicles, womb, fundament, but principally the thighs and legs. The matter of them is usually melancholy blood, for Varices often grow in men of a melancholy temper, and which usually feed on The matter. gross meats, or such as breed gross and melancholy humours. Also women with child, are commonly troubled with them, by reason of the heaping together of their suppressed menstrual evacuation. The precedent causes are a vehement concussion of the body, leaping, running, a painful journey on foot, a fall, the carrying of a The causes. heavy burden, torture or Racking. This kind of disease gives manifest signs thereof Signs. by the largeness, thickness, swelling and colour of the Veins. It is best not to meddle with such as are inveterate; for of such being cured there The cure. is to be feared a reflux of the melancholy blood to the noble parts, whence there may be imminent danger of malign Ulcers, a Cancer, Madness or suffocation. When as many Varices and diversely implicit are in the legs, they often swell with congealed and dried blood, and cause pain which is increased by going and compression. Such like Varices are to be opened by dividing the vein with a Lancet, and then the blood must be pressed out, and evacuated by pressing it upwards The cutting of Varices and downwards; which I have oft times done, and that with happy success to the patients, whom I have made to rest for some few days, and have applied convenient medicines. A Varix is often cut in the inside of the leg a little below the knee, in which place commonly the original thereof is seen. He which goes about to intercept a Varix downwards from the first original and as it were fountain thereof, makes the cure far more difficult. For hence it is divided as it were into many rivulets, all which the Chirurgeon is forced to follow. A Varix is therefore cut or taken away so to intercept the passage of the blood and For what intention a Varix must be cut. humours mixed together therewith, flowing to an Ulcer seated beneath; or else lest that by the too great quantity of blood, the vessel should be broken, and death be occasioned by a haemorrhagy proceeding from thence. Now this is the manner of cutting it. Let the patient lie upon his back on a bench or table, then make a ligature Paulus cap. 82. lib. 6. The manner how to cut it. upon the leg in two places the distance of some four fingers each from other, wherein the excision may be made, for so the Vein will swell up and come more in sight, and besides you may also mark it with ink; then taking the skin up between your fingers cut it longwayes according as you have marked it, then free the bared vein from the adjacent bodies; and put thereunder a blunt pointed needle (lest you prick the vein) thread with a strong double thread, and so bind it fast; and then let it be opened with a Lancet, in the middle under the Ligature just as you open a vein, and draw as much therehence as shall be fit. Then strait make a Ligature in the lower part of the forementioned Vein, and then cut away as much of the said Vein as is convenient between the Ligatures, and so let the ends thereof withdraw themselves into the flesh above and below; let these ligatures alone until such time as they fall away of themselves. The operation being performed, let an astringent medicine be applied to the wound and the neighbouring parts; neither must you stir the wound any more for the space of three days. Then do all other things as are fit to be done to other such affects. CHAP. XXI. Of Fistula's. A Fistula is a sinuous, white, narrow, callous and not seldom unperceivable Ulcer. It took its denomination from the similitude of a reeden What a Fistulai●. (Fistula) that is, a pipe, like whose hollowness it is. A Fistula is bred in sundry parts of the body, and commonly follows upon Abscesses or Ulcers not well cured. A Callous is a certain fleshy substance, white, solid, or dense and hard, dry and What a Gallousus. without pain, generated by heaping up of dried excrementitious phlegm, or else adult melancholy, encompassing the circuit of the Ulcer, and substituting its self into the place of laudable flesh. The Sinus or cavity of a Fistula is sometimes dry, and The differences of Fistula's. otherwhile drops with continual moisture: sometimes the dropping of the matter suddenly ceases, and the orifice thereof is shut up, that so it may deceive both the Chirurgeon and the Patient with a false show of an absolute cure; for within a while after it will open again and run as formerly it did. Some Fistula's are bred by the corruption of a bone, others of a nerve, others of membranes, and others of other parts of the body. Some run strait in, others and that the greater part, have turnings and windings; some have one, others have more orifices and windings; some are at the joints, others penetrate into some capaoity of the body, as into the chest, belly, guts, womb bladder; some are easily, others difficultly cured, and some wholly uncurable. There are divers signs of Fistula's according to the variety The signs. of the parts they possess; for if that which you touch with the end of your probe make resistance, and resound, than you may know that it is come to the bone; and than if the end of the probe slip up and down as on a smooth and polite superficies, it is a sign that the bone is yet sound; but if it stop and stay in any place as in a rough way, then know that the bone is eaten, rough and perished; sometimes the bone lies bare, and then you need not use the probe. Besides also it is a sign that The sign that the bone is ba●e from the condition of the matter which is cast fur●h. the bone is affected, if there be a purulent efflux of an unctuous or oily matter, not much unlike that marrow wherewith the bone is nourished. For every excrement shows the condition of the nourishment of the part whence it is sent; in a Fistula which penetrates to a Nerve, the patient is troubled with a pricking pain, especially when you come to search it with a probe, especially if the matter which flows down be more acrid. Oft times if it be cold, the member is stupefied the motion Aetius tetra. 4. sect. 2 cap. 55. being weakened; besides also the matter which flows from thence is more subtle, and somewhat like unto that which flows from the bones, yet not oily nor fat, but sanious and viscous resembling the condition of the alimentary humour of the Nerves. The same usually appears and happens in Fistula's which penetrate to the Tendons and those membranes which involve the muscles. If the Fistula be within the flesh, the matter flowing thence is more thick and plentiful, smooth, white and equal. If it descend into the Veins or Arteries, the same happen as in those of the Nerves; but that there is no such great pain in searching with your probe, nor no offence or impediment in the use of any member: yet if the matter of the Fistulous Ulcer be so acrid, as that it corrode the vessels, blood will flow forth; and that more thick if it be from a vein, but more subtle and with some murmuring if from an Artery. Old Fistula's and such as have run for many years, if suddenly Old Fistula's if closed prove mortal. shut up, cause death, especially in an ancient and weak body. CHAP. XXII. Of the cure of Fistula's. FOr the cure; in the first place it will be expedient to search the Fistula; & that How to find out the windings and cavities of Fistula's. either with a wax size, a probe of lead, gold or silver, to find out the depth and windings or corners thereof. But if the Fistula be hollowed with two or more orifices, and those cuniculous, so that you cannot possibly and certainly search or find them all out with your probe; then must you cast an injection into some one of these holes, and so observe the places where it comes forth, for so you may learn how many, and how deep or superficiary cavities there be; then by making incisions you must lay open and cut away the callous parts. You must make incisions with an incision knife or razor, or else apply actual or potential cauteries; for nature cannot unless the Callous substance be first taken away, restore or generate flesh or agglutinate the distant bodies. For hard things cannot grow together, unless by the interposition of glue, such as is laudable blood; but a callous body on all sides possessing the surface of the ulcerated flesh, hinders the flowing of the blood out of the capillary veins for the restoring of the lost substance and uniting of the disjoined parts. If you at any time make caustic injections into the caustic injections. Fistula, you must presently stop the orifice thereof, that so they may have time to work the effect, for which they are intended. Which thing we may conjecture by the tumour of the part, the digesture of the flowing matter, and its lesser quantity. Then you must hasten the falling away of the Eschar, and then the Ulcer must be dressed like other Ulcers. But oft times the Callous which possesses the sinuous cavity of a Fistula, overcome by the power of acrid and escharoticke medicines comes Colsu● lib. 5. whole forth, and falls out like a pipe, and so leaves a pure Ulcer underneath it. Which I observed in a certain Gentleman, when I had washed with strong Aegyptiacum divers times a Fistulous Ulcer in his thigh shot through with a bullet; then presently by putting in my Balsam formerly described, he grew well in a short time. Fistula's which are near great vessels, Nerves or principal entrails, must not be meddled with, unless with great caution. When a Fistula proceeds by the fault of a Remedies for a Fistula proceeding from a corrupt bone. corrupt bone, it is to be considered whether that fault in your bone be superficiary, or deeper in, or whether it is wholly rotten and perished. For if the default be superficiary it may easily be taken away with a desquammatory Treapan; but if it penetrate even to the marrow, it must be taken forth with cutting mullets, first having made way with a Terebellum. But if the bone be quite rotten and perished, it must be wholly taken away, which may be fitly done, in the joints of the fingers, the radius of the Cubite and Legge; but no such thing may be attempted in the socket of the Huckle bone, the head of the Thigh bone, or any of the Rack bones when they are mortified, neither in those Fistula's, which are of their own nature uncurable; but you shall think you have discharged your duty and done sufficiently for the Patient, if you leave it with a prognosticke. Of this nature are Fistula's which penetrate The cure of what Fistula's may be attempted, and which may not. even to the bowels, which come into the parts o'erspread with large vessels or Nerves, which happen to effeminate and tender persons, who had rather dye by much, than to suffer the pain and torment of the operation. Like caution must be used, when by the cutting of a Fistula there is fear of greater danger, as of convulsion if the disease be in a nervous part. In these and the like cases the Chirurgeon shall not set upon the perfect cure of the disease, but shall think it better to prevent by all A palliative cure of a Fistula. means possible that the disease by fresh supplies become no worse, which may be done if he prevent the falling down of any new defluxion into the part; if by an artificial diet he have a care that excrementitious humours be not too plentifully generated in the body; or so order it, that being generated they may be evacuated at certain times, or else diverted from the more noble to the base parts. But in the mean space it shall be requisite to waste the faulty flesh, which grows up more than is fitting in the Ulcer, and to cleanse the sordes or filth, with medicines, which may do it without biting or acrimony and putrefaction. CHAP. XXIII. Of the Fistula's in the Fundament. FIstula's in the Fundament are bred of the same causes as other kinds of The causes. Fistula's are; to wit, of a wound or abscess not well cured, or of a haemorrhoide which is suppurated. Such as are occult, may be known by dropping Signs. down of the sanious and purulent humour by the Fundament and the pain of the adjacent parts. But such as are manifest by the help of your probe you may find whither they go and how far they reach. For this purpose the Chirurgeon shall put his finger into the Fundament of the patient, and then put a Leaden probe into the orifice of the Fistula, which if it come to the finger without interposition of any medium, it is a sign it penetrats into the capacity of the Gut. Besides also then there flows not only by the fundament but also by the orifice which the malign humour hath opened by its acrimony, much matter, somewhiles sanious, and oft times also breeding Worms. Fistula's may be judged cuniculous, and running into many turnings and windings, if the probe do not enter far in, and yet not withstanding more matter flows therehence than reason requires should proceed from so small an Ulcer. You may in the o●ifices of all Fistula's, perceive a certain callous wart, which the common Surgeons term a Hen's arse. Many symptoms accompany Fistula's Symptoms. which are in the Fundament, as a Tenesmus, strangury & falling down of the Fundament. If the Fustula must be cured by manual operation, let the patient lie so upon his back, that lifting up his legs, his thighs may press his belly, then let the Chirurgeon, having his nail pared, put his finger besmeared with some ointment The art of binding and cu●ing a Fistula of the Fundament. into the patient's Fundament; then let him thrust in at the orifice of the Fistula a thick Leaden needle drawing after it a thread consisting of thread and horse hairs woven together, and then with his finger taking hold thereof and somewhat crooking it, draw it forth at the Fundament, together with the end of the thread. Then let him knit the two ends of the thread with a draw or loose knot, that so he may straiten them at his pleasure. But before you bind them you shall draw the thread somewhat roughly towards you as though you meant to saw the flesh therein contained, that you may by this means cut the Fistula without any fear of an Haemorrhagye, or flux of blood. It sometimes happens that such Fistula's penetrate not into the Gut; so that the finger by interposition of some callous body cannot meet with the needle or probe. Then it is convenient to put in a hollow iron or silver probe so through the cavity thereof to thrust a sharp pointed needle, and that by pricking and cutting may destroy the callous; which thing you cannot perform with the formerly described leaden probe, which hath a blunt point, unless with great pain. The description of a hollow Silver probe to be used with a needle, as also a Leaden probe. A. Shows the Needle. B. The hollow probe. C. The needle with the probe. D. The Leaden needle drawing a thread after it. The Callus being wasted, the Fistula shall be bound as we formerly mentioned That which is superficiary needs no binding, only it must be cut with a crooked scalprum, and the Callus being consumed, the rest of the cure must be performed after the manner of other Ulcers. But you must note, that if any parcel of the Callous body remain untouched by the medicine or instrument, the Fistula reviving again will cause a relapse. CHAP. XXIIII. Of Haemorrboides. HAemorrhoides, as the word usually taken, are tumours at the extremities What they are. of the veins encompassing the Fundament, caused by the defluxion of an humour commonly melancholic, and representing a certain kind of Varices. Some of these run at an hole being opened, which sometimes in space of time Their differences. contracts a Callus; others only swell, and cast forth no moisture; some are manifest; others lie only hid within. Those which run, commonly cast forth blood mixed with yellowish serous moisture, which stimulates the blood to break forth, and by its acrimony opens the mouths of the veins. But such as do not run, are either like blisters, such as happen in burns, and by practitioners are usually called vesicales, and are caused by the defluxion of a phlegmatic and serous humour; or else represent a Grape, whence they are called Wales, generated by the afflux of blood laudable in quality, but overaboundant in quantiry; or else they express the manner of a disease, whence they are termed morales, proceeding from the suppression of melancholic blood; or else they represent warts, whence they are styled Verrucales, enjoying the same material cause of the generation as the morales do. This affect is cause of many accidents in men; for the perpetual effluxe of blood Symptoms. extinguisheth the vivide and lively colour of the face, calls on a dropsy, overthrows the strength of the whole body. The flux of Haemorrhoides is commonly every month, sometimes only four times in a year. Great pain, inflammation, an Abscess which may at length end in a Fistula, unless it be resisted by convenient remedies, do oft times forerun the evacuation of the Haemorrhoides. But if the Haemorrhoides flow in a moderate quantity, if the patients brook it well, they ought not to be stayed, for that they free the patients from the fear of imminent evils, as melancholy, leprosy, strangury and the like. Besides, if they be stopped without a Sent. 37. sect: 6, epid. cause, they by their reflux into the Lungs cause their inflammation, or else break the vessels thereof, and by flowing to the Liver cause a dropsy by the suffocation of the native heat; they cause a dropsy and universal leanness on the contrary, if they flow immoderately, by refrigerating the Liver by loss of too much blood; wherefore when as they flow too immoderately, they must be stayed with a pledget of hares down dipped in the ensuing medicine. ℞. pull. aloes, thuris, ballast. sang draconis, A remedy for the immoderate flowing of the Heamor●hoides. an. ℥ ss. incorporentur simul cum ovi albumine, fiat medicamentum ad usum. When they are stretched out and swollne without bleeding, it is convenient to beat an Onion roasted in the embers with an Ox's gall, and apply this medicine to the swollen places, and renew it every five hours. This kind of remedy is very prevalent For suppressed Heamorrhoides. for internal Haemorrhoides; but such as are manifest may be opened with horseleeches, or a Lancet. The juice or mass of the herb called commonly Dead nettle or Arkeangell, applied to the swollen Haemorrhoides opens them, and makes the congealed blood flow there hence. The Fungus and Thymus being diseases about the fundament are cured by the same remedy. If acrimony heat and pain do too cruelly afflict the patient, you must make him enter into a bath, and presently after apply to the ulcers (if any such be) this following remedy. ℞. Olei ros. ℥ iiij. cerusae ℥ i. Litharg. ℥ ss cerae novae, ʒuj. opij ℈ i. fiaet unguent. secundum artem. Or else. ℞ an.ʒj. opij ℈ i. fiat unguentum cum oleo rosarum & mucagine sem. psilij, addendo vitellum unius out. You may easily prosecute the residue of the cure according to the general rules of Art. The end of the Thirteenth Book. OF BANDAGES, OR, LIGATURES. THE FOURTEENTH BOOK. CHAP. I. Of the differences of Bandages. BAndages, wherewith we use to bind, do much differ amongst themselves. But their differences (in Galens' opinion) are chiefly Lib. de fascijs. drawn from six things; to wit, their matter, figure, length, breadth, making, and parts whereof they consist. Now the matter of Bandages is threefold; Membranous or of skins, which is accommodated peculiarly to the fractured grisles of the Nose; of Woollen, proper to inflamed parts, as those which have need of no astriction; of Linen, as when any thing is to be fast bound: and of Linen clothes, some are made of flax, othersome of hemp, as Hypocrates observes. But Bandages do thus differ amongst Sect. 3. de Chir. office themselves in structure, for that some thereof consist of that matter which is sufficiently close and strong of itself, such are the membranous; others are woven, as the linen ones. But that Linen is to be made choice of for this use, and judged What cloth best for rulers. the best, not which is new and never formerly used, but that which hath already been worn and served for other uses, that so the Bandages made thereof may be the more soft and pliable: yet must they be of such strength, that they may not break with stretching, and that they may straight contain and repel the humour ready to flow down, and so hinder it from entering the part. These, besides, must not be hemmed nor stitched, must have no lace nor seam; for hems and seams by their hardness press into, and hurt the flesh that lies under them. Lace, whether in the midst or edges of the rowler, makes the Ligature unequal. For the Member where it is touched with the Lace, as that which will not yield, is pressed more hard; but with the cloth in the middle more gently, as that which is more lax. Furthermore, these Ligatures must be of clean cloth, that if occasion be, they may be moistened or steeped in liquor appropriate to the disease, and that they may not corrupt, or make worse that liquor by their moistening therein. Now the Bandages which are made of Linen clothes must be cut longways, and not athwart, for so they shall keep more firm and strong that which they bind, and besides, they will be always alike, and not broader in one place than in another. But they thus differ in figure, for that some of them are rolled up, to which nothing must be sowed, for that they ought to be of a due length to bind up the member: others are cut or divided, which truly consist of one piece, but that divided in the end (such are usually taken to bind up the breasts) or else in the midst; others are sowed together, which consist of many branches sowed together, and ending in divers heads, and representing divers figures, such are the Bandages appropriated to the head. But they thus differ in length, for that some of them are shorter, others longer: so in like sort for breadth; for some are broader, others narrower. Yet we cannot certainly define nor set down neither the length, nor breadth of Rulers, for that they must be various, according to the different length and thickness of the members or parts. Generally they ought both in length and breadth to fit the parts, whereunto they are used. For these parts require a binding different each from other, the head, the neck, shoulders, arms, breasts, groins, testicles, fundament, hips, thighs, legs, feet and toes. For the parts of Bandages, we term one part their body, another their heads. By the body we mean their due length & breadth; but their ends, whether they run longways or across, we according to Galen, term them their heads. Com. ad sect. 22. sect. 2. de office chir. CHAP. II. showeth the indications and general precepts of fitting of Bandages and Ligatures. THere are, in Hypocrates opinion, two indications of fitting Bandages or 1. & 2. sect. lib. de fract. Ligatures; the one whereof is taken from the part affected; the other from the affect itself. From the part affected: so the leg, if you at any time bind it up, must be bound longways; for if you bind it overthwart, the binding will loosen as soon as the patient begins to go, and put forth his leg, for then the muscles take upon them another figure. On the contrary the Arm or Elbow must be bound up, bending in and turned to the breast, for otherwise at the first bending, if it be bound when it is stretched forth, the Ligature will be slacked, for that (as we formerly said) the figure of the muscles is perverted. Now for this indication, let each one persuade himself thus much, That the part must be bound up in that figure, wherein we would have it remain. Now for that indication which is drawn from the disease, if there be a hollow ulcer, sinuous and cuniculous, casting forth great store of Sanies, then must you begin We must always begin our ligatures at the bottom of a sinus. the ligature and binding from the bottom of the sinus, and end at the orifice of the ulcer; and this precept must you always observe, whether the sinus be sealed in the top, bottom, middle, or sides of the ulcer. For thus the filth therein contained shall be emptied and cast forth, and the lips of the ulcer too far separated, shall be joined together; otherwise the contained filth will eat into all that lies near it, increase the ulcer, and make it uncurable by rotting the bones which lie under it with this acride sanies or filth. But some Ligatures are remedies Hipp. sent. 4. sect. 2. office of themselves, as those which perform their duties of themselves, and whereto the cure is committed, as are these which restore to their native unity, those parts which are disjoined: others are not used for their own sakes, but only to serve to hold fast such medicines as have a curative faculty. This kind of Ligature is either yet a doing, and is termed by Hippoc. Deligatio operans; or else done and finished, Initio 2. sect. off. and is called, Deligatio operata: for the first, that the Ligature may be well made, it is fit that it be close rolled together, and besides, that the Surgeon hold it stiff and straight in his hand, and not carelessly, for so he shall bind up the member the better. Also he must in the binding observe, that the ends of the Rowler, and consequently their fastening may not fall to be on the affected or grieved part; for it is better that they come above or below, or else on the side: besides also, he must have a special care that there be no knot tied upon the same place, or upon the region of the back, buttocks, sides, joints, or back part of the head, or to conclude in any other part upon which the Patient uses to lean, rest or lie. Also on that part where we intent to sow or fasten the Rulers, you must double in their ends, that so the fastening or suture may be the stronger, otherwise how close soever they shall be wrapped or rolled about the member, yet will they not remain firm, especially if they be of a great breadth. For the second kind of Ligature, to wit, that which is already done and finished; the Surgeon, the performer thereof, must consider to what end it was done, and whether he hath performed it well and fitly, as also neatly and elegantly, Ligatures' must not be only lightly, but also neatly performed. to the satisfaction both of himself and the beholders. For it is the part of a skilful Workman every where handsomely and rightly to perform that which may so be done. In fractures and luxations & all dislocations of bones, as also in wounds and contusions, you must begin your bandage with two or three windings or wraps about upon the place, and that (if you can) more straight than in other places, that so the set bones may be the better kept in their places, and that the humours, if any be already fallen thither, may by this straight compression be pressed forth, as also to hinder and prevent the entrance in of any other which may be ready to fall down. But in fractures (as those which never happen without contusion) the blood flows, and is pressed forth of its proper vessels, as those which are violently battered and torn, which causes sugillation in the neighbouring flesh, which first looks red, but afterwards black and blue by reason of the corruption of the blood poured forth under the skin. Wherefore after these first windings, which I formerly mentioned, you must continue your rolling a great way from the broken or luxated part; he which does otherwise, will more and more draw the blood and humours into the affected part, and cause Impostumes, and other malign accidents. Now the blood which flows, goes but one way downwards, but that which is pressed is Gal. come. ad sent. 25. sect. 1. lib. de fract. carried as it were in two paths, to wit, from above downwards, and from below upwards. Yet you must have a care that you rather drive it back into the body and bowels, than towards the extremities thereof, as being parts which are uncapable of so much matter, and not furnished with sufficient strength to suffer that burden, which threatens to fall upon it, without danger and the increase of prenaturall accidents. But when this mass and burden of humours is thrust back into the body, it is then ruled and kept from doing harm by the strength and benefit of the faculties remaining in the bowels and the native heat. CHAP. III. Of the three kinds of Bandages necessary in fractures. TWo sorts of Ligatures are principally necessary for the Surgeon, according to Hypocrates, by which the bones aswell broken as dislocated Sent. 24. sect 2. office may be held firm when they are restored to their natural place. Of these some are called Hypodesmides, that is, Under-binders: others, Hypodesmides. Epidesmi, that is, Over-binders. There are sometimes but two under-binders used, but more commonly three. The first must first of all be cast over the fracture, and wrapped there some three or four times about, than the Surgeon must mark and observe the figure of the fracture; for as that shall be, so must he vary the manner of his binding. For the ligature must be drawn straight upon the side opposite to that whereto the luxation or fracture most inclines, that so the bone which stands forth may be forced into its seat, and so forced may be the more firmly there contained. Therefore if the right side be the more prominent or standing forth, thence must you begin your ligation, and so draw your ligature to the left side. On the contrary, if the left side be more prominent, beginning there, you shall go towards the opposite side in binding and rolling it. Here therefore would I require a Surgeon to be Ambidexter, (i.) having both his hands at command, that so he may the more exquisitely perform such variety of ligations. But let him in rolling, bend or move this first ligature upwards, that is, towards the body, for the former reasons. But neither is this manner of ligation peculiar to fractures, but common to them with luxations: for, into what part soever the luxated bone flew, then when it is restored, that side must be bound the more loosely and gently whence it departed, and that on the contrary more hard unto which it went. Therefore the ligature must be drawn from the side whereunto the bone went; so that on this side it be more loose and soft, and not straight pressed with bolsters or rulers, that so it may be more inclined to the side opposite to the luxation. If the ligation be otherwise performed, it succeeds not well, for the part is relaxed, and moved out of its natural seat: wherefore there will be no small danger, lest the bone be forced out again, and removed from its place, whereinto it was restored by art and the hand. Which thing Hypocrates so much feared, that on the contrary he willed that the set bone should be drawn somewhat more unto the part contrary to that whereunto it was driven by force, than the natural and proper site thereof should require. But to return to our former discourse of the three Ligatures: The first under-binder being put on, we then take the second, with which we in like sort begin at the fracture, but having wrapped it once or twice about there, for that, as we formerly said, we must not force back, and press so much blood towards the extremities, as we must do towards the body and bowels. Wherefore this Ligature shall be drawn from above downwards, gently straining it to press forth the blood contained in the wounded part: When by rolling you shall come to the end of that part, than you shall carry back again that which remains thereof, to wit, upwards; But otherwise you may take the third under-binder, wherewith you may When the third under-binder is necessary. Epidesmi. begin to roll, whereas you left with the second, and you may carry it thus, rolling it from below upwards. These under-bindings thus finished, apply your bolsters, after them your over or upper-bindings, which are oft times two, but sometimes three. The first hath two heads, and is wrapped both from the right hand and the left, for the preservation of the first under-binder and the bolsters, and restoring the muscles to their native figure. The two other which remain, consist of one head, & the one of them must be rolled from below upwards, the other from above downwards, after such a manner, that they may be directly contrary to the under-binders; as if they were rolled from the right hand, than these must be from the left. Now this is the manner of Hypocrates his Ligation, which, for that it is now grown out of use, we must here set down that which is in common use. They do not at this time use any over-binders, but that which we termed the third under-binder serves our Surgeons in stead of the three forementioned The manner of binding now in use. over-binders. Wherefore they carry this third under-binder, wrapped from below upwards (as we formerly said) contrary to the first and second under-binder; as if these begun on the right side, this shall be rolled from the left, and shall end whereas the first under-binder ended. And you must not only draw it indifferently hard, but also make the spires and windings more rare. This third rowler is of this use in this manner of Ligation, that is, it restores the muscles to their native figure, from whence they were somewhat altered by the drawing and rolling of the two former Ligatures. But you must always have regard, that you observe that What mean to be observed in wrapping the Ligatures. measure in wrapping your Ligatures, which reason, with the sense of the patient, and ease in suffering, prescribes; having regard that the tumour become not inflamed. Also the habit of the body ought to prescribe a measure in Ligation: for tender bodies cannot away with so hard binding as hard. Verily, in fractures and luxations, the humours by too straight binding are pressed into the extreme parts of the body; whence grievous and oft times enormous Oedema's proceed: for healing whereof the Ligature must be loosed, and then the tumified parts pressed by a new rolling, which must be performed from below upwards, and so, by forcing the matter of the Tumour thither, it may be helped; for there is no other hope or way to drive the humour back again. He which doth this, forsakes the proper cure of the disease, so to resist the symptom, which the Surgeon shall never refuse to do, as often as any necessary cause shall require it. For this cause Hypocrates bids, that the Bandages be loosed every three days, and then to ●oment the part with hot Why Hippoc. bids to lose the Ligatures every third, day. water, that so the humours, which (drawn thither by the vehemency of pain) have settled in the part, may be dissolved and dispersed, and itching and other such like symptoms prevented. The fear of all accidents being past, let the Ligation be sooner or later loosed, and more slacked than it formerly was accustomed; that so the blood and laudable matter, whereof a Callus may ensue, may flow more freely to the affected part. CHAP. four Of the binding up of Fractures associated with a wound. IT sometimes happens, that a Fracture is associated by a wound, and yet How to bind up a Fracture with a wound. for all this it is fit to bind the part with a Ligature, otherwise there will be no small danger of swelling, inflammation, and other ill accidents, by reason of the too plentiful afflux of humours from the neighbouring parts. But it is not fit to endeavour to use that kind of binding which is performed with many circumvolutions or wrappings about. For, seeing the wound must be dressed every day, the part must each day necessarily be stirred, and the Ligature, consisting of so many windings, loosed; which thing will cause pain, and consequently hinder the knitting and uniting which is performed by rest. Therefore this kind of binding may be performed by one only rolling about the wound, and that with a rowler which consists of a twice or thrice doubled cloth, made in manner of a bolster, and sewed with as much conveniency as you can, that it may be so large as to encompass and cover all the wound, for these reasons; which shall be delivered at large in our Treatise of Fractures. But if the wound run long-ways, let the bolsters and splints be applied to the sides of the wound, that so the lips of the wound may be pressed together, and the contained filth pressed forth. But if it be made overthwart, we must abstain from bolsters and splints: for that, in Galens' opinion, they would dilate the wound, and the purulent Ad sent. 12. sect. de fract. matter would be pressed out, and cast back into the wound. CHAP. V. Certain common precepts of the binding up of Fractures and Luxations. IN every Fracture and Luxation, the depressed, hollow and extenuated parts, such as are near unto the joints, aught to be filled up with bolsters, or clothes put about them, so to make the part equal, that so they may be equally and on every side pressed by the splints, and the bones more firmly contained in their seats. So when the knee is bound up, you must fill the ham or that cavity which is there, that so the ligation may be the better and speedilier performed. The same must be done under the armpits, above the heel, in the arm near the wrist; and, to conclude, in all other parts which have a conspicuous inequality by reason of some manifest cavity. When you have finished your binding, then inquire of the patient, whether the member seem not to be bound too straight. For if he say, that Hipp. sent. 37. & 38. sect. 1. de fract. he is unable to endure it so hard bound, then must the binding be somewhat slackened. For, too straight binding causes pain, heat, defluxion, a gangrene, and lastly, a sphacel or mortification: but too loose is unprofitable, for that it doth not contain the parts in that state we desire. It is a sign of a just ligation that is neither too The signs of too straight and loose binding up. straight nor too loose, if the ensuing day the part be swollen with an oedematous tumour, caused by the blood pressed forth of the broken place; but of too straight ligation, if the part be hard swollen; and of too loose, if it be no whit swollen, as that which hath pressed no blood out of the affected part. Now if a hard tumour, caused by too straight binding, trouble the patient, it must presently be loosed, for fear of more grievous symptoms, and the part must be fomented with warm Hydraeleum; and another indifferent, yea verily, more loose ligature must be made in stead thereof, as long as the pain and inflammation shall continue; in which time and for which cause, you shall lay nothing upon the part which is any thing burdensome. When the patient begins to recover, for three or four days space, especially if you find him of a more compact habit and a strong man, the ligature must be kept firm and not loosed. If on the third day, and so until the seventh, the spires or windings be found more loose, and the part affected more slender; then we must judge it to be for the better. For hence you may gather, that there is an expression and digestion of the humours, causing the tumour made by force of the ligation. Verily, broken bones fitly bound up, are better set, and more firmly agglutinated, which Why we must make more straight ligation on the broken part. is the cause, why in the place of the fracture the ligation must be made the straighter, in other places more loosely. If the fractured bone stand forth in any part, it must there be more straight pressed with bolsters and splints. To conclude, the seventh day being past, we must bind the part more straight than before: for that then inflammation, pain, and the like accidents, are not to be feared. But these things which we have hitherto spoken of the three kinds of Ligatures, cannot take place in each fractured part of the body, as in the chaps, collar-bones, head, nose, ribs. For, seeing such parts are not round and long, a Ligature cannot be wrapped about them, as it may on the arms, thighs, and legs, but only be put on their outsides. CHAP. VI The uses for which Ligatures serve. BY that which we have formerly delivered, you may understand that Ligatures are of use to restore those things which are separated and The first benefit of Ligatures. moved forth of their places, and join together those which gape; as in fractures, wounds, contusions, sinewous ulcers, and other like affects against nature, in which the solution of continuity stands in need of the help of Bandages, for the reparation thereof. Besides also, by the help of The second. Bandages these things are kept asunder or separated, which otherwise would grow together, against nature; as in Burns, wherein the fingers and the hams would mutually grow together; as also the armpits to the chests, the chin to the breast, unless they be hindered by due Ligation. Bandages do also conduce to refresh emaciated parts: wherefore if the right leg waste for want of nourishment, the left The third. leg, beginning at the foot, may be conveniently rolled up even to the groin. If the right arm consume, bind the left with a straight Ligature, beginning at the hand, and ending at the armepit. For thus a great portion of blood from the bound-up part is sent back into the vena cava, from whence it regurgitates into the almost empty vessels of the emaciated part. But I would have the sound part to be so bound, that thereby it become not painful; for a dolorifick ligation causes a greater attractation of blood and spirits, as also exercise: wherefore I would have it during that time to be at rest, and keep holiday. Ligatures' also conduce to the stopping of bleedings: which you may perceive by this, that when you open a The fourth. vein with your launcet, the blood is presently stayed, laying on a bolster and making a ligature. Also Ligatures are useful for women presently after their delivery; for their womb being bound about with Ligatures, the blood wherewith their The fifth. womb was too much moistened, is expelled, the strength of the expulsive faculty being by this means stirred up to the expulsion thereof: and it also hinders the empty womb from being swollen up with wind, which otherwise would presently enter thereinto. This same Ligature is a help to such as are with child, for the more easy carrying of their burden; especially those whose Child lies so far The sixth. downwards, that lying as it were in the den of the hips, it hangs between the thighs, and so hinders the free going of the mother. Therefore the woman with child is not only eased by this binding of her womb with this Ligature, which is commonly termed, the navel Ligature; but also, her child being held up higher in her womb, she hath frecer and more liberty to walk. Ligatures are in like sort The seventh. good for revulsion and derivation: as also for holding of medicines which are laid to a part, as the neck, breast or belly. Lastly, there is a triple use of Ligatures in The eighth, the particular use of ligatures in the amputation of members. amputation of members, as arms and legs. The first to draw and hold upwards the skin and muscles lying under it, that the operation being performed, they may, by their falling down again, cover the ends of the cutoff bones; and so by that means help forwards the agglutination and cicatrisation; and when it is healed up, cause the lame member to move more freely, and with less pain; and also to perform the former actions, this, as it were, cushion or bolster of musculous flesh lying thereunder. The second is, they hinder the bleeding by pressing together the veins and arteries. The third is, they by straight binding intercept the free passage of the animal spirits, and so deprive the part which lies thereunder of the sense of feeling, by making it, as it were, stupid or num. CHAP. VII. Of Bolsters or Compresses. Bolsters have a double use; the first is to fill up the cavities and those parts The first use of Bolsters. which are not of an equal thickness to their ends. We have examples of cavities in the Armpits, Clavicles, Hams & Groins; and of parts which grow small towards their ends, in the arms towards the wrists, in the legs towards the feet, in the thighs towards the knees. Therefore you must fill these parts with bolsters and linen clothes, that so they may be all of one bigness to their ends. The second use of bolsters, is to defend and preserve the first two or three Rulers The second use of them. or Under-binders, the which we said before must be applied immediately to the fractured part. Bolsters, according to this two fold use, differ amongst themselves, for that when they are used in the first mentioned kind, they must be applied athwart; but when in the latter, long-ways or downright. You may also use Bolsters, lest the too straight binding of the Ligatures' cause The third use of them. pain and trouble to the new set bones. A three or four times doubled cloth will serve for the thickness of your Bolsters, but the length and breadth must be more or less, according to the condition of the parts and disease for which they must be applied. CHAP. VIII. Of the use of Splints, Junks, and Cases. HAving delivered the uses of Ligatures and Bolsters, it remains that we say somewhat of the other things, which serve to hold the bones in their places; as Splints, Junks, Cases, and such other like. Splints The matter of Splints. are made and composed of past board, of thin splinters of wood, of leather, such as sho●-soales are made with; of the rinds of trees, or plates of Latin, or lead, and such other like, which have a gentle and yielding stiffness; yet would I have them made as light as may be, lest they by their weight become troublesome to the afflicted part. But for their length, breadth, and number, let them be fitted agreeable to the part whereto they must be used. Let also their figure be strait or crooked according to the condition of the member whereto they must be applied. You must have a special care, that they run not so far as the swellings out, or eminencies of the bones; as the ankles, knees, elbows, and the like, lest they hurt them by their pressure: also you must have a care, that they be smaller at their ends, and thicker in their middles, whereas they lie upon the broken bone. The use of splints is, to hold fast and firm, that they may Their use. stir no way the broken and luxated bones, after they be set and restored to their places. That they perform this use, it is fit there be no thick bolsters under them, nor over many rulers; for so through so thick a space, they would not so straight press the part. Junkes are made of sticks the bigness of ones finger, wrapped What Junkare. about with rushes, and then with linen cloth: they are principally used in fractures of the thighs and legs. Cases are made of plates of Latin, or else of some light wood; their use is, to contain the bones in their due figure, when the patient is to The matter and use of Cases. be carried out of one bed or chamber into another, or else hath need to go to stool: lastly, if we must rest somewhat more strongly upon the broken or luxated members, these Cases will hinder the bones from stirring or flying out on the right side or left, above or below, we sleeping or waking, being willing or unwilling; and in like sort left being not as yet well knit, or more loosely bound up for fear of pain, inflammation, or a gangrene, they hang down, fall, or fly in sunder by reason of the inequalities of the bed. Such Cases, Junkes, and the like, which serve for restoring and fast holding of broken and luxated bones, we may, according to Hypocrates his mind, call them in general Glossocomia. All which things, the Glossocomium, a general name for such things. young Surgeon, which is not as yet exercised in the works of Art, can scarce tell what they are. But in the mean time, whilst that he may come to be exercised therein, or see others perform these operations, I, as plainly as possibly I could, have in words given him their portraiture or shape. The end of the fourteenth Book. OF FRACTURES. THE FIFTEENTH BOOK. CHAP. I. What a Fracture is, and what the differences thereof are. A Fracture, in Galens' opinion, is the solution of continuity in a Lib. 6. method. bone, which by the Greeks is called Catagma. There are many sorts of hurting or offending the bones: as the drawing them asunder, luxation, or putting them out of joint; their unnatural growing together, their cutting or dividing asunder; contusion, abscess, putrefaction, rottenness, laying bare the periostium being violated or lost; and lastly, that whereof we now treat, a Fracture. Again, the varieties of Fractures are almost infinite. For one is complete and perfect, another imperfect; one runs long-wise, another transverse, another oblique; one while it is broken into great pieces, another while into little and small scales, which have either a blunt, or else a sharp end, and prick the adjacent bodies of the muscles, nerves, veins or arteries. It sometimes happens, that the bone is not broken into splinters, that is, long-ways, but together, and at once into two pieces overthwart, which Fracture is called Raphanedon, that is, after the manner of What it is for a bone to be broken Raphanedon. a Radish. A Fracture is made Caryedon, or like a nut, when as the bone flies into many What Caryedon, or Alphitidon. small pieces, severed each from other, as when a Nut is broken with a hammer or mallet upon an Anvil: Which fracture is also termed Alphitidon, by reason of the resemblance it hath to meal or flower; and such is often seen in fractures made by bullets, shot out of guns and such fiery engines. Contrary to these are those fractures which are called Schidacidon, as rend into splinters, or after the manner of What Schidacidon. a board or piece of timber, that is, right-downe, and alongst the bone: and these fractures are either apparent to the eye, or else not apparent, and therefore called Capillarie, being so small, as that they cannot be perceived by the eye, unless you put ink upon them, and then shave them with your Scrapers. Sometimes the bone is only pressed down by the stroke, sometimes on the contrary it flies up, as if it were vaulted. They call it attrition, when the bone is broken into many small fragments, and as it were scales or chips. The fragments of fractured bones are sometimes smooth and polished, otherwhiles unequal, and as it were sharp and rough with little teeth, or pricks. Some fractures touch only the surface of the bone, fetching off only a scale; othersome change not the site of fractured bones, but only cleaves them lengthways, without the plucking away of any fragment; othersome penetrate even to their marrow. Furthermore some Fractures are simple and alone by themselves; othersome are accompanied with a troop of other affects and symptoms; as a wound, haemorrhagye, inflammation, gangrene, and the like. Hereunto you may also add the differences drawn from the parts which the Fractures possess; as from the head, ribs, limbs, joints, and other members of the body. Add also these which are taken from the habit of bodies, aged, young, full of ill humours, well tempered; almost all which have their proper and peculiar indications for curing. Now the causes The causes of fractures. of Fractures, are the too violent assaults or strokes of all external things, which may cut, bruise, break, or shake: in this number of causes may also be reckoned falls from high places, and infinite other things, which would be long and tedious to reckon up. CHAP. II. Of the signs of a Fracture. WE may know by evident signs that a bone is broken: the first whereof, and most certain, is, when by handling the part which The first sign of a broken bone. we suspect to be broken, we feel pieces of the bone severed asunder, and hear a certain crackling of these pieces under our hands, caused by the attrition of the shattered bones. Another sign is taken from the impotency of the part, which chiefly betrays Another. its self, when both the bones, the leg, and brace-bones, the ell and wand are broken. For if only the brace-bone or wand be broken, the Patient may go on his leg, and stir his arm: for the brace-bone serves for the sustaining of the muscles, and not of the body, as the leg bone doth. The third A third. sign is drawn from the figure of the part changed besides nature: for it is there hollow, from whence the bone is flown or gone, but gibbous or bunching out whither it is run. Great pain in the interim torments the patient by reason of the wronged periostium, and that membrane which involves the marrow and the sympathy of the adjacent parts which are compressed or pricked. CHAP. III. Of Prognostics to be made in Fractures. We must prognosticate in Fractures, whether they are to end in the destruction or welfare of the patient; or whether their cure shall be long or short, easy, or else difficult and dangerous; and lastly, what accidents and symptoms may happen thereupon. He shall easily attain to the knowledge of all these things, who is not only well seen in the anatomical description of the bones, but also in the temper, composition and complexion of the whole body. Wherefore in the first place, I think good to admonish the Surgeon of this, that in winter when all is stiff with cold, by a little fall, or Why bones are more brittle in frosty weather. some such sleight occasion, the bones may be quickly and readily broken. For then the bones, being dried by the dryness of the air encompassing us, become more brittle; which every one of the Vulgar usually observe to happen both in waxen and tallow candles: but when the season is moist, the bones are also more moist, and therefore more flexible and yielding to the violence of the obvious and offending body. Wherefore also you may gather this to the framing of your Prognostics, That bones by reason of their natural dryness are not so easily agglutinated Why the solution of continuity in bones is not so easily repaired. Gal. in art par. and consolidated as flesh; though in Children, according to Galen, by reason of the abundance of their humidity, the lost substance may be repaired, according (as they term it) to the first intention, that is, by restoring of the same kind of substance or matter. But in others, about the Fractures a certain hard substance usually concreats, of that nourishment of the broken bone which abounds, which glues together the fragments thereof, being fitly put together. This substance is then termed a Callus, and it is so hardened in time, that the bone thereafter in the broken part is seen to be more firm and hard than it is in any other: therefore that usual saying in Physic is not without reason; That rest is necessary for the uniting of broken bones. For the Callus is easily dissolved, if they be moved before their perfect and solid agglutination. The matter of a Callus ought to be indifferent and laudable in quantity and quality, even as blood which flows for the regeneration of the lost flesh in wounds. It is fit, that there may be sufficient matter for such a Callus, that the part have a laudable temper, otherwise there either will be no Callus, or certainly it will grow more slowly. Fractures are far more easily repaired in young Why bones sooner knitin young bodies. bodies than in old: for in these there is plenty of the primigenious and radical moisture, that is laudably holding and glutinous; and in the other there is store of waterish and excrementitious. By this you may easily conjecture, that you cannot certainly set down a time necessary for the generating a Callus: for in some it happens later, in some sooner: the cause of which variety is also to be referred to the constitution of the year and region, the temper and diet of the Patient, and manner of Ligation. For, those Patients whose powers are weak, and blood waterish and thin, in these the generation of a Callus uses to be more slow: On the contrary, Meats of gross and tough nourishment conduce to the generation of a Callus. strong powers hasten to agglutinate the bones, if there be plenty of gross and viscous matter; whereby it comes to pass, that meats of grosser nutriment are to be used, and medicines applied which may help forwards the endeavour of nature, as we shall declare hereafter. When the bones are broken near unto the joints, the motion afterwards uses to be more difficult, especially if the Callus, which is substituted, be somewhat thick and bunching forth. But if, together with the violence Fractures at joints dangerous. and force of the Fracture, the joints shall be broken and bruised, the motion will not only be lost, but the life brought in danger, by reason of the greatness of the inflammation, which usually happens in such affects, and the excess of pain in a tendinous body. These fractures wherein both the bones of the arm or leg are broken, are more difficult to cure, than those which happen but to one of them. For they are handled & kept in their places with more difficulty, because that which Hipp. sect. 18. & 19 sect. i. de fracturis. remains whole, serves the other for a rest or stay to which it may lean. Moreover, there is longer time required to substitute a Callus to a great bone, than to a little one. Again these bones which are more rare and spongy, are sooner glued together by the interposition of a Callus, than these which are dense and solid. A Callus sooner grows in sanguine, than in choleric bodies. But broken bones cannot be so happily agglutinated, nor restored in any body, but that always some asperity or unequal protuberancie may be seen on that part where the Callus is generated. Wherefore the Surgeon ought to make artificial Ligations, that the Callus may Ligations conduce to the handsomeness of a Callus. not stand out too far, nor sink down too low. That Fracture is least troublesome which is simple; on the contrary, that is more troublesome which is made into splinters; but that is most troublesome and worst of all which is in small and sharp fragments, because there is danger of convulsion by pricking a nerve, or the periostium. Sometimes the fragments of a broken bone keep themselves in their due place: they also oft times fly forth thereof, so that one of them gets above another; which when it happens, you may perceive an inequality by the depression of the one part and the bunching forth of the other, as also pain by the pricking: besides also the member is made shorter than it was, and than the sound member on the opposite side is, and more swollen by the contraction of the muscles towards their original. Wherefore when a bone is broken, if you perceive aniething so depressed, Extension must presently be made after the bone is broken. presently putting your hand on both sides above and below, stretch forth the bone as forcibly as you can; for otherwise, the muscles and nerves, stretched and contracted, will never of their own accord suffer the bones to be restored to their proper seat and themselves. This extension must be performed in the first days, for afterwards there will happen inflammation: which being present, it is dangerous to draw the nerves and tendons too violently; for hence would ensue an imposthume, convulsion, gangrene and mortification. Therefore Hypocrates forbids Sent. 36. sect. 3. de fract. you to defer such extension until the third, or fourth day. Fractures are thought dangerous, whose fragments are great, and fly out, especially in these bones which are filled with marrow on the inside. When broken or dislocated bones cannot be restored to themselves and their natural place, the part wastes for want of nourishment; both for that the natural site of the veins, arteries and nerves is perverted, as also because the part itself lies immovable, or scarce movable: whereby it cometh to pass, that the spirits do not freely flow thereto, as neither the nutritive juice cometh thither in sufficient plenty. When the dislocated or broken member is troubled with any great inflammation, it is doubtful whether or no a In inflammations the restoring of the bone must not be attempted. convulsion will happen, if we attempt to restore it, or the parts thereof to their seat: therefore it is better, if it may be done, to defer the reducing thereof so long, until the humour which possesses the part be dissolved, the tumour abated, and the bitterness of pain mitigated. CHAP. IU. The general cure of broken and dislocated bones. TO cure a broken and dislocated bone, is to restore it to its former figure and site. For the performance whereof, the Surgeon must propose three things to himself: The first is, to restore the bone to its place: The second Three things to be performed in curing broken and dislocated bones. is, that he contain or stay it being so restored: The third is, that he hinder the increase of malign symptoms and accidents; or else if they do happen, that then he temper and correct their present malignity. Such accidents are pain, inflammation, a fever, abscess, gangrene and sphacel. For the first intention, you may easily restore broken or dislocated bone, if presently, as soon as the mischance is got, or else the same day, you endeavour to restore it: for the bitterness of pain or inflammation, which may trouble the patient, is not as yet very great, neither is the contraction of the muscles upwards as yet very much or stubborn. Therefore first of all, the Patient with his whole body, but How to put the bones in their places. especially with the broken or dislocated part, as also the Surgeon, must be in some place which hath good and sufficient light. Then let trusty and skilful attendants be there, good ligatures, and also, if need so require, good engines. His friends which are present, let them see and hold their peace, neither say, nor do any thing which may hinder the Work of the Surgeon. Then putting one hand above, that is, towards the centre of the body, and the other below, as near as he can to the part affected, let him stretch forth the member: for if you lay your hand any distance from the part affected, you will hurt the sound part by too much compression, neither will you much avail yourself by stretching it at such a distance. But if you only endeavour below with your hand or ligature, assisting to make extension Hipp. sent. 60. sect. 2. de fract. thereof, it will be dangerous if there be nothing above which may withstand or hold, lest that you draw the whole body to you. This being done, according as I have delivered, it is fit the Surgeon make a right or strait extension of the part affected: for when the bone is either broken or out of joint, there is a contraction of the muscles towards their original, and consequently of the bones by them, as it is observed by Galen. Wherefore it is impossible to restore the bones to their Adsent. 1. sect. 1. de fract. former seat, without the extension of the muscles. But the part being thus extended, the broken bones will sooner and more easily be restored to their former seat. Which being restored, you shall presently with your hand press it down, if there be any thing that bunches or stands out. And lastly, you shall bind it up, by applying bolsters and splints as shall be fit. But if the bone be dislocated or forth of joint, then presently after the extension thereof, it will be requisite to bend it somewhat about, and so to draw it in. The Surgeon is sometimes forced to use engines When instruments or engines are necessary. for this work, especially if the luxation be inveterate, if the broken or luxated bones be great; and that in strong and rustic bodies, and such as have large joints: for that then there is need of greater strength, than is in the hand of the Surgeon alone. For, by how much the muscles of the Patient are the stronger, by so much will they be contracted more powerfully upwards towards their originals. Yet have a care that you extend them not too violently, lest by rending and breaking asunder the muscles and nerves, you cause the forementioned symptoms, pain, convulsion, a palsy and gangrene: all which sooner happen to strong and aged bodies, What bodies are sooner hurt by violent extension. than to children, eunuchs, women, youths, and generally all moist bodies, for that they are less hurt by violent extension and pulling, by reason of their native and much humidity and softness. For thus skins of leather, moistened with any liquor, are easily wretched and drawn out as one pleaseth: but such as are dry & hard, being less tractable, will sooner rend and tear, than stretch further out. Therefore the Surgeon shall use a mean in extending and drawing forth of members, as shall be most agreeable to the habits of the bodies. You may know the bone is set, and Signs of a bone well set. the setting performed as is fit, if the pain be assuaged; to wit, the fibres of the muscles, and the other parts being restored to their former site, and all compression, which the bones moved out of their places have made, being taken away; if, to your feeling there be nothing bunching out, nor rugged, but the surface of the member remain smooth and equal; and lastly, if the broken or dislocated member compares with its opposite in the composure of the joints, as the knees and ankles answer justly and equally in length and thickness. For which purpose it must not suffice the Surgeon to view it once, but even as often as he shall dress it. For it may happen, that the bone which is well set, may by some chance, as by the Causes and signs of the relapse of a set bone. Patients unconsiderate turning himself in his bed, or as it were a convulsive twitching of the members or joints whilst he sleeps, the muscles of their own accord contracting themselves towards their originals, that the member may again fall out; and it will give manifest signs thereof by renewing the pain, by pressing or pricking the adjacent bodies: which pain will not cease, before it be restored to its place: and hereof the Surgeon ought to have diligent care. For if, whilst the Callus is in growing, one bone ride over another, the bone itself will afterwards be so much the shorter, and consequently the whole member; so that if this error shall happen in a broken leg, the Patient will halt ever after, to his great grief, and the Surgeon's shame. Wherefore the Patient shall take heed, as much as in him lies, that he stir not the broken member, before that the Callus be hardened. Such diligent care needs not be had in dislocations. For these once set, and artificially bound up, do not afterwards so easily fall forth as broken bones. The second scope is, that the bones which shall be restored may be firmly kept in their state and place. That shall be done by Bandages; as ligatures, bolsters, and other things, whereof hereafter we shall make particular mention. Hither tend proper and fit medicines, to wit, applying of oil of Roses with the whites of Eggs, and the like repelling things; and then resolving medicines, as the present necessity shall require. It will be convenient, to moisten your rulers and bolsters in oxycrate for this purpose, or else in Rose vinegar, if the Fracture be simple, or with red wine, or the like liquor warm (in Galens' opinion) if a wound be joined to the Ad sent. 21. sect. 1. de fract. fracture; and it will be fit to moisten fractures oftener in Summer: For so the part is strengthened, the defluxion being repelled, whereby the inflammation and pain are hindered. You must desist from humecting and watering the part when the symptoms are past, lest you retard the generating of a Callus; for which you must labour by these means which we shall hereafter declare. To this purpose also conduces the rest and lying of the part in its proper figure and site accustomed in health, that so it may the longer remain in the same place unstirred. Besides also, it is expedient then only to dress the part, when it is needful, & with those things that are requisite, shunning, as much as may be, inflammation and pain. That figure What the middle figure is, and why best. is thought the best, which is the middle, that is, which contains the muscles in their site, which is without pain; so that the Patient may long endure it without labour or trouble. All these thing being performed, the Patient must be asked, Whether the member be bound up too straight? If he answer, No, (unless peradventure a little upon the fracture or luxation, for there it is fit it should be more straight bound) then may you know that the binding is moderate. And this Fit time for losing of Ligatures in fractures and dislocations. same first ligation is to be kept in fractures without losing for three or four days space, unless peradventure pain urge you to the contrary. In dislocations the same binding may be kept for seven or eight days, unless by chance some symptom may happen, which may force us to open it before that time: for the Surgeon must with all his art have a care to prohibit the happening of evil accidents and symptoms, which, how he may bring to pass, shall be declared in the following Chapter. CHAP. V. By what means you may perform the third intention in curing fractures and dislocations, which is, the hindering and correction of accidents and symptoms. THat we may attain unto this third scope, it is requisite we handle as gently and without pain, as we may, the broken or dislocated member; Four choice means to hinder accidents. we drive away the defluxion ready to fall down upon the part by medicines, repelling the humour, and strengthening the part; we, by appointing a good diet, hinder the begetting of excrements in the body, and divert them by purging and phlebotomy. But if these accidents be already present, we must cure them according to the kind and nature of each of them: for they are various. Amongst which is reckoned itching, which in the beginning torments the Patient: this ariseth from a collection and suppression of subacride vapours, The causes and differences of itching. arising from the blood, and other humours under the skin. Whence a light biting, which causeth a simple itch, or else a more grievous and acride one, from whence (in Galens' opinion) proceeds a painful itching. Wherefore such matter, as the Ad sent. 4. sect. 1. de fract. cause, being evacuated, all itching ceaseth. But this cannot easily and freely be evacuated and breathed out, because the pores of the part are shut up, and as it were oppressed with the burden of the emplasters, bolsters, and ligatures, which are put about the part. Hereunto may be added, that the part its self doth not so perfectly perform and enjoy its wont faculties and actions: by which it cometh to pass, that the heat thereof is more languide than may suffice to discuss the fuliginous matter there collected. Wherefore it will be convenient to lose the ligatures Remedies against the itching. every third day, that, as by losing their ties, their sanious and fuliginous excrements, shut up under the skin, may freely pass forth, lest in continuance they should fret and ulcerate it; as it happens to most of those who provide not for it by losing their ligatures. Besides also, the part must be long fomented with hot water alone, or else with a decoction of sage, chamomile, roses, and melilote made in wine and water: for long fomenting attenuates and evacuates, but shorter fills and mollifies, as it is delivered by Hypocrates. Also gentle frictions, performed with your hand, or a warm linen clothe upwards, to the right side and left, and circularly to every side, are good. But if the skin be already risen into blisters, they must be cut, lest the matter contained thereunder may corrode and ulcerate the skin: then must the skin be anointed with some cooling and drying medicine; as, Ung. album Camphoratum Rhasis, Desiccativum rubrum, unguentum rosatum sine aceto; adding thereto the powder of a rotten post, or prepared Tutia, or the like. Other accidents more grievous than these, do often happen, but Hipp. sent. 46. sect. 3. de fract. we will treat of them hereafter. But if the scales of the bone underneath be quite severed from the whole, then must they be presently taken forth, especially if they prick the muscles: But if the bone be broken into splinters, and so prominent out of the wounded flesh as that it cannot be restored into its seat, it must be cut off with your cutting mallets, or parrots beak, as occasion shall offer its self. In the interim, you must have a care that the part enjoy perspiration, and by change of place and rising, now and then it may be as it were ventilated: also you must see that it be not over-burdened, neither too straight bound, otherwise it will be apt to inflammation. Thus much concerning fractures and dislocations in general: now we must descend to particulars, beginning with a fracture of the Nose. CHAP. VI Of the Fracture of the Nose. THe Nose is gristly in its lower part, but bony in the upper. Wherefore it Hipp. sent. 46. sect. 2. de art. suffers no fracture in the gristly part (unless peradventure a Sedes) but only a depression, distortion or contusion. But a fracture often happens to the bony part, & so great a depression to the in nerside, that unless it be provided for by diligent restoring it, the nose will become flat, or wrested aside, whence there will be difficulty of breathing. That this kind of fracture may be restored, How to reduce the nose into its natural figure. that bone which stands too far out must be pressed down; but that which is depressed, must be lifted up with a spatherne, or little stick handsomely fashioned and wrapped about with cotton or a linen rag, so to avoid pain. Therefore you shall hold the spatherne in one hand, and reduce and order it with the other. The bone being restored, directories or tents of a convenient bigness shall be put into the nose; which tents shall be made of sponge, or flax, or a piece of a beasts or sheep's lungs. For these things are soft, and do not only hinder the bones of the Nose that they fall no more, but also lift them up higher. And then the Nose shall be in some sort stayed with bolsters on each side, even until the perfect agglutination of the bones, lest the figure and straightness should be vitiated and spoilt. I have oft times put golden, silver and leaden pipes into fractured noses, and fastened them with a thread to the Patient's night cap, which, by one and the same means, kept the bones from being again depressed, gave the matter free passage forth, and nothing hindered the breathing. In the mean time we must see, that we do not press the Nose with too straight binding, unless peradventure some other thing persuade; lest they become either too wide, too flat, or crooked. If any wound accompany the fracture, that shall be cured after the same manner, as the wounds of the head. The fracture restored, the following medicine, which hath a faculty to repel and repress the defluxion, to strengthen and keep the part in its due posture, and to dry up and waste the matter which hath already fallen down, shall be applied to the Nose, and all the other dry parts. ℞. thuris, mastiches, boli armeniae, sanguinis draconis. an. ℥ ss. aluminis rochae, A fit astringent and drying medicine. resinae pini. an. ʒ ij. pulverisentur subtilissimè: Or else, ℞. farinae volatilis ℥ ss. albuminum ovorum quantum sufficit, incorporentur simul, & fiat medicamentum. Neither shall you use any other art to cure the cartilagineous part of the nose being fractured. Wherefore Hypocrates terms that solution of continuity that Sent. 47. sect. 〈◊〉. de art. & Gal. in Com. there happens, A fracture, as if it were in a bone; because he could find no other name more fitly to express it: for a gristle, next to a bone, is the hardest of all the parts of our body. A Callus uses to grow in fractured noses, unless something hinder within the space of twelve or fifteen days. CHAP. VII. Of the Fracture of the lower Jaw. THe lower Jaw runs into two, as it were, horns or tops: the one whereof A description of the lower Jaw. ends sharp, and receives a tendon from the temporal muscle; the other ends blunt and round under the mammillary process, and it is there implanted in a small cavity; it is joined together in the middle of the chin by Symphysis, and is marrowie within. The Fracture, The manner of restoring a broken Jaw. which happens thereto, is restored by putting your fingers into the Patient's mouth, and pressing them on the inside and outside, that so the fractured bones put together may be smoothed and united. But if they be broken wholly athwart, so that the bones lie over each other, extension must be made on both sides on contrary parts, upwards and downwards, whereby the bones may be composed and joined more easily to one another. The teeth in the mean while, if they be either shaken or removed out of their sockets, must be restored to their former places, and tied with a gold or silver wyar, or else an ordinary thread, to the next firm teeth, until such time as they shall be fastened, and the bones perfectly knit by a Callus. To which purpose the ordered fragments of the fractured bone shall be stayed, by putting a splint on the outside, made of such leather as shoe soles are made; the midst thereof being divided at the Chin, and of such length and breadth as may serve the Jaw: than you shall make ligation with a ligature two fingers broad, The description of a fit ligature for the under Jaw. and of such length as shall be sufficient, divided at both the ends, and cut longways in the midst thereof; that so it may engirt the chin on both sides. Then there will be four heads of such a ligature so divided at the ends; the two lower whereof being brought to the crown of the head, shall be there fastened and sowed to the Patient's nightcap. The two upper drawn athwart shall likewise be sowed as artificially as may be, to the cap in the nap of the neck. It is a most certain sign, that the Jaw is restored and well set, if the teeth fastened therein stand in their due rank and order. The patient shall not lie down upon his broken jaw, lest the fragments of the bones should again fall out, and cause a greater defluxion. Unless inflammation, or some other grievous symptom, shall happen, it is strengthened with a Callus within twenty days; for that it is spongious, hollow, and full of marrow, especially in the midst thereof: yet sometimes, it heals more In what time it may be healed. slowly, according as the temper of the patient is, which takes also place in other fractured bones. The agglutinating and repelling medicine, described in the former chapter, shall be used; as also others, as occasion shall offer itself. The Patient must be fed with liquid meats, which stand not in need of chewing, until such time as the Callus shall grow hard, lest the scarce or ill-joyned fragments should fly insunder with the labour of chewing. Therefore shall he be nourished with water-gruel, pomadoes, cullasses, barley creames, jellies, broths, rear eggs, restaurative liquors, and other things of the like nature. CHAP. VIII. Of the Fracture of the Clavicle or Collar-bone. AS the nature and kind of the fractured Clavicle shall be, so must the cure and restoring thereof be performed. But howsoever this bone Hipp. sect. 63. sect. 1. de art. shall be broken, always the end fastened to the shoulder and shoulderblade, is lower than that which is joined to the chest; for that the arm draws it downwards. The collar-bone, if broken athwart, is more easily restored and healed, than if it be cloven long-ways. For, every bone broken athwart doth more easily return into its former state or seat, whiles you lift it up on this or that side with your fingers. But that which is broken schidacidon, or into splinters, or longways, is more difficultly joined and united to the ends and fragments: for those pieces, which were set, will be plucked asunder, even by the least motion of the arms; and that which was knit with the shoulder, will fall down to the lower part of the breast. The reason of which is, the Collar-bone is not moved of its self, but consents in motion with the arm. In restoring this or How to restore the fractured Clavicle. The first way. any other fracture, you must have a care that the bones ride not one over another, neither be drawn nor depart too far in sunder: therefore it will be here convenient, that one servant draw the arm backwards, and another pull the shoulder towards him the contrary way; for so there will be made, as I may so term it, a counter-extension. While which is in doing, the Surgeon with his fingers shall restore the fracture, pressing down that which stood up too high, and lifting up that which is pressed down too low. Some, that they may more easily restore this kind of The second way. fracture, put a clew of yarn under the Patient's armepit; so to fill up the cavity thereof: then they forcibly press the elbow to the ribs, and then force the bone into its former seat. But if it happen, that the ends of the broken bones shall be so The third way. depressed, that they cannot be drawn upwards by the forementioned means: then must the Patient be laid with his back, just between the shoulders, upon a pillow hard stuffed, or a trey turned with the bottom upwards, and covered with a rug or some such thing. Then the servant shall so long press down the Patient's shoulders with his hands, until the ends of the bones, lying hid and pressed down, fly out and show themselves. Which being done, the Surgeon may easily restore or set the fractured bone. But if the bone be broken so into splinters that it cannot be restored, and any of the splinters prick and wound the flesh, and so cause difficulty of breathing, you then must cut the skin even against them, and with your instrument lift up all the depressed splinters, and cut off their sharp points; so to prevent all deadly accidents, which thereupon may be feared. If there be many fragments, they, after they are set, shall be covered with a knitting medicine made of wheat flower, frankincense, bowl armenic, sanguis draconis, resina pini, made into powder, and mixed with the whites of eggs, putting upon it splints, covered with How to bind up the fractured clavicle. soft worn linen rags; covered over likewise with the same medicine, and then three bolsters dipped in the same; two whereof shall be laid upon the sides, but the third and thickest upon the prominent fracture, so to repress it and hold it in. For thus the fragments shall not be able to stir or lift themselves up further than they should, either to the rightside or left. Now these Bolsters must be of a convenient thickness and breadth, sufficient to fill up the cavities which are above and below that bone. Then shall you make fit ligation with a rowler, having a double head cast crossewise, of a hands breadth, and some two else and a half long, more or less, according to the Patient's body. Now he shall be so rolled up, as it may draw his arm somewhat backwards, and in the interim his armpits shall be filled with bolsters, especially that next the broken bone; for so the Patient may more easily suffer the binding. Also you shall wish the Patient, that he of himself bend his arm backwards, and set his hand upon his hip, as the Country Clowns use to do, when they play at leapfrog. But how great diligence soever you use It is a difficult matter perfectly to restore a fractured clavicle. in curing this sort of fracture, yet can it scarce be so performed, but that there will some deformity remain in the part: for that a ligature cannot be rolled about the collar-bone, as it may about a leg or an arm. A Callus oft time's grows on this bone, within the space of twenty days, because it is rare and spongious. CHAP. IX. Of the fracture of the shoulderblade. THe Greeks call that Omoplata, which the Latins term Scapula, or Scapulae An anatomical description of the shoulderblade. patella, that is, the shoulderblade. It is fastened on the back to the ribs, noll, the Vertebrae of the chest and neck; but not by articulation, but only by the interposition of muscles, of which we have spoken in our Anatomy. But on the forepart it is articulated after the manner of other bones with the collar-bone, the shoulder, or armebone: for with its process, which represents a prick or thorn, and by some, for that it is more long and prominent, is called Acromion, (that is, as you would say, the top or spire of the said shoulderblade) it receives the Collar-bone. Therefore some Anatomists, according to Hypocrates as they suppose, call all this articulation of the Collar-bone with the hollowed process of the shoulderblade, Acromion. There is another process of the said Blade-bone, called Cervix om●platae, or the neck of the Shoulderblade: this truly is very short, but ending in a broad and sinuated head, provided for the receiving of the Shoulder or armebone. Not far from this process is another, called Coracoides, for that the end thereof is crooked like a Crow's beak. This keeps the shoulder bone in its place, and conduces to the strength of that part. The shoulderblade may be fractured in any part thereof, that is, either on the ridge, How many ways the shoulderblade may be broken. which runs like a hill, alongst the midst thereof, for its safety, as we see in the Vertebrae of the back. So also in the broader part thereof it may be thrust in and depressed; and also in that articulation, whereby the top of the shoulder is knit to it. According to this variety of these fractured parts, the happening accidents are more grievous or gentle. We know the spin or ridge of the Shoulderblade to be broken, when a dolorificke inequality is perceived by touching or feeling it. But you may know, that the broader or thinner part thereof is depressed, if you feel a cavity, and a pricking pain molest the part, and if a numbness trouble the arm, being stretched forth. The fragments, if they yet stick to their bone, and do not prick the flesh, The cure. must be restored to their state and place, and there kept with agglutinative medicines, and such as generate a Callus, as also with bolsters and rulers fitted to the place. But if they do not adhere to the bone, or prick the flesh lying under them, then must you make incision in the flesh over against them, that so you may take them out with your Crow's beak. But although they stir up and down, yet if they still adhere to the periostium and ligaments, (if so be that they trouble not the muscles by pricking them) then must they not be taken forth: for I have oftener than once observed, that they have within some short time after grown to the adjacent bones. But if they, being wholly separated, do not so much as adhere to the periostium, then must they necessarily be plucked away; otherwise within some short space after, they will be driven forth by the strength of nature, for that they participate not any more in life with the whole. For that which is quick, saith Hypocrates, uses to expel that which is dead far from it. The truth whereof was Lib. de vuln. Capitis. A history. manifested in the Marquis of Villars, who at the battle of Dreux was wounded in his shoulder with a pistol bullet, certain splinters of the broken bone were plucked forth with the pieces of his harness, and of the leaden bullet; and within some short space after, the wound was cicatrized, and fully and perfectly healed. But more than seven years after, a defluxion and inflammation arising in that place by reason of his labour in arms, and the heaviness of his armour at the battle of Montcontour, the wound broke open again; so that many shivers of the bone, Nature of its own accord makes itself way to cast forth strange bodies and matters. Why a fracture in the joint of the shoulder is deadly. with the residue of the leaden bullet, came forth of themselves. But if the fracture shall happen in the neck of the shoulder blade or dearticulation of the shoulder, there is scarce any hope of recovery; as I have observed in Anthony of Bourbon, King of Navarre; Francis of Lorraine, Duke of Guise; the Count Rhingrave Philibert, and many other in these late civil wars. For there are many large vessels about this dearticulation, to wit, the axillary vein and artery, the nerves arising from the Vertebrae of the neck, which are thence disseminated into all the muscles of the arm. Besides, also inflammation and putrefaction arising there are easily communicated by reason of their neighbourhood to the heart and other principal parts, whence grievous symptoms, and oft times death itself, ensues. CHAP. X. Of the fracture and depression of the Sternon, or Breastbone. THe Sternum is sometimes broken, otherwiles only thrust in without a fracture. The inequality perceivable by your feeling, shows a fracture, Signs that the sternum is broken. as also the going in with a thrust with your finger, and the sound or noise of the bones crackling under your fingers. But a manifest cavity in the part, a cough, spitting of blood, and difficulty of breathing by compression of the Signs that it is depressed. membrane investing the ribs and the lungs, argue the depression thereof. For the restoring of this bone, whether broken or depressed, the patient must be laid on his The cure. back, with a cushion stuffed with tow or hay under the vertebrae of the back, as we set down in the setting of the Collar-bone. Then a servant shall lie strongly with both his hands on his shoulders, as if he would press them down, whilst the Surgeon, in the mean time pressing the ribs on each side, shall restore and set the bone with his hand; and then the formerly described medicines shall be applied for to hinder inflammation, and assuage pain; bolsters shall be fitted thereto, and a ligature shall be made cross-ways above the shoulders, but that not too straight, lest it hinder the Patients breathing. I by these means, at the appointment A history. of Anthony of Bourbon King of Navarre, cured Anthony Benand a Knight of the Order, who had his breastplate bended and driven in, with an iron bullet shot out of a Field-Peece, as also his sternum together therewith, and he fell down as dead with the blow; he did spit blood for three months after I had set the bone: yet for all this he lives at this day in perfect health. CHAP. XI. Of the fracture of the ribs. THe true ribs, for that they are bonny, may be broken in any part of them. But the bastard ribs cannot be truly broken unless at the back bone, In what place the short ribs may be broken. because they are only bonny in that part, but gristly of the foreside towards the breastbone; wherefore there they can only be folded or crooked in. These which are subject to fractures, may be broken inwards and outwards. But oft times it comes to pass, that they are not absolutely broken, but cleft into splinters, and that sometimes inwards, but not outwards. Thus the fissure doth ofttimes not exceed the middle substance of the rib; but sometimes it so breaks through it all, that the fragments and splinters do prick and wound the membrane, which invests and lines them on the inside, and then there is great danger. But when the fracture is simple without a wound, compression, puncture of the membrane, and lastly, without any other symptom; then the danger is less. Therefore Hypocrates wisheth, that these, who are thus affected, fill themselves more freely Sent. 56. sect. 3. de art. with meat; for that moderate repletion of the belly, is (as it were) a certain prop or stay for the ribs, keeping them well in their place and state: which rule chiefly takes place in fractures of the bastard ribs. For such as have them broken, usually feel themselves better after, than before meat. For emptiness of meat, or of the stomach, makes a suspension of the ribs, as not underpropped by the meat. Now that fracture which is outwardly, is far more easy to heal, than that which Why an internal fracture of the ribs is deadly. is inwardly; for that this pricketh the membrane or Pleura, and causeth inflammation, which may easily end in an Empyema. Add hereunto, that this is not so easily to be handled or dealt withal, as the other: whereby it cometh to pass, that it cannot be so easily restored; for that these things cannot be so fully and freely performed in this kind of fracture, which are necessary to the setting of the bone, as to draw it out, hold it and join it together. It is therefore healed within twenty days, if nothing else hinder. The signs of fractured ribs are not obscure; for by The signs. feeling the grieved part with your fingers, you may easily perceive the fracture by the inequality of the bones, and their noise or crackling, especially, if they be quite broke asunder. But if a rib be broken on the inside, a pricking pain, far more grievous than in a Pleurisy, troubles the Patient; because the sharp splinters prick the costal membrane: whence great difficulty in breathing, a cough and spitting of blood ensue. For blood, flowing from the vessels broken by the violence The cause of spitting blood when the ribs are broken. of the thing causing the fracture, is (as it were) sucked up by the lungs, and so by a dry cough carried into the wizened, and at length spit out of the mouth. Some, to pull up the bone that is quite broken and depressed, apply a cupping glass, and that is ill done: for there is caused greater attraction of humours, and excess of pain by the pressure and contraction of the adjacent parts, by the cupping-glass; wherefore Hypocrates also forbids it. Therefore it is better to endeavour to restore Sent. 51. sect. 3. de art. Paulus lib. 6. cap. 96. Avicen. 4. The cure. it after this following manner. Let the Patient lie upon his sound fide, and let there be laid upon the fractured side an emplaster made of Turpentine, rosin, black pitch, wheat flower, mastic and aloes, and spread upon a strong and new cloth. When it hath stuck there some time, then pluck it suddenly with great violence from below upwards: for so the rib will follow together therewith, and be plucked and drawn upwards. It is not sufficient to have done this once, but you must do it often, until such time as the Patient shall find himself better, and to breathe more easily. There will be much more hope of restitution, if, whilst the Surgeon do this diligently, the Patient forbear coughing, and hold his breath. Otherwise, if necessity urge, as if sharp splinters with most bitter tormenting pain prick the costal membrane overspred with many nerves, veins, and arteries, which run under the ribs, whence difficulty of breathing, spitting of blood, a cough and fever ensue; then the only way to deliver the Patient from danger of imminent death, is, to make incision on the part, where the rib is broken, that so laying it bare, you may discern the pricking fragments, and take them out with your instrument, or else cut them off. And if you make a great wound by incision, then shall you few it up, and cure it according to the common rules of curing wounds. Now Diet, Phlebotomy and Purgation, which (as Hypocrates saith) A simple fracture may be cured only by Surgery. are not very needful in a simple fracture, for that there are no symptoms, which may require such remedies; yet, they, by reason of the complicated symptoms, as a convulsion, fever, Empyema, and the like, must here be prescribed, by the advice of the Physician which over-sees the cure. A Cerate, and other remedies fitting the occasion, shall be applied to the grieved part: no other ligatures can be used, than such as are fit to hold fast and stay the local medicines. There is no other rule of site and lying, than such as is taken from the will and content of the Patient. CHAP. XII. Of certain preternatural affects which ensue upon broken ribs. MAny symptoms ensue upon fractured and contused ribs: but amongst the rest, there are two which are not common, whereof we will treat in this place. The first is, the inflation, or rising up of the contused flesh, which also ensues upon light affects of the bone, which have been neglected at the beginning. But the flesh is not merely puffed up of its self, but also with a certain phlegmatic, glutinous and viscous humour gathering thereinto. The cause hereof is, the weakness of the digestive faculty of the part, occasioned by the stroke and distemper; which therefore cannot assimilate the The cause. nourishment flowing more plentifully than it was wont, either drawn thither by means of the pain, or sent thither by a blind violence of nature, stirred thereto by a desire of its own preservation. Wherefore this half crude humour remaining there, raiseth much flatuling from its self, or else wrought upon by the weaker heat, it is resolved into cloudy vapours; whence it cometh to pass, that the flesh is swollen up in that place, and the skin on the contrary grows soft, as if it were blown The signs. up with a quill. Therefore laying your hand thereon, you may hear the noise of the wind going forth thereof, and see a cavity left in the part, as it is usually seen in oedematous tumours. Unless you remedy this inflation, there will ensue an inflammation, fever, abscess, difficulty of breathing; and lastly, that second kind of affect, whereof we have determined to treat in this Chapter, to wit, the putrefaction, corruption, or blasting of the ribs. An abscess, and the separation of the flesh from the bone, is the cause hereof: for hence it cometh to pass, that the bone, despoiled of its natural and fleshly clothing wherewith it was cherished, is easily offended by the touch of the entering air, which it never formerly felt, and so at length it becometh (as it were) blasted: which when it happens, they spit up filth, and so fall into a consumption, and at length dye. To withstand all these inconveniencies, you must, as speedily as you can, restore the fractured bones by the formerly The cure. delivered means. And then this mucous tumour must be resolved by proper heating and discussing medicines, and kept down by bolsters and rulers; that so the flesh may touch the bone, and cover it as it usually did. But the ligature shall not be made so straight, as to hinder the ribs from their wont motion in expiration and inspiration. If the tumour degenerate into an Abscess, it shallbe speedily opened, lest the matter, kept in too long, corrupt the bone which lies under it, by the contagion of its putrefaction. The Ulcer being opened, the matter shall be evacuated by putting a pipe into the ulcer; the end whereof shallbe bound about with a thread, lest it fall into the capacity of the chest, and that it may be drawn forth at your pleasure. CHAP. XIII. Of the fracture of the Vertebrae, or Rackbones of the back, and of their processes. THe Vertebrae are somewhiles broken, otherwhiles bruised, or strained The affects of the vertebrae. on the inside, whereby it cometh to pass, that the membranes which invest the spinal marrow, as also the spinal marrow its self, are compressed and straitened, which cause many malign accidents; which, whether they be curable or not, may be certainly foretold by their magnitude. Amongst these symptoms, are the stupidity, or numbness and palsy of the arms, legs, fundament and bladder, which diminish, or else take away from them the faculty of sense and motion; so that their urine and excrements come from them against their wills and knowledge, or else are wholly suppressed. Which when they happen (saith Hypocrates) you may foretell that death is at hand, by reason that Sect. 2. Prorh. the spinal marrow is hurt. Having made such a prognosticke, you may make an The cure of fractured Vertebrae. incision, so to take forth the splinters of the broken vertebrae, which, driven in, press the spinal marrow, and the nerves thereof. If you cannot do this, at least you shall apply such medicines as may assuage pain, and hinder inflammation; and then the broken bones shall be restored to their places, and contained therein by those means which we shall mention when we come to treat of the luxation of the spin. But if that the processes only of the vertebrae be broken, the fragments The cure of the processes. shall be put in their places, unless they be quite severed from their periostium. But if they be severed, you shall open the skin and take them forth, and then dress the wound as is fit. We understand, that only the processes of the vertebrae are Signs that only the processes are fractured. broken, if, in the absence of the forementioned symptoms of numbness and the palsy, you, laying your finger upon the grieved part, feel something, as a bony fragment, shaking and moving thereunder, with a certain crackling noise, and cavity, and depression; and then, if when the Patient holds down his head, and bends his back, he feel far more pain, than when he stands up strait on his feet. For in stooping, the skin of the back is somewhat stretched forth, and extended, and also forced upon the sharp Splinters of the fragments, whence proceeds a dolorificke solution of continuity, and a pricking: in standing strait up, on the contrary, the stretched skin is relaxed, and consequently less molested by the sharp fragments. The fractured processes of the vertebrae easily heal, unless they be associated with some other more grievous symptom which may hinder; such as is a certain great contusion, and the like. For, as we formerly said out of Hypocrates, All rare and spongy bones are knit by a Callus within a few days. CHAP. XIV. Of the fracture of the holybone. ALso the Holybone in a certain part thereof, which may be easily healed, may be broken by the blow of bruising things, as by a bullet shot What fracture of the Holybone curable and what not. out of a musket, as I have observed in many. But if the fracture violate, together with the vertebrae thereof, the spinal marrow contained therein, than the Patient can scarce scape death, for the reasons showed in the former Chapter. CHAP. XV. Of the fracture of the Rump. THe Rump is composed of four bones: the first whereof hath a cavity, The description of the rump. wherein it receives the lowest vertebrae of the Holybone: the other three are joined together by Symphysis or Coalition; at the end of these hangs a certain small gristle. The fracture of these bones shall be cured by putting your finger into the Patient's fundament, and so thrusting it even to The cure. the fractured place. For, thus you may thrust the fragment forth, and fit and restore it to the rest of the bones by your other hand lying upon the back. But that it may be the sooner healed, it is fit the Patient keep his bed, during all the time of the cure. But if there be a necessity to rise, he shall so sit in a perforated seat, that there may be nothing which may press the broken part; and fitting remedies for healing fractures shall be applied, as occasion shall offer its self. CHAP. XVI. Of the fracture of the Hip, or Os Ilium. THe Hip consists of three bones: The first is named Os Ilium, the Haunch-bone; The description of the Hip. the other, Os Ischion, the Huckle bone; the third, Os pubis, the Share-bone. These three bones in men of full growth, are so fast knit and joined together, that they can by no means be separated; but in children they may be separated without much ado. This bone may be broken in any part thereof, either by a stroke, or by a fall from high upon any hard body. You shall know the fracture by the same kind of signs, as you know others, to wit, The signs. pain, pricking, a depressed cavity, and inequality, and also a numbness of the leg of the same side. The splinters of the bones (if quite broke off) must by making incision The cure. be taken away at the first dressing: in performance of which operation, you must have a care, that you hurt not with your instrument the heads of the muscles, nor any vessels, especially which are great; nor lastly, that large nerve which is sent into the muscles of the thigh and leg. On the contrary, such fragments as are not broken or severed from their periostium, shall be smoothed and set in order with your fingers, as is fitting. Other things shall be done according as art and necessity shall persuade and require. CHAP. XVII. Of a fracture of the Shoulder, or Armebone. THe Armebone is round, hollow, full of marrow, rising up with an indifferent The description of the arm or shoulder-bone. neck, and ending on the upper part into somewhat a thick head. On the lower part it hath two processes, the one before, the other behind: between which there is (as it were) an half circle, or the cavity of a pulley, each end whereof leads into its cavity, of which one is interior, another exterior; that by these (as it were) hollow stops, the bending and extension of the arm might be limited: lest that the bone of the cubite, if the circle should have been perfect, sliding equally this way and that way, might, by its turning, have gone quite round, as a rope runs in a pulley; which thing would much have confused the motion of the Cubite. For so the extension, or bending it back, would have been equal to the necessary bending it inwards. It is very expedient that a Surgeon know these things, that so he may the better know how to restore the fractures and luxations of this part. If one of the fragments of this broken The cure. bone shall lie much over the other, and the patient have a good strong body, than the arm shall be much extended, the Patient being so set upon a low seat, that he may not rise, when the fracture shall be a-setting, and so hinder the begun work; and also, that so the Surgeon may the more easily perform his operation upon the Patient seated under him: yet Hypocrates, regarding another thing, would have the Patient to sit higher. But you must have a care, that the shoulder-bone itself be drawn directly downwards, and the cubit so bended as when you put it into a scarf. For if any one set this bone, lifting the arm upwards, or otherwise extending it, then must it be kept in that posture: for otherwise, if the figure be changed, the setting will quickly be spoilt, when as you come to put the arm in a scarf. Wherefore the Surgeon must diligently and carefully observe, How the arm must be placed when the bone is set. that in setting a broken arm, he put it in such a posture, that resting on the breast, it look down towards the girdle. You must have a care in laying the splints, and rolling your ligatures, that they hurt not, nor press too hard upon the joints. For, in the opinion of Hypocrates, by the pressure of parts which are nervous, Sect. 3. office sect. 1. de fract. fleshless, and consequently endued with exquisite sense, by the splints there is danger of most grievous pain, inflammation, denudation both of the bone and nerve; but chiefly, if such compression hurt the inner part, towards which the arm is bended: wherefore the splints made for this place must be the shorter. Therefore, after the Armebone is set, the arm shall be laid upon the breast in a right angle, and there bound up in a scarf, lest that the Patient, when he hath need to stir, spoil and undo the setting, and figure of the broken bone. But the arm In what time it will knit. must be kept in quiet, until such time as the fragments shall be confirmed with a Callus, which usually is in forty days, sooner or later, according to the different constitutions of bodies. CHAP. XVIII. Of the fracture of the Cubit, or the Ell and Wand. IT sometimes happeneth, that the Cubite and Wand are broken together The difference▪ and at once, and otherwhiles that but the one of them is fractured. Now they are broken either in their midst or ends; their ends (I say) which are either towards the elbow, or else towards the wrist. That fracture is worst of all, wherein both the bones are broken, for then the member is made wholly impotent to perform any sort of action, and the cure is also more difficult; for the member cannot so easily be contained in its state: for that bone which remains whole, serves for a stay to the arm, and hinders the muscles from being drawn back, which usually draw back and shrink up themselves, whensoever both bones are broken. Hence it is, that that fracture is judged the worst, wherein the Cubir or el bone is broken. But that is easiest of all, wherein only the Wand is broken, for so the The cure. fractured part is sustained by the Ell-bone: When both the bones are broken, there must be made a stronger extension, for that the muscles are the more contracted. Therefore, whensoever either of them remains whole, it doth more service in sustaining the other, than any either ligatures of splints, for that it keeps the muscles right in their places. Wherefore, after the bones shall be set and rolled up with ligatures and splints, the arm must be so carried up in a scarf put about the neck, that the hand may not be much higher than the elbow, lest the blood and other humours may fall down thereinto. But the hand shall be set in that posture which is between prone and supine, for so the Wand shall lie directly under the Ell, as we have read it observed by Hypocrates. The reason is, for that by a supine figure Sent. 3. sect. 1. de fract. or situation, both the bone and muscles are perverted: for first, for the bone, the Apophysis, styloides and Olecranum of the Cubit, aught to be in an equal plain, and to be seated each against other; which is not so in a supine figure, as wherein the Processus styloides of the Cubit is set against the inner process of the arm bone. But in muscles, for that, like as the insertion and site of the head of a muscle is, such also is the site of the belly thereof, and lastly, such the insertion of the tail thereof; but by a supine figure, the muscles arising from the inner process of the arm bone and bending the cubit, shall have their tail placed in an higher and more exterior site. In the interim, you must not omit, but that the Patient's arm may, with as little pain as possibly you can, be bended and extended now and then, lest by the too long rest of the tied up part, and the intermission of its proper function, the bones of the joint may be soldered together by the interposition, and as it were glue of the defluxion which falls abundantly into the joint of the Ell-bow, and neighbouring parts, whence the stiffness and unmovableness thereof, as if there were a Callus grown there: from whence it may happen, that the arm thereafter may neither be bended, nor extended, which I have observed to have happened to many. Whereof also Galen makes mention, and calls this kind of Com. in lib. de art. vitiated conformation Ancyle and Ancylosis. If a wound also associate a fracture of the arm, then see, that you put about it plates of Latin, or Pasteboard, and make a convenient Ligature, and that the fragments of the bones be kept in the same state wherein they were set and restored. Moreover, let him lay his arm upon a soft pillow or cushion, as the following Figure shows you. The figure of a fractured Arm, with a wound bound up, and seated, as is fit. CHAP. XIX. Of the fracture of a Hand. THe bones of the Wrest, and Afterwrest, may be broken: but, Sect. 〈◊〉. de fract. sent. 9 in Hypocrates opinion, chiefly by that kind of fracture which is called a Sedes; now if they shall happen to be broken, this shall be the manner of restoring them. Let the Patient lay forth his hand upon some even The cure. and smooth table, then let your servant stretch forth the broken bones, & the workmaster restore them thus extended, and put them in their proper seats. But being restored, they must be kept in their places by such remedies as are used in other fractures; to wit, cerates, compresses, linen clothes, and splints. Now the fractured fingers shall be tied or bound to their neighbours, that so they may the more easily, as bound to a stake, be kept in that state wherein they have been put by the hand of the Workman. But these bones, seeing they are of a rare and spongy nature, are in a short time and easily strengthened, or knit by a Callus. These things To what purpose the carrying of a bail in a fractured hand serves. being done, the hollowness or palm of the hand shall be filled with a Tennis ball, for thus the broken bones shall not only be more easily kept in their places, but also the fingers themselves shall be kept in a middle posture, that is, not wholly open, nor quite shut. If they be kept in any other figure, the ensuing Callus will either deprave or quite abolish that action of the hand, whereby we take hold of any thing. The case stands otherwise with the fractured Toes; for they shall be kept strait and even out, lest they should hinder our going or standing. CHAP. XX. Of the fracture of a Thigh. IT is a hard thing to bring the fragments of the broken thigh together to be set, by reason of the large and strong muscles of that part; which whilst they are drawn back towards their original, by a motion both natural and convulsive, they carry together with them the fragment of the bone, whereinto they are inserted. Therefore, when as Why the bone of the thigh is more difficultly set. the fracture of this bone shall be restored, the Patient must lie upon his back with his leg stretched forth, and the Surgeon must strongly and with great force extend the thigh; but if he alone shall not be able sufficiently to extend it, he shall employ two other strong attendants, by whose joynt-helpe the fragments may be fitted and set each against other. For this purpose, when as the strength of the hand was not sufficient, the Ancients used an Instrument, called a Glossocomium, whereof this is the figure. The figure of a Glossocomium, or Extender. In stead of this Glossocomium, you may make use of my pulley; for Hypocrates Sent. 67. & 68 sect. 2. de fract. in this bone when it is broken, doth approve of extension so great, that although by the greatness of the extension the ends of the fragments be somewhat distant asunder, an empty space being left between; yet notwithstanding would he have ligature made. For it is not here as it is in the extensions of other bones, whereas the casting about of Ligatures keeps the muscles unmoveable: but here, in the extended thighs, the deligation is not of such force, as that it may stay and keep the bones and muscles in that state, wherein the Surgeon hath placed them. For, seeing that the muscles of the thigh are large and strong, they overcome the ligation, and are not kept under by it. The Surgeon, in setting it, shall also consider, that the thighbone is hollowed on the inner side, but gibbous on the outside, therefore it must be set in its native figure. Otherwise, if any, unmindful of this consideration, The natural and internal crookedness must be preserved in setting the bone. would have it strait, he shall make his Patient halt all his life after: wherefore this inner and native hollowness must be filled up and preserved by putting in a compress or bolster, spread over with unguentum rosatum, or the like glutinous thing that it may not fall off: for thus also the ligation shall the more faithfully keep the fragments of the bone in their places. Moreover, compresses shall be applied The part to be bound up, must be made plain either by nature or art. to the more slender and less protuberating parts of the thigh, as those which are next the ham and knee, that so the whole ligation may be alike, and consequently the more firm. Now ligatures, as we formerly noted, are ordained for three things. The first is, that the bones may be kept in that state wherein they were set, until they be strengthened by a Callus. The second is, to hinder defluxion, which easily falls into the broken and luxated parts, both by reason of pain, as also by weakness. The third is, to stay and hold fast the splints and medicines which are applied. Inflammation is hindered by repressing and hindering the blood and other humours, ready to flow down, from entering into the part, and by pressing those humours, which are preternaturally contained in the part, into the neighbouring parts above and below. Wherefore there must no small care be had of preparing ligatures, to wit, that they be made of choice and well woven cloth, yet not course or rough; and let them be of such length and breadth, as the Surgeon, persuaded by an artificial conjecture, shall judge to be fit for the thickness and length of the member, and greatness of the fracture: for ligatures ought to be of breadth to involve and cover all the fractured part, and a great part of that which is sound. But seeing that in my Book of Bandages, I have seemed chiefly to set down and approve the manner of binding used by Hypocrates, now I The manner of binding used by Surgeons at this day. think good here in this place to describe that which is in common use amongst our Surgeons. Our Surgeons therefore at this day require three Ligatures for fractures, the first whereof they presently cast upon the hurt part, whether broken or dislocated, or only strained, making the first wrappings upon it; so that they most and straitliest bind it there, but less and more loosely on both sides thereof. Such circumvolutions, or wrappings, are drawn upwards, and there ended. They must be rolled Why the windings of the upper ligatures must be thicker and straighter than the lower. thick, and not wide; for so if they presently follow, and lie one upon another, they will hold the bones more firmly, and more far and wide press forth and repress the superfluous blood from the sound part. They presently in like sort cast the second ligature upon the very fracture, giving it two wraps, then going downwards; yet so, as that they are opener or wider, and farther distant each from other, and not so close together, as the circumvolutions of the first ligature; that so they may press the humours the less to the extremities of the part, as those which cannot receive and bear, without inflammation and danger of a gangrene, such abundance of humours, for that they are not sufficiently spacious, as also more remote from the fountain of native heat, which is greater in the centre than in the circumference. At the lower end of the hurt part the circumvolutions either end, or else are twined thence back again. They cast on the third ligature in that lower end Why the third ligature must be rolled contrary to the two first. of the hurt part, and roll it smoothly and gently upwards, the windings being made contrary to the windings of the first and second ligatures; that they may so draw back into their natural state the muscles, which peradventure have been drawn aside by the force of the former wrappings. These ligations finished, they apply three splints of pasteboard, or some such matter; the first below the fracture, and that truly more broad, and of sufficient length; and then two others, one on each side, distant each from other some finger's breadth, to the end to keep the bone that it do not stir to this side or that, being wrapped about with Tow or Cotton. Then they think of placing or laying the part, to which purpose they propound The Surgeon must be mindful of three things in placing the member. to themselves three scopes. The first is, that the part may lie soft; the second, smooth, or even; the third, somewhat high. The hurt part ought truly to lie soft, for that hard lying presses it, and causes pain and inflammation; which whiles the Patient cannot patiently endure, he is forced to change his place, whilst he every way seeks ease for his pain: and thus he now and then moves the fractured part, which ought to be kept quiet without any motion. It must lie smooth or even, because an unequal or uneven site distorts or draws awry the part, whilst one portion of the hurt part is borne up, and sustained by that which lies under it; but the other hanging down hath nothing thereunder, whereupon it may rest. Therefore Hypocrates bids us diligently to take heed, that the heel do not hang down, Sect. 2. de fract. nor the foot remain without a pillow, for hence pain and a troublesome defluxion of humours is to be feared. But the part ought to lie somewhat high, that the defluxion may be hindered, which is easily stirred up by a prone and declining site: for if the foot shall be placed in a lower figure, the blood which flows thither from the leg, will cause inflammation. But on the contrary, if it be higher, nothing can flow down thereinto. Therefore absolutely not only the foot, but also the thigh and leg, are to be placed higher than the rest of the body: yet, keeping such a mean, that the part may not be too much distended, as Hypocrates admonisheth Sent. 33. & 56. sect. 2. de fract. us. In the mean time, this hurt leg or side, aught to be of equal length with the sound, and for that purpose it must be stayed on both sides with Junks, as we shall show you hereafter, when we come to speak of a broken leg. The bandage being performed as we have said, the following night, and the next day the Patient feels the member more straight bound, than when it was first wrapped; yea, verily the knee is lifted up into a soft tumour by the expression of the humour from the wounded part: but on the contrary, the ensuing day the ligation is slackened and relaxed, some portion of the humour contained in the part being digested. Also the next day all things are perceived more loose, there being made a larger resolution of the humour. Then therefore the Bandages must be loosed, and that When the first ligation must be loosed. not only, lest that the fragments of the bones should fall forth of their place, but also that we may gratify the Patient by that alteration or change of place, and besides that we may avoid itching, which usually happens to parts too long bound up, by reason of the suppression of acride and fuliginous excrements, which use to be gathered in great quantity in a part at rest and bound up, both from the excrementitious humours, wherewith the part is moistened, and the alimentary humours in a part which is idle and at quiet; by reason the difflation and transpiration are hindered by want of exercise, and the pores of the skin shut up by the abundance of the ligatures: so that by the suppression thereof, many have not only an itching, but also, the skin being broke by the acrimony of these, as well vapours as humours, which are kept shut and penned up, have ulcers break forth. Therefore when such accidents shall be feared, the part shall so long be fomented with warm water and oil, as you shall think fit: for, such fomenting assuageth pain, relaxeth that which was too much straitened by the binding, and amends the refrigeration of the part, caused by the repercussion and expression of the blood and spirits, the native and internal heat being by this means revived. If, together with the tumour, there be a contusion and sugillation, it must be the longer fomented, that the excrementitious humour residing in the part may be digested. But if this quantity of time shall not suffice, then must you use stronger digestives: yet have a care you use them not too long; for so you should hinder the generation of a Callus. Therefore that saying of Hypocrates must here be remembered, which saith, That a weak fomentation, and the short time of using one doth attract, but not discuss; but a Sent. 15. sect. 3. 〈◊〉 office longer and stronger wastes the flesh. Besides also, you must have regard to the temper and habit of the Patient; for fomentations, used to plethoric bodies, draw superfluous humours to the part. The Ancients bid, that the ligatures be loosed every third day, until their seventh day; but after the seventh, on every seventh day: but hereof nothing can be certainly and perpetually decreed. For, according to the accidents the Patients must be dressed sooner or later, more often or seldom, renewing the ligatures, and the rest of the dressing. Therefore, if no symptom urge, I would have none of these things, which are done to the Patient at the first dressing, to be moved, unless as slowly and seldom as you may. For you hinder the knitting of the bone, if you never so little move the ends of the fragments thereof: for, as you see wood is joined together by glue, and pewter with sowder; so the fragments of bones are, by the providence of nature, glued and soldered together by a Callus. Wherefore broken bones have very much need of rest, to the generating of Rest necessary for the knitting of set bones. a Callus; otherwise, the matter thereof flowing down, quickly flows away, and nothing is done. You may much help forwards the generation of a Callus, which is begun about the thirteenth or fifteenth day, by applying an emplaster made with the white of an egg, having the powder of red rose leaves, and wheat flower mixed therewith, and other Catagmatick plasters, which shall hereafter be described in speaking of the fracture of a leg. CHAP. XXI. Of the fracture of the Thigh nigh to the joint, or the upper or lower head of the bone. A Fracture sometimes happens at the joint of the hip in the neck of the thighbone, as I once observed in an honest matron. I being called to A history. her, when I had observed the hurt Thigh to be shorter than the whole, with the outward prominency of the Ischium, which at the first sight I supposed to proceed from the head of the thigh bone, I presently persuaded myself it was a dislocation and no fracture; I then therefore extended the bone, and forced (as I thought) the head thereof into its cavity. The equality of both the legs in bigness which followed upon this extension, increased my persuasion that it was a dislocation. The next day I visited her the second time, and found her in great pain, her hurt leg the shorter, and her foot wrested inwards. Then I loosed all her ligatures, and perceived such a prominency as I did formerly. Wherefore I end voured again to force in the head of the bone, as I formerly did. But as I was busied therein, I heard a little crackling, and also I considered, that there was no cavity nor depression in the joint, by which signs I certainly persuaded myself, that the bone was broken, and not dislocated. Neither only such kind of Fractures, but also the separation of the appendix or head of this bone from its place, may induce one to think it a dislocation; which thing hath sometimes deceived some heedless Surgeons, who have not dreamt of the divulsion or Another fracture of the thigh, resembling a luxation. separation of the appendix from the top of the Thighbone, but have judged it only a dislocation. Then therefore (that I may return to my former narration) I set the bone, and joined the fragments together, laid thereupon splints with compresses, made ligations with a rowler, having two heads wrapped about the joint, and the body crossewise, and I defended her foot with a Case, that none of the clothes might press it. I fastened a rope to a post, and so let it come down into the midst of the bed, and tied many knots thereon, for the better taking hold and lifting up herself; the which thing you must always do in fractures and dislocations of the thigh and leg, that so your Patients may have some stay, whereby they may succour themselves with their hands, as oft as they desire to rise, or lift themselves up in their beds, or go to stool; as also, that they may give perspiration, and as it were ventilation to the loins, buttocks, rump, and other parts, compressed and wearied with long lying, for want whereof they are molested with heat and pain; whence ulcers arise, which ofttimes torment the Patient with such tormenting heat and pain, that he is even consumed by a fever, watchings, and want of rest. This opportunity of raising the body out of the bed, is by so Why the fracture of a bon. near a joint is more dangerous. much the more needful in this place, by how much the fracture is nearer the joint: for there it is more dangerous than in the midst of the thigh, and consequently more difficult to dress and heal, for that the part is bloodless, and by reason of the multitude of the nerves, tendons and ligaments, which are obnoxious to many malign symptoms. But the Surgeon must have diligent care in this kind of fracture, and must look often that the bone, which is set, do not fall forth again, which easily happens here by any light stirring of the body, & the like occasion, for that the thigh hath but one only bone. Therefore, as oft as the Bandages shall be loosed, and the fracture dressed, he shall attentively view the figure of the bone, and the magnitude of the affected part, comparing it with the sound; for the set and composed fragments of the broken bone, can scarce fall asunder, but that the one must lie upon the other. But before it be knit, the part must be extended and restored to its state, that so the Patient may not halt during the residue of his life. For I have read it written in Avicen, that scarce any do so well recover a fractured Lib. 3. sen. 6. tract. 1. c. 14. thigh, that they do not halt thereof: therefore the Patient must be careful, that he move himself, or his body, as little as he can. Many of the Ancients have set down the time of the consolidation of this bone to be fifty days: but (as I formerly said) there can be no certain or determinate time hereof. But in what time soever this bone shall be knit, the Patient must not In what space the thigh bone may be knit. stand or go thereon presently upon it; for that there remains a weakness in the part a long time after, so that the Patients are forced to use Crutches to go withal, in the mean space while they recover more strength. CHAP. XXII. Of the Fracture of the Patella, or whirle-bone of the Knee. THe Whirle-bone of the knee is oft times contused, but not so frequently broken: yet when that happens, it goes into two or three pieces, sometimes The differences. long-wise, sometimes athwart. Sometimes it is broken in the midst, and somewhiles shivered into many splinters, and all these either with, or without a wound. The signs are, impotency in going, a hollowness Signs. in that place, and a sensible separation of the fragments of the hurt part, and the crackling of these parts under your hand. It is set after this manner; Wish the Patient Cure. to stretch forth his leg, yea, he must keep it extended all the while, until it be knit; and therefore left he should bend it unawares, the hollowness of the Ham shall be filled with a bolster: for by bending of the knee, the set fragments of the whirle-bone would again fly in sunder. This being done, the fragments shall by the hand of the Surgeon be set as is fitting, and be kept so set by the application of convenient remedies, making ligatures, and applying Junks, as we said must be done in a fracture of the Thighbone. And lastly, you must observe and do in this, as in the fracture of a leg. For the Prognostic, this I affirm, That I have seen none of those who have had this bone fractured, who have not halted during the rest of their lives. The cause hereof is, the knitting by the concretion of a Callus hinders the free bending of the knee; going, especially on even Why those halt who have had this bonefractured. ground is more easy to the Patient, but an ascent is far more difficult, and absolutely painful. The Patient must necessarily for this kind of fracture lie or keep his bed, at the least for forty days. CHAP. XXIII. Of a broken Leg. THis kind of Fracture is cured after the same manner as that of the arm or cubit. Hypocrates admonisheth us, that the Tibia, or Leg-bone is Sent. 65. sect. 2. de fract. more dangerous to be broken, and more difficult and slow to be healed than the Fibula, or Shinbone; because that is the thicker, and as it were the upholder of the whole bulk of the body: but this other is but as it were a certain additament or assistant, provided for the staying or bearing up of the muscles of the leg, by which the foot is moved. The leg bone being only broken, the signs thereof are perceived only in the inner part of the leg; for that the Shinbone being whole, suffers it not to throw or cast forth its self. On the contrary, when the Shinbone only is broken, the signs thereof appear only in the external part of the leg; because the leg bone, being opposed thereto, doth not suffer it to cast in its self, and with its fragments to turn inwards. But when both the bones are broken, the signs of the fracture may equally appear both Signs that both the bones are broken. here and there. But when only one of these bones are broken, the fracture is far more easy to dress and heal, because that which remains whole, is a much more firm stay to that which is hurt, than any splints can be. But that I may the better instruct and make ready the Surgeon for the restoring of this fracture, I will illustrate the matter by an example from myself. John Nestor, Doctor of Physic, Richard Hubert, and I, went together to visit a Patient at the Place of the Friar A history. Minorites. Wherefore, intending to pass over the Seine within sight of the place, I endeavoured to make my horse take boat, and therefore switched him over the buttocks. The Jade, madded herewith, so struck at me with his heels, that he broke both the bones of my left leg, some four fingers breadth above my ankle. Then I, fearing some worse mischief, and lest the Jade should double his blow, flew back; and as I fled back, the broken bones flew in sunder; and breaking through the flesh, stocking and boot, showed themselves, whereby I felt as much pain, as it is credible a man was able to endure. Wherefore I was presently carried into the boat, that so I might be carried to the other side of the water to be dressed: but the stirring of the boat as they rowed, almost killed me with bitterness of pain, for that the sharp fragments of the bones were rubbed against the flesh which lay next them. Being ferried over, as I was conveyed into the next houses, my pain was much increased, whilst lifted by the hands of divers persons, one while up, another down, sometimes to the left side, otherwhiles to the right with my whole body, and all the parts thereof. When at the length, I was laid upon a bed, I was somewhat freed from the bitterness of my pain, and had time to wipe off the sweat, which ran down over all my body. Then was I dressed with such a medicine, as the time and place would afford; we composed it of the white of an egg, wheat flower, soot of a chimney, and melted butter. For the rest, I entreated Richard A soon made medicine. Hubert, that he would handle me, as if he knew me not, neither that, moved for love of me, he should remit any thing of the severity of art, but chiefly, that he What to do when the leg is broken. would stretch my foot strait out, and if the wound were not sufficiently wide, that he would enlarge it with his incision knife, that so he might the more easily set the broken bones in their due place; that he would with his fingers (whose judgement is far more certain than the best made instruments) search, whether the splinters which were in the wound were quite severed from the bone, and therefore to be taken forth; that he would with his hand press forth the blood, and the clods of blood which were in a great quantity concrete at the mouth of the wound; that he would bind up and place my leg in that site and manner, as he thought best: which is, that he should have three rulers in a readiness; the first whereof he should cast directly upon the wound, so that he should begin his ligation at the wound: also he should put splints about it; some three, but others two fingers breadth, of the length of half a foot, somewhat depressed and hollowed, whereby they might be the more easily put about the leg, more straight at their ends, and a finger's distance each from other, which at the last he should bind with fillets, like those wherewith Women use to bind up their hair; yet so, that the binding might be more straight upon the wound: and that he would fill the cavity of the ham, and of the ankles, with bolsters made of flax wrapped in linen clothes: that he would fortify the sides of my leg with Junkes made of bents or little sticks, and lined with linen cloth, stretched from my heel to my groin, and bound over in four places; so that the straight figure of the leg might scarcely be perverted by any force: that he would gently, and smoothly lift up my leg to an indifferent height: and lastly, that he should arm it from the violence of external injuries, by putting it in a box or case. But you must note, that the fit placing or laying of the leg is a matter of such moment, that if any error be here committed, it will cause no less than lameness. For if it be lifted up higher than is fit, the Callus will be hollow on the foreside; if lower, than it will be gibbous or bunching forth. Neither also do they commit a small error, who do not fill up the cavities at the ankles after the forementioned manner: for, hereupon the heel will be much afflicted, whilst it is forced to sustain a tedious and painful compression, which at length brings a hot distemper, because the spirits cannot freely flow thereto; which I, finding by experience, not knowing the cause, wished them ever now and then to lift up my heel, whereby it might enjoy the benefit of perspiration, and the spirits have free entrance thereinto, & the contained vapours passing forth. To conclude, my hurt leg was laid upon a cushion after the manner you see here described. The figure of a Leg fractured with a wound, and bound up. CHAP. XXIV. Of some things to be observed in Ligation, when a fracture is associated with a wound. THis, taken out of the doctrine of the Ancients, aught to be kept firm and ratified, That Ligation must be made upon the wound; otherwise That the ligation must be most straight upon the wound. the wounded part will presently lift itself up into a great tumour, receiving the humours pressed thither by the force of the Ligation made on this and that side, above and bolow, whence ensue many malign symptoms. You may make trial hereof upon a sound fleshy part; for if you bind it above and What symptoms ensue the want of binding upon the wounded part. below, not touching that which is in the midst, it will be lifted up into a great tumour, and change the flourishing and native colour into a livide or blackish hue, by reason of the flowing and abundance of the humours pressed forth on every side from the neighbouring parts. Therefore such things will happen much the rather in a wounded or ulcerated part. But for this cause, the ulcer will remain unsuppurated and weeping, crude and liquid sanies flowing there-hence, like unto that which usually flows from inflamed eyes. Such sanies, if it fall upon the bones, and make any stay there, it, with the touch thereof, burns and corrupts them, and so much the more, if they be rare and soft. These will be the signs of such corruption of Signs of the corruption of the bones. the bones; if a greater quantity, and that more filthy sanies, flow from the ulcer, than was accustomed, or the nature of a simple ulcer requires; if the lips of the ulcer be inverted; if the flesh be more soft and flaccid about them; if a sorrowful sense of a beating, and also deep pain torment the Patient by fits; if, by searching with your Probe, you perceive the bone to be spoilt of its periostium; and lastly, if you find it scaily and rough, or also if your Probe be put down somewhat hard, it run into the substance of the bone. But we have treated sufficiently hereof in our particular Treatise of the rottenness of the bones. But certainly such rottenness will never happen to the bone, if the hurt part be bound up, as is fit, and according to art. Wherefore I judge it not amiss, again to admonish the Surgeon of this, That as far as the thing shall suffer, he make his rollings upon When the wounded part must be omitted in ligation. the wound; unless by chance there be such excessive pain and great inflammation, that, through occasion of such symptoms and accidents, he be diverted from this proper and legitimate cure of the disease. Therefore then, because nothing more can be done, let him only do this, which may be done without offence; that is, let him supply the defect of ligation and rulers, with a linen cloth, not too weak, nor too much worn, being twice or thrice doubled, and which may serve to compass the wound and neighbouring parts once about: let him sew the edges thereof at the sides of the wound, lest he be forced to stir the fragments of the bones (which once set aught to be kept unmoved) as often as the wound comes to be dressed. For, broken bones do not require such frequent dressing, as wounds and ulcers do. By this it appears, that as want of binding, and too much looseness in absence of pain and a Phlegmon, so also too straight ligation, when pain is present, brings a Phlegmon and Abscess to the wound. Therefore let all things here, according to the forementioned rules and circumstances, be indifferent. I have for this purpose thought good to reiterate these things, because you shall as yet find many, who follow the practice of Paulus, and make many circumvolutions here and there, above and below the wound, which presently they carry crossewise. But this cross or lattice-like kind of ligation is wholly to be disliked, and that Lattice like binding to be shunned. only to be used which we have described, according to the mind of Hypocrates. Now it is time, that I return to the former history of my mishap, and declare what was done to me after that first dressing, which I have formerly mentioned. CHAP. XXV. What was used to the Author's Leg after the first dressing. I Being brought home to mine own house in Paris in the afternoon, they took from me, out of the Basilica of the left arm, some six ounces of blood. And then at the second dressing the lips or edges of the wound and places thereabout were anointed with unguentum rosatum, which, by a joint consent of Vnguentum rosatum, wherefore good in fractures. the Ancients, is much commended in the beginnings of fractures: for it will assuage pain, and hinder inflammation, by repelling the humours far from the wounded part: for it is cold, astringent and repelling, as the composition thereof shows; for it is made ex oleo omphacino, aqua rosacea, pauco aceto & cera alba. Therefore I used this ointment for six days; I dipped the compresses and rulers somewhiles in oxycrate, otherwhiles in thick and astringent red wine, for the strengthening of the part, and repressing the humours; You must have a care, that the compresses and rulers grow not hard by dryness. which two things we must have a care of in Hypocrates opinion, in fractures especially with a wound. Wherefore if at any time the compresses or rulers seemed to dry, I now and then moistened them with the oxycrate, or rose vinegar: for, by their too much dryness, pain and inflammation happen; and if they bind the part somewhat more straight, they hurt it also by their hardness. You shall see many surgeons, who in this kind of affect, from the beginning to the end, use only astringent and emplastic medicines, wholly contrary to the method set down by Hypocrates, and commended by Galen. For, by the continued use of such things, the pores and breathing places of the skin are shut up; whence the fuliginous excrement being suppressed, the external heat is increased, and itching caused, and at length an ulcer by the fretting of the acride and serous humour long suppressed. Whereby you may learn, that astringent and emplastic medicines must not be used above six days. In stead hereof you shall use the emplasters, which I shall presently describe. In the beginning of my disease I used so spare a diet, that for nine days, I ate nothing each day, but twelve stewed prunes, and six morsels of bread, and drank a Paris pint of sugared water, of which water this was the composition. ℞. sacc. albis. ℥ xii. aquae font. lb xii. cinam. ʒ iii bulliant simul secundum artem: The description of a sugared water. Otherwhiles I used syrup of maiden's hair with boiled water: Otherwhiles, the divine drink (as they term it) whereof this is the composition. ℞. aquaecoctae lb. vi. sacc. albis. ℥ iiii. succ. limb. ℥ i. agitentur & transvasentur saepius in vasis vitreis. I was purged when need required with a bowl of Cassia with Rhubarb. I used also suppositories of Castle soap to make me go to stool; for, if at any time I wanted due evacuation, a preternatural heat presently seized upon my kidneys. With this, though exquisite manner of diet, I could not prevail, but that a fever took me upon the eleventh day of my disease, and a defluxion, which turned into an Abscess, long flowing with much matter. I think the occasion hereof was some portion The causes of a fever and abscess, ensuing upon a fracture. of the humour suppressed in the bottom of the wound; as also by too loose binding, by reason that I could not endure just or more straight binding; and lastly, scales or shivers of bones quite broke off, and therefore unapt to be agglutinated: for these therefore putrefying, drew by consent the proper nourishment of the part into putrefaction, and by the putredinous heat thence arising, did plentifully administer the material and efficient cause to the defluxion and inflammation. I was moved to think they were scales, severed from their bone, by the thin and crude sanies flowing from the wound, the much swollen sides of the wound, and the Signs of scales severed from their bones. more loose and spongy flesh thereabouts. To these causes, this also did accrue, one night amongst the rest, as I slept, the muscles so contracted themselves by a violent motion, that they drew my whole Leg upwards; so that the bones, by the vehemency of the convulsion, were displaced, and pressed the sides of the wound; neither could they be perfectly composed or set, unless by a new extension and impulsion, which was much more painful to me than the former. My fever, when it had lasted with me seven days, at length enjoyed a Crisis and end, partly by the eruption of matter, and partly by sweat, flowing from me in a plenteous manner. CHAP. XXVI. What may be the cause of the convulsive twitching of broken members. THis contraction, and (as it were) convulsive twitching, usually happens to fractured members in the time of sleep. I think the cause thereof is, for that the native heat withdraws its self while we sleep, into the Why the extreme parts are cold when we sleep. centre of the body; whereby it cometh to pass, that the extreme parts grow cold. In the mean while, nature, by its accustomed providence, sends spirits to the supply of the hurt part. But because they are not received of the part evil affected and unapt thereto, they betake themselves together, and suddenly, according to their wont celerity, thither from whence they came, the muscles follow their motion: with the muscles, the bones, whereinto they are inserted, are together drawn; whereby it comes to pass, that they are again displaced, and with great torment of pain, fall from their former seat. This contraction of the muscles is towards their original. CHAP. XXVII. Certain Documents concerning the parts, whereon the Patient must necessarily rest, whilst he lies in his bed. THose who have their Leg or the like bone broken, because they are hindered by the bitterness of pain, and also wish for their cure or consolidation, The natural faculties languish in the parts by idleness, but are strengthened by action. are forced to keep themselves without stirring, and upon their backs in their beds for a long time together. In the mean space, the parts whereupon they must necessarily lie, as the heel, back, holybone, rump, the muscles of the broken thigh or leg remain stretched forth and unmoveable, set at liberty from their usual functions. Whereby it comes to pass, that all their strength decays, and grows dull by little and little. Moreover also, by the suppression of the fuliginous and acride excrements, and want of perspiration, they grow preternaturally hot; whence defluxion, an abscess and ulcer, happen to them, but principally to the holybone, the rump and heel: to the former, for that How, and what ulcers happen upon the fracture of the leg, to the rump & heel. they are defended with small store of flesh; to the latter, for that it is of more exquisite sense. Now the ulcers of these parts are difficulty healed, yea, and ofttimes they cause a gangrene in the flesh, and a rottenness and mortification in the bones there-under, and for the most part a continued fever, delirium, convulsion, and (by that sympathy which generally accompanies such affects) a hicketing. For the heel and stomach are two very nervous parts, the latter in the whole body thereof, and by a large portion of the nerves of the sixth conjugation; but the other by the great tendon passing under it, the which is produced by the meeting, and as it were growing together of the three muscles of the calf of the leg. All which are deadly, both by dissipation of the native heat by the feverish, and that which is preternatural; as also by the infection of the noble parts, whose use the life cannot want, by carrion-like vapours. When as I considered all these things with myself, and (become more skilful by the example of others) understood how dangerous they were, I wished them now and then to lift my heel up out of Remedies for the prevention of the foresaid ulcers. the bed; and taking hold of the rope which hung over my head, I heaved up myself, that so the parts, pressed with continual lying, might transpire, and be ventilated. Moreover also I rested these parts upon a round cushion, being open in the middle, and stuffed with soft feathers, and laid under my rump and heel, that they might be refreshed by the benefit and gentle breathing of the air: and I did ofttimes apply linen clothes, spread over with unguentum rosatum, for the asswaging of the pain and heat. Besides also, I devised a Casse of Latin, wherein the The use of a Latin Casse. broken leg being laid, is kept in its place, far more surely and certainly than by any Junks; and moreover also, it may all be moved to and again at the Patient's pleasure. This Casse will also hinder the heel from lying with all its body and weight upon the bed, putting a soft and thick bolster under the calf, in that place where the Casse is hollow: besides also, it arms and defends it against the falling down and weight of the bedclothes, having a little arch made over and above, of the same matter. All which shall be made manifest unto you by the following figure. The figure of a Casse. A A. Show the bottom or belly of the Casse. B B. The wings or sides to be opened and shut at pleasure: C. The end of the wings, whereto the sole or arch is fitted. D D. The Arch. E E. The Sole. F F. An open space, whereat the heel hangs forth of the Casse. Now it remains, that I tell you what remedies I applied to the Abscess which happened upon my wound. When therefore I perceived an Abscess to breed, I composed a suppurative medicine of the yoalks of eggs, common oil, turpentine, A suppuratis 〈◊〉 medicine. and a little wheat flower, and I used it until it was opened: then to cleanse it I used this following remedy. ℞. syrupi rosatis & terebinth. venetae, an. ℥ two. pulveris radicis ireos florentiae, aloes, A d●te: ●ive. mastiches, farinae hordei, an. ʒss. incorporentur omnia simul & fiat mundificativum: but I had a care, that the place, whereat I conjectured the quite severed scales of the bones must break forth, should be filled with tents made of sponge or flax, that so, by this means, I might keep the ulcer open at my pleasure. But I put into the Catagmatick powders have power to cast forth the scales of bones. bottom of the ulcer catagmatick and cephalic powders, with a little burnt Alum to procure the egress of the formerly mentioned scales. These at length cast forth, I cicatrized the ulcer with burnt Alum. For, this having a drying and astringent faculty, confirms and hardens the flesh, which is loose and spongy, and flowing with liquid sanies, and helps forwards natures endeavour in cicatrisation. For, the fragments of the bones, they, by reason of their natural dryness and hardness, cannot be joined and knit together by themselves without a medium: but they need a certain substance, which, thickening and concreting at their ends, doth at length The causes both efficient and material of a Callus. glue them together, and (as it were) fasten them with solder. This substance hath its matter of the proper substance and marrow of the bones; but the form from the native heat, and emplastic medicines, which moderately heat. For, on the contrary, these medicines, which, by their too much heat, do discuss and attenuate, do (as it were) melt and dissolve the matter of the Callus, and so hinder the knitting. Wherefore for this purpose, I would wish you to make use of the following emplasters, of whose efficacy I have had experience: for, hence they are called knitting or consolidating plasters. ℞. olei myrtill. & rosarum omphac. an. lb. ss. rad. altheae lb. two. rad. fraxini, & fol. cjusdem, rad. consolidae majoris & fol. ejusdem, fol. salicis an. m. i fiat decoctio in sufficienti Medicines conducing to the generation of a Callus. quantitate vini nigri, & aquaefabrorum, ad medi●tatis consumptionem, add in colatura pulveris myrrhae & thuris an. ℥ ss. adipis hirci lb. ss. terebinth. lotae ℥ iiii. mestichesʒiii. lethargy auri & argenti an. ℥ two. boli armeni●, & terrae sigillata, an. ℥ i. ss. miniiʒvi. cerae albae quantum sufficit, fiat emplastrum, ut artis est. In stead hereof you may use the black emplaster, where of this is the description. ℞. lethargy auri lb. i olei & aceti lb. two. coquantur simul lento igne donec nigrum & The black plaster. splendens reddatur emplastrum, & non adhaereat digitis. Or else, ℞. olei rosat. & myrtill. an. ℥ two. nucum cupressi, boli armen. sanguinis drac. pulverisatorum an. ℥. ss. emplastri diachalciteos ℥ iiii. liquefaciant simul, & fiat emplastrum secundum artem. In defect of these, you may use a Cere-cloth, or tela Gualteri, whereof this is the description. ℞. pulveris thuris, farinae volatilis, mastiches, boli arm. resinae pini, nucum cupressi, rubiae tinctorum, an. ℥ two. sevi arietini & cerae albae an. lb. ss. fiat emplastrum: into which The description of a Spa●adrapum or cere-cloth. (whilst it is hot) dip a warm linen cloth, for the forementioned use. Emplastrum Diacalcithios, by the common consent of all the Ancients, is much commended for fractures: but it must undergo different preparations, according to the condition of the time, for in summer it must be dissolved in the juice of plantain and nightshade, lest it should heat more than is fit. It is convenient, in the interim, to have regard to the temper of the affected bodies; for neither are the bodies of children to be so much dried as these of old men: otherwise, if such drying medicines should be applied to young bodies as to old, the matter of the Callus would be dissolved, it would be so far from concreting; wherefore the Surgeon must take great heed in the choice of his medicines. For, often times remedies, good of themselves, are by use made not good, because they are used and applied without judgement: which Medicines good of themselves, not good by event. is the cause that oft times pernicious accidents happen, or else the Callus becomes more soft, hard, slender, crooked, or lastly concretes more slowly by the great error, and to the great shame of the Surgeon. CHAP. XXVIII. By what means we may know the Callus is a breeding. THen I knew that my leg begun to knit, when as less matter than was When the Callus is breeding the ulcer must be seldom dressed. usual came from the ulcer, when the pain slackened, and lastly; when as the convulsive twitchings ceased; which caused me to judge it fit to dress it seldomer than I was used to do. For, by the frequent detersion in dressing an ulcer, whilst a Callus is breeding, the matters whereof it is to be made, are drawn away and spent, which are (as they term them) Ros, Cambium, and Gluten, which are the proper and genuine nourishments both of the bony, as also of the fleshy substance. I by other signs also conjectured the breeding of the Callus, to wit, by the sweeting of a certain dewy blood out of the edges and pores of the wound, which gently died and bedewed the bolsters and ligatures, proceeding from the effluxe of the subtler and gentler portion of that matter, which plenteously flowed down for the breeding of a Callus. As also, by a tickling and pleasing sense of a certain vapour, continually creeping, with a moderate and gentle heat, from the upper parts even to the place of the wound. Wherefore thence forwards Hipp. sent. 43. sect. 1. de fract. I somewhat loosened the ligation, lest, by keeping it too straight, I should hinder from entering to the fragments of the bones, the matter of the Callus, which is a portion of the blood, temperate in quality, and moderate in quantity. Then therefore I thought good, to use nourishments fit to generate more gross, thick and tenacious blood, and sufficient for generating a Callus; such as are the extremities, tendinous Meats fit for generating a Callus. and gristly parts of beasts, as the heads, feet, legs and ears of Hogs, Oxen, Sheep, Kids; all which I boiled with Rice, French Barley, and the like, using somewhiles one, somewhiles another, to please my stomach & palate. I also sometimes fed upon frumity, or wheat sodden in Capon broth with the yoalks of eggs; I drank red, thick and astringent wine, indifferently tempered with water. For my second course, I ate chestnuts and medlars: neither do I without some reason, thus particularise my diet: for that gross nourishments, especially if they be friable and fragile, as beef is, are alike hurtful (for as much as pertains to the generating of a Callus) as light meats are. For that makes the Callus too dry, these too tender. Wherefore Galen pronounces these meats only fit for generating a Callus, which are neither Lib. 6. meth. cap. 〈◊〉▪ fragile nor friable, neither serous and thin, nor too dry; but indifferent gross, and also viscide, fat and tough. These meats, digested by the stomach into Chilus; are sent into the guts, and from hence, by the mesaraick veins, into the Gate-veine, and the hollow part of the Liver, thence into the Hollow-veine, and so into the Veins dispersed over all the body and the parts thereof. There are also some of these veins which carry blood into the bones; but in the large cavities of the bones is marrow contained, as in the small a certain marrowie substance, proportionable thereto, being their proper nourishment. The generation of marrow is from the grosser portion of the blood; which flows into the greater cavities of the bones by larger veins and arteries, but into the less by lesser, which end in their pores and small passages. For, in large bones you may observe large and apparent passages, by which the veins and arteries enter for the forementioned use. By the same ways the nerves also insinuate themselves, from whence proceeds a membrane which involves the marrow of the bones, the which by that means is endued with most exquisite sense, as experience teacheth; which is the cause that makes many Why the marrow may seem to have sense of feeling. believe, that the marrow hath sense of feeling, because the membranes thereof being hurt cause most bitter pain. Therefore out of the marrow and the proper substance of the bone, there sweats a certain gross and terrestrial juice, whereof, by the power of the assimilating faculty, which serves in stead of the formative, a Callus grows and knits. Simple fractures of the leg are usually knit in fi●tle days; In what space the leg is usually knit. but through the occasion of the wound and the scales quite broke off, and other accidents which befell me, it was three whole months before the fragments of the bones were perfectly knit, and it was also another month, before I could go upon my leg without the help of a Crutch. Going was painful to me for some few days, because the Callus had taken up some place of the muscles: for, before my former freedom of motion could return again to the broken and knit part, it was necessaire, that the Tendons and Membranes should separate themselves by little and little from the scar. In the performance of all these things, I had the diligent and faithful assistance amongst the Surgeons, to omit Physicians, of Anthony Portall, the King's Surgeon. CHAP. XXIX. Of those things which may hinder the generation of a Callus, and how to correct the faults thereof, if it be ill form. HAving already spoken of the signs of a Callus beginning to concrete, of its generation and the manner thereof: it now remains, that we treat of those things which hinder the generation thereof; and what on the contrary help forwards the conformation and concretion thereof. Now these things which either wholly hinder, or else retard the generation of a Callus, have a strong and powerful discussive and attenuating Discussing and unctuous medicines hinder the generation of a Callus. faculty; or else they are unctuous, oily and moist. For, by such the juice, whereof the Callus ought to be, is either melted and consumed, or else grows soft, and is relaxed. But on the contrary, those things which help forwards a Callus must be drying, incrassating, thickening, hardening and emplastic, moderately hot and What helps forward the generation thereof. astringent. But for moist and relaxing medicines, they ought to have no place here, unless when it happens that the Callus is ill form, that is, too thick, or crooked, or otherwise ill shapen, whereby it may be wasted and broken, so to be restored again after a better manner. Yet notwithstanding, such things are not to be attempted, unless when the Callus is yet green, and so depraved, that the fault thereof doth very much pervert the native conformation of the part, and exceedingly offend the action. Then therefore in such a case, the place must be fomented with a decoction of a sheep's head and guts, wherein shall be boiled the roots of Marshmallows, of bryony, the seeds of Line, of Faenugreeke, Pigeons dung, Bay-berries, and the like. You shall also use this following ointment and plaster. ℞. unguenti de Althaea ℥ iiii. olei liliorum, & axungiae anseris an. ℥ i. aquae vitae parum, liquefiant simul, fiat linimentum quo liniatur pars. Then apply this following emplaster. ℞. emplast. de Vigo cum mercurio, cerati oesypati descriptione Philagrii, an. ℥ iii olei anethini & liliorum an. ℥ i. liquefiant omnia simul, fiat emplastrum; let it be spread upon leather for the foresaid use. When by this means the Callus shall seem to be sufficiently mollified, it shall be broken, and the bones restored to their natural state, and the cure of the fracture to be followed as at the beginning. If the Callus be become too hard through age, it is better not to break it, but to let it alone, lest some What Callus must not be broken, though distorte, or otherwise ill conformed. worse accident befall the Patient. For it may so fall out, that by your labouring to break it, the bone may break in some other part, before it break in that which is knit by the Callus. Therefore the discreet Patient had rather live lame, than for eschewing it, to undergo the hazard of his life. If the Callus be too gross, it shallbe diminished (if it be as yet fresh) with emollient, resolving, and powerfully astringent medicines, which have force to dissolve, dry and exhaust. It will also be good strongly to rub the Callus with oil of Bays, wherein Saltpetre, or some other kind of Salt hath been dissolved, then wrapped about with a Rowler, to bind it very straight, putting a leaden plate thereon, whereby the flowing down of the nourishing humour into the part, may be forbidden; that thus by little and little the Callus may decay and diminish. If on the contrary, it any ways happen, that the Callus The causes of too slender a Callus. be more thin and slender, or grows more slowly, for that it is too straight bound, or because the idle part is longer kept in quiet than is fit, without exercising of its proper function (which cause is to be reckoned amongst the chief causes of the leaneness, even for this reason, for that exercise stirs up the native heat of the part, the worker of digestion and nutrition) or else for that they feed upon such nourishments as offend in quality, or quantity, or both, or for that the ligature used to the part is too often loosed, or because the part its self is too hastily and before the time put to undergo solid offices and motions. According to the variety of causes, medicines shall be applied. For if the ligature of the part be too straight, it shall be loosed, Remedies therefore. yea verily the fractured place, the ligature being taken away, shall be quite freed from ligation, and a new kind of ligature must be made, which must be rolled down from the root of the vessels, that is, from the armepitts, if the arm; or from the groin, if the leg be broken, to the fracture: yet so, as that you may leave it untouched or taken in, for thus the blood is pressed from the fountain and spring, and forced into the affected part, by a way quite contrary to that, whereby we have formerly taught in fear of inflammation, to hinder it from entrance into the affected part. Also gentle frictions and fomentations with warm water may be profitably made, from which you must then desist when the part shall begin to grow hot and swell. If any too long continue these frictions and fomentations, he shall resolve When we must desist from fomenting and frictions. that which he hath drawn thither. For this we have often times observed, that frictions & fomentations have contrary effects, according to the shortness and continuance of time. Pications will also conduce to this purpose, and other things which customarily are used to members troubled with an atrophic, or want of nourishment. CHAP. XXX. Of fomentations which be used to broken bones. DIvers fomentations are used to broken bones for several causes. When Warm water. we use warm water for a fomentation, we mean that, which is just between hot and cold, that is, which feels luke warm to the hand of the Physician and Patient. A fomentation of such water used for The effects thereof. some short space doth moderately heat, attenuate and prepare for resolution, the humour which is in the surface of the body; it draws blood and an alimentary humour to the part labouring of an Atrophia; it assuages pain, relaxes that which is too much extended, and moderately heats the member refrigerated through occasion of too straight binding, or by any other means. On the contrary, too hot fomenting cools by accident, digesting and discussing the hot humour which was contained in the member. We mean a short time is spent in fomenting, when the Notes of short, just, and too long fomenting. part begins to grow red and swell; a just space, when the part is manifestly red and swollen: but we conjecture, that much or too much time is spent thereon, if the redness, which formerly appeared, go away, and the tumour, which lifted up the part, subside. Also in fomenting, you must have regard to the body whereto it is used. For if it be plethoric, an indifferent fomentation will distend the part with plenty Fomentations hurt plethoric bodies. of superfluous humours; but if it be lean and spare, it will make the part more fleshy and succulent. Now it remains, that we say somewhat of the fracture of the bones of the feet. CHAP. XXXI. Of the fracture of the bones of the feet. THe bones of the Instep, back and toes of the feet, may be fractured as the Why the fractured bones of the foot must be kept in a straight posture. bones of the hands may. Wherefore these shall be cured like them, but that the bones of the Toes must not be kept in a crooked posture, as the bones of the fingers must, lest their action should perish or be depraved. For as we use our legs to walk, so we use our feet to stand-Besides also the Patient shall keep his bed until they be knit. The end of the fifteenth Book. OF DISLOCATIONS, OR, LUXATIONS. THE SIXTEENTH BOOK. CHAP. I. Of the kinds and manners of Dislocations. A Dislocation is the departure or falling out of the head of a What a Luxation properly so called is. What a Luxation not properly so called is. bone from its proper cavity, into an unaccustomed place besides nature, hindering voluntary motion. There is another kind of Luxation, which is caused by a violent distension, and as it were a certain divarication, and dilatation, or extension into length and breadth of the ligaments, and all the nervous bodies, which contain, strengthen, and bind together the joints. Thus those who have been tormented and racked, have that thick ligament which is in the inner cavity of the huckle bone too violently extended: Those who have suffered the Strappado, have the ligaments, encompassing the articulation of the Armebone, with the shoulderblade, forcibly and violently distended. Such also is their affect whose foot is strained by slipping. There is a third kind of Luxation, when as The third kind of Dislocation. those bones which are joined contiguous, and one (as it were) bound to the sides of another, gape or fly asunder: as in the Arm, when the ●ll parts from the wand; in the leg, when the one focile flies from the other: yet this may be referred to the second sort of dislocations, because it happens not without dilatation, or else the breaking of the ligaments. There is also a fourth added to these, as when the Epiphyses The fourth. and heads of bones are plucked from the bone whereon they were placed or fastened: which unproperly called kind of Luxation, hath place chiefly in the bones of young people, and it is known by the impotency of the part, and by the noise and grating together of the crackling bones when they are handled. Now the bones of young folks are also incident to another casualty: for as the bones of old people are broken by violence by reason of their dryness and hardness, thus the bones of children are bended or crooked in by reason of their natural softness and humidity. CHAP. II. Of the differences of Dislocations. SOme Dislocations are simple, others compound. We term them simple What Luxations are simple which have no other preternatural affect joined with them; and such compound, as are complicated with one or more preternatural affects; as when a dislocation is associated with a wound, fracture, great What compound. pain, inflammation, and an abscess. For, through occasion of these we are often compelled so long to let alone the luxation, until these be remitted of themselves, or by our art. Some Dislocations are complete and perfect, as when What a complete Luxation is. the bone wholly falls out of its cavity: othersome are unperfect, as when it is only lightly moved, and not wholly fallen out; wherefore we only call them subluxations or strains. Differences of Luxations are also drawn from the place: for What a subluxation or strain. sometimes the bone is wrested forwards, otherwhiles backwards, upwards, downwards; somewhiles it may be wrested, according to all these differences of site, and otherwhiles only according to some of them. Differences are also taken from the condition of the dislocated Joint in greatness and littleness, from the superficiary or deep excavation of the sinus or hollowness; and lastly from the time, as if it be lately done, or of some long continuance. I have judged it fit to set down all these, for that there are several indications of curing, according to the variety of each of these, as we shall teach hereafter. CHAP. III. Of the causes of Dislocations. THere are three general causes of Luxations, internal, external, and hereditary. The internal are excrementitious humours and flatulencies, Internal causes of dislocations. which, settling into the joints with great force and plenty, do so make slippery, soften & relax the ligaments which bind together the bones, that they easily fall out of their cavities; or else they so fill and distend these ligaments, and make them so short, that being contracted, they also contract the appendices of the bones from whence they arise, and so pluck them from the bone whereon they are placed, or else draw the heads of the bones out of their cavities, chiefly if the violence of a noxious humour doth also concur, which possessing and filling up the cavities of the joints, puts them from their seats, as it oft times happens to the joint of the hip by Sciaticas, and to the Vertebrae of the spin, by whose Luxation people become gibbous, or otherwise crooked. But external causes of external causes. Dislocations are, falls from high, bruising and heavy blows, the Rack, Strappado, slipping in going, and all such like things, which may force the heads of the bones to fly out of their seats, or cavities, which also happens sometimes to infants in their birth, when as they are too carelessly and violently drawn forth by the Midwife, so that either their arms or legs are put out of joint. Hereditary causes are such Hereditary causes. as the Parents transfuse into their offspring: hence it is, that crooked not necessarily, but often times are generated by crooked, and lame by lame. The truth whereof is evident by daily experience. Besides also Hypocrates himself avers, Sect 3. sent. 88 & 94 sect. 82. 4. sent. 3. & 4. lib. de art. that infants in the very womb may have their Joints dislocated by a fall, blow and compression, & by the too much humidity and looseness of the Joints: whence also we see many crook legged and footed from their nativity; so that none need marvel or make any doubt hereof. We have read it observed by Galen In librum de Artic. that children may have impostumes in their mother's wombs, which may Children may have impostumes in their mother's wombs. cast forth quitture, the ulcers being opened of their own accord, and be cicatrized by the only benefit of nature. It also happens to many from their first conformation, that the cavities of their Joints are less depressed than they should be, and that their verges are more dilated than they ought to be; whereby it happens that the heads of the bones can the less enter into them. It falls out, that othersome have the ligaments, appointed by nature for fastening together the bones of the joint, whether inserted or placed about, so weak, that from their first original they are not of sufficient strength, or else abound with much phlegm, either bred together with them, or flowing from some other place; so that by their too much slipperiness they less faithfully contain the knit or articulations of the bones. In all these, as the bones are easily dislocated, so they may presently be easily restored without the assistance of a Surgeon, as I have sometimes observed in some. CHAP. four The signs of dislocations. SOme of the signs whereby we come to the knowledge of a luxated The common sign of all dislocations. bone, are common to all dislocations; others are proper only to several Luxations. It is a common sign, that there is always a tumour in that part whereto the bone runs, and a hollowness on that side from whence it is flown. Now the proper signs shall be showed, when as we come to treat of the particular kinds of Luxations. We know a perfect Dislocation by the lost action of the part, that is to say, the lost motion; pain also breeds a suspicion of a dislocation: for the head of the bone, which (moved out of its place) is forced into another, presses the flesh, and distends the nerves also moved out of their place. Hereto also conduces the comparing of the sound joint with that which is hurt, in which collation, it is fit the sound part, which is compared with the hurt, be no ways, neither by nature nor any accident, wronged, nor deformed, nor withered or decayed, nor swollen above measure, otherwise it may cozen and deceive you, if you be less wary. Labour Signs of an unperfect dislocation. and difficulty of action in moving, is a sign of an uncomplete Luxation, or strain. Now we thus know, that the ligaments, serving to the connexion of the articulations, are extended and relaxed, if the head of the bone, pressed with your fingers, be easily driven unto the contrary part, and suddenly fly thence back again; if thrusting your finger into the joint, it easily enter, nothing resisting it, as though all were empty within; if the motion be difficult, or none at all. CHAP. V. Of Prognostics to be made upon luxations. ALl Joints may be perverted or luxated, but all of them cannot in like manner be restored. For the head may be dislocated, but thereupon present What luxations be uncureable. death ensues, by reason of the compression of the whole spinal marrow presently at the original thereof; such also is the dislocation of a vertebra of the spin, and of the Jawbone, which, slipped forth on both sides, hath caused inflammation, and a great tumour before that it be set. The bones of other Joints, as they are more or less dislocated, and moved out of their seats, so may they be more easily or difficultly restored. For, by how much they are the less moved out of their places, by so much they are the more quickly, and by how Why those bones which are hardly dislocated, are hard to be set. much they are the further, by so much they are the more slowly and difficultly set. Also an indication, taken from the figure of the luxated bone, gives a sign of the easy or hard restoring of the dislocation; as in the Arm, by how much the bones be the more easily dislocated, by so much once luxated they are the more easily restored. Bones do not easily fall out of joint in fleshy bodies; but when they chance to be put out, they are not easily got in again. For in such, the articulation is straight on every side held in by the thickness of the muscles, and the plenty of the fat lying thereabouts. On the contrary, such as are lean, especially those who formerly have been more fat, have their joints more lax, whereby it comes to pass, that their bones may easily be put forth of joint: besides also, through the default of the digestive faculty, they have their joints replete with mucous humours; whence it is, that the heads of the bones, as standing in a slippery place, are the less stable, as it is recorded by Hypocrates. But slender bodies, which are naturally dry, compact and dense, have their muscles and ligaments more strong and Sect. 1. de arti●. sent. 29. dry; wherefore their bones are the more difficultly displaced, and displaced, the more difficultly set. Some bones, joined amongst themselves, do sometimes fly asunder, as when the shoulder blade flies from the collar-bone at the Acromion, and Celsus lib. 8. cap. 11. in the Arm the Ell from the Wand, and in the Leg the one focile from the other, and the Heelebone from the Ankle. Bones thus separated will never be joined together again, will never recover their former comely figure, never their strength of action. For, than it most usually happens, that the ligaments are either broke asunder, or else resolved and become lax. Those whose bones are dislocated by an external cause, they, after they be set, may easily fall out again, for that the ligaments, moistened and bedewed with an excrementitious humour, cannot firmly hold them: oft times the ligaments are not wholly broken, but only in some portion thereof; and hence the action of the part either perishes, or is debilitated. Also that dislocation is uncureable, when as the ligaments, steeped and swollen up with an excrementitious humidity, are so much shortened and contracted in their length, as they have acquired in their breadth: and thus they draw away and pluck off the appendices of the bones from whence they arise, and by reason Why the plucking of an appendix from a bone is uncureable. the bone and the appendix do enter and receive each other by many cavities and prominencies, therefore they cannot, by how skilful hand soever they be handled, be again fitly placed and put together. Old and inveterate dislocations, wherein a tough humour possessing the cavity is concrete in stead of the head of the bone, are not to be restored; as neither when the heads of the luxated bones have by continual attrition made themselves a new cavity in the neighbouring bone: neither if they be restored, is the restitution firm and of continuance; because the natural cavity is possessed by another matter, and the new made near thereto cannot well and faithfully contain the received head of the bone. Those who have their shoulder dislocated, may use their hand for many actions, as well as the opposite sound hand; for the weight of the body is not sustained by the hands, as it is by the legs. And by how much the hand is the more exercised, by so much the arm becomes the more corpulent. Contrarily, if the thigh bone be dislocated, especially if it be wrested inwards, the whole leg quickly decays by an atrophia, because the part doth absolutely lose all motion: for by the opinion of Hypocrates, the performance Hipp. sent. 88 sect. 3. de art. of the proper action increases strength, and makes the part in better plight; but idleness debilitates and makes it lean. If a great wound and fracture be joined with a luxation, there is danger, lest while we use extension for restoring the part, we draw the nerves too violently, and so break the nerves, veins and arteries, whence would ensue fear of inflammation, convulsion, and other malign symptoms. Wherefore Hypocrates judges it better in such a concourse and complication Sent. 10 sect. 5. lib. 6. epid & sect. 3. de art. sent 88 of preternatural affects, absolutely not to meddle at all with the setting of the dislocated bone: for, by attempting the restitution, certain death; but by omitting it only lameness is to be feared. Every dislocation must be restored before inflammation You must not endeavour to set an inflamed joint. come; but if it be already present, you must presently be careful to take it away. For other things, let the Patient rest, lest if the affect be irritated, the increase and excess of pain cause a convulsion, gangrene, and lastly death, as I remember I have sometimes observed. Therefore when inflammation, and other malign symptoms shall be mitigated and corrected, then may you endeavour to restore the luxation, especially if the habit of the body and member affected may admit it. For if the body be slender, delicate and tender, than the restitution will be more speedy and facile. But on the contrary, more difficult, if it be gross and compact; And let thus much suffice for prognostics in Luxations. CHAP. VI Of the general cure of Dislocations. FOr all that I have heretofore delivered the general method of curing Five intentions in curing dislocations. Fractures and dislocations, yet it shall not be unprofitable to repeat here in this place, those things which may be accommodated to this Treatise of curing Luxations. Now he that will cure Dislocations, must have regard to five intentions, which it will be fitting to perform in order. The first is, of Holding; The second, of Drawing or Extending; The third, of Forcing in; The fourth, of Placing in convenient figure and site; The fifth, of Correcting the concomitant, or following symptoms. The first scope, which we said was of Holding, is meant either of the whole body, The benefit of holding the member in dislocations. or else of some part thereof only. The whole body must be holden by the strong embracement of your servant or attendant, when as the shoulder, the vertebrae, or the thigh-bones are dislocated. But in the dislocation of the Collar-bone, elbow, hand, knee, or foot and leg, it is sufficient only to hold the part straight in your hands. There is necessity of holding either the body, or else some part thereof, lest, while the dislocated bone is extended, the whole body follow by continuance of parts, if there be nothing which may hinder: for if the body should follow him that draws or extends, all the workmasters labour and endeavour to restore it, is to no purpose. The use of the second scope, that is, of Drawing or Extending, The use of intention. is, that there may be a free space and distance between the luxated bones, by which distance the dislocated bone may the more freely be forced into its cavity. But the manner of drawing or extending is different in quantity and manner, according to the various strength of the muscles and ligaments, and dislocation of the bones to this or that part. Therefore this work is almost always performed by the hands; which when they cannot suffice, we must use the assistance of instruments and engines, whose figures you shall see hereafter delineated. But that you may not do amiss, you may so far use extension, until the head of the bone be brought just against its cavity. When the Surgeon hath brought it to this pass, then must he hasten to the third intention, which is, to put the head of the bone first moved The manner of setting it, or putting it into its place. and gently bended, into its cavity. For he must have a special care, that he force it no other way than into its proper cavity: for it would be dangerous, lest he should turn it from one extreme into another, and the bone, for example's sake, of the thigh, which was dislocated into the forepart by too violent forcing, by exceeding the middle cavity, may be driven and dislocated into the hinder part. To shun this, the bone shall be put back the same way that it fell out, which may be easily done in fresh and late happening dislocations. We understand that the bone is set Signs that the bone is set. by the noise, or as it were a popp, or sound like that, which solid and sounding bodies, being fully and forcibly thrust into their cavities, do make; by the similitude and consent in figure, magnitude and all conformation of the affected part with the sound, and lastly, by the mitigation of the pain. The fourth scope, which is of the The benefit of sit placing the member. convenient site of the part, must be so fulfilled, that the bone after it is set may be kept in its cavity, and not fly forth again. Wherefore if the arm be dislocated, it shall be carried bound up in a scarf: if the thigh, knee, leg, or foot be luxated, they shall be fitly laid in a bed; but in the interim the Surgeon, presently after he hath set them, shall have a care, that the affected joint be wrapped about with stoups and clothes, or compresses steeped in rose vinegar, and spread with convenient medicines, then let it be bound with an artificial deligation, rolling the ligatures unto the part contrary to that whereto the dislocated bone flew. For the which purpose The manner of binding up the set joint. thicker bolsters shall be there applied whence the bone came out, otherwise there will be some danger, lest it should be again displaced: when these things are done, he shall for four or five days space meddle with nothing about the Dislocation, unless pain, or some such like symptom happen. For then the fifth scope The cure of inveterate ●uxations. will call us from that cessation and rest, which is, to correct the symptoms and complicate affections, as pain, inflammation, a wound, fracture, and others, whereof we have spoken abundantly in our Treatise of Fractures. Before we attempt to set inveterate dislocations, we must endeavour to humect the ligaments, tendons and muscles by fomentations, cataplasms, emplasters, liniments, and other remedies, that so these parts may be more obedient to the Surgeon's hand: then must the dislocated bones be moved, with a gentle motion up and down, to and again, that by this means the excrementitious humour, which by continuance of time hath flowed down, may wax hot, be attenuated, resolved or made slippery, and also the fibres of the muscles, ligaments, and nervous bodies, placed about the joint for the defence thereof, may be loosed, that so they may presently be more freely extended. But if a great swelling, pain and inflammation urge, we must first think of assuaging and curing them, then of the restoring the Dislocation. CHAP. VII. The description of certain engines, serving for the restoring of Dislocations. BEfore I come to the particular kinds of Dislocations, I think it not amiss to describe three sorts of Bandages, and give you their figures, These ligatures are not for deligation, but extension. as those which are most fit to hold and extend Dislocations. The first Ligature, designed by this letter A, is made for holding the member. The second, marked with the letter B, is fit for drawing or extension, and consists of one knot. The third, whereto the letter C is put, consisting of two knots, is to hold or bind more straight. The delineation of the three Ligatures. I have thought good also to delineate the following Engine, made for to draw and extend more powerfully, when the hand will not serve. It is made like a Pulley, marked with these letters D D. Within this there lie hid three wheels, through whose furrows runs the rope which is to be drawn, marked with this letter H. At the ends of the Pulley are hooks fastened, the one of which is to fasten the Pulley to a Post, the other is to draw the ligature fastened to the part. The Boxes or Cases wherein the Pulley is kept, is maked with B B. Their covers are marked with A A. A screw pin which may be twined, and so fastened to a Post, that so one of the ends of the Pulley may be hooked thereto, is signed with C. A Gimlet (marked by F.) to make a hole in a Post, so to let in the screw pin. You may see all these things expressed in this following figure. A Pulley. Some Practitioners in stead of this Pulley make use of the hereafter described Instrument, which they term Manubrium versatile, or a Hand-vice. The end thereof is fashioned like a Gimlet, and is to be twined into a Post. Within that handle lies a screw with a hooked end, whereto the string or ligature must be fastened. Now the screw-rod or male-screw runs into the female by the twining about of the handle: and thus the ligature is drawn as much as will suffice, for the setting the dislocated bone. Manubrium versatile, or, A Hand-vice. Having delivered these things thus in general, now I come to treat of the Luxations of each part, from the Jawbone even to the toes of the feet. CHAP. VIII. Of the Dislocation of the Jawbone. THe Jawbone is dislocated by many occasions, and not seldom by The causes. yawning, and other more strong openings of the mouth. It is more frequently luxated into the fore, than into the hind part, by reason of Differences. the mammillary additaments, which hinder it from falling backwards. The dislocation is sometimes but on one side, otherwhiles on both. If the Signs that only one part is dislocated. one side only be luxated, it (together with the chin) is drawn awry unto the contrary side which is not dislocated; the place is hollow from whence it is flown, but swollen whither it is gone; the Patient cannot shut his mouth, but is forced to gape, so that he cannot eat; the Jaw, together with the teeth therein, hangs somewhat forwards; neither do the teeth answer fitly to one another, but the Dogge-teeths are under the shearers. But if both sides be dislocated, all the Jaw and Chin Signs that both sides are dislocated. hang forwards and towards the breast; besides also, the temporal muscles appear distended, spittle runs out of the Patient's mouth against his will, the lower teeth stand further forth than the upper, which is the occasion that the mouth cannot be shut, neither the tongue have free volubility to speak, the Patient stammering in his speech. When it is dislocated on both sides, it is more difficultly restored, and Prognostics. all the symptoms are more vehement; wherefore it must be set with all speed, otherwise the Patient will presently have grievous pain about his throat, inflammation, a fever, whereupon oft times death ensues within ten days, by reason of the five branches of nerves, which, arising from the second and fifth conjugation of the Why death quickly ensues upon the dislocation of both sides of the jaw. brain, are distributed into the moving muscles thereof, which, too violently extended, bring the forementioned symptoms. Practitioners affirm, that the Jaw, twelve days after it is set, is free from the danger of relapse. If it have been dislocated some few days, before you go about to restore it, you must use softening and relaxing medicines to it: but when it is put in the joint, apply a medicine made of the whites of eggs, and oil of roses, to assuage pain, and apply clothes dipped in oxycrate. At the second dressing you shall apply such things as have power to agglutinate and strengthen the ligaments and other relaxed parts, and also to keep it being restored in its place. This shall be the form of such a medicine. ℞. Pulu. boli armeni, sang. draconis, farinae volat. mastic. picis, resinae, an. ℥. ss. An astringent medicine. albuminis ovorum q. s. fiat medicamentum: afterwards you may use Emplast. Diacalcitheos' dissolved in oil of Roses and Vinegar, and other things, as occasion shall be. CHAP. IX. How to set the Jaw dislocated forwards on both sides. FIrst of all the Patient must be placed upon the ground, or some low seat with his face upwards, and his head must be firmly held by your servant, The first manner of setting a jawbone. that so it may be the more immovable: then the Surgeon shall put both his thumbs, wrapped in clothes (left he hurt them by rubbing them upon the Patient's teeth, as also to keep them from slipping) into the Patient's mouth, and press with them the larger teeth of the luxated Jaw, but put his other fingers without under his chin, & so lift up the whole Jaw with them. But if the operation cannot be thus done, for that the mouth on the inside is so shut and closed that the thumbs Another. cannot be put thereinto, then must you thrust in wooden wedges made of soft wood, as hazle or fir, being cut square, and of some finger's thickness. These shall be wedged in on each side above the grinders; then cast a ligature under his chin, whose ends your servant shall hold in his hands, and setting his knees upon the Patient's shoulders, shall pull them upwards; then at the same time the Surgeon shall press downwards the wooden wedges. The Jawbones thus restored, shallbe kept so by convenient ligation, and dressed with medicines, as it is fitting; and in the mean space you must forbid the Patient to speak, or needlessly to open his mouth. Wherefore he must abstain from hard meats, and such as require much chewing, Dict. until his pain be quite passed, and use only spoone-meats, as Barley-creames, pomadoes, jellies, cullasses, broths, and the like. CHAP. X. Of restoring the Jaw dislocated forwards but on one side. THe Patient must be placed on a low seat, so that he may be under the What the Surgeon. Surgeon, than your servant, standing at his back, shall hold his head firm and steady, that it may not follow the Surgeon drawing, extending, and doing other things necessary for restoring it. Then the Surgeon, putting his thumb between the grinders, shall press down the Jaw, and gently drawing it aside, force it into its cavity: in the mean while, also the Patient, What the Patient ought to do. as much as in him lies, shall help forwards the Surgeons endeavour, in opening his mouth as little as he can; lest the muscles should be extended; and he shall only gape so wide as to admit the Surgeon's thumb, for so the temporal muscles shall be restored to their place, and favour the restitution. If he open his mouth as wide as he can, they will be extended after a convulsive manner; if on the contrary he shut his teeth too close, there will be no passage for the Surgeon's Thumb unto his grinding teeth. Some there be which affirm, that the Jawbone may sometimes Signs that the Jaw is dislocated backwards. be dislocated towards the hind part, and that then the mouth is so close shut, that the Patient cannot open it nor gape, and that the lower rank of teeth stands further in, and nearer the throat than the upper. Now for restoring it, the Patient's The Cure. head must be straight holden behind, whilst the Surgeon, the mean while putting both his thumbs into the Patient's mouth, holding his other fingers without under the party's chin, he shall, by shaking it, draw it to him, or forwards, and so restore it to its place. For my own part, I confess I never saw this kind of Luxation, and I easily persuade myself, that it can scarce ever happen, for the reason I gave in the former Chapter. But nevertheless, if it by any means chance to happen, yet can it not be a perfect Luxation, but an imperfect one; the Jaw being only but a little thrust back to the throat to those mammillary additaments. And then it may easily be restored by lifting or drawing forth the Jaw, and suddenly forcing it from below upwards. CHAP. XI. Of the Luxation of the Collar-bone. AS the Collar-bones may be broken, wrested and crooked, so also they Differences of the luxated Collar-bones. may be dislocated. Now they are dislocated, either against the sternum, or against the shoulderblade, or acromion thereof: yet both these kinds of dislocations are very rare, by reason of the straight and firm connexion which the Collar-bone hath with the foresaid parts; but chiefly where it is joined to the sternum, it can scarce be depressed, for that it is as it were underpropt with the first rib. But it may be dislocated inwardly, outwardly, The Cure. and side-wise, and according to this variety there must be divers ways to restore it; yet generally the Collar-bone is put into its place by moving or extending the arm. But if need require, the Patient shall be laid upon the ground with his face upwards, a trey with the bottom upwards, a hard stuffed Cushion, or the like thing being put under his shoulders: for thus it will so come to pass, that the shoulder and chest will stand so forth, that presently by lifting up, by pressing down, or drawing forth the arm forwards or backwards, as the bone shallbe flown out to this or that part, you may restore it; for thus the prominency may be forced into its cavity. But it will be requisite to bind it up, and lay bolsters thereon, and to give it rest, as if it were fractured. Galen writes; that when he was five and thirty years old, whilst he exercised himself in the place of Exercise, his Collar-bone was so far Com. ad. sent. 62. sect. 1. de art. separated from the Acromion, that there was the space of three fingers between them. And that this Luxation was restored in forty days space, by so straight and strong a Ligation, that he perceived the motion of the beating arteries under the bone. But you shall find very few, who will suffer such strain ligation so long, though it be never so necessary. Verily, this kind of Luxation is hard to be known, but far more difficult to be healed. I have known many Surgeons deceived, who have taken the Luxation of the Collar-bone for the dislocation of the top of the shoulder. For then the Epomis or top of the shoulder swells, and the place from whence the Collar-bone is flown, is depressed with a manifest cavity, with vehement pain, inflammation, and impotency of lifting up, or otherwise moving the arm, or performing other actions which are done by the help of the shoulder. Certainly, if this bone, when it is dislocated, be not set, the Patient shall be lame during his life, so that he shall not be able, neither to put his hand to his head nor mouth. CHAP. XII. Of the Luxation of the Spine, or Backbone. THe Backebone consists of many bony vertebrae, like rolls or wheels mutually jointed or knit together, by their smoothness and circular An anatomical description of the Spine. form conspiring to an aptness of moving or bending forwards. For if it should consist of one bone, we should stand continually with the trunk of our bodies immovable, as thrust thorough with a stake. The vertebrae have a hole passing through the midst of them, whereby the marrow, passing this way out from the brain as by a pipe, may serve for the generation of the sensitive and motive nerves, and their distribution into all parts beneath the head. For which purpose it is perforated with many holes on the sides, through each whereof certain conjugations of the nerves pass forth into the rest of the body, and veins and arteries pass in for the propagation of nourishment and life. The whole exterior face of the Spine is rough, and as it were armed with four sorts of apophyses or The variety of the processes of the Spine. processes, whereof some stand up, others down; some direct, others transverse. Wherefore from these thorny and sharp processes, the whole hath acquired the name of the Spina. The vertebrae the further from the neck they are, the greater they grow, so that those which are the lowest, are the largest: for it is agreeable to reason, that that which bears, should be bigger than that which is borne. Hence we see, that the Holybone is placed under the rest as a foundation. The side processes Gal. cap. 7. lib. 13. de usu partium. of the Rackbones of the Chest, besides the benefit of defending the spinal marrow shut up therein from external injuries, have also another, which is, they firm and fasten the bones of the ribs by a strong tie. There lies a gristle, and a ●ough, and (as it were) albuminous humour between the vertebrae, which makes them, as also all the other joints of the body, slippery, and fit for motion: the Spine is flexible with notable agility forwards only, but not backwards, for that so there would be continual danger of breaking the Hollow ascendent vein, and the great descending artery running thereunder. Therefore the dearticulations of the vertebrae, mutually strengthened with strong ligaments, do look more backwards. I have thought good to premise these things of the nature of the Spine, before I come to the Dislocations happening thereto: I willingly omit divers other things which are most copiously delivered by Galen, content only to add thus Lib. 13. de usu partium. much; That there is nothing to be found in the whole structure of Man's bones, which more clearly manifests the industry of God's great workmanship, than this composure of the Spine and the vertebrae thereof. CHAP. XIII. Of the Dislocation of the Head. THe head stands upon the neck knit by dearticulation to the first vertebra The connexion of the head with the first Rackbone of the neck thereof, by the interposition of two processes which arise from the basis thereof, near the hole through which the marrow of the brain passes down into the back bone, and they are received by fit cavities, hollowed in this first vertebra These processes sometimes fall out of their cavities, Prognostic and cause a dislocation behind, whereby the spinal marrow is too violently and hard compressed, bruised and extended, the chin is fastened to the breast, and the Patient can neither drink nor speak: wherefore death speedily follows upon this kind of Luxation, not through any fault of the Surgeon, but by the greatness of the disease, refusing all cure. CHAP. XIV. Of the Dislocation of the vertebrae, or Rackebones of the neck. THe other vertebrae of the neck may be both dislocated and strained. Dislocation verily, unless it be speedily helped, brings sudden death: The danger hereof. for, by this means the spinal marrow is presently oppressed at the very original thereof, and the nerves, there-hence arising, suffer also together therewith, and principally those which serve for respiration; whereby it cometh to pass, that the animal spirit cannot come and disperse its self into the rest of the body lying thereunder; hence proceed sudden inflammation, the squinsy, and a difficulty, or rather a defect of breathing. But a strain or incomplete Signe●… sympto●… their 〈…〉 tion. Luxation brings not the like calamity: by this the vertebrae, a little moved out of their seats, are turned a little to the hind or fore part, than the neck is wrested aside, the face looks black, and there is difficulty of speaking and breathing. Such, whether dislocation or strain, is thus restored. The Patient must be set upon The Cure. allow seat, and then one must lean and lie with his whole weight upon his shoulders; and the mean while the Surgeon must take the Patient's head, about his ears, betwixt his hands, and so shake and move it to every part, until the vertebra be restored to its place. We may know it is set by the sudden ceasing of the pain, which Signs of their restitution. before grievously afflicted the Patient, and by the free turning and moving his head & neck every way. After the restoring it, the head must be inclined to the part opposite to the Luxation, and the neck must be bound up about the dearticulation of the shoulder; but yet so, that the ligature be not too straight, lest by pressing the weazon and gullet, it straiten the passages of breathing and swallowing. CHAP. XV. Of the Dislocated Vertebrae of the Back. THe Rack bones of the back may be dislocated inwards, outwards, to the Differences and signs. right side, and to the left. We know they are dislocated inwards, when as they leave a depressed cavity in the spin; outwardly, when they make a bunch on the back; and we know they are luxated to the right or left side, when as they obliquely bunch forth to this or that side. The vertebrae are dislocated by a Causes. cause either internal, or external, as is common to all other Luxations; the internal is either the defluxion of humours from the whole body, or any part to them and their ligaments; or else a congestion proceeding from the proper and native weakness of these parts; or an attraction arising from pain and heat. The external is a fall from high upon some hard body, a heavy and bruising blow, much and often stooping, as in Dressers and Looker's to Vineyards, and Paviers, decrepit old men; and also such, as through an incurable dislocation of the Thighbone, are forced in walking to stoop down, and hold their hand upon their thigh. But a vertebra cannot be forced or thrust inwards, unless by a great deal of violence; The danger of a vertebra dislocated inwards. and if it at any time happen, it is not but with the breaking of the ties and ligaments, for they will break rather than suffer so great extension. Such a dislocation is deadly, for that the spinal marrow is exceedingly violated by too straight compression, whence proceeds dulness, and loss of sense in the members lying thereunder. Neither is restitution to be hoped for, because we cannot through the belly Hipp. sent. 51. sect. 3. de art. & Gal. in come. force it into its place: the urine is then suppressed, as also the excrements of the belly; sometimes on the contrary, both of them break forth against the Patient's mind, the knees and legs grow cold, their sense and motion being lost. Such things happen more frequently, when the spin is luxated inwards, than when it is dislocated outwards, for that the nerves, thence arising, run and are carried more inwardly into the body. Besides, the pressed spinal marrow becomes inflamed; and that being inflamed, the parts of the same kind, and such as are joined thereto, are also inflamed by consent, whence it happeneth, that the bladder cannot cast forth the urine. Now where the sinews are pressed, they can no more receive the irradiation of the animal faculty. Hence follows the deprivation of the sense and motion in the parts whereto they are carried, therefore the contained excrements do no more provoke to expulsion by their troublesome sense, neither are pressed to keep them in; thence proceeds their suppression, and hence their breaking forth against their wills. But the spin outwardly dislocated, scarce causes any compression of the marrow or nerves. CHAP. XVI. How to restore the Spine outwardly dislocated. THe vertebrae outwardly dislocated, when as they stand bunching forth, than it is fit to lay and stretch forth the Patient upon a table, The cure. with his face downwards, and straight to bind him about with towels under the armpits, & about the flanks and thighs. And then to draw and extend, as much as we can, upwards and downwards, yet without violence: for unless such extension be made, restitution is not to be hoped for, by reason of the processes and hollowed cavities of the vertebrae, whereby, for the faster knitting, they mutually receive each other. Then must you lie with your hands upon the extuberancie, and force in the prominent vertebrae. But if it cannot be thus restored, then will it be convenient to wrap two pieces Another manner of cure. of wood, of four fingers long, and one thick, more or less, in linen clothes, and so to apply one on each side of the dislocated vertebrae, and so with your hands to press them against the bunching forth vertebrae, until you force them back into their seats, just after the manner you see it here delineated. In the mean while have a care, that you touch not the processes which stand up How to keep the restored vertebrae in their places. in the ridge of the Spine, for they are easily broken. You may know that the vertebrae are restored by the equal smoothness of the whole Spine. It is fit, after you have restored it, to bind up the part, and lay splints or plates of Lead neatly made for that purpose upon it; but so, that they may not press the crists or middle processes of the vertebrae, which I formerly mentioned, but only the sides: then the Patient shall be laid upon his back in his bed, and the splints long kept on, lest the vertebrae should fall out again. CHAP. XVII. A more particular inquiry of the Dislocation of the Vertebrae, proceeding from an internal cause. THe vertebrae are in like sort luxated by the antecedent cause, as we have formerly said, which is caused by the natural imbecility of the parts, principally of the nervous ligament, by which all the vertebrae are bound each to other; this ligament comes not to the spinal marrow, but only binds together the vertebrae on their outsides. For, besides the two membranes proceeding from the two Meninges of the Brain, wherewith the marrow is covered, there is a third strong and nervous coat put upon it, lest; whilst the spin is diversely bended, the bended marrow should be broken. This third coat arises from the pericranium, as soon as it arrives at the first vertebrae of the neck. Now that Ligament, wherewith we said the joints of the vertebrae were mutually knit and fastened, is encompassed with a tough and glutinous humour for the frecer motion of the vertebrae. Sometimes another cold, crude, gross and viscide humour, confused and mixed herewith by great defluxions and catarrhs, begets a tumour, which doth not only distend the nerves proceeding forth of the holes of the vertebrae, but also distends the ligaments wherewith they are bound together: which so distended, and (as it were) drawn aside, do draw together with them the vertebrae, one while towards the right side, another while to the left, somewhiles inwards, otherwhiles outwards, and thus move them out of their seats, and dislocate them. A dislocated vertebra, standing forth and making a bunch, is termed in Greek Cyphosis, (Those thus affected we may call, Bunch-backed.) But when it is depressed, it is named Cyphosis. Lordosis. Scoliosis. Lordosis, (Such we may term, Saddle-backt.) But when the same is luxated to the right or left side, it maketh a Scoliosis (or Crookedness,) which wresting the spin, draws it into the similitude of this letter S. Galen adds a fourth default of the Com. add sent. 2. sect. 3. lib. 〈◊〉 art. vertebrae, which is, when their joints are moved by reason of the looseness of their ligaments, the vertebrae yet remaining in their places, and he calls it a Seisis (or shaking). They also note another defect peculiar to the spinal marrow, which is, when Seisis. as it (the vertebrae being not moved whereto it adheres) is plucked and severed from The separation of the spinal marrow from the encompassing vertebrae. them: this disease is occasioned by a fall from on high, by a great stroke, and by all occasions which may much shake, and consequently depress the spinal marrow, or by any other means remove, or put it forth of its place. Scarce any recovers of this disease, for many reasons, which any exercised in the art, may easily think upon: But let us return to the internal cause of Luxations. Fluid and soft bodies, such as children's, usually are very subject to generate this internal cause of defluxion. If external occasions shall concur with these internal causes, the vertebrae will sooner be dislocated. Thus Nurses, whilst they too straight lace the breasts The error of Nurses in binding and lacing of Children. and sides of girls, so to make them slender, cause the breastbone to east its self in forwards or backwards, or else the one shoulder to be bigger or fuller, the other more spare and lean. The same error is committed, if they lay children more frequently and longupon their sides, than upon their backs; or if, taking them up when they wake, they take them only by the feet or legs, and never put their other hand under their backs, never so much as thinking that children grow most towards their heads. CHAP. XVIII. Prognostics of the Dislocated Vertebrae of the back. IF in Infancy it happen that the vertebrae of the back shall be dislocated, the ribs will grow little or nothing in breadth, but run outwards before; therefore the chest loseth its natural latitude, and stands out with a sharp point. Hence they Hipp. sent. 6. sect. 3. de art. become asthmaticke, the lungs and muscles which serve for breathing, being pressed together and straitened; and that they may the easilier breathe, they are forced to hold up their heads, whence also they seem to have great throats. Now because the weazon being thus pressed, the breath is carried through a straight passage; therefore they whease as they breath, and snort in their sleep, for that their lungs, which receive and send forth the breath or air, be of less bigness: besides also, they are subject to great distillations upon their lungs, whereby it cometh to pass, that they are shorter lived. But such as are bunch-backed below the midriff, are incident to diseases of the kidneys and bladder, and have smaller and slenderer thighs and legs, and they more slowly and sparingly cast forth hair and have beards; to conclude, they are less fruitful, and more subject to barrenness, than such as have their crookedness above their midriff. The Bunches which proceed from external causes are oft times curable; but such as have their original from an inward cause are absolutely uncureable, unless they be withstood at the first with great care & industry. Wherefore such as have it by kind, never are helped. Such as, whilst they are yet Children, before their bodies be come to perfect growth, have their Spine crooked and bunching out, their bodies use not to grow at the Spine, but their legs and arms come to their perfect and full growth; yet the parts belonging to their breasts and back, become more slender. Neither is it any wonder, for seeing Why, when the spin is luxated, the parts belonging to the chest are nourished and grow the less. the veins, arteries, and nerves are not in their places, the spirits do neither freely, nor the alimentary juices plenteously flow by these straitened passages, whence leanness must needs ensue: but the limbs shall thence have no wrong, for that not the whole body, but the neighbouring parts only are infected with the contagion of this evil. When divers vertebrae, following each other in order, are together and Why the Luxation of one vertebra is more dangerous than of many. at one time dislocated, the dislocation is less dangerous, than if one alone were luxated. For, when one only vertebrae is dislocated, it carries the spinal marrow so away with it, that it forces it almost into a sharp angle; wherefore being more straight pressed, it must necessarily be either broken or hurt, which is absolutely deadly, for that it is the brains substitute. But when divers vertebrae are dislocated at once, it must of necessity be forced only into an obtuse angle, or rather a semicircle; by which compression it certainly suffers, but not so, as that death must necessarily ensue thereof. Hereto may seem to belong that which is pronounced by Hypocrates; A circular moving of the vertebrae out of their places is less dangerous Sent. 51. sect. 3. lib. de art. than an angular. CHAP. XIX. Of the Dislocation of the Rump. THe Rump oft times is after a sort dislocated inwards by a violent fall upon the buttocks, or a great blow; in this affect the Patient cannot bring his heel to his buttocks, neither, unless with much force, bend The signe●…. his knee. Going to stool is painful to him, neither can he sit unless in a hollow chair. That this (as it were) dislocation may be restored, you must The C●re. thrust your finger in by the Fundament, even to the place affected, as we have said in a fracture: then must you strongly raise up the bone, and with your other hand at the same time join it rightly on the outside with the neighbouring parts; lastly it must be strengthened with the formerly mentioned remedies, and kept in its place. Now it will be recovered about the twentieth day after it is set. During all which time the Patient must not go to stool, unless sitting upon a hollow seat, lest the bone, as yet scarce well recovered, should fall again out of its place. CHAP. XX. Of the Luxation of the Ribs. THe Ribs may by a great and bruising stroke be dislocated, and fall Cause●. from the vertebrae whereto they are articulated, and they may be driven inwards, or sideways. Of which kind of Luxation, though there be no particular mention made by the Ancients, yet they confess, that all the bones may fall, or be removed from their seats or cavities, wherein they are received and articulated. The sign of a Rib dislocated and slipped on Signs. one side, is, a manifest inequality, which here makes a hollowness, and there a bunching forth; but it is a sign that it is driven in, when as there is only a depressed cavity where it is knit and fastened to the vertebrae. Such dislocations cause divers symptoms, as difficulty of breathing, the hurt rib hindering the free moving of the chest; a painfulness in bowing down, or lifting up the body, occasioned by a pain counterfeiting a pleurisy; the rising or pu●●ing up of the musculous flesh about the rib, by a mucous and flatulent humour there generated: the reasons whereof we formerly mentioned in our Treatise of Fractures. To withstand all these, the Cure. dislocation must be forthwith restored, than the puffing up of the flesh must be helped. Wherefore, if the dislocated. Rib shall fall upon the upper side of the vertebrae, the Patient shall be set upright, hanging by his arms upon the top of some high door or window: then the head of the rib, where it stands forth, shallbe pressed down, until it be put into its cavity. Again, if the rib shall fall out upon the lower side of the vertebra, it will be requisite, that the Patient bend his face do 〈◊〉 wards, setting his hands upon his knees; then the dislocation may be restored by pressing or thrusting in the knot or bunch which stands forth. But if the luxated rib fall inwards, it can no more be restored or drawn forth by the hand of the Surgeon, than a vertebra which is dislocated towards the inside, for the reasons formerly delivered. Gal. Com. add sent. 3. sect. 1. de art. CHAP. XXI. Of a Dislocated shoulder. THe shoulder is easily dislocated, because the ligaments of its dearticulation are soft and loose; as also for that the cavity of the shoulderblade is not very deep; and besides, it is every where smooth and polite, no otherwise than that of the shoulder-bone, for that it is herein received. Add hereunto, that there is no internal Why there is no internal ligament from the armebone to the shoulder blade. ligament from bone to bone, which may strengthen that dearticulation, as is in the leg and knee. Wherein notwithstanding, we must not think nature defective, but rather admire God's providence in this thing; for that this articulation serves not only for extension and bending, as that of the Elbow, but besides, for a round or circular motion, as that which carries the arm round about, now up, then down, according to each difference of site. The shoulder-bone, which Hypocrates calls the Armebone, may be dislocated Differences of a luxated shoulder. four manner of ways; upwards, downwards, or into the Armepit, forwards and outwards, but never backwards, or to the hind part. For, seeing that there the cavity of the blade-bone, which receives the head of the arm-bone, which Hypocrates calls a Joint, lies and stands against it; who is it that can but imagine Sent. 1. sect. 1. lib. de art. any such dislocation? In like sort it is never dislocated inwardly, for on this part it hath the flesh of a strong muscle, termed Deltoides, lying over it, besides also the back and acromion of the Blade, and lastly, the anker-like or beake-like process, all which four hinder this joint from slipping inwards. Now Hypocrates saith, that he hath only seen one kind of Dislocation of this bone, to wit, that which is downwards or to the armepit: and certainly it is the most usual and frequent, wherefore we intent to handle it in the first place. When the shoulder is dislocated downwards into the Armepit, a depressed cavity may be perceived in the upper Signs of the shoulder dislocated downwards. part of the joint; the acromion of the Blade shows more sharp and standing forth than ordinary, for that the head of the shoulder-bone is slipped down, and hid under the armepit, causing a swelling forth in that place; the Elbow also casts itself (as it were) outwards, and stands further off from the ribs; and though you force it, yet can you not make it to touch them; the Patient cannot lift up his hand to his care on that side, neither to his mouth, nor shoulder. Which sign is not peculiar to the luxated shoulder, but common to it, affected with a contusion, fracture, inflammation, wound, abscess, scirrhus, or any defluxion upon the nerves, arising out of the vertebrae of the neck, and sent into the arm: also this arm is longer than the other. Lastly (which also is common to each difference of a luxated shoulder) the Patient can move his arm by no kind of motion without sense of pain, by reason of the extended and pressed muscles, some also of their fibres being broken. There are six ways to restore the shoulder luxated downwards into the armepit. The first is, when it is performed with one's fist, or a towel. The second, The ways to restore it. with a clew of yarn, which put under the armepit, shall be thrust up with one's heel. The third, with ones shoulder put under the Armhole, which manner, together with the first, is most fit for new and easily to be restored luxations, as in those who have loose flesh, and effeminate persons, as children, eunuchs, and women. The fourth, with a ball put under the Armepit, and then the Arm cast over a piece of wood held upon two men's shoulders, or two standing posts. The fifth, with a Ladder. The sixth, with an Instrument, called an Ambi. We will describe these six ways, and present them to your view. CHAP. XXII. Of the first manner of setting a Shoulder, which is with ones fist. FIrst, let one of sufficient strength, placed on the opposite side, firmly hold the Patient upon the joint of the Shoulder, lest he move up and down with his whole body, at the necessary extension, working and putting it in: then let another, taking hold of his arm above the elbow, so draw and extend it downwards, that the head thereof may be set just against its cavity, hollowed in the blade-bone. Then at last let the Surgeon lift and force up Gal. come. ad sent. 23. sect. 1. de art. with his fist the head of the bone into its cavity. Here this is chiefly to be observed, that in fresh luxations, especially in a body soft, effeminate, moist, and not over corpulent, that it sometimes comes to pass, that by the only means of just extension, the head of the bone, freed from the muscles and other particles wherewith it was, as it were, entangled, will betake itself into its proper cavity; the muscles being by this means restored to their place and figure, and drawing the bone with them, as they draw themselves towards their heads, as it were with a sudden gird or twitch: wherefore in many, whilst we thought no such thing, it sufficed for restitution A perfect setting the luxated shoulder by extension only. only to have extended the arm. But if the Luxation be inveterate, and the hand cannot serve, then must the Patient's shoulder be fastened to a Post with the forementioned Ligature, or else committed to one's charge, who may stand at his back, and hold him fast. Then the arm shall presently be tied about, a little above the elbow, with a fillet, whereto a cord shall be fastened; which, being put or fastened to the Pulley, shall be drawn or stretched forth, as much as need shall require. Lastly the Surgeon, with a towel, or such like Ligature, fastened about his neck, and hanging down, and so put under the Patient's armepit near to the Luxation, shall, raising himself upon his feet with the whole strength of his neck, lift up the shoulder, and also at the same time bringing his arm to the Patient's breast, shall set the head of the shoulder-bone, forced with both his hands into its cavity, as you may see by this ensuing figure. An expression of the first manner of putting a Shoulder into Joint. Then must you cover all the adjacent parts with a medicine made ex farina volatili, bolo armenio, myrtillis, pice, resina & alumine, beaten into powder, and mixed with the white of an egg. Then must the hollowness under the arm be filled with a clew of Woollen or Cotton yarn, or a linen cloth spread over with a little oil of Roses or Myrtles, a little vinegar, and unguentum rosatum, or infrigidans Galeni, lest it stick to the hairs, if there be any there. The part must afterwards be bound up with a ligature, consisting of two heads, of some five fingers breadth, and two else long, more or less, according as the body shall require. The midst thereof shall be put immediately under the armepit, and then crossed over the lame shoulder, and so crossing it as much as shallbe fit, it shall be wrapped under the opposite arm. And lastly, the arm shall be laid upon the breast, and put in a scarf, in a middle figure almost to right angles, so that by lifting up the hand he may almost touch his sound shoulder, lest the bone, newly set, may fall out again; neither shall the first dressing be stirred, until four or five days be past, unless the greatness of some happening symptom divert us from this our purpose. CHAP. XXIII. Of the second manner of restoring a Shoulder, that is, with the heel; when as the Patient by reason of pain can neither sit, nor stand. THe Patient must be laid with his back on the ground upon a Cover-lid, or Mat, and a clew of yarn or leathern-ball, stuffed with tow or cotton, Hipp. sent. 12. sect. 1. de art. of such bigness as may serve to fill up the cavity, must be put under his armpit, that so the bone may straightways the more easily be forced by the heel into its cavity. Then let the Surgeon sit beside him, even over against the luxated shoulder; and if his right shoulder be luxated, he shall put his right heel to the ball, which filled up the armepit; but if the left, than the left heel: then let him forthwith draw towards him the Patient's arm, taking hold thereof with both his hands, and at the same instant of time strongly press the armepit with his heel. Whilst this is in doing, one shall stand at the Patients back, who shall lift up his shoulder with a towel, or some such thing fitted for that purpose, and also with his heel press down the top of the shoulderblade: another also shall sit on the other side of the Patient, who, holding him, shall hinder him from stirring this way or that way, at the necessary extension in setting it, as you may see it expressed by the following figure. The expression of the second manner of restoring a Shoulder. CHAP. XXIV. Of the third manner of restoring a Shoulder. SOme one who is of a competent height and strength shall put the sharp part of the top of his shoulder under the Patient's armepit, and also at the same time shall somewhat violently draw his arm towards his own breast, so that the Patients whole body may (as it were) hang thereby. In the mean time another, for the greater impression, shall lay his weight on the luxated shoulder, shaking it with his whole body. Thus the shoulder, drawn downwards by the one which stands under the armhole, and moved and shaken by the other, who hangs upon it, may be restored into its seat, by the help of the Surgeon concurring therewith, and with his hand governing these violent motions, as the following figure shows. The figure of the third manner of putting a Shoulder into Joint. CHAP. XXV. Of the fourth manner of restoring a dislocated Shoulder. YOu must take a perch, or piece of Wood (somewhat resembling that which the Water-bearers of Paris use to put on their shoulders) some two inches broad, and some six foot long; in the midst hereof let there be fastened a clew of yarn, or ball of sufficient bigness to fill up the cavity of the armhole. Let there be two pins put in, one on each side of the ball, each alike distant therefrom, with which, as with stays, the shoulder may be kept in, and upon the ball, that it slip not away from it. Let two strong men, taller than the Patient, either by nature or art, put this perch upon their shoulders; then let the Patient put his armepit upon that place where the ball stands up; the Surgeon must be ready to pull his hanging arm downwards. Thus the Patient shall (as it were) hang on the perch with his shoulder, and so the head of the bone shall be forced into its cavity, as this ensuing Figure declares; wherein you may see the perch or yoke, with the two wooden pins and ball fastened in the midst, delineated by its self. The figure of the fourth manner of restoring the Shoulder. CHAP. XXVI. Of the fifth manner of putting the Shoulder into joint, which is performed by a Ladder. YOu may also restore a Shoulder dislocated into the Armepit, by the help of a Ladder, after the following manner. Let some round body, as a ball, or clew of yarn, which (as we formerly said) may serve to fill the Armepit, be fastened upon one of the upper steps of a Ladder; at the foot of the Ladder set a low stool, whereupon let the Patient mount; then bind both his legs, and also his sound arm behind his back, lest, when you are about your operation, he hinder and spoil all you do, by laying his hand, or setting his foot upon the Ladder. Then let his Arm be presently put over the step of the Ladder, and his Armepit put upon the there fastened bal, the Patient in the mean while being wished to come with his whole body as near unto the steps of the Ladder as he is able; for otherwise, besides that there is no other hope of restoring the Luxation, there would be no small danger of breaking the shoulder-bone. Also let him take heed, that he put not his head between the steps. Then his Arm, bound above the Elbow with fille●●ing, or some other ligature fit for that purpose, shall be drawn down by the hand of some that assist you, and at the same time let the stool be plucked from under his feet, so that he may hang upon the Ladder. Thus by this means the head of the Shoulder will be restored by its self, the endeavour of the Surgeon assisting, and pressing down the shoulderblade, and moving it to and again. The bone being set, the stool, which a little before was plucked from under the Patient's feet, shall be put there again, that he may, with the more ease and less pain, pull back his Arm from the step of the Ladder. For if he should lift it high up to draw it over, there would be danger, lest being newly set, and not well stayed, the head of the bone might fall out again. I have thought good to have all these things here expressed, that you may learn this operation, as if you see it done before you. The delineation of the fifth manner of restoring a Shoulder. I have not thought fit in this place to omit the industry of Nicholas Picart, the Duke of Guise his Surgeon; who being called to a certain Countryman to set his Shoulder being out of joint, and finding none in the place besides the Patient and his wife, who might assist him in this work, he put the Patient, bound after the forementioned manner, to a Ladder; then immediately he tied a staff at the lower end of the Ligature, which was fastened about the Patient's arm above his Elbow; then put it so tied under one of the steps of the Ladder, as low as he could, and got astride thereupon, and sat thereon with his whole weight, and at the same instant made his wife to pluck the stool from under his feet: which being done, the bone presently came into its place, as you may see by the following figure. Another figure expressing the fourth manner of restoring a dislocated Shoulder. Another figure to the same purpose. If you have never a Ladder, you may use a piece of Wood, laid across upon two Posts. Also you may use a door, as the other figure shows, wherein you must observe a flat piece of Wood or spatula with strings thereat, whose use shall be shown in the following Chapter. CHAP. XXVII. The sixth manner of restoring a Shoulder, luxated into the Armepit. HIppocrates writes, that this is the best way of all to restore a dislocated Shoulder. You must take a wooden spatula of some four or five finger's breadth, and some two fingers thickness or less, but some yard Sect. 1. lib. 1. de 〈◊〉. sent. 19 or thereupon long; the one end thereof must be narrow and thin, with a round head standing up and lightly hollowed, that put under the Armepit, it may receive part of the head of the shoulder-bone, the which for that purpose must not bend towards the ribs, but to the top of the Shoulder. This upper part of the spatula must be wrapped about with a linen or woollen rag, The description of the Glossocomium termed Am●i. or some such soft thing, that it may be the softer, and hurt the less; and than it must be so thrust under the Armepit, that it may throughly penetrate into the inner part between the ribs, and the head of the Shoulder-bone. There must, besides in this spatula, be two holes in three several places, each alike distant from other, through which let soft strings be put, whereby it may be tied to the arm, stretched all the length thereof even to the fingers, in one place a little below the head of the shoulder-bone, in another a little above the elbow, and the third at the wrist, that so they may hold it firm. Therefore let the distances of the holes be fitted to this purpose; but principally you must have a care of this, that the upper part of the spatula reaching beyond the head of the arm, enter even to the innermost Cavity of the armepit; then, a cross pin or piece of wood must be made fast through two posts or a frame, & well fastened thereto, and thereupon the Arm with the spatula must be so put over, that the pin may be under the armepit, the body weighing one way, and the arm another: which being done, the arm must be drawn down one way, and the body another about the pin. Now this cross pin must be put on such a height that the patient may stand on tipp-toes. Now this is the very best way of restoring a shoulder. In stead of two posts or a frame, you may make shift with a ladder, door, beds posts, and such like things as shall be there present. I have heard Henry Arvet, a very good surgeon of Orleans say, that he never attempted this manner of putting into joint a shoulder dislocated into the armepit without good success, unless by chance (which also is noted by Hypocrates) that the flesh is Sect. 1. de art. sent. 21. grown into the cavity, and the head of the bone hath made itself another cavity in the place whereinto it is fallen; for in this case the bone will either not be restored, or else not remain in its place, but fall back notwithstanding into the new hollowed cavity, which serves it in stead of its natural socket or cavity. But I must here admonish young Surgeons, that if the bone be not restored at the first endeavour and onset, that they do not despair and presently desist from their intended operation, but they must wind about, and gently move the joint: for so at the length it will be more easily moved, and enter into the natural cavity. When it is in, it must be bound up with compresses and rulers after the forementioned manner. To the former figures I have thought good to add this, which expresseth the manner of restoring a shoulder luxated into the armepit with a spatula, after the manner Hip. sent. 64. 4. de arti●. of Hypocrates. This spatula fastened with an iron pin to the standing frame may be turned, lifted up, and pressed down at your pleasure. A. shows the wooden spatula. B. The frame or standing posts. Hypocrates his Glossocomium termed Ambi. For the more certain use of this instrument the patient must sit upon a seat which must be somewhat lower than the standing frame, that so the spatula which is How to make use of the Ambi. thrust into the armepit may be the more forcibly depressed, so to force in the head of the shoulder-bone; the patient's feet must also be tied, that he may not raise himself up whilst the Surgeon endeavours to restore it. Now he shall then endeavour to restore it, when he shall have bound the stretched forth arm of the dislocated shoulder unto the spatula, & thrust the one end thereof under the slipped forth head of the shoulder bone, as we have formerly showed; for then by pressing down the other end of the spatula which goes to the hand, the bone is forced into its cavity. You must diligently observe the wooden spatula, which therefore I have caused to be expressed by itself, which Hypocrates calleth Ambi, whose head is a little hollowed where it is noted with this letter B. The whole spatula is marked with this letter A. with three strings hanging thereat, provided for the binding of the arm, that it may be kept steady, as you may perceive by the ensuing figure. The figure of an Ambi fitted to a dislocated shoulder. There are other additions to this Ambi, whose figure I now exhibited to your view, by the invention of Nicholas Picart the Duke of Lorrain's Surgeon, the use and knowledge whereof, bestowed upon me by the inventor himself, I would not envy the studious reader. Another figure of an Ambi with the additaments. AA. Show the two ears, as it were, stops made to hold and keep in the top of the shoulder, lest it should slip out when it is put into the frame or supporter. BB. The frame or supporter whereon the Ambi rests. CC. The pin or axletree which fastens the Ambi to the supporter. DD. Screw-pinnes to fasten the foot of the supporter that it stir not in the operation. EE. The holes in the foot of the supporter, whereby you may fasten the screw-pins to the floor. CHAP. XXVIII. How to restore a shoulder dislocated forewards. IT is seldom that the shoulder is luxated towards the foreside; yet there is nothing so stable and firm in our bodies which may not be violated by a violent assault; so that those bones do also fall out of joint; whose articulations are strengthened for the firmer connexion with fleshly, nervous, gristly and bony stays or bars. This you may perceive by this kind of dislocated shoulder, strengthened as it were with a strong wall on every hand; to wit, the Acromium and the end of the collar bone, seeming to hinder it, as also the great and strong muscles, Epomis and Biceps. Hypocrates, shut up within the straight bounds of the Com. ad sen. 〈◊〉 & 23. sect. 1 de articulis. lesser Asia, never saw this kind of dislocation, which was observed fivetimes by Galen. I profess I have seen it but once, and that was in a certain Nun, which weary of the Nunnery, cast herself down out of a window, and bore the fall and weight of her body upon her elbow, so that her shoulder was dislocated forewards. This kind of dislocation is known by the depravation of the conformation or figure Signs. of the member, by the head of the shoulder wrested out towards the breast, as also the patient cannot bend his elbow. It is restored by the same means as other Cure. luxations of other parts, to wit, by straight holding, extending, and forcing in. Therefore the patient must be placed upon the ground with his face upwards, and then you must extend the shoulder otherwise than you do when it is luxated into the armepit. For when it falleth into the armhole, it is first drawn forewards, then forced upwards, until it be brought just against the cavity whereinto it must enter. But in this kind of luxation, because the top of the shoulder is in the fore parts of the dearticulation shut up with muscles, opened both to the outer, as also to the inner part, you must work to the contrary; to wit, to the hind part. But first of all you must place a servant at the back of the patient, who may draw back a strong and broad Bandage cast about the armepit (such as is the Carchesius, which consists Sent. 23. sect. 1. de art. of two contrary and continued strings) lest that when the arm shall be extended, the shoulder follow: also you must put a clew of yarn to fill up the armepit. Then must you extend the arm, casting another ligature a little above the elbow, and in the interim have a care that the head thereof fall not into the armepit, which may be done both by putting the forementioned clew under the arm, and drawing the head another way; then must you permit, by slacking your extension, the joint freed from the encompassing muscles, to be drawn and forced into its cavity, by the muscles forcible recoiling, as with an unanimous consent, into themselves and their originals, for thus it will easily be restored, and such extension only is sufficient thereto. CHAP. XXIX. Of the shoulder luxated outwardly. THe dislocation also of the shoulder to the outward parts seldom happens; but yet, if it may at any time happen, the extension of the arm will be very difficult, but yet more difficult towards the outward part than towards Signs. the inward; there is a depressed cavity perceived towards the chest; but externally a bunching forth, to wit, in that part from whence the head of the shoulder-bone is fled. For the restoring hereof, the patient must be The cure. laid flat on his belly, and the elbow must be forcibly drawn contrary to that whereto it is fled, to wit, inwardly to the breast; and also the standing forth head of the arm-bone, must be forced into its cavity, for thus it shall be easily restored. But into what part soever the shoulder-bone is dislocated, the arm must be extended and What to be done to hold in the shoulder after it is restored. drawn directly downwards. After the restitution fitting medicines shall be put about the joint. Let there be somewhat put into the armepit which may fill it up, and let compresses or bolsters be applied to that part to which the luxated bone fell; then all these things shall be strengthened and held fast with a strong and broad two headed ligature put under the armepit, and so brought across upon the joint of the shoulder, and thence carried unto the opposite armepit by so many windings as shall be judged requisite. Then the arm must be put and carried in a scarf to right angles, which figure must be observed not only in every luxation of the shoulder, but in each fracture of the arm also, for that it is less painful, and consequently, such as the arm may stand the longest therein without moving. CHAP. XXX. Of the shoulder dislocated upwards. THe head of the shoulder also may sometimes be luxated into the upper part. Which when it happens, it shows itself by bunching forth Signs. at the end of the Collar bone, the hollowness of the armepit is found larger than usual, the elbow flies further from the ribs than when it fell downwards, now the arm is wholly unable to perform the usual actions. It is fit for the restitution of such a luxation, that the Surgeon stoop down, and put his shoulder under the patient's arm, and then stand up as high as he can upon his feet, Cure. and therewithal press down the head of the shoulder-bone into the cavity, or else make some other to do it. Otherwise it is fit to lay the Patient upon his back on the ground, and whilst some one extends the affected arm by drawing it downwards, the Surgeon with his own hand may force down the head of the bone into its cavity. The operation performed, the same things shall be done as in other luxations, compresses being applied to that part whereto the bone flew, and it being also bound up with ligatures. Now you may understand in these four forementioned kinds of dislocations, that the bone which was luxated is restored, by the sound which shall be heard as you force it in, by the restitution of the accustomed actions, which are perceived by the bending, extending, and lifting it up, by the mitigation of the pain, and lastly by the collation and comparing of the affected arm with the sound, and by its similitude and equality therewith. CHAP. XXXI. Of the dislocation of the Elbow. THe Elbow may also be four manner of ways dislocated, to wit, inwardly, The Author seems not to agree with Hipp. Sent. ult. Sect. 3. fract. and Celsus in the setting down the kinds of a dislocated Elbow. outwardly, upwards and downwards. By the part which is inwards, I mean that which looks towards the centre of the body, when as the arm is placed in a natural site, to wit, in a middle figure between prone and supine; I make the outward part, that which is contrary thereto. By the upper part I mean that which is towards the heaven, and by the lower that which is next to the earth: and by how much the joint of the elbow consists of more heads and cavities, than that of the shoulder, by so much when it is luxated it is the more difficultly set, and it is also more subject to inflammation, and to grow hard thereupon, as Hypocrates saith. Now the joint of the elbow is more difficultly dislocated than that of the shoulder, and more hardly set, for that the bones of the cubit and arm do receive and enter each other by that manner of articulation which is termed Ginglymus, as we have formerly more at large treated in our Anatomy, and a little before in our treatise of fractures. The Elbow is therefore dislocated, for that the processes thereof are not turned about the shoulder-bone in a full orb, and by an absolute turning. Wherefore if at any time the cubit be bended more straight and closely than that the inner process can retain its place and station in the bottom of its sinu●, the hind process falleth out and is dislocated backwards. But when as the foreprocesse is extended more violently, and forced against the bottom of its cavity, it flies and departs out of its place as beaten or forced thence, and this kind of luxation is far more difficultly restored than the former: add hereunto that the utter extremity of the cubite, which is called Olecranum, is the higher, but the other inner is The Author doth not agree with Hypocrates and Celsus, in setting down the notes of these dislocations: for those notes which are here attributed to an outward and inward luxation, these Celsus hath given to an elbow dislocated towards the fore and out part; and those which are here attributed to the elbow dislocated upwards & downwards; those Celsus hath attribured to a dislocation to the out and insides. Inflammation hinders reposition. the lower; whence it is that every one can better and more easily bend than extend their cubits. Therefore such a dislocation is caused by a more violent force, than that which is made to the inner side. The sign of this luxation is, the arm remains extended, neither can it be bended, for the inner process stays in the external cavity, which is hollowed in the bottom of the shoulder-bone, which formerly was possessed by the inner part of the Olecranum; which thing makes the restitution difficult, for that this process is kept, as it were, imprisoned there. But when it falleth out dislocated to the fore part, the arm is crooked, neither is it extended, and it is also shorter than the other. But if the elbow be fallen out of its place according to the other manner of dislocations, to wit, upwards or downwards, the natural figure thereof is perverted, for the arm is stretched forth, but little notwithstanding bended towards that part from whence the bone went, that is, figured after a middle manner between bending and extending thereof. What kind soever of dislocation shall befall it, the action of the Elbow will either not be at all, or certainly not well until that it be restored to its former place; there is a swelling in the part wherinto it is flown, and a cavity there from whence it is fled, which also happens in the dislocations of all other parts. Furthermore, one dislocation of the Elbow is complete and perfect, another imperfect. The latter as it easily happens, and through a small occasion, so it is easily restored; but on the contrary a perfect, as it hardly happens, and not unless with great violence, so it is not so easily restored again, especially if that you do not prevent inflammation, for being inflamed it makes the restitution either difficult, or wholly impossible, principally that which falleth outwards. CHAP. XXXII. How to restore the Elbow, dislocated outwardly. YOu may know that the elbow is dislocated outwardly, if at any time you Sign. shall observe the arm to be distended, and not able to be bended. Wherefore you must forth with undertake the restitution thereof, for fear of defluxion and inflammation, which the bitterness of pain usually causeth, upon what part soever the luxation happen. There is one manner of restoring it, Cure. which is, you must cause one to hold hard and steady the patients arm a little under the joint of the shoulder, and in the mean while let the Surgeon draw the arm, taking hold thereof with his hand, and also force the shoulder-bone outwards, and the eminency of the cubit inwards, but let him by little and little draw and extend the arm, wresting it gently this way and that way, that he may bring back the bone which fell out into its cavity. I have thus expressly delivered this, that the young Surgeon may understand, that the arm must not be bended for the restoring of this kind of dislocation; for restitution cannot so be hoped for, because by this kind of A Caution. luxation the inner process of the cubit possesseth the place of the exterior process in the cavity of the shoulder-bone. Wherefore, whilst the arm is bended or crooked, the cubit is only lifted up, and not drawn into its seat. But if we cannot attain to the restitution thereof with our hands alone, you must cause the dislocated arm lightly bended to embrace a post, then must the end of the cubit called Olecranum be tied or bound about with a strong ligature or line, and then wrested into its cavity by putting a battoon or staff into the ligature, as is demonstrated by this ensuing figure. A figure which shows the way how to restore the Elbow, by putting it about a post, with a battoon. A figure which shows how to restore the elbow by only casting a line about it. There is also another more exquisite way of restoring it, which is expressed by the latter figure, wherein a line of some inch breadth is cast about the Olecranum of the arm, embracing a post or pillar, and it is drawn so long, until the dislocated bone be brought into its seat. Now we know that the bone is returned into its place, and restored, when the pain ceaseth, and the figure and whole natural conformation is restored to the arm, and the bending and extending thereof is easy, and not painful. CHAP. XXXIII. Of the dislocation of the Elbow to the inside, and of a complete and uncompleat luxation. IF the Elbow be dislocated to the inner part, the arm must be strongly and powerfully extended, then bended quickly and with sudden violence, The cure. so that his hand may smite upon his shoulder. Some put some round thing into the bought of the Elbow, and upon that do suddenly force the Elbow to the shoulder, as we have formerly said. If the Cubit bone be only lightly moved out of its place into the upper or lower place, it is easily restored by drawing and forcing it into its cavity, after this following manner. Let two extend the arm, taking hold thereof at the shoulder and wrest, and each draw towards himself; and also the Surgeon (who shall there be present) shall force the bone which is dislocated from that part whereunto it is bended, unto the contrary: after he shall thus have restored it, he shall lay the arm in a strait angle, and so bind it up, and apply fit medicines formerly mentioned, and so let him carry it in a scarf put about his neck, as we said in the dislocation of the shoulder. Hypocrates Sent. 63. sect. 3. defract. bids, that the patient, after it is set, shall often endeavour to bend his hand upwards and downwards, and also extend and bend his arm, yea, and also to attempt to lift up some heavy thing with his hand; for so it will come to pass, that the ligaments of this joint may become more soft, ready, and able to perform their accustomed functions, and also the bones of the cubite and shoulder shall be freed from the affect termed Ancylosis, whereto they are incident by the luxations of this part. Now Why the elbow is most subject to Ancylosis. Ancylosis is a certain preternatural agglutination, co-agmentation, and as it were union of sundry and several bones in the same joint, which afterwards hinders the bending and extension thereof. Now, a Callus is generated in the Elbow sooner than in any other articulation, whether it remaineth out, or be put into joint, by reason that by rest and cessation from the accustomed actions, a viscide humour which is placed naturally in the joints, as also another which is preternatural, drawn thither by pain, floweth down, and is hardened, and glueth the bones together, as I have observed in many, by reason of the Idleness and too long rest of this part. Wherefore, that we may withstand this affect, the whole ligation must be loosed sooner and oftener than otherwise, that is to say, every third day, and then the patient's arm must be gently moved every way. Within the space of twenty, or twenty five days, these restored bones recover their strength, sooner or later, according to the happening accidents. It is necessary also that the Surgeon know that the Radius or Wand sometimes falleth out when the cubite or el is wholly dislocated; wherefore he must be mindful in setting the cubit, that he also restore the Wand to its place; in the upper part it hath a round process lightly hollowed, wherein it receiveth the shoulder-bone: it hath also an eminency which admitteth the two-headed muscle. CHAP. XXXIV. Of the dislocation of the Styliformis or bodkin-like process of the cubit or ell. THe process of the Ell called Styloides, being articulated to the wrest by Diathrosis, by which it is received in a small cavity, is dislocated, and falleth Differences and causes. out sometimes inwards, somewhiles outwards. The cause usually is the falling of the body from high upon the hands. It is restored, if that you force it into its seat, diligently bind it, & apply thereto very astringent & drying medicines. But yet, though you shall diligently perform all things which may be Cure. done in dislocations, yet you shall never so bring it to pass that this bone shall be perfectly restored, and absolutely put into the place where hence it went: which thing we have read, observed by Hypocrates; when (saith he) the greater bone, to wit the Ell, is removed from the other, that is the wand, it is not easily restored to its Sent. 1. sect. 2. & sent. ult. sect. 3. de fract. own nature again; for that, seeing that neither any other common connexion of two bones, which they call Symphysis or union, when it is drawn asunder and destroyed, may be reduced into its former nature, by reason these ligaments wherewith they were formerly contained, and as it were continued, are too violently distended and relaxed, whence it happens, that I have in these cases often observed, that the diligence and care of the Surgeon hath nothing availed. CHAP. XXXV. Of the dislocation of the Wrest. We understand by the wrist, a certain bony body, consisting of a composure of eight bones knit to the whole cubit by Diarthrosis. For the wrest considered wholly in its self, is knit and articulated Here, as before chap. 31, the Author dissents from Celsus and Hypocrates in expressing the names and signs of these dislocations. with the Ell & wand: with that, against the little finger; with this, against the thumb: for thus as it were by two connexion's, the joint is made more firm. Yet may it be dislocated inwardly, outwardly, & towards the sides. We say it is luxated inwardly when the hand stands upwards, but outwardly, when it is crooked in & cannot be extended. But if it chance to be dislocated sidewayes, it stands awry either towards the little finger, or else towards the thumb, as the luxation befalls to this or that side. The cause hereof may seem to depend upon the different dearticulation of the Ell and wand with the hand or wrest. For the wand, which is articulated on the lower part with the wrist at the thumb, by its upper part, whilst it receives the outward swelling or condyle of the Ell in its cavity, performs the circular motions of the hands. But the cubit or ell, which in like sort is connected on the lower part by Diarthrosis at the little finger with the wrist, being articulated on the upper part with the shoulder-bone bends and extends, or stretches forth the hand. There is one way to restore the formerly mentioned dislocations. The arm on one side and the hand on another must be extended upon a hard resisting and smooth place, so that it may lie flat; and you must have a care that the part whence the dislocated bone fell be the lower in its site and place, and the part whether it is gone, the higher. Then to conclude, the prominencies of the bones must be pressed down by the hand of the Surgeon, until by the force of compression and site the luxated bones be thrust and forced into their places and cavities. CHAP. XXXVI. Of the dislocated bones of the Wrest. THe wrist consists of eight bones, which cannot unless by extraordinary violence be put or fall out of their places. Yet if they shall at any time fall out, they will show it by the tumour of the part whereto they are gone, Sign. and by the depression of that wherefrom they are fled. They may be restored, if the diseased hand be extended upon a table; and if the bones shall be dislocated inwards, the hand shall be placed with the palm upwards, than the Surgeon shall, with the palm of his hand, press down the eminencies of the Cure. bones, and force each bone into its place. But if the luxation be outwards, he shall lay the palm next to the table, and press it after the same manner. To conclude, if the luxation shall be toward either side, the luxated bones shall be thrust towards the contrary, and the restored bones shall be presently contained in their places with fit remedies, binding, rolling, and carrying the hand in a scarf. CHAP. XXXVII. Of the dislocated bones of the Afterwrest. THere are four bones in the Palm or Afterwrest, the two middlemost Celsus lib. 〈◊〉. Cap. 18. whereof cannot be dislocated sidewayes, because they are hindered and kept from falling aside by the opposition of the parts, as it were resisting them. Neither can that which answereth to the little finger, nor that whereon the forefinger rests, be dislocated towards that side which is next the middle bones, whereof we now spoke, but only on the other side, freed from the neighbourhood of the bones: but all of them may be dislocated inwardly and outwardly. They may be restored as those of the Wrest. CHAP. XXXVIII. Of the dislocated Fingers. ALso the bones of the fingers may be four several ways dislocated, in Why the dislocated fingers may be easily restored. wardly, outwardly, and towards each side. To restore them, they must be laid strait upon a table, and so put into joint again. For thus they may be easily restored, by reason their sockets are not deep, and their joints are shorter, and ligaments less strong. In twelve days space they will recover their strength, as also those dislocations that happen to the Wrest and Afterwrest. CHAP. XXXIX. Of a dislocated Thigh or Hipp. THe Thigh or Hipp may be dislocated, and fall forth towards all the four Hip. sent. 68 sect. 3. de art. parts. But most frequently inwards, next to that outwards, but very seldom either forwards or backwards. A subluxation cannot happen in this joint, as neither in the shoulder, especially from an external cause, contrary to which it usually happens in the elbow, hand, knee, and foot. The cause hereof is, for that the heads of the thigh and shoulder-bone are exactly round, and the sockets which receive them have certain borders and edges encompassing them: Gal. come. ad sent. 47. sect. 4. de art. hereunto may be added, that strong muscles encompass each dearticulation, so that it cannot come to pass that part of the heads of such bones may be contained in the cavity, and other parts stand or fall forth, but that they will quickly be restored to their places by the motion and wheeling about of the joint, and the strength of the A subluxation may befall the Thigh from an internal cause. encompassing muscles. But a subluxation may seem to happen in these parts from an internal cause. For then the ligaments and ties being softened and relaxed, cannot draw and carry back the head of the bone standing forth so far as the edges of the socket. If the Hip be dislocated towards the inner part, that leg becomes longer and larger than the other, but the knee appears somewhat lower, and looks outwardly with the whole foot, neither can the patient stand upon his leg. To conclude, the head of the Thighbone betrays itself lying in the groin, with a swelling manifest both to the eye and hand; now the leg is longer than that which is sound, for that the head of the thigh is out of its socket or cavity, and situated lower, to wit, in the groin, therefore the leg is made by so much the larger. Now the knee stands forth, because necessarily the lower head of the thighbone stands contrary to the socket. For this is common to all dislocated bones, that when as the dislocation happens towards the one side, the other end of the bone flies out to the contrary. Whence it is, that if the upperhead of the Thighbone shall fall inwards, than the other head, which is at the knee, must necessarily look outwards. The like happens in other dislocations. The leg cannot be bended towards the groin, for that the dislocated bone holds the extending muscles of the same part so stiffly stretched out, that they cannot yield, or apply themselves to the benders. For flexion or bending aught to precede extension, and extension flexion. CHAP. XL. Prognostics belonging to a dislocated Hipp. THere is this danger in the dislocations of the Hipp, that either the bone Why the thighbone dislocated is difficultly restored, or restored easily falls out again. cannot be put into the place again, at least unless with very much trouble, or else being put in, that it may presently fall out again. For if the tendons of the muscles, the ligaments, and other nervous parts of the member be hard and strong, they by reason of their contumacy and stiffness will hardly suffer the bone to return to its place. If that they be soft, loose, effeminate and weak, they will not contain the restored bone in its place. Neither will it be any better contained, if that short, but yet strong and round, ligament, which fastens the head of the Thighbone on the inside in the Socket or Cavity of the huckle bone, be broken or relaxed. Now it may be broken by some violent shock or accident, it may be relaxed by the congestion and long stay of The breaking and relaxation of the internal ligament. some excrementitious, tough, and viscous humour lying about the joint, through which means it waxeth soft. But if it be broken, how often soever the bone be restored, it will presently fall out again. If it be relaxed, there is only this hope to contain the restored bone, that is, to consume and draw away the heaped up humidity by application of medicines and Cauteries of both kinds, for which purpose those are more effectual which do actually burn, for that they dry and strengthen more powerfully. Leanness of the body, and the want of aponeurosis, that is, of Gal. come. ad sent. 42 sect. 4. de art. broad tendont and external ligaments, whereof many encompass the knee, increases the difficulty of containing it in the place. But the parts adjoining to the dislocated & not set bone fall away by little & little, and consume with an Atrophia or want of nourishment; both because the part itself is forced to desist from the accustomed actions and functions, as also for that the veins, arteries, and nerves being more straitened and put out of their places, hinder the spirits and nourishment from flowing so freely as they ought, to the part: whence it comes to pass, that the part itself made more weak, the native heat being debilitated through idleness, it can neither attract the alimentary juice, neither can it digest & assimilate that little thereof which flows and falleth thereto. Verily the Thighbone, as long as it is forth of the cavity, grows no more, after the manner as the other bones of the body do, and therefore in some space of time you may perceive it to be shorter than the sound bone. Notwithstanding the bones of the leg and foot are not hindered of their growth, for that they are not out of their proper places. Now for that the whole leg appears more slender, you must think that happens only by the extenuation & leanness of the proper muscles thereof. The same thing happens to the whole hand, in the largest acception, when as the shoulder is out of joint, unless that the calamity and loss hereof is the less. For the shoulder being forth of joint you may do something with your hand, whereby it will come to pass that no small portion of nourishment may flow down into these parts. But the Thighbone being dislocated, especially inwards in a child unborn, or an infant, much less alimentary nourishment flows to that part, because it can much less use the foot and leg by reason of the dislocation of the Hipp, than it can do the hand by a luxation of the shoulder. But now we must thus understand that which is said by Hypocrates, That dislocated bones and not restored do decrease or are hindered from their just growth, to be Hypocrates explained sect. 1. & 〈◊〉. lib. de art. only in those who have not yet attained to their full and naturally appointed growth in every dimension. For in men of full growth, the bones which are not restored, become more slender, but yet no shorter, as appears by that which he hath delivered of the shoulder. CHAP. XLI. Of the signs of the Hipp, dislocated outwardly or inwardly. THe thighbone or Hipp when it is dislocated outwardly, and not restored, after some time the pain is assuaged, and flesh grows about it, the head of the bone wears itself a new cavity in the adjoining Hipp, whereinto it betakes itself, so that at the length the patients may go without a staff, neither so deformed a leanness will waste their leg. But if the luxation happen inwards, a greater leanness will befall them, by reason that the vessels naturally Ad sent. 51. sect. 3. de art. run more inwardly, as Galen observes in the dislocation of the Vertebrae to the inside; therefore it comes to pass that they are more grievously oppressed: besides the thighbone cannot wag or once stir against the share-bone: wherefore if the bone thus dislocated be not restored to its joint again, than they must cast their leg about as they walk, just as we see oxen do. Wherefore the sound leg whilst they go, takes much less space than the lame, because this, whilst it stirreth or moveth, must necessarily fetch a compass about, but that performeth its motion in a right line. Besides, whilst the patients stand upon their lame leg to put forwards the sound, they are forced to stand crooked, whereupon they are forced to stay themselves with a staff that they fall not. Furthermore those who have this bone dislocated either backwards or outwards, Signs of the thighbone dislocated out-wards. so that it cannot be restored, have the part itself grow stiff and hard; which is the cause why the ham may be bended without great pain, and they may stand, and go upon the tops of their toes; besides also, when they desire ●o go faster, they are forced to stoop, and strengthen themselves by laying their hand on their lame thigh at every step, both for that their lame leg is the shorter, as also because the whole weight of the body should not lie wholly or perpendicularly upon the joint or head of the thighbone. Yet in continuance of time, when they are used to it, they may go without any staff in their hands. Yet in the interim, the sound leg becomes more deformed in the composure & figure, because, whilst it succours the opposite and lame leg by the firm standing on the ground, it bears the weight of the whole body, in performance wherereof the ham must necessarily now and then bend. But on the contrary, when as the head of the thigh being dislocated inwards is not put into the joint, if the patient be arrived at his full growth, after that the head of the bone hath made itself a cavity in the neighbouring bone wherein it may rest, he may be able to walk without a staff, because the dislocated leg cannot easily be bended towards the groin or ham, and he will sooner rest upon his heel than upon his toes. This kind of dislocation if it be inveterate, can never be restored. And these things happen, when as the thighbone is dislocated inwards, or when the internal ligament which fastens the dearticulation shall be broken or relaxed. But the contrary shall plainly appear if the dislocation shall happen to be outwards; for then the lame leg becomes the shorter, because the head of the thigh flies into a place higher than its cavity, and the muscles of that part are contracted towards their original, and convulsively draw the bone upwards together with them. The whole leg, together with the knee and foot looketh inwards, they cannot go upon their heels, but upon the setting on of the toes. The leg may be bended, which it cannot be in a dislocation of the thigh inwards, as Paulus shows. Therefore we Paul. Aeg. lib. 6. cap. 8. Hip. sent. 91. sect. 3. lib. de artic. must diligently observe that sentence of Hypocrates which is read with a negative, in these words. Sed neque conflectere quemadmodum sanum crus possunt, that they ought to be read with an affirmative after this manner. Sed conflectere etc. quin & crew ipsum etc. But now the lame leg will better sustain the weight of the body in an external, than in an internal dislocation; for then the head of the thigh is more perpendicularly subject to the whole weight of the body. Therefore when in success of time it shall by wearing have made itself a cavity in the neighbouring bone, which in time will be confirmed, so that there will remain no hope of restoring the dislocation, nevertheless the patient shall be able to go without a staff, for that then no sense of pain will trouble him; whence it follows, that the whole leg also will become less lean, for that going is less painful, neither are the vessels so much pressed as in that dislocation which is made inwardly. CHAP. XLII. Of the thighbone dislocated forewards. IT seldom happeneth that the thigh is dislocated forwards; yet when as it shall happen, it is known by these signs. The head of the thigh lieth towards the share; whence the groins swell up, and the buttock on the contrary is wrinkled and extenuated by reason of the contraction of the muscles; the patient cannot extend his leg without pain, no verily, not so much as bend it towards the groin, for that the fore muscle which ariseth from the haunch-bone, is so pressed by the head of the thigh, that it cannot be distended; neither can the ham be bended without very much pain. But the lame leg is equal at the heel with the other leg, yet the patient cannot stand upon the setting on of the toes; therefore when he is forced to go, he toucheth the ground with his heel only, yea, verily the sole of his foot is less inclined to the fore side, neither doth it seldom happen, that the urine, by this accident, is suppressed; because the head of the thigh oppresses the greater nerves from whence those arise which are carried to the Stopping of urine by reason of an internal dislocation of the thighbone. bladder, which through the occasion of this compression is pained and inflamed by consent: now when inflammation shall seize upon the Sphinct muscle, the urine can scarcely flow out, for that it is hindered by the swelling. CHAP. XLIII. Of the thighbone dislocated backwards. Seldom also is the thighbone dislocated backwards, because the hind part of the cavity of the hucklebone is deeper and more depressed than Signs. the fore; whence it is that the dislocation of the thigh to the inner part is more frequent than the rest. The patient can neither extend nor bend his leg by reason of the much compression and tension of the muscles which encompass the head of the thigh by this kind of luxation. But the pain is increased when he would bend his ham, for that then the muscles are the more strongly extended. The lame leg is shorter than the sound: when the Buttocks are pressed, the head of the thigh is perceived hid amongst the muscles of that part; but the opposite groin is lax, soft, and depressed with a manifest cavity. The heel touches not the ground, for that the head of the thigh is plucked back again by the muscles of the buttocks amongst which it lieth hid, but principally by that which is the larger, and which is said to make as it were the pillow or cushion of the buttocks; for this is much more pressed in this kind of dislocation than the rest: whence it is, that the patient cannot bend his knee, because the extension of the nervous production or large tendon which covers the knee is so great. But if the patient will stand upon the foot of his luxated leg without a staff, he shall fall down backwards, for that the body is inclined to that part, the head of the thigh being not directly underneath for the propping or bearing up of the body; wherefore he is forced to sustain himself upon a crutch on his same side. Having premised these things of the differences, signs, symptoms and prognostics, it now remaineth, that we briefly describe the different ways of restoring them, according to the difference of the parts whither it is fallen. First, you must place the patient upon a bench or table, grovelling, The general cure. or with his face upwards, or upon one side, laying some soft quilt or coverlid under him, that he may lie the easier. Now you must place him so, that the part unto which the bone is flown, may be the higher, but from whence it is fled, the lower. For if the thighbone be dislocated outwards or backwards, then must the patient be laid grovelling; if inwardly, upon his back; if forwards, then upon his side. Then must extension and impulsion be made towards the cavity, that so it may be forced thereinto: but if the dislocation be fresh, & in a soft body, as a woman, child, and such like, whose joints are more lax, it shall not be any ways needful to make great extension with strong ligatures for the restoring it; the Surgeon's hand shall suffice, or a List or towel cast about it. In the interim the bone shall be kept fast with compresses applied about the joint: then the Surgeon shall extend the thigh, taking hold thereof above the knee, in a strait line, and so set it directly against the cavity, and then presently thrust it thereinto. For thus shall he restore it, if so be that in thrusting it, he lift up the head thereof somewhat higher, lest the lips of the cavity force it back, and hinder it from entering. Now because unless there be just extension, there can be no restitution hoped for, it is far better in that part, that is, to extend it somewhat more than is necessary, yet so, that you do not endanger the breaking of any muscles, tendon or other nervous body. For, as Hypocrates Sect. 2. lib. de fract. writes, when as the muscles are strong and large, you may safely extend them, if so be that you displace nothing by the force of the extension. If your hand will not suffice to make just extension, you must use the help of an Engine, such as is our Pulley, fastened to two posts, so much of the rope being let forth, and drawn up again, as shall suffice for the business in hand; in the performance whereof, it is fit that the patient's friends absent themselves from this sad spectacle, and that the Surgeon be resolute, and not deterred from his business by no lamentation, neither of the patient nor his friends. But for that we write these things chiefly for the benefit of young practitioners, it seemeth meet, that having delivered these things in general, of restoring the thighbone, that we run over these generalities in each particular, beginning with that dislocation which is made inwardly. CHAP. XLIV. Of restoring the Thighbone dislocated inwards. IT is fit to place the patient after the foresaid manner, upon a table or bench, in the midst whereof shall stand fastened a wooden pin of a feet length, and as thick as the handle of a spade useth to be; but it must be wrapped about with some soft cloth, lest the hardness hurt the buttocks, betwixt which it must stand, as we read that Hypocrates did in the Sect. 2. lib. de fract. extension of a broken leg. The wooden pin hath this use, to hold the body that it may not follow him that draweth or extendeth it; & that the extension being made as much as is requisie, it may go between the perinaeum & the head of the dislocated thigh. For thus there is no greatneed of counter-extension towards the upper parts; and besides it helpeth to force back the bone into its cavity, the help of the Surgeon concurring, who twining somewhiles to this, & otherwhiles to that side, doth direct the whole work. But when the extension hath need of counter-extension, than it is How to make extension and counter-extension in this kind of fracture. needful you have such ligatures at hand, as we have mentioned in the restoring of a dislocated shoulder, to be drawn above the shoulder. One of these shall be fastened above the joint of the hip, & extended by a strong man; another shallbe cast above the knee by another with the like force. But if you cannot have a wooden pin, another strong & like ligature shallbe put upon the joint directly at the hip, & held stiff by the hands of a strong man, yet so that it may not touch the head of the thigh by pressing it, for so it would hinder the restoring thereof. This manner of extension is common to four kinds of luxation of the thighbone. But the manner of forcing the bone into its cavity, must be varied in each, according to the different condition of the parts whereunto the head inclineth; to wit, it must be forced outwards if it be fallen inwards, and contrary in the rest, as the kind of the dislocation shall be. Some too clownish and ignorant knot-knitters fasten the lower ligature below the ankle, and thus the joints of the foot and knee are more extended than that of the hip or hucklebone, for that they are nearer to the ligature, & consequently to the active force: but they ought to do otherwise; therefore in a dislocated shoulder, you shall not fasten the ligatures to the hand or wrest, but above the elbow. But if the hands shall not be sufficient for this work, then must you make use of engines. Wherefore then Ligatures made for extension must be fastened near the part to be extended. the patient being placed as is fit, and the affected part firmly held, some round thing shall be put into the groin, and the patient's knee, together with his whole leg shall be drawn violently inwards, towards the other leg. And in the mean while, the head of the thigh shall be strongly forced towards the cavity of the hucklebone; and so at length restored, as the following figure shows. A figure which manifesteth the way of restoring the thigh. bone dissocated inwards. When the head of the thigh by just extension is freed from the muscles wherewith A general precept. it was enfolded, and the muscles also extended that they may give way and yield themselves more pliant, then must the rope be somewhat slaked, and then you must also desist from extending, otherwise the restitution cannot be performed, for that the stronger extension of the engine will resist the hand of the Surgeon, thrusting and forcing it into the cavity. This precept must be observed in the restoring of this & other dislocations. You shall know that the thigh is restored by the equality of the legs, by the free & painless extension & inflection of the lame leg. Lastly, by the application of agglutinative medicines (whereof we have formerly spoken) the restored bone shall be confirmed in its place; to which purpose ligation shall be made, the ligature being first cast upon the place whereinto the head of the thigh fell, and thence brought to the opposite or sound side by the belly and loins. In the mean while the cavity of the groin must be filled with somewhat a thick bolster which may keep the head of the bone in the cavity. Neither must you omit junks stretched down even to the ankles, as we have observed in the fracture of the thigh. Then must both the thighs be bound together, whereby the dislocated member may be unmoveable, and more & more strengthened. Neither must this dressing be loosed, until four or five days be passed, unless peradventure the sudden happening of some other more grievous symptom shall persuade otherwise. To conclude, the patient must be kept in his bed for the space of a month, that the relaxed muscles, nerves and ligaments may have space to recover their former strength, otherwise, there is danger left the bone may again fall out by the too forward and speedy walking upon it. For the site of the thigh it must be placed and kept in a middle figure, yet this middle Sect. 2. lib. de fract. figure consists in the extension, not in the flexion, as it is demonstrated by Hypocrates, for that such a figure is familiar and accustomable to the leg. CHAP. XLV. Of restoring the Thigh dislocated outwardly. THE patient must be placed grovelling upon a table in this kind of dislocation also, and ligatures as before, cast upon the hip and lower part of the thigh, than extension must be made downwards, and counter-extension upwards; then presently the head of the bone must be forced by the hand of the Surgeon into its place. If the hand be not sufficient for this purpose, our pulley must be used, as the following figure showeth. A figure which expresseth the manner of restoring the Thigh luxated outwards. This kind of dislocation is the easilyest restored of all these which happen in the When it is that only extension serves for the restoring the dislocated thigh. thigh or hip, so that I have divers tmes observed the head of the thigh to have been drawn back into its cavity by the only regress of the extended muscles into themselves towards their originals, somewhiles with a noise or pop, otherwhiles without, which being done, laying a compress upon the joint, you shall perform all other circumstances as before in an internal dislocation. CHAP. XLVI. Of restoring the Thigh dislocated forewards. WHen the thigh is luxated forewards, the patient must be laid upon his sound side, and tied as we have formerly delivered. Then the Surgeon shall lay a Bolster upon the prominent head of the bone, and have a care that his servant firmly hold it: then immediately just extension being made, he shall with his hand force the bone into the cavity; but if his hand will not serve, he shall attempt it with his knee. Then to conclude he shall use the rest of the things formerly mentioned to contain the restored bone. CHAP. XLVII. Of restoring the Thigh dislocated backwards. THe patient shall be placed grovelling upon a table or bench, and the member extended, as in the rest, one ligature stretched from the groin, another from the knee; then the Surgeon shall endeavour to force back with his hand that which stands up, and also to draw away the knee from the sound leg. The bone thus placed and restored, the cure requires nothing else, than to be bound up and kept long in bed, lest that the thigh, if it should be moved, the nerves being yet more loose, might again fall out, For the thigh is in great danger of relapse, for that the cavity of the Hucklebone is only depressed, as far as it goes in, and the burden of the hanging or adjoining Thigh is heavy. CHAP. XLVIII. Of the dislocation of the Whirle-bone of the knee. THe Whirle-bone of the knee may fall forth into the inner, outer, upper and lower part; but never to the hind part, because the bones which it The differences. covers do not suffer it. To restore it, the patient must stand with his foot firmly upon some even place, and then the Surgeon must force The cure. and reduce it with his hands from the part into which it is preternaturally slidden. When it shall be restored, the cavity of the ham shall be filled up with bolsters, so that he may not bend his leg, for if it be bended, there is no small danger of the falling back of the whirl-bone. Then a case or box shallbe put about it, on the side especially whereto it fell, being made somewhat flat & round resembling the whirl-bone its self, and it shall be bound on with ligatures, and medicines so fast that it may not stir a jot. After the part shall seem to have had sufficient rest, it is fit that the patient try and accustom by little and little to bend his knee, until at length he shall find that he may easily and safely move that joint. CHAP. XLIX. Of the dislocated Knee. THe knee also may be dislocated three manner of ways, that is, into the inner, outer, and hind part, but very seldom towards the foreside and that The differences. not without some grievous and forcible violence; for the Whirle-bone lying upon it, hinders it from slipping out, and holds it in. The other ways are easy, because the cavity of the leg-bone is superficiary and very smooth, but the cavity of the lower end of the thighbone is made in the manner of a spout or gutter, & besides the head thereof is very smooth and slippery; but the whole joint is much more lax than the joint of the Elbow: so that as it may be the more easily dislocated, so may it the better be restored; and as it may be the more easily, so may it Ad●… sect. 3. de fract. be the more safely dislocated, for that inflammation is less to be feared here, as it is observed by Hypocrates. Falls from high, leaping, and too violent running are the causes of this dislocation. The sign thereof is the disability of bending or lifting up the leg to the thigh, so that the patient cannot touch his buttock with his heel. The dislocation of the knee which is inwardly and outwardly is restored with indifferent How to restore a knee dislocated backwards. extension and forcing of the bones into their seats from those parts whereunto they have fallen. But to restore a dislocation made backwards, the patient shall be placed upon a bench of an indifferent height, so that the Surgeon may be behind him who may bend with both his hands & bring to his buttocks the patient's leg put betwixt his own legs. But if the restitution do not thus succeed, you must make a clew of yearn, and fasten it upon the midst of a staff, let one put this into the cavity of his ham, upon the place whereas the bone stands out, and so force it forwards; then let another cast a ligature of some three fingers breadth upon his knee, and draw it upwards/ with his hands, then presently and at once they all shall so bend and crook the lame leg that the heel thereof may touch his buttocks. CHAP. L. Of a knee dislocated forewards. BUt if the knee be dislocated forwards (which seldom happens) the patient shall be placed upon a table and a convenient ligation made above, The cure. and another close beneath the knee. Then the Surgeon shall so long press down with both his hands the bone which is out of joint, until it shall return to its place again. To which purpose if the strength of the hand will not serve to make just extension each way, you may make use of our engine, as you may perceive by this following figure. A figure showing the manner of restoring a knee dislocated forwards. You shall know that the bone is restored by the free and painless extension of the leg; then will their be place for medicines, bolsters and strengthening ligatures. In the mean space the patient shall forbear going, so long as the part shall seem to require. CHAP. LI. Of the separation of the greater and lesser Focile. THe Fibula or lesser Focile is fastened and adheres to the Tibia, leg bone, The joining of the leg and shin 〈◊〉▪ or greater Focile without any cavity, above at the knee and below at the ankle. But it may be plucked or drawn aside three manner of ways, that is, forwards, and to each side: this chance happens when in going we take no sure footing, so that we slip with our feet this way and that way as in 〈◊〉 slippery place, and so wrest it inwards or outwards; for then the weight of our body lying upon it, draws the leg, as it were, infunder, so that the one Focile is dislocated or separated from the other. The same may happen by a fall from an high place, or some grievous and bruising blow: besides also, their appendices are sometimes separated from them. For the restoring of all these into their proper places, it is fit they The cure. be drawn and forced by the hand of the Surgeon into their seats: then shall they be straight bound up, putting compresses to that part unto which the Fibula flew; beginning also your ligation at the very luxation, for the forementioned reasons. The patient shall rest forty days, to wit, as long as shall be sufficient for the strengthening of the ligaments. CHAP. LII. Of the Leg-bone or greater Focile dislocated and divided from the Pastern bone. ALso the Leg-bone is sometimes dislocated, and divided from the pastern bone, as well inwardly, as outwardly; which may be known by the Differences and signs. swelling out of the bone to this or that part; if it be only a subluxation or strain, it may be easily restored, by gently forcing it into the place again. After the bone shall be restored, it shall be kept so by compresses and fit deligation, by cross and contrary binding to the side opposite to that towards which the bone fell, that so also in some measure it may be more and more forced into its place. In the mean time you must have a care that you do not too straight press the great and large tendon which is at the heel. This kind of dislocation is restored in forty days, unless some accident happen which may hinder it. CHAP. LIII. Of the dislocation of the Heel. WHosoever leaping from an high place have fallen very heavy upon their heel, have their heel dislocated and divided from the pastern bone. This dislocation happens more frequently inwardly than outwardly, because the prominency of the lesser Focile embraces Causes and differences. the pastern bone; whence it is, that there it is more straight and firmly knit. It is restored by extension and forcing it in, which will be no very difficult matter, unless some great defluxion or inflammation hinder it. For the binding up, it must be straitest in the part affected, The cure. that so the blood may be pressed from thence into the neighbouring parts; yet using such a moderation, that it may not be painful, nor press more straight than is fit, the nerves and gross tendon which runs to the heel. This dislocation is not confirmed before the fortieth day, though nothing happen which may hinder it. Yet usually it happeneth that many symptoms ensue by the vehemency of the contusion. Wherefore it will not be amiss to handle them in a particular chapter. CHAP. LIV. Of the Symptoms which follow upon the contusion of the Heel. IT happeneth by the vehemency of this contusion, that the veins and arteries do as it were vomit up blood both through the secret Why blood-letting necessary in the fracture of a heel. passages of their coats, as also by their ends or orifices, whence an Ecchymosis or blackness over all the heel, pain, swelling, and other the like ensue, which implore remedies, & the Surgeon's help, to wit, convenient diet, and drawing of blood by opening a vein (of which though Hypocrates makes no mention, yet it is here requisite Hip. sect. 3. de fracturis. by reason of the fever and inflammation) and if need require purgation, principally such as may divert the matter by causing vomit, and lastly, the application of local medicines, chiefly such as may soften and rarify the skin under the heel, otherwise usually hard and thick (such as are fomentations of warm water & oil) so that divers times we are forced to scarify it with a lancet, shunning the quick flesh. For so at length the blood poured forth into the part, and there heaped up, is more easily attenuated and at length resolved. But these things must all be performed before the inflammation seize upon the part, otherwise there will be danger of a convulsion. For the blood, when it falls out of the vessels, readily putrefies, by Why the heel is subject to inflammation. reason the density of this part hinders it from ventilation and dispersing to the adjacent parts. Hereto may be added that the large and great Tendon which covers the heel, is endued with exquisite sense, and also the part itself is on every side spread over with many nerves. Besides also there is further danger of inflammation by lying upon the back and heel, as we before admonished you in the Fracture of a leg. Therefore I would have the Surgeon to be here most attentive and diligent to perform these things which we have mentioned, lest by inflammation a Gangrene and mortification (for here the sanious flesh presently falls upon the bone) happen together with a continued and sharp fever, with trembling, hicketting and raving. For the corruption of this part first by contagion assails the next, and thence a fever assails the heart by the arteries pressed and growing hot by the putrid heat, & by the nerves and that great and notable tendon made by the concourse of the three Gal. add sent. 2●. sec. 2. 〈…〉 fract. muscles of the calf of the leg, the muscles, brain and stomach are evilly affected and drawn into consent, and so cause convulsions, raving and a deadly hicketting. CHAP. LV. Of the dislocated pasterre or Ancle-bone. THe Astragalus or Pastern bone may be dislocated and fall out of its Sig●es. place to every side. Wherefore when it falls out towards the inner part, the sole of the foot is turned outwards, when it flies out to the contrary, the sign is also contrary: if it be dislocated to the foreside, on the hind side the broad Tendon coming under the heel is hardened and distended; but if it be luxated backwards, the whole heel is as it were hid in the foot: neither doth this kind of dislocation happen without much violence. It is restored by extending it with the hands, and forcing it into the Cure. contrary part to that from whence it fell. Being restored it is kept so by application of medicines and fit ligation. The patient must keep his bed long in this case, lest that bone which sustains and bears up the whole body, may again sink under the burden, and break out, the sinews being not well knit and strengthened. CHAP. LVI. Of the dislocation of the Instep and back of the foot. THe bones also of the Instep and back of the foot may be luxated, and that either upwards or downwards, or to one side, though seldom sidewise, for the reason formerly rendered, speaking of the dislocation of the like bones of the hand. If that they stand upwards, then must the patient tread Cure. hard upon some plain or even place, and then the Surgeon by pressing them with his hand shall force them into their places; on the contrary, if they stand out of the sole of the foot, then must you press them thence upwards, and restore each bone to its place. They may be restored after the same manner if they be flown out to either side. But you must note that although the ligatures consist but of one head in other dislocatious, yet here Hypocrates would have such used as have two heads, for that the dislocation happens more frequently from below upwards, or from above Sent. 14. sect. 2. lib. de fract. downwards, than sidewise. CHAP. LVII. Of the dislocation of the Toes. NOw the Toes may be four ways dislocated, even as the fingers of The differences. the hand; and they may be restored just after the same manner, that is, extend them directly forth, and then force each joint into its place, and lastly bind them up as is fitting. The restitution of all of them is easy, for that they cannot far transgress their bounds. To conclude, Cure. the bones of the feet are dislocated and restored by the same means as those of the hands, but that when as any thing is dislocated in the foot, the patient must keep his bed, but when any thing is amiss in the hand, he must carry it in a scarf. The patient must rest twenty days, that is, until he can firmly stand upon his feet. CHAP. LVIII. Of the symptoms, and other accidents which may befall a broken or dislocated member. MAny things may befall broken or dislocated members by the means of the fracture, or dislocation; such as are bruises, great pain, inflammation, a fever, imposthume, gangrene, mortification, ulcer, fistula, and atrophia, all which require a skilful and diligent Surgeon for their cure. A confusion happens by the fall of some heavy thing upon the part, or by a fall from high, whence follows the effusion of blood poured out under Remedies for a confusion. the skin: which if it be poured forth in great plenty, must be speedily evacuated by scarification, and the part eased of that burden, lest it should thence gangrenate. And by how much the blood shall appear more thick and the skin more dense, by so much the scarification shall be made more deep. You may also for the same purpose apply leeches. Concerning pain we formerly said, that it usually happens by reason that the What may happen by pain. bones are moved out of their places, whence it happeneth that they become troublesome to the muscles and nerves by pricking and pressing them. Hence ensue inflammations, as also impostumation and a fever, oft times a gangrene, and in conclusion a mortification corrupting and rotting the bones; otherwhiles a sinuousulcer or fistula. But an Atrophia and leanness ariseth by the sloth and idleness of the member decaying all the strength thereof, and by too straight ligation intercepting the passages of the blood otherwise ready to fall and flow thither. Now the leanness which is occasioned by too straight ligation receives cure by the Remedies for the leanness or Atrophia of any member. slackening of the ligatures wherewith the member was bound. That which proceeds from idleness is helped by moderate exercise, by extending, bending, lifting up and depressing the member, if so be that he can away with exercise. Otherwise he shall use frictions and fomentations with warm water. The frictions must be moderate in hardness and gentleness, in length and shortness. The same moderation shall be observed in the warmness of the water, and in the time of fomenting. For What measure to be used in fomenting. too long fomenting resolves the blood that is drawn. But that which is too little or short a space draws little or nothing at all: after the fomentation, hot and emplastic medicines made of pitch, turpentine, euphorbium, pellitory of Spain, sulphur, and the like, shall be applied. They shall be renewed every day more often or seldom, as the thing itself shall seem to require. These medicines are termed Dropaces; whose form is thus. ℞ picis nigrae, ammoniaci, bdeliis, gummi elemi in aqua vitae dissolutorum an. ℥ two. olei laurini ℥ i. pulveris piperis, A dropax. zinziberis, granorum paradisi, baccarum lauri et juniperi, an. ℥ two. fiat emplastrum secundum artem, extendatur super alutam. It is also good to bind about the opposite Binding of the sound part opposite to the emaciated. sound part with a ligature, yet without pain; as if the right arm shall decay for want of nourishment, the left shall be bound, beginning your ligation at the hand, and continuing it to the Armepit. If this mischance shall seize upon the right leg, than the left shall be swathed up from the sole of the foot to the groin. For thus a great portion of the blood is forced back into the vena cava, or hollow vein, and from this being distended and over full, into the part affected and gaping with the vessels almost empty; besides also it is convenient to keep the sound part in rest, that so it may draw the less nourishment, and by that means there will be more store to refresh the weak part. Some wish also to bind up the decaying member with moderate ligation; for How to bind up the emaciated part. thus, say they, the blood is drawn thither; for when as we intent to let blood by opening a vein with a lancet, we bind the arm. Also it is good to dip it into water somewhat more than warm, and hold it there until it grow red and swell; for thus blood is drawn into the veins, as they find, which use to draw blood of the saphena and salvatella. Now if, when as these things and the like be done, the lame part grow hot, red and swollen, then know that health is to be hoped for; but if the contrary happen, the case is desperate, wherefore you need attempt nothing further. Furthermore, there is sometimes hardness left in the joints, after fractures and Signs that an Atrophia is curable. dislocations are restored. It is fit to soften this, by resolving the contained humour by fomentations, liniments, cataplasms, emplasters made of the roots of Marshmallows, briony, lilies, line seed, fenugreek seed, and the like, and also of gums dissolved in strong vinegar, as Ammoniacum, bdelium, opopanax, labdanum. sagapenum, styrax liquida, and Adeps anserinus, gallinaceus, humanus, oleum liliorum, and the like. Also you must wish the patient to move the part ever now and then, every day, yet so, that it be not painful to him, that so the penned up humour may grow hot, be attenuated, and at length discussed, and lastly the part itself restored as far as art can perform it; for oft times it cannot be helped any thing at all. For if the member be weak and lame by reason that the fracture happened near the joint, for the residue of his life the motion thereof useth to be painful and difficult, and oft time's none at all, especially if the Callus which grows there be somewhat thick and great, and lastly, if the joint itself shall be contused and broken by the stroke, as it ofttimes happens in wounds made by Gun-shot. The End of the sixteenth Book. OF DIVERS OTHER PRETER NATURAL AFFECTS, WHOSE CURE IS COMMONLY PERFORMED BY SURGERY. THE SEVENTEENTH BOOK. CHAP. I. Of an Alopecia, or the falling away of the hairs of the head. AN Alopecia is the falling away of the hair of the head, and sometimes also of the eyebrows, chin and other parts; the Gal. c. 2. lib. 1. de comp. med. securlocos. French commonly call it the Pelade. Physician's term it the Alopecia, for that old Fox's subject, by reason of their age, to have the scab, are troubled oft times with this disease. This affect is caused either through defect of nourishment fit to The cause. nourish the hairs, as in old age through want of the radical humidity, or by the corruption of the alimentary matter of the same, as after long fevers, in the Lues venerea, leprosy, the corruption of the whole body and all the humours, whence followeth a corruption of the vapours and fuliginous excrements; or else by the vicious constitution of the pores in the skin in rarity, and constriction or density, as by the too much use of hot ointments made for colouring the hair, or such as are used to take off hair, therefore called Depilatoria, or by the burning of the skin, or loss thereof, having a scar in stead thereof, by reason of whose density the hair cannot spring out, as by too much laxity the fuliginous matter of the hair stays not, but presenly vanisheth away. The Alopecia which comes by old age, a consumption, burn, baldness, leprosy and What Alopecia uncurable. What curable, and how. a scald head, is uncurable: that which admits of cure, the cause being taken away, is helped. Wherefore, if it proceed from the corruption of humours, let a Physician be called, who as he shall think it fit, shall appoint diet, purging and phlebotomy. Then the Surgeon shall shave off that hair which is remaining, and shall first use resolving fomentations, apply Leaches and Horns to digest the vicious humour which is under the skin, then shall he wash the head to take away the filth with a lie wherein the roots of Orris and Aloes have been boiled. Lastly, he shall use both attractive fomentations and medicines for to draw forth the humour which is become laudable in the whole body by the benefit of diet fitly appointed. But if the Alopecia shall happen through defect of nourishment, the part shall be rubbed so long with a course linen cloth, or a fig leaf, or onions, until it wax red; besides also the skin shall be pricked in many places with a needle, and then ointments applied made of Labdanum, pigeon's dung, stavisager, oil of bays, turpentine and wax, to draw the blood and matter of the hairs. If the hair be lost by the Lues venerea, the patient shall be anointed with quicksilver to sufficient salivation. To conclude, as the causes of this disease shall be, so must the remdies be fitted which are used. CHAP. II. Of the Tinea, or scaled Head. THE Tinea (let me soterme it in Latin, whilst a fitter word may be found) or a scald head, is a disease possessing the musculous skin of the head or Lib. 1. de comp. med. sect. locos. the hairy scalp, and eating thereinto like a moth. There are three differences thereof, the first is called by Galen scaly or branlike, for that whilst it is scratched it casts many branlike scales: some Practitioners term it a dry scall, because of the great adustion of the humour causing it. Another is called ficosa, a fig-like scall, because when it is despoiled of the crust or scab which is yellow, there appear grains of quick and red flesh, like to the inner seeds or grains of figs, and casting out a bloody matter. Galen names the third Anchor, and it is also vulgarly termed the corrosive or ulcerous scall, for that the many ulcers wherewith it abounds are open with many small holes flowing with liquid sanies like the washing of flesh, stinking, corrupt and carrion-like, somewhiles livid, somewhiles yellowish. These holes, if they be somewhat larger, make another difference which is called Cerion or Favosa (that is, like a honey comb) because as Galen thinks, the matter which floweth Cap. 8. lib. citati. from these, resembleth honey in colour and consistence. They all proceed of an humour which is more or less vicious, for a less corrupt humour causeth a scaly, a more corrupt, the fig-like, but the most corrupt produceth the ulcerous. If it shall happen to an infant by reason of the fault and contagion of the nurse, or else presently after it is borne, it scarce admits of cure; neither must we attempt that before the child come to that age, that he may be able to endure the cure & medicines. But you may in the mean while apply the leaves of Colworts or beets besmeared with fresh butter, or other gentle medicine having a faculty to mollify and open the passage for the shut up matter. Those who are of sufficient age to away with medicines, The cure. may bleed, purge, bathe, according to art by the advice of a Physician. For local medicines in a scaly scall, softening and discussing fomentations shall be appointed, For a scaly scall. made of the roots of marshmallows, Lilies, Docks, Sorrell boiled in lie with a little vinegar added thereto. The head shall be twice in a day fomented with such a decoction, and on the sixth day the hair being shaved off, it shall be scarified, and then leeches and horns put to it so scarified. Then it shall be forth with anointed with oil of stavisager mixed with black soap, both to draw & repress the malignity of the humour impact in the part. You may also use the following medicine even to the perfect cure of the disease, as that which is much commended in this kind of disease by Vigo, Gordonius, and Guido; it is thus made. ℞. elleb. albi & An ointment for a scalled head. nigri, uttrament. auripigmenti, lethargy auri, calcis viva, vitriol. alum. galla. fulig. ciner. faecis vini usti, an ℥ ss. argenti vivi extincti, ℥ iii aerisʒii. fiat pulvis qui incorporetur cum succo boraginis, scabiosae, fumariae, oxylapathi, aceti, an. quart. i. olei antiqui lib. i. bulliant usque ad consumpt succorum, in fine decoctionis cineres ponantur, addendo picis liquidae ℥ ss. cerae quantum sufficit, fiat unguentum: These authors testify that this will heal any kind of scall. Certainly none can dislallow of it who well considereth the engredients and composure thereof. A crusty also or fig-like scall shall be so long fomented with the prescribed fomentation, until the crusts or scabs fall off, yet there is nothing so good and effectual The cure of a crusty scall. as Cresses beaten or fried with hog's suet. For it will make it fall off in the space of four and twenty hours, besides, if it be continued it will heal them throughly, A poultis of Cresses. as I have known by experience, and reason also stands therewith; for according to Galen, Cresses are hot and dry. When the crusts shall be fallen away, the parts affected Lib. 7. simple. shall be anointed with the formerly prescribed ointment. I have cured many with a little oil of vitriol, and sometimes also with Aegyptiacum made somewhat more strong than ordinary. But if the root of the hairs appear rotten, they shall be plucked out one by one; yet if such putrefaction shall possess the whole hairy sculpe, and trouble all the roots of the hair, that you may pluck them out the more readily, & with less pain, you may besmear a cotton cloth on the rougher side with this following medicine. ℞. picis nigrae ℥ vi. picis res. ℥ two. pull. viridis aeris, A plaster to pluck away the hair at once, & vitriol. rom. an. ℥ i. vel ℥ ss. sulphur. viv. ʒ ss. coquantur omnia simul in aceti acerrimi quantitate sufficient, fiat medicamentum ad usum: let it be applied to the head, and remain on for two days; then let it be quickly and forcibly plucked away against the hair, that so the hairs sticking to the plaster may by that means be plucked away therewith: you shall use this medicine so long as need shall seem to require. For the third kind of scall which is termed a Corrosive or ulcerous, the first indication The cure of an ulcerous scall. is to cleanse the ulcers with this following ointment. ℞. unguenti enulati cum mercurio duplicato, aegyptiaci, an. ℥ iii vitriol. albi in pulverem redacti ℥ i. incorporentur simul, fiat unguentum ad usum; also you may use the formerly described ointment. But if any pain or other accident fall out, you must with stand it by the assistance and direction of some good Physician; verily these following medicines against all kinds of Scalls have been found out by reason, and approved by use. ℞. Camphur. ℥ ss. alum. roch. vitriol. vir. aeris, sulph. vivi, fulig. forn. an. ʒvi. olei amygd. dulcium & axungiae porci, aii. ℥ two. incorporentur simul in mortario, fiat unguentum. Some take the dung which lieth rotting in a sheep-fold; they use that which is liquid, & rub it upon the ulcerated places, & lay a double cloth dipped in that liquor upon it. But if the patient cannot be cured with all these medicines, & that you find his body in some parts thereof troubled in like sort with crusty ulcers, I would wish that his head might be anointed with an ointment made of Axungia, argentum vivum, & a little Sulphur, & then fitsom emplastrum Vigonis cum mercurio into the fashion of a cap; also some plasters of the A contumacious scall must be cured as we cure the Lues Venerea. same may be applied to the shoulders, thighs and legs, and so let him be kept in a very warm chamber, and all things done as if he had the Lues venerea. This kind of cure was first (that I know of) attempted by Simon Blanch the King's Surgeon, upon a certain young man, when as he in vain had diligently tried all other usual medicines. A scalled head ofttimes appeareth very loathsome to the eye, casting forth virulent and stinking sanies; at the first it is hardly cured, but being old, far more difficultly. For divers times it breaketh out afresh, when you think it killed, by reason of the impression of the malign putrefaction remaining in the part, which wholly corrupts the temper thereof. Moreover, ofttimes being healed, it hath left an Alopecia behind it, a great shame to the Surgeons. Which is the reason, that most of them judge it best to leave the cure thereof to Empirics and women. CHAP. III. Of the Vertigo, or Giddiness. THE Vertigo is a sudden darkening of the eyes and sight by a vaporous What the Vertigo is, and the causes thereof. & hot spirit which ascendeth to the head by the sleepy arteries, and fills the brain, disturbing the humours and spirits which are contained there, & tossing them unequally, as if one ran round, or had drunk too much wine. This hot spirit ofttimes riseth from the heart upwards by the internal sleepy arteries to the Rete mirabile, or wonderful net; otherwhiles it is generated in the brain, its self being more hot than is fitting; also it ofttimes ariseth from the stomach, spleen, liver and other entrails being too hot. The sign of this disease is the sudden The signe●. darkening of the sight, and the closing up as it were of the eyes, the body being lightly turned about, or by looking upon wheels running round, or whirl pits in waters, or by looking down any deep or steep places. If the original of the disease proceed from the brain, the patients are troubled with the headache, heaviness of the head, and noise in the ears, and ofttimes they lose their smell. Paulus Aegineta for the cure bids us to open the arteries of the temples. But if the matter of the Lib. 6. disease arise from some other place, as from some of the lower entrails, such opening of an artery little availeth. Wherefore then some skilful Physician must be consulted, with who may give directions for phlebotomy, if the original of the disease proceed from the heat of the entrails; by purging, if occasioned by the foulness of the stomach. But if such a Vertigo be a critical symptom of some acute disease affecting the Crisis by vomit or bleeding, than the whole business of freeing the patient A critical Vertigo. thereof must be committed to nature. CHAP. IU. Of the Hemicrania, or Megrim. THE Megrim is properly a disease affecting the one side of the head, right, or left. It sometimes passeth no higher than the temporal muscles, otherwhiles it reacheth to the top of the crown. The cause of such pain proceedeth either from the veins and external arteries, or from the meanings, or from the very substance of the brain, or from the pericranium, or the hairy scalp covering the pericranium, or lasty, from putrid vapours arising to the head from the ventricle, womb, or other inferior member. Yet an external cause may bring this affect, to wit, the too hot or cold constitution of the encompassing air, drunkenness, gluttony, the use of hot and vaporous meats, some noisome vapour or smoke, as of Antimony, quicksilver, or the like, drawn up by the nose, which is the reason that Goldsmiths, and such as gild metals are commonly troubled with this disease. But whence foever the cause of the evil proceedeth, it is either a simple distemper, or with matter: with matter, I say, which again is either simple or compound. Now, this affect is either The differences. alone, or accompanied with other affects, as inflammation and tension. The heaviness of head argues plenty of humour; pricking, beating and tension shows that there is plenty of vapours mixed with the humours, and shut up in the nervous, arterious, or membranous body of the head. If the pain proceed from the inflamed meanings, a fever followeth thereon, especially, if the humour causing pain do putrefy. If the pain be superficiary, it is seated in the pericranium. If profound, deep and piercing to the bottom of the eyes, it is an argument that the meanings are affected, and a fever ensues, if there be inflammation, and the matter putrefy: and then oft times the tormenting pain is so great and grievous, that the patient is afraid to have his head touched, if it be but with your finger, neither can he away with any noise, or small murmuring, nor light, nor smells however sweet, no nor the fume of Vine. The pain is sometimes continual, otherwhiles by fits. If the cause of the pain In what kind of Megrim the opening of an Artery is good. proceed from hot, thin & vaporous blood, which will yield to no medicines, a very necessary, profitable & speedy remedy may be had by opening an artery in the temples, whether the disease proceed from the internal or external vessels. For hence always ensueth an evacuation of the conjunct matter, blood and spirits. I have experimented this in many, but especially in the Prince de la Roche sur-you. His Physicians, A history. when he was troubled with this grievous Megrim, were Chapaine, the Kings, and Castellane, the Queen's chief Physicians, and jews Duret, who notwithstanding could help him nothing by blood-letting, cupping, baths, fictions, diet or any other kind of remedy either taken inwardly or applied outwardly. I being called, said, that there was only hope one way to recover his health, which was to open the artery of the temple in the same side that the pain was; for I thought it probable, that the cause of his pain was not contained in the veins, but in the 〈◊〉, in which case by the testimony of the ancients, there was nothing better than the opening or bleeding of an artery, whereof I had made trial upon myself to my great good. When as the Physicians had approved of this my advice, I presently betake myself to the work, and choose out the artery in the pained temple, which was both the more swollen and beat more vehemently than the rest. I open this, as we use to do in the bleeding of a vein, with one incision, and take more than two saucers of blood flying out with great violence, and leaping; the pain presently ceased, neither did it ever molest him again. Yet this opening of an Artery is suspected by many, for that it is troublesome to stay the gushing forth blood, and cicatrise the place, by reason of the density, hardness, and continual pulsation of the artery, and lastly, for that when it is cicatrized there may be danger of an Aneurisma. Wherefore they think it better first to divide the skin, then to separate the artery from all the adjacent particles, and then to bind it in two places, and lastly divide it, as we have formerly told you must be done in Varices. But this is the opinion of men who fear all things where there is no cause; for I have learned by frequent No danger in opening an artery. experience that the apertion of an artery, which is performed with a Lancet, as we do in opening a vein, is not at all dangerous; and the consolidation or healing is somewhat flower than in a vein, but yet will be done at length, but that no flux of blood will happen, if so be that the ligation be fitly performed, and remain so for four days with fitting pledgets. CHAP. V. Of certain affects of the eyes, and first of staying up the upper eyelid when it is too lax. OF the diseases which befall the eyes, some possess the whole substance thereof, as the Ophthalmia, a Phlegmon thereof: others are proper and peculiar to some parts thereof, as that which is termed Gutta ferena to the optic nerve. Whence Galen made a threefold difference of the Differences. diseases of the eyes, as that some happened to the eye by hurting or offending the chief organ thereof, that is, the crystalline humour; others by hindering the animal faculty, the chief causer of sight, from entering into them; and lastly, other some by offending the parts subservient to the prime organ or instrument. Now of all these diseases, the eye hath some of them common with the other parts of the body, such as are an ulcer, wound, phlegmon, contusion and the like: other some are peculiar and proper to the eye, such as are the Aegilops, Cataracta, Glaucoma, and divers others of this kind. Some have their upper eyelid fall down, Paul. Aegin. lib. 8. cap. 6. by reason that the upper skin thereof is relaxed more than is sufficient to cover the eye, the gristle in the mean while not relaxing itself together therewith. Hence proceeds a double trouble; the first, for that the eye cannot be easily opened; the other, because the hairs of the relaxed eyelid run in towards the eye, and become troublesome thereto by pricking it. The cause of such relaxation is either a particular The cause. palsy of that part, which is frequent in old people, or the defluxion or falling down of a waterish humour, and that not acride or biting; which appears by this, that those who are thus affected have a rank of hairs growing under the natural rank, by reason of the abundance of heaped up humour, as it is most probable. For thus a wet and marish ground hath the greatest plenty of grass. Now if this same humour were acride, it would cause an itching, and consequently become troublesome to the patient, and it would also fret insunder and destroy the roots of the other hairs, so far it is from yielding matter for the preternatural generation of new. It is fit, before you do any thing for the cure, that you mark with ink the portion The cure. thereof which is superfluous, and therefore to be cut away, lest if you should cut off more than is requisite, the eyelid should remain turned up, and so cause another kind of affect, which the ancients have called Ectropion. Then the eye being covered, take and lift up with your fingers the middle part of the skin of the eyelid, not taking hold of the gristle beneath it, and then cut it athwart, taking away just so much as shall be necessary to make it as it were natural; lastly, join the lips of the wound together with a simple future of three or four stitches, that so it may be cicatrized; for the cicatrisation restrains the eyelid from falling down so loosely, at least some part thereof being taken away. There aught to be some measure, and heed taken in the amputation, otherwise you must necessarily run into the one or other inconvenience, as if too much be cut away, than the eye will not be covered, if too little, than you have done nothing, and the patient is troubled to no purpose. If there shall be many hairs grown preternaturally, you shall pluck them away with an instrument made for the same purpose; then their roots shall be burned with a gentle cautery, the eye being left untouched, for a scar presently arising will hinder them from growing again. CHAP. VI Of Lagophthalmus, or the Hare eye. SUch as have their eyelids too short, sleep with their eyes open, for that they cannot be covered by the too short skin of the eyelids: the greeks term this affect, Lagophthalmos. The cause is either Paulus Aegin. lib. 6. cap. 10. internal or external: internal, as by a Carbuncle, Impostume, or Ulcer: external, as by a wound made by a sword, burn, fall, & the like. If this mishap proceed by reason of a cicatrisation, it is curable, if so that the short eyelid be of an indifferent thickness. But if it have been from the first conformation, or by some other means, whereby much of the substance is lost, as that which happens by burning and a carbuncle, than it is uncureable. For the cure, you shall use relaxing and emollient fomentations, than the skin shall be divided above the whole scar, in figure of an half moon, with the The cure. horns looking downwards. Then the edges of the incision shall be opened, and lint put into the middle thereof, that so it may hinder the lips from joining together again. Then shall you apply a plaster upon the lint, and so bind up the part with a fitting ligature that may somewhat press upon the whole eye, lest it should lift itself somewhat upwards again, and so return into its ancient, but not natural figure. But in cutting the skin, you must take care that your incision harm not the gristle; for if it be cut, the eyelid falls down, neither can it be afterwards lifted up. But now for the lower eyelid: it is subject to sundry diseases, amongst which there is one which answereth in proportion to that, which we late mentioned, which is, when as it is lifted upwards little or nothing, but hangs and gapes, and cannot be joined with the upper, and therefore it doth not cover the eye, which affect is familiar Ectropion, or the turning up or out of the Eyelid. to old people; it is called Ectropion, and it may be helped by the means formerly delivered. CHAP. VII. Of the Chalazion, or Haile-stone, and the Hordeolum or Barly-corne of the eyelids. THe Chalazion is a round and clear pimple which grows upon the upper Paul. cap. 16. lib. 6. eyelid, it is also movable and may be stirred this way and that way with your fingers: the Latins call it Grando, for that it resembles a Hailstones Another pimple not much unlike this grows sometimes upon the verges of the eyelids above the place of the hairs. It is termed Hordeolum, by reason of the similitude it hath with a barley corn. The matter of these is contained in its proper The cure. cist or skin, and therefore is hardly brought to suppuration. At the first beginning it may be resolved and discussed. But when as it is once grown and concrete into a plaster or stone-like hardness, it is scarce curable. Wherefore it is best to perform the cure by opening them, that so the contained matter may flow, or be pressed forth. If the pimple or swelling be small, then thrust it through with a needle and thread, and leave the thread therein of such length that you may fasten the ends thereof with a little of the emplaster called Gratia Dei like glue to the forehead, if it be on the upper eyelid; or to the cheeks, if on the lower. You must draw through a fresh one every second day, as is usually done in chirurgical setons. For thus at length the swelling will be destroyed and made plain. CHAP. VIII. Of the Hydatis or Fatness of the Eyelids. THe Hydatis is a certain fatty substance like a piece of fat seated and lying What Hydatis is. under the skin of the upper eyelid. It is a disease incident to children, who are of a more humid nature: wherefore it is a soft and loose tumour making the whole eyelid, which it possesseth, oedematous; so that, as if depressed with a weight, it cannot be lifted up. It hath its name, for that it hath as it were a bladder distended with a whayish humour, which kind of fault is observed by Galen in the liver. Those, who are thus affected, have their eyes look Com. ad aphor. 55. sect. 7. red, and flow with tears, neither can they behold the sun, or endure the light. The cure is performed by cutting off the superfluous substance, not hurting the neighbouring The cure. parts; and then presently put some salt into the place whence it was taken out (unless the vehemency of pain hinder) that so the place may be dried and strengthened, and the rest of the matter (if any such be) may be consumed, and hindered from growing again. Lastly, you shall cover the whole eye with the white of an Egg dissolved in rose-water, or some other repercussive. CHAP. IX. Of the Eye. lids fastened or glued together. SOmetimes it cometh to pass that the upper eyelid is glued or fastened to the under, so that the eye cannot be opened, or so that the one of them may stick or be fastened to the white coat of the eye, or to the Paulus cap. 15. lib. 6. horny. This fault is sometimes drawn from the first original, that is, by the default of the forming faculty in the womb (for thus many infants are born with their singers fastened together, with their fundaments, privities and ears unperforated) the eye in all other respects being well composed. The cause of this affect sometimes proceeds from a wound, otherwhiles from a bourn, scald or impostumation, The cause. as the breaking of the small pox. It is cured by putting in a fit instrument, & so opening them; but with such moderation, that you touch not the horny coat, for otherwise it would fall out. Therefore you must put the end or point of your probe The cure. under the eyelids, and so lifting them up (that you hurt not the substance of the eye) divide them with a crooked incision knife. The incision made, let the white of an egg beaten with some rose-water be put into the eye; let the eyelids be kept open, yea let the patient himself be careful that he often turn it upwards, and lift it up with his fingers, not only that the medicine may be applied to the ulcer, but also that they may not grow together again. In the night time let a little pledget dipped in water, and that either simple, or wherein some vitriol hath been dissolved, be laid thereon. For thus you shall hinder the eyelids from joining together again. Then on the third day the parts or edges of the eyelids shall be touched with waters drying without biting or acrimony, that so they may be cicatrized. But if the eyelid adhere to the horny coat at the pupilla or apple of the eye, the patient will either be quite blind, or very ill of sight. For the scar which ensues will hinder the shapes of things from entering to the crystalline humour, and the visive spirits from passing forth to the objects. For prognostickes, you may learn out of Celsus, that this cure is subject to a relapse, so that it may be A disease subject to relapse. shunned neither by diligence nor industry, but that the eyelid will always adhere and cleave to the eye. CHAP. X. Of the itching of the Eyelids. MAny have their Eyelids itch vehemently by reason of salt phlegm, which often times excoriating and exulcorating the parts themselves, yields a sanies, which joins together the eyelids in the night time as if they were glued together, and makes them watery and bleared. This affect doth so torment the patients, that it oft times makes them require the Physicians help. Wherefore general medicines being premised, the Ulcers shall be washed with the following Collyrium. ℞. aquae mellis in balneo mariae destillatae ℥ iii sacchari candi. ʒi. redactaeʒss. fiat collyrium. Which A detergent collyrium. if it do no good, you may use this which follows. ℞. Ung. Aegyptiac. ʒi. dissolve in aquae plantaginis quantitate sufficienti. Let the ulcerated eyelids betouchd with a soft linen rag dipped therein, but with care that none thereof fall upon the eye. But when the patient goes to bed, let him cause them to be anointed with the following ointment, very effectual in this case. ℞. axungiae porci et butyri recentis, an. ℥ ss. tuth. praepar. ʒss. antimon. in aquae euphrasiae praeparati, ℈ two. camphor aegra. iiii. misce, et in mortario plumbeo ducantur per tres horas, conflatum indeunguentum, servetur in pyxide plumbea. Some commend and use certain waters fit to cleanse, dry, bind, strengthen, and absolutely free the eyelids from itching and redness; of which this is one. ℞. aquae euphrag. faeniculi, chelidon. an ℥ ss. sarcocal. nutritae ℈ two. vitriol. rom. ʒi. misceantur simul & bulliant unica ebullitione; postea coletur liquor, & servetur ad usum dictum. Or else. ℞. aquaeros. & vini alb. boni an. ℥ iiii. tuth. praepar. aloës an. ʒi. flor. aeni ℈ two. camphor. gra. two. Let them be boiled according to art, and kept in a glass to wash the eyelids. Or else, ℞. vini albi lbss. salis come. ʒi. let them be put into a clean barber's basin and covered, and kept there five or six days, and be stirred once a day, and let the eyelids be touched with this liquor. Some wish that the patient's urine be kept all night in a barber's basin, and so the patient's eyelids be washed therewith. Verily in this affect we must not fear the use of acride medicines, for I once You need not fear to use acride medicines in the itching of the eyelids. Lib. 2. cap. 4. fract. 3. saw a woman of fifty years of age, who washed her eyelids when they itched with the sharpest vinegar she could get, and affirmed that she found better success of this than of any other medicine. Vigo prescribes a water whose efficacy above other medicines in this affect, he saith, hath been proved; and that it is to be esteemed more worth than gold, the description thereof is thus. ℞. aq. ros. vini albi oderiferi mediocris vinosit atis an. ℥ iiii. myrobalan. citrini trit. ʒiss. thurisʒii. bulliant omnia simul usque ad consumptionem tertiae partis; deinde immediatè addantur floris aris ℈ two. camph. gr. two. Let the liquor be kept in a glass well stopped for the foresaid use. CHAP. XI. Of Lippitudo, or Bleare-eyes. THere are many whose eyes are never dry, but always flow with a thin, acrid and hot humour, which causeth roughness, and upon small occasions inflammations, blear or bloodshot eyes, and at length also Strabismut or sqinting. Lippitudo is nothing else but a certain white filth flowing What lippitudo is. from the eyes, which oft times agglutinates or joins together the eyelids. This disease often troubles all the life time, and is to be cured by no remedy: in some it is curable. Such as have this disease from their infancy, are not to be cured, for it remains with them till their dying day. For large heads, and such as are replete with acride or much excrementitious phlegm, scarce yield to medicines. There is much difference whether the phlegm flow down by the internal vessels under the scull, or by the external which are between the skull and the skin, or by both. For if the internal veins cast forth this matter, it will be difficultly cured, if it be cured at all. But if the external vessels cast it forth, that cure is not unprofitable, which having used medicines respecting the whole body, applies astringent medicines to the shaved crown, as Empl. contra rupturam, which may straighten the veins, and as it were suspend the phlegm, useth cupping, and commands frictions to be made towards the hind part of the head, and lastly, maketh a Seton in the neck. There are some who cauterise the top of the crown with a hot iron, even to the bone, so that it may cast a scaile, thus to divert and stay the defluxion. For local A Collyrium of vitriol to stay the defluxions of the eyes. medicines, a Collyrium made with a good quantity of rose-water, with a little vitriol dissolved therein, may serve for all. CHAP. XII. Of the Ophthalmia, or inflammation of the Eyes. AN Ophthalmia is an inflammation of the coat Adnata and consequently What Ophthalmia is, and the causes thereof. of the whole eye, being troublesome by the heat, redness, beating, renitency, and lastly pain. It hath its original either by some primitive cause or occasion, as a fall, stroke, dust, or small sand flying into the eyes. For the eye is a smooth part, so that it is easily offended by rough things, as saith Hypocrates, lib. de carnibus. Or by an antecedent cause, as a defluxion falling upon the eyes. The signs follow the nature of the material cause, Signs. for from blood especially choleric and thin, it is full of heat, redness and pain; from the same allayed with phlegm all of them are more remiss. But if a heaviness possess the whole head, the original of the disease proceeds therfrom. But if a hot pain trouble the forehead the disease, may be thought to proceed from some hot distemper of the Dura water, or the pericranium; but if in the very time of the raging of the disease the patient vomit, the matter of the disease proceeds from the stomach. But from whence soever it cometh there is scarce that pain of any part of the body, which may be compared to the pain of the inflamed eyes. Verily the greatness of the inflammation hath forced the eyes out of their orb, and broken them asunder in divers. Therefore there is no part of Physic more blazed abroad than for sore eyes. For the cure, the Surgeon shall consider and intend three things, diet, the evacuation The cure. of the antecedent and conjunct cause, and the overcoming it by topicke remedies. The diet shall be moderate, eschewing all things that may fill the head with vapours; and those things used that by astriction may strengthen the orifice of the ventricle, and prohibit the vapours from flying up to the head; the patient shall be forbidden the use of wine, unless peradventure the disease may proceed from a gross and viscide humour, as Galen delivers it. The evacuation of the matter flowing into the eye, shall be performed by purging medicines, phlebotomy in Com. ad aphor. 31. sect. 6. the arm, cupping the shoulders and neck with scarification, and without: and lastly, by frictions, as the Physician that hath undertaken the cure shall think it fit. Galen Lib. 13. meth. cap. ult. after universal remedies for old inflammations of the eyes, commends the opening of the veins and arteries in the forehead and temples, because for the most part the vessels thereabouts distended with acride, hot and vaporous blood, cause great & vehement pains in the eye. For the impugning of the conjunct cause, divers topic medicines shall be applied, according to the four sundry times or seasons that every phlegmon usually hath. For in the beginning, when as the acride matter flows down with much violence, repercussives do much conduce 〈◊〉 and tempered with resolving medicines, are good also in the increase. ℞. aq. ros. et plantag. an. ℥ ss. mucagin. gum. Tragacanth. ʒii. album. ovi quod sufficit, fiat collyrium, let it be dropped warm into the eye, and let a double cloth dipped in the same collyrium be put upon it. Or, ℞. mucag. sem. psil. An percussive medicine. & cydon. extractae in aq. plant. an. ℥ ss. aq. solan. & lactis muliebris, an. ℥ i. trochise. alb. rha.. ℈ i. fiat collyrium, use this like the former. The veins of the templesmay be streightene● by the following medicine. ℞. bol. arm. sang. drac. & mast. an. ℥ i. ss. alb. ovi, aquae ros. & acet. an. ℥ i. tereb. lot. & ol. cidon. an. ℥. ss. fiat defensivum. You may also use ungde Astringent emplasters. Bolo, empl. diacal. or contrarupturam dissolved in oil of myrtles, and a little vinegar. But if the bitterness of the pain be intolerable, the following cataplasm shall be applied. ℞. medul. pomor. sub. ciner. coctorum. ℥ iii lactis muliebris ℥ ss. let it be applied to the eye, the formerly prescribed collyrium being first dropped in. Or, ℞. mucag. An anodine cataplasm. sem. psil. & cidon. an. ℥ ss. micae panis albi in lacte infusi, ℥ two. aquae ros. ℥ ss. fiat cataplasma. The blood of a turtle Dove, Pigeon or Hen drawn by opening a vein under the wings, dropped into the eye, assuageth pain. Baths are not only anodine, but also stay the defluxion by diverting the matter thereof by sweats; therefore Galen much The efficacy of Baths in pains of the eyes. Adaphor. sect. 7. commends them in such defluxions of the eyes as come by fits. In the state when as the pain is either quite taken away or assuaged, you may use the following medicines. ℞. sarcocol. in lacte muliebri nutritae, ʒi. aloës lotain aq. rofar. ℈ two. trochis. alb. rha.. ʒss. sacchar cand.. ʒii. aquae ros. ℥ iii fiat collyrium. Or, ℞. sem. faeniculi, & fanug. an. Detergent Colllicia. ʒii. flow chamae. & melil. an. m. ss. coquantur in aq. come. ad ℥ iii colaturae adde tuthiae praep. & sareoc. nutritae in lacte muliebri. an. ʒi. ss. sacchari cand.. ℥ ss. fiat collyrium ut artis est. In the declination the eye shall be fomented with a carminative decoction, and then this collyrium dropped thereinto. ℞. nutritaeʒii. aloës & myrrh. an. ʒi. aq. ros. & euphrag. an. ℥ two. fiat collyrium, ut artis est. CHAP. XIII. Of the Proptosis, that is, the falling or starting forth of the eye, and of the Phthisis, and Chemosis of the same. THe greeks call that affect Proptosis, the Latins procidentia or Exitus oculi, when as the eye stands, and is cast out of the orb by the occasion of a matter filling and lifting up the eye into a greater bigness, and largeness of substance. The cause of this disease is sometimes external, as by too violent straining to vomit, by hard labour in childbirth, by excessive and wondrous The cause. violent shouting, or crying out. It sometimes happeneth that a great and cruel pain of the head, or the too straight binding of the forehead and temples for the easing thereof, or the palsy of the muscles of the eye, give beginning to this disease. Certainly sometimes the eye is so much distended by the defluxion of humours, that it breaks in sunder, and the humours thereof are shed, and blindness enfues thereof, as I remember befell the sister of Lewis de Billy merchant, dwelling at Paris near S. Michael's bridge. The cure shall be diversified according to the causes. Therefore universal medicines being premised, cupping glasses shallbe applied to the original The cure. of the spinal marrow, and the shoulders; as also cauteries, or Seton's: the eye shall be pressed or held down with clothes doubled and steeped in an astringent decoction made of the juice of Acacia, red roses, the leaves of poppy, henbane, roses and pomegranate pills: of which things poultices may be made by addition of barley meal and the like. There is sometimes to be seen in the eye an affect contrary to this, and it is termed Atrophia. By this the whole substance of the eye grows lank and decays, and The Atrophia of the eye. the apple itself becomes much less. But if the consumption and emaciation take hold of the pupil only, the greeks, by a peculiar name and different from the general, term it a Phihisis, as Paulus teacheth. Contrary causes shall be opposed to each affect; hot and attractive fomentations shall be applied; frictions shall be used The Phihisis thereof. Lib. 3. cap. 22. in the neighbouring parts, and lastly all things shall be applied which may without danger be used to attract the blood and spirits into the parts. There is another affect of the eye, of affinity to the Proptosis, which by the Greeks is termed Chemosis. Now this is nothing else than when both the eyelids are turned The●…sis ●…sis. Paulus li. 3. cap. up by a great inflammation, so that they can scarce cover the eyes, and the white of the eye is lifted much higher up than the black. Sometimes the Adnata changing his wont, looketh red; besides also, this affect may take its original from external causes, as a wound, contusion and the like. But according to the variety of the causes, and the condition of the present affect fixed and remaining in the part, divers remedies shall be appointed. CHAP. XIV. Of the Ungula, or Web. THE Ungula, Pterygion or Web is the growth of a certain fibrous and membranous flesh upon the upper coat of the eye called Adnata, arising more frequently in the bigger, but sometimes in the lesser corner towards the temples. When it is neglected, it covers not only the Adnata, but also some portion of the Cornea, and coming to the pupil itself hurts the sight thereof. Such a Web sometimes adheres not at all to the Adnata, but is only stretched over it from the corners of the eye, so that you may thrust a probe between it and the Adnata: it is of several colours, somewhiles red; somewhiles yellow, somewhiles duekish, & otherwhiles white. It hath its original either from external causes, as a blow, fall, and the like; or from internal, as the defluxion of humours into the eyes. The Ungula What Web curable, and what incurable. which is inveterate, and that hath acquired much thickness and breadth, and besides doth difficultly adhere to the Adnata, is difficultly taken away, neither may it be helped by medicines whereby scars in the eyes are extenuated. But that which covereth the whole pupil must not be touched by the Surgeon, for being cut away, the scar which is left by its density hindereth the entrance of objects to the crystalline humour, and the egress of the animal spirit to them. But oftentimes it is accompanied with an inflammation of the eyes, a burning itching, weeping defluxion, and swelling of the eyelids. That the cure may rightly and happily proceed, he The cure. must first use a spare diet, purging medicines shall be given, and blood taken away by opening a vein, especially, if there be great inflammation. For particular remedies, this excrescence shall be eaten away, or at least kept from growth by dropping into the eye collyrium of vitriol described in wounds of the eyes. But if that we profit nothing by this means, it remaineth, that we take it away with the hand after the following manner. You shall set the patient upon a form or stool, and make him lean much back, The cutting of the Web. and be so held firmly, that he may not fall nor stir; then must you open his sore eye, putting therein the speculum oculi formerly described in treating of the wounds of this part, and then must you lift up the Web itself with a sharp little hook, with the point turned a little in, and put under the midst of the Web; when you have lifted it a little up, thrust a needle threaded with a smooth thread between it & the Adnata, then taking hold of the hook, and the two ends of the thread drawn through with the needle, and lifting up the Web by them, you shall gently begin to separate it from the substance of the eye lying there-under, beginning at the original thereof with a crooked incision knife, and so prosecute it even to the end, yet so as you hurt no part of the Adnata, nor Cornea. The figures of little hooks, a needle, and crooked incision knife. Little Hooks. A needle. A crooked incision knife. Then must it be cut off with a pair sissers, and the white of an egg beaten with some Rose-water laid thereon, and often renewed. Afterwards the eye must every day be opened, lest coming to cicatrisation, the eyelids shall be glued together in that part whereas the Web is taken away, which also shall be hindered by putting of common salt, sage and cummin seeds into the eye, being first champed and chawed in the mouth. There are some who in stead of the crooked knife separate the Web from the Adnata with a horses hair, others do it with a goose quill made ready for the same purpose, taking heed that they hurt not the caruncle at the corner by the nose, for it will follow if that you draw the Web away too violently; and if it be cut, there will remain a hole, through which during the rest of the life a weeping humour will continually flow, a disease by the Greeks termed Rhyas. If after the cutting, there be fear of inflammation, linen rags moistened in repelling medicines, formerly prescribed in wounds of the eye, shall be laid thereupon. CHAP. XV. Of the Aegilops, fistula lachrimosa, or weeping Fistula of the eye. AT the greater corner of the eye there is a glandule, made for the receiving The use of the glandule at the greater corner of the eye. and containing the moisture which serveth for the lubricating and humecting the eye, lest it should dry by continual motion. This Glandule sometimes by a sanguine or pituitous defluxion falling violently from the brain, swells, impostumates & ulcerates with an ulcer, not seldom degenerating The differences. into a fistula, so that in success of time it rotteth the bone that lieth under it: of such fistulas, some are open outwardly, and these usually have their original from a phlegmon; other some are inwardly, and those are such as at first swelled by the defluxion or congestion of a phlegmatic matter, so that there appeareth no hole outwardly, but only a tumour of the bigness of a pease; this tumour being pressed, floweth with a sanious, serous and red, or otherwise with a white and viscide matter, and that either by the corner of the eye, or by the inside of the nose. Some have this matter flowing continually, others have it only monthly, which is proper periodical and Typical Fistulas. also to some fistulas. Such weeping fistulas if they become old, cause an Atrophia of the eye, & sometimes blindness, & a stinking breath. Therefore we must diligently and speedily by physical and chirurgical means resist the breeding disease. Wherefore, having used general medicines, we must come to particulars. Therefore if the ulcer be not sufficiently wide, it shall be enlarged by putting tents of sponge therein. The flesh of the Glandule increasing more than is fit, shall be corrected by The cure. putting therein the cathaereticke powders of Mercury, calcined vitriol, or some aqua fortis, or oil of vitriol, and lastly, by a potential cautery. If you cannot prevail by these means, and that the bone begins to rot, and the patient be stout hearted, then use an actual cautery whose use is far more effectual, ready, certain and excellent The efficacy of an actual cautery. than a potential cautery, as I have tried in many with happy success. In my opinion it makes no matter, whether the cautery be of gold, silver or iron; for the efficacy it hath, proceedeth not from the matter, but from the fire. Yet if we must religiously observe and make choice of metals, I had rather have it of Iron, as that which hath a far more drying and astringent faculty than gold, for that the element of earth beareth the chief sway thererein, as appeareth by the waters which flow through iron mines. Wherefore you shall cause to be made a triangular Iron, sharp at the end, that it may the more speedily penetrate. And then the sound eye and adjacent parts being well covered and defended, and the patient's head firmly holden in one's hands, lest the patient being frighted, stir himself in the very instant of the operation. But a plate of iron somewhat depressed in the midst, for the cavity of the greater corner, shall be applied and fitted to the pained eye. This plate shall be perforated that the hot Iron may pass thereby to the fistula lying thereunder, and so may only touch that which is to be cauterised. The figure of a cautery, and a plate with a hole therein. After the bone is burnt with the cautery, a collyrium made of the whites of eggs Things to be done after the cauterizing. beaten in plantain and nightshade waters must be poured into the hole itself, the eye and all the neighbouring parts; but the patient shall be laid in bed, with his head somewhat high, and the collyrium shall be renewed as often and as soon as you shall perceive it to grow dry. Then the fall of the Eschar shall be procured by anointing it with fresh butter; when it is fallen away, the ulcer shall be cleansed, filled with flesh, and lastly cicatrized. CHAP. XVI. Of the Staphiloma, or grape. like swelling. STaphiloma is the swelling of the horny and grape-like coat, bred What a Staphiloma is, and the causes thereof? through the occasion of an humour flowing down upon the eye, or by an ulcer, the horny coat being relaxed, or thrust forth by the violence of the pustule generated beneath. It in shape resembleth a grape, whence the greeks style it Staphyloma. This tumour is sometimes blackish, otherwhiles whitish. For if the horny coat be ulcerated and fretted in sunder, so that the grapie coat show itself, and fall through the ulcer, than the Staphyloma will look black like a ripe grape, for the utter part of the Uvea is blackish. But if the Cornea be only relaxed and not broken, than the swelling appears of a whitish colour like an unripe grape. The Ancients Paulus and Aetim. have made many kinds or differences thereof. For if it be but a small hole of the broken Cornea by which the Uvea showeth or thrusteth forth its self, they then termed it Myocephalon, that is, like the head of a fly. But if the hole were large, and also callous, they called it Clavus, or a nail; If it were yet larger, than they termed it Acinus, or a grape. But in what shape or figure soever this disease shall happen, it bringeth Every Staphiloma infers incurable blindness. two discommodities, the one of blindness, the other of deformity. Wherefore here is no place for surgery to restore the sight, which is already lost, but only to amend the deformity of the eye; which is by cutting off that which is prominent. But you must take heed that you cut away no more than is fit, for so there would be danger of pouring out the humours of the eye. CHAP. XVII. Of the Hypopyon, that is, the sappurate or putrefied eye. PUS, or Quitture is sometimes gathered between the horny and grapy coat from an internal, or external cause; From an internal, as by a The cause. great defluxion, and oft times after an inflammation, but externally, by a stroke, through which occasion a vein being opened hath poured forth blood thither, which may presently be turned into Quitture. For the cure, universal remedies being premised, cupping-glasses shall be applied, with scarification, and frictions used. Anodine and digestive collyria shall be poured from above downwards. Galen writes that he hath sometimes evacuated this matter, the Cornea being opened at the Iris, in which place all the coats meet, concur and are Lib. 4. method. cap. ult. terminated. I have done the like, and that with good success, James Guillemeau the the King's Surgeon being present, the Quitture being expressed and evacuated after the apertion. The Ulcer shall be cleansed with Hydronel, or some other such like medicine. CHAP. XVIII. Of the Mydriasis, or dilatation of the pupil of the eye. MYdriasis is the dilatation of the pupil of the eye; and this happeneth either by nature or chance: the former proceedeth from the default of The cause. the first conformation, neither is it curable; but the other is of two sorts; for it is either from an internal cause, the offspring of an humour flowing down from the brain, wherefore Physical means must be used for the cure thereof. Now that which cometh by any external occasion, as a blow, The cure. fall or contusion upon the eye, must be cured by presently applying repercussive and anodyne medicines, the defluxion must be hindered by diet skilfully appointed, phlebotomy, cupping, scarification, frictions, and other remedies which may seem convenient. Then must you come to resolving medicines; as the blood of a Turtle Dove, Pigeon, or Chicken reeking hot out of the vein, being poured upon the eye and the neighbouring parts. Then this following cataplasm shall be applied thereto. ℞. farinae fabar. & hordei an. ℥ iiii. ol. rosar. & myrtillor. an. ℥ i. ss. pull. ireos flor.. ʒii. cum sapa fiat cataplasma. You may also use the following fomentation. ℞. rosar. rub. A digesting Cataplasm. & myrtill. an. m. i florum melil. & chamam. an. p. i nucum cupress. ℥ i. vini austeri lb. ss. aq. rosar. & plantag. an. ℥ iii make a decoction of them all for a fomentation to be used with a sponge. CHAP. XIX. Of a Cataract. A Cataract is called also by the Greeks Hypochyma, by the Latins, A Cataract. suffusic. Howsoever you term it, it is nothing else but the concretion of an humour into a certain thin skin under the horny coat, just against the apple or pupil, and as it were swimming upon the watery humour; and whereas the place ought to be empty, opposing itself to the internal faculty of seeing, whereby it differeth from spots and scars growing upon the horny The differences. coat and Adnata. It sometimes covereth the whole pupil, otherwhiles but the one half thereof, and somewhiles but a small portion thereof. According to this variety the sight is either quite lost, weak, or somewhat depraved; because the animal visive spirit cannot in its entire substance pass through the density thereof. The defluxion of the humour whence it proceeds, is either caused by an external occasion, Causes. as a stroke, fall, or by the heat or coldness of the encompassing air, troublesome to the head and eyes; or else it is by an internal means, as the multitude; or else the acride hot and thin quality of the humours. This disease also sometimes taketh its original from gross and fumid vapours sent from a crude stomach, or from vaporous meats or drinks, up to the brain, and so it falleth into the eyes, where by the coldness, straightness and tarrying in the place, they turn into moisture, and at length into that concretion or film which we see: The signs may be easily drawn, Signs. from that we have already delivered. For when the cataract is form and ripe, it resembleth a certain thin membrane spread over the pupil, and appeareth of a different colour, according to the variety of the humour whereof it consisteth, one while white, another while black, blue, ashcoloured, livid, citrine, greene. It sometimes resembleth quicksilver, which is very trembling and fugitive, more than the rest. At the first when it beginneth to breed they seem to see many things, as flies flying up and down, hairs, nets, and the like, as if they were carelessly tossed up and down before their eyes: sometimes every thing appeareth two, and somewhiles less than they are; because the visive spirit is hindered from passing to the objects by the density of the skin, like as a cloud shadowing the light of the Sun. Whence it is that the Patients are duller sighted about noon, and surer and quicker sighted in the morning and evening, for that the little visive spirit diffused through the air, is dispersed by the greater light, but contracted by the less. Now if this film cover half the pupil, than all things show but by halves; but if the midst thereof be covered and as it were the centre of the Crystalline humour, than they seem as if they had holes or windows: but if it cover it all, then can he see nothing at all, but only the shadows of visible bodies, and of the Sun, Moon, Stars, lighted candles, and the like luminous things, and that but confusedly and as by conjecture. CHAP. XX. The physical cure of a beginning Cataract. A Beginning Cataract is hindered from growing and concretion by Diet for such as are troubled with a Cataract. diet conveniently and artificially prescribed, by the abstinence from wine, especially more strong and vaporous, and forbearing the use of meats, which yield a phlegmatic juice and vaporous, as pease, beans, turnips, chestnuts, and lastly all such things as have the faculty of stirring up the humours, and causing defluxion in the body, such as are all salt & spiced meats, as also garlic, onions, mustard. The immoderate use of venery hurts more than all the rest, for that it more violently exagitates the whole body, weakens the brain and head, and begets crude humours. Let his bread be seasoned with some fennel seeds, for it is thought to have a faculty Bread seasoned with fennel seeds. of helping the fight, and clearing the eyes, and dissipating the misty vapours in the stomach before they can ascend to the brain. Wherefore by the same reason it is good to use marmelade of quinces, conserve of roses, and common drige powder, or any such like composed of things good to break wind, or corroborate the ventricle. Phlebotomy and purging, if they be requisite, shall be fitly appointed: Ventoses shall be applied to the shoulders and neck; the phlegmatic matter shall be diverted and evacuated by the mouth with using masticatories in the morning. There be some which believe that a beginning cataract may be dissipated and discussed by often rubbing the eyelids with the fingers, and in like sort by the often and earnest beholding of the Stars, and the Moon when it is at the full, looking-glasses, diamonds, and all other such like bright shining things. I believe that by beams plentifully How bright shining things may dissipart a beginning Cataract. and suddenly brought and diffused over the eye, directly opposite against some bright shining thing, it may seem to have a penetrating, dividing, dissolving, as also a consuming and drying faculty. Besides, also the hot breath of him who holdeth in his mouth, and chaweth fennel seeds, aniseeds, coriander-seeds, nutmeg, cinnamon, cloves, and the like, hath a great faculty, the eyes being first gently rubbed with the finger, it being breathed in, near at hand and often received, to heat, attenuate, resolve, digest, and diffuse the humour which is ready to concrete. Moreover, this collyrium of John Vigo is thought very powerful to clear the eyes, strengthen the sight, hinder suffusions, and discuss them if at any time they concrete and begin to gather. ℞. hepatis hircini sani & recentis lib. two. calami aromatici & A Collyrium dissipating a beginning Cataract. mellis an. ℥ 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. succiruta, ʒiii. aquae chelidoniae, faniculi, verbenia cuphosiae, an. ʒiii. piperis longi, nucis moschatae, caryophyllorum an. ʒii. croci ℈ two. floris rorismarini aliquantum contriti, m. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. sarcocolla, aloës hepaticae, an. ʒiii. fellis raiae, leporis & perdicis, an. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 i. terantur omnia, tritisque adde sacchari albi ℥ two. rosatiʒvi. conjiciantur in alembicum vitreum & distillentur in balnco Mariae; Let this distilled liquor be often dropped into the eyes. But if you prevail nothing by all these medicines, and that the cloudy and heaped up humour doth daily increase and thicken, then must you abstain from remedies, and expect until it be no more heaped up, but thickened, yea until it seem to be grown somewhat hard. For so at length it may be couched with a needle; otherwise if this same skin shall not be ripe, but more tender than is fitting, when you shall come to the operation, it will be broken and thrust through with the needle, and not couched. On the contrary, if it be too hard, it will resist the needle, neither will it suffer itself to be easily couched. Wherefore it is requisite that the A Cataract must not be couched unless it be ripe. Surgeon know when it is ripe, and he must diligently observe the signs whereby he may discern a ripe Cataract from an unripe; and that which is curable, from that which is uncurable. For that only which is ripe and curable is to be couched; that which is unripe, that is, such an one as is more tender, and as it were crude, and that which is more hard and dense, and lastly, that which is uncureable must not be attempted at all. CHAP. XXI. By what signs ripe and curable cataracts may be discerned from unripe and uncurable ones. IF the sound eye being shut, the pupil of the sore or suffused eye, after it shall be rubbed with your thumb, be presently dilated and diffused, and with the like celerity return into the place, figure, colour and state, it is thought by some to show a ripe and confirmed cataract. But an unripe and not to be couched, if the pupil remain dilated and diffused for a long while after. But it is a common sign of a ripe, as also more dense and consequently uncurable suffusion, to be able to see nor distinguish no visible thing beside light and brightness; for to discern other objects showeth that it is not yet ripe. Therefore the sound eye being shut and pressed, the pupil of the other rubbed with your thumb, is dilated, enlarged, swelleth and is more diffused; the visive spirits by this compression being as it were forced from the sound into the fore eye. But these following cataracts are judged uncurable, that is, such as are great, such as when the eyelid is rubbed are nothing dilated or diffused, whose pupil becometh no broader by this rubbing: for hence you may gather that the stopping or obstruction is in the optic nerve, so that how cunningly and wellsoever the cataract be conched, yet will the Patient continue blind; you shall do no more good in couching a Uncurable Cataracts. cataract, which is in an eye consumed and wasted with a Phthisis. Also that cataract is uncurable which is occasioned by a most grievous disease, to wit, by most bitter and cruel pains of the head, or by a violent blow. Such as are of a plaisterlike, green, black, livid, citrine and quicksilver-like colour, are usually uncurable. On Curable Cataracts. the contrary, such as are of a Chestnut colour, or of a sky or sea-water colour, with some little whiteness; yield great hope of a happy and successful cure. CHAP. XXII. Of the couching a Cataract. AFter you shall know by the forementioned signs, that the Cataract is curable, When to couch a Cataract. it remains that you attempt the couching thereof, but so, that there be nothing which may hinder. For if the pain of the head, cough, nauseousness or vomiting at that time trouble the patient, you shall then bestow your labour in vain: Wherefore you must expect until these symptoms be gone. Then make choice of a season fitting for that purpose, that is, in the decrease of the moon, when the air is not troubled with thunder nor lightning, and when as the Sun is not in Aries, because that sign hath dominion over the head. Then let the Surgeon consult a Physician whether purging or blood-letting be convenient for the Patient, so to resist plethoric symptoms, otherways ready to yield matter for relapse. Two days after you must make choice of a place furnished with indifferent or competent The place light, and the Patient being fasting shall be placed in a straight chair, so that the light may not fall with the beams directly upon him, but sidewise. The eye which shall be cured must be made more steady, by laying and binding wool upon the other: Then the Surgeon shall feat and place himself directly against the Patient upon a seat somewhat higher, and bidding the Patient put his hands down to his girdle, he shall hold the patient's legs between his knees. One shall stand at the Patients back who shall hold his head and keep it from stirring; for by a little stirring he may lose his sight for ever. Then must you prepare and make ready The needle your needle, and thrust it often into some strong thick cloth, that it may be as it were smooth by this motion, and for the performance of the work in hand with the less pain somewhat warmed. It must be made of iron or steel, and not of gold or silver, it must be also flatted on the sides, and sharp pointed, that so it may the better pierce into the eye, and wholly couch the Cataract once taken hold of; and lest it should slip in the Surgeon's hand, and be less steady, it shall be put into a handle, as you may see by the following figure. A needle inserted in a handle for the couching of Cataracts. All things being thus in a readiness, you must bid the patient to turn the sight of his eye towards his nose, and the needle must be boldly thrust (for it is received in a place that is void, and only filled with spirits) directly by the coat Adnata, in the middle space between the lesser corner & the horny coat, just against the midst of the Cataract, yet so, as that you hurt no vein of the Adnata, & then by stirring it as it were diversely until it come to the midst of the pupil and suffusion. When it is come Gal. lib. 10. de usts partium. cap. 5. Cells. lib. 7. thither, the needle must be inclined from above downwards to the suffusion, and there to be stirred gently until by little and little it couch or bring down the Cataract as whole as may be beneath the compass of the pupil; let him still follow it though couched with his needle, and somewhat violently depress, and keep it down for some short space, that so it may rest and stay in that lower place whether it is depressed. The Surgeon shall try whether it firmly remain there or no, bidding the patient presently to move his eye; For if it remain constantly so, and do not return The sign of a Cataract well couched. again, the cure is perfect. Then must the needle be lifted up by little and little, neither must it presently be taken forth, that if the Cataract should bear up, or rise again, that it might again, and so often (whilst the work is yet hot, and all things in a readiness) be couched towards the lesser corner, until it be fully and surely hid. Then must you draw back the needle gently, and after the same manner as you put it in; lest if you use not moderation, you bring back the Cataract, from whence you couched it, or grievously offend the crystalline humour, the prime instrument of sight, or the pupil with danger of dilating thereof. Some as soon as the work is done, give the patient something in his hand to look upon: but Paulus approves Lib. 6. cap. 21. not thereof, for he fears lest his endeavouring or striving to see, may draw back the Cataract. Wherefore it is more wisdom and better, presently after the drawing What to be done after the couching of a Cataract. forth of the needle, to put on a soft rag the white of an egg beaten in rose-water with a little choice alum, and so apply it to the eye and neighbouring parts for to bind and hinder the inflammation; then also you must together therewith bind up the sound eye, lest by stirring to see, it might together therewith draw and move the fore eye, by reason of the sympathy and consent they mutually have by the optic nerves. After all things are thus performed, the patient shall be laid in a solt bed, & so placed, that his head may lie somewhat high; let him be laid far from noise, let him not speak, nor eat any hard thing that may trouble his jaws, wherefore let him feed upon liquid meats, as pomado, barley cream, cullisses, jellies, rear eggs, and other meats of the like nature. At the end of eight days the ligature that binds up his eyes shall be loosed, and his eyes washed with rose water, and putting on spectacles, or some taffeta, the patient shall by little and little accustom himself to the light, lest he should be offended by the sudden meeting with light. But if the suffusion, after some short while after, lift itself up again, it must be couched again, but through a new hole, for the eye is pained and tender in the former place. It sometimes happens by the touch of the needle that the Cataract is not couched whole, but is broken into many pieces; then therefore each of them must be followed, and couched severally: if there be any very small particle which escapes the needle, it must be let alone, for there is no doubt but that in process of time it may be dissolved by the force of the native heat. There are also some Cataracts Of a Cataract which is broken to pieces. which at the first touch of the needle are diffused & turn into a substance like to milk or troubled water, for that they are not throughly ripe, yet these put us in good hope of recovery, and it be but for this, that they can never afterwards concrete into one body as before. Wherefore at the length they are also discussed by the strength of the native heat, and then the eye recovers its former splendour. If that any other symptoms come unlooked for, they shall be helped by new counsels and their appropriate remedies. CHAP. XXIII. Of the stopping of the passage of the ears, and the falling of things thereinto. IT sometimes happeneth that children are born without any holes in their ears, a certain fleshy or membranous substance growing The cause. in their bottom or first entrance. The same may also happen afterwards by accident, they being ulcerated by some imposthume or wound, and the ear shut up by some fleshy excrescence or scar. When as the stopping is in the bottom of the cavity, the cure is more difficult than if it were in the first entrance. But there The cure. is a double way of cure; for this substance, whatsoever it be, must either be cut out, or else eaten away and consumed by acrid and catheriticke medicines; in performance of which there is need of great moderation of the mind and hand. For it is a part endued with most exquisite sense and near the brain, wherefore by handling it too roughly, there is fear of distension of the nerves, and consequently of death. Sometimes also the preternatural falling of strange bodies into this passage, maketh a stopping of the ears, such as are fragments of stones, gold, silver, iron and the like metals, pearls, cherry-stones, or kernels, peafe and other such like pulse. Now solid and bonny bodies still retain the same magnitude; but pease, seeds and kernels, by drawing the moisture there implanted into them, swell up, and cause vehement pain by the distension of the neighbouring parts, wherefore the sooner they are drawn forth, the better it is for the patient. This shall be done with small pincers and instruments made in the shape of earepicks. But if you profit nothing thus, then must you use such gymblets as are made for the drawing forth of bullets shot deep into the body. Little stones and bodies of the like stony hardness shall be The concussive force of sneesing. forced forth by the brain, provoked to concussion by sneesing, & by dropping some oil of almonds first into the passage of the ear, that the way may be the more slippery; for it will come to pass by this sneesing, or violence of the internal air forcibly seeking passage out, that at length they may be cast forth, the mouth and nostrils being stopped with the hand. But if we cannot thus prevail, it remains, that we cut open the passage with an incision knife, so much as shall be sufficient for the putting in and using of an instrument for to extract them. If any creeping things of little creatures, as fleas, ticks, pismires, gnats and the like, which sometimes happeneth, shall get therein, you may kill them by dropping in a little oil and vinegar. There is a certain little creeping thing, which for piercing and getting into the ears, the French call Perse-oreille (we an Eare-wigge). This, if it chance to get into the ear, may be killed by the foresaid means, you may also catch it, or draw it forth by laying half an apple to your ear, as a bait for it. CHAP. XXIV. Of getting of little bones and such like things out of the jaws and throat. SOmetimes little bones and such like things in eating greedily use to stick, or as it were fasten themselves in the jaws or throat. Such bodies The cure different according to the places where they stick. if you can come to the sight of them shall be taken out with long, slender and crooked mallets made like a Crane's beak. If they do not appear, nor there be no means to take them forth, they shallbe cast forth by causing vomit, or with swallowing a crust of bread, or a dry fig gently chawed, and so swallowed; or else they shall be thrust down into the stomach, or plucked back with a leek, or some other such like long and stiff crooked body anointed with oil and thrust down the throat. If any such like thing shall get into the Weazon you must cause coughing by taking sharp things, or else sneesing, so to cast forth whatsoever is there troublesome. CHAP. XXV. Of the toothache. OF all pains, there is none which more cruelly tormenteth the patients The Tooth ache a most cruel pain. than the toothache. For we see them ofttimes after the manner of other bones to suffer inflammation, which will quickly suppurate, and they become rotten, and at length fall away piecemeal; for we see them by daily experience to be eaten and hollowed, and to breed worms, some portion of them putrefying. The cause of such pain is either internal, or external and primitive. The internal is a hot or cold defluxion of humours The cause thereof. upon them, filling their sockets, & thence consequently driving out the teeth; which is the reason that they stand sometimes so far forth, that the patient neither dares nor can make use of them to chaw for fear of pain; for that they are loose in their sockets by the relaxation of the gums, caused by the falling down of the defluxion. When as they are rotten and perforated even to the roots, if any portion of the liquor in drinking, fall into them, they are pained as if you thrust in a pin or bodkin, the bitterness of the pain is such. The signs of a hot defluxion are sharp Signs of this or that defluxion. and pricking pain, as if needles were thrust into them, a great pulsation in the root of the pained tooth and the temples, and some ease by the use of cold things. Now the signs of a cold defluxion are a great heaviness of the head, much and frequent spitting, some mitigation by the use of hot remedies. In the bitterness of pain we must not presently run to Tooth-drawer's, or cause them presently to go in hand to pluck them out. First consult a Physician, who may prescribe remedies according to the variety of the causes. Now here are three intentions of cureing. The first is concerning diet; the other for the evacuation of the defluxion or antecedent Three scopes of curing. cause; the third for the application of proper remedies for the asswaging of pain. The two former scopes, to wit, of diet, and diverting the defluxion by purging, phlebotomy, application of cupping glasses to the neck and shoulders, and fcarification, do absolutely belong to the Physician. Now for proper and to pick medicines they shall be chosen contrary to the cause. Wherefore in a hot cause, it is good washing the mouth with the juice of Pomgranats, plantain water, a little vinegar A cold & repercussive lotion for the mouth. wherein roses, balaustiae and sumach have been boiled. But such things as shall be applied for the mitigating of the pain of the teeth, aught to be things of very subtle parts, for that the teeth are parts of dense consistence. Therefore the ancients have always mixed vinegar in such kind of remedies. ℞. rosar. rub. sumach. hordei, an. m. ss. conquassatiʒii. santalorum an. ʒi. lactucae summitatum rubi, solani, plantaginis, an. m. ss. bulliant omnia in aquae lib. iiii. & pauco aceto ad hordei crepaturam. Wash the mouth with such a decoction being warm. You may also make Trochisces for the same purpose after this manner. ℞. sem. hyoscyami, sandarachae, coriandri, Trochisces for a hot defluxion. opii an. ʒss. terantur & cum aceto incorporentur, formentur que trochisci apponendi dentibus dolentibus. Or else, ℞. seminis portulacae, hyoscyami, coriandri, lentium, corticis santali citrini, rosar. rub. pyrethri, camphorae, an. ʒss. Let them all be beaten together with strong vinegar, and made into trochisces, with which being dissolved in rose water, let the gums and whole mouth be washed when need requireth. But if the pain be not assuaged with these, you shall come to narcoticks, which may narcotics. stupefie the nerve; as, ℞. seminis hyoscyami albi, opii, camphorae, papaveris albi, an. quantum sufficit, coquantur cum sapa, et denti applicentur. Besides, you must also put this following medicine into the ear of the pained side. ℞. opii & castorei, an. ℈ i. misceantur cum oleo rosato: It hath sometimes availed in swollen and distended gums, being first lightly scarified, to have applied leeches, for the evacuation of the conjunct matter, as also to have opened the veins under the tongue, or these which are behind the ears. For I remember that I, by these three kinds of remedies, assuaged great pains of the teeth. Yet there be some who in this affect open not these veins which are behind the ears, but those which are conspicuous in the hole of the ear in the upper part thereof. Pain of the teeth arising from a cold cause and defluxion, may be helped by these remedies; boil rosemary, sage, and pellitory of Spain in wine and vinegar, and add thereto a little aqua vitae, in this liquor dissolve a little treacle, and wash your teeth therewith. Others mingle Gum ammoniacum dissolved in aqua vitae with a little sandar acha and myrrh, and lay it to the pained tooth, after Vigoes' counsel. Mesue thinks that beaten garlic carried in the right or left hand, assuages the pain, as the teeth ache upon the right or left side. But I being once troubled with grievous pain in this kind, followed the counsel of a certain old woman, and laid garlic roasted under the embers to my pained tooth, and the pain forthwith ceased. The same remedy used to others troubled with the like affect, had like success. Moreover, some think it available if it be put into the auditory passage. Others drop into the ears oil of castoreum, or of cloves, or some such other chemical oil. It is good also to wash the teeth with the following decoction. ℞. pyrethriʒss. menthe et rutae an. p. i bulliant in aceto, and with this decoction being warm, wash the teeth. Some like fumes better, & they make them of the seeds of Coloquintida and Hot fumes. mustard, and other like; they take the smoke by holding their mouths over a funnel. Other some boil pellitory of Spain, ginger, cinnamon, alum, common salt, nut megs, cypress nuts, anise and mustard seeds, and euphorbium in oxycrate, and in the end of the decoction add a little aqua vitae, and receive the vapour thereof through a funnel: as also they wash their teeth with the decoction, and put cotton dipped therein into the ear, first dropping in a little thereof. Some there are which affirm that to wash the teeth with a decoction of Spurge is a very good and anodyne medicine in the toothache. I have oft times assuaged intolerable pains of the teeth by applying vesicatories under the ear, to wit, in that cavity whereas the lower Vesicatories. jaw is articulated with the upper: for the vein, artery and sinew which are distributed to the roots of the teeth, lie thereunder. Wherefore the blisters being opened, a thin liquor runs out, which doth not only cause, but also nourish or feed the disease. But if the tooth be hollowed, and that the patient will not have it pulled out, there is no speedier remedy, than to put in caustick medicines, as oil of vitriol, aqua fortis, Caustics. and also a hot iron; for thus the nerve is burnt insunder, and loseth its sense. Yet some affirm that the milky juice that flows from Spurge made into a paste with Olibanum and amylum, and put into the hollowed tooth, will make it presently to fall away in pieces. When the Gums and Cheeks are swollen with a manifest tumour, than the patient begins to be somewhat better and more at ease. For so by the strength of nature, the tumour causing the pain is carried from within outwards. But of what nature soever the matter which causeth the pain be, it is convenient to intercept the course thereof with Empl. contra rupturam, made with pitch and mastic, and applied to the temple on that side where the tooth acheth. CHAP. XXVI. Of other affects of the teeth. THe teeth are also troubled with other preternatural affects. For sometimes they shake by relaxation of the gums, or else become corrupt and rotten, or have worms in them, or else are set on edge. For the first, the gums are relaxed either by an external or primitive cause, as a fall or Causes of looseness of the teeth. blow: or else by an internal or antecedent, as by the defluxion of acrid or waterish humours from the brain, or through want of nourishment in old bodies. If the teeth grow loose by the means of the decaying gums, the disease is then incurable: but you may withstand the other causes by the use of such things as fasten the teeth, shunning on the contrary such as may loosen them. Therefore the patient must not speak too earnestly, neither chaw hard things. If they become loose by a fall or blow, they must not be taken forth, but restored and fastened to the next that remain firm, for in time they will be confirmed in their sockets, as I tried in Anthony de la Rue a tailor, who had his jaw broken with the pommel of a dagger, and three of his teeth loosened and almost shaken out of their sockets; the jaw being restored, A History. the teeth were also put in their places, and bound to the rest with a double waxed thread; for the rest, I fed the patient with broths, jellies, and the like, and I made astringent gargarisms of cypress nuts, myrtle berries, and a little alum boiled in oxycrate, and I wished him to hold it a good while in his mouth: by these means I brought it so to pass, that he within a while after could chaw as easily upon those teeth, as upon the other. I heard it reported by a credible person, that he saw a Lady of the prime nobility, who instead of a rotten tooth she drew, made a sound tooth, drawn from one of her waiting maids at the same time, to be substituted and inserted, which tooth in process of time, as it were taking root, grew so firm, as that she could chaw upon it as well as upon any of the rest. But as I formerly said, I have this but by hearsay. Now the teeth are corroded or eaten in by an acride and thin humour penetrating The causes of hollow teeth. by a plenteous and frequent defluxion even to their roots, and being there contained, it putrefies, and becoming more acride, it doth not only draw the teeth into the contagion of its putrefaction, but also perforats and corrodes them. The putrefaction may be corrected, if after general medicines, you put oil of vitriol or aqua fortis into the hole of the eaten tooth: or else, if you burn the tooth The cure. itself to the root with a small iron wyar being red hot: you shall thrust this hot iron through a pipe or cane made for the same purpose, lest it should harm any sound part by the touch thereof, and thus the putrefaction, the cause of the arrosion, may be stayed. But if the hole be on the one side between two teeth, then shall you file away so much of the sound tooth as that you may have sufficient liberty to thrust in your wiar without doing any harm. The forms of Files made for filing the teeth. Worms breeding by putrefaction in the roots of the teeth, shall be killed by the use of caustics, by gargles or lotions made of vinegar wherein, either pellitory of Causes of worms in the teeth. Spain hath been steeped, or Treacle dissolved also; Aloes and Garlic are good to be used for this purpose. Setting the teeth on edge happens to them by the immoderate eating of acride or tart things, or by the continual ascent of vapours endued with the same quality, Causes of setting the teeth an edge. from the orifice of the ventricle to the mouth, or by a cold defluxion, especially of acride phlegm, falling from the brain upon the teeth, or else by the too excessive use of cold or stupising liquors. This affect is taken away, if after general medicines and shunning those things that cherish the disease, the teeth be often washed with aqua vitae, or good wine wherein sage, rosemary, cloves, nutmegs and other things of the like nature have been boiled. CHAP. XXVII. Of drawing of teeth. Tooth are drawn, either for that they cause intolerable pains, which will not yield to medicines, or else for that they are rotten and hollowed, so that they cause the breath to smell; or else for that they infect the sound and whole teeth, and draw them into the like corruption, or because they stand out of order. Besides, when they are too deep and strongly rooted, so that they cannot be plucked out, they must oft times be broken of necessity, that so you may drop some caustick thing into their roots, which may take away the sense, and consequently the pain. The hand must be used with much moderation in the drawing out of a tooth; for the Jaw is sometimes dislocated by the A caveat in drawing of teeth. too violent drawing out of the lower teeth. But the temples, eyes and brain are shaken with greater danger by the too rude drawing of the upper teeth. Wherefore they must first be cut about, that the gums may be loosed from them, then shake them with your fingers, and do this until they begin to be loose; for a tooth which is fast in, and is plucked out with one pull, ofttimes breaks the jaw, and brings forth the piece together therewith, whence follow a fever and a great flux of blood not easily to be stayed (for blood or pus flowing out in great plenty is, in Celsus opinion, Lib. 7. cap. 18. the sign of a broken bone) & many other malign and deadly symptoms: some have had their mouths drawn so awry, during the rest of their lives, so that they could scarce gape. Besides, if the tooth be much eaten, the hole thereof must be filled either with Lint, or a cork, or a piece of lead well fitted thereto, lest it be broken under your forceps, when it is twitched more straightly to be plucked out, and the root remain, ready in a short time to cause more grievous pain. But judgement must be used, and you must take special care lest you take a sound tooth for a pained one; for ofttimes the patient cannot tell, for that the bitterness of pain by neighbourhood is equally diffused over all the jaw. Therefore for the better plucking out a The manner of drawing teeth. tooth, observing these things which I have mentioned, the patient shall be placed in a low seat, bending back his head between the Tooth-drawer's legs; then the Tooth-drawer shall deeply scarify about the tooth, separating the gums therfrom with the instruments marked with this letter A. and then if spoilt as it were of the wall of the gums, it grow loose, it must be shaken and thrust out by forcing it with the three-pointed levatory noted with this letter B. but if it stick in too fast, and will not stir at all, then must the tooth be taken hold of with some of these toothed forcipes marked with these letters C. D. E. now one, than another, as the greatness, figure, and site shall seem to require. I would have a tooth-drawer expert and diligent in the use of such toothed mullets; for unless one know readily and cunningly how to use them, he can scarce so carry himself, but that he will force out three teeth at once, ofttimes leaving that untouched which caused the pain. The effigies of Forcipes or mullets for the drawing of teeth. Instruments for scraping the teeth, and a three-pointed levatory. The form of another Instrument for drawing of teeth. After the tooth is drawn, let the blood flow freely, that so the part may be freed What to be done when the tooth is plukt out. from pain, and the matter of the tumour discharged. Then let the tooth-drawer press the flesh of the gums on both sides with his fingers whereas he took out the tooth, that so the socket that was too much dilated and oft times torn by the violence of the pluck, may be closed again. Lastly, the mouth shall be washed with oxycrate; and if the weather be cold, the patient shall take heed of going much in the open air, lest it cause a new defluxion upon his teeth. CHAP. XXVIII. Of cleansing the Teeth. Pieces of meat in eating sometimes stick between the teeth, and becoming corrupt by long staying there, do also hurt the teeth themselves, Causes of foul or rusty teeth. and spoil the sweetness of the breath. He that would eschew this, ought presently after meat to wash his mouth with wine mixed with water, or oxycrate, and well to cleanse his teeth that no slimy matter adhere to them. Many folks teeth by their own default gather an earthy filth of a yellowish colour, which eats into them by little and little, as rust eats into iron. This rusty filthiness, or as it were mouldiness of the teeth, doth also oft times grow by the omitting of their proper duty, that is, of chawing. Whence soever this slimy The cure. filth proceeds, we must get Dentifrices to fetch it off withal, and then the teeth must be presently rubbed with aqua fortis and aqua vitae mixed together, that if there be any thing that hath scaped the Dentifrices, it may be all fetched off; yet such acride washings are hurtful to the sound teeth, for that they by little and little consume A caution in the use of acride things. and waste the flesh of the gums. Dentifrices shall be made of the root of marsh mallows boiled in white wine & Alum; and as when the teeth are loose we must abstain from such things as are hard to be eaten and chawed, but much more from breaking of such things as are of a bony consistence, also here we must shun all things that by their toughness stick to the teeth. Many for the cleansing of the teeth, commend a powder made of scuttle bones, purple shells, pumice stone, burnt alum, and heart's horn, and a little cinnamon, which is a singular remedy for the teeth howsoever affected. Many other are content with bread only toasted & beaten; but this following water is very effectual to whiten the teeth. ℞. sal. ammon. & gemmei, an. ℥ i. alum. roch. ℥ ss. aquae ros. quod A water to whiten the teeth. sufficit, destillentur. And let the teeth be cleansed with this distilled liquor. CHAP. XXIX. Of the impediment and contraction of the Tongue. THe tongue is sometimes tied and short from the nativity; as when the The cause of being tonguetied. liberty of the tongue is restrained by the subject and neighbouring as well membraines as muscles, being either too short or too hard. Sometimes this disease happens after they are borne by some accident or preternatural affect, as by too hard a scar left by the healing of an ulcer under the tongue. The patient at his beginning to speak, is too slow in speaking, but presently leaving his slowness he becomes too quick, so that he stammers. If the disease The cure. proceed from the astriction and shortness of the ligamental membrane lying under the tongue, than the in incision shall be made broadwise, having great care that the veins and arteries which are there, be not violated, for fear lest they should cause a haemorrhagy not easily to be stayed: Then the mouth shall be presently washed with oxycrate, and some lint dipped in syrup of dried roses, or honey of roses put into the midst of the incision, lest the part of the ligament, especially on the night time when the tongue is silent and at rest, should grow to the rest of the ligament. For the same purpose the finger shall be often thrust this way, and the tongue more violently rolled up and down, & thrust out of the mouth. Yet sometimes this ligament is so thick & short, and therefore holds down the tongue so close, that you cannot come to cut it with a knife or lancet without great and manifest danger of death by bleeding: Therefore in such a case a needle and thread shall be thrust through it, and so the Another way to cut it. thread shall be tied straighter and straiter every day, until by little and little this ligamental tie of the tongue, which by its immoderate shortness intercepts the liberty of the motion shall be consumed and broken. CHAP. XXX. Of superfluous Fingers, and such as stick together. EAch hand hath naturally five fingers only; whatsoever is more or less The differences. is against nature: and if there be fewer, it is a fault not to be helped by art. But if there be more, that for the most part may be helped by art: superfluous fingers usually grow by the thumb, or the little finger, but seldom otherwise, These are either wholly fleshy, or have bones of their kind and nails upon them. Those which are of a bony nature do either arise from the joints of the natural fingers, and are jointed like them, and so are oft times movable, or else from some middle space of a joint, and these have not power to stir or move. Now they are sometimes equal in magnitude to the natural fingers to which they grow, yet more frequently they are shorter. Those which are only fleshy, are easily amputated and made even with a razor; but such as are also bony cannot be cut off, unless with the cutting mullets hereafter described, and this is a disease of the fingers in number. There is also another disease in figure, for they sometimes stick together, and otherwhiles they are very little separated. This fault happens either from the first original by the error of the formative faculty; or else it happens afterwards by accident, as by a wound or burn ill cured. For neighbouring fingers being ulcerated do easily grow together, unless they be kept a sunder by a linen rag. And if they by chance shall grow together by a little and thin skin and flesh, they shall forthwith be divided with a sharp razor; but if they be joined by the interposition of a more gross and dense substance, to wit, the nerves, tendons, and vessels, being knit together on each side, it will be best not to meddle at all with the dividing them. Cutting Mullets neatly made for the cutting off superfluous Fingers. Neither must we omit, that many have their nails run with such bony sharpness The cure of nails running into the flesh of the fingers. into the flesh of their fingers lying under them, that they cause most cruel pain; neither commonly do you avail any thing by paring them; for growing up within a while after, they press downwards again with the more violence. Therefore the Surgeon is often forced to cut away all the flesh whereinto the sharpness of the nail runs. Which I have done in many with happy success. Many have corns growing upon their fingers in divers fashions: They are taken off by paring away by little How to take off the corns of the fingers. and little the callous hardness, and then laying a head of garlic beaten thereon. Yet the cure is more quick and certain which is performed by caustics, as aqua fortis, or oil of vitriol. CHAP. XXXI. Of the too short a Praepuce, and of such as havebin circumcised. WHen as the Praepuce or foreskin is too short, it cannot cover the glans. This happens either by nature, to wit, by the first conformation, or afterwards by some accident, as to those whom religion and the custom The cause. of their nation bids to be circumcised. The cure is thus. The Praepuce is turned up, and then the inner membrane thereof is cut round, and great The cure. care is had, that the vein and artery which are there between the two membranes of the Praepuce, be not cut in sunder. Hence it is drawn downward by extension, until it cover the glans, a deficcative emplaster being first put between it and the glans, lest they should grow together. Then a pipe being first put into the urinary passage, the praepuce shall be there bound until the incision be cicatrized. This cure is used to the Jews, when having abjured their religion full of superstitions, for handsomeness sake, they would cover the nut of their yard with a praepuce, and so recover their cut off skin. CHAP. XXXII. Of Phymosis and Paraphymosis, that is, so great a constriction of the praepuce about the Glans or Nut, that it cannot be bared or uncovered at Pleasure. THe prepuce is straitened about the Glans two ways; for it either covers the whole nut, & so straight encompasses the end thereof, that it cannot be drawn upwards, and consequently the nut cannot be uncovered; or else it leaves the Glans bare under it, being fastened so stiffly to the roots thereof, that it cannot be turned up, nor drawn down, or over the Glans. The first manner of constriction is termed Phymosis, the latter Paraphymosis. The Phymosis happens either by the fault The causes. of the first conformation, or else by a scar, through which occasion the praepuce hath grown lesser, as by the growing of warts. Now Paraphymosis is often occasioned by the inflammation of the yard, by impure copulation; for hence ulcers breed between the praepuce and Glans, with swelling, and so great inflammation, that the praepuce cannot be turned back. Whence it is that they cannot be handled and cured as you would, and a gangrene of the part may follow, which may by the contagion The cure. bring death to all the body, unless it be hindered & prevented by amputation: but if a scar be the cause of the constriction of the praepuce, the patient being placed in a convenient site, let the praepuce be drawn forth and extended, and as much as may be stretched and enlarged, then let the scar be gently cut in three or four places on the inner side with a crooked knife, but so, that the gashes come not to the outside, and let them be an equal distance each from other. But if a fleshy excrescence or a wart shall be the occasion of this straightness and constriction, it shall be consumed by the same remedies, by which the warts of the womb and yard are consumed or taken off. But when as the praepuce doth closely adhere to the Glans on every side, the cure is not to be hoped for, much less to be attempted. CHAP. XXXIII. Of those whose Glans is not rightly perforated, and of the too short or straight ligament, bridle, or Cord of the yard. SOme at their birth, by evil conformation, have not their Glans perforated in the middle, but have only a small hole underneath, toward the bridle The cause. & ligament of the yard, called the cord. Which is the cause, that they do not make water in a straight line, unless they turn up their yard toward their belly, neither by the same reason can they beget children, because through this fault of conformation, the seed is hindered from being cast directly into the womb. The cure is wholly chirurgical, and is thus performed. The praepuce The cure. is taken hold of and extended with the left hand, but with the right hand, the extremity thereof, with the end of the Glans, is cut even to that hole which is underneath. But such as have the bridle or ligament of the yard too short, so that the yard cannot stand strait, but crooked, and as it were turned downwards; in these also the generation of children is hindered, because the seed cannot be cast directly and plentifully into the womb. Therefore this ligament must be cut with much de xterity, and the wound cured after the manner of other wounds, having regard to the part. Children also are sometimes borne into the world with their fundaments unperforated, Such as are borne without a ho●… their fund●… are not long lived. for a skin preternaturally covering the part, hinders the passage forth of the excrements; those must have a passage made by art with an instrument, for so at length the excrements will come forth: yet I have found by experience, that such children are not naturally long lived, neither to live many days after such section. CHAP. XXXIV. Of the causes of the stone. THE stones which are in the bladder have for the most part had their first original in the reins or kidneys, to wit, falling down from thence Why children are subject to the stone in the bladder. by the ureters into the bladder. The cause of these is twofold, that is, material and efficient. Gross, tough, and viscide humours, which crudities produce by the distempers of the bowels and immoderate exercises, chiefly immediately after meat, yield matter for the stone; whence it is that children are more subject to this disease than those of other ages. But the efficient cause is either the immoderate heat of the kidneys, by means whereof the subtler part The cause. of the humours is resolved, but the grosser and more earthy subsides, and is hardened as we see bricks hardened by the sun and fire; or the more remiss heat of the bladder, sufficient to bake into a stone the faces or dregges of the urine gathered in great plenty in the capacity of the bladder. The straightness of the ureters and urenary passage may be accounted as an assistant cause. For by this means the thinner portion of the urine floweth forth, but that which is more feculent and muddy being stayed behind, groweth as by scaile upon scaile, by addition and collection of new matter into a stony mass. And as a week oftentimes dipped by the Chandler into melted tallow, by the copious adhesion of the tallowy substance presently becomes a large candle; thus the more gross and viscide faeces of the urine stay as it were at the bars of the gathered gravel, and by their continual appulse are at length wrought and fashioned into a true stone. CHAP. XXXV. Of the signs of the stone of the Kidneys and bladder. THE signs of the stone in the reins, are the subsiding of red or yellow sand in the urine, a certain obscure itching at the kidneys, and the sense of a weight or heaviness at the loins, a sharp and Why the thigh i●…●umme in the stone of the reins. pricking pain in moving or bending the body, a numbness of the thigh of the same side, by reason of the compression caused by the stone, of the nerves descending out of the vertebrae of the loins of the thigh. But when the stone is in the bladder, the fundament and Signs of the stone in the bladder. whole perinaeum is pressed as it were with a heavy weight, especially if the stone be of any bigness, a troublesome & pricking pain runs to the very end of the yard, and there is a continual itching of that part, with a desire to scratch it: hence also by the pain and heat there is a tension of the yard, and a frequent and needless desire to make water, and sometimes their urine cometh from them drop by drop. A most grievous pain torments the patient in making water, which he is forced to show by stamping with his feet, bending of his whole body, and the grating of his teeth. He Why such as have a stone in the bladder are troubled with the falling of the fundament. is oft times so tormented with excess of pain, that the Sphincter being relaxed, the right gut falleth down, accompanied with the swelling heat and pain of the Haemorrhoid veins of that place. The cause of such tormentis, the frequent striving of the bladder to expel the stone wholly contrary to the nature thereof, whereto by sympathy the expulsive faculty of the guts and all their parts of the belly come as it were for supply. The sediment of the urine is gross & viscid, and ofttimes like the whites of eggs, which argueth the weakness of the native heat not attenuating the juices. The patient looketh of a pale and yellowish complexion and hollow eyed, by reason of the almost continual watching which is caused by the bitterness of pain; yet may it more certainly be known by putting in, or searching with a Cathaeter. How to sear●n for the stonein the bladder with a Cathaeter. Which to do, the patient shall be wished to stand with his body somewhat stooping, leaning against somewhat with his back, and holding his knees some foot asunder. Then the Cathaeter being bigger or lesser as the body shall require, and anointed with oil or butter, shall be thrust with a skilful hand into the passage of the urine, and so into the capacity of the bladder. But if the Cathaeter cannot come to that capacity, the patient shall be placed in such a posture; then shall he be laid upon his back on a bench, or the feet of a bed, with his knees bended, and his heels drawn to his buttocks, after which manner he must almost lie when he is to be cut for the stone, as shall be shown hereafter. For thus the Cathaeter is more easily thrust into the bladder, and shows there is a stone by the meeting and obscure sound of the obvious, hard and resisting body. You must have sundry Cashaeters, that they may serve for every body bigger and lesser, and these must be crooked, smooth and hollow. When being thrust into the urenary passage (which before unawares I omitted) they come to the neck of the bladder, they must not be thrust straight into the bladder, but taking hold of the yard with the left hand, they must be gently thrust with the right directly into the bladder, especially in men, by reason of the length and crookedness of the way, which trends in the form of this letter S. It is not so in The figure of the neck of the bladder is different in men and women. women by reason of the shortness and straightness of the neck of the bladder. It is fit your Cathaeters be hollow or fistulous in manner of a pipe, that they may receive a silver wiar or string, that may hinder the gross and viscide humour, clotted blood, or the like, from stopping the further end of the Cathaeter, through which the suppressed urine ought to pass & be made. But now assoon as we perceive that the Cathaeter is come into the capacity of the bladder, the wiar must be drawn forth, that so the urine may the freelier flow out by the hollowness of the Cathaeter. You may perceive the shapes of these instruments by this following figure. The figure of Cathaeters, and of a silver string or wiar. CHAP. XXXVI. Prognostickes in the stone. WHen the stone is cast forth of the kidney (whereas it bred by little and little) and is so driven into one of the ureters, that it wholly stop it, yet thereupon there followeth no suppression of the urine; for seeing nature hath made divers parts of our body double, all the urine floweth into the other ureter. But if they shall be both stopped with stones, there is no doubt but the urine will be wholly suppressed, and death ensue by the suffocation and extinction of the native heat, by How death may ensue by the suppression of the urine. the urine flowing back by the rivelits of the veins over all the whole body. Such as have a small stone cast forth of their reins into the cavity of the ureters, these, until this stone be fallen into the bladder, have cruel pain with gripings, with often desire to go to stool and make water, but ofttimes do neither. For such ofttimes have their bellies distended with flatulencies: an argument hereof is their continual belching, or breaking of wind. But by sneesing & coughing, or any other concussion of the whole body, a pricking pain is forthwith felt, whereas the stone stops, especially if it be either rough, or have sharp points like horns. This pain is communicated to the hip and thigh by sympathy, and some have the stones drawn up as it were with great violence. To these may be added the Colic, choleric vomiting, and almost a general sweat. The stone in the kidneys is most commonly bred in such as are ancient, by reason of the weakness of the expulsive faculty. But the stone in the bladder happeneth to such as are more young, because the native heat is more vigorous in such, and strong and inordinate motions increase the strength of the expulsive faculty. When the stone is in the bladder, and the urine appeareth bloody, it is the sign of a small, as also a prickly and rough stone, for thus it more easily entereth into the neck of the bladder, and exulcerateth it being fleshy, whence the blood cometh away with the urine, and most cruel pain as of needles thrust into the flesh, especially after labour and much exercise: on the contrary, a larger and more smooth stone will not cause such tormenting pain, and it causeth a milky water. The shapes of stones bred in the kidneys are various, according to the variety of the strainers through which they pass whilst they are bred. Verily I have seen Why stones of the kidneys have sundry shapes. stones which represented the figure of grayhounds, hogs and other creatures, and things wholly contrary to man's nature, by the production of their prickles and as it were branches. Some are four square, others longish and like a finger, other some of a round figure with many protuberancies like a pine apple kernel; neither is the variety less in magnitude, number and colour: for some are yellowish, others whitish, red, ashcoloured or some other like, according to the various temper of the affected bodies. The stones of choleric and lean men usually concrete by preternatural heat and dryness; but those of phlegmatic or fat bodies, of a certain as it were congelation and obstruction of the passages. A stone falling sometimes from the bottom of the bladder into the passage of the urine quite stops it up, and thence followeth a total suppression of the urine. Therefore than the patient shall be placed upon his back and his legs being lifted up on high, he shall be shaken and tossed up and down, just as one would shake up a sack to fill it; for thus it is forced back into the bladder from whence it came, from the passage of the urine whereinto it was got; yet it may also be forced back by thrusting in a Cathaeter. The pain which afflicteth such as have the stone is some while continual, yet more frequently it cometh by fits and returns, sometimes monthly, other whiles yearly. Such as have the stone in the kidneys make for the most part waterish urine. Women are Why men are more subject to to the stone than women. not so subject to the stone as men, for they have the neck of their bladder more short and broad, as also more strait; wherefore the matter of the stone by reason of the shortness of the passage is evacuated in gravel, before it can be gathered and grow into a stone of a just magnitude; yet stones breed in some women and those equally as big as in men, and therefore they are to be cured by section and the like remedies. When the stone exceedeth the bigness of an egg, it can scarce be taken away without the tearing of the bladder, whence happeneth an unvoluntary shedding of the water, curable by no art, because the bladder, seeing it is nervous and without blood, being once torn admitteth no consolidation, add hereto that inflammation and a What stones ca●… taken out of the bladdes without killing the patient. gangrene often following the rending of the bladder bring inevitable death. The patient runs the same hazard, if along stone be pulled out sidewise with your instrument, or if it be enclosed in a membrain (which kind of stone can scace be found with a Cathaeter) and so be fastened to the bladder, or otherwise if the stone itself be fastened into the substance of the bladder, or lastly if by any chance the Surgeon being about to pluck out the stone shall hurt the body of the bladder with his instruments. Yet stones of an indifferent bigness are more safely extracted out of the bladder than those which are less, and the patient more frequently and happily recovereth. For they do not scape from the instrument, and the patient being used a long while to endure pain, as that which hath been a long time a growing, doth more easily and constantly away with the inflammation, pain and other symptoms, which happen after cutting, yea in cutting. Having thus spoken of the causes, signs, places, symptoms and prognostics, we must come to the cure, beginning with that part which is termed Prophylactice, that is, the preventing part. CHAP. XXXVII. What cure is to be used when we fear the stone. DIet must first be appointed, which by the convenient use of the six What diet such must use as fear the stone. things not natural (as they term them) may heap up small store of gross, tough and viscide humours in our bodies. Therefore cold and cloudy air is to be shunned. They must abstain from fish, beef, pork, waterfoule, pulse, cheese, milk meats, fried and hard eggs, rice, cakes and all pastry, unleavened bread, and lastly all manner of obstructing meats. Also garlic, onions, leeks, mustard, spices, & lastly all things which overheat the blood and humours must be shunned, especially if you fear that the stone is concrete by the heat of the reins. Standing and muddy waters, thick and troubled wines, bear, and such kind of liquors must be eschewed. Satiety in meats and drinks is to be shunned, as that which breeds crudities. Also long watching and continual labour because they inflame the blood, cause crudities, and preternatural heat must carefully be eschewed, as also all more vehement passions of the mind. If the body be plethoric, than it must be evacuated by phlebotomy, purging and vomiting, which is accounted for a singular remedy for the prevention of this disease. For the performance of all which things a Physician shall be consulted. But because Physicians are not in every place and always at hand, I have thought good to set down these following medicines; yet we must first remember this counsel of Galen; The Lib. 13. method. use of diuretics, and strong purging medicines is hurtful, as often as there is inflammation in the reins and bladder, for so the confluxe of the humours to the affected parts is the greater, whence the inflammation and pain are increased. Wherefore first using relaxing medicines, as six drams of Cassia newly drawn, with ℈ iv. of Rhubarb in powder mixed therewith; then lenitive and refrigerating medicines shall be inwardly and outwardly used, such as is this following syrup. ℞. summitatum malu. bismal. & violar. an. m. ss. rad. alth. ℥ i. glycyr. ℥ ss. 4. sem. frigid. A lenitive and lubricating syrup. major. an. ʒi. fiàt decoctio. ℞. pradict. decoctionis lb. ss. in colatura dissolve sacch. albiss. ℥ two. mellis albi ℥ iss. fiat syrupus secund. artem; let the patient use this often. This following apozem is also very effectual for the same purpose. ℞. rad. aspar. gramin. polyp. quercini, A diuretic Apozem. passul. mund. an. ℥ ss. betonic. herniar. agrimon. omnium capill. & pimpinel. an. m. ss. 4. sem. frigid. major. & sem. funic. an. ʒi. folior. sen. ʒvi. fiat decoct. ad lb. ss. incolatura dissolve syrupi de Alth●● & de ●erniar. an. ℥ iss. Make a clear apozem and let it be aromatized with a little cinnamon, for two doses; let him take the first dosis in the morning two hours before meat, and the other at four of the clock in the afternoon. Moreover this following broth hath an excellent and certain power to prevent the stone. ℞. hordei integr. p. i. radic. petroselini, acetoes. foenicul. cichor. brusci an. ℥ i 4. sem. frigidorum A diuretic and ●…h. conquassatorum. an. ℥ ss. fol. acetoes. portul. lactucae, summitatum malvae, & violar. an. m. ss. bulliant in aqua fluviatili cum gallo gallinaceo & crure vitulino; let the broth be kept, and let the Patient take thereof six ounces for four days; in the morning two hours before meat, with an ounce of the juice of Citrons gently warmed with the same broth at the time of the taking thereof; for thus, much urine will be made in a short while after, full of a sandy sediment and a gross viscide humour. Whereby you may certainly gather that this kind of broth is very effectual to cleanse the passages of the urine, neither in the interim, doth it any harm to the stomach and other parts by which it passeth: so that it may be rightly esteemed a medicinal nourishment. You may also profitably use this following powder. ℞. nucleorum mespilorum A diuretic powder. ℥ i. pull. elect. diamarg. frig. ʒii. 4. sem. frigid. majorum mund. glycyrhizae rasae, ʒi. sem. saxifrag. ʒii. sem. milii solis, genist. pimpinel. brusci & asparag. an. ℈ i. sem. altheae, ʒiss, succh. albiss. ℥ vi. fiat pulvis; let him take a spoon full in the morning three hours before meat. Also some think that lie made of the stalks and husks of beans is The lie made of the ashes of bean stalks a diuretic. Anodine glisters in the stone. a good preservative against this disease. Besides the use of this following clyster hath done good to many. ℞. fol. lactuc. scariol. portul. an. m. i. flor. viol. & nenuph. an. p. i fiat decoctio. ad lib. i. in colatura dissolve cassiae fistulae ℥ i. mellis viol. & sacch. rub. an. ℥ iss. olei viol. ℥ iiii. siat clyster. This which followeth is the fitter to assuage the pain. ℞. flo. cham. melil. summitat. aneth. berul. an. p. two. fiat decoctio in lacte vaccino; in colatura dissolve cassiae fistul. & sacchar. alb. an. ℥ i. vitellos ovorum num. two. anʒii. fiat clyster. In the interim let the kidneys be anointed on the outside with unguentum rosatum, refrigerans Galen. and populeon used severally, or mixed together, laying thereupon a double linen clothe dipped in oxycrate. But if the concretion of the stone be of a cold cause, the remedies must be varied, as follows; ℞. terebinth. venet. ʒi. citriʒii. aquae coct. ʒii. fiat potio. Or else, ℞. cassiaerecent. extract. ʒvi. benedict. lax. ʒiii. aq. foenicul. ℥ two. aq. asparag. ℥ i. fiat potio; let him take it Remedies against the stone of the kidneys coming from a cold cause. three hours before dinner: this following apozem is also good. ℞. anʒiii. bismal. cum toto, beton. an. m. ss. anʒii. sem. melon. glycyrhiz. ras. an. ʒiiss. ficus num. 4. fiat. decoct. ad quart. iii in express● colatura, dissolve syrup. de caphan. & oxymilitis scillitici an. ℥ i. ss. sacchar. albis. ℥ iii fiat apozema pro tribus dosibus, clarificetur & aromatiz. cum. ʒi. cinam. & ʒss. saint. citrin. let him take four ounces three hours before dinner. Or else, ℞. rad petrosel. foenicul. an. ℥ i. saxifrag. pimp. gram. & bardan. an. m. ss. quatuor seminum frig. major. mundat. & milii. solis an. ʒii. fiat decoctio, cape de colatura lb. ss. in qua dissolve sacch. rub. & syrup. capill. ven. an. ℥ i. ss. Let it be taken at three doses, two hours before meat. The following powder is very effectual to dissolve the matter of the stone. ℞. sem. petrosel. & rad. ejusdem mundat. an ℥ ss. sem. cardui, quem colcitrapam vocant, ℥ i. let them be dried in an oven or stone with a gentle fire, afterwards let them be beaten severally and make a powder, whereof let the patient take ℈ i. ss. or two scruples with white wine, or chicken broth fasting in the morning by the space of three days. Or, ℞. coriand. praep. ℈ iv. anʒii. zinzib. & cinam. an. ℈ two. electiʒi. cari ℈ two. galang. nucis moschat. & lapid. judiaci an. ℈ i. diacrydi●ʒii. ss. misce, fiat pulvis: the dosis is about ʒi. with white wine three hours before meat. Against the flatulencies which much distend the guts in this kind of disease, glisters shall be thus made; ℞. malu. bismal. pariet. origani, calament. Carminative glisters. flo. chamaem. sumitat. anethi, an. m. ss. anisi, carvi. cumini, foenic. an. ℥ ss. baccar. laur. ʒiii. rutaeʒii. fiat decoctio, in colatura, dissolve bened. lax. vel diaphaenic. ℥ ss. lauriʒiii. sacchar. rub. ℥ i. olei aneth. chamaem. & rutar. an. ℥ i. fiat clyster. Or, ℞. olei nucum & vini mal. an. lb. ss. aq. vitae. ℥ ss. fiat clyster; let it be kept long, that so it may have the more power to discuss the wind. CHAP. XXXVIII. What is to be done, when the stone falleth out of the Kidney into the Ureter. Ofttimes it falleth out that the reins using their expulsive faculty force down the stone (whose concretion and generation the Physicians Signs of the stone stopping in the ureter. by the formerly prescribed means could not hinder) from themselves into the ureters; but it stayeth there either by reason of the straightness of the place, or the debility of the expulsive faculty. Therefore then cruel pain tormenteth the patient in that place whereas the stone sticketh, which also by consent may be communicated to the hip, bladder, ●esticles and yard, with a continual desire to make water and go to stool. In this case it behooveth the Physician that he supply the defect of nature, and assist the weak endeavours. Therefore let the patient if he be able mount upon a trotting horse, and ride upon Remedies 〈…〉 force ●own the stone sticking in the ureter. him the space of some two miles, or if he can have no opportunity to do, so, then let him run up and down a pair of stairs until he be weary, and even sweat again; for the stone by this exercise is ofttimes shaken into the bladder; then presently shall be given or taken by the mouth such things as have a lenitive and relaxing faculty, as oil of sweet almonds newly drawn and that without fire, and mixed with the water of pellitory of the wall and white wine. Let frictions of the whole body be made from above downwards with hot clothes; let Ventoses with a great flame be applied one while to the loins, and another while to the bottom of the belly, a little below the grieved place; and unless the patient vomit of his own accord, or by the bitterness of his pain, let vomiting be procured with a draught of water and oil luke warm; for vomiting hath much force to drive down the stone, by reason of the compression of the parts, which is caused by such an endeavour: lastly, if the stone descend not by the power of these remedies, than the patient must be put into a Semicupium, that is, a Halfe-bath, made of the following decoction. ℞. malvae, bismal. cum toto an. m. two. beton. nasturt. saxifrag. berul. parietar. violar. A decoction for a bath. an. m. iii semin. melonum, milii solis, alkekengi an. ʒvi. cicer. rub lb. i. rad. appiis, gram. faeniculi, & eryngii, an. ℥ iiii. in sufficienti quantitate aquae pro incessu; coquantur ista omnia inclusa sacco; herein let the patient sit up to the navel: neither is is fit that the patient tarry longer in such a bath than is requisite, for the spirits are dissipated, and the powers resolved by too long stay therein. But on the contrary, if the patient remain as long as is sufficient in these rightly made, the pain is mitigated, the extended parts relaxed, and the passages of urine opened and dilated, and thus the stone descendeth into the bladder. But if it be not moved by this means any thing at all out of the place, and that the same total suppression of urine do as yet remain, neither before the patient entered into the bath the putting of a Cat●aeter into the bladder did any thing avail, yet notwithstanding he shall try the same again after the patient is come out of the bath, that he may be throughly satisfied whether peradventure there may be any other thing in these first passages of the yard and neck of the bladder, which may withhold the urine; for the Cathaeter will enter far more easily, the parts being relaxed by the warmness of the bath: then inject some oil of sweet almonds with a syringe into the Urethra or passage of the yard; whilst all these things are in doing, let not the patient come into the cold air. But here I have thought good to describe a chair for a bath, wherein the patient may fitly sit. The figure of a chair for a Semicupium. A. showeth the whole frame of the Chair. B. The hole wherein the patient must sit. C. The Cistern that holds the water. D. A Cock to empty the water when it groweth cold. E. A Funnel whereby to pour in warm water. There may also be another decoction made for the bath, as thus: ℞. rad. raph. alth. an. lb. two. rad. rusc. petrosel. & asparag. an. lb. i cumin. foenicul. ameos an. ℥ iiii. sem. lini, faenug. an. ʒvi. fol. marub. parietar. florum chamaem. melil. anethi, an. m. two. bulliant omnia secundum artem in aquae sufficienti, & vini albi odoriferi exigua quantitate ad consumptionem tertiae partis pro Semicupio. Also the same decoction may be used for glisters, adding thereto two yolkes of eggs, and four ounces of oil of lilies, with ʒi. of oil of Juniper, which hath a certain force to assuage the pain of the stone and colic. But a far less quantity of the decoction in a glister must be used in these diseases, than usually is appointed in other diseases; otherwise there will be danger lest the guts being distended should more press upon the kidneys and ureters, troubled in some sort with inflammation, and so increase the pain and other symptoms. This following cataplasm shall be profitably applied to the grieved place, to wit, the loins or flanks and bottom of the belly, for it is very powerful to assuage pain, and help forwards the falling down of the stone. ℞. rad. alth. & raphani, an. ℥ iiii. pariet. foenic. senecionis, nasturt. berul. an. m. i herniariae m. ss. omnibus in aquasufficienti An Anodine Cataplasm. decoctis, & deinde contritis, add olei aneth. chamaem. & pingued, cuniculi, an. ℥ two. farin. cicer. quantum sufficit, fiat cataplasma ad usum praedictum. After by these means the Signs of the stone fallen out of the ureter into the bladder. stone forced out of the ureter is fallen into the bladder, the pain presently (if there be but one stone, for sometimes more with much gravel do again fall into the ureter) is mitigated, and then the patient is troubled with an itching and pricking at the end of his yard and fundament. Therefore than unless he be very weak, it is fit that he ride and walk a foot, and take ʒiv. of species Lithontribon in four doses with white wine, or the broth of red Cicers three hours before dinner and supper. Besides, let him plentifully drink good wine, and after he hath drunk, let him hold in his urine as long as he can; that so it being gathered in greater plenty, it may presently thrust the stone out of the bladder with the more force: for which purpose you may also inject the following liquor into the bladder. ℞. syrupi capill. ven. ℥ i. aquae alkekengi ℥ iii olei scorpionum. ℥ ss. Let it be injected into the bladder with a syringe. CHAP. XXXIX. What must be done the stone being fallen into the neck of the bladder, or passage of the yard. AFter the stone is fallen out of the capacity of the bladder, and stops in the neck thereof, or passage of the yard, the Surgeon shall have a special care that he do not force or thrust back the stone from whence it came, but rather that he press it gently with his fingers to the end of the yard, the passage being first made slippery by injecting some oil of sweet almonds. But if it stop in the end of the Glans, it must be plucked out with some crooked instrument; to which if it will not yield, a Gimlet with a pipe or case thereto, shall be put into the passage of the yard, and so it shall be gotten out, or else broken to pieces by the turning or twining about of the Gimlet, which I remember I have divers times attempted and done; for such Gimlets are made with sharp screws, like ordinary Gimlets. The delineation of a Gimlet made to break the stones in the passage of the yard, together with its pipe, or case. The effigies of another lesser Gimlet. Verily what Gimlets soever are made for this business, their body nor point must be no thicker than a small probe; lest whilst they are forced or thrust into the urethra, or urinary passage, they might hurt the bodies next unto them by their violent entrance. CHAP. XL. What course must be taken, if the stone sticking in the Urethra or urinary passage, cannot be gotten out by the forementioned arts. BUT if the stone be more thick, hard, rough and remote from the end of the yard, than that it may be gotten out by the means formerly mentioned in the precedent chapter, and if that the urine be wholly suppressed When the yard may besafely cut. therewith; then must you cut the yard upon the side with a straight wound: for you must not make incision on the upper part for fear of a flux of blood, for a large vein and artery lieth thereunder; nor in the lower part, for so it would scarce ever heal again, for that it is a bloodless part, and besides, the continual and acride falling of the urine would hinder the agglutination: wherefore the incision must be made on the side, on that part whereas the stone most resists and swells out. For that part is the more fleshy; yet first the end of the skin of the prepuce must be much drawn up so to cover the Glans, which being done, the Urethra shall be tied with a thread a little above the stone, that so the stone may be stayed there, and may not fall back again. Therefore then, incision being made, the stone must be taken forth, and the skin which was drawn more violently to cover the Glans is to be let go back again; for so it will come to pass that a whole part of the skin may cover the cut yard, and so it may be the more speedily united and the urine may naturally flow out. I have by this means ofttimes taken forth the stone with the instruments here delineated. Instruments fit to take the stone forth of the opened Urethra, or urenary passage of the yard. Then for the agglutination, if need require, it will be requisite to sew up the lips of the wound, and apply this agglutinative medicine following. ℞. tereb venet. ℥ iiii. gum. elemi, ℥ i. sang. dracon & mastic. an. ʒss. fiat medicamentum ut dictum est: then the An agglutinative medicine. whole yard must be covered over with a repercussive medicine made of the whites of eggs, with the powder of bowl armenick, aloes, farina volatilis, and oil of roses. Lastly, if need so require, a wax candle, or leaden string anointed with Venice turpentine shall be thrust into the Urethra to hasten the agglutination, and retain the natural smoothness and straightness of the urenary passage, lest peradventure a caruncle how to hasten the agglutination. grow therein. CHAP. XLI. What manner of section is to be made when a stone is in a boy's bladder. HItherto we have showed, by what means it is convenient to draw small stones out of the ureter, bladder and passage of the urine; now will we briefly show the manner of taking of greater stones out of the bladder, which is performed by incision and iron instruments, and I will deliver the practice thereof first in children, then in men, and lastly in Why the boy must be shaken before cutting. women. First therefore let the Surgeon take the boy (upon whom it is determined the work shall be performed) under the arm holes, and so give him five or six shakes, that so the stone may descend the more downwards to the neck of the bladder. The must you cause a strong man sitting upon a high seat to lay the child upon his back with his face from himward, having his hips lying upon his knees. The How to place the child before dissection. child must lie somewhat high that he may breathe the freelier, & let not the nervous parts be too much stretched, but let all parts be loose and free for the drawing forth of the stone. Furthermore, it is fit that this strong man, the child's legs being bended back, wish the child, that putting his legs to his hams, that he draw them up as much as he can, & let the other be sure he keep them so; for this site of the child much conduceth to well performing of the work. Then let the Surgeon thrust two of the fingers of his left hand as far into the child's fundament as he is able; but let him with his other hand press the lower belly, first wrapping a cloth about his hand, that so the compression may be the less troublesome, and lest inflammation should happen rather by this means than by the incision. Now the compression hath this use, to cause the stone descend out of the bottom of the bladder into the neck thereof under the os pubis, whither after it is arrived, it must be there kept, & as it were governed by the command of your hand, lest it should slide from that place whereto you have brought it. These things thus done, nothing now remaineth, but that the Surgeon, with a wound some two fingers breadth distant from the fundament, cut through all the flesh even to the stone on the left side of the perinaeum. But in the interim, Where to divide the perinaeum. let him beware that he hurt not the intestinum rectum; for it may, and usually doth happen, that whilst the stone is brought out of the bottom of the bladder to the neck thereof, this gut is doubled in: now if it be cut with your incision knife, it cometh to pass that the excrements may sometimes come out at the wound, and the urine by the fundament, which thing hath in many hindered the agglutination and consolidation of the wound; yet in some others it hath done little harm, because Nature very powerful in children. in this tender age many things happen, which may seem to exceed nature: the incision being made, the stone must be plucked forth with the instrument here expressed. Hooks to pull stones forth of children's bladders. The stone being drawn out, a small pipe shall be put into the wound, and there kept for some space after, for reasons hereafter to be delivered; then his knees shall be bound together, for thus the wound will the sooner close and be agglutinated. General rules must be reduced to particular bodies. The residue of the cure shall be performed by reducing the general cure of wounds, to the particular temper of the child's age, and the peculiar nature of the child in cure. CHAP. XLII. How to cut men, for the taking out of the stone in the bladder. seeing we cannot otherwise help such men as have stones in their bladders, we must come to the extreme remedy, to wit, cutting. But the patient must What to be done before dissection. first be purged, and if the case require, draw somebloud; yet must you not immediately after this, or the day following hasten to the work, for the patient cannot but be weakened by purging & bleeding. Also it is expedient for some days before to foment the privities with such things as relax and soften, that by their yielding, the stone may the more easily be extracted. Now the cure is thus to be performed; The patient shall be placed upon a firm table or bench with a cloth many times How to lay the patient. doubled under his buttocks, and a pillow under his loins & back, so that he may lie half upright with his thighs lifted up, and his legs and heels drawn back to his buttocks. Then shall his feet be bound with a ligature of three fingers breadth cast about his ankles, and with the heads thereof being drawn upwards to his neck, and cast about it, and so brought downwards, both his hands shall be bound to his knees, as the following figure showeth. The figure of a man lying ready to be cut for the stone. The patient thus bound, it is fit you have four strong men at hand; that is, two to hold his arms, and other two who may so firmly and straightly hold the knee with one hand, and the foot with the other, that he may neither move his limbs, nor stir his buttocks, but be forced to keep in the same posture with his whole body. Then the Surgeon shall thrust into the urenary passage even to the bladder, a silver or Why the probe must be ●it on the outside. iron and hollow probe, anointed with oil, and opened or slit on the out side, that the point of the knife may enter thereinto, and that it may guide the hand of the workman, and keep the knife from piercing any farther into the bodies lying there-under. The figure of this probe is here expressed. Probes with slits in their ends. He shall gently wrest the probe, being so thrust in, towards the left side, and also Why the s●ame of the perinaeum must not be cut. he who standeth on the patients right hand, shall with his left hand gently lift up his Cod, that so in the free and open space of the left side of the perinaeum, the Surgeon may have the more liberty to make the incision upon the probe which is thrust in and turned that way. But in making this incision, the Surgeon must be careful that he hurt not the seam of the perinaeum and fundament. For if that seam be cut, it will not be easily consolidated, for that it is callous and bloodless, therefore the urine would continually drop forth this way. But if the wound be made too near the fundament, there is danger, lest by forcible plucking forth of the stone he may break some of the haemorrhoide veins, whence a bleeding may ensue, which is scarce to be stopped by any means, or that he may rend the sphincter muscle, or body of the bladder, so that it can never be repaired. Therefore it must be made the space of two fingers from the fundament, according to the straightness of the fibres, that so it Where to make the wound to take forth the stone. may be the more easily restored afterwards. Neither must the incision thus made, exceed the bigness of ones thumb, for that it is afterwards enlarged by putting in the Crow's beak and the dilater, but more by the stone as it is plucked forth. But that which is cut, is neither so speedily nor easily healed up, as that which is torn. Then presently put into the wound some one of these silver instruments delineated That which is torn is sooner healed than that which is cut. here below, and called by the name of Guiders, for that they serve as guides to the other instruments which are to be put into the bladder; these are made with a round & prominent head, whereby it may be put into the described cavity of the probe, and they are noted by these letters A. A. then there are others marked with the letters B. B. and called by the like name, and are to be put under the former, being made forked at the end, that so it may, as it were, embrace the end of the former. The figures of Guiders of two sorts. Now the probe is to be drawn forth, and the Guiders to be thrust and turned up and down in the bladder, and at length to be stayed there by putting in the pin; yet such Guiders as want a pin are fitter for the hand, and are by some called spathoe. Then must they be held betwixt the Surgeon's fingers. It will be also necessary for the Surgeon to put another instrument called the Duck's bill between the two Guiders into the capacity of the bladder, he must thrust it in some what violently, and dilate it so thrust in with both his hands, turning it every way to enlarge the wound as much as shall be sufficient for the admitting the other instruments which are to be put into the bladder; yet it is far better for the patient, if that the wound may with this one instrument be sufficiently dilated, and the stone pulled forth with the same without the help of any other. The effigies of an instrument called a Duck's bill. Which if you have not in a readiness, and the largeness of the stone require more dilatation, then must you put in this Dilater, for being put into the bladder, and the handle pressed together, it will dilate the incision as much as you desire. The figure of a Dilater shut and opened. The wound by the help of this instrument being dilated as much as is sufficient' then put in the straight Ducks-bill before described, or the crooked here express. Crooked Forcipes like a Ducks-bill. The stone may be sought & taken hold of with these instruments, and being taken hold on, the branches of the instrument shall be tied together, lest they should suffer that to slide away which they have once taken hold of. Neither shall the stone be suddenly plucked out, but easily shaken too & again, and at the length gently drawn forth. Yet you must beware that you do not press it too straightly in the forcep●, lest you should break it in pieces: Some, lest it should slip away, when they have once taken hold thereof, put their two fingers into the fundament, and put them above the stone that it may not fall out, nor slip back again, which I think conduceth much to the easy extraction of the stone. There are others who strengthen this comprehension by putting in on each side above and below these winged instrument, so that the stone can slip forth on no side. Winged instruments to hold the stone with the Ducks-beake. The figure of another. The figure of another winged instrument, the end of whose handle is fastened by a screw, as also a bended iron plate which is marked with this letter A. for the firmer holding thereof. After the stone is by these means drawn forth, observe diligently whether it be worn on any side, and as it were laevigated; for that happeneth by the wearing or A note of more stones than one. rubbing of one or more stones upon it, yet there is no surer way to know this, than by searching with a Cathaeter. The one end of the following instrument may supply the want of a Cathaeter or probe, and the other may serve for a scoop or Cleanser. A cleanser or scoop whereby you may search whether there be any more stones behind, as also cleanse or purge the bladder from gravel, clots of blood, and other such bodies, as use to remain behind after the drawing forth of the stone. For if other stones remain behind, they shall be drawn forth as the former, How to cleanse the bladder. which being done, the end of the instrument, which is crooked and hollowed like a scoop or spoon, shall be thrust by the wound into the bladder, and therewith you shall gather together and take out what gravel soever, clotted blood, and the like refuse as shall be there, for that they may yield matter for another stone. But if you find that the stone which is in the bladder be too great, so that it may not be plucked How to break a stone that cannot be taken out whole and at once. forth without great and fearful rending of the bladder, it will be better to take hold thereof with this Crow's bill and so break it to pieces. The effigies of a toothed Crowesbill made neatly to break greater stones, with a screw to force it together. This Crow's bill hath only three teeth, and those sharp ones on the inside, of which two are placed above, and one below, which is the middlemost, so that it falleth between the two upper. When the stone is broken, all the pieces thereof must be taken forth, and we must have a special care, lest any piece thereof lie hid; for that in time, increased by the access of a tough and viscous matter, or conjoined with other fragments by the interposition of the like matter as glue, may rise to a stone of a large bigness. CHAP. XLIII. What cure must be used to the wound, when the stone is taken forth. THE stone being drawn out, if the greatness of the wound so require, it Of sewing the wound when the stone is taken forth. shall have one or two stitches with a needle and thread, leaving only so much space as shall be sufficient to put in a pipe for the use we shall hereafter show, your thread must be of crimson silk waxed, and let it not be too small, lest it by binding should cut asunder the fleshy lips of the wound, or rot in a short time, either by the moisture of the urine, or matter flowing from the ulcer. Therefore you shall take up much flesh with the skin in sewing it, lest the lips of the wound being torn, your labour prove in vain, and so you are forced to trouble the patient with making a new one. Things being thus performed, a silver pipe shall be put through the wound into the bladder, whereof I have here given you divers forms, that you may take your choice, and so fit them to the wounds, and not the wounds to them, which oft times in want of instruments the Surgeons are forced to do, to the great harm of the patient. Silver pipes to be put into the bladder when the stone is drawn out. These must have no holes in their sides (as those here expressed) but only in their ends, that all the matter of the wound, and the filth gathered and concrete in the bladder may flow and be carried forth this way. When clear urine shall begin to flow out of the wound, there shall be no more need of a pipe; therefore if you continue it, & keep it longer in the wound, there is some danger lest nature accustomed to that way, may afterwards neglect to send the water through the urethra, or urenary passage. Neither must you forget to defend the parts near to the wound with the following repercussive medicine, to hinder the defluxion and inflammation, which are incident by reason of the pain. ℞. album. ovorum. nu. three pull. boli armeni, sanguinis dracon. an. ℥ iii olei ros. ℥ i. pilorum leporinorum quantum sufficit, make a A repercussive medicine. medicine of the consistence of honey. CHAP. XLIV. How to lay the patient after the stone is taken away. ALL things which we have recited being faithfully and diligently performed, the patient shall be placed in his bed, laying under him as it were a pillow filled with bran, or oat chaff, to drink up the urine which floweth from him. You must have divers of these pillows, that they may be changed as need shall require. Sometimes after the drawing forth of the stone, the blood in great quantity falleth into the Cod, which unless Remedies for the Cod, lest it gangrenate. you be careful to provide against, with discussing, drying, and consuming medicines, it is to be feared, that it may gangrenate. Wherefore if any accidents happen in curing these kind of wounds, you must diligently withstand them. After some few days a warm injection shall be cast into the bladder by the wound, consisting of the waters of plantain, nightshade & roses, with a little syrup of dried roses. It will help to temper the heat of the bladder caused both by the wound and contusion, as also by the violent thrusting in of the instruments. Also it sometimes happens, that after the drawing forth of the stone, clots of blood and other impurity may fall into the urenary passage, and so stop the urine that it cannot flow forth. Therefore you must in like sort put a hollow probe for some days into the urethra, that keeping the passage open, all the grosser filth may flow out together with the urine. CHAP. XLV. How to cure the wound made by the incision. YOu must cure this wound after the manner of other bloody wounds, What things hasten the union. to wit, by agglutination and cicatrisation, the filth, or such things as may hinder, being taken away by detergent medicines. The patient shall hasten the agglutination if he lie crosslegged, and keep a slender diet until the seventh or ninth day be past. He must wholly abstain from wine, unless it be very weak; in stead thereof let him use a decoction of barley and liquorish, or mead, or water and sugar, or boiled water mixed with syrups of dried roses, maidenhair, and the like. Let his meat be pomado, raisins, stewed prunes, chickens boiled, with the cold seeds, lettuce, purslane, sorrel, borage, spinach, and the like. If he be bound in his belly, a Physician shall be called, who may help it, by appointing either Cassia, a glister, or some other kind of medicine, as he shall think good. CHAP. XLVI. What cure is to be used to Ulcers, when as the urine flows through them, long after the stone is drawn out. MAny after the stone is drawneout, cannot have the ulcer consolidated, therefore the urine flows out this way continually by little and little, and against the patients will during the rest of his life, unless the Surgeon help it. Therefore the callous lips of the wound must be amputated, so to make a green wound of an old ulcer; then must they be How to make a fresh wound of an old ulcer. tied up, and bound with the instrument we term a Retinaculum or stay; this must be perforated with three holes, answering to three other on the other side, needles shall be thrust through these holes, taking hold of much flesh, and shall be knit about it: then glutinative medicines shall be applied, such as are Venice Turpentine, gum Elemi, sanguis Draconis, bowl armenick, and the like; after five or six days the needles shall be taken out, and also the stay taken away. For than you shall find the wound almost glued, and there will nothing remain but only to cicatrise it. The figure of a Retinaculum or Stay. A. shows the greater. B. the lesser, that you may know that you must use divers according to the different bigness of the wound. If a Retinaculum or stay be wanting, you may conjoin the lips of the wound after What to do in want of a stay. this following manner. Put two quills somewhat longer than the wound, on each side one, and then presently thrust them through with needles having thread in them, taking hold of the flesh between, as often as need shall require, then tying the thread upon them. For thus the wound shall be agglutinated, and the fleshy lips of the wound kept from being torn, which would be in danger if the needle & thread were only used. CHAP. XLVII. How to take stones out of women's bladders. WE know by the same signs that the stone is in a woman's bladder as we do in a man's, yet it is far more easily searched by a Cathaeter, How to search for the stone in women. for that the neck of the bladder in the shorter, broader, and the more straight. Wherefore it may not only be found by a Cathaeter put into the bladder, but also by the fingers thrust into the neck of the womb, turning them up towards the inner side of the Os pubis, and placing the sick woman in the same posture as we mentioned in the cure of men. Yet you must observe that maids younger than seven years old, that are troubled with the stone, cannot be searched by the neck of the womb, without great violence. Therefore the stone must be drawn from them by the same means as from boys, to wit, by thrusting the fingers into the fundament; for thus the stone being found out, and the lower belly also pressed with the other hand, it must be brought to the neck of the bladder, and then drawn forth by the forementioned means. Yet if the riper years of the patient permit it to be done without violence, the whole work shall be more easily and happily performed, by putting the fingers into the neck of the womb, for that the bladder is nearer the neck of the womb, than it is to the right gut. Wherefore the fingers thus thrust in, a Cathaeter shall be presently put into the neck of the bladder. This Cathaeter must be hollow, or slit on the outside like those before described, but not crooked, but straight, as you may perceive by the following figure. A Cathaeter upon which, being put into the Bladder, the neck thereof may be cut, to draw out a stone from a woman. Upon this instrument the neck of the bladder may be cut, and then with the Dilater made for the same purpose, the incision shall be dilated as much as need requites; yet with this caution, that seeing the neck of a woman's bladder is the shorter, it admits not so great dilatation as a man's, for otherwise there is danger that it may come to the body of the bladder, whence an unvoluntary shedding of the water may ensue and continue thereafter. The incision being dilated, the Surgeon putting one or two of his fingers into the neck of the womb, shall press the bottom of the bladder, and then thrust his crooked instruments or forcipes in by the wound, and with these he shall easily pluck out the stone, which he shall keep with his fingers from slipping back again. Yet Laurence Collo the Kings Surgeon, and both his suns (than whom I do not know whether ever there were better cutters for the stone) do otherwise perform this operation; for they do not thrust their fingers into the fundament or neck of the womb, but contenting themselves with putting in only the Guiders (whereof we formerly made mention) into the passage of the urine, they presently thereupon make a straight incision directly at the mouth of the neck of the bladder, and not on the side, as is usually done in men. Then they gently by the same way thrust the forcipes hollowed on the outside formerly delineated, and so dilate the wound by tearing it as much as shall be sufficient for the drawing of the stone forth of the bladder. The residue of the cure is the same with that formerly mentioned in men: yet this is to be added, that if an ulcer grow in the neck of the bladder by reason of the rending it, you may by putting in the speculum matricis, dilate the neck of the womb, that fitting remedies may be applied with the more ease. CHAP. XLVIII. Of the suppression of the Urine by internal causes. BEsides the formentioned causes of suppressed urine, or difficulty of making of water, there are many other, lest any may think that the urine is stopped only by the stone or gravel, as Surgeons think, who in this In suppression of the urine we must not presently fly to diuretics. case presently use diuretickes. Therefore the urine is suppressed by external and internal causes. The internal causes are clotted blood, tough phlegm, warts, caruncles bred in the passages of the urine, stones, and gravel; the urine is sometimes suppressed, because the matter thereof, to wit, the serous or whayish part of the blood, is either consumed by the feavourish heat, or carried other ways by sweats or a scouring; sometimes also the flatulency there contained, or inflammation arising in the parts made for the urine and the neighbouring members, suppresses the urine. For the right gut if it be inflamed, intercepts the passage of the urine, either by a tumour whereby it presseth upon the bladder, or by the communication of the inflammation. Thus by the default of an ill affected liver, the urine is oft times suppressed in such as have the dropsy; or else by dulness or decay of the attractive, or separative faculty of the reins by some great distemper, or by the default of the animal faculty, as in such as are in a frenzy, lethargy, convulsion, apoplexy. Besides also a tough and viscide humour falling from the whole body into the passages of the urine, obstructs and shuts up the passage. Also too long holding the water sometimes causes this affect. For when the bladder is distended above measure, the passage thereof is drawn together and made more straight: hereto may be added that the too great distension of the bladder is a hindrance that it cannot use the Why the too long holding the urine causeth the suppression thereof. expulsive faculty, and straiten itself about the urine to the exclusion thereof; hereto also pain succeeds, which presently dejects all the faculties of the part which it seizeth upon. Thus of late a certain young man, riding on horseback before his Mistress, and therefore not daring to make water, when he had great need so to do, had his urine so suppressed that returning from his journey home into the city, he could A history. by no means possible make water. In the mean time he had grievous pain in the bottom of his belly and the perinaeum, with gripings and a sweatall over his body, so that he almost swooned. I being called, when I had procured him to make water by putting in a hollow Cathaeter, and pressing the bottom of his belly, whereof he forthwith made two pints; I told them that it was not occasioned by the stone, which notwithstanding the standers by imagined to be the occasion of that suppression of urine. For thence forward there appeared no signs of the stone in the youth, neither was he afterwards troubled with the stopping of his urine. CHAP. XLIX. A digression concerning the purging of such things as are unprofitable in the whole body by the urine. IThink it not amiss to testify by the following histories, the providence of nature in expelling by urine such things as are unprofitable in the whole body. Mounsieur Sarret the King's secretary was wounded in the right arm with a pistol bullet; many and A history. malign symptoms happened thereupon, but principally great inflammations, flowing with much sanies and pus or quitture: it sometimes happened that without any reason this purulent and sanious effluxe of matter was stayed in the inflammation; whereof while we solicitously enquired into the cause, we found both his stools and water commixed with much purulent filth, and this through the whole course of the disease, whereof notwithstanding by god's assistance he recovered, and remains whole and sound; we observed that as long as his arm flowed with this filthy matter, so long were his excrements of the belly and bladder free from the sanious and purulent matter: as long on the contrary as the ulcers of the arm were dry, so long were the excrements of the guts and bladder sanious and purulent. The same accident befell a Gentleman called Mounsieur da la Croix, who received a deadly wound with a sword on the left A history. arm, though Germane Chavall, and Master Rasse most expert Surgeons, and others, who together with me had him in cure, thought it was not so for this reason, because the pus cannot run so long a way in the body, neither if it were so, could that be done without the infection and corruption of the whole mass of blood, whilst it flows through the veins; therefore to be more probable that this quantity of filth, mixed with excrements and urine, flowed by reason of the default of the liver, or of some other bowel, rather than from the wounded arm: I was of a contrary opinion How the pus may flow from the wounded arm, by the urine and excrements. for these following reasons. First for that which was apparently seen in the patient; for as long as the excrement and urine were free from this purulent matter, so long his arm plentifully flowed therewith; this on the contrary being dry, much purulent matter was voided both by stool and urine. Another was, that as our whole body is perspirable, so it is also (if I may so term it) confluxible. The third was an example taken from the glasses which the French term Monte-vins (that is, Mount-wines) for if a glass that is full of wine be set under another that is filled with water, you may see the wine raise itself out of the lower vessel to the upper through the midst of the water, & so the water descend through the midst of the wine, yet so, that they do not mix themselves, but the one take & possess the place of the other. If this may be done by art, by things only natural, & to be discerned by our eyes, what may be done in our bodies, in which by reason of the presence of a more noble soul, all the works of nature are far more perfect? What is it which we may despair to be done in the like case? For doth not the laudable blood flow to the guts, kidneys, spleen, bladder of the gall, by the impulse of nature together with the excrements, which presently the parts themselves separate from their nutriment? Doth not milk from the breasts flow sometimes forth of the wombs of women lately delivered? Yet that cannot be carried down thither, unless by the passages of the mamillary veins and arteries, which meet with the mouths of the vessels of the womb in the middle of the strait muscles of the Epigastrium. Therefore no marvel if according 〈◊〉. de ●ac. affect. ● cap. 4. to Galen the pus unmixed with the blood flowing from the whole body by the veins and arteries into the kidneys and bladder, be cast forth together with the urine. These and the like things are done by nature, not taught by any counsel or reason, but only assisted by the strength of the segregating and expulsive faculty; and certainly we presently dissecting the dead body, observed that it all, as also all the bowels thereof, were free from inflammation and ulceration, neither was there any sign or impression of any purulent matter in any part thereof. CHAP. L. By what external causes the urine is suppressed; and prognostickes concerning the suppression thereof. THere are also many external causes, through whose occasion the urine may be suppressed. Such are bathing and swimming in cold water; the too long continued application of Narcoticke medicines upon the reins, perinaeum and share; the use of cold meats and drinks, and such other like. Moreover, the dislocation of some Vertebra of the loins to the inside, for that it Why the dislocation of a vertebra of the loins may cause a suppression of urine. presseth the nerves disseminated thence into the bladder; therefore it causeth a stupidity or numbness of the bladder. Whence it is, that it cannot perceive itself to be vellicated by the acrimony of the urine, and consequently it is not stirred up to the expulsion thereof. But from whatsoever cause the suppression of the urine proceeds, if it persevere for some days, death is to be feared, unless either a fever, Why the suppression of the urine becomes deadly. which may consume the matter of the urine, or a scouring or flux, which may divert it, shall happen thereupon. For thus by stay it acquireth an acride and venenate quality, which flowing by the veins readily infecteth the mass of blood, and carried to the brain much molests it by reason of that similitude and sympathy of condition which the bladder hath with the Meninges. But nature, if A fever following thereon helps the suppression of urine. prevalent, easily freeth itself from this danger by a manifest evacuation by stool, otherwise it must necessarily call as it were to its aid, a feavourish heat, which may send the abounding matter of this serous humidity out through the skin, either by a sensible evacuation as by sweat; because sweat and urine have one common matter: or else disperse and breathe it out by transpiration, which is an insensible excretion. CHAP. LI. Of bloody Urine. SOME piss pure blood, others mixed, and that either with urine, & then The differences that which is expelled resembles the washing of flesh newly killed; or else with pus, or matter, and that either alone or mixed with the urine. There may be divers causes of this symptom, as the too great quantity Causes. of blood gathered in the body, which by the suppression of the accustomed & periodical evacuation, by the courses or haemorrhoids, now turns its course to the reins & bladder; the fretting asunder of some vessel by an acride humour, or the breaking thereof by carrying or lifting of some heavy burden, by leaping, falling from high, a great blow, the falling of some wait upon the loins, riding post too violently, the too immoderate use of venery, & lastly, from any kind of painful & more violent exercise, by a rough & sharp stone in the kidneys, by the weakness of the retentive faculty of the kidneys, by a wound of some of the parts belonging to the urine, by the too frequent use of diuretic and hot meats and medicines, or else of things in their whole nature contrary to the urenary parts; for by these and the like causes, the reins are oft times so inflamed, that they necessarily impostumate, and at length the imposthume being broken it turns into an ulcer, casting forth quitture by the urine. In so great variety of the causes of bloody urine, we may gather whence the causes of Signs of what causes they proceed. this symptom may arise, by the depraved action of this, or that part, by the condition of the flowing blood, to wit, pure or mixed, and that either with the urine alone, or with pus. For example, if this bloody matter flow from the lungs, liver, kidneys, dislocated Vertebrae, the straight gut, or other the like part: you may discern it by the seat of the pain and symptoms, as a fever; and the propriety of the pain, and other things which have preceded, or are yet present. And we may gather the same by the plenty and quality, for if, for example, the pus flow from an ulcer of the arm, the purulent matter will flow by turns, one while by the urine, so that little is cast forth by the ulcer; then presently on the contrary the urine becomes more clear. That purulent matter which flows from the lungs by reason of an Empyema, or from the liver, or any other bowel placed above the midriff, the pus which is cast forth with the urine, is both in greater plenty and more exactly mixed with the urine, than that which flows from the kidneys and bladder. It neither belongs to our purpose, or a Surgeon's office, either to undertake, or deliver the cure of this affect. It shall suffice Cure. only to note that the cure of this symptom is not to be hoped for so long as the cause remains. And if this blood flow by the opening of a vessel, it shall be stayed by astringent medicines; if broken, by agglutinative; if corroded or fretted asunder, by sarcoticke. CHAP. LII. Of the signs of ulcerated Kidneys. I Had not determined to follow or particularly handle the causes of bloody urines, yet because that which is occasioned by the ulcerated reins or bladder more frequently happens, therefore I have thought good briefly to speak thereof in this place. The signs of an ulcer of the reins are, pain in the loins, matter howsoever mixed with the urine, never evacuated by itself, but always flowing forth with the urine, and residing in the bottom of the chamberpot, with a sanious and red sediment, fleshy and as it were bloody fibres swimming up and Why the matter which flows from the kidneys is less stinking than that which flows from the bladder. down in the urine, the smell of the filth is not so great as that which flows from the ulcerated bladder, for that the kidneys, seeing they are of a fleshy substance, do far better ripen and digest the purulent matter than the bladder which is nervous and bloodless. CHAP. LIII. Of the signs of the ulcerated Bladder. ULCERS are in the bottom of the bladder and the neck thereof. The signs of an ulcer in the bladder are, a deep pain at the sharebones; Differences. the great stinch of the matter flowing therefrom; white and thin skins swimming up and down in the water. But when the ulcer possesseth the neck of the bladder, the pain is more gentle, neither doth it trouble before the patient come to make water, but in the very making thereof, and a little while after. But it is common both to the one and the other, that the yard is extended in making of water, to wit, by reason of the pain caused by the urine fretting of the ulcerated part in the passage by: neither is the matter seen mixed with the urine, as is usual in an ulcer of the upper parts, because it is poured forth not together with the urine, but after it. CHAP. LIV. Prognostics of the ulcerated reins and Bladder. ULCERS of the kidneys are more easily and readily healed than those of Why ulcers of the bladder are cured with more difficulty. the bladder; for fleshy parts more speedily heal and knit, than bloodless and nervous parts. Ulcers which are in the bottom of the bladder, are uncurable, or certainly most difficult to heal, for besides that they are in a bloodless part, they are daily vellicated and exasperated by the continual afflux of the contained urine; for all the urine is never evacuated: now that which remains after making water, becomes more acride by the distemper and heat of the part, for that the bladder is always gathered about it, & dilated & straitened according to the quantity of the contained urine: therefore in the Ischuria, that is, the suppression or difficulty of making water, you may sometimes see a quart of water made at once. Those which have their legs fall away, having an ulcer in their bladder, are near their deaths. Ulcers arising in these parts, unless they be consolidated in a short time, remain uncureable. CHAP. LV. What cure must be used in the suppression of the Urine. IN curing the suppression of the urine, the indication must be taken from the nature of the disease, and cause thereof, if it be yet present or not. Scopes of curing. But the diversity of the parts, by which being hurt, the Ischuria happens, intimates the variety of medicines, neither must we presently run to diuretickes, and things breaking the stone, which many Empirics do. For hence grievous and malign symptoms often arise, especially if this suppression To what suppression of the urine diuretics must not be used. proceed from an acride humour, or blood pressed out by a bruise, immoderate venery, and all more vehement exercise, a hot and acride potion, as of Cantharideses, by too long abstaining from making water, by a Phlegmon, or ulcer of the urenary parts. For thus the pain and inflammation are increased, whence follows a gangrene, & at length death. Wherefore attempt nothing in this case without the advice of a Physician, no not when you must come to Surgery. For diuretics can scarce have place in another case, than when the urenary passages are obstructed by gravel, To which and when to be used. or a gross and viscide humour, or else in some cold country, or in the application of Narcoticks to the loins, although we must not here use these before we have first made use of general medicines: now Diuretickes may be administered sundry ways, as hereafter shall appear. ℞. agrimon. urtic. parietar. surculos rubros habentis, an. m. i. rad. asparag. mundat. ℥ iiii. gran. alkekengi, nu. xx. sem. malvae ℥ ss. rad. acor. ℥ i. bulliant omnia simul in sex libris aquae dulcis ad tertias, deinde coletur. Let the patient take ℥ iiii. hereof with ℥ i. of sugar candy, and drink it warm fasting in a morning, three hours before meat. Thirty or forty Ivy berries beaten in white wine, and given the patient to drink some two hours before meat, are good for the same purpose. Also ʒi. of nettle seeds made into fine powder and drunk in chicken broth, is good for the same purpose. A decoction also of Grummell, Goat's saxifrage, pellitory of the wall, white saxifrage, the roots of parsley, asparagus, acorus, bruscus, and orris drunk in the quantity of some three or four ounces, is profitable also for the same purpose. Yet this following water is commended above the rest to provoke urine, & open the passages thereof, from what cause soever the stoppage thereof proceed. ℞. radic. osmund. regal. cyp. A diuretic water. bismal. gram. petrosel. foenic. an. ℥ two. raph. crassior. intaleol. ℥ iiii. macerentur per noctem in aceto albo acerrimo, bulliant postea in aquae fluvialis lb. x. saxifrag. christ. marin. rub. tinct. milii solis, summitat. malvae, bismal. an. p. two. berul. cicer. rub. an. p. i sem. melon. citrul. an. ℥ two. ss. alkekengi, gra. xx. glycyrhiz. ℥ i. bulliant omnia simul ad tertias: in colatura infunde per noctem fol. sen. oriental. lb. ss. fiat iterum parva ebullitio, in expressione colata infunde cinam. elect. ʒvi. colentur; iterum colatura injiciatur in alembicum vitreum, postea tereb. venet. lucid. lb two. aq. vitae ℥ vi. agitentur omnia simul diligentissime. Lutetur alembicum luto sapientiae, fiat destillatio lento igne in balneo mariae. Use it after the following manner. ℞. aq. stillatitiae prescriptae ℥ two. aut iii According to the operation which it shall perform, let the patient take it four hours before meat. Also radish water destilled in balneo mariae is given in the quantity of ℥ iiii. with sugar, and that with good success. Baths and semicupia, or half baths artificially made, relax, soften, dilate, and open all the body; therefore the prescribed Why the use of diuretickes is better after bathing. To cleanse the ulcers of the kidneys and bladder. diuretickes mixed with half a dram of Treacle may be fitly given at the going forth of the bath. These medicines following are judged fit to cleanse the ulcers of the kidneys and bladder. Syrup of maiden hair, of roses, taken in the quantity of ℥ i. with hydromel, or barley water: Asses or Goat's milk are also much commended in this affect, because they cleanse the ulcers by their ferous or whayish portion, and agglutinate by their cheeselike. They must be taken warm from the dug, with honey of roses or a little salt, lest they corrupt in the stomach; and that to the quantity of four ounces, drinking or eating nothing presently upon it. The following Trochisces are also good for the same purpose. ℞. quatuor sem. frigid. major. Trochisces to heal the ulcers of the kidneys. seminis papaveris albi, portulac. plantag. cydon, myrtil, gum. tragacanth. et arub. pinear. glycyrrhi. mund. hordei mund. mucag. psilii, amygdal. dulcium, an. ℥ i. boli armen. sanguine. dracon. spodii, rosar. mastic. terra, sigil. myrrhae, an. ℥ two. cum oxymelite, conficiantur secundum artem trochisci. Let the patient take ʒss. dissolved in whey, ptisan, barley water, and the like; they may also be profitably dissolved in plantain water, and injected into the bladder. Let the patient abstain from wine, and instead thereof let him use barley water, or hydromel, or a ptisan made of an ounce of raisins of the Drink in stead of wine. sun, stoned and boiled in five pints of fair water, in an earthen pipkin well leaded, or in a glass, until one pint be consumed, adding thereto of liquorice scraped and beaten ℥ i. of the cold seeds likewise beaten two drams. Let it, after it hath boiled a little more, be strained through an hippocras bag, with a quartern of sugar, and two drams of choice cinnamon added thereto, and so let it be kept for usual drink. CHAP. LVI. Of the Diabete, or inabilty to hold the Urine. THe Diabete is a disease, wherein presently after one hath drunk, the urine is presently made in great plenty, by the dissolution of the retentive What Diabete is. faculty of the reins, and the depravation of immoderation of the attractive faculty. The external causes are the unseasonable and immoderate use of hot and diuretic things, and all more violent and vehement The causes. exercises. The internal causes are the inflammation of the liver, lungs, spleen, but especially of the kidneys and bladder. This affect must be diligently distinguished from the excretion of morbific causes by urine. The loins in this disease are molested with a pricking and biting pain, and there is a continual & unquenchable thirst: and although this disease proceed from a hot distemper, yet the urine is not coloured, Signs. red, troubled, or thick, but thin, and white or waterish, by reason the matter Why the urines are waterish. thereof makes very small stay in the stomach, liver, and hollow vein, being presently drawn away by the heat of the kidneys or bladder. If the affect long endure, the patient for want of nourishment falleth away, whence certain death ensues. For the cure of so great a disease, the matter must be purged, which causes or feeds the inflammation or phlegmon, and consequently blood must be let. We must abstain The cure. from the four cold seeds, for although they may profit by their first quality, yet will they hurt by their diuretic faculty. Refrigerating and astringent nourishments must be used, and such as generate gross humours, as Rice, thick and astringent wine mixed with much water. Exceeding cold, yea Narcotick things shall be applied Narcoticke things to be applied to the loins. to the loins, for otherwise by reason of the thickness of the muscles of those parts, the force, unless of exceeding refrigerating things, will not be able to arrive at the reins; of this kind are oil of white poppy, henbain, opium, purslain, and lettuce seed, mandrake vinegar, and the like: of which, cataplasms, plasters, and ointments, may be made, fit to corroberate the parts, and correct the heat. CHAP. LVII. Of the Strangury. THe Strangury is an affect having some affinity with the Diabete, as that wherein the water is unvoluntarily made, but not together at once, but by drops, continually and with pain. The external causes of a strangury What the Strangury is. are, the too abundant drinking of cold water, & all too long stay in a cold place. The internal causes are, the defluxion of cold humours into the urenary parts, The causes. for hence they are resolved by a certain palsy, and the sphincter of the bladder is relaxed, so that he cannot hold his water according to his desire: inflammation also & all distemper causeth this affect, and whatsoever in some sort obstructs the passage of the urine, as clotted blood, thick phlegm, gravel, and the like. And because, according to Galens' opinion, all sorts of distemper may cause this discase, divers medicines shall be appointed according to the difference of the distemper. Therefore against a cold distemper fomentations shall be provided of a decoction of mallows, Com. ad aphor. 15. sect. 3. roses, origanum, calamint, and the like, & so applied to the privities: then presently after let them be anointed with oil of bays, and of Castoreum, and the like. Strong and pure wine shall be prescribed for his drink, and that not only in this cause, but also when the Strangury happens by the occasion of obstruction, caused by a gross and cold humour, if so be that the body be not plethoric. But if inflammation together with a Plethora or fullness hath caused this affect, we may, according to Galens' advice, heal it by blood-letting. But if obstruction be in fault, that shall be taken Adaphor. 48. sect. 7. away by diuretickes either hot or cold, according to the condition of the matter obstructing. We here omit to speak of the Dysuria, or difficulty of making water, because the remedies are in general the same with those which are used in the Ischuria, or suppression of urine. CHAP. LVIII. Of the Cholike. WHensoever the Guts being obstructed, or otherwise affected, the excrements are hindered from passing forth, & if the fault be in the small guts, the affect is termed Volvulus, Ileos', & miserere mei, but if it be in the great rguts, it is called the Colic, from the part affected, which is the Colon, that is, the continuity of the greater What Ileos', or iliaca pass●o is. What 〈◊〉 passio or the Cholick●●s. Lib. 3. Lib. 3. c. 43. guts; but especially that portion of the greater guts, which is properly and especially named Colon, or the colic Gut. Therefore Avicen rightly defines the Colic, A pain of the Guts wherein the excrements are difficultly evacuated by the fundament. Paulus Aegineta reduceth all the causes of the Colic how various soever to four heads, to wit, to the grossness, or toughness of the humours impact in the coats of the guts: flatulencies hindered from passage forth: the inflammation of the guts: and lastly, the collection of acride and biting humours. Now we will treat of each of these in particular. Almost the same causes produce the grossness of humours, and flatulencies in the guts, to wit, the use of flatulent, and phlegmatic, ●ough, and viscide meats, yea also of such as are of good nourishment, if sundry thereof, and of sundry kinds be eaten at the same meal, and in greater quantity than is fit. For hence crudity and obstruction, and at length the collection of flatulencies, whereon a tensive pain ensues. This kind of Colic is also caused by the use of crude fruits, and too cold drink, drunken especially when as any is too hot by exercise, or any other way: for thus the stomach and the guts continued thereto, are refrigerated, and the humours and excrements therein contained are congealed, and, as it were, bound up. The Colic The manner of the Stone colic. which is caused by the inflammation of the kidneys, happens by the Sympathy of the reins pained or troubled with the stone or gravel contained in them or the ureters. Therefore then also pain troubles the patient at his hips and loins, because the nerves, which arising from the vertebrae of the loins, are oppressed by the weight of the stones and gravel, about the joint of the hip are disseminated into the muscles of the loins and thigh. Also the ureters are pained (for they seem nothing else but certain hollow nerves) and also the cremaster muscles, so that the patient's testicles may seem to be drawn upwards with much violence. Hence great, phlegmatic, and choleric vomiting, and sweat of the whole body, all which do not surcease before that the stone, or gravel shall be forced down into the bladder. Now vomiting happens in this affect, for that the ventricle by reason of its continuity and neighbourhood which it hath with the guts, suffers by consent or sympathy. For the stomach is of the same kind or matter as the guts are, so that the guts seem nothing else but a certain production of the stomach. Therefore if at any time nature endeavour to expel any thing that is troublesome in the kidneys, ureters, coats How a hot distemper causeth the Colic. of the guts, mesentery, pancreas, and hypochondryes, it causeth a Colic with pain and vomiting. A hot and dry distemper also causeth the Colic, producing a pricking and biting pain by drying the excrements shut up in the guts, as also by wasting as it were the radical humours of that place provided for the lubricating of the guts. Acride, viscide, and tough phlegm causeth the same. There is also another cause of the Colic which is not so common, to wit, the twining of the guts, that is, when The folding of the guts the cause of the colic. they are so twined, folded, and doubled, that the excrements, as it were, bound in their knots, cannot be expelled, as it manifestly happens in the rupture called Enterocele, by the falling of the guts into the cod. Likewise also worms generated in the Colic Gut, whilst that they mutually fold or twine themselves up, do also twine the Colon itself and fold it with them. Also the too long stay of the excrements in the guts, whether it shall happen by the peculiar default of the too hot and dry body of the patient, or by his diet, that is, the use of too dry meats, or exercises and pains taken in the heat of the sun, or by the greatness of business, the mind being carried away, causeth the Colic, with headache, and plenty of vapours flying upwards. I remember I once dissected the body of a boy of some twelve years old, who A history. had his guts folded with many as it were ties or knots, of the restrained, too hard & dry excrements, the which he cast out by his mouth a little before his death, which brought him to his end, being not helped in time by fitting medicines. Now these are the causes of the Colic, according to the opinion of the ancient and modern Physicians, of whose signs I judge it not amiss here to treat in particular. You shall Signs whereby we know that the collic● proceeds from this or that cause. know the patient is troubled with the stone colic by the pain which is fixed and as it were kept in one place, to wit, of the kidneys; by his former manner of life, as, if the patient hath formerly voided stones or gravel together with his urine; by the pain of the hips and testicles for the formerly mentioned causes, & lastly, by that the patient casts forth by stool or urine, for that the great & laborious endeavour of nature to cast forth the stone which is in the kidneys, is propagated by a certain sympathy, & like study of the neighbouring parts stirring up the expulsive faculties each to his work. The signs of a flatulent colic are, a tensive pain, such as if the guts were rend or torn in pieces, together with a noise or rumbling in the belly. The force of the shut up wind is sometimes so great, that it rendeth or teareth the guts in sunder, no otherwise than a swine's bladder too hard blown up. Which when it happens, the patient dies with much vomiting, because the stomach oppressed with wind, can contain nor embrace no meat. The colic which is occasioned by the too long keeping in of the excrements, is accompanied with the weight and pain of the belly, the tension of the guts, headache, apparent hardness of the belly, & the complaint of the patient that he hath not gone to stool in a long time. That which proceeds from a choleric inflammation, yields a sense of great heat & pulsation in the midst of the belly, by reason of the veins and arteries which are in the pancreas and coats of the guts, and there are the other signs of a Phlegmon, although also this as it were inflammation may arise also from salt, acride & viscous phlegm, which nature can neither expel upwards by vomit, nor downwards by stool, this sundry times is associated with a difficulty of making water, for that when as the right gut is inflamed the bladder is pressed by reason of their society or neighbourhood. The colic which proceeds from the contorsion of the guts shows itself by the excessive cruelty of the pain, arising for that the guts are not in their due site and place, and because the excrements by their too long detension acquire a preternatural heat; & this is the cause of the death of many such as have Ruptures, for that the gut falling down from the natural place into the Cod, being a preternatural place, is red oubled & kept thereas it were bound, whereby the excrements being baked becoming more acridly hot cause inflammation, and by raising up flatulencies increase the distension through all the guts, until at length a deadly Ileos' or colic arising, they come forth at the mouth. For prognostics; it is better to have the pain in the colic to wander up and down, than to be Avicen li. 3. Hip. aphor. 10. sect. 4. fixed; it is good also that the excrements are not wholly suppressed. But the evil signs that here appear pronounce the affect either difficult or deadly. Now these show that it is deadly, intolerable tormenting pain, continual vomiting, cold sweat, coldness of the extreme parts, hickiting by reason of the sympathy the stomach hath with the guts, a Frenzy by the consent of the brain with the stomach, and ofttimes a convulsion by drawing the matter into the nerves. But such as have griping and pain about their navel and loins, which can neither be helped by medicine nor otherwise, it ends in a Dropsy. The cure must be diversified according to the variety of the causes, The cure. for the stone colic is cured by medicines proper to the stone; that which is caused by an Enterocele, is cured by the only restoring the gut to its place; that which is occasioned by worms, requires medicines fit to kill and cast forth the worms. But that which proceeds from the weakness and refrigeration of the guts and stomach, is cured by neating and strengthening medicines aswell applied out-wardly as taken in inwardly by the mouth, or otherways. The beginning of the cure of that which is occasioned by tough phlegm and flatulencies, is by the mitigation of the pain, seeing there is nothing which more dejects the powers than pain. To this Baths and anodine fomentations. purpose shall you provide baths, Semicupia, fomentations of mallows, marshmallows, violet leaves, pennyroyal, fennel, Origanum, the seeds of time and faenugreek, flowers of camomile, melilore, and other such like, which have power to heat, dry, attenuate, and rarify the skin, so to dissipate the wind. But all such must be actually hot. Also the belly may be anointed with this following ointment. ℞. olei cham●m. An ointment. aneth. butyr. recent. an. ℥ i. sem. apii, petros. & galang. an. ʒss. aq. vitae, ol. salviaaut thymi chimice extract. q. s. The following lineament is much commended by Hollerius. ℞. olei rut. & nardi, an. ʒvi. dissolutiʒii. liquefactis simul add Z●betaegr. iv. croci, gr. vi. fiat linimentum. Also little bags made with millet, oats and salt fried with a little white wine in a frying pan, shall be applied hot upon the belly & flanks, and renewed before they grow cold. You may, in stead of these bags, use ox Why glisters in the col●ick must be given in less quantity. bladders half filled with a decoction of resolving things; as salt, rosemary, thime, lavender, bay-berries and the like: then inject a clyster being thus made. ℞. quatuor remol. an. m. i. orig. puleg. calamenth. an. m. ss. anisi, carui an. m. ss. flor. aneth. an. p. 1. bulliant in hydromele ad lib. i. in qua dissolve bened. laxat. mellis anthosatis, sacc. rub. an. ℥ i. olei aneth. & chamaem. an. ℥ iss. Let a clyster be made to be injected at twice; for the guts being stretched out cannot contain the accustomed dosis of a clyster: also this following clyster is much approved. ℞. vini malvat. & olei nucum, an. ℥ iii aqua vitae, ℥ i. olei juniperi, & rut. per quintam essent. extract. an. ʒiii. Let this be injected as hot as the patient can endure. I have ofttimes as by miracle helped intolerable pain caused by the wind colic and phlegm with this clyster. Avicen prescribes a carminative clyster made of hyssop, origanum, acorus, aniseeds and English galengall. Let the patient feed upon meats of good juice & easy digestion, as broths made with the yolks of eggs, saffron, hot herbs and a nutmeg; let him drink good wine, as Muskedine, or Hippocras made with good wine so to heat the stomach & guts. For in Galens' opinion, all windiness is generated by a remiss heat. But if the pain shall continue, a large Cupping-glass shall be applied to the navel to draw and dissipate the windiness; the belly shall be bound with strong and broad ligatures, to strengthen the guts, and discuss the matter of flatulencies. The patients taught by nature, use this remedy, whilst none admonishing them, they press the belly with their hands in the bitterness of pain. But if the pain cannot be thus appeased, we must come to such medicines as work Specific medicines. by an occult property, as the dried gut of a Wolf, for a dram thereof made into powder is given in wine with good success. That colic which is caused by a choleric The cure of a choleric colic. inflammation requires contrary medicines, to wit, blood-letting and a refrigerating diet; potions made of Diacatholicon and Cassia dissolved in barley water, also cooling glisters. Avicen prescribes narcoticks, for that being cold, they are contrary to the morbi●ick cause which is hot and dry; such are pills of Philonium. Also pills of Hyerapicra in the quantity of ℈ iv. with opium and saffron, of each one grain, may be used. Also baths are appointed, made of water wherein mallows, marshmallows, violet leaves, flowers of white lilies, lettuce, purslane, have been boiled, to correct the acrimony of the choleric and hot humours, whence the disease and symptom ariseth. That colic which is like to this, and proceeds from salt, acride, thick and tough phlegm, is cured, the humour being first attenuated and diffused, and at length evacuated by medicines taken by the mouth and otherwise according to the prescription of the learned Phisi●ian. But Avicen cures that which is occasioned by the suppression of the hardened excrements, and twining of them by meats which have an emollient faculty, such as humecting broths, as that which is made of an old cock tired with running, & threshed to death, & so boiled with dill, polypody and a little salt, until the flesh fall from the bones; also he useth detergent glisters such as this which follows. ℞. betae, m. i furfuris, p. i ficus, nu. x. alth. m. i fiat decoctio a● lb. i. in qua dissolve nitri & muriae an. ʒii. sacch. rub. ℥ i. ol. sesamini, ℥ two. But if the obstruction be more contumacious, you must use more powerful ones made adʒii. But if the obstruction do notwithstanding remain, so that the excrements come forth at the mouth, Marianus Sanctus wisheth (by the counsel of many who have so freed themselves from this deadly symptom) to drink three pounds of quicksilver with water only. For the doubled and as it were twined up gut is unfolded by the weight of the quicksilver, and the The force of quicksilver in the unfolding of the guts. A history. excrements are depressed and thrust forth, and the worms are killed which gave occasion to this affect. John of S. Germans that most worthy Apothecary hath told me that he saw a Gentleman who when as he could not be freed from the pain of the colliok by any means prescribed by learned Physicians, at length by the counsel of a certain German his friend, drank three ounces of oil of sweet almonds drawn without fire, and mixed with some white wine and pellitory water, and swallowed a leaden bullet besmeared with quicksilver, and that bullet coming presently out by his fundament, he was wholly freed from his colic. CHAP. LIX. Of Phlebotomy, or Blood-letting. Phlebotomy is the opening of a vein, evacuating the blood with the rest of the humours; thus Arteriotomie, is the opening of an Artery. What Phlebotomy is. The first scope of Phlebotomy is the evacuation of the blood offending in quantity, although ofttimes, the Physicians intention is to draw forth the blood which offends in quality, or either way by opening The●…. a vein. Repletion which is caused by the quantity is twofold, the one ad vires, that is, to the strength, the veins being otherwise not very much swelled; this Repletion twofold. makes men infirm and weak, nature not able to bear this humour, of what kind soever it be. The other is termed ad vasa, that is, to the vessels, the which is so called comparatively to the plenty of blood, although the strength may very well away therewith. The vessels are ofttimes broke by this kind of repletion, so that the patient casts and spits up blood, or else evacuats it by the nose, womb, haemorrhoids, or varices. The repletion which is ad vires is known by the heaviness and wearisomeness of the whole body; but that which is ad vasa is perceived by their distension The signs. and fullness, both of them stand in need of evacuation. But blood is only to be let by opening a vein, for five respects: the first is to lessen the abundance of 〈◊〉 scopes in letting blood. blood, as in Phlethorick bodies, and those who are troubled with inflammation without any plenitude. The second is for divertion, or revulsion, as when a vein of the right arm is opened to stay the bleeding of the left nosthrile. The third is to allure or draw down, as when the saphena is opened in the ankle to draw down the courses in women. The fourth is for alteration or introduction of another quality, as when in sharp fevers we open a vein to breathe out that blood which is heated in the vessels, and cooling the residue which remains behind. The fifth is to prevent imminent diseases, as when in the Spring and Autumn we draw blood by opening a vein in such as are subject to spitting of blood, the squinancy, pleurisy, falling sickness, apoplexy, madness, gout, or in such as are wounded, for to prevent the inflammation which is to be feared. Before blood letting, if there be any old excrements in the guts, they shall be evacuated by a gentle clyster, or suppository, lest the mesaraicke veins should thence draw unto them any impurity. Blood must, From whom we must not draw blood. not be drawn from ancient people unless some present necessity require it, lest the native heat which is but languid in them should be brought to extreme debility and their substance decay; neither must any in like sort be taken from children, for fear of resolving their powers by reason of the tenderness of their substance, & rareness of their habit. The quantity of blood which is to be let, must be considered by the strength of the patient, and greatness of the disease: therefore if the patient be weak, and the disease require large evacuation, it will be convenient to part the letting of blood, yea by the interposition of some days. The vein of the forehead When and for what it is necessary. being opened is good for the pain of the hind part of the head; yet first we foment the part with warm water, that so the skin may be the foster, and the blood drawn into the veins in greater plenty. In the squinancy the veins which are under the tongue must be opened assant, without putting any ligatures about the neck for fear of strangling. Phlebotomy is necessary in all diseases which stop or hinder the breathing, or take away the voice or speech, as likewise in all contusions by a heavy stroke, or fall from high, in an apoplexy, squinancy, and burning fever, though the strength be not great, nor the blood faulty in quantity or quality, blood must not be let in the height of a fever. Most judge it fit to draw blood from the veins most remote from the affected and inflamed part, for that thus the course of the humours may be diverted, the next veins on the contrary being opened the humours may be the more drawn into the affected part, and so increase the burden and pain. But this opinion of theirs is very erroneous, for an opened vein always evacuates and disburdens the next part. For I have sundry times opened the veins and arteries of the affected part, as of the hands & feet in the Gout of these parts; of the temples in the Megrim; whereupon the pain always was somewhat assuaged, for that together with the evacuated blood, the malignity of the Gout, and the hot spirits (the causers of the headache or Megrim) were evacuated. For thus Galen wisheth to open 13. meth. cap. ul●. the arteries of the temples in a great and contumacious defluxion falling upon the eyes, or in the Megrim or headache. CHAP. LX. How to open a vein, and draw blood from thence. THE first thing is, to seat or place the patient in as good a posture How to place the patient. as you can, to wit, in his bed if he be weak; but in a chair if strong, yet so, that the light may fall directly upon the vein which you intent to open. Then the Surgeon shall rub the arm with his Rubbing the arm. hand, or a warm linen cloth, that the blood may flow the more plenitfully into the vein. Then he shall bind the vein with a ligature Binding it before we open the vein. a little above the place appointed to be opened, and he shall draw back the blood upwards towards the ligature from the lower part; and if it be the right arm, he shall take hold thereof with his left hand, but if the left, then with his right hand, pressing the vein in the mean time with his thumb a little below the place where you mean to open it, lest it should slip away; and that it may be the more swollen by forcing up the blood. Then with his nail he shall mark or design the place to be opened, and shall anoint it being so marked with butter or oil whereby the skin may be relaxed, and the lancet enter more easily, and therefore the section may be the less painful. He shall hold his lancet between his thumb and fore finger, neither too near, nor too far from the point; he shall rest his other three fingers upon the patient's arm, that so his hand may be the more steady & less trembling. Then shall he open the vein with an incision agreeable to the magnitude of the vessel, & the indifferent thickness of the contained blood somewhataslant, diligently avoiding the artery which lies under the basilica, & the nerve, or tendon of the two-headed muscle, Why the basilica & median may not be opened so safely as the cephalick. which lies under the Median vein. But for the Cephalic it may be opened without danger. As much blood as is sufficient being drawn, according to the mind of the Physician, he shall lose the ligature, and laying a little bolster under, he shall with a ligature bind up the wounded part to stay the bleeding; the ligation shall be The bindingup after blood-letting. neither too straight, nor lose, but so that the patient may freely bend and extend his arm; wherefore whilst that is in doing he must not hold his arm straight out, but gently bended, otherwise he cannot freely bend it. The figure of a Lancet to let blood withal. CHAP. LXI. Of Cupping-glasses, or ventoses. CUpping-glasses are applied especially when the matter conjunct and impact in any part is to be evacuated, and then chiefly there is place for The use of cupping-glasses. sacrification after the cupping-glasses: yet they are also applied for revulsion and divertion; for when an humour continually flows down into the eyes, they may be applied to the shoulders with a great flame, for so they draw more strongly and effectually. They are also applied under women's breasts, for to stop the courses flowing too immoderately, but to their thighs for to provoke them. They are also applied to such as are bit by venomous beasts, as also to parts possessed by a pestiferous Bub● or Carbuncle, so to draw the poison from within outwards. For (as Celsus saith) a Cupping-glass where it is fastened on, if the skin be first scarified, draws forth blood, but if it be whole, than it draws spirit. Lib. 2. cap. 1. Also they are applied to the belly, when any gross or thick windiness, shut up in the guts, or membraines of the muscles of the Epigastrium, or lower belly causing the Colic, is to be discussed. Also they are fastened to the Hypocondry's, when as flatulency in the liver, or spleen swells up the entrail lying thereunder, or in too great a bleeding at the nose. Also they are set against the reins in the bottom of the belly, whereas the ureters run down to draw down the stone into the bladder, when as it stops in the middle or entrance of the ureter. You shall make choice of greater and lesser Cupping-glasses according to the condition of the part, and the contained matter. But to those parts whereto these cannot by reason of their greatness be applied, you may fit horns for the same purpose. The figures of Cupping-glasses of different bigness, with little holes in their bottoms, which shall be stopped with wax when you apply them to the part; but opened when you would take them off, that so the air may enter in with the more ease. A Lancet. Horns which without fire, by only sucking at the upper hole, draw from the part lying under them. CHAP. LXII. Of Leaches, and their use. IN those parts of the body whereto Cupping-glasses and horns cannot be applied, to those Leeches may for the most part be put, as to the fundament The use of Leaches. to open the coat of the haemorrhoide veins, to the mouth of the womb, the gums, lips, nose, fingers. After the Leech being filled with blood shall fall off, if the disease require a large evacuation of blood, and the part affected may endure it, Cupping-glasses, or horns, or other Leeches shall be substituted. If the Leeches be handled with the bare hand, they are angered, and become so stomachful as that they will not bite; wherefore you shall hold them How to apply them. in a white & clean linen cloth, & apply them to the skin, being first lightly scarified, or besmeared with the blood of some other creature, for thus they will take hold of the flesh, together with the skin more greedily & fully. To cause them fall off you How to cause them to fall off. shall put some powder of Aloes, salt or ashes upon their heads. If any desire to know how much blood they have drawn, let him sprinkle them with salt made into powder, as soon as they are come off, for thus they will vomit up what blood soever they have sucked. If you desire they should suck more blood than they are able to contain, cut off their tails as they suck, for thus they will make no end of sucking, for that it runs out as they suck it. The Leeches by sucking draw the blood not only from the affected part whereto they are applied, but also from the adjacent and distant parts. Also sometimes the part bleeds a good while after the Leeches be fallen away, which happens not by scarification after the application of Cupping-glasses or horns. If you cannot stop the bleeding after the falling away of the Leeches, then press the half of a bean upon the wound, until it stick of itself, for thus it will stay; also a burnt rag may be fitly applied with a little bolster and fit ligature. The end of the seventeenth Book. OF THE GOUT. THE EIGHTEENTH BOOK. CHAP. I. The description of the Gout. THE Gout is a disease occupying and harming the substance of the Joints by the falling down and collection of a virulent matter accompanied What it is. by the four humours. This word Arthritus or Gout, is general for every joint so affected; yet it enjoys divers particular names in sundry joints of the body: as that which falleth upon the joint of the Jaw, is termed Siagonagra, Particular gouts. for that the greeks call the Jaw Siagon; that which affects the neck is termed Trachelagra, for that the neck is in Greek termed Tracheloes: that which troubles the back bone is called Rhachisagra, for the spin is termed Rhachis: that which molests the shoulders Omagra, for the joint of the shoulder is styled Omos: that which affects the joints of the Collar-bones Cleisagra, for that the Greeks call this bone Cleis: that in the Elbow, P●chyagra, for Pechis signifieth the elbow: the gout in the hand is called Chiragra, in the Hip Ischias, in the knee Gonagra, in the feet Podagra, for that the Hand, Hip, Knee, and Foot are in Greek termed Cheir, Ischion, Gony, and Pous. When as there is great abundance of humours in a body, and the patient leads a sedentary life, not some one, but all the joints of the body are at once troubled with the Gout. CHAP. II. Of the occult causes of the Gout. THe humour causing the Gout is not of a more known, or easily expressed nature than that which causeth the plague, Lues venerea, or falling sickness. For it is of a kind and nature clean different from that which causeth Lib. 12. Cap. 12. a Phlegmon, oedema, erysipelas, or Scirrbus; for, as Aëtius saith, it never cometh to suppuration like other humours, not for that, as I think, because it happens in bloodless parts, but through the occasion of some occlut malignity. Hereto may be added that the humours which cause the forementioned tumours, when as they fall down upon any part, not then truly when they are turned into pus or matter, do they cause so sharp pains as that which causeth the Gout, for the panic thereof is far more sharp, than of that humour which breedeth an ulcerated Cancer. Besides these humours, when they fall upon the joints through any other occasion, never turn into knots, only that which causeth the Gout in the joints, after it hath fallen thither, is at length hardened into a certain knotty and as it were plaisterlike substance to be amended by no remedies. But seeing it offends not The resemblance of the Goat to the Epilepsy. the parts by which it flows down, (no more than the matter which creeping upwards from the lower parts to the brain, causeth the Epilepsy) as soon as it falleth into the spaces of the Joints it causeth cruel pain, one while with heat, another while with cold. For you may see some troubled with the Gout, who complain that their pained Joints are burnt, there are others to whom they seem colder than any ice, so that they cannot be sufficiently heated to their hearts desire; verily you may sometimes see in the same body troubled with the Gout, that the Joints of the right side will as it were burn with heat, but on the left side will be stiff with cold; or which is more, the knee in the same side to be tormented with a hot distemper, and the ankle troubled with a cold. Lastly, there sometimes happens a succession of pain in a succession of days, as the same joints will be this day troubled with a hot, The strange variety of the Gout. to morrow with a cold distemper, so that we need not marvel to see Physicians prescribe one while hot, another while cold medicines against the same disease of the same part and body. Also it sometimes happens that the malignity of this humour doth not only not yield to medicines, but is rather made worse, so that the patients affirm that they are far better when they have none, than when they have any remedies applied. For all things being rightly done, and according to reason, yet the disease will come again at certain seasons by fits: and hereupon it is said by Horace: Qui cupit, aut metuit, juvat illum sic domus aut res, Ut lippum pictae tabulae, fomenta podagram. Riches the covetous, and fearful so do please, As pictures sore eyes, Baths the Gout do ease. Certainly such as have this disease hereditarily, can no more be helped and throughly freed therefrom, than those in whom the matter of the disease is become knotty, whereof Ovid thus speaketh: Tollere nodosam nescit medicina podagram. Physic cannot the knotty Gout to heal. These reasons have induced many to believe that the essence of this disease is unknown, for there is a certain occult and inexplicable virulency, the author of so great malignity and contumacy. Which Avicen seems to acknowledge, when he writes that there is a certain kind of Gout whose matter is so acute and malign, Lib. 3. sect. 22. tract. 2. cap. 3. that if it at any time be augmented by the force of anger, it may suffice to kill the party by sudden death. Therefore Galen himself writes that Treacle must be used in all arthritical and gouty affects, and as I think, for no other reason, than for Lib. de ther. ad Pisonem c. 15. that it dries, wastes and weakens the malignity thereof. Gordonius is of the same opinion, but addeth withal, that the body must be prepared and purged before we use Treacle. Therefore the matter of the gout is a thin and virulent humour, yet not contagious, offending in quality rather than quantity, causing extreme pains, The matter of the gout partakes of occult malignity. and therefore instigating the humours together with the caliginous and flatulent spirits prepared or ready for defluxion upon the affected parts. Therefore as the bitings of Asps, and stingings of Wasp's cause cruel pain with sudden swelling and blistering, which is by the heat of the humours which the poison hath tainted, and not by the simple solution of continuity, seeing that we daily see Shoemakers and Tailors pricking their flesh with awls and needles without having any such symptom. Thus the virulency of the gout causeth intolerable tormenting pain, not by the abundance, because it happens to many who have the gout, no sign of defluxion appearing in the joints, but only by a malign and inexplicable quality, by reason whereof these pains do not cease unless abated by the help of medicines, or nature, or both. The recital of the following histories will give much light to that unexplicable and virulent malignity of the matter causing the gout. Whilst King Charles A history. the ninth, of happy memory, was at Bordeaux, there was brought to Chappellaine and Castellan the King's Physicians, and Taste a Physician of Bordeaux, Nicholas Lambert and myself Surgeons, a certain Gentle woman some forty years old, exceedingly troubled for many years by reason of a tumour scarce equalling the bigness of a pease, on the outside of the joint of the left Hip: one of her tormenting fits took her in my presence; she presently began to cry and ●oare, and A terrible fit. rashly and violently to throw her body this way and that way, with motions and gestures above a woman's, yea a man's nature. For she thrust her head between her legs, laid her feet upon her shoulders, you would have said she had been possessed of the Devil. This fit held her some quarter of an hour,; during all which time I heedfully observed whether the grieved part swelled any bigger than it was accustomed, whether there happened any new inflammation; but there was no alteration as far as I could gather by sight or feeling, but only that she cried out more loudly when as I touched it. The fit passed, a great heat took her, all her body ran down with sweat, with so great weariness and weakness of all her members, that she could not so much as stir her little finger. There could be How an Epileptic fit differs from the gout. no suspicion of an Epileptic fit, for this woman all the time of her agony did perfectly make use of all her senses, did speak, discourse, and had no convulsion. Neither did she spare any cost or diligence, whereby she might be cured of her disease by the help of Physicians, or famous Surgeons; she consulted also witches, wizzards and charmers, so that she had left nothing unattempted, but all art was exceeded by the greatness of the disease. When I had showed all these things at our consultation, we all with one consent were of this opinion, to apply a potential Cautery to the grieved part, or the tumour. I myself applied it: after the fall or the Eschar very black and virulent sanies flowed out, which freed the woman of her pain and disease for ever after. Whence you may gather, that the cause of so great evil was a certain venenate malignity, hurting rather by an unexplicable quality than quantity; which being overcome and evacuated by the Cautery, all pain absolutely ceased. Upon the like occasion, but on the right arm, the wife of the Queen's Coachman at Amboise consulted Chappellaine, Castella● and me, earnestly craving ease of her pain, for she was so grievously tormented by fits, that through impatiency, being careless of herself, she endeavoured to cast her lelse headlong out of her chamber window, for fear whereof she had a guard put upon her. We judged that the like monster was to be assaulted with the like weapon, neither were we deceived, for using a potential cautery, this had like success as the former. Wherefore the bitterness of the pain of the gout is not occasioned by the only weakness of the joints; for thus the pain should be continual, and always like itself; neither is it from the distemper of a simple humour, for no such thing happens in other tumors of what kind soever they be of; but it proceeds from a venenate, malign, occult and inexplicable quality of the matter: wherefore this disease stands in need of a diligent Physician and a painful Surgeon. CHAP. III. Of the manifest causes of the Gout. ALthough these things may be true which we have delivered of the occult The first primitive cause of the gout. cause of the gout, yet there be and are vulgarly assigned others, of which a probable reason may be rendered, wherein this malignity whereof we have spoken lies hid and is seated. Therefore as of many other diseases, so also of the gout there are assigned three causes; that is, the primitive, antecedent and conjunct; the primitive is two fold, one drawn from their first original and their mother's womb, which happens to such as are generated of gouty parents, chiefly if whilst they were conceived, this gouty matter did actually abound and fall upon Lib. de aëre, loc. & aqua. Lib. 1. cap. 17. the joints. For the seed falls from all the parts of the body, as saith Hypocrates, and Aristole affirms lib. de gener. animal. Yet this causes not an inevitable necessity of having the gout, for as many begot of sound and healthful parents are taken by the gout by their proper & primary default; so many live free from this disease, whose fathers notwithstanding were troubled therewith. It is probable that they have this benefit and privilege by the goodness of their mother's seed, and the laudable temper of the womb; whereof the one by the mixture & the other by the gentle heat, may amend and correct the faults of the paternal seed; for otherwise the disease would become hereditary, and gouty persons would necessarily generate gouty; for the seed followeth the temper and complexion of the party generating, as it is showed by Avicen. Another primitive cause is from unordinate diet, especially in the Li. 3. feu. 22. tract. 2. cap. 5. Another primitive cause of the gout. use of meat, drink, exercise and Venery. Lastly by unprofitable humours which are generated and heaped up in the body, which in process of time acquire a virulent malignity; for these fill the head with vapours raised up from them, whence the membranes, nerves and tendons, and consequently the joints become more lax and weak. They offend in feeding who eat much meat, and that of sundry kinds at the same meal, who drink strong wine without any mixture, who sleep presently after meat, and which use not moderate exercises; for hence a plenitude, an obstruction of the vessels, crudities, and the increase of excrements, especially serous. Which if they flow down unto the joints, without doubt they cause this disease; for the joints are weak either by nature or accident in comparison of the other parts of the body: by nature, as if they be loose and soft from their first original; by accident, as by a blow, fall, hard travelling, running in the sun by day, in the cold by night, racking, too frequent venery, especially suddenly after meat; for thus the heat is dissolved by reason of the dissipation of the spirits caused in the effusion of seed, whence many crude humours, which by an unseasonable motion are sent into the sinews & joints. Through this occasion old men, because their native heat is the more weak, are commonly troubled with the gout. Besides also the suppression of excrements accustomed to be avoided at certain times, as the courses, haemorrhoides, vomit, scouring, causeth this disease. Hence it is, that in the opinion of Hypocrates, Aph. 29. Sect. 6. A woman is not troubled with the gout, unless her courses fail her. They are in the same case who have old and running ulcers suddenly healed, or varixes cut and healed, unless by a strict course of diet they hinder the generation and increase of accustomed excrements. Also those which recover of great and long diseases, unless they be fully and perfectly purged, either by nature or art, these humours falling into the joints, which are the relics of the disease, make them to become gouty; and thus much for the primitive cause. The internal or antecedent cause is, the abundance The antecedent cause of the gout. of humours, the largeness of the vessels and passages which run to the joints, the strength of the amandating bowels, the looseness, softness and imbecility of the receiving joints. The conjunct cause is the humour itself impact and shut up The conjunct. in the capacities and cavities of the joints. Now the unprofitable humour, on every side sent down by the strength of the expulsive faculty, sooner lingers about the joints, for that they are of a cold nature and dense, so that once impact in that place, it cannot be easily digested and resolved. This humour than causeth pain by reason of distension or solution of continnity, distemper, and besides the virulency and Five causes of the pain of the gout. malignity which it acquires. But it savours of the nature sometimes of one, sometimes of more humours; whence the gout is either phlegmonous, or ●rysipilatous, oedematous, or mixed. The concourse of flatulencies, together with the flowing down humours, and as it were tumult by the hindrance of transpiration, increaseth the dolorificke distension in the membranes, tendons, ligaments and other bodies wherein the joint consists. CHAP. IU. Out of what part the matter of the Gout may flow down upon the joints. THE matter of the gout cometh for the most part from the liver, What and how the matter of the gout comes down from the brain. or brain; that which descends from the brain is phlegmatic, serous, thin and clear, such as usually drops out of the nose, endued with a malign and venenate quality. Now it passeth out by the musculous skin and pericranium, as also through that large hole by which the spinal marrow, the brains substitute, is propagated into the spin, by the coats and tendons of the nerves into the spaces of the joints, and it is commonly cold. That which proceeds from the liver is diffused by the great vein and arteries filled and puffed up, and participates of the nature of the four humours, of which the mass of the blood consists, more frequently accompanied with a hot distemper, together with a gouty malignity. Besides this Gout by congestion. manner of the gout which is caused by defluxion, there is another which is by congestion; as when the too weak digestive faculty of the joints cannot assimilate the juices sent to them. CHAP. V. The signs of the arthritick humour flowing from the brain. WHen the defluxion is at hand, there is a heaviness of the head, a desire to rest, and a dulness with the pain of the outer parts, then chiefly perceptible, when the hairs are turned up, or backwards; moreover, the musculous skin of the head is puffed up as swollen with a certain oedematous tumour; the patients, seem to be much different from themselves by reason of the functions of the mind hurt by the malignity of the humour, from whence the natural faculties are not free; as the crudities of the stomach, and the frequent and acride belchings may testify. CHAP. VI The signs of a gouty humour proceeding from the liver. THe right Hypocondrie is hot in such gouty persons, yea the inner parts When the gout which proceeds from the default of the liver, assimulates the nature of an oedema. are much heated by the bowel; blood and choler carry the sway, the veins are large and swollen, a defluxion suddenly falls down, especially if there be a greater quantity of choler than of other humours in the mass of the blood. But if, as it often falls out, the whole blood, by means of crudities degenerate into phlegm and a wheyish humour; then will it come to pass, that the gout also, which proceeds from the liver, may be pituitous or phlegmatic, and participate of the nature of an oedema, like that which proceeds from the brain. As if the same mass of blood decline towards melancholy, the gout which thence ariseth Why the gout seldom proceeds from melancholy. resembles the nature of a scirrhus; yet that can scarce happen, that melancholy by reason of the thickness and slowness to motion may fall upon the joints. Yet notwithstanding, because we speak of that which may be of these, it will not be unprofitable briefly to distinguish the signs of each humour, and the differences of gouts to be deduced from thence. CHAP. VII. By what signs we may understand this or that humour to accompany the gouty malignity. YOu may give a guess hereat by the patient's age, temper, season of the year, condition of the country where he lives, his diet and condition of life, the increase of the pain in the morning, noon, evening or night, by the propriety of the beating, pricking, sharp or dull pain; by numbness, as in a melancholy gout or itching; as in that which is caused by tough phlegm, by the sensible appearance of the part in shape and colour (as for example sake in a phlegmatic gout, the colour of the affected part is very little changed from its self, and the neighbouring well parts, in a sanguine gout it looks red, in a choleric it is fiery or pale, in a melancholy livid or blackish) by the heat and bigness which is greater in a sanguine and phlegmatic than in the rest, by the change, and lastly by things helping and hurting. And there be some, who for the knowledge of these differences wish us to view the patient's urine, and feel their pulse, and consider these excrements which in each particular nature are accustomed to abound or flow, and are now suddenly and unaccustomarily suppressed. For hence may be taken the signs of the dominion of this or that humour. But a more ample knowledge of these things may be drawn from the humours predominant in each person, and the signs of tumors formerly delivered. Only this is to be noted by the way, that the gout which is caused by melancholy is rare to be found. CHAP. VIII. Prognostics in the Gout. BY the writings of Physicians the pains of the gout are accounted amongst the most grievous and acute; so that through vehemency of pain many are almost mad, and wish themselves dead. They have certain periods and fits according to the matter and condition of the humour wherein this malign and inexplicable gouty virulency resides. Yet they more frequently invade in the Spring and Autumn; such as have it hereditary The gout frequent in the Spring & Fall. What gout uncurable. are scarce ever throughly free therefrom, as neither such as have it knotty: for in the former it was borne with them, and implanted, and as it were fixed in the original of life: but in the other the matter is become plaisterlike, so that it can neither be resolved nor ripened: that which proceeds from a cold and pituitous matter, causeth not such cruel tormenting pain, as that which is of a hot, sanguine or choleric cause, neither is it so speedily healed, for that the hot and thin matter is more readily dissolved; therefore commonly it ceaseth not until forty days be passed: besides also, by how much the substance of the affected part is more dense, and the expulsive faculty more weak, by so much the pain is more tedious. Hence it is, that those gouty pains which molest the knee, heel and huckle bone, are more contumacious. The gout which proceeds of a hot matter, rests not before the fourteenth or twentieth day. That which is occasioned by acride choler, by the bitterness of Gal●und aphor. 49. Sect. 〈◊〉. the inflammation and pain causeth a difficulty of breathing, raving, and sundry times a gangrene of the affected part, and lastly death; and healed, it often leaves a palsy behind it. Amongst all the gouty pains, the Sciatica challengeth the prime place, Why the Sciatica causeth lameness. by the greatness of the pain and multitude of symptoms; it brings unquietness and watching, a fever, dislocation, perpetual lameness & the decay of the whole leg, yea and often times of the whole body. Now lameness, and leanness or decay of the part are thus occasioned, for that the decurrent humour forceth the head of the thighbone out of the cavity of the hucklebone; this being forced out presseth the muscles, veins, arteries, and that notable and large nerve which runs alongst the thigh even to the furthest joints of the toes, and by the way is diversely dispersed over the muscles of the whole leg. Therefore because the head of the thigh is put out of its place, the patient is forced to halt; because the vessels and nerves are oppressed, the nourishment and spirits do not freely flow into the parts thereunder, whence proceeds their decay. Yet it sundry times happens, that the head of the thigh being not displaced, many halt because the viscide humour, which is naturally implanted in that place and continually flows thither, both for the nutrition of these parts, and the lubrication of the joint for quicker motion, is hardened by heat and idleness, and the other unprofitable humours which flow down do there concrete, and so intercept the liberty of motion. A gross and viscide humour into what joint soever it falleth and stayeth, doth the same. For by concretion it turns into a plaster like nature at or near the joint, possessing the cavities thereof, and it depraveth the figure of the part, making it crooked and knotted, which formerly was straight and smooth. Furthermore every distemperature caused by the defluxion of humours, if it shall lie long upon any part, depraves all the actions, and ofttimes wholly abolisheth them; so that there may be three causes of the leanness or decay Three causes of the lameness or decay of the limoes. of the joint by the gout, the obstruction or compression of the vessels, idleness and a hectic distemper: but two of lameness, dislocation and the concretion of an adventitious humour impact in the joint. If contrary to custom and reason the pains of the gout do not go away or return at their accustomed periods, most grievous and dangerous diseases thereon follow; for the matter accustomed to flow down into the joints, if it seize upon the substance of the liver, causes a Phlegmon; if it stay in the larger veins, a continual fever; if it flow into the membrane investing the ribs, a Pleurisy; if it betake itself to the guts and adhere to their coats, the Colic or illiaca passio; and to conclude, it produceth divers other symptoms, according to the diversity of the parts whereto it flows and abides. For thus sundry How the gout turns into the palsy. that have been troubled with the gout, become paralytic, because the matter which formerly flowed down into the joints, stays in the substance and pores of the nerves, and so hinders the spirit that it cannot freely in its whole substance pass though them: hence therefore comes the resolution of the part, whereinto the nerve is inserted. Old men can never be quite or absolutely cured of the gout, for that the mass of their blood is so departed from its primary & native goodness, that it can no more be restored, than dead or soured wine. The gout which proceeds from a cold cause, invadeth slowly and by little and little, and is helped by the use of hot things; that which is from a hot matter, quickly shows itself, and is helped by the use of cold things. Now, although the gout more frequently returns in the spring Why the gout takes one in winter and the midst of summer. and fall, yet it comes in the midst of winter, the nerves being weakened by the excess of cold, and the humours pressed out; otherwhiles in the midst of summer, the same being diffused and dissipated. Lastly, it comes at any time or season of the year, if those who are subject to this disease feed plenteously, and do all things according to their own minds and desire. Those who are troubled with the gout, feel and perceive change of weather, storms, reins, snows, winds and such like, before they come. A southerly constitution of the air, for example, fills the body with humidities, and stirs up the humours that lie quiet in the body, and therefore cause defluxions upon the weaker parts, such as the joints, both by nature, as being without blood and flesh, as also by accident, for that they a long time have been accustomed to be so tormented; therefore their pains are increased in a wet season. Many of these that are troubled with the gout, desire venery in the bitterness of their Why such as have the gout upon them, do ofttimes desire Venery. pain, because the internal heat wherewith they then are inflamed doth not dissipate into spirits and air, as the feverish heat doth, but dissolves, and as it were melts down the seminal humour, which dissolved, flows to the genitals, filleth and distends them. The same thing befalls carriage and running horses, for in these by labour, much heat sends flatulencies to the bottom of the belly. Yet venery is very Venery hurtful in the gout. hurtful to such as are troubled with the gout, because it dissipates the spirits and native heat, and increaseth the unnatural heat; whereby it cometh to pass that the nervous parts are weakened, and the pain exasperated. Rich men, that is, such as feed riotously on variety of dainties, and in the mean space live idly and lazily are more frequently and cruelly tormented with the gout than poor people, who live sparingly and hardly: Wherefore there have been seen not a few of such rich and riotous persons, who having spent their estates, have therewith changed their health, together with their fortune and diet, and so have been wholly freed from the gout. CHAP. IX. The general method of preventing and curing the Gout. THose who desire to prevent the gout, must not glut themselves with meat, must be quick to labour, and abstain from wine and Venery, or certainly must not use them, unless for their health's sake, must vomit and purge at certain times. Hypocrates writes, that boys are not troubled with the gout before the use of venery. Yet at this day many eunuchs are seen to have the Aph. 30. Sect. 6. gout, but especially those who abound with idleness and pleasure, yet these we have heretofore mentioned are very effectual, not only for the prevention, but also for the cure of the present disease. Yet we must diligently distinguish the causes, what they be, & whence they may proceed, & oppose thereto remedies contrary in quantity and quality. There are absolutely three distinct causes of the gout; A tainture from the parents; a corruption of the humours by diet and air; a native, or adventitious weakness of the joints. Against these there is a twofold indication; the first Two general scopes of cutting the gout. is the evacuation and alteration of the peccant humours, the other the strengthening of the weak joints. These two shall be performed by diet conveniently appointed, purging, blood-letting, provocation of the haemorrhoids, courses, vomit, sweat, urine, and fit application of local medicines. Therefore, when the time shall come, wherein the gout accustometh to return by course, the patient shall have a care of himself by a diligent manner of diet, he shall lessen the matter of the disease by phlebotomy (if that the gout shall arise from the blood) from the opposite part, Whence blood must be let in the gout. that by the same means revulsion and evacuation may be made; as if the upper parts be inslamed, blood shall be drawn from the lower; if on the contrary the lower, out of the upper, always observing the straightness of the fibres. Thus the right arm being troubled with a gouty inflammation, the Sapheia of the right leg shall be opened, and so on the contrary; but if this general blood-letting being premised, the pain shall not cease, it will be requisite to open the vein next to the pain, which I have often performed with happy success. Yet phlebotomy hath not the like effect in all, for it is not available to such as are continually and uncertainly troubled with gouty pains, or whose bodies are What gouty persons find no benefit by phlebotomy. weak and cold, wherein phlegm only is predominant. We may say the same of purging, for though it be ofttimes necessary, yet too frequently reiterated, it proves hurtful, furthermore, neither of these remedies is usually very profitable to such as observe no order in meat and drink, which use Venery too intemperately, who abound with crude and contumacious humours; whose joints by long vexation of the disease, have contracted a hectic distemper and weakness, so that they are departed from their natural constitution, and suffered a great change of their proper substance. Wherefore as often as these greater remedies shall be used, a Physician shall be called, who according to his judgement may determine thereof. In what gout diet proves more effectual than medicines. For ofttimes diet proveth more available than medicines: therefore the Patient (if the matter of the gout be hot) shall either drink no wine at all, or else very much allayed, that is, as much as his custom and the constitution of his stomach can endure. A fit time for purging and bleeding is the Spring and Autumn, because, according to the opinion of Hippocrates, gouts reign chiefly in these seasons; Aphor. 55. Sect. 6. in Autumn, for that the heat of the precedent Summer debilitareth the digestive faculty, the native heat being dissipared; as also the eating of Summer fruits hath heaped up plenty of crude humours in the body, which easily flow down into the passages of the joints opened and dilated by the Summer's heat: add hereunto that the inequality or variableness of Autumn weakeneth all the nervous parts, and consequently the joints. But in the Spring, for that the humours forced inwards by the coldness of the winter, are drawn forth from the centre to the circumference of the body, and being attenuated, fall into the joints upon a very small occasion. Therefore there is great both necessity and opportunity for evacuation, which if it shall not avert the accustomed fit, yet it will make it more gentle and easy. CHAP. X. Of Vomiting. VOmiting is by all the Ancients exceedingly commended, not only for To what gout vomiting is to be used. the prevention, but also for the cure, especially when as the matter floweth from the brain and stomach; for the phlegmatic, serous and choleric humours, which usually flow from the joints, are excluded and diverted by vomit, and also there is attenuation of that phlegm, which being more thick and viscide, adhereth to the roots of the stomach: yet you What time the ●ittest therefore. must consider and see that the patient be not of too weak a stomach and brain, for in this case vomiting is to be suspected. For the time, such as have excrementitious humours flowing down to the stomach through any occasion, as by exercise and motion, must vomit before they eat; on the contrary, such as are overcharged with an old congestion of humours, must vomit after they have eaten something. Certainly it is safer vomiting after meat, than it is before. For the dry stomach cannot, unless with great contention and straining, free itself from the viscide humours impact in the coats thereof; and hence there is no small danger of breaking a vein or artery in the Chest or Lungs, especially if the patient be straight chested, and long necked, the season cold, and he unaccustomed to such evacuation. I remember that with this kind of remedy I cured a certain Gentleman of Geneva, A history. grievously molested with a cruel pain in his shoulder, and thereby impotent to use his left arm; the Physicians and Surgeons of Lions seemed to omit nothing else for his cure. For they had used purging, phlebotomy, hunger, a Diet drink of Gudiacum and China (although his disease was not occasioned by the Lues Venerea) and divers other to pick medicines, neither yet did they any thing avail. Now learning by him that he was not apt to vomit, but that it was difficult to him, I wished him How to make one vomit easily. to feed more plentifully, & that of many & sundry meats, as fat meat, onions, leeks; with sundry drinks, as bear, ptisan, sweet and sharp wine, and that he should as it were overcharge his stomach at this meal, and presently after get him to his bed; for so it would happen, that nature not enduring so great confusion & perturbation of meats & drinks, whereof some were corrupted already in the stomach, & othersome scarce altered at all, nature not enduring this confusion and perturbation, would easily and of its own accord provoke the stomach to vomit; which that it might the better succeed, he should help forward nature's endeavour, by thrusting his finger or a feather into his throat, that so the thick and tenacious phlegm might by the same means be evacuated: and not content to do thus once, I wished him to do the like the second & third day following, for so it verifieth that saying of Hypocrates: The second and third day exclude the relics of the first: afterwards, that he Lib. de●rat. victis. should vomit twice a month: chaw mastic fasting: rub his neck and the pained part with aqu● vitae, stengthened by infusing therein lavender, rosemary, and cloves grossly beaten: confirm his arm by indifferent exercise: he performed all this, and so became free from his pain, and recovered the use of his arm. Those who do not like such plentiful feeding, shall drink a great quantity of warm water wherein radish roots have been boiled, and they shall have a care lest by using their stomaches to this excretion by vomit they weaken the digestive and retentive faculty thereof. Wherefore such as can naturally, shall think it sufficient to vomit twice a month. CHAP. XI. The other general remedies for the Gout. THe defluxion of serous humours is very ●itly diverted from the joints by How Diuretics are good for the gout. the urine by the use of diuretic medicines. Therefore the roots of Sorrel, parsley, ruscus, asparagus, and grass, and the like, shall be boiled in broth, and given to such as have the gout: for when the urine floweth much and thick, the pain is lessened. Many have found benefit by Issues or ●on●anels. issues; for the Arthritick malignity flows forth of these, as by rivulets: experience shows it in such as are troubled with the Lues Venere●, for in those that you cannot overcome the malignity by the proper antidote, that is, Quicksilver, they feel no greater ease of the pain, than by application of Caustics, and making of issues. They shall be made in sundry places according to the difference of the pained joints, Where to be made. to wit, in the beginning of the neck, if the defluxion proceed from the brain, and fall into the joints of the Collar-bones or shoulder; if into the Elbow or hand, under the muscle Epomis; if into the hip, knees, and feet, some three fingers breadth under the knee, on the inside: for thus there will follow more plentiful evacuation, by reason that the Sapphire runneth down that way. Yet if the patient be troubled with much business, and must travel much on horseback, then shall they be made An actual cautery. on the outside of the leg, between the two bones thereof, that so they may trouble him the less in riding. If any had rather use an actual cautery, let him take such an one as is triangular and sharp, that so he may with more speed and less pain perform that which he intends, and let him thrust it through a plate of iron which hath a hole therein, and let the place be marked lest he should ●rre; the ulcer shall be kept open by putting in a pill of gold, silver, lint, of the root of orris, hermodactiles, gentian, wax, wherewith some powder of vitriol, mercury or alum shall be incorporated, lest it should fill up with flesh sooner than the Physician shall think Pills. fit. In the mean space, the head, ofttimes the original of the evil, shall be evacuated by taking in the winter the pills cochiae, and the Assa●ereth; but in summer sine quibus, or Imperiales, before the Full of the Moon. ℞. pull. hyer● simp. ʒi. agar. recent. troch. & rhei an. ʒii. myroball. chebul. ʒss. tamarind. ℈ two. cum infusione senae, fiat massa de qu● formentur pill. vi. pro drachma; let the patient take two before supper every eighth day; the day after he shall drink some broth of the decoction of Cicers and the Diuretic roots. Also these following pills will be good to purge the phlegmatic and serous humour. ℞. pillular. foetid. & de hermodactil. an. ʒss. formentur cum succo vel syrup. rosar. solut. Or else, ℞. al●ës. ʒiii. agarici trochis. & rhei, an. ʒi. massae pilul. arthrit. & de hermodact. an. ℈ two. diacrid. ℈ i. come me●●e rosat● fiat massa, capiat pondus, ʒi. as the Physician shall think fit, by whose advice these shall be used and changed as occasion shall offer itself, and the nature of the humour causing the disease. The day after the purging, the patient shall take three hours before meat half a dram of Treacle, to strengthen the entrailes: pills are preferred before liquid Common pills with the addition of scamony. medicines, for that by their long stay in the stomach they easily attract the noxious humour from the brain, & the other more distant parts. I have known some Physicians who mixing with ordinary pills a good quantity of scamony, as 7. or 8. grains, with a little ginger, lest it should hurt the stomach, have purged by stool a great quantity Treacle, how useful in the gout. of serous humours; the day following they gave barley cream to correct the harm which the scamonie may have done to the stomach. Others for the same purpose give treacle, which doth not only strengthen the entrailes, but also weakens the virulency of the gouty malignity; the orifice of the ventricle must be shut after meat, that so the vapours ascending to the brain may be restrained: for this Cephalick fumigation. purpose common Drige powder, Marmelate, or conserve of roses are good. In a wet season use Cephalic perfumes thus made. ℞. thu●is, vernicis, & mastic. an. ʒi. granorum juniperi, baccarum lauri, an. ℥ ss. aloësʒii. odora●●ʒi. ss. Let them be grossly beaten; let the fume be received in row or carded Cotton, and so applied to the head. Also the excrementitious humours shall be dried up by the following powder strewed on the patient's head for fifteen days. ℞. fol. ros. rub. senae, staechad. utriusque an. m. ss. milii, ℥ iiii. furfuris loti in vino albo, ℥ iii florum chamaem. melil. an. p 1. sem. anisi, ℥ i. salis come. ℥ two. fiat omnium pulvis. Let it be put into linen Cephalic bags bags, with which, being warmed at the fire in a frying-pan, and kept with stirring, the head shall be rubbed. Let the following medicine be chawed, and kept in the mouth in the form of a masticatory, in the time of the falling down of the defluxion. ℞. cubelarum, nucis moschat. glycyrrhiz. anis. an. ʒ i pyrethri, ʒ two. mastic. rad.. A masticatory. st●phisagr. eryngii, an. ʒii. Let them all be made into powder, and mixed together, & tied up in a little taffeta to the bigness of a hazel nut, and let them be rolled up and down the mouth with the tongue to cause spitting or salivation. Working with the hands, and frictions of the arms, especially in the morning after the evacuation of the excrements, are good for such as are troubled with the Gout in the feet, for so, it not only causeth revulsion from the feet, but also the resolution of that which is unprofitable. CHAP. XII. What Diet is convenient for such as have the Gout. AFTER the body is once fed, they must not return to meat before that the concoction be perfected in the stomach, lest the liver be forced to draw by the mesaraicke veins that which is yet crude and ill digested, and as it were forced thence. Whence the depravation of the nutriment of the whole body; for the following decoctions do not amend The fault of the first concoction, is not amended in the altar. the default of the first. Let them make choice of meat of good juice and easy digestion, roasted for such as are phlegmatic, but boiled for such as are choleric: as they shall shun much variety at one meal, so must they eschew the use of pulses, milk-meats, salads, and sharp things, as verjuice, vinegar, the juice of oranges, and citrons. They shall not eat unless they be hungry, and shall desist therefrom before they be fully satisfied, if it be but for this, that whilst the native heat is busied in the digestion of meat plenteously eaten, it is diverted from the concoction of the noxious humours. The flesh of great fowl, as swans, crane's, peacocks are not of laudable juice, and are with more difficulty digested in the stomach. Some of the ancients have disallowed of the eating of Capons, and the like birds, because they are subject Capon's subject to the Gout. to be troubled with the Gout in the feet. Fishes are to be shunned, for that they heap up excrementitious humours, and are easily corrupted in the stomach, yea & relax it by continual use. Of the flesh of beasts veale is most to be commended, for that it breeds temperate blood, and laudable juice, and is easily digested. Neither in the mean time is mutton to be found fault withal. But the like hunger or abstinence must not be appointed to all men troubled with the Gout, for such as are of a sanguine and choleric complexion, because they are endued with much, and Choleric person cannot away with long fasting. much wasting heat, are to be refreshed with more plentiful nourishment; for hunger sharpens choler, and so augments their pains; neither in the interim must they be fed with too moist meats, for too much moisture, besides that it is the author of putrefaction, will cause defluxions, and draw down the matter to the joints. Therefore the Choleric humour must be incrassated and refrigerated by taking things inwardly, and applying things outwardly, lest by its tenuity it should fall down into the grieved parts. To this purpose conduce broths altered with lettuce, purslane, sorrel, and the like herbs, and barley creames made with a decoction of the four cold seeds. Phlegmatic bodies, by reason that they have not so vigorous Phlegmatic bodies infasting feed upon themselves. heat, do as it were carry their provant about them, wherefore they must not be fed, neither with many nor with moist meats. All that are troubled with the Gout must shun those things which are hard of digestion, and which are soon corrupted, for they all have a certain remiss fever which diminisheth the native heat, & makes the meats apt to putrefy. Too plentiful drinking not only of wine, but also of any other liquor is to be avoided. For by too great a quantity of moisture the meat floats in the stomach, and the native heat is in some sort extinguished, whence proceed crudities. Some physicians comm●nd the use of white wine, for that it provokes urine, which is not altogether to be disallowed if so be that the body be free from excrements, otherwise by this, as it were a vehicle, especially if the temperature White wine not good for the gout. of the body be somewhat more hot, they shall be carried down into the joints. Therefore in such a case I should rather advise them to use clarer, which is somewhat Claret may be the safelier drunk. weak and astringent, for that it doth not so much offend the head nor joints, and it shuts and strengthens the orifices of the vessels. Yet it will be more convenient wholly to abstain therefrom, and in stead thereof to drink a Hydromel made after this manner. ℞. aquae lb. iiii. mellis oped. q. i bulliant ad consumptionem lb. i bene despumando, Hydrom● most safely. add ad finem, salviae p. i. imo si ●ger sit pituitosus, cinamomi aut caryophyllorum momentum. For choleric persons make a sugared water thus. ℞. aquae fontis lb. iiii. sacchari β. ss. cinamomiʒ. two. For thus the stomach shall also be strengthened; also he may drink ptisan, wherein at A 〈◊〉 ‑ 〈◊〉. the end of the decoction shall be boiled some dried roses, or else some syrup of pomegranates added thereto, lest it should offend the stomach; as soon as it comes from off the fire, let it stand and settle, and then strain it through an Hippocras bag, or clean linen cloth. CHAP. XIII. How to strengthen the Joints. IT is a matter of much consequence for the prevention of this evil, to strengten the joints, whereby they may be able to resist the humours preternaturally falling down upon them. Wherefore it is good morning and evening to rub them with Oleum O●phacinum, that is, oil made of olives not come to their perfect maturity; or with oil of roses mixed with common salt finely powdered. It may also be mixed with common oil, adding thereto the powder of heart's horn, as that which hath an astringent and drying faculty. Also it is good to bathe them in this following Lye. ℞. cort. granat. nucum cupres. A●…●tation to strengthen the joints. gallarum, sumach. cortic. querni, an. ℥ two. salis come. alumin. roch. an. ℥ i. salviae, ●●rismar. lavendul. lauri, ivae arthretic. an. m. i. rosar. rub. m. ss. bulliant omnia in sex lb. vini crassi & astringentis & lixivio parato ex aquae chalibeatae & cinere querno. Then ●oment the part with sponges or cotton clothes; after this fomentation shall be carefully wiped & dried with hot linen clothes, taking heed of cold. The juice of unripe The juice of haws with oxycrate. Haws tempered with oxycrate is a singular thing for this purpose. But if you desire to strengthen the joints weakened by a cold cause, then, ℞. salviae, r●rism. thymi, lavendul. laur. absinth. an. m. i. caryophyl. zinzib. piperis, conquas●atorum an. ℥ i. infundantur in aquae vitae & vini rubri astringenti●, an. lb. iiii. bulliant leniter in balneo mariae. With this liquor foment the joints morning and evening. Some think it good to strengthen the joints, to tread grapes in vintage time, which if they be not able to do, then let them wash their feet in the Must or new pressed Wine. Also bags may be thus made for the same purpose. ℞. salis come. alum. roch. cort. granat. Bags. sumach. berberis, nucum cupressi, an. ℥ iiii. fol. salviae, roris●ar. rosar. rub. an. m. ss. Let them be all put in linen bags and boiled in Lie, and so make a decoction for to foment the joints. CHAP. XIIII. Of the Palliative Cure of the Gout and the material causes thereof. HERE also must we consider the causes whence this disease proceeds, the The scopes of curing temper of the diseased body, the parts affected, & those from whence it proceeds. For as these are not always alike, so neither can one and the like remedy be useful in every Gout. For first those which proceed of a cold cause require other remedies, than those which arise from a hot, and that which proceeds from any one simple humour, than that which ariseth from divers mixed together. For Choler alone causeth cruel pains, but tempered by the admixture of Phlegm, it becomes more gentle. Furthermore some remedies are good in the beginning, some in the increase, and some at other times. Neither may we use repercussives in the Sciatica, as we may in the Gout of the feet and other joints; unless peradventure the part be fearfully inflamed. Taking these things to consideration we must observe that the Palliative cure of that Gout, which Repercussives not to be used in the scinatica. The palliative cure performed by four scopes. cannot absolutely be helped, as that which is hereditary and inveterate, is performed by four scopes. The first is, by appointing a convenient diet in the six things which are termed not natural. The second by evacuating and diverting the antecedent matter, both by purging and phlebotomy. The third, by applying topicke medicines according to the condition of the morbificke humour and nature of the part. The fourth, by correcting the symptoms, but especially the pain, whereof in these affects there is oft times so great excess by reason of the unexplicable and invincible malignity of the virulent quality associating the humour, that it alone is oft times sufficient to kill the patient. And because the variety of morbificke causes, brings a variety of remedies, fitted to these four intentions, therefore it behoves a physician to be most attentive in the distinction of the causes. For he may be easily deceived and mistake one for another; for arthritick pains proceeding from a cold matter, if they be mitigated by the application of Narcoticke and cold medicines, it An argument taken from that which helpeth, or giveth ease, is not always, certain. How cold diseases may be helped by cold, and hot by hot medicines. The first thing that may deceive a Physician. may induce us to believe that the material cause is hot, though really it be not so; for Narcotickes assuage pain, not for that they are contrary to the cause thereof, but because they take away the sense by inducing a numbness; on the contrary, the material cause may sometimes seem cold, which notwithstanding is hot, for that it becomes better by application of hot medicines, that is, by taking an argument from that which helps, because contraries are cured by contraries, and the like preserved by the like. But herein consists the error, for that hot medicines profit not by their contrariety, but by the attenuation of the gross matter, by the rarefaction of the skin and dissipating them into air. Whence you may gather that an argument drawn from that which helps and hurts, is very deceitful: moreover it may happen that a large quantity of cold matter flowing down from the brain, may cause great pain by reason of the virulency, & a small quantity of choler mixed therewith, which serves for a vehicle to carry down the tough and slow phlegm into the joints, whence the patient becomes thirsty and feavourish by reason of the heat and inflammation of these parts, whereby such as are less cautelous and heedy will easily be induced to believe that some hot matter is the occasion of this Gout. Now when as not some The second. one simple humour, but different by reason of mixture, causeth the Gout, the yellowish colour of the part may deceive one, as, if the evil matter should proceed from choler only, which by the tenuity of its substance leaving the centre, easily possesseth the circumference of the body or part: & notwithstanding much phlegm being as it were enraged by the admixtion of a little choler, may be the chief cause of the disease, and may peradventure be discovered by the increase of pain in the night season. A fever arising by means of pain and watching may increase the conceived opinion of choler, which attenuating and diffusing the humours, drives The third. them into the joints, and causeth fiery urines, tinctured with much choler, and a quick pulse. Yet notwithstanding the Physician shall be in error, if deceived with The fourth. these appearances, he attempt the cure of this Gout, as arising from a hot, and not from a cold cause: yet I am not ignorant that the cure of the proper disease must be neglected for the cure of the symptoms. Besides also it may come to pass, that choler The third. may be the cause of the Gout, and notwithstanding no signs thereof may appear in the skin, and surface of the affected part, because the coldness of the ambient air, and the force of applied Narcoticks may have destroyed the colour of the juices lying therunder, and as it were imprinted a certain blackness. It also happens, that the body being overcharged with a great quantity of gross and viscide humours, the The six●. expulsive faculty may discharge some portion thereof unto the joints, but leave the rest impact in the cavity of some entrail, where causing obstruction and putrefaction may presently cause a fever, and that intermitting, if it be small, & obstruct only the lesser veins, & these of the habit of the body. Wherefore then it is not sufficient that the Physician employ himself in the cure of the Gout, but it behoves him much more to attend the cure of the fever, which if it be continual, it discredits the physician, and endangers the patient; if it be intermitting, it easily becomes continual, unless it be withstood with fit remedies, that is, unless you let blood, the belly being first gently purged, and nature be presently freed by a stronger purge of the troublesome burden of the humours. Now it is convenient the purge be somewhat stronger than ordinary, for if it should be too weak, it will stir up the humours, but Why strong purges must be given to such as have the gout. not carry them away, & they thus agitated will fall into the pained and weak joints, and cause the Gout to increase. By this it appears how deceitful that conjecture is, which relies & is grounded on one sign, as often as we must pronounce judgement of morbificke causes. Wherefore to conclude we must think that opinion most certain concerning the matter of the disease, which is strengthened with multiplicity of signs, as those which are drawn from the colour of the part, the heat or That judgement most certain which rests upon multiplicity of signs. coldness manifest to the touch, those things that help and hurt, the patients familiar and usual diet, temper, age, region, season of they year, propriety of pain, the exacerbation or excess thereof, in what days, & in what hours of the day, the length of these ●its, the urine and other excrements coming from the patient's body. But for that not a few are in that heresy, that they think that we must neither purge nor let blood in the Gout, we must here convince that opinion. For seeing that Physic Why we must use purging and bleeding in the gout. is the addition of that which wants, and the taking away of those things that are superfluous, and the Gout is a disease which hath its essence from the plenty of abounding humours, certainly without the evacuation of them by purging and bleeding, we cannot hope to cure, either it, or the pain which accompanies it. Metrius, in his Treatise of the Gout writes, that it must be cured by purging, used not only in the declination, but also in the height of the disease, which we have found true by Lib. de affect. ubi de Arthri●. loquitur. Ad●ph. 23. sect. 1. Lib. decur. per 〈◊〉. missionem. experience; and it is consonant to this saying of Hypocrates; in pains we must purge by the stool. Besides also, Galen professeth that in great inflammations, fevers, and pains, he knew no greater nor surer remedy than to let blood, even to the fainting of the patient. If those which are in this case shall not become better by purging and phlebotomy conveniently prescribed, than it happens by means of drunkenness, gluttony, and the like distemper. For hence abundance of crude humours are heaped up, which by their contumacy yield themselves less obedient to medicines. Therefore such gouty persons as are intemperate and given to gluttony and venery, may hope for no health by use of medicines. CHAP. XV. Of local medicines which may be used to a cold Gout. LIttle do to pick medicines avail, unless the body of the gouty patient shall be purged from excrementitious humours; besides also there is danger lest by the use of repelling medicines, the virulency It is not safe to use repercussives in the gout before purging. of the humours may be driven into the entrailes, which thing hath been the cause of sudden death to many. Now in the first place we will speak of local medicines which are thought meet for a phlegmatic juice, because this is more frequent, than that which is from a hot cause. At the beginning in every gout, the sciatica excepted, we must use astringent things which have a faculty to bind or strengthen the joints, and to dry and waste the excrementitious humour. As, ℞. fol. sabinae m. ss. nucum cupressi ℥ iii An astringent Cataplasm. aluminis roch. ℥ i. gum. tragacanthae. ℥ iiii. mucaginispsilii & cydon. quantum sufficit, fiat cataplasma. Or, ℞. ●●ercoris bubuli recentis lb. i mellis ros. ℥ iiii. olei ros. & aceti an. ℥ two. bulliant simulparum, fiat cataplasma. Or else, ℞. olei rosar. & myrtill. an. ℥ two. pulveris myrrhae & aloes an. ℥ i. acaciae ℥ liss. incorporentur cum aqua gallarum coctarum, & fiat unguentum. Some boil sage, camomile and melilote flowers, wormwood and A discussing fomentation. dane-wort, of each a handful in a sufficient quantity of vinegar, than they put the grieved part into this decoction being warm; & by frequent using this medicine, it hath been found to repel and consume the noxious humour, not only cold, but also choleric, and also to strengthen the part. The fresh faeces of Olives laid to the part, assuage pain: dried Oranges boiled in vinegar, beaten and applied doth same. Or, ℞. medii corticis ulmi lb. ss. caudae equin. stoechad. consolid. majoris, One partly astringent and partly discussing. an. m. ss. aluminis roch. thuris an. ʒiii. hordeiʒv. lixiviis come. quantum sufficit, fiat cataplasma ad formampultis satis liquidae. Commonly then when as the part swelleth up, the pain is lessened, for that the expulsive faculty driveth the humour from the centre into the circumference of the part, that is, from within outwards; for in like sort, such as have the tooth ache have less pain when their cheeks begin to swell. After repercussives, we must come to those which evacuate the contained humour by evacuating or resolving it. For every defluxion of humours remaining in any part requires evacuation. Neither must we marvel thereat, if the digested humour doth not vanish at the first time; for we must have regard to the cold phlegm which is thick and viscide; as also of the part which is ligamentous, membranous and nervous, and consequently more dense than fleshy parts. ℞. rad. Bryon. sigilli Why the gouty humour doth not presently vanish upon the use of repercussives. Greater discussers. beat. Mariae an. ℥ iv. bulliant in lixivio, postea terantur, & colentur per setaceum, addendo farin. hordei & faburum an. ℥ i. olei chamaem. ℥ iii fiat cataplasma. Or, ℞. farin. hordei & lupin. an. ℥ iii sulphuris vivi & salis. come. an. ℥ i. mellis come. ℥ v. pull. aloës & myrrhae an. ℥ ss. aq. vit. ℥ i. cum lixivio fiat cataplasma. Or, ℞. succi caulium rub. aceti boni, an. ℥ iiii. farin. hordei ℥ iss. pull. Hermodactyl. ℥ ss. vitellos ovorum nu. three olei chamaem. ℥ iii croci ℈ two. some burn the roots and stalks of colworts, and mix the ashes with hog's grease and the powder of Orris, and so make a pultis. Or, ℞. Lactis vaccini lb. two. micae panis albi quantum sufficit, bulliant simul; addendo pulveris subtilis A Cataplasune good for any gout at any time. florum●homaem. & meliloti an. m. ss. croci ℈ i. vitellos ovorum nu. iiii. ol. rosar. ℥ iii butyri recentis ℥ i. terebinth. ℥ two. fiat cataplasma ad formam pultis satis liquidae. This Cataplasm may be applied with good success, not only to phlegmatic & cold, but also to any gout, at any time to mitigate the extremity of the pain in men of any temper, and it must be changed twice or thrice a day. Also Treacle dissolved in wine, and annoynted on the part, is said to assuage this pain. You may for the same purpose make and apply emplasters, unguents, cerats and liniments: This may be the form of an emplaster. ℞. gummi ammoniaci, bdeliis, s●yracis, an. ℥ two. cum aceto & Discussing emplasters. aqua vit. dissolve, & add farin. foenugr. ℥ ss. olei chamaem. & anethi, an. ℥ two. cerae quantum sufficit, fiat emplastrum molle. Or, ℞. rad. bryon. sigil. beat. Mariae, an. ℥ v. bulliant in lixivio completè, & colentur per setaceum, addendo olei cham. ℥ iiii. sevi hircini ℥ iiii. cerae nov. quantum sufficit, fiat emplastrum molle. Or, ℞. anʒii. dissolvantur in aceto, post●a colentur, add olei li●iorum, ierebinth. venet. an ℥ i. picis navalis, & cer. nov. quantum sufficit; fiat emplastrum molle. Or else, ℞. succi r●d. enul. camp. & ebuli an. ℥ iii rad. alth. lb. ss. coquantur & colentur per setaceum, addendo storum cham. melil. sambuci, rorismar. & hyperici an. p. two. nucum cupressi, nu. iiii. ol. cham. aneth. hyper. liliorum, de spica an. ʒii. pi●guedinis anatis, gallin. anseris an. ʒss. ranas virides vivas nu. vi. catelloes duos nuper natos, bulliant omnia simul, in lb. two. ss. vini oderiferi, & unâ aquae vit. ad consumptionem succorum & vini, & ossium catellorum dissolutionem, & fortiter exprimantur; expressioni add terebinth. ℥ iii cer. quantum sufficit. fiat emplastrum molle. Also, Emp. de vigo. Oxicroceum, de mucilaginibus, de meliloto and the like mixed together, and softened with a little oil or axungia, are of the like faculty, and good for the same purpose. Let this be the form of an ointment. ℞. anserem pinguem, & imple catellis duobus, Ointments. de quibus deme cutem, viscera, caput & pedes; item accipe ranas nu. x. colubros detracta cute in frusta dissectos nu. iv. mithridat. & theriac. an. ℥ ss. fol. salviae, rorismar. thymi, rutae, an. m. ss. baccarum lauri, & juniperi conquassat. an. ℥ i. pulveris nuc. moschat. zinzib. caryophyl. & piper. an. ʒi. de co quod stillabat fiat unguentum vel linimentum cum cera & terebinth. veneta, pauca aqua vitae addita; this marvellously assuageth the pain of the gout arising from a cold cause. Another, ℞. Gummi pini, & lodani, an. ℥ iv gummi elemi & picis naval. an. ℥ ss. claraeʒvi. chamaemel. & liliorum an. ℥ iv. vini rub. lb. i ss. aq. vit. & salv. an, ʒvi. dissolvantur omnia simul lento igne, baculo semper agitando, deinde add pull. ireos, flor. baccarum lauri, & hermodactyl. and ℥ iiss. mastiches, myrrhae & olibani an. ℥ two. farinae fabar. ℥ iv. incorporentur omnia simul, fiat unguentum molle. Or else, ℞. mucag. seminis foen●gr. in aceto extract. quantum volueris, cui misce mellis quantum sufficit; let them be boiled together until they acquire the consistence of an ointment. These things shall be changed, as often as need shall seem to require. Also anodine and discussing fomentations are good to Discussing fomentations. resolve; as this, ℞. fol. rutae, salv. rorismar. an. m. i bulliant cum aceto & vino; and so make a decoction for a fomentation, which you may use not only in a cold gout, but also in a hot, because it resolveth and strengtheneth the part by astriction, and freeth it from the defluxion: you must have a care that the medicines which are used Remedies must be often changed in the gout. to pains of the gout be changed now and then. For in this kind of disease that remedy which did good a little before, and now availeth, will in a short time become hurtful. But if the contumacy and excess of the pain be so great, that it will not yield to the described medicines, than it is fit, because the disease is extreme, to use (according to Hypocrates counsel) extreme remedies, such as are those which follow. ℞. axungiae A great discusser. gallinae, olei laurini mastic. & ●uphorb. an. ℥ i. pulver. euphorb. & pyreth. an. ʒi. fiat litus; herewith let the part be rubbed every day, for it is a very effectual medicine. For euphorbium and pellitory by their heat attenuate and resolve, the capon's grease and oil of bays, relax, the oil of mastic strengtheneth the part and hindereth a new defluxion. Also there is made a very anodine ointment of oil of foxes, wherein earthworms, the roots of elecampane and bryoni● have been boiled, with a little An anodine. turpentine and wax; this softens, attenuates and resolves the cold humour impact in the joints. Or else, ℞. seminis sinapi pulverisatis, & aceto acerrimo dissoluti, ℥ iii mellis anacardini ℥ two. aquae vitae ℥ i. salis come. ʒii. Let them be all mixed together, and applied to the pained part. Or, ℞. picis nigrae, ℥ iii terebinth. venetae ℥ two. sulphuris vivi subtiliter pulverisatis ℥ iii olei quant. sufficit, liquefiant simul, fiat emplastrum; Let it be spread upon leather, and laid upon the part for two or three days space, if the patient perceive any ease thereby; if otherwise, let it be changed as we said before. Some for the same purpose apply nettles thereto, and presently after wash the part in sea or salt water. Others foment the part with vinegar wherein pigeons' dung hath been boiled. A vesicatory made of very sour leaven, cantharides, and a little aqua A vesicatory against the contumacy of the conjunct matter. vitae, is very powerful to evacuate the conjunct matter. For thus the malign and virulent serum, or whayish humour is let out, whence follows some ease of the pain. Now there are some gouty pains, which cannot be lessened or assuaged unless by remedies more powerful than the distemper, therefore vesicatories ought not to be rejected, seeing that the Ancients in this affect have also made use of actual cauteries, as we shall show hereafter. Christopher Andreas in his book termed Oëcoitarie [that is, Domestic physic] much commends Ox dung wrapped in cabbage or vine leaves, and roasted in the embers, and so applied hot to the grieved part. CHAP. XVI. Of local medicines to be applied to a hot or sanguine Gout. HEre must we in the beginning make use of repercussives, such as are cold and dry, that they may contend with the morbificke matter by both What repercussives are here required. their qualities; also let them be astrictive, so to add strength to the part. But I would have you always to understand that you must first premise general medicines. ℞. albuminum ovorum nu. iv. succi lactuca & solani an. ℥ i. aq. rosar. ℥ two. incorporentur simul, & fiat linimentum saepius renovandum. Others take the meal of barley, lentils, acatia, oil of roses, myrtles, and with a little vinegar they make a cataplasm; Or, ℞. sumach, myrtillorum, boli arm. an. ʒss. acatiae, corticum granat. balust. an. ʒi. aq. plantag. & rosar. an. ℥ iii ol. rosatis ℥ iss. aceti ℥ i. farinae hordei & lentium quantum satis erit, fiat cataplasma. This is very excellent and effectual to stay or hinder phlegmonous and erysipelatous tumors. Also you may make a Cataplasm ex mucagine Cydoniorum in aqua rosarum extracta, cassiae fistula, oleo rosato, & aceto. Or, ℞. pampinorum vitis viridum, m. two. terantur & bulliant in oxycrato ex aqua fabrorum, cui add sumach. conquassati ℥ i. olei rosat. ℥ two. farinae hordei quantum sufficit, fiat cataplasma. Or else, ℞. succi sempervivi, hyoscyami, & portulacae An excellent astringent cataplasm. an. ℥ iv. corticum mali granati ℥ iss. farinae hordei ℥ v. vini austeri quantum sufficit, fiat cataplasma; this is much commended, for it hath entering thereinto wine and the pomegranate pill, which both are very great astrictives; and the juices are exceeding cooling, the meal also hinders and thickens the sanguine humours that are ready to flow down, and make the medicine of a good consistence. Another, ℞. fol. hyoscyami & acetosae an. m. i involvantur papyro, & sub cineribus coquantur, mox cum unguento populeon. aut rosat. ℥ two. incorporentur; and then lay this Cataplasm thus made warm unto the part. Another, ℞. florum hyoscyami lb. two. ponantur in phiala vitreata, & reconde in fimo equino donec putruerint, accipe ex putredine ℥ two. in quibus dissolve olei de junipero ℥ ss. fiat linimentum adusum. Others beat the pulp of a Gourd or citrul in a mortar, and so apply it. Another, ℞. mucag. sem. psilii, & cyton. extract. in aquae rosar. & solani an. ℥ iiii. olei rosati omphacini, ℥ iii vini granatorum ℥ i. vitellos ovorum cum albumine nu. three camphoraeʒi. incorporentur simul, fiat linimentum. Or else, ℞. ol. rosat. omphacini ℥ iv. album. ovorum cum vitellis nu. vi. succi plantag. & solani, an ℥ i. farinae hordei ℥ iii incorporentur simul, fiat cataplasma. Or, ℞. farinae fabarum & hordei an. ℥ iii olei rosatis, ℥ two. oxycrati quantum sufficit, coquantur simul, fiat cataplasma. Another, ℞. mucag. sem. psilii ℥ iiii. ol. rosatis ℥ two. aceti ℥ i. vitellos ovorum, nu. three croci ℈ i. misce. Pliny reporteth that Sextus Pomponius the Governor of the hither Spain, as he Lib. 22. cap. 25. overlooked the winowing of his corn, was taken by the pain of the gout in his feet, wherefore he covered himself with the Wheat above his knees, and so was eased, his feet being wonderfully dried; and he afterwards used this kind of remedy. It is note worthy, which often happeneth, that the pain cannot be altogether eased by such like remedies, by reason of the abundance of blood impact in the part; Phlebotomy to evacuate the conjunct matter, and assuage pain. wherefore it must be evacuated: which I have done in many with good success, opening the vein which was most swelled and nigh to the affected part; for the pain was presently assuaged. Neither must we too long make use of repercussives; lest the matter become so hardened, that it can scarce be afterwards resolved, as when it shall be concrete into knots and plaisterlike stones: resolving medicines are to be mixed with repercussives conveniently applied, so to discuss the humour remaining as yet in the part, whereof shall be spoken in the following Chapter. CHAP. XVII. Of local medicines for a choleric gout. THe repercussives that must first be used in this kind of gout ought to be cold and moist, that so they may resist both the qualities of choler: such What repercussives are here required. are the leaves of nightshade, purslane, houseleek, henbane, sorrel, plantain, poppy, cold water, and the like, whereof may be made divers compositions. As, ℞. succi hyosciami, sempervivi. lactuc. an. ℥ two. hordeiʒi. olei rosatis, ℥ two. agitando simul fiat medicamentum; let it be applied and often changed, for so at length it will assuage the inflammation. Some think the brain of a hog mixed with white starch, or barley meal and oil of roses, an excellent medicine. The leaves of mallows boiled in water, and beaten with a pestle, and applied, assuage pain. ℞. mucag. sem. psilii extract. in aq. solani, vel rosarum ℥ two. farin. hordei ℥ i. a●eti q. s. fiat linimentum. Or else, ℞. unguent. rosat. mesuae, & populei. an. ℥ iii succi melonum ℥ two. alb. ovorum, nu. three misceantur simul pro litu. Also a sponge dipped in oxycrate, and pressed out again and applied thereto doth the same. Or else, ℞. fol. caulium rub. m. two. coquantur in oxycrato & terantur: add ovorum vitellos tres, olei rosatis ℥ iii farinae hordei quantum sufficit, ●ingatur cataplasma: Also you may take the crude juice of coleworts, dane-weede, and roses beaten and pressed out, and of these incorporated with oil of roses and barley meal make a cataplasm. In winter time, when as these things cannot be had green, you may use unguentum infrigedans Galeni & populeon. Or else, ℞. cerae albae ℥ i. croci ℈ i. opii ℈ iiii. olei rosati quantum A cerate with opium. sufficit, marcerentur opium & crocus in aceto, deinde terantur & incorporentur cum cera & oleo, fiat ceratum; spread it upon a cloth, & lay it upon the part, and all about it, and let it be often renewed. Some cut Frogs open and apply them to the grieved part. It is confirmed by sundry men's experience, that the pain of the sciatica, when it would yield to no other remedy, to have been assuaged by anointing the part affected with the mucous water or jelly of Snails, being used for the space of seven or eight days; the truth whereof was assured me by the worthy ●he water of Snails. Gentleman the Lord of Longemean, a man of great honesty and credit, who himself was troubled for six months space with the sciatica. This water is thus made, Take fifty or sixty red Snails, put them in a copper pot or kettle, and sprinkle them over with common salt, and keep them so for the space of a day; then press them in a course or hair cloth; in the expressed liquor dip linen rags, and apply them so dipped to the part affected, and renew them often. But if there be great inflammation, the Snails shall be boiled in Vinegar and Rose-water. They say that Citrons or Oranges boiled in Vinegar, and beaten in a mortar, and incorporated with a little barley or bean flower, are good against these pains. Or else, ℞. pomorum coctorum in lacte lib. i. butyri ℥ i. vitellos ovorum, nu. two. aceti ℥ i. fiat cataplasma. There are some who take cheese crud newly made, and mix it in a mortar with oil of Roses and barley meal, and so apply it; it represseth the inflammation and assuageth pain. Others mix Cassia newly extracted forth of the Cane, with the juice of Gourds or Melons. Others apply to the part the leaves of Coleworts, and Dane-weede or smallage, or all three mixed together and beaten with a little Vinegar. Others macerate or steep an ounce of linseed in Wurt, and make the mucilage extracted therefrom into Cataplasm with some oil of Roses and barley meal. Some put oil of poppyes to the pulp of citruls or Gourds being beaten, and so incorporate them together, and apply it. This following medicine hath its credit from a certain Gascoine of Basas that was A historic. throughly cured therewith, when as he had been vexed long & much with gouty pains, above the common custom of such as are troubled with that disease. Thus it is; Take a great ridge tile thick & strong, and heat it red hot in the fire, then put it into such another tile of the same bigness, but cold, lest it should burn the bedclothes, than A particular s●ove. forthwith fill the hot one with so many Danewurt leaves, that the patient may safely lay the affected part therein; without any danger of burning it. Then let the patient endure the heat that comes therefrom, and by sweat receive the fruit thereof, for the space of an hour, substituting fresh Danewurt leaves, if the former become too dry, as also another hot tile, if the former shall grow too cold before the hour be ended. This being done, let the part be dried with warm and dry linen clothes. Use this particular stove for the space of fifteen days, and that in the morning fasting; afterwards anoint the part with this following ointment. ℞. succi ebuli lb i. ss. olei come. lb i misceantur simul, and let them be put into a straight mouthed glass, and well luted up; then let it boil in balnco Mariae, being An ointment of the juice of Danewurt. first mixed with some wine, until the half thereof be consumed, for the space of run or twelve hours, then let it cool, and so keep it for use, adding thereto in the time of anointing, some few drops of aquavitae. It may be anointed twice or thrice in a day, long after meat. Moreover the roots and leaves of Danewurt boiled in water, beaten and applied assuage pain; the oil thereof chimically extracted performs the same. But if the contumacious pain cannot be mitigated by the described remedies, and becoming intolerably hot and raging, make the patient almost to swoon, then must we fly to narcoticks. For although the temper of the part may be weakened by these, the native heat diminished or rather exstinguished; yet this is a far When to use narcoticks. less inconvenience than to let the whole body be wasted by pain; These things have a powerful refrigerating and drying faculty, taking away the sense of the pain, and furthermore, incrassate, thin, acride and biting humours, such as choleric humours are. Wherefore if the matter which causeth the pain be thick, we must abstain from narcoticks, or certainly use them with great caution. ℞. micae panis secalini parum cocti in lacte ℥ two. vitellos ovorum, nu. two opiiʒi. saccorum solani, hyosciami, A cataplasm with opium. mandragorae, portulacae, sempervivi, an. ℥ i. Let them be mixed together and applied, and often changed. Or else, ℞. fol. hyosciami cicutae, acetoes. an. m. i bulliant in oxycrato & contundantur, cumque vitellis ovorum crudorum nu. two. & olei rosat. ℥ two. farin● hordei quod sit satis, incorporentur, fiat cataplasma; with the use thereof I am accustomed to assuage great pains. Or else, ℞. Opiiʒiii. camphor. ʒss. olei nenuph. ℥ i. lactis ℥ two. unguent. ros. Galeni ℥ iv. incorporentur simul in mortario, applicentur. Moreover, cold water applied & dropped upon the part drop by drop, is narcotick and stupefactive, as Hypocrates affirmeth, Aphor. 29. Sect. 5. for a moderate numbness mitigateth pain; there is also another reason why it may be profitably used in all pains of the Gout, for that by repelling the humours, it hindereth their defluxion into the part. Mandrake apples boiled in milk, and beaten, do the something; also the leaves of henbane, hemlock, lettuce, purslane, being so boiled, do the same. If any desire to use these more cold, he must apply them crude, and not boiled. But the excess of pain being mitigated, we must desist from the use of such narcotickes, and they must rather be strengthened with hot and digerating things; otherwise there will be danger lest it be too much weakened, the temper thereof being destroyed, and so afterwards it may be subject to every kind of defluxion. How to amend the harm done by narcoticks. Wherefore it shall be strengthened with the formerly described discussing fomentations, and these ensuing remedies. As, ℞. gum. ammoniaci & bdeliis an. ℥ i. dissolvantur in aceto, & passentur per setaceum, addendo styracis liquid. & fari●. foenug. Dicussers. an. ●…ss. pull. ireos ℥ iiii. olei ch●maem. ℥ two. pyrethriʒii. cum cera fiat emplastrum molle. Or else, ℞. rad. emul●, ebuli altheae an lb. ss. sem. lini, foenugr. an. ʒii. ficuum ping. nu. xx. coquantur completè & trajiciantur per setaceum, addendo pull. euphorb. ʒii. olei chamaem. aneth. & rutacei, an. ℥ iii medullae cervi ℥ iv. fiat cataplasma. Yet you must use moderation in discussing, lest the subtler part of the impact humour being A mean to be used in discussing. discussed, the grosser part may turn into a stony consistence, which also is to be feared in using repercussives. I also omitted, that, according to the opinion of the Ancients, baths of fresh water, wherein cooling herbs have been boiled, used three hours after meat, conduce much to the asswaging of pain; for so used, they are more convenient in choleric natures, and spare bodies, for that they humect the more, and quickly digest Baths assuage the pain of the gout. the thin and choleric, and consequently acride vapours, the pores being opened, and the humours dissipated by the gentle warmness of the bath. After the bath, the body must be anointed with hydraeleum, or oil and water tempered together, lest the native heat exhale, and the body become more weak. Meats of more gross juice are more convenient, as beef, sheeps-feets, and the like, if so be that How meats of gross juice are profitable. the patient can digest them, for these inspissate the choleric blood, and make it more unfit for defluxion. CHAP. XVIII. What remedies must be used in pains of the joints proceeding of a distemper only, without matter. Pains also happen in the joints by distemper without any matter, which though rare, yet because I happened once to feel them, I have thought A history. good to show what remedies I used against them. I once earnestly busied in study, and therefore not sensible of such external injuries as might befall me; a little wind coming secretly in by the crannies of my study, fell upon my left Hip; at length wearied with study, as soon as I rose up to go my way, I could not stand upon my feet, I felt such bitter pain without any swelling or humour which might be discerned. Therefore I was forced to go to bed, and calling to mind, that cold, which was absolutely hurtful to the nerves, had bred me that pain, I attempted to drive it away by the frequent 〈…〉 p●●p. 10. sect. 5. application of very hot clothes; which, though they scorched and blistered the Divers remedies or pain arising from a cold distemper without matter. sound parts adjoining thereto, yet did they scarce make any impression upon the part where the pain was settled, the distemper was so great, and so firmly fixed therein. And I laid thereto bags filled with fried oats and millet, and dipped in hot red wine; as also ox bladders half filled with a decoction of hot herbs. And lastly, a wooden dish almost filled with hot ashes, covered over with sage, rosemary, and rue lightly bruised, and so covered with a cloth, which, sprinkled over with aqua vitae, sent forth a vapour which assuaged the pain. Also brown bread newly drawn out of the oven, and sprinkled over with Rose-water, and applied, did very much good. And that I might more fully expel this hurtful cold, I put stone bottles filled with hot water, to the soles of my feet, that the brain might be heated by the straightness and continuity of the nerves. At length, by the help of these remedies, I was very well freed from this contumacious distemper, when it had held me for the space of four and twenty hours. There is another kind of gouty pain sometimes caused by a certain excrementitious matter, but so thin and subtle that it cannot be discerned by the eyes. It A fuliginous vapour sometimes the cause of the gout. is a certain fuliginous or sooty vapour, like to that which passeth from burning candles or lamps, which adhers and concreets to any thing that is opposed thereto; which being infected by the mixture of a virulent serous humour whithersoever it runneth, causeth extreme pain, somewhiles in these, and otherwhiles in other joints, unless you make a way therefore, when as it seeketh passage forth, which must be done by horns, cupping-glasses, vesicatories, cauteries, or other the like art. CHAP. XIX. What is to be done after the fit of the gout is over. IT is convenient when the pain is assuaged, that you strengthen the How to strengthen the joints. joints. Now, to strengthen them is not only to bind and dry, but wholly to amend the weakness left in the part by the disease, that is, to discuss the humour, if any superfluity thereof remain; but to humect the part, if the moisture be exhausted and dried up. But Remedies for the weakness left in the joints after the pain is gone. such as are troubled with the gout, after they are freed from their pain, have notwithstanding such impotency of their joints that they cannot go of a long time after; for that the nerves and tendons which are in great number in the feet, being moistened with much phlegm, are so relaxed, that they can no more sustain or bear themselves upon their feet, than paper when it is wet can be made to stand. Wherefore, that they may recover the use of their feet, the impacted humour must by all means be discussed, and spent with fomentations, cataplasms, drying and astringent emplasters. You may use the formerly described fomentation, increasing the quantity of alum and salt, and adding thereto a like quantity of sulphur vivum: then the following emplaster shall be applied thereto. ℞. mas. emplast. contra rupturam ℥ iiii. tereb. ℥ two. pulv. ros. rub. nucum cupress. gallarum, gran, myrtil. & fol. ejusdem, thuris, mastic. & caryophyl. an. ʒi. malaxentur ominae simul, manibus inunctis oleo myrtino & mastichino, fiat emplastrum. Let it be spread upon leather to a just bigness, and applied to the top and sole of the foot. Draw over the plaster, and the whole leg a stocking made of a tanned dogs skin; this emplaster strengtheneth the nerves, draweth forth the humour impact therein, and intercepts the defluxion. But the dogge-skinne stocking preserveth The benefit of a dog-skinne stocking. the native heat of the part, and for that it bindeth, hindereth the defluxion into the feet. CHAP. XX. Of the Tophi, or knots which grow at the joints of such as are troubled with the Gout. SOme that are troubled with the gout, have knotty bunches growing in Whence the tophi are generated. their joints, which by the Ancients were called Tophi. These are generated by the congestion of gross, viscide and crude phlegm, with a little admixtion of an acride and choleric humour. These matters remain settled in the part, for that it being too weak cannot digest and depress them; wherefore being there impact, they easily concrete into a certain plasterlike or chalke-like substance, whilst by the adventitious and burning heat caused by pain, and the gouty malignity, their more subtle part is The unfit application of discussive & re percussive medicines cause the tophi. dispersed, but the grosser subsides. Yet sometimes the unfit application of repercussive or discussive medicines is a cause of the generation of these Tophi. For by the former, the impact matter is incrassated and gathered together; but by the latter, the subtle part being discussed, the remnant that subsides concretes into Tophi. Those medicines which are made to mollify, aught to have a moderately Mollifying medicines. heating, and humecting faculty, that they may diffuse, and as it were dissolve the impact matter; such is warm water, the decoction of emollient herbs, the decoction of Calves or Sheep's entrailes, heads and feet: after these or the like fomentations, you shall use the following medicine. ℞. axungiae, human. anseris & gallinae, medul, cervin. an. ℥ two. tereb. ven. ℥ i. aq. vit. parum, cerae quantum suficit, fiat unguentum molle. Then this which followeth will be good. ℞. rad. alth. liliorum, bryon. lapath. acuti, an. ℥ iiii. coquantur complete & trajiciantur per setaceum; add gum. ammon. bd●l. galb. opopanaci● in aceto dissolutorum ℥ i. medul. cervin. ℥ iss. incorporentur simal, & applicentur. Or else, ℞. olei liliorum, amygd. dull. medullae cruris cer. an. ℥ two ss. mucag. sem. lini, alth. foenugr. an. ℥ i. cerae quantum sufficit; fiat ceratum. Or else ℞. empl. de vigo cum mercurio, & cerat. de aesipo humidae descript. Philagrii, an. ℥. two. malaxentur simul cum oleo lilior. fiat massa. Or else, ℞. gum. ammon. opopan. galb. bdel. dissolutorum in aceto, an. ℥ two. panno lineo colatis, add pulv. sulph. nitr. sinap●, pyrethri, an. ℥ ss. styracis, liq. & axung. hum. an. ℥ i. res. pini, terab. ven. an. ℥. ss. cerae quantum sufficit, fiat ceratum molle. This which follows is thought most effectual in the opinion of Galen and Avicen. ℞. pedes porcel. benesalsos, nu. iiii. veterem Lib. 10. simp. c. 7 sc. 22. lib. 3. tract. 2. cap. 21. pernam, cum illis coque: addendo sub finem, radicis bryoniae, lapath. acut. an. ℥ iii axun●… tauri. & medul. cervin. an. ℥ i. cum caseo putrefacto fiat empl. molle ad usum: This which follows is also most effectual. ℞. casei acris & putrefacti, ℥ iiii. pull. sulph. vivi cuphorb. & pyreth. an. ʒiii. decoctionis veter is pernae & porcellorum quod sufficit ad incorporandum, ducantur in mortario, & fiat empl. adusum. Or else, ℞. spumae nitri, ℥ vi. tereb. ℥ two. olei veteris, ℥ viii. lixiviis, quo lanae pileorum lavantur, & cerae quantum sufficit, fiat ceratum sat is molle. After the use of emollients, a fumigation shall be made in this manner. Heat a cogle-stone, millstone or brick, red hot in the fire, take it forth, and An effectual fumigation. cast upon it a sufficient quantity of very sharp vinegar, & aquavitae, the rising vapour shall be diligently received by the affected member, for this hath a faculty to attenuate and cut gross, viscide, and plaster like matter, yea also, and to break the skin, yet that is broken oft time of its own accord, without the help of either medicine or instrument. To conclude, these medicines which are good to mollify scirrhous tumours, the same are also good to soften the gouty knots and tophi. But we must note that these knotty bunches are sometimes suppurated, not truly by the impact & plasterlike matter, but by a new defluxion coming on a sudden, & then it is necessary to make way for the contained matter, which being done, first there cometh forth a humour like milk, than a plasterlike matter, than it leaves behind it an ulcer to be cured by applying thereto Empl. gratia dei, and others as the Surgeon shall think fit. CHAP. XXI. Of flatulencies contained in the joints, and counter feiting true Gouts, and of the remedies to be used thereto. Ofttimes there is small quantity of humour, which moves the pain of the gout; but much flatulency mixed therewith, especially in great In what joints flatulencies are chiefly generated. Signs of flatulencies. joints, as in the huckle or hippe-bone, and the knees; they sometimes cause so great distension, that they drive the heads of the bones forth of their places. You may partly understand it is so, if a tensive pain afflict the patient with any sense of heaviness; if when you press the tumour with your fingers, the place retain no mark or impression thereof, as happens in an oedema, but on the contrary, a flatulent spirit lifts it up as it were by renitency, as if one should thrust a pair of bellows which are filled with wind, hence the part cannot perform its duty, for that the spaces of the joints are possessed with abundance of flatulencies, so that the liberty of motion is intercepted, and the member is kept as it were bound up. Many no very skilful Surgeons putting their fingers to these kind How flatulencies may make you believe there is p●s or matter. of tumors, so that lifting up the one they press down the other, when as they perceive the flatulency, as it were, rising between their fingers, supposing it to be the motion of pus, or matter already generated and flowing up and down, as is usual in impostumes, they have opened it by incision; but when as nothing flowed forth it appeared how much they were deceived, yet in the interim, by this their rashness they have caused many dangerous symptoms, as increase of pain, defluxion of humours, by force whereof the bones have been dislocated, and brought to the patient an uncurable lameness. But these flatulent gouts are seldom without some phlegmatic matter, which is neither too crude, nor viscide. Such like flatulencies are not easily Why hard to cure. discussed, nor at the first endeavour, by reason of a cold distemper which they bring to the part, and the density of the membranes and ligaments by which the articulation is knit and fastened, so that scarce any part of that which is there shut up can breathe forth of such straight passages. Therefore the cure must be undertaken with resolving, discussing, and drying fomentations, as for example, with a decoction of fennel, aniseeds, rue, chamornill, melilote, sage, rosemary, origanum, calamints, horehound, and the like, boiled in wine with a little Lie, rose vinegar, and common salt. This following ointment shall be used after the fomentation. ℞. olei chamoem. aneth. rut. ●auri, an. ℥ two. cum cera alba, fiat linimentum addendo aq. vitae parum. After you have anointed it, apply thereto this following cataplasm. ℞. flor. cham. melil. aneth. ros. rub. pulv. an. m i. fol. malu. & absinth. an. m ss. furfur, m i bulliant omnia simul cum lixivio, & vinorubre, deinde pistentur cum medulla panis, & farina fabarum, quantum sufficit, fiat cataplasma, addendo ol. rosar. & myrtin. an. ℥ two. Some highly approve of this following medicine for the wasting of flatulencies. ℞. axun. suil. ℥ iv. calcis vivae, ℥ i ss. terantur diligenter in mortario, & incorporata applicentur. Or else, ℞. stercor. caprar. cocti cum vino & aceto, an. lb. ss. tereb. venet. & mell. come. an. ℥ two. aq. vitae, ℥ ss. pull. rad. lreos florent. & sabin. an. ℥ iii olei rut. & aneth. an. ℥ i. farin. fabarum quantum sufficit. Make a cataplasm to the form of a pultis. Also stoops dipped in oxycrate, and wrung out, shall be applied: in this oxycrate shall be boiled wormwood, origanum, camomile, melilote, rue, common salt, adding thereto some aqua vitae. Then the part shall be bound up as straight as the patient can endure it; in conclusion, that the native strength may by little and little be restored to the part, it shall be fomented with Lie made of the ashes of Oake-wood and the cuttings of vines, wherein shall be boiled, salt, sulphur, choice alum, and wetting linen clothes, or stoups therein, and applying them, it shall be straight swathed up. Yet if great pain shall more cruelly vex the part, then neglecting for a time the proper cure of the disease, you shall withstand the symptom by rubbing the part, and anointing it with some discussing oil, laying thereon some moist wool & other anodyne things. CHAP. XXII. Of the Ischias, Hipgout, or Sciatica. FOR that the hipgout in the greatness of the causes, bitterness of pain, and vehemency of other symptoms, easily exceeds the other kinds of Gout, therefore I have thought good to treat thereof in particular. Why it hath the most grievous symptoms. The pain of the Sciatica is therefore the most bitter, and the symptoms most violent, for that the dearticulation of the huckle bone, with the head of the Thigh bone, is more deep than the rest; because also the phlegmatic humour which causeth it, is commonly more plenteous, cold, gross, and viscid, that flows down into this joint, and lastly because the Sciatica commonly succeeds some other chronical disease, by reason of the translation and falling down thither of the matter, become malign and corrupt by the long continuance of the former disease. But the pain not only troubles the hip, but entering deep, is extended to the muscles The cause of the large spreading of the pain. of the buttocks, the groins, knees, and very ends of the toes, yea often times it vexeth the patient with a sense of pain in the very vertebrae of the loins, so that it makes the patients, and also oft times the very Physicians and Surgeons to think it the wind or stone Colic. The cause of such wandering and dispersed pain is to be referred to the manifold distribution of the nerves which come to that joint from the loins and holybone, for they are sent into the muscles of the buttocks, and so dispersed over the whole leg to the very ends of the toes, as it is showed in our Anatomy. Therefore the pain is largely extended, that is, to what part soever a nerve runs which comes from the affected Hip. Often times there is no swelling, no redness, nor distemper manifest to the eye, by reason that the veins are very few which rise into the surface and skin of this part, and the humour lies, as it were, sunk in; which is the cause that divers times the excrementitious humours mixed with statulencie, run so violently into the cavity of this joint, that relaxing the ligaments, as well proper as common, the head of the thighbone is easily driven out from hence, so that it may never be restored again, if it remain so for any space of The thighbone often dislocated by the Sciatica. time; for that in this time the humour falling down into this cavity, by delay concretes as it were into a stony body, and the head of the Thighbone wears itself another cavity in the neighbouring bone, but the lips of the true cavity, which are gristly, become more strait and depressed, and lastly all the ligamentous bodies moistened with this excrementitious humour become more loose and weak, whence succeed many and most grievous symptoms, as lameness, & the decay not only of the thigh & leg, but at length of the whole body, and lastly a slow and hectic fever, which in continuance of time will consume the patient for the causes formerly mentioned. Therefore let Physicians and Surgeons have a care that they resist it at the first, and with such powerful remedies as are mentioned in the following chapter, hinder the springing up and growth of the formerly mentioned symptoms. CHAP. XXIII. The cure of the Sciatica. THough the Sciatica be commonly occasioned by tough phlegm, yet if the patient be strong and abound with blood, and all things else consent, Why we must open a vein in the Sciatica. it shall be good to draw blood by opening a vein; for phlebotomy equally evacuates all humours; therefore the falling down of the humours into the part affected, is thereby hindered, or retarded. Verily I have known no speedier remedy to assuage the pain of inflammation, than blood-letting, being first made on the Basilica of the grieved side for revulsions sake; and then for evacuation of the conjunct matter on the vena ischiadica, which is at the outside of the ankle, if the pain of the Sciatica be more on the outside; or else on the Sapheia, which is on When the vena ischiadica and sapheia must be opened in the sciatica. the inside of the ankle, if the inner parts be more pained. The quantity of blood which is to be drawn must be left to the judgement of the physician, without whose advice I would attempt nothing in this case. Also acride glisters are good, if there be nothing which may hinder, as ulcers of the guts, or haemorrhoids. ℞. rad. acor. ℥ two. centaur. rut. salv. rorism. calam. origan. puleg. an. m ss. staechad. arabic. flo. cham. melil. aneth. an. p i. sem. anis. & foenic. an. ℥ ss. fiat decoctio ad lb. i. in colatura dissolve hierae & diaphen. an. ℥ ss. mellis anthos. sacch. rub. an. ℥ i. olei liliorum ℥ iii fiat clyster. Strong purgations are also here useful, as of pillul. foetid. arthritic. Assai●reth. de Hermodactilis, and others used in phlegmatic causes. Electuarium Diacar●hami Strong purgations in the scia●ica. purgeth choler and phlegm. Often vomitings do not only evacuate the humours, but also make revulsion, as we have formerly delivered. Baths and sweats profit no otherwise than a decoction of guajacum or sarsaparilla. If heat molest the part, than foment it with oil of roses and vinegar, especially if the pain be deep in, for vinegar by its tenuity pierceth to the bottom, and makes way for the oil, which of its own nature is anodyne. After the use of general medicines you shall apply attractive and resolving things: emplasters of pitch and sulphur, or of Ammoniacum, euphorbium, Terebinthina, Propolis, Galbanum, Bdelium, Opopanax, draw the humour from within to the surface or skin. As in like sort also the chemical oil of sage, rosemary, pellitory of Spain, and such other like do the same, which by reason of the tenuity of their substance, and their separation from earthy impurity, have far more powerful and expedite faculties to penetrate and discuss. Yet must you use none of all these without very good judgement and deliberation, otherwise there will be danger of inflammation. There may also be made somentations of discussing and resolving herbs, as the roots and leaves of dane-weeds, orris, Bay and Juniper berries, the seeds of faenugreeke, anise, fennel, the leaves of sage, rosemary, chamomile, melilote, elder, and the like, boiled in wine and oil: the following plaster is much commended by the ancients to digest, or resolve and assuage the pain, with this which draws forth thorns, splinters, and rotten bones. ℞. sem. 〈◊〉. mundat. spumaborac▪ salis ●…moniaci, rad. aristoloch. rotund. colocynth. terebinth. venet. an. ʒ x. foenug. piperis longi, xylobalsam. thur. myrrhae, adipis cap. gum. pini, an. ʒ v. cerae, lb. ss. lactis ficus sylv. ℥ ss. ex omnibus secundum artem praeparatis cum olei liliorum, & vini generosi quantitat. sufficient, fiat emplastrum. Let it be applied to the Hip. Or, ℞. sinapi acerrimo aceto dissoluti, ℥ two. fermenti acris, ℥ ss. pull. hermodact. ʒ two. mellis come. ℥ iii tereb. ℥ iv. olei laur. & de spicâ, an. ℥ two. far. foenug. ℥ i ss. terrae formicarum cum ovis, lb i. fol. laur. salv. rut. rorismarin. an. m. ss. vermium terrest. praepar. lb ss. The earth with the eggs and worms shall be boiled apart with the white wine, and herbs cut in pieces, and these being strained out, the rest of the things shall be added according to art, and then it shall be applied to the Hip. Or else, ℞. rad. enul. camp. sigil. salom. bryon. bismal. an. ℥ two. coquantur complete & terantur, trajiciantur per setaceum, addendo farin. foenug. & hordei, an. ℥ i. olei liliorum, & chamaem. an. ℥ iii tereb. ℥ iv. cerae quantum sufficit, fiat cataplasma. It resolves, assuageth pain, and calleth forth the humours to the skin. Or else, ℞. rad. sigil. beatae Mariae, ℥ vi. empl. diachyl. albi, ʒ iv. croci in aqua vitae dissoluti, ʒ two. terebinth. ℥ i. ol. de spica nardi quantum sufficit, fiat empl. Let it be spread upon leather and applied warm. I have oftentimes suddenly assuaged the pain of the sciatica by putting to the pained Hippolito the root of black Bryony cut into slices, Black bryony discusseth. and applied, when the matter was cold. Or else, ℞. cerae citrin. & tereb. abiet. an. ℥ two. liquefiant simul in vase duplici, & ubi refrixerint, add pulv. Hermodact. ℥ ss. flor. chamaem. irid. flor. an. ʒ iii spicae nardi, flor. thymi, an. ʒ two. interioris cinamomi elect. & semin. nasturt. an. ʒ two. croci, ℈ iv. malaxantur simul manibus axungia porciveterenon salita unctis, & fiat massa empl. But if the pain be not by this means assuaged, then must we come to more powerful medicines, as to use great Cupping Glasses applied with much flame, and to vesicatories. As, ℞. cantharid. quibus detractae sunt alae, ʒ two. A strong vesicatory. staphisagr. ʒ iii sinapi, ʒ i ss fermenti acerrimi ℥ ss. incorporentur simul, & fiat vesicatorium. Also blisters may be raised by applying the inner rind of Travellers joy to The inner rind of Travellers-joy a vesicatory. the wait of some two dams, a little beneath the grieved part: you must have a care that the ulcers that remain after the skin of the blisters is taken off, do run, & be kept open for some time after, that so more of the humour contained in the part may be drawn away. But if we cannot avail by these means, we must according to Hypocrates his counsel, come to the last and extremest temedy. Such (saith he) Aph. ult. sect. 6. as troubled with a long pain of the sciatica, have their Hip fall out of joint, their leg consumes, & they become lame unless they be burnt: we have also read the same approved by Celsus. It is the last (saith he) and most effectual medicine in longer diseases, to cauterise with hot irons the skin of the Hip in three or four places; Lib. 4. cap. 22. and then not to heal up these ulcers or fontenels as soon as may be, but to keep them open by putting thereinto bullets of gold, or silver, or pills of Gentian, or wax melted and wrought up with the powder of vitriol, mercury, and the like cathaeretickes until the affect against which we use this remedy be helped, for by this means many have been helped. Therefore three or four actual cauteries, or hot irons shall be so thrust in about the joint of the Hip, that they may enter into the flesh some finger's breadth, yet so that you shun the nerves. Cauteryes here do good, for The use of cauteries in the sciatica. that by heating the part, they heat and dissolve the cold humours, they cut, attenuate, and draw forth the gross and viscide, so that they flow out by the ulcers, together with the quitture. Over and besides, the ligaments are strengthened by their cicatrisation, and their looseness helped; & by this means the whole part is notably corroborated. CHAP. XXIIII. Of the flatulent convulsion, or convulsive contraction, which is commonly called by the French, Gout Grampe, and by the English, the Cramp. THat which the French call Gout grampe, we hear intend to treat of, induced thereto rather by the affinity of the name, than of the thing, What the Cr●mp is. for if one speak truly, it is a certain kind of convulsion generated by a flatulent matter, by the violence of whose running down or motion, ofttimes the neck, arms, and legs are either extended, or contracted into themselves with great pain, but that for a short time. The cause thereof is a gross and tough vapour, insinuating itself into the branches of the nerves, and the The cause thereof. membranes of the muscles. It takes one on the night, rather than on the day, for that then the heat and spirits usually retire themselves into the entrailes and centre of the body; whence it is that flatulencies may be generated, which will fill up, distend and pull the part whereinto they run, just as we see lute-strings are extended. This affect often takes such as swim in cold water, & causeth many to be drowned, though excellent swimmers, their members by this means being so straight Who subject thereto. contracted, that they cannot by any means be extended. For the skin by the coldness of the water is contracted and condensed, and the pores thereof shut, so that the engendered flatulencies have no passage forth. Such as give themselves to drunkenness and gluttony, or sloth and idleness, are usually more frequently troubled with this disease, by reason of their heaping up of crudities. Therefore it is cured by moderate diet, and ordering of the body, and exercise of each part thereof, for thus they The cure. gather strength, and the generation of the flatulent matter is hindered. In the very time when it takes one, the patient shall be cured by long rubbing with warm clothes, and aqua vitae, wherein the leaves of sage, rosemary, time, savoury, lavender, cloves, ginger, and the like discussing and resolving things, have been infused. The extension and flexion of the members or joints, and walking, are also good. The End of the Eighteenth Book. OF THE LUES VENEREA, AND THOSE SYMPTOMS WHICH HAPPEN BY MEANS THEREOF. THE NINETEENTH BOOK. CHAP. I. A description of the Lues Venerea. THe French call the Lues Venerea, the Neapolitan disease, the Italians What the Lues venerea is. and Germans [as also the English] term it the French disease, the Latins call it Pudendagra, others name it otherwise. But it makes no great matter how it be called, if the thing itself be understood. Therefore the Lues Venerea is a disease gotten or taken by touch, but chiefly that which is in unclean copulation; and it partakes of an occult quality, commonly taking its original from ulcers of the privy parts, and then further manifesting its self by pustles of the head, and other external parts; and lastly, infecting the entrailes and inner parts with cruel and nocturnal tormenting pain of the head, shoulders, joints, and other parts. In process of time, it causeth knots and hard Tophi; and lastly corrupts What hurt it doth to the body. and fowls the bones, dissolving them, the flesh about them being ofttimes not hurt; but it corrupteth and weakeneth the substance of other parts, according to the condition of each of them, the distemper and evil habit of the affected bodies, and the inveteration or continuance of the morbificke cause. For some lose one of their eyes, others both, some lose a great portion of the eyelids, othersome look very ghastly, and not like themselves, and some become squinteyed. Some lose their hearing, others have their noses fall flat, the palate of their mouths perforated with the loss of the bone Ethmoides, so that in stead of free and perfect utterance, they falter and fumble in their speech. Some have their mouths drawn awry, others their yards cut off, and women a great part of their privities tainted with corruption. There be some who have the Urethra or passage of the yard obstructed by budding caruncles, or inflamed pustles, so that they cannot make water without the help of a Catheter, ready to die within a short time, either by the suppression of the urine, or by a Gangrene arising in these parts, unless you secure them by the amputation of their yards. Others become lame of their arms, and othersome of their legs, and a third sort grow stiff by the contraction of all their members, so that they have nothing left them sound but their voice, which serveth for no other purpose but to bewail their miseries, for which it is scantly sufficient. Wherefore should I trouble you with mention of those, that can scantly draw their breath by reason of an Asthma, or those whose bodies waste with a hectic fever and slow consumption? It fares far worse with these, who have all their bodies deformed by a Leprosy arising there hence, and have all their throttles and throats The Leprosy sometimes the offspring of the Lues vene●ea. eaten with putrid and cancrous ulcers; their hair falling off from their heads, their hands and feet cleft with tetters and scaly chinks: neither is their case much better, who, having their brains tainted with this disease, have their whole bodies shaken by fits of the falling sickness; who troubled with a filthy and cursed flux of the belly, do continually cast forth stinking and bloody filth. Lastly, there are no kind of diseases, no sorts of symptoms, wherewith this disease is not complicate, never to be taken away, unless the virulency of this murrain be wholly taken away, and impugned by its proper Antidote, that is, argentum vivum. CHAP. II. Of the causes of the Lues Venerea. THere are two efficient causes of the Lues venerea; the first is, a certain occult and specific quality, which cannot be demonstrated; yet it may The Lues venerea the scourge of whoremongers. be referred to God, as by whose command this hath assailed mankind, as a scourge or punishment to restrain the too wanton and lascivious lusts of unpure whoremongers. The other is an impure touch or contagion, and principally, that which happeneth in copulation. Whether the man or woman have their privities troubled with virulent ulcers, or be molested with a virulent strangury (which disease crafty Whores colour by the name of the whites) the malignity catcheth hold of the other; thus a woman taketh this disease by a man casting it into her hot, open and moist womb; but a man taketh it from a woman, which, for example sake, hath some small while before received the virulent seed of a whoremaster polluted with this disease, the mucous sanies whereof remaining in the wrinkles of the woman's womb, may be drawn in by the pores of the standing and open yard, whence succeed malign ulcers, and a virulent strangury. This virulency, like a torch or candle set on fire, will by little and little be propagated and sent by the veins, arteries and nerves to the noble parts; whose malignity a strong liver not enduring, by the strength of the natural expulsive faculty, will send it into the groins, whereon follow Abscesses, therefore called venereal Bubo's. These, if they return in again, and cast not forth matter by being opened, they will, by their falling back into the veins and arteries, infect the mass of the Venereal Bubo's returning in again occasion the Lues venerea. blood by the like tainture, & thence will ensue the Lues venerea. Yet this disease may be got by a more occult manner of touch, as by breathing only. For it is not altogether besides reason and experience, that a woman long troubled with this disease, may by importunate and often kissing, transfuse malignity into a child; for the tender and soft substance of a little child may be altered, infected, and by little and The Lues venerea may be got by the only communication of vapour. little corrupted by receiving of filthy, and in their whole kind malign vapours. For it is known, and now vulgarly believed, that midwives by receiving the child of a woman infected with this disease, to have got this affect, the malignity being taken and drawn into their bodies through the pores of their hands by the passages of the veins and arteries. Neither doth it spare any condition, sex, nor age of men: for, not only whosoever use copulation, but such as onély lie with them, may be taken by this virulency; yea verily, if they only lie in the sheets or cover which retain his sweat, or the virulency cast forth by an ulcer. The same danger may assail those who shall drink in the same vessel after such as are troubled with this disease. For by the impure touch of their lips, they leave a virulent sanies and spittle upon the edges of the cup, which is no less contagious in its kind than the virulency of leprous persons, or the some of mad dogs. Wherefore it is no How nurses may infect children, and they their nurses. marvel if children nursed by an infected nurse, draw in the seeds of this disease together with the milk, which is only blood whitened in the breasts; or infected sucking children by their hot and ulcerated mouths, may transfuse this malignity into the body of the nurse, by the rare, loose and porous substance of the dugs which it frequently sucketh. This following history is very memorable to this purpose. A certain very good A history. Citizen of this City of Paris granted to his wife being a very chaste woman, that conditionally she should nurse her own child of which she was lately delivered, she should have a nurse in the house to ease her of some part of the labour: by ill hap, the nurse they took was troubled with this disease; wherefore she presently infected the child, the child the mother, the mother her husband, and he two of his children who frequently accompanied him at bed and board, being ignorant of that malignity wherewith he was inwardly tainted. In the mean while the mother when she observed that her nurse child came not forward, but cried almost perpetually, she asked my counsel to tell her the cause of the disease; which was not hard to be done, for the wholebody thereof was replenished with venereal scabs and pustles, the hired nurses and the mother's nipples were eaten in with virulent ulcers; also the fathers, and the two other children's bodies, whereof the one was three, the other four years old, were troubled with the like pustles and scabs. I told them that they had all the Lues venerea, which took its original and first offspring by malign contagion from the hired nurse. I had them in cure, and by Gods help healed them all; except the sucking child, which died in the cure. But the hired nurse was sound lashed in the prison, and should have been whipped through all the streets of the City, but that the magistrate had a care to preserve the credit of the unfortunate family. CHAP. III. In what humour the malignity of the Lues venerea resides. THough in the opinion of many the antecedent cause of this disease be the mass of blood containing the four humours, yet I had rather place the matter, and primary, and chief seat thereof in gross and viscide phlegm infected with the malign quality of the venereous venom, and from this beginning and foundation, I think by a certain contagious growth it sooner or later infects the other humours, as each of them is disposed or apt to suffer. Of which my opinion there are many arguments, but this chiefly, That by the evacuation of a phlegmatic humour, whether by the mouth and salivation, or by stool, urine, or sweat in men of what temper soever, whether choleric, sanguine or melancholy, the disease is helped or cured. Secondly, for that the excess of pain is Why the pain is worse upon the night than on the day. more by night than by day, because then the phlegm bearing sway, severs the perio●tium from the bone, or else offends it and the rest of the membranous and nervous bodies by the acrimony of its malignity. Thirdly, because the patients are hurt by the use of cold things, but usually find benefit by hot medicines, whither they be ointments, plasters, fumigations, or whatsoever else, inwardly taken, or out-wardly applied. Fourthly, for that in venereous pustles, there is found a certain hardness at the root, though outwardly they make show of choler or blood. For being opened, you shall find them stuffed with a certain plasterlike and tophous matter, or else with tough phlegm, or viscous pus; whence arise these hard tophi, or bony excressences upon the bones, if not from phlegmatic humours there heaped up and concrete? Fifthly, for that the spermaticke and cold parts do primarily and principally feel the harm of this disease. Sixtly, for that the ulcers which overspread the body by means of this disease, admit of no cure, unless you first cause sweats. Therefore if the matter of the disease, and such ulcers as accompany it were hot and dry, it would grow worse, and be rather increased by a decoction of This disease sometimes lies long hid in the body before it show itself. Guajacum, the roots of China, or sarsaparilla. Seventhly, because ofttimes this disease, the seed thereof being taken or drawn into the body, so lieth hid for the space of a year, that it shows no sign thereof, which happens not in diseases proceeding from an hot matter, which causeth quick and violent motions. By this it appeareth that the basis and foundation of the Lues venerea is placed or seated in a phlegmatic humour; yet may I not deny, but that other humours confused therewith may be also in fault, and defiled with the like contagion. For there are scarce any tumors which proceed from a simple humour, and that of one kind; but as in tumors, so here the denomination is to be taken from that humour which carrieth the chief sway. CHAP. four Of the signs of the Lues Venerea. WHen the Lues venerea is lately taken, malign ulcers appear in the privities, swellings in the groins, a virulent strangury runneth ofttimes with filthy sanies, which proceeds either from the prostata, or the ulcers of the urethra; the patient is troubled with pains in his joints, head, and shoulders, and as it were break of his arms, legs and all his members, they are weary without a cause, so that neither the foot nor hand can easily perform his duty; their mouths are inflamed, a swelling troubles their throats, which takes away their freedom of speaking & swallowing, yea of their very spittle; pustles rise over all their bodies, but chiefly certain garlands of them engirt their temples and heads; the shedding or loss of the hair, disgraceth the head and chin; and leanness deformeth the rest of the body; yet all of these use not to appear in all bodies, but some of them in some. But the most certain signs of this disease The most certain signs of the Lues venerea. are, a callous ulcer in the privities, hard and ill conditioned, and this same is judged to have the same force in a prognosticke, if after it be cicatrized, it retain the same callous hardness; the Bubo's, or swellings in the groins to return back into the body without coming to suppuration, or other manifest cause: these two signs, if they concur in the same patient, you may judge or foretell that the Lues venerea is either present, or at hand; yet this disease happeneth to many without the concourse of these two signs, which also bewrayeth itself by other manifest signs, as ulcers and pustles in the rest of the body, rebellious against medicines though powerful, and discreetly applied, unless the whole body be anointed with Argentum vivum. But when as the disease becometh inveterate, many become impotent to venery, and the malignity and number of the symptoms increase, their pains remain fixed and stable, very hard and knotted tophi grow upon the bones; and ofttimes they become rotten and foul, as also the hands and feet by the corruption of salt phlegm are troubled with chaps or clefts, and their heads are seized upon by an ophiasis and alopecia; whitish tumors with roots deep fastened in, arise in sundry parts of the body, filled with a matter like the meat of a chestnut, or like a tendon; if they be opened they degenerate into divers ulcers, as putrid, eating, and other such, according to the nature and condition of the affected bodies. But why the pains are more grievous on the night season: this may be added Two other causes of the excess of pain in the night. to the true reason we rendered in the precedent Chapter; first for that the venereous virulency lying as it were asleep is stirred up and enraged by the warmness of the bed and cover thereof; Secondly, by reason of the patient's thoughts which on the night season are wholly turned and fixed upon the only object of pain. CHAP. V. Of Prognostics. IF the disease be lately taken, associated by a few symptoms, as with some small number of pustles, and little & wand'ring pains, The signs of a curable Lues Venerea. and the body besides be young and in good case, and the constitution of the season be good and favourable, as the spring, than the cure is easy, and may be happily performed. But on the contrary, that which is inveterate and enraged by the fellowship of many and malign symptoms, as a fixed pain of the head, knots and rottenness of the bones, ill natured ulcers in a body very much fallen away and weak, and whereof the cure hath been already sundry times undertaken by Empyricks, but in vain; or else by learned Physicians, but to whose remedies, approved by reason and experience, the malignity of the disease and the rebellious virulency hath refused to yield, is to be thought uncurable, especially, if to these so The signs of an uncurable one. many evils, this be added, that the patient be almost wasted with a consumption and hectic leanness, by reason of the decay of the native moisture. Wherefore you must only attempt such by a palliative cure; yet be wary here in making your prognosticke: for many have been accounted in a desperate case, who have recovered; for by the benefit of God and nature, wonders ofttimes happen in diseases. Young men who are of a rare or lax habit of body are more subject to this disease, than such as are of a contrary habit and complexion. For as not all who are conversant with such as have the Plague, or live in a pestilent air, are alike affected; so neither all who lie or accompany with such as have the Lues venerea, are alike infected or tainted. The pains of such as have this disease, are How these pains differ from those of the gout. far different from the pains of the Gout. For those of the Gout return and torment by certain periods and fits, but the other are continual and almost always like themselves; Gouty pains possess the joints, and in these condense a plasterlike matter into knots; but those of the Pocks are rather fastened in the midst of the bones, and at length dissolve them by rottenness and putrefaction. Venereous ulcers which are upon the yard are hard to cure, but if being healed, they shall remain hard and callous, they are signs of the disease lying hid in the body. Generally, the Lues venerea which now reigneth is far more mild and easy The Lues venerea bcomes more gentle than formerly it was. to be cured than that which was in former times, when as it first began amongst us: besides, each day it seemeth to be milder than other. Astrologers think the cause hereof to be this, for that the celestial influences which first brought in this disease, in success of time by the contrary revolutions of the Stars, lose their power and become weak; so that it may seem somewhat likely, that at length aftersome few years it may wholly cease; no otherwise than the disease termed Mentagra, which was very like this in many symptoms, and troubled many of the Romans in the reign of Tiberius; and the Lichen, which in the time of Claudius (who succeeded Tiberius) vexed not only Italy, but all Europe besides. Yet Physicians had rather take to themselves the glory of this less raging disease, and to refer it to the many and wholesome means, which have been invented, used and opposed thereto by the most happy labours of noble wits. CHAP. VI How many, and what means there are to oppugn this disease. MAny sorts of remedies have been found out by many to oppugn and Why the decoction of Guajacum is not sufficient to impugn the disease. overcome this disease. Yet at this day there are only four which are principally used. The first is by a decoction of Guajacum; the second by unction; the third by emplasters, and the fourth by fumigation; all of them by Hydrargyrum, the first excepted. Yet that is not sufficiently strong and powerful; for experience hath taught, that the decoction of Guajacum hath not sufficient strength to extinguish the venom of the venereous virulency, but only to give it ease for a time; for because it heats, attenuates, provokes sweat and urine, wastes the excrementitious humours by drying them, it seemeth to cure the disease, for that thereupon, for some time, the pain and all other symptoms seem more remiss; but these endeavours are weak and deceitful, as whereby that only which is more subtle in the humours in fault, is exhausted and dispersed by sweat. But Hydrargyrum, as a certain higher power, contains therein all the power of Guajacum, yet much more excellent and efficacious; for besides that it heats, attenuates, Hydrargyrum, is sufficient to overcome the disease. cuts, resolves and dries, it provokes sweat and urine, and besides it expels noxious humours upwards and downwards, by the mouth and stool. By which evacuations not only the more subtle, but also the more gross and feculent excrements, wherein the seat of this disease is properly fixed, are dispersed and evacuated; by which the Physician may be bold to assure himself of certain victory over the disease. But after the use of the decoction of Guajacum, fresh pains and knots arise by the relics of the more gross and viscous humours left in the cavities of the entrailes; but Hydrargyrum leaves no relics behind it. CHAP. VII. How to make choice of the wood Guajacum. THat is preferred before the rest, which is of a great log, of a dusky colour, new, gummy, with a fresh strong smell, an acride and some what biting taste, the bark cleaving very close to the wood. It hath a faculty to The faculty. heat, rarify, attenuate, attract, to cause sweat, and move urine, and besides by a specific property to weaken the viculency of the Lues Venerea. There are three substances taken notice of in this wood: the first is the bark, the other is a whitish wood which is next to the bark, the third is the heart of the wood, that is, the inner, The parts. blackish, and more dusky part thereof. The bark is the more dry, wherefore you shall use it when as you would dry more powerfully; the middle substance is The hot and fiery faculty of the bark. more moist, because it is more succulent and fat; that which lieth between both is of a mild temper. Wherefore the two last are more convenient for delicate natures and rare bodies, which require less drying. Furthermore, the bark must be given to dense and strong natures, that by the more fiery force thereof, the humours may be made more fluid, and the passages of the body more passable. But I would here be understood to mean such bark as is not putrid and rotten with age, to which fault it is very subject, for that long before it be shipped by our people, the wood lieth in heaps upon the shore in the open air, until they can find chapmen for it; which, when it is brought aboard, it is stowed in the hold or bottom of the ship, where beneath by the sea through the chinks of the boards, and above by the mariners, it usually gathereth much dirt. When it is brought hither to us, it is bought and sold by weight, wherefore that it may keep the weight, the Druggist's lay it up in vaults and cellars under ground, where the surface thereof bedewed with much moisture can scarce escape mouldiness and rottenness. Wherefore I do not like to give the decoction either of the bark or wood which is next thereto to sick people. CHAP. VIII. Of the preparation of the decoction of Guajacum. FIrst you must have your Guajacum shaved into small pieces, and to every pound of the shave, add of fair water eight, ten, or twelve pints, The proportion of the Guajacum to the water. more or less as the nature of the party, and condition of the disease shall seem to require, according to the rule of the formerly mentioned indications. Let the water be hot or warm, especially if it be in winter, that so it may the more easily & throughly enter into the body of the wood, & draw into itself the faculties thereof in the space of twenty four hours, wherein it is Why the decoction ought to be performed with a dry heat. macerated; then boil it in balneo, to avoid empyreuma, or taste of fire, which it will contract by boiling it over a hot fire. Yet some nothing regard this, but think the patient sufficiently served, if they make a decoction in an earthen pot well glazed, over a gentle fire, so that no part of the liquor may run over the mouth of the vessel, for that thus so much of the strength of the decoction might vanish away. Howsoever it be made, let it be boiled to the consumption of half, a third, or fourth part, as the nature of the patient, & disease shall seem to require. There be some who mix divers simples therewith, which have an occult and proper sympathy with that part of the body which is principally hurt by the disease, which at the least may serve in stead of a vehicle to carry the faculties of the decoction thither where the disease most reigneth. Others add thereto purging medicines, whose judgement I cannot approve of, for that I think it is not for the patients good to attempt two evacuations Whether it be fit to add purges to a decoction of Guajacum. at once, that is, to expel the humours by sweat by the habit of the body, and by purging by the belly; for that as much urine, so also much sweat shows little evacuation by stool. For these two motions are contrary, which nature cannot brook at once. For purging draws from the circumference to the Centre, but sweat runs Hip. aph. ult. sect. 6. a quite contrary course, and this is the opinion of many & great physicians. This first decoction being boiled out, & strained the like quantity of water shall be put to the stuff, or mass, that so being boiled again without any further infusion, & strained, with the addition of a little cinnamon for the strengthening of the stomach, the patient may use it at his meals, and between his meals, if he be dry, for his ordinary drink. The quantity of the first decoction to be taken at once, aught to be some five or six ounces, and it shall be drunk warm, that so it may be the sooner brought into action, and lest the actual coldness should offend the stomach; and then the How, and in what quantity this decoction must be taken. patient being well covered, shall keep himself in bed, and there expect sweat, which if it come slowly on, it shall be helped forwards with stone bottles filled full of hot water, and put to the soles of the feet. If any parts in the interim shall be much pained, they shall be comforted by applying of swine's bladders half filled with the How to dry the sweat of the body. same decoction heated. Neither will it be unprofitable before the decoction be drunk, to rub over all the body with warm linen clothes, that by this means the humours may be attenuated, and the pores of the skin opened. When he shall have sweated some two hours, the parts opposite to the grieved places, shall first be wiped, then presently, but more gently, the grieved parts themselves, lest a greater confluxe of humours flow thereto. These things being done, he shall keep himself in bed, shunning the cold air until he be cooled and come to himself again, some two hours after, he shall so dine, as the disease and his former custom shall seem to require; six hours after, betaking himself to his bed, he shall drink the like quantity of the decoction, and order himself as before. But if he be either weak, or weary of his bed, it shall be sufficient to keep the house without lying down; for although he shall not sweat, yet there will be a great dissipation of the vapours, and venenate spitits, by infensible transpiration; for the Lues venerea by the only communication of these, often times catcheth hold, and propagates itself in lying with a bedfellow tainted therewith. But as it is requisite to have let blood, and purged the body by the advice of a physician, before the taking of the decoction of Guajacum; so whilst he doth take it, it much conduceth to keep the belly soluble (which is much bound by the heat & dryness of such a drink) and to preserve the purity of the first veins by a clyster, or laxative medicine taken every fifth, or sixth day. But for the use of it, we must warily observe, taking indication not only from the malignity, and contumacy of the disease, but also from the particular nature of the patient; for such as have their body wasted by heat and leanness, and their skin dry and scaily, (whence you may gather a great adustion of the humours, and, as it were, a certain incineration of the habit of the body) must more sparingly make use of these things, but rather temper the body by humecting things taken inwardly, and applied outwardly, as baths, ointments without quicksilver, and other such like things. And then a very weak decoction of Guajacum shall be used for a few days before your unction with Quickesilver. A more plentiful diet, as it draws forth the disease, which of its own nature is long, so a more sparing and slender diet The manner of diet. makes the ulcers more rebellious and contumacious, by a hectic dryness. Therefore a middle course must be kept, and meats made choice of which are fit, and naturally engender good and laudable juice in the body. For it is not only great ignorance, but much more cruelty, to go about to contain all patients without any difference, within the straight allowance of four ounces of Ship-bisket, and twelve damask prunes: for I judge it far better to diet the patient with Lamb, Veale, Kid, Pullet's, fat Larks, and Blackbirds, as those which have a far greater familiarity with our bodies, than Prunes and the like Junkets. Let his bread be made of white wheat, well leavened, neither too new, or tough, neither too old or hard. Let his drink be made of the mass, or strainings of the first decoction of Guajacum boiled with more water, as was formerly mentioned; yet if there arise any great weakness of the faculties, you may permit the use of some little wine, drinking especially before each mealea cup of the last mentioned decoction. Let him avoid To whom, and what manner of wine may be allowed. sleep presently after meat, for so the head is filled with gross vapours. Passions or perturbations of the mind must also be avoided, for that by these the spirits are inflamed and dissipated; all delights of honest pleasure are to be desired, but venety wholly avoided, as that which weakens all the nervous parts. Many in stead of a decoction of Guajacum, use a decoction of China. Now this China is the root of a certain rush, knotty, rare, & heavy, when it is fresh, but light when it is waxed old; it is The description of China. also without smell, whence many judge it void of any effectual quality, it is brought into use out of India, it is thus prepared, it is cut into thin round slices, boiled in fountain or river water, and is given to patients to drink morning and evening after this manner. ℞. rad. chin. in taleol. sect. ℥ two. aquoe font. lb xii. infundantur per hor. xii. & coquantur The preparation. ad consumption. tertiae partis. Let him take ℥ vi. in the morning, and so much at night; let him expect a sweat in his bed: a second decoction may be made of the mass remaining of the first, but with a less quantity of water put thereto, which also by longer boiling may draw forth the strength remaining in the mass, & be used at meals for ordinary drink. There are some who make a third decoction thereof, buthat is wholly unprofitable and unuseful. Sarsaparilla is prepared also just after the same manner. Of sarsaparilla. CHAP. IX. Of the second manner of curing the Lues venerea, which is performed by friction, or unction. THe cure of the Lues venerea which is performed by unction and friction is more certain, yet not in every kind, condition and season thereof. For if the disease be inveterate from an humour, tough, gross, viscous, and When the body must be, prepared with humecting things before unction. more tenaciously fixed inthe solid parts, as you may gather by the knotty tumors of the bones; for than we are so far from doing any good with a friction used at the first, that on the contrary we bring the patient in danger of his life, unless we shall have first prepared the humour to expulsion, by emollient & digesting things first used. But if it be lately taken with movable pains, pustles, and ulcers in the jaws, throat, and privy parts, then may it be easily cured without such preparatives, especially if the humour be sufficiently obedient, and as it were prepared of itself, and its own nature. Therefore first using general medicines, you may afterwards come to use the unction with Hydrargyrum. CHAP. X. Of the choice, preparation and mixing of Hydrargyrum. HYdrargum which is clear, thin, white and fluid, is the best: on the contrary, that which is livid, and not so fluid, is thought to be adulterated by the admixture of some lead. That it may be the purer, strain it through some sheep's leather, for by pressing it, when it is bound up, it passeth through by its subtlety, and leaves the filth and leaden dross behind it on the inside. Then it may be boiled in vinegar with sage, rosemary, time, chamomile, melilote, and strained again, that so many ways cleansed, it may enter into ointments and plasters. To kill it more surely, it shall be long wrought, and as it were ground in a mortar, that it may be broken and separated into most small particles, How to kill argentum vivum. thatby this means it may not be able to gather itself into the former body: to which purpose you may also add some sulphur, or sublimate, as we shall show hereafter. It is most usually mixed with hog's grease, adding thereto some oil of turpentine, nutmegs, cloves, sage, and Galens' treacle. If a Leucophlegmatia together with the Lues venerea affect the body, then hot, attenuating, cutting, and drying things shall be added to the medicine, which shall be provided for unction; the same What to mix therewith. shall be done when as we would have it to enter into the substance of the bones. But if the patient be of a choleric temper, and his blood easy to be inflamed, you shall make choice of less hot, attractive and discussing things. As when the body shall be replenished with knotty and scirrhous tumors, or squalide by excessive dryness, then shall emollient and humecting things be mixed therewith. But that such ointments may have a better consistence, I use to add to each pound thereof, four, five, or six yolkes of hard eggs. Therefore this shall be the form of the ointment called Vigoes. ℞. axung. porci, lb i olei chamaem. anethi, mastic. & laurini, an ℥ i. styrac. An unction with argentum vivum. liquid. ʒx. rad. enulae, camp. parum tritae, & ebult, an. ℥ iii pull. euphorb. ℥ ss. vini oderif. lb i bulliant omnia simulusque ad consumpiionem vini, deinde colentur; colaturae adde lythargyrae auri, ℥ vi. thuris, mastic. an. ʒvi. res. pini, ℥ iss. tereb. venet. ℥ i. argenti vivi, ℥ iv. cerae albae, ℥ iss. liquefactis oleis, cum ceraincorporentur omnia simul, fiat linimentum ad usum. Or else, ℞. argenti vivi praeparati, ℥ vi. sublimiti, ʒss. sulphuris vivi, ℥ ss. axung. porci; salis expertis, lb i vitellos ovorum sub cineribus coctorum, nu. three Another. olei terebinth. & laurini, an. ℥ two. theriac. vet. & mithridate. ℥ ss. fiat linimentum ut artis est. You shall compose it thus, first the sublimatum and sulphur shall be finely powdered, How to make it than some part of the Argentum vivum and hogs grease putto them, then presently after, some of the hard yolkes of eggs, continually and diligently stirring and mixing them all together. All these being well incorporate, add some more argentum vivum, hog's grease, and yolks of eggs, and incorporate them with the former; at the last add the oils, than Treacle, and Mithridate, and so let them all be beaten together for a whole day's space, and thus you shall make an ointment of a good consistence, which I have often used with good success. Yet the How to prepare the hogsgrease before you mix the argentum vivum therewith. hog's grease shall be first boiled with the hot herbs good for the sinews, as sage, rosemary, time, marjerome, lavender, and others which the season affords. For so the axungia acquires a more attenuating faculty, and consolidating of those parts which the Lues venere● afflicts. Besides, when unguents are made for this purpose, that such virulency may be drawn from within outwards, by sweats and transpiration through the pores of the skin, no man need doubt, but that they ought to be furnished with relaxing, rarifying, and attractive faculties. But axungia, besides that it is very fit to kill the argentum vivum, it also relaxeth and mollifieth. Now Oleum lanrinum, de spicâ, rutaceum, rarify, digest, and assuage pain. Turpentine also extinguisheth, and bridleth the argentum vivum, moderately heats, resolves and strengthens the nervous parts. But argentum vivum is the proper antidote of the Lues venerea, as that which cures it howsoever used, drying by the subtlety of the parts, and provoking sweat. Verily Treacle and Mithridate somewhat conduce to retund the virulency of this disease, but unless argentum vivum assist as a ferret to hunt, and an alexiterium to impugn the disease, they can do no great matter. CHAP. XI. How to use the Unction. THe body and humours apt to cause or nourish a plethora or inflammation, being prepared by digestive syrupes, and evacuated by purging and bleeding as is fitting, according to the direction of some Physician, the patient shall be shut up in a parlour or chamber, hot either by nature or art, & free from cold blasts of wind. For cold is most pernicious in this disease, both for that it hurts the nervous parts, already ill affected by reason of the disease, as also for that it Cold most hurtful to such as are troubled with the Lues 〈…〉 lessens the efficacy of medicines. Wherefore many do ill in this, who, whether in winter or summer, anoint their patients in a large room, exposed on every side to the winds. They deal somewhat more wisely, who put a cloth fastened like half a tent presently behind the patient, though anointed by the fire side, so to keep away the cold air from him. Yet it is safest to set, and anoint the patient either in a little room, or else in some corner of a large room, separated from the rest of the room by some hangings, and building a stove, or making some fire therein, for so he may stand or sit as he best likes, the longer, and with the less offence, and be equally heated on every side, whereas such as are anointed in a chimney by a fires side cannot but be heated unequally, being ready to burn on the one side, whilst the other is cold, which motions are contrary and hurtful to that we require: besides, if the patient shall be weak, he cannot stand and endure the heat of the fire. Or if he be shamefaced, he will be unwilling to show all his body at once naked to the Surgeon, but he may without any harm, and with modesty, lying on a bed in a little room, wherein a stove is made, have all his limbs anointed about the joints, and presently bound up, either with stoops, or carded cotton, or brown paper. CHAP. XII. What cautions to be observed in rubbing or anointing the patient. HE shall be anointed or rubbed over with the ointment in the morning, the concoction & distribution of the meat being perfected, which functions otherwise would not be well performed, the powers of nature being The patient, if it may be conveniently done, must be anointed fasting. distracted into several operations. Yet if the patient shall be weak, you may some hour before the unction, give him some jelly, the yolk of an egg, or some broth made of meat, boiled to pieces, but very sparingly, lest nature, intent upon the concoction of solid meats, or in great quantity, should be drawn away from that which we intent. At first let only the joints of the limbs be anointed, as about the wrists, elbows, knees, ankles, shoulders. But afterward, In what places the body must be anointed. if the patient shall be more strong, and a greater commotion of the humours and body seem necessary, the emunctories of the principal parts may also be anointed, and the whole spin of the back; yet having much care, and always shunning the principal and noble parts, lest we should do as those butcherly Empirics do, who equally, and in like manner daub and rub over all the body, from the soles of the feet, to the crown of the head: moreover, diligent regard must be had of those parts, which are seized upon by the symptoms of this disease, that they may be more anointed, and that it may be more throughly rubbed in. Yet you must always begin your anointing or rubbing at those parts which are less offended, lest the humours should be drawn in greater measure to the grieved part. And as gentle Where to begin the unction. frications do not sufficiently open the pores of the skin, so more strong and hard ones shut them up, cause pain, and more plentifully attract the morbificke matter. Wherefore it will be more convenient to use moderate frictions, taking indication from the strength of the patient, as that whereto we must still have the chief regard. There is also another thing whereto the physician & Surgeon must diligently attend, as that, which if it be not carefully prevented, will either hasten the death of the patient, or make him subject to a relapse; that is, the quantity of the remedies and unctions, and the number of the frictions. Which consideration, together with that which is of the degrees of the temperaments of the whole body, and each part thereof, much troubles and exerciseth the minds of good Physicians, and maketh the art conjectural, it is so far from being attained to by Empirics. Yet we must endeavour What it is that maketh the art of Physic conjectural. by method and reason, that by the rule of indications so frequently mentioned, we may attain to the knowledge thereof, as near as may be. For to have perfect knowledge hereof, and to say that those need only four, others five, and other some six, more or fewer frictions at the beginning, which Empirics commonly do, is a thing both impossible and vain. All these must be changed and ordered according to the malignity and continuance of the disease, and the condition of the affected bodies. Verily we must so long use frictions and unctions, until the virulent humours be perfectly evacuated by spitting and salivation, by stool, urine, sweat or insensible transpiration. Which you may understand by the falling away & drying up of the pustles and ulcers, and the ceasing of the pains and other symptoms proper to this disease. In many, by reason of the more dense and compact habit Who must be rubbed over once, who twice in a day, and who but every other day. of the body, nature is more slow in excretion. Yet I have learned by long experience that it is best to anoint and chafe such twice in a day, to wit, morning and evening, six hours after meat. For so you shall profit more in one day, than by the single frictions of three days. But on the contrary, I have often, and with good success, rubbed over but each other day more rare and delicate bodies, giving them one or two days rest to recollect their strength, which by the too much dissolution of their spirits becoming too weak, were not sufficient to expel the relics of the morbific matter. And certainly about the end of the appointed friction, especially when as the patients begin to flux at the mouth, the bodies, together with the noxious humours are made so fluid by the means of the precedent frictions, that one friction is then more efficacious, than two were at the beginning. Therefore as Galen bids, Lib. de venae. sect. when as the disease is great, and the strength of the patient infirm, that we should part our blood-letting, and draw a little and a little at once; so also here when as we shall observe nature stirred up, and ready bend to any kind of evacuation by the mouth, stool, or other like, you ought not to use any unction or friction o●●ner than once in a day, yea certainly it will be better to intermit for some few days. For thus Massa reports, that there was a certain man who almost wasted with a consumption, being continually afflicted with the most grievous pains of this disease, & reputed in a desperate case by other physicians, was notwithstanding at length recovered by him, when as he had anointed him thirty seven times, putting sometime between for the recovery of his strength. I myself have observed others, who thus, by the interposition of one or two days, being rubbed over some fifteen or seventeen times, have perfectly recovered. Wherefore you must take this course in resolved and weak bodies, yet in the interim must you have a care, that the frictions be not too weak, and so few, that the morbific cause may not be touched to the quick: for in this kind of disease nature doth not of itself endeavour any Crisis, or excretion; Nature is not sufficiently able to expel the virulent matter. Signs that the crisis is nigh. it requires the auxiliary forces of medicines, by whose assistance it may expel all the malignity. These are signs of such a Crisis, either at hand, or already present, if the patient be so restless, so loath all things, that he cannot remain in one place either standing or lying, he can neither eat nor drink, if he be oppressed with a continual weariness, almost ready to swoon, yet have a good and equal pulse, and gripings in his belly afflict him with bloody & viscous dejections, until at length nature after one or two days, portion of the morbific matter being spent, be somewhat freed, and all pains and symptoms so much abated, as the excretions have proceeded. But whereas medicines are not sufficient in number or strength, there follows an unperfect Crisis, which leaves behind it some relics of the morbific matter, which like leven do so by little & little infect the whole mass of the humours, that ofttimes after ten years' space, the disease riseth as out of an ambush, or lurking hole, Inconveniences following upon immoderate unctions. and becomes far worse than before. But we must in like manner have a care lest these medicines, that are either given inwardly, or applied outwardly, be not too strong: for by causing such colliquation of the radical moisture and solid parts, many have been brought into an incurable consumption. In others sordid and putrid ulcers have thence arisen in the mouth, which having eaten a great part of the palate and tongue, have degenerated into a deadly Cancer. In others hereupon the tongue hath so swelled up, that it hath filled the whole capacity of the mouth, so that it could not be bended to any part of the mouth for chawing, whereupon they have by little and little been famished. In other some there hath been caused so great colliquation of humours, that for a whole month after, tough and filthy slaver hath continually flowed out of their mouths. Other some have the muscles of their jaws relaxed; others troubled with a convulsion, so that during the rest of their lives they can scarce gape. Others by losing a portion of their jaw, have lost some of their teeth. But you must not always so long anoint and chafe the body, until a flux of the mouth or belly appear. For you may find sundry persons, who, if you should anoint or rub them to death, you cannot bring them to flux at the mouth; yet these will recover notwithstanding, excretion being made either by insensible transpiration, or evacuation of urine, or some gentle flux of the belly, either procured by art, or coming of itself. In which case I have observed that many have received much good by a purging decoction of Guajacum, administered according to the quantity of the peccant humour, and given for some days in the morning, adding thereto white For what persons a purging decoction of Guajacum is good. The cure of a Dysentery occasioned by too strong friction. wine, if the body abounded with tough and viscide humours. Dysenteryes, or bloody-fluxes caused by unctions, may be helped by Glisters, wherein much hogsgrease is dissolved to rotund the acrimony caused by the medicine and humour which nourisheth the Dysentery. Also new Treacle dissolved in new milk, is thought wonderfully to mitigate this symptom. CHAP. XIII. Of the third manner of Cure, which is performed by cerates, and emplasters, as the substitutes of unctions. FOr that sundry by reason of the name, abhor the use of friction, which is performed by the forementioned ointments, therefore there is found out another manner of cure, by cerates and emplasters, as substitutes of Frictions, but that usually is somewhat slower: for which purpose it is not needful only to use the things which are described by Vigo, but The cure by emplasters more slow. you may also devise other, which are more or less anodyne, emollient, attenuating, discussing, or drying, according to the condition of the present disease, symptoms, humours and patient, never omitting Hydrargyrum, the only antidote of this disease. Such emplasters mitigate pains and knots, and resolve all hardness, and are absolutely very effectual, for continually sticking to the body, they continually operate. In what case they are chiefly useful. Wherefore they are of prime use in relapses of this disease, or when the humours are thick and viscous, or otherwise lie deep in the body, and very difficult to root out. But for that they work more slowly oft times, such as use them are forced at length to use some frictions to stimulate nature, and cause the speedier excretion. Yet in some whose bodies and humours have been fluid, either by nature or art, the applied emplasters have in three days space procured evacuation sufficient for the disease, so that if they had not been taken away, they would have caused a colliquation, like that which we lately mentioned in too violent friction. Wherefore you shall use the like discretion in taking off these, as you use in your unctions and friction. Instead of Emp. de Vigo, this following may be fitly used. ℞. massae emp. de melil. The description of an emplaster. & oxycrocei, an. lb ss. argenti vivi extin. ℥ vi. ol●o laurino, & de spica, reducantur ad formam emplastri. These plasters must be equally spread upon leather, and laid upon the same places of the joints, as were formerly mentioned in the cure by frictions. Yet some there be, who cover with the plaster all the arm, from the hand even to the shoulder, and all the leg, from the top of the knee, even to the ends of the toes, which thing I do not disallow of, if so be that the places of the joints be covered over with a thicker plaster. They must be left sticking there so long, until nature be stirred up and provoked to cause excretion of the virulent humours. Yet if in the interim great itching shall arise in the parts, you may take them off so long until the parts shall be fomented with a decoction of the flowers of chamomile, melilote, red roses, and the like, made in wine, to discuss that which caused the itching, and then you may lay them on again. Some, to hinder the rising of any itch, lay not the bare plaster to the part, but cover it over with sarsenet, so to keep it from sticking, and thus intercept the transpiration of the part, the cause of itching. They shall be stronger or weaker, and lie to the part a longer or shorter space, as long as the indications, so often formerly mentioned, shall seem to require. The effects of emplasters are the same as of frictions, for they cause excretion, one while by insensible transpiration, otherwhiles by a Diarrhae●, or flux of the belly, sometimes by urines, but most frequently (which Crisis is also most certain) by salivation. Sordid and virulent ulcers often breed in the mouth, tongue, palate, and What excretion best in this disease. gums by salivation, by reason of the acrimony of the virulent humours adhering to the sides of the mouth: to hinder the growth of these, many inject glisters made of emollient things, especially at the beginning of the salivation, so to draw downwards the humours forcibly flying up in greater quantity than is fit, although the part itself may endure them. There are also some, who to the same end give a purging medicine at the very To avoid the ulcers of the mouth. To cure them. time when as the humours are ready to move upwards, the which I think is not a safe course. The cure of such ulcers is far different from the cure of others. For they ought by no means to be repercussed or repelled, how inflamed soever they be, but only to be mitigated by anodyne gargarisms, so only to lessen the heat, and that by this frequent washing of the mouth, you may hinder the sticking or furring of viscide humours to such like ulcers. A decoction of barley, cow's milk warm, held and gargled in the mouth, the mucilages of the seeds of mallows, marsh-malloxes, psilium, lettuce, line extracted in the water of barley, mallows, and pellitory of the wall, are good for this purpose; for thus the ulcers become more mild, and the tenacity of the adherent humours is loosed. You must at the first beware of strong detergent medicines, for almost all such have acrimony joined with them, which will increase the pain, but chiefly in the state of the disease: for so, the ulcers gently cleansed by frequent gargling, would become worse by the use of acride things. Therefore it shall be sufficient to make use of the forementioned medicines, so to hinder the increase of the filth, and inflammation of the ulcers, if so be that such ulcers be not too exceeding malign and burning. For if it shall happen either by the powerful efficacy of the applied plasters, or by the violence of nature in its motion of the ill humours upwards, that such store of viscous, and gross humours are carried to the mouth, that it wants little, but that the part itself is overruled by the morbificke matter, so that by the violence and continuance of the flux, the mouth and jaws become so swelled, that a gangrene is to be feared, by hindering the entrance of the spirits, and extinguishing of the native heat of these parts. In this case we are forced to leave the proper cure for to withstand the accidents, and for this purpose we use restrictive & repelling things, such as are barley water, plantain, Reestrictive & repelling gargarisms. nightshade, knotgrass, shepherd's Purse, etc. with syrup of roses, violets, quinces, berberies, pomegranates, etc. also such are the mucilages and decoctions of the seeds of lettuce, psilium, quinces, plantain, cucumbers, melons, white poppy, hen-bane, in the waters of roses, plantain, nightshade, waterlillies, wood bin●, etc. Also it is convenient to procure sweats by stoves, or the application of any hot and dry things; for thus the humours which run forth of the vessels into all the surface of the body, are diverted. But when as the course of the humours running to the mouth, is beginning to stop, and the tumors and ulcers begin to lessen, than nothing hinders, but that we may use gently detergent things, as syr. rosarum siccarum, mell rosatum, Diamoron, Dianucum, and the like. But when it is time to dry the ulcers, they may be lightly touched with alum water, or with aqua fortis, such as goldsmiths To dry the ulcers of the mouth. have used for the separation of metals. They may also frequently use drying gargarisms made with astriction of the waters of roses, plantain, nightshade, shepherd's purse, knot grass, and dog's tongue, boiling therein balaustia, ros. rub. myr●il. sumach. alumen. acacia, berber. galla; malicor. and the like. During the time of fluxing or salivation you must diet and ●eed the patient with liquid meats, and those of good juice, and easy digestion, for that then he can neither chaw, swallow, nor digest hard things. For nature wholly intent upon the excretion of the noxious and peccant humours, as also weakened by the bitterness of pain, watchings, and unquietness, and consequently a great resolution of the spirits, cannot insist powerfully upon the work of concoction. Therefore he shall be fed with rear new laid eggs, caudles of the same, barley creames, culesses made of a decoction of knuckles Manner of diet when the mouth is ulcerated. of veal, and a capon, and jellies, and with these in small quantity, but frequently administered, always gargling his mouth before he eat. For his drink he shall use a decoction of Guajacum aromatized with a little cinnamon, but if any desire that the drink shall become nourishment, for that the patients cannot feed on more solid To make their drink nourishing. meats, you may give them old wine, claret and thin, mixed with some barley water. Some there are who steep some crumbs of pure manchet in the aforesaid ●ine, and then press it out, but yet so, that there may some part of the bread remain therein, which may make it more nourishing, and less sharp or acride. Others steep bread hot out of the oven, in wine, for the space of a night, than they distil it all over in balneo Mariae; the liquor which first comes over is more strong and hot, but that which flows out afterwards, more mild, and such as the patient may use to mix with his wine without any danger, for his better nourishment, and the recovery of his strength. For to refresh the spirits in fear of fainting, Muskedine, Hippocras, rose vinegar, and the like, put to the nose to smell to, will be sufficient, unless peradventure the patient should naturally abhor such things, for so they would rather deject the powers and spirits. In the interim you must have care of the belly, that you keep it open by gentle and emollient glisters. CHAP. XIIII. Of the fourth manner of curing the Lues venerea. SOme have devised a fourth manner of curing the Lues venerea, which is by suffitus or fumigations. I do not much approve hereof, by reason of sundry malign symptoms which thence arise, for they infect and corrupt by their venomous contagion, the brain and lungs, by whom they are primarily and fully received, whence the patients during the residue The hurt that follows upon fumigations. of their lives have stinking breaths. Yea many while they have been thus handled, have been taken hold of by a convulsion, and a trembling of their heads, hands, & legs, with a deafness, apoplexy, and lastly miserable death, by reason of the malign vapours of sulphur and quicksilver, whereof cinnabaris consists, drawn in by their mouth, nose, and all the rest of the body. Wherefore I can never approve the use of such fumigations which are to be received in ●umes by the mouth and nostrils for to work upon the whole body; yet I do not dislike of that, which is undertaken for some one part only, as to dry up ill conditioned ulcers, which so affect What fumigations good. it, that they cannot be overcome by any other means, or for to disperse or digest knots, or to resolve fixed pains, otherwise unmoveable. These fumigations by reason of the admixture of Argentum vivum have an attenuating, cutting, resolving, and colliquating faculty. Those who prepare these fumigations for the cure of the whole disease and body, take this course. They put the patient under a tent or canopy The common manner of using them. made close on every side, lest any thing should expire, and they put in unto him a vessel filled with hot coals, whereupon they plentifully throw Cinnabaris, that so they may on every side enjoy the rising fume, just after the same manner as Farriers use to smoke their horses for the glanders: they repeat this every day so long, until they begin to flux at the mouth. The principal matter or basis of such fumigations, as we have already noted, is cinnabaris consisting of sulphur and argentum vivum mixed together; there is added also, radix ireos flor. thus, olibanum, myrrha, juncus The matter of them. odoratus, assa odorata, mastiche, terebinthina, & theri●●●, all which have a faculty to resolve and strengthen the spirits, and nature, and correct the stench and evil quality of the argentum vivum. There are also other fumigations made after another manner, but that also when as the argentum vivum is extinct, and as it were fixed after this manner; let some lead be melted, and let there be poured or put thereto some argentum vivum, then let it all be powdered, adding thereto Antimony, Aloes, Mastic, coprose, orpiment, and Benjamin made into powder, and framed into Trochisces Trochisces for fumigations. with some turpentine. Or else, ℞. cinnabaris, ℥ i. styracus rub. & calamitae, nu●is moschat. an. ʒiii. benzoini, ℥ ss. ponderisʒii. for the foresaid use. The terebinthina is added to incorporate the dry things, and the gums are added to yield matter to the fume. But virulent ulcers of the Lues venerea shall not be fumigated before they be cleansed; also this following fumigation is good. ℞. ●…baris, ℥ i. benzoini, myrrhae, styracis, olibani, opopanacis, an. ℥ ss. mastiches, macis, thuris, is, a. ʒ●●. excipiantur terebinthina, & fiat suffumigium. CHAP. XV. The cure of the symptoms, or symptomaticke affects of the Lues venerea, and first of the Ulcers of the Yard. CAllous and malign ulcers in this disease may grow all over the yard; but these are far more malign which arise on the prepuce, than those that The ulcers of the pr●puce more malign than those of the Glans grow on the Glans, or nut of the yard. Now they are rebellious to the common medicines of ulcers which happen other ways, & they are also subject to turn into a gangrene, so that sundry, who have not in time provided for themselves by the use of argentum vivum, are forced for their negligence to suffer the loss of their Glans, and oft times of their whole yard. Yet I am of opinion that I think we must begin the cure of all ulcers of the yard with the general remedies of ulcers. For all ulcers arising in these parts by reason of copulation, are not virulent. But when as we shall find that we do no good by this means, and that the disease notwithstanding grows worse and worse, then must we come to make use of such things as receive argentum vivum, that by these we may resist the virulency which is ready to disperse itself over all the body, yet it is absolutely necessary that all these things be endued with such faculties as may retund the malign acrimony of this venom, such an one is this following collyrium of Lanfranck. ℞. vini Lanfrancke. Collyrium. albi, lb i aq. ros. &. plantag. an. quart. i. auripig. ʒii. viridis ●ris, ʒi. aloes, myrrhae, an. ℈ two. terantur subtilissime, & fiat collyrium. Also these ulcers may be profitably touched with mercury water, or aqua fortis which the Goldsmiths have used, or else mercury in powder, or our aegyptiacum: but the falling away of the Eschar shall be procured with basilicon, or fresh butter. Yet I think it not fit to use these acrid things without very great caution, for fear of a gangrene, which easily happens to this part. But if such ulcers are so stubborn, that they will not yield to these remedies, then must we come to the friction or unction of the groins perinaum, and ulcers, with the ointments formerly prescribed for the general friction. Also fumigations may be made, as we mentioned in the former chapter. For thus at length the malignity of the virulent humour will be overcome, and the callous hardness mollified; and lastly the ulcers themselves cleansed, and being cleansed, consolidated. Sometimes after the perfect cure of such ulcers, there will appear manifest signs of the Lues venerea in many, which showed not themselves before, for that the virulency flowed forth of the running ulcers, and now this vent being stopped, it flows back into the body, and shows signs thereof in other parts; and these men have need of a general unction. CHAP. XVI. & by us vulgarly in English the running of the 〈◊〉. How a Gonnorhoea differeth from a * This which by our Author is here termed 〈…〉 virulent 〈…〉 & in Fr●ch chaude●●sse, is the same which by other Authors is usually termed 〈…〉, virulent strangury. EVen, to this day very many have thought that the virulent strangury hath some affinity with the Gonnorhoea of the Ancients, but you shall understand by that which follows, that they are much different. For a Gonnorhoea is an unvoluntary effusion of seed running from the whole body to the genitals, by reason of the resolution and palsy of the retentive faculty of these parts, as it is delivered by Galen, lib. de loc. affect. This disease befalleth others by the collection of the blood and seminal matter by the vessels of the whole body, which not turning into fat and good flesh, takes its course to the genitals; but on the contrary, a virulent strangury is a running, or rather dropping What a virulent strangury is. out of the urenary passage, of a yellowish, livide, bloody, filthy sanies, like to pus or matter not well concocted, oftentimes fretting and exulcerating the passage with the acrimony, and causing a painful erection of the yard, and distension of all the genital parts. For in this erection there is caused as it were a convulsive contraction of these parts. And hence it is that the patients complain, that they feel as it were The cause of the convulsive distension of the ●ard. a string stretched stiff in that part, which draws the yard as it were downwards. The cause hereof is a gross and flatulent spirit, filling and distending by its plenty, the whole channel or hollow nerve; yea, verily, the whole porous substance of the yard. If to these symptoms this be added, that the urenary passage be exulcerated, a grievous pain afflicts the patient whilst he makes water, for that the ulcers are irritated by the sharp urine passing that way. Such a virulent strangury or running of the reins ofttimes continueth for two or three years' space: but the Gonnorhaea, or running of the seed cannot endure so long, but that it will bring the body to an extreme and deadly leanness, for that the matter of the seed is of the more benign and laudable portion of the blood, as you may perceive by those who have too immoderately used copulation but the space of one night. For such have their faces more lean and lank, and the rest of their bodies enervated, languisheth and becometh 〈…〉 definite. 〈…〉 Galen. dull. By this we have delivered, it may be perceived that the running of a virulent strangury, is not the running of a seminal humour, fit for generation of issue, What kind of matter floweth forth in a virulent strangury. but rather of a viscous and acride filth, which hath acquired a venenate malignity by the corruption of the whole substance. CHAP. XVII. Of the causes and differences of the scalding, or sharpness of the urine. THe heat or scalding of the water, which is one kind of the virulent strangury, ariseth from some one of these three causes, to wit, repletion, inanition and contagion. That which proceeds from repletion, proceeds either The cause of a particular repletion of the privy parts. from too great abundance of blood, or by a painful and cedious journey in the hot sun, or by feeding upon hot, acride, diuretic and ●larulent meats, causing tension and heat in the urenary parts, whence proceeds the inflammation of them and the genital parts, whence it happens that not only a seminal, but also much other moisture may flow unto these parts, but principally to the prostatae, which are glandules situate at the roots, or beginning of the neck of the bladder, in which place the spermaticke vessels end; also abstinence from venery causeth this plenitude in some who have usually had to do with women, especially the expulsive faculty of the seminal and urenary parts being weak, so that they are not of themselves able to free themselves from this burden. For then the suppressed matter is corrupted, and by its acrimony contracted, by an adventitious and putredinous heat, it causeth heat and pain in the passage forth. The prostata swelling with such inflamed matter, in process of time become ulcerated, the abscess being broken. The purulent sanies dropping and flowing hence alongst the urinary passage causes ulcers by the acrimony, which the urine falling upon, exasperates, whence sharp pain, which also continueth for some short time after making of water, and together there with by reason of the inflammation, the pains attraction, and the vaporous spirits distension, the yard stands and is contracted with pain, as we noted in the former chapter. But that which happens through inanition, is acquired The causes of the inanition of the genital parts. by the immoderate and unfit use of venery, for hereby the oily and radical moisture of the forementioned glandules is exhausted, which wasted and spent, the urine cannot but be troublesome and sharp by the way to the whole urethra. From which sense of sharp pain, the scalding of the urine hath its denomination. That which comes by contagion, is caused by impure copulation with an unclean person, or with a woman, which some short while before hath received the tainted seed of a virulent person, or else hath the whites, or her privities troubled with hidden and secret ulcers, or carrieth a virulent spirit shut up or hidden there, which heated and resuscitated by copulation, presently infects the whole body with the like contagion, no otherwise than the sting of a Scorpion or Phalangium, by casting a little poison into the skin, presently infects the whole body, the force of the poison spreading further than one would believe, so that the party falls down dead in a short while after. Thus therefore the seminal humour contained in the prostatae, is corrupted The reason of a contagious strangury. by the tainture of the ill drawn thence by the yard, and the contagion infects the part itself; whence follows an abcesse, which casting forth the virulency by the urenary passage, causeth a virulent strangury; and the malign vapour carried up with some portion of the humour unto the entrailes and principal parts, cause the Lues venerea. CHAP. XVIII. Prognostics in a virulent strangury. WE ought not to be negligent or careless in curing this affect, for A virulent strangury continues with some during their, lives. of it proceed pernicious accidents, as we have formerly told you, and neglected, it becomes uncurable, so that some have it run out of their urenary passage during their lives; ofttimes to their former misery is added a suppression of the urine, the prostatae and neck of the bladder being inflamed and unmeasurably swelled. Copulation, and the use of acride or flatulent meats increase this inflammation, and also together therewith cause an Ischuria, or stoppage of the urine; they are worse at the change of the moon▪ certain death follows upon such a stoppage; as I observed A history. in a certain man, who troubled for ten years' space with a virulent strangury, at length died by the stoppage of his water. He used to be taken with a stopping of his urine, as often as he used any violent exercise, and then he helped himself by putting up a silver Catheter, which for that purpose he still carried about him; it happened on a certain time, that he could not thrust it up into his bladder, wherefore he sent for me, that I might help him to make water, for which purpose when I had used all my skill, it proved in vain: when he was dead, and his body opened, his bladder was found full and very much distended with urine, but the prostatae preternaturally From what part the matter of a virulent strangury flows. swelled, ulcerated, and full of matter resembling that, which formerly used to run out of his yard, whereby you may gather, that this virulency flows from the prostatae, which runs forth of the yard in a virulent strangury, and not from the reins, as many have imagined. Certainly, a virulent strangury, if it be of any long continuance, is to be judged a certain particular Lues venerea, so that it cannot be cured unless by frictions with Hydrargyrum. But the ulcers which possess the neck of the bladder are easily discerned from these which are in the body or capacity thereof. For in the latter the filth comes away as the patient makes water, and is found mixed with the urine, with certain strings or membranous bodies coming forth in the urine: to these may be added, the far greater stinch of this filth which issueth out of the capacity of the bladder. Now must we treat of the cure of both these diseases, that is, the Gonnorh●● and virulent strangury, but first of the former. CHAP. XIX. The chief heads of curing a Gonnorhoea. LEt a Physician be called, who may give direction for purging, bleeding and diet, if the affect proceed from a fullness and abundance of blood and seminal matter; all things shall be shunned which breed more Diet. blood in the body, which increase seed, and stir to venery. Wherefore he must abstain from wine, unless it be weak and astringent, and he must not only eschew familiarity with women, but their very pictures, and all things which may call them into his remembrance, especially if he love them dearly; For a strangury occasioned by repletion. strong exercises do good, as the carrying of heavy burdens even until they sweat, swimming in cold water, little sleep, refrigerations of the loins and genital parts by anointing them with unguentum rosatum refrigerans Galeni & nutritum, putting thereupon a double cloth steeped in oxycrate, and often renewed. But if the resolution or weakness of the retentive faculty of these parts be the cause of this disease, contracted by too much use of venery before they arrive at an age fit to perform For the decay of the retentive faculty. such exercise; in this case strengthening and astringent things must both be taken inwardly, and applied outwardly. But now I hasten to treat of the virulent strangury, which is more proper to my purpose. CHAP. XX. The general cure both of the scalding of the water, and the virulent strangury. We must diversely order the cure of this disease, according to the variety of the causes and accidents thereof. First, care must be had of the diet, and all such things shunned as inflame the blood, or cause windiness; of which nature are all diuretic and slatulent things, as also strong and Diet. violent exercises. Purging and bleeding are convenient, especially, if fullness cause the affect. women's companies must be shunned and thoughts of venereous matters; the patient ought not to lie upon a soft bed, but upon a quilt or matterice, and never, if he can help it, upon his back; boiled meats are better than roasted, especially boiled with sorrel, lettuce, purslain, cleansed barley, & the four cold seeds beaten, for sauce, let him use none, unless the juice of an orange, pomegranate, or verjuice; let him shun wine, and in stead thereof use a decoction of barley and liquerice, a hydromel, or hydrosaccharum with a little cinnamon, or that which is termed Potus divinus. In the morning let him sup of a barley cream wherein hath been boiled a nodulus of the four cold seeds beaten together with the seeds of white poppy; for thus it refrigerateth, mitigateth and cleanseth; also the syrups of marshmallows and maidenhair are good. Also purging the belly with half an ounce of Cassia, sometimes alone, otherwhiles with a dram or half a dram of Rhubarb in powder put thereto, is good. And these following pills are also convenient. ℞. massae pi●ul. sine quibus ℈ i. electiʒss. caphurae gr. iiii. cum terebinthina formenntur pilul●; Pill●. let them be taken after the first sleep. Venice turpentine alone, or adding thereto some Rhubarb in powder, with oil of sweet almonds newly drawn without fire, or some syrup of maidenhair is a singular medicine in this case, for it hath an excellent The force of Venice turpentine in this disease. lenitive and cleansing faculty, as also to help forwards the expulsive faculty, to cast forth the virulent matter contained in the prostatae. You may by the bitterness perceive how it resists putrefaction and you may gather how it performs its office in the reins and urenary parts, by the smell it leaves in the urine after the use thereof. But if there be any who cannot take it in form of a bowl, you may easily How to be made potable. make it potable, by dissolving it in a mortar with the yolk of an egg and some white wine, as I learned of a certain Apothecary, who kept it as a great secret. If the disease come by inanition or emptiness, it shall be helped by fatty injections, oily and emollient potions, and inwardly taking and applying these things which have the like faculty, and shunning these things which caused the disease. How to cure that which happens by contagion, or unpure copulation, it shall be abundantly showed in the ensuing chapter. CHAP. XXI. The proper cure of a virulent strangury. FIRST we must begin with the mitigation of pain, and staying the inflammation, which shall be performed by making injection into the urethra with this following decoction warm. ℞. sem. psilii, An injection to stay inflammation. lactucae, papav. albi, plantag. cydon. lini, hyosciami albi, an. ʒii. detrahantur mucores in aquis solani & rosar. ad quantitatem sufficientem, add trochisc. alborum Rhasis camphoratorum in pollinem redactorum, ʒi. misce simul, & fiat injectio frequens. For this because it hath a refrigerating faculty, will help the inflammation, mitigate pain, and by the mucilaginous faculty lenify the roughness of the urethra, and defend it by covering it with the slimy substance, against the acrimony of the urine and virulent humours. In stead hereof you may use cow's milk newly milked, or warmed at the fire. Milk doth not only conduce hereto being thus injected, but also drunk, for it hath a refrigerating The faculties of milk against a virulent, strangury. and cleansing faculty and by the subtlety of the parts it quickly arrives at the urenary passages. Furthermore it will be good to anoint with cerat. refriger. Galeni addita camphora, or with ceratum santalinum, ung. comitissae, or nutritum, upon the region of the kidneys, loins and perinaeum, as also to anoint the Cod and Yard. But before you use the foresaid ointments or the like, let them be melted over the fire, but have a care that you make them not too hot, lest they should lose their refrigerating quality, which is the thing we chiefly desire in them. Having used the foresaid ointment, How to make water without pain. it will be convenient to apply thereupon some linen clothes moistened in oxycrate composed ex aquis plantaginis, solani, sempervivi, rosarum, and the like. If the patient be tormented with intolerable pain in making water, and also some small time after, as it commonly cometh to pass, I would wish him that he should make water putting his yard into a chamber-pot filled with milk or water warmed. The pain by this means being assuaged, we must come to the cleansing of the ulcers by this or the like injection. ℞. hydromelitis symp. ℥ iv. syr. de rosis siccis, & de absinth. Detergent injections. an. ℥ ss. fiat injectio. But if there be need of more powerful detersion, you may safely add, as I have frequently tried, a little aegyptiacum. I have also found this following decoction to be very good for this purpose. ℞. vini albi oderiferi, lb ss. aquar. plantag. & ros. an. ℥ two. auripigmenti, ʒss. viridis aeris, ℈ i. aloës oped. ʒss. pulverisentur pulverisanda; & bulliant simul. Keep the decoction for to make injection withal. You may increase or diminish the quantity and force of the ingredients entering into this composition, as the patient and disease shall seem to require. The ulcers being thus cleansed, we must hasten to dry them, so that we may at length cicatrise How the cleansed ulcers may be dried. them. This may be done by drying up the superfluous moisture, and strengthening the parts that are moistened and relaxed by the continual defluxion, for which purpose this following decoction is very profitable. ℞. aq. fabrorum, lb i psidiarum, ballast. nucum cupres. conquassatorum. an. ʒi ss. s●●in. sumach. & herber. an. ʒii. syrup. rosar. & de absinth. an. ℥ i. fiat decoctio. You may keep it for an injection to be often injected into the urethra with a syringe, so long as that there shall no matter or filth flow out thereat, for then there is certain hope of the cure. CHAP. XXII. Of Caruncles, or fleshy excresc●u●●s which sometimes happen to grow in the Urethra, by the heat or sc●lding of the urine. ASharpe humour which flows from the Glandules termed Prostatae, and continually runs alongst the urenary passage, in some places by the way How caruncles come to grow upon the ulcers of the genital parts. it frets, and exulcerateth by the acrimony the urethra in men, but the neck of the womb in women. In these, as also is usual in other ulcers, there sometimes grows up a superfluous flesh, which oft times hinders the casting or coming forth of the seed & urine by their appropriate and common passage, whence many mischiefs arise; whence it is that such ulcers as have caruncles growing upon them must be diligently cured. But first we must know whether they be new or old. For the latter are more difficulty to be cured than the former, Callous caruncle, hard to cure. because the caruncles that grow upon them become callous and hard, being oft times cicatrized. We know that there are caruncles, if the Catheter cannot freely pass alongst the passage of the urine, but finds so many stops in the way, as it meets Signs. with Caruncles that stop the passage; if the patient can hardly make water, or if his water run in a very small stream, or two streams, or crookedly, or only by drop and drop, with such tormenting pain that he is ready to let go his excrements, yea and oft times doth so, after the same manner as such as are troubled with the stone in the bladder. After making water, as also after copulation, some portion of the urine and seed stays at the rough places of the caruncles, so that the patient is forced to press his yard, to press forth such relics. Sometimes the urine is wholly stopped, whence proceeds such distension of the bladder, that it causeth inflammation, The suppressed urine comes forth whereas it can get vene. and the urine flowing back into the body, hastens the death of the patient. Yet sometimes the urine thus suppressed, sweats forth preternaturally in sundry places, as at the fundament, perinaeum, cod, yard, groins. As soon as we, by any of the forementioned signs, shall suspect that there is a Caruncle about to grow, it is expedient forthwith to use means for the cure thereof; for a caruncle from a very little beginning doth in a short time grow so big, that at the length it becomes incurable, verily you may easily guess at the difficulty of the cure by that we have formerly delivered of the essence hereof, besides, medicines can very hardly arrive thereat. The fittest season for the undertaking thereof is the spring, and the next thereto is The fittest time for the cure. Why venery must be eschewed. winter; yet if it be very troublesome, you must delay no time. Whilst the cure is in hand, the patient aught wholly to abstain from venery, for by the use thereof, the kidneys, spermaticke vessels, prostatae, and the whole yard, swell up and wax hot, and consequently draw to them from the neighbouring and upper parts, whence abundance of excrements in the affected parts, much hindering the cure. You must beware of acrid and corroding things in the use of detergent injections, for that thus the urethra being endued with most exquisite sense, may be easily offended, whence might ensue many and ill accidents. Neither must we be frighted if at some times we see blood flow forth of secret or hidden caruncles. For this helps to shorten the cure, because the disease is hindered from growth, by taking away portion of the conjunct matter, the part also itself is eased from the oppressing burden, for the material cause of caruncles is superfluous blood. Wherefore unless such bleeding happen of itself, it is not amiss to procure it by thrusting in a Cathaeter somewhat hard, The particular cure. yet with good advice. If the Caruncles be inveterate, and callous, then must they be mollified by fomentations, ointments, cataplasms, plasters, and fumigations; you may thus a make fomentation. ℞. rad, alth. & lilior al●. an. ℥ iv. rad. bryani●, & foenicul. A fomentation. an. ℥ iss. fol. malvar. violarum, parietar. & mercur. an. m ss. sem. lini, faenugr. an. ℥ ss. caricas ping. nu. xii. florum chamaem. & melil. an. p i. contundantur contu●denda, & incidenda incidantur, bulliant omnia in aqua communi: make a fomentation, and apply it with soft sponges. Of the mass of the strained-out things, you may make a cataplasm after this manner. ℞. praedicta materialia, terantur, & trajiciantur, add A cataplasm. ●xungiae porci, unguenti basiliconis, an. ℥ two. fiat cataplasma: let it be applied presently after the fomentation. You may use this following lineament whilst the cataplasm is providing. ℞. unguenti alth. & agrippae an. ℥ iss. oesipi humidae, & axung. A littiment. human. an. ℥ i. butyri recentis, olei lilior. & chamaem. an. ʒvi. liquefiant simul, addendo aquae vitae ℥ i. fiat linimentum: let it be applied outwardly upon the part wherein the Caruncles are. For the same purpose plasters shall be applied, which may be diversified, and fitted as you shall think good; yet Emplastrum de Vigo Vigoes' emplaster effectual to soften a caruncle. truly made, exceedeth all the rest in a mollifying faculty, and in wasting such callous hardness. The following fumigation is also good for the same purpose, take some pieces of a mille-stone (for this we use in stead of the pyrites mentioned by the Ancients) or else some Bricks of a large size, after they are heated hot in the fire, let them be put into a pan, and set under a close stool, then cause the patient to sit thereon, as if he were going to stool, then pour upon the hot stones equal A suffumigium. parts of very sharp vinegar, and very good Aqua vitae, and casting clothes about him, that nothing may exhale in vain: let him receive the ascending vapour at his Fundament, Perinaeum, Scrotum, and Urethra. Moreover, that this medicine may work the better effect, you may put the Patient naked into the Barrel noted with this letter A. so that he may sit upon a seat or board perforated on that part, whereas his Genitals are, then place the pan holding the hot stones between his legs, then presently sprinkle the stones with the forementioned liquor, by the door marked with the letter, B. Thus the Patient shall easily receive the fume that exhales therefrom, and none thereof be lost, he covering and vailing himself Ad Glauc. lib. 2. cap. 5. on every side. Such a fumigation, in Galens' opinion, hath a faculty to penetrate, cut, resolve, soften and digest scirrhous hardnesses. A Barrel fitted to receive the Fume in. CHAP. XXIII. What other remedies shall be used to Caruncles occasioned by the Lues venerea. BUT if you suspect that these Caruncles come or are occasioned by a virulent humour, or the malignity of the Lues venerea, it is meet that the Particular defaults of the Lues 〈◊〉 not to be cured unless by the generallremedy of the viruleney. patient observe such a diet as usually is prescribed to such as are troubled with the Lues venerea; let him use a decoction of Guajacum, and let the perinaeum and the whole yard be anointed with ointment made for the Lues venerea; otherwise the Surgeon will lose his labour. In the interim whilst he shall sweat in his bed, he shall be wished to hold between his legs a stone bottle filled with hot water, or else a hot brick wrapped in linen clothes, moistened in vinegar and aqua vitae; for thus the heat and vapour will ascend to the genitals, which, together with the help of the applied ointment, will dissolve the matter of the Caruncles, and being thus softened, they must be consumed with convenient Caruncles if callous, must first be softened. medicines. Wherefore first if they become callous, or cicatrized (which you may suspect if they cast forth no excrementitious humidity) they shall be exasperated, excoriated and torn with a leaden Cathaeter having a rough button at the end like a round file. He shall so long use the Cathaeter put into the Urethra, thrusting it up and down the same way so long and often as he shall think fit for the breaking and tearing the Caruncles, he shall permit them thus torn to bleed freely, so to ease the affected part. You may also for the same purpose put into the Urethra the Cathaeter marked with this letter B. whereinto putting a silver wiar sharp at the upper end, that by often thrusting it in and out, it may wear and make plain the resisting caruncles. Verily by this means I have helped many much perplexed with the fearful danger of this disease. Some better like of the Cathaeter marked with the letter A. being thus used: it is thrust into the Urethra with the prominent cutting sides downwards, and then pressing the yard on the outside close with your hand to the Cathaeter in the place where the Caruncles are, it is drawn forth again. Cathaeters' fit to wear asunder, or tear Caruncles. A. showeth the Cathaeter with the inserted silver wiar, but not hanging forth thereat. B. showeth the Cathaeter with the inserted silver wiar hanging forth at the end. The thus torn Caruncle shall be strawed over with the following powder, being very effectual to waste and consume all Caruncles of the privities without much pain. ℞. herb. sabin. in umbra exsiccat. ʒ two. ocrae, antimon. tuth. praparat. an. ʒ ss. fiat A powder to waste caruncles. pulv. subtilissimus, let it be applied in the following manner. Put the powder into the pipe or Cathaeter having holes in the sides thereof, the which is the lowermost of the last described. Then put the Cathater into the urenary passage until the slit or openness of the side come to the Caruncle, then into the hollowness of the Cathaeter put a silver wiar, wrapped about the end with a little linen rag, which as it How to apply it. is thrust up, will also thrust up the powder therewith, until it shall come to the slit against the caruncle, then will it adhere to the caruncle, bloody by reason of the late attrition. Then shall you draw forth the Cathater, first twining it about, that so it may not scrape off the powder again. If intolerable pain hereupon happen, it shall be assuaged, and the inflammation restrained by the following injection. ℞. succorum An injection to hinder inflammation. portulacae, plantag. solani, & sempervivi, an. ℥ ss. album ovorum, nu. vi. agitentur diu in mortario plumbeo; let it be injected warm into the urethra with a syringe. In stead hereof you may also make use of another injection, which is formerly prescribed. Neither will it be unprofitable to apply repercussives to the genitals, to hinder pain and inflammation. You may also use other medicines, having a faculty to consume An emplaster used by the Surgeons of Monipelier for Caruncles. the Caruncle, amongst which these following are excellent. ℞. viridis aeris, auripigmenti, vitriol. Rom. aluminis roch. an. ℥ two. infundantur omnia in acet. acerrimo, atque inter duo marmora in pollinem redigantur: then let it be exposed to the summer sun, and dried, again infused in sharp vinegar, and then as before ground upon a marble, so that you shall find nothing sharp with your fingers; lastly let it be opposed to the sun until it may be made into most subtle powder, and all the acrimony be vanished, which will be commonly in eight days space. Then, ℞. ol. rosat. ℥ iv. lythargyri ℥ two coquantur ad ignem, quousque coiërint in emplast. solidae consistentiae, ab ignetum semotis, add pulv. praedict. ℥ two. let them be mixed with a spatula, and put upon the fire until it come to so hard a consistence, that it will stick to a wax candle, or lead wiar, so that it may not come off by handling with your hands. The Surgeons of Mantpelier, use this medicine: This following is another, ℞. tuthiae praepar. Another emplaster. ʒ vi. antimonii, ʒ iii trochisc. alborum, Rhas. camphorat. ʒ i corticis granati, aluminis usti, an. ʒ i ss. spongia ustae, ℈ two. let them all be made into powder: then, ℞. ung. diapo ●pholigos, & alb. Rhasis, an. ℥ two. misceantur cum praedictis pulveribus in mortario plumbeo, & diu agitentur: let a very fine rag be spread over with this ointment, How to apply it. and wrapped about a wax candle, and so thrust into the Urethra, and then draw forth the candle again by twining it a contrary way; so let the end of the rag hang out of the yard, so to pluck it forth again, when as you shall think it hath done what it can to the Caruncle, which is, when it hath covered it with the medicine with which it was spread. Some also make wax candles with a slender, but stiff week, whose end, which is to be put to wear and consume the Caruncle, is composed of the following medicine. ℞. emplastri nigri, vel diachylonis ireati ℥ two. pull. sabinae, ocrae, vitriol. Rom. calcin. pull. mer. an. ʒ ss. omnia liquescant simul ad dictum usum. Whilst the cure shall be in hand by these following medicines, let the patient be careful that he so shake his yard after making water, that he may shake forth all the A caution 〈◊〉 making water. relics of the urine which may chance to stop at the Caruncles; for if but one drop should stay there, it would be sufficient to spoil the whole operation of the applied medicines. After that the Caruncle shall be worn away and wholly consumed by the described medicines, which you may know by the urine flowing forth Signs that the Caruncle is worn away. freely, and in a full stream, and by thrusting up a Cathaeter into the bladder without any stoppage; than it remains that the ulcers be dried & cicatrized; for which purpose the following injection is very powerful and effectual, and without any acrimony. ℞. aq. fabrorum lb ss. nuc. cupress. gallar. cort. granat. an. ʒ i ss. alum. roch. ʒ ss. bulliant omnia simul secund. art. so make a decoction for an injection, which you An epuloticke injection. shall use so long, until no excrementitious humidity distil out of the yard. The following powder dries more powerfully, and consequently hastens forwards cicatrisation, and it is also without acrimony. ℞. lapidem calamin. lotum, test as over ●m ust as, corallum rubrum, corticom granat. comminue omnia in pollinem; let this powder be used to the ulcers, with a wax candle joined to some unguentum desiccativum rubrum, or some such like thing. Also strings or rods of lead thrust into the urethra as thick as the passage will suffer, even to the ulcers, being first be smeared with quicksilver, Quicksilver by drying causeth cicatrication. and kept in day and night as long as the patient can endure, are good to be used. For they dry by their touch and cicatrise, they dilate the urenary passage without pain, and lastly hinder the sides of the ulcer from corrupting one another. CHAP. XXIIII. Of venereal Buboes, or swellings in the Groins. THe virulency of the Lues venerea is sometimes communicated to the Liver, which if it have a powerful expulsive faculty, it expels it into the groins, as the proper emunctories thereof, whence proceed The efficient and material causes of venereous Bubo's. venereal Bubo's. The matter of these for the most part is abundance of cold, tough, and viscous humours, as you may gather by the hardness and whiteness of the tumour, the pravity of the pain, and contumacy of curing; which also is another reason, besides these that we formerly mentioned, why the virulency of this disease may be thought commonly to fasten itself in a phlegmatic humour. Yet sometimes venereal Bubo's proceed from a hot, acride and choleric humour, associated with great pain and heat, and which thereupon often degenerate into virulent & corroding ulcers. Some venereous Bubo's are such conjoined accidents of the Lues venerea, What Bubo's foretell the Lues venerea. that they foretell it; such are these which for a small while show a manifest tumour, and suddenly without any manifest occasion hide themselves again, and return back to the noble parts. Others are distinct from the Lues venerea though they have a similitude of essence and matter therewith, and which therefore may be healed, the Lues venerea yet remaining uncured. Such are these which are usually seen, and which therefore compared with the former may be termed simple and not implicit. For the cure, you must not use discussing medicines, lest resolving the more subtle part, the grosser dregs become impact and concrete there; but much less must we use repercussives, for that the matter is virulent. Wherefore only attractive and suppurating medicines are here to be used, agreeable to the humour predominant and causing the tumour, as more hot things in aedematous and scirrhous tumors, than in those which resemble the nature of a phlegmon or erysipelas: the indication taken from the rarity and density of bodies insinuates the same variety. The applying of cupping glasses is very effectual to draw it forth. But when as it is drawn Cupping. forth, you shall forthwith apply an emplastic medicine, and then you shall come to suppuratives. When the tumour is ripe it shall be opened with a potential cautery, A potential Cautery. if it proceed from a cold cause; for by the inducing of heat the residue of the crude matter is more easily concocted, besides when as an ulcer of this kind is opened, the matter will be more easily evacuated, neither shall it be fit to use any tent, but only to apply pledgets. The residue of the cure shall be performed by detergent medicines, and then if need require, the patient shall be let blood, and the humours evacuated by a purging medicine, but not before the perfect maturity thereof. CHAP. XXV. Of the Exostosis, bunches or knots growing upon the bones by reason of the Lues Venerea. Heard tumors, Exostoses and knots have their matter from thick and tough phlegm, which cannot be dissolved, unless by hot medicines, The matter of knots, and virulent Tophi. which have a mollifying & dissolving faculty. For which purpose, besides those medicines which usually are applied to seirrous tumors, you must also make use of arg. viv. commonly after this manner. &. empl. filii Zach. & Ceronei, an. ℥ iii euphorb. ℥ ss. euplast. de vigo, ℥ two iter at aesyp. descript. Philagr. ℥ i. argent. vivi extinct. ℥ vi. fiat emplastrum. Spread it upon leather for your An emplaster against the bunching out of the bones. use. In the mean space let the patient observe a sparing diet; for thus he shall be helped, if so be that the substance of the bones be yet unperished. For if it be putrefyed & rotten, than the described medicines are of no use, but you must of necessity lay bare the bone, either by incision, or else by an actual or potential cautery; but I had rather do it with an actual, for that it extracts the virulency impact in the bones, as also it hastens the abscess, or falling away of the corrupted bone. It shall be of a convenient figure to cauterise the bone, as, round, square or long. I usually, before the application of such a Caustick, first divide the flesh that lies over it with an incision knife, that so the pain may be the less, because the flesh cannot be burnt through but in a long time, by which the fire may come to the bone. But it will not be amiss, before we treat of this art, first to consider the nature of the rottenness of the bones. CHAP. XXVI. Why the bones become rotten, and by what signs it may be perceived. THat solution of Continuity which is in the bones, is called by Galen, Catagma. Gal. meth. 6. This usually is the cause of rottenness; for, bones that are grated, bruised, rend, perforated, broken, luxated, inflamed and despoiled of the flesh and skin, are easily corrupted; for despoiled of their covering, they are altered by the appulse of the air, which they formerly never felt, whence also their blood and proper nourishment is dried up and exhausted. Besides also, the sanies running down by reason of wounds and old ulcers, in process The frequent cause of the rottenness of bones. of time, fastens itself into their substance, and putrefies by little and little; this putrefaction is increased and caused by the too much use of oily and fatty medicines, as moist and suppurate things; for hence the ulcer becometh more filthy and malign, the flesh of the neighbouring parts groweth hot, is turned into pus, which presently falling upon the bone lying under it, inflames it. Lastly, the bones are subject Hip. lib. de ulc. & fract. Gal. lib. de tum. cont. nat. to the same diseases, as the flesh that lieth under them is; besides also according to Galen, the beginning of inflammation ofttimes proceeds from the bones; but they beat not, because, according to the opinion of the ancients, pulsation is a dolorificke motion of the Arteries, but the bones want sense. Which verily I cannot deny, but also we must confess that the membrane that encompasseth them, and the arteries that enter into their body, are endued with most exquisite sense. Wherefore the arteries compressed and waxing hot by reason of the inflamed bone, cause a sense of pain in the periostium, so that the patients complain of a dull and deep pain, as it were sunk into the substance of the bones. The rottenness or corruption Signs of the rottenness. is ofttimes manifest to the eye, as when the bone is laid bare, for than it varieth from the natural colour, and becomes livide, yellowish or black. Otherwise you may perceive it by touch, as by searching it with a probe, as when you meet with any inequality or roughness, or when by but gently touching it, your probe runs into the substance of the bone, as into rotten wood, for a bone is naturally hard, but being rotten, becomes soft. Yet hardness is not an infallible sign of a sound bone. Hardness is no infallible sign of sound bones. For I have seen rotten and bared bones, to have sometimes grown so hard, by the appulse of the air, that a Trepan could not, without a strong endeavour, enter them. Also the rottenness of the bone is known by the condition of the filth which flows forth of the ulcer, for it is not only more thin and liquid, but also more stinking. Furthermore, such ulcers have a soft, loose and watery flesh; besides also, they are untoward and rebellious to sarcotick & epuloticke medicines; to which if they chance to yield and be cicatrized, yet within a short while after the scar will relent of its own accord, for that nature, destitute of the firm and sound foundation of the bones, cannot build up a laudable and constant flesh. Neither is it sufficient that the Surgeon know certainly that the bone is rotten and corrupt, it is furthermore fit he know, whether this corruption be supersiciary, or pierce deep into the substance of the bone, that he may know how much of the bone must be scailed. For scailing is the The cure of a rotten bone. only cure of that which is corrupted; now it is scailed by that which dries exceedingly, and draws forth all the humidity, aswell the excrementitious, the author of the rottenness, as the alimentary. For thus it remains without blood and nourishment, and consequently life also; whence it must of necessity scaile or fall off, being destitute of the glue or moisture which joined it to the sound parts in vicinity and communion of life, like as leaves which fall away from the trees, the humidity being exhausted, by which, as by glue, they adhered to the boughs. For this purpose Catagmatick powders are prepared to amend the corruption which is only superficiary. ℞. pull. aloes, cretae combustae, pompholygos, an. ʒii. ireos flor. aristoloch. A catagmatick powder. rot. myrrh. cerussae, an. ʒi. pull. osteor. combust. ʒss. terantur sublitiss. fiat pulvis; let it be applied either alone by itself, or else with honey and a little aqua vitae. Also the following emplaster being applied, stirs up nature to the exclusion of the broken bones, and cleanseth the ulcers from the more gross and viscide sanies. ℞. cer. nov.. A desquamatory or scailing p●ai●er. Dios. 3. cap 78. res. pini, gum. ammon. & elemi, an. ʒvi. tereb. ℥ iii pull. mastic. myrrh. an. ℥ ss. aristol. rot. ireos flor. aloes, opopan. euphorb. an. ʒi. olei rosati quantum sufficit, fiat emplast. secundum artem. Euphorbium, according to Dioscorides, takes off the scailes of bones in one day. Hereto also conduceth Emp. de betonica. Or, ℞. olei caryophyl. ℥ ss. camph. ʒii. misceantur simul in mortario, & atere. But if that part of the bone which is corrupt cannot thus be taken away, then must you use the scailing Trepans and Scrapers described formerly in wounds of the head; especially if any more great or solid bone be foul. Furthermore the here described Trepan will be good to perforate the rotten bone in many places where it is corrupted, until, as it were, a certain bloody moisture issue forth at the holes; for thus it more freely enjoys the air, and also the force of the medicines admitted by these holes works more powerfully. A Trepan with two triangular bits & a pin to hold them in the stock: as also another Trepan having four. square & six-square bits convenient for to be used in the rottenness of greater bones. But if the rottenness be more deep, and the bone more hard, either by nature or accident, as by the occasion of the too long admission of the air, than the rotten scailes shall be cut off by the instruments described in wounds of the head, driving them into the bone with leaden mallets, lest the part should be too much offended or shaken with the blow. The scailes and fragments shall be taken forth with mullets, Signs that the rottenness is taken away. the signs that all the rottenness is taken away, are the solidness of the bone thereunder, and the bloody moisture sweeting out thereat. CHAP. XXVII. Of actual & potential Cauteries. BUT if the described remedies cannot take place, by reason of the malignity or magnitude of the rottenness, then must we come to actual Actual Cauteries to be preferred before potential. and potential cauteries. But I should rather approve of actual, because by strengthening the part, they consume the excrementitious humours wherewith it is overcharged, to wit, the matter of the Caries; which is not so effectually performed by potential cauteries. Yet are we ofttimes forced to use these, to please the patients which are terrified at and afraid of hot irons. Potential Potential Cauteries. Cauteries are aqua fortis, aqua vitrioli, scalding oil, melted sulphur and boiling, and the like; in pouring on of which I would have the Surgeon to be prudent and industrious, lest he should rashly violate the neighbouring sound parts by the burning touch of these things; which his temerity would cause vehement pains, inflammations and other horrid symptoms. For actual cauteries, their variety in figure is so great, that it cannot be defined, much less set down in writing; for they must be varied according to the largeness of the rottenness, and the figure and conformation of the fouled bones. Such as are more usual I have thought good here to delineate unto you, content only to admonish you thus much, that some of these work by pricking, some by cutting, some flatwise, and other some with their points made of the form of an Olive leaf. Sundry forms of actual Cauteries fit in all necessary cases of all parts. Other Cauteries. Other Cauteries for the same purpose. The following figure of a Cautery is fit for virulent knots that arise in the scull, when you desire to take away the flesh that covers the bone; for this purpose it is made hollow and sharp in a triangular and quadrangular form, divided as it were into three branches, that you may so make use of which you please. The figure of a hellow and cutting Cautery. The Cauteries whose forms are hereafter expressed take place in rotten bones that lie deep in, wherein you cannot make use of the formerly described without touching of the neighbouring sound parts. To avoid which danger you shall put your Cautery even to the bone through an iron pipe, which may keep the neighbouring and fleshy parts from burning. Actual Cauteries with their pipes. Great discommodities ensue upon too rash, that is, too frequently applied Cauteries, or too long adhering to the bone; for by this immoderate and fiery heat not only the excrementitious humidity of the rotten bone is consumed, but also the radical and substantial moisture of the part is exhausted, wherein alone nature, endeavouring to cast off the corrupt scailes, and sever the sound from the rotten bone, and to substitute flesh, stands and consists. Whereof, the measure of applying of Manner of applying of Cauteries. Cauteries ought to be taken from the greatness of the rottenness, and the excrementitious, or after a manner foaming humidity sweeting through the pores of the bone. But before you press your cautery into the rotten bone which lies very deep in, as that which happens in the thigh bone, and upon other very fleshy parts, you must diligently defend the neighbouring, sound and fleshy parts, as it were with a covering, for that the humour diffused by the touch of the fire, burns the other places whereunto it diffuseth itself like scalding oil. After the cauterization you must help forwards the falling away of the scailes, by sometimes dropping in our oil of whelps, being made scalding hot. This oil, though very fit for this Oil of whelps helps forwards the casting off of scailes. purpose, yet do I not judge it fit to use it too often, it may suffice to have dropped it in some twice or thrice. For at length it may violate the found bone, that lies under the rotten, by the oily, subtle and moist substance. Furthermore, a bone is the most dry part of the body, therefore unctuous and moist medicines are contrary to its temper and consistence. But it conduceth often and gently to move the scailes already beginning to separate themselves, and it hastens the slackness of nature in casting them off. Yet may you not use force, unless peradventure when as they hang as it were by a slender thread; otherwise if the unwary Surgeon forcibly pluck A caution in moving the scailes of burnt bones. away the scailes before that nature hath put a cover upon the sound bone, he shall give way to a new alteration and foulness by the appulse of the air. Furthermore, after the corrupt scaile is falling off by the force of nature expelling it, you must have diligent heed that you put not eating or corroding medicines upon the bone that is under it; for thus thou shalt consume or waste the flesh which nature hath generared thereupon, which composed of newly concreted blood, is like in softness to newly curdled milk, which otherwise in time would grow into a more solid and hard consistence. This undergrowing flesh by little and little thrusts the rotten bone above it, out of its place, and is the cause of the scailing thereof; it is at the first gathered together like the grains of a pomegranate, with a red, smooth and equal sanies, and not stinking, and at length it casts forth a white matter. Therefore than we must rather straw thereon Cephalick powder composed of such things as have a faculty Cephalick powders of what composed. to dry without biting, such as are Orris roots, washed aloes, mastic, myrrh, barley flower, and the like. Lastly, it must be cicatrized; it is better that scailes of bones fall away of themselves by the only force of nature, than to be plucked away by the force of medicines or instruments; because, such as are too violently and forcibly plucked away, leave corners like to fistulous ulcers. Neither ought the corrupted membranes when they are turned into pus to be plucked away too violently, or to be touched by too acride medicines; for pain hereupon arising, hath divers times caused inflammation, convulsion and other pernicious symptoms. Therefore it is better to commit this business to nature, which in success of time, by making use of the expulsive faculty, will easily free itself from this rotten substance; for that which is quick as far as it is able, will still put away that which is dead from it. CHAP. XXVIII. Of a unluerary potion. BUt if the contumacious rottenness of the bone and also a rebellious ulcer shall not yield to the described remedies, it will be convenient to prescribe a vulnerary potion to the patient. For nature helped by such a potion, hath to my knowledge sundry times done wondrous things, in the amendment of corrupt bones, and consolidation of ulcers. For these potions though they do not purge the noxious humours away by stool, yet are they wondrous The use of vulnerary potions. effectual to cleanse ulcers, and free them from the excess of excrementitious humours, to cleanse the blood, and purge it from all impurity, to agglutinate broken bones, and knit the sinews. I have here thought good to speak of them, and chiefly, for that they were much commended by the Ancients, but neglected by the modern Physicians and Surgeons. But if the cure of wounds and old ulcers be performed by detersion, and the reposition of the lost substance, what medicine can sooner or rather do it than that, which by its admirable and almost divine force so purgeth the blood, that thereof, as from a fit and laudable matter, the flesh or any other lost substance may be fitly restored, and the part recover its former union? But if fistulous Ulcers, Cancers, Gouts & the like diseases be offended by the use of salt, spiced, acride meats and others which are of subtle parts, as mustard, onions and garlic, or any other excess in meat, or drink; why may they not become mild and gentle by medicated and contrary meats and drinks, or at least be reduced to a more equal temper? Therefore that Surgeons may know of what things such compositions may arise, I have here thought good to reckon them up, that you may learn what they are. Scabious. Sanicle. Bugle. Mous-eare. Burnet. Madder. tansy. Tops of hemp. Tops of Brambles. Sow's bread. Comfory the greater and lesser. Vervine. Bistorte. Mugwurte. Periwinkle. Centaury. Adder's tongue. Betonie. Carduus benedictus. The cordial flowers. Aristolochia, or Birth-wurts. Speedwell. agrimony. The capillaryes. Herb Robert. Dove's foot. Dog's tongue. Avenes. Prunella. Osmund. Clarye. Gentian. Herniaria. Red Colewurt or Cabbage. Scordium. Cat's mint. Cinque foil. River Crabs. Mace. Bole armenick. Petum or Tobacco. Mead-sweet. Colts-foot. Dandelion. Plantain. St. John's wurte. Of all these the Surgeon shall make choice according to the mind and judgement of the Physician, such as he shall think fit and proper to every ulcer or wound, or to each wounded and ulcerated part, according to the condition of the time, the temper of the patient and kind or nature of the disease. You may make drinks not only of the decoctions of these, but also of their juices in white wine, or oenomel, which are good not only to purify the mass of the blood, to cleanse sanious, virulent, filthy and dissenterious ulcers, but also to drive away putrefaction, scail bones, dissolve clotted blood in bruises, to draw, pluck out and exterminate all strange bodies, as I have often observed to my great admiration. They are composed usually after this manner. ℞. savic. bugul. scabios. beton. scored. nepet. an. m. 〈◊〉. uvar. mund. sem. hyper. The form of a vulnerary potion. & card. ben. an. ℥ i. trium flor. cord. an. p. two. coquantur complete in aq. communi; postea in fine add vini alb. mell. ros. & cinnam. quod sufficit, fiat decoctio, coletur per manicam. Let him drink ℥ iii in the morning 3. hours before dinner. You may also with good success make injections with the same liquor into fistulous and sinuous ulcers, as also to wash the sordid ulcers therewith. You may also boil the same simples, as herbs, flowers and seeds in the patient's broths, that so they may acquire a medicinable and nourishing faculty. For the time of the affect, wherein you may with good success make use of these, we have read in Guido, that he used not to prescribe these potions to his patients when as they were newly wounded, for that they commonly are composed of things hot and opening, which heat and attenuate the blood, whence there would In what time of the disease they are chiefly to be used. be danger of a defluxion, upon the affected part. Wherefore when the matter is come to suppuration, when as there nothing remains, but to cleanse the ulcer and fill it with flesh, no inflammation as now remaining in the part, I judge these potions may then be used with good success. CHAP. XXIX. Of Tetters, Ringworms or Chaps occasioned by the Lues venerea. UPon the cure of the Lues venerea, usually Tetters and Chaps happen thereupon, which make furrows in the palms of the hands & soles of the feet. They acquire their matter from salt phlegm, or adust choler, or the relics of the venereous virulency sent thither. The cure especially when as the disease is grown old, is difficult, by reason that the humour hath long accustomed to flow that way, & for that it hath corrupted the habit of the part by the continual defluxion; but the cure is more easy if the disease be newly bred. Now you may know it is newly bred by the redness, accompanied by a great itching, and not only Signs of the new bred disease. a dryness of the skin, but also a thickness & denseness thereof. That which is old, besides these forerecited signs, have scaily & branlike hardnesses conjoined therewith, which by scratching & rubbing cast off scailes. For general medicines, the distemper The cure of newly come Tetters. of the liver & habit of the body must be corrected, which by the occasion of the former disease & remedies apt to inflame the blood, cannot but much swerve from their native temper. This may be done by diet conveniently appointed, by purging and altering medicines, bleeding, bathing, applying of cupping-glasses and horns. For topic or particular medicines, wash such as are newly or lately bred with the following water which dries and is of subtle parts. ℞. aq. ros. & pariet. an ℥ i. aq. alum. ℥ two. calc. ʒii. A water drying virulent tetters. alum. ʒiii. pull. subls. ℈ iiii. fiat lent. et minim. ebul. in baln. mar. This water shall be made more or less forcible according to the condition of the disease. Or, ℞. ol. tart. ℥ two. s●p. come. ℥ iv. misc. fiat unguent. ad usum. If the Physician shall think good, let the patient use a decoction of Guajacum, but that very weak. But old Tetters and Chaps must be The cure of old tetters. softened with emollient, attenuating and inciding decoctions, as also with liniments, ointments and plasters having the same effect. Then let the residue of the cure be performed by fumigations, such as this which follows. ℞. pull. cinab. ℥ two. lad. ass. odor. stirac. A Fumigation. call. an. ℥ ss. anʒiii. olei tart & theriac. q. s. fiant trochisci; use at each time some ℥ ss. of them, and let only the affected parts receive the smoke. Some commend the rubbing of the hands with the following medicine. Take the ashes of wine lees, make thereof a lie, & strain it though an hippocras bag, than put thereto some rennet, let them be well mixed together in a mortar, and herewith let the hands be rubbed or washed. Or, ℞. unguent. enul. ℥ iii fugit. ℥ two. Or else, ℞. res. pini, ℥ i. cerus. ℥ ss. argent. viv. A Lineament. ʒiii. succi citri & lapath. acut. an. ℥ ss. Let them be incorporated & make a lineament to be used to the part. If to this you add sublimate so washed & prepared, as women use for their faces, you shall make it more effectual. Others take burnt alum made into powder, and incorporated with the yolk of an egg, the juice of Citrons, and a little aloes dissolved in exymel scilliticum. CHAP. XXX. Of curing the Lues Venerea in infants and little children. Infants ofttimes conceive the seeds of this disease in the wombs of their mothers, and are borne infected therewithal, pustles presently arising over all the bodies, infecting with the like disease as many nurses as give them suck; they scarce ever recover thereof, for that they contracted the disease from their first conformation. But such as are somewhat bigger, if they chance to catch the disease after they are born by sucking some infected nurse, or by any other occasion or kind of contagion, often times receive cure. For first, you shall cause the nurse to use the aqua theriacalis hereunder described, for the space of 20 or more days, that so she may the better arm herself against the contagion of this disease, The cure. & yield milk which may have the faculty both of meat and medicine; she shall be careful as often as she gives the child suck, to wash and dry her teat or pap, lest the virulency that the child breathes out at his mouth, be impact in the little holes of the teat through which the milk flows out. Now the pustules of little children shall be anointed with some ointment that receives argentum vivum in some small quantity, as unguentum enulatum cum mercurio, or the like. Then shall it be swathed or bound up in swaths and clothes aired with the formerly described fumigations. For the rest, it shall be kept as warm as you can in some warm place. These & the like must be done not in one continued course, but at several seasons, otherwise it is to be feared, that it would cause ulcers to arise in the mouth, or else salivation. If any ulcers arise in the mouth and spread therein, they shall be touched with the formerly described waters, but made somewhat weaker, having regard to the tender age of the patient; if the infant shall get this disease of its nurse, let the nurse be presently changed, for it being otherwise nourished with tainted and virulent blood, can never be healed. Many have by these means recovered; but such as have perished, have not perished by the default of medicines, but by the malignity and vehemency of the disease. A description of the aqua Theriacalis, or treacle water formerly mentioned. ℞. rasur. interior. ligni sancti gummosi, lb two. polypod. querni, ℥ iv. vini albi dulcedinis expertis lb two. aqua font an. puriss. lb viii. aquar. cichor. & fumar. an. ℥ iv. sem. junip. A treacle water heder. & baccar. lauri an. ℥ two. caryophil. & macis, an. ℥ ss. cort. citri saccharo conduit. cons. ros. anthos, cichor. buglos. borag. an. ℥ ss. cons. anulae camp. theriac. vet. & mithrid. an. ℥ two. distil them all in balneo Mariae after the following manner. Let the Guajacum be infused in equal parts of wine and the forementioned waters for the space The manner of making it. of twelve hours, and the residue of the things in that which remains of the same wine and waters for six hours' space, beating such things as may require it, then let them be mixed altogether, that so the liquor may be endued with all their faculties. Which that it may be the more effectually performed, let them be boiled, put up in glass bottles closely stopped for some three or four hours' space, in a large kettle filled with boiling water, then let them be put into a glass alembicke, and so distilled. Give ℥ iv. of this distilled liquor at once, being aromatized with ʒi. of cinnamon, and ℈ i. of Diamargariton, and ℥ ss. of sugar, to give it a pleasing taste. Such a drink doth not only retunde the virulency of the Lues venerea, but strengthens the noble parts. Rondeletius makes an aqua theriacalis after this manner. ℞. theriac. vet: lb i acetoes. m iii rad. gram. ℥ iii puleg. card. ben. an. m two. flor. chamaem. p two. temperentur Rondeletius his Treacle water. omnia in vino albo, & distillentur in vase vitrio: reserve the water for use; whereof let the patient take ℥ two. with ℥ iii of sorrel and bugloss water: he wisheth this to be done when he shall enter into bed or a stove; for so this distilled liquor will cause sweat more easily, and mitigate pain, whether given by itself, or with a decoction of Grommell, or of chyna, or burre-docke roots; yet if the patient be of a phlegmatic constitution, he shall use a decoction of Guajacum in stead of a decoction of chyna, for it penetrates more speedily, by reason of its subtlety, of parts, and also expels the dolorificke matter. The End of the Nineteenth Book. OF THE SMALL POCKS AND MEASLES: AS ALSO OF WORMS AND THE LEPROSY. THE TWENTIETH BOOK. CHAP. I. Of the causes of the Small Pocks and Measles. FOR that the small Pocks and Measles are diseases, which usually are forerunners and foretellers of the plague, not only by the corruption of humours, but oft times by default of the air; moreover, for that worms are oft times generated in the plague, I have thought good to write of these things, to the end that by this treatise the young Surgeon may be more amply and perfectly instructed in that pestilent disease. Also I have thought good to treat of the Leprosy as being the offspring of the highest corruption of humours in the body. Now the small pocks are pustles, and the meazels spots which arise in the top of the skin by reason of the impurity of the corrupt blood sent thither by What the small pocks and Measles are. Their matter. the force of nature. Most of the Ancients have delivered that this impurity is the relics of the menstruous blood remaining in the body of the infant, being of that matter from whence it drew nourishment in the womb, which lying still or quiet for some space of time, but stirred up at the first opportunity of a hotter summer, or a foutherly or rainy season, or a hidden malignity in the air, and boiling up, or working with the whole mass of the blood, spread or show themselves upon the whole surface of the body. An argument hereof is, there are few or none who have not been troubled with this disease, at lest once in their lives, which when it begins to show itself, not content to set upon some one, it commonly seizeth upon more: now commonly there is as much difference between the small pocks and measles, as there is between a Carbuncle and a pestilent Bubo. For the small pocks arise of a more gross and viscous matter, to wit, of a phlegmatic humour. But the measles of a more subtle and hot, that is, a choleric matter, therefore this yields no marks thereof, but certain small spots without any tumour, and these either red, purple, or black. But the small pocks are extuberating pustles, white in the midst, but red in the circumference, an argument of blood mixed with choler, yet they are scarce known at the beginning, that is, on the first or second day they appear; but on the third and fourth day they bunch out and rise up into a tumour, becoming white before they turn into a scab; but the measles remain still the same. Furthermore the small pocks prick like needles by reason of a certain acrimony, and cause an itching; the measles do neither, either because the Why the Measles do not itch. matter is not so acride and biting, or else for that it is more subtle, it easily exhales, neither is it kept shut up under the skin. The patients often sneeses when as these matters seek passage out, by reason of the putrid vapours ascending from the lower parts upwards to the brain. They are held with a continual fever, with pains in their backs, itching of their nose, headache, and a vertiginous heaviness, and with a kind of swooning or fainting, a nauseous disposition, and vomiting, a hoarseness, difficult and frequent breathing, an inclination to sleep a heaviness of all the members their eyes are fiery and swollen, their urine reduce and troubled. For prognostickes, we may ruley say thus much. That the matter whence this affect takes its original, partakes of so malign, pestilent and contagious a quality, that not Prognostickes. content to mang●e and spoil the fleshy parts, it also eats and corrupts the bones, like the Lues venerea, as I observed not only in Anno Dom. 1568. but also in divers other years, whereof I think it not amiss to set down this notable example. The daughter of Claude Piquè bookseller, dwelling in S. James his street at Paris, A history. being some four or five years old, having been sick of the small pocks for the space of a month, and nature could not overcome the malignity of the disease, there rose abscesses upon the sternon and the joints of the shoulders, whose eating and virulent matter, corroded the bones of the sternon, and divided them insunder; also it consumed a great part of the top of the shoulder-bone, and the head of the blade-bone: of this thing I had witnesses with me, Marcus Myron physician of Paris, and at this present the King's chief physician, John Doreau Surgeon to the Conte de Bryane, the body being dissected in their presence. Also you may observe in many killed by the malignity of this disease, and dissected, that it causeth such impression of corruption in the principal parts, as brings the dropsy, ptisick, a hoarseness, Asthma, bloody flux ulcerating the guts, and at length bringing death, as the pustles have raged or reigned over these or these entrailes, as you see them to do over the surface What grievous and pernicious symptoms may happen by the small pocks. of the body; for they do not only molest the external parts, by leaving the impressions and scars of the pustles and ulcers, rooting themselves deep in the flesh, but also oft times they take away the faculty of motion, eating asunder, and weakening the joints of the elbow, wrest, knee and ankle. Moreover sundry have been deprived of their sight by them, as the Lord of Guymenay, others have lost their hearing, and other some their smelling, a fleshy excrescence growing in the passages of the nose and ears. But if any relics of the disease remain, and that the whole matter thereof be not expelled by the strength of nature, than symptoms afterwards arise, which savour of the malignity of the humour, yea and equal the harm of the symptoms of the Lues venerea. CHAP. II. Of the cure of the Small Pocks and Measles. THe cure of this disease useth to be divers, according to the condition of the humour free from, or partaker of the venenate quality. For if it partake The cure. of malignity, and the child be a sucking child, such things shall be given to the Nurse as may infringe and overcome the strength of the malignity, as we shall show more at large, when we come to treat of the cure of children which are sick of the plague; howsoever it be, the child must be kept in a warm room free from wind, and must be wrapped and covered with scarlet clothes, until the pocks come forth. There shall be provided for the Nurse medicated broths with purslane, lettuce, 〈◊〉, succory, borage, and French barley bound up in a cloth. She shall shun all salt, spiced and baked meats, and in stead of wine drink a decoction of liquerice, raisons and sorrel roots. She shall also take purging medicines, as if she were sick of the same disease, that so her milk may become medicineable. Lastly, she shall observe the same diet as is usually prescribed to such as have the plague. You shall give the child no pap, or if you give it any, let it be very little. But if the child be weaned, let him abstain from flesh, until the fever The child must have no pap. have left him, and the pocks be fully come forth: in stead of flesh let him feed on barley and almond creames, chicken broths, wherein the forenamed herbs have been boiled, pomadoes, jellies, culasses, prunes and raisins. Let his drink be a ptisan made of French barley, grass and sorrel roots, or with a nodula containing the four cold seeds, the pulp of prunes and raisins, with the shave of Ivory and harrs-horne; Between meals the same decoction may be mixed with some syrup of violets, but not of roses or any other astringent syrup, lest we hinder the course and inclination of the humour outwards. Let his sleep be moderate, for too sound sleep draws back the matter to the centre, and increaseth the fever; you must neither How sound sleep doth harm in this disease. Of purging, bleeding, and sudorifickes.. purge, nor draw blood the disease increasing or being at the height, unless peradventure there be a great plenitude, or else the disease complicate with other, as with a pleurifie, inflammation of the eyes, or a squinancy which require it, lest the motion of nature should be disturbed; but you shall think it sufficient to lose the belly with a gentle clyster: but when the height of the disease is over, and in the declension thereof. you may with Cassia or some stronger medicine evacuate part of the humours and the relics of the disease. But in the state and increase it is better to use sudorificks, which by attenuating the humours and relaxing the pores of the skin may drive the cause of the disease from the centre to the circumference, which otherwise residing in the body might be a cause of death; as I and Richard Hubert A history. observed in two maids, whereof one was four, and the other seventeen years old; for we dissecting them both being dead, found their entrailes covered with scabby or crusted pustles, like those that break forth upon the skin. We must not think that ableeding at nose at the beginning of the disease, or in the first four or five days should carry away the matter and original of the disease, for nevertheless the pocks will come forth; but for that this is a true and natural crissis of this disease, as that which is carried to the surface and circumference of the body, such bleeding must not be stopped, unless you fear it will cause downing. The matter shall be drawn out with a decoction of figs, husked lentils, citron seeds, the seeds of fennel, parsley, A sudorificke decoction. smallage, roots of grass, raisins and dates. For such a decoction, certainly if it have power to cause sweat, hath also a faculty to send forth unto the skin the morbificke humour; the seeds of fennel and the like opening things relax and open the pores of the skin; figs lenify the acrimony of the matter, and gently cleanse, the lentils keep the jaws and throat, and all the inward parts from pustles, and hinder a flux by reason of their moderate astriction, but having their husks on, they would bind more than is required in the disease; dates are thought to comfort the stomach, and citron seeds to defend the heart from malignity, liquerice to smooth the throat, and hinder hoarseness and cause sweat. But these things shall be given long after meat, for When it is best to procure sweat. it is not fit to sweat presently after meat; some there be who would have the child wrapped in linen clothes steeped in this decoction being hot, and afterwards hard wrung forth. Yet I had rather to use bladders or sponges, or hot bricks for the same purpose; certainly a decoction of millet, figs and raisins, with some sugar, causeth sweat powerfully. Neither is it amiss whilst the patient is covered in all other parts of his body, and sweats, to fan his face, for thus the native heat is kept in & so strengthened, and fainting hindered, and a greater excretion of excrementitious humours caused. To which purpose you may also put now and then to the patient's nose a nodulus made with a little vinegar & water of roses, camphire, the powder of sanders, and other odoriferous things which have cooling faculty, this also will keep the nose from pustles. CHAP. III. What parts must be armed against, and preserved from the Pocks. THe eyes, nose, throat, lungs, and inward parts ought to be kept freer from the eruption of pustles than the other parts; for that their nature and consistence is more obnoxious to the malignity of this virulency, and they are easilyer corrupted and blemished. Therefore lest the eyes should be How to defend the eyes. hurt, you must defend them when you first begin to suspect the disease, with the eyelids, also moistening them with rose-water, verjuice or vinegar, and a little Camphire. There are some also who for this purpose make a decoction of Sumach, berbery-seeds, pomegranate pills, aloe, sand a little faffron; the juice of sour pomegranates, and the water of the whites of eggs dropped in with rose-water, are good for the same purpose; also woman's milk mixed with rose-water and often renewed, and lastly, all such things as have a repercussive quality. Yet if the eyes When the eyes must●… be the fended by repercussives only. be much swollen and red, you shall not use repercussives alone, but mix therewith discussers and cleansers, such as are fit by a familiarity of nature to strengthen the sight; and let these be tempered with some fennel or eye-bright water. Then the patient shall not look upon the light or red things for fear of pain and inflammation; wherefore in the state of the disease when the pain and inflammation of the eyes are at their height, gently drying and discussive things properly conducing to the eyes are most convenient, as washed aloes, tuttye and Antimony in the water of fennel, eye bright and roses. The formerly mentioned nodulus will preserve the How to defend the nose. nose, and linen clothes dipped in the foresaid astringent decoction, put into the nostrils and outwardly applied. We shall defend the jaws, throat and throttle, How the mouth and preserve the integrity of the voice by a gargoyle of oxycrate, or the juice of sour pomegranates, holding also the grains of them in their mouths, & often rolling them up & down therein, as also by nodulas of the seeds of psilium, quinces & the like cold & astringent things. We must provide for the lungs & respiration by syrupes of jujubes, How the lungs. violets, roses, white poppyes, pomgranats, waterlillies, and the like. Now when as the pocks are throughly come forth, then may you permit the patient to use somewhat a freer dier, and you must wholly busy yourself in ripening and evacuating the matter, drying and scailing them. But for the meazels, they are cured by resolution only, and not by suppuration; the pocks may be ripened by anointing them with fresh butter, by fomenting them with a decoction of the roots of mallows, lilies, figs, line-seeds and the like. After they are ripe, they shall have their How to prevent pock-arres. heads clipped off with a pair of sizzers, or else be opened with a golden or silver needle, lest the matter contained in them, should corrode the flesh that lies thereunder, and after the cure, leave the prints or pockholes behind it, which would cause some deformity; the pus, or matter being evacuated, they shall be dried up with unguent. rosat. adding thereto ceruse, lethargy, aloes and a little saffron in powder; for these have not only a faculty to dry, but also to regenerate flesh; for the same purpose the flower of barley and lupins are dissolved or mixed with rose-water, and the affected parts anointed therewith with a fine linen rag; some anoint them with the swath of bacon boiled in water and wine, then presently strew upon them the flower of barley or lupins, or both of them. Others mix crude honey newly taken from the comb, with barley flower, and therewithal anoint the pustles so to dry them; being dried up like a scurf or scab, they anoint them with oil of roses, violets, almonds, or else with some cream, that they may the sooner fall away, the pustles being broken; tedious itchings solicit the patients to scratch, whence happens excoriation and filthy ulcers, for scratching is the occasion of greater attraction. Wherefore you shall bind the sick child's hands, and foment the itching parts with a decoction of marsh mallows, barley and lupins, with the addition of some salt. But if it be already excoriated, then shall you heal it with unguent. albumcamphorat. adding thereto a little powder of Aloes or Cinnabaris, or a little desiccativum rubrum. But if notwithstnding all your application of repelling medicines, Remedies for excoriation. pustles nevertheless break forth at the eyes, then must they be diligently cured with all manner of Collyria, having a care that the inflammation of that part grow not to that bigness, as to break the eyes, & that which sometimes happens to drive them forth of their proper orbs. If any crusty ulcers arise in the nostrils, they may be dried and caused to fall away by putting up of ointments. Such as arise in the mouth, palate For the ulcers of the mouth and jaws. and throat, with hoarseness and difficulty of swallowing, may be helped by gargarisms made with barley water, the waters of plantain and chervil, with some syrup of red roses, or Diamoron dissolved therein; the patient shall hold in his mouth sugar of roses or the tablets of Elect. diatragacanth. frigid. The Pock-arres left in To help the unsighrly scars of the face. the face, if they bunch out undecently, shall be clipped away with a pair of sizzers, and then anointed. with fresh unguent. citrin. or else with this lineament. ℞. amyli triticei, & amygdalarum excorticatarum, an. ʒiss. gum. tragacanth. ʒss. seminis melonum, fabarum siccarum excorticat. farinae hordei, an. ℥ iiii. Let them all be made into fine powder, and then incorporated with rose-water, and so make a lineament, wherewith anoint the face with a feather; let it be wiped away in the morning, washing the face with some water and wheat bran; hereto also conduceth lac virginale; Goose, ducks and Capon's grease are good to smooth the roughness of the skin, as also oil of lilies; hares blood of one newly killed and hot is good to fill and plain, as also whiten the Pock-holes, if they be often rubbed therewith. In stead here of many use the swath of Bacon rubbed warm thereon; also the distilled waters of bean flowers, lily roots, reed-roots, egge-shels, and oil of eggs are thought very prevalent to waste and smooth the Pock-arres. A Discourse of certain monstrous creatures which breed against nature in the bodies of men, women, and little children, which may serve as an induction to the ensuing discourse of worms. As in the macrocosmos or bigger world, so in the microcosmos or lesser world there A comparison between the bigger and lesser world. The generation of wind in man's body. are winds, thunders, earthquakes, showers, inundations of waters, sterilities, fertilities, stones, mountains and sundry sorts of fruits and creatures thence arise. For who can deny but that there is wind contained shut up in Flatulent abscesses, and in the guts of those that are troubled with the colic? Flatulencies make so great a noise in divers women's bellies, if so be you stand near them, that you would think you heard a great number of frogs croaking on the night time: That water is contained Of water. in watery abseesses, and the belly of such as have the dropsy, is manifested by that cure which is performed by the letting forth of the water; in fits of Agues the whole body is no otherwise shaken and trembles, than the earth when it is heard to bellow, and felt to shake under our feet. He which shall see the stones which are taken Of stones. out of the bladder, & come from the kidneys and divers other parts of the body, cannot deny but that stones are generated in our bodies. Furthermore we see both Of fruits from the first conformation. men & women who in their face, or some other parts, show the impression, or imprinted figure of a cherry, plumb, service, fig, mulberry & the like fruit; the cause hereof is thought to be the power of the imagination concurring with the formative faculty, and the tenderness of the yielding and waxe-like embxyon, easy to be brought into any form or figure by reason of the proper and native humidity. For you shall find that all their mothers whilst they went with them have earnestly desired or longed for such things, which, whilst they have too earnestly agitated in their minds, they have trans-ferred the shape unto the child, whilst that they could not enjoy the things themselves. Now who can deny but that bunches on the back, and large wens resemble mountains? Who can gainsay, but that squalide sterility may be assimulated to the hectic dryness of wasted and consumed persons? and fertility deciphered by the body distended with much flesh and fat, so that the legs can scarce stand under the burden of the belly? But that divers creatures are generated in one creature, that is, in man, and that in sundry parts of him; the following histories shall make it evident. Hollerius tells that a certain Italian by frequent smelling to the herb Basill had a Lib. de morh. inter cap. I. Scorpion bred in his brain, which caused long and vehement pain, and at length death; therefore I have here expressed the figure of that Scorpion found when as his brain was opened. The figure of a Scorpion. It makes Hollerius conjecture of the cause and original of this Scorpion, probable for that Chrysippus, Dyophanes and Pliny write, that of basil beaten between two stones, and laid in the sun, therewill come Scorpions. Fernelius writes that in a certain soldier, who was flat nosed, upon the too long restraint or stoppage of a certain filthy matter that flowed out of the nose, that there Lib. 5. de part. morbis cap. 7. were generated two hairy worms of the bigness of ones finger, which at length made him mad, he had no manifest fever, and he died about the twentieth day: this was their shape, by as much as we can gather by Fernelius his words. The effigies of the worms mentioned by Fernelius. jews Duret a man of great learning and credit, told me that he had come forth with his urine, after a long and difficult disease, a quick creature, of colour red, but otherwise A history. like in shape a Millepes, that is, a Cheslope, or Hog-louce. The shape of a Millepes cast forth by urine. Count Charles of Mansfieldt, last summer troubled with a grievous and continual fever, in the duke of Guise's place cast forth a filthy matter at his yard, in the shape A history. of a live thing almost just in this form. The shape of a thing cast forth by urine. Monstrous creatures also of sundry forms are also generated in the wombs of Nicolaus Flor. Gord. lib. 7. c. 18. women; somewiles alone, otherwhiles with a mola, and sometimes with a child naturally and well made, as frogs, toads, serpents, lizzards: which therefore the Ancients have turmed the Lumbards' brethren, for that it was usual with their women, that together with their natural and perfect issue they brought into the world worms, serpents, and monstrous creatures of that kind generated in their wombs, for that they always more respected the deckling of their bodies, than they did their diet. For it happened whilst they fed on fruits, weeds and trash, and such things as were of ill juice, they generated a putrid matter, or certainly very subject to putrefaction and corruption, and consequently opportune to generate such unperfect Lib. error popul. creatures. Joubertus telleth that there were two Italian women, that in one month brought forth each of them a monstrous birth; the one that married a Tailor, brought forth a thing so little, that is resembled a Rat without a tail; but the other a Gentlewoman, brought forth a larger, for it was of the bigness of a Cat; both of them were black, and as soon as they came out of the womb, they ran up high on the wall, and held fast thereon with their nails. Licosthenes writes that in Anno Dom. 1494. a woman at Cracovia, in the street which taketh name from the holy Ghost, was delivered of a dead child, who had a serpen fastened upon his back, which fed upon this dead child, as you perceive by this following figure. The figure of a serpent fastened to a child. Levinus Lemnius. tells a very strange history to this purpose. Some few years agone Lib. de occuls. nat. mir. cap. 8. (saith he) a certain woman of the Isle in Flanders, which being with child by a Sailer, her belly swollen up so speedily, that it seemed she would not be able to carry her burden to the term prescribed by nature; her ninth month being ended, she calls a midwife, and presently after strong throws and pains, she first brought forth a deformed lump of flesh, having as it were two handles on the sides, stretched forth to the length and manner of arms, and it moved and panted with a certain vital motion, after the manner of sponges and sea-nettles; but afterwards there came forth of her womb a monster with a crooked nose, a long and round neck, terrible eyes, a sharp tail, and wonderful quick of the feet, it was shaped much after this manner. The shape of a monster that came forth of a woman's womb. As soon as it came into the light it filled the whole room with a noise and hissing, running to every side to find out a lurking hole wherein to hide its head, but the women which were present, with a joint consent fell upon it, and smothered it with cushions, at length the poor woman wearied with long travel, was delivered of a boy, but so evilly entreated and handled by this monster, that it died as soon as it was christened. Cornelius Gemma a Physician of Louvain, telleth that there were many very monstrous Lib. de divinis nature. charactcrismis. and strange things cast forth both upwards and downwards out of the belly of a certain maid of Louvain, of the age of fifteen years. Amongst the rest, she cast forth at her fundament, together with her excrements, a living creature some foot and half long, thicker than one's thumb, very like an eel, but that it had a very hairy tail; I have here given you the figure of the monster as it was expressed by him. The figure of a monster that came forth of a maid's belly. Master Peter Bark and Claude le Grand, Surgeons of Verdun, lately affirmed to A history. me that they cured the wife of a certain Citizen of Verdun, which out of an Abscess broken in the belly, cast forth a great number of worms, together with the quitture, and these were of the thickness of ones finger, with sharp heads, which so gnawed her guts, that the excrements for a long time came forth at the ulcer, but now she is perfectly recovered. Anthony Benenius a Physician of Florence telleth that one Menusierus●…an ●…an A history. of forty years of age, troubled with continual pains at his stomach, was 〈◊〉 at the point of death, neither found he any help by the counsels of many Physicians which he used. At length coming to have his advice, he gave him a vomit, by means whereof he cast up a great quantity of corrupt and putrid matter, yet was he not thereby eased of his pain. Therefore he gave him another vomit, by force whereof he cast up much matter like to the former, and together therewith a worm of four fingers long, having a red round head, of the bigness of a great pease, covered over the body with a soft downiness, with a worked tail, in manner of an half moon, going upon four feet, two before, and two behind. The figure of a work cast forth by vomit. Why should I mention the prodigious bodies which are found in Abscesses, as The efficient & material auses of such things as are pretematurally generated in our bodies. stones, chalk, sand, coals, snaile-shels, straws, hay, horns, hairs, and many kinds of living and dead creatures? For there is nothing in the generation of these things (caused by corruption, preceded by much alteration) which may make us admire, or hold us in suspense, especially if we shall consider that nature, the fruitful parent of all things, hath put divers portions and particles of the universal matter whereof the greater world is composed into this microcosmos, or little world, man; whereby he might the rather seem to be made to the resemblance and form of the greater. Wherefore it so desports itself here, that it may counterfeit and resemble all the actions and motions which it useth to perform in the scene of the greater world, in this little one, if so be that matter be not wanting. CHAP. four Of the worms which use to breed in the guts. A Gross, viscide and crude humour is the material cause of worms, which How worms are generated. having got the beginning of corruption in the stomach, is quickly carried into the guts,, and there it putrefies, having not acquired the form of laudable Chylus in the first concoction. This, for that it is viscide, tenaciously adheres to the guts, neither is it easily evacuated with the other excrements; therefore by delay it further putrefies, & by the efficacy of heat, it turns into the matter and nourishment for worms. This alimentary humour being consumed, unless some fresh supply the want thereof, which may ease their hunger, they move themselves The reason that they sometimes come forth at the mouth. in the guts with great violence, they cause grievous and great pains, yea, and ofttimes they creep up to the stomach, and so come forth by the mouth, and sometimes they ascend into the holes of the palate, and come forth at the nose. Worms are of three sorts; for some are round & long, others broad and long, others short & slender. The first are called by the Ancients, Teretes, that is, round; for that they are The differences of worms. long and round. The second are named Teniae, for that their bodies are long & broad like a rowler or swath. The third are termed Ascarides, for that they commonly wrap themselves up round. Other differences of worms are taken from their colours, as red, white, black, ashcoloured, yellowish. Some also are hairy, with a great head like the little fish which the French call Chabot, we, a Millers-thumbe; in some diseases many worms are generated and cast forth by fundament, as small as hairs, and usually of colour white, and these are they which are called Ascarides. The diversity of colours in worms proceedeth not from the like distinct diversity of humours whereof they are generated. For the melancholic and choleric humour by their qualities are wholly unfit to generate worms. But this manifold variety in colour, is by reason of the different corruption of the chylous or phlegmatic humour whereof they are bred. The long and broad worms are oftentimes stretched alongst all the guts, being like to a mucous or albuminous substance, and verily I A history. saw one voided by a woman, which was like to a serpent, and some six foot long; which ought not to seem strange, seeing it is noted by the Ancients, that they have s●… worms so long, as the length of the whole guts, that is, seven times the length of ones body. Wicrus writes that he saw a country man who voided a worm eight foot and one inch long, in head and mouth resembling a Duck, which therefore A history. I have thought good here to express. The figure of a worm, generated in, and cast forth of the Guts. Valeriola affirmeth that he saw a worm above nine foot long. Now as worms differ in shape, so are their places of generation also different. For the round and In observat. long worms are commonly generated in the smaller guts, the rest in the greater, but especially the Ascarides: none breed in the stomach, as that which is the place of the first concoction. There truly the matter which breedeth these worms, gets the In what places of the belly worms are generated. first rudiment of corruption, but comes to perfection only in the guts; they breed in some infants in their mother's bellies, by the pravity and corrupt nature of the humour flowing from the mother for the nourishment of the child, which for that than they do not expel it by siege, it by delay putrefieth the more, and yields fit matter for the breeding of worms, as some have observed out of Hypocrates. Lastly, worms breed in people of any age that are Belly-Gods and given to gluttony, Ad finem lib. 4. de morbis. as also in such as feed upon meats of ill juice, and apt to corrupt, as crude summer fruits, cheese, and milke-meates. But to know in what part of the Guts the worms do lurk, you must note, that when they are in the small guts, the patients complain Signs of worms in the small guts. of a pain in their stomach, with a dogge-like appetite, whereby they require many and several things without reason, a great part of the nourishment being consumed by the worms lying there; they are also subject to often fainting, by reason of the sympathy which the stomach, being a part of most exquisite sense, hath with the heart, the nose itches, the breath stinks, by reason of the exhalations sent up from the meat corrupting in the stomach; through which occasion they are also given to sleep, but are now and then waked therefrom by sudden start and fears; they are held with a continued and slow fever, a dry cough, a winking with their eyelids, and often changing of the colour of their faces. But long and broad worms, being the innates of the greater guts, show themselves by stools replenished with many Signs of worms in the great guts. Signs of Ascarides. sloughs, here and there resembling the seeds of a Muskmelon or cucumber. Ascarides are known by the itching they cause in the fundament, causing a sense as if it were Ants running up and down; causing also a tenesmus, and falling down of the fundament. This is the cause of all these symptoms; their sleep is turbulent and often clamorous, when as hot, acride and subtle vapours, raised by the worms from the like humour and their food, are sent up to the head; but sound sleep by the contrary, as when a misty vapour is sent up from a gross and cold matter. They dream they eat in their sleep, for that while the worms do more greedily consume the chylous matter in the guts, they stir up the sense of the like action in the fantasy. They grate or gnash their teeth by reason of a certain convulsisick repletion, the muscles of the temples and jaws being distended by plenty of vapours. A dry cough comes by the consent of the vital parts serving for respiration, which the natural, to wit, the Diaphragma or midriff, smit upon by acride vapours, and irritated as though there were some humour to be expelled by coughing. These same acride fumes assailing the orifice of the ventricle, cause either a hicketting, or else a fainting, according to the condition of their consistence, gross or thin; these carried up to the parts of the face cause an itching of the nose, a darkness of the fight, and a sudden changing of the colour in the cheeks. Great worms are worse than little ones, red than white, living than dead, many than few, variegated than those of one colour, Why worms of divers colours are more dangerous. as those which are signs of a greater corruption. Such as are cast forth bloody and sprinkled with blood, are deadly, for they show that the substance of the guts is eaten asunder; for ofttimes they corrode and perforate the body of the gut wherein they are contained, and thence penetrare into divers parts of the belly, so that they have come forth sometimes at the Navel, having eaten themselves a passage forth, as Hollerius affirmeth. When as children troubled with the worms draw their breath with difficulty, and wake moist over all their bodies, it is a sign that death is at hand. If at the beginning of sharp fevers, round worms come forth alive, it is a sign of a pestilent fever, the malignity of whose matter they could not endure, but were forced to come forth. But if they be cast forth dead, they are signs of greater corruption in the humours, and of a more venenate malignity. CHAP. V. What cure to be used for the Worms. IN this disease there is but one indication, that is, the exclusion or The general indications of curing he worms. casting out of the worms, either alive or dead, forth of the body, as being such that in their whole kind are against nature; all things must be shunned which are apt to heap up putrefaction in the body by their corruption, such as are crude fruits, cheese, milke-meats, fishes, and lastly such things as are of a difficult and hard digestion, but prone to corruption. Pap is fit for children, for that they require moist things, but these aught to answer in a certain similitude to the consistence and thickness of milk, that so they may the more easily be concocted & assimulated, & such only is that pap which is made with wheat flower, not crude, but baked in an oven, that the pap made therewith may not be too viscide nor thick, if it should only be boiled in a pan as much as the milk would require; or else the milk would be too terrestrial, or too waterish, all the fatty portion thereof being resolved, the cheesy and whayish portion remaining, if it should boil so much as were necessary for the full boiling of the crude meat; they which use meal otherwise in pap yield matter for the generating of gross and viscide humours in the stomach, whence happens obstruction in the first veins and substance of the liver, by obstruction worms breed in the guts, and the stone in the kidneys and bladder. The patient must be fed often, and with meats of good juice, lest the worms through want of nourishment, should gnaw the substance of the guts. Now when as such things breed of a putrid matter, the patient shall be purged, and the putrefaction repressed by medicines mentioned in our treatise of the plague. For the quick kill and casting of them forth, syrup of Succory, or of lemons with Wherefore, and wherewith such as have the worms must be purged. rhubarb, a little Treacle, or Mithridate, is a singular medicine, if there be no fever; you may also for the same purpose use this following medicine. ℞. cornu cervi, pull. rasur. eboris, an. ʒ i ss. sem. tanacet. & contra verm. an. ʒ i fiat decoctio pro parva dofis, in colatur a infunde rhei optimi, ʒ i cinam. ℈ i. dissolve syrupi de absinthio ℥ ss. make a potion, give it in the morning three hours before any broth. Oil of Olives drunk, kills worms, as also water of knotgrass drunk with milk, and in like manner all bitter things. Yet I could first wish them to give a clyster made of milk, honey and sugar, without oils and bitter things, lest shunning thereof, they leave the lower guts, and come upwards, for this is natural to worms, to shun bitter things, and follow sweet things. Whence you may learn, that to the bitter things which you give by the mouth, you must always mix sweet things, that alured by the sweetness, they may devour them more greedily, that so they may kill them. Therefore I would with milk and Sugar, mix the seeds of centaury, rue, wormwood, aloes, and the like: harts-horne is very effectual against worms, wherefore you may infuse Hartshorn good against the worms. the shave thereof in the water or drink that the patient drinks, as also to boil some thereof in his broths. So also treacle drunk or taken in broth, killeth the worms; purslane boiled in broths, and destilled and drunk, is also good against the worms, as also succory and mints, also a decoction of the lesser house-leek and sebestens given with sugar before meat; it is no less effectual to put wormeseeds in their pap, and in roasted apples, and so to give them it. Also you may make suppositories after this manner, and put them up into the fundament. ℞. coralli subalbi, rasurae eboris, cornu cerviusti, ireos an. ℈ two. mellis albi ℥ two ss. aquae centi●odiae q. s. Suppositories against the Ascarides. adomnia concorporanda, fiant Glandes': let one be put up every day, of the weight of ʒ two. for children; these suppositories are chiefly to be used for Ascarides, as those which adhere to the right gut. To such children as can take nothing by the mouth, you shall apply cataplasms to their navells made of the powder of cummin seeds, the flower of lupins, wormwood, southern wood, tansy, the leaves of Artichokes, rue, the powder of coloquintida, citron seeds, aloes, arsemart, horse mint, peach leaves, Costus amarus, Zedoaria, soap and oxegall. Such cataplasms are oft times spread over all the belly, mixing therewith astringent things for the strengthening of the part, as oil of myrtles, Quinces and mastic; you may also apply a great onion hollowed in the midst, and filled with Aloes and Treacle, and so roasted in the embers, then beaten with bitter almonds, and an ox gall. Also you may make emplasters of bitter things, as this which follows. ℞. fellis bubuli, & sucei absinthii, an.. ℥ two. colocyn. ℥ i. terantur & misceantur simul, incorporentur cum farina lupinorum: make hereof an A plaster against the worms. emplaster to be laid upon the Navel. Liniments and ointments may be also made for the same purpose to anoint the belly, you may also make plasters for the navel of Pillulae Ruff. anointing in the mean time the fundament with honey and sugar, that they may be chafed from above with bitter things, and alured downwards with sweet things. Or else take worms that have been cast forth, dry them in an iron pan over the fire, then powder them, and give them with wine or some other liquor to be drunk, for so they are thought quickly to kill the rest of the worms. Hereto also conduceth the juice of citrons, drunk with the oil of bitter almonds, or salad oil. Also some make baths against this affect of wormwood, galls, peach leaves boiled in water, and then bathe the child therein. But in curing the worms, you must observe that this disease is oft times entangled with another more grievous disease, as an acute and burning fever, a flux or A caution. scouring, and the like, in which (as for example sake) a fever being present and conjoined therewith, if you shall give wormseeds, old Treacle, myrrh, aloes, you shall increase the fever and flux, for that bitter things are very contrary to the cure of these affects. But if, on the contrary, in a flux whereby the worms are excluded, you shall give coral, and the flower of Lentiles, you shall augment the fever, making the matter more contumacious by dry and astringent things. Therefore the Physician shall be careful in considering whether the fever be a symptom of the A fever sometimes a symptom and sometimes a disease. worms, or on the contrary it be essential, and not symptomaticke, that this being known, he may principally insist in the use of such medicines as resist both affects, as purging and bitterish in a fever and worms, but bitter and somewhat astrictive things in the worms and flux. CHAP. VI A short description of the Elephantiasis or Leprosy, and of the causes thereof. THis disease is termed Elephantiasis because the skin of such as are troubled therewith, is rough, scabious, wrinkled and unequal, like the skin of an Elephant. Yet this name may seem to be imposed thereon by reason of the greatness of the disease. Some from the opinion of the Arabians have termed it Lepra or Leprosy (but unproperly, for the Lepra is a kind of Scab and disease of the skin, which is vulgarly called Malum sancti manis) which word for the present we will use, as that which prevails by custom and antiquity. Now the Leprosy (according to Paulus) is a Cancer of the whole body, the which (as Avicen adds) corrupts the complexion, form and figure of the members. Galen thinks the cause ariseth from the error of the sanguifying faculty, through Lib. 4. cap. 1. Lib. 2. cap. 11. whose default the assimulation in the flesh and habit of the body is depraved, and much changed from itself, and the rule of nature. But ad Glauconem, he defines this disease, An effusion of troubled or gross blood into the veins and habit of the whole body. This disease is judged great, for that it partakes of a certain venenate virulency, depraving the members and comeliness of the whole body. Now it appears that the Leprosy partakes of a certain venenate virulency by this, that such There is a certain hidden virulency in the Leprosy. as are melancholic in the whole habit of their bodies, are not leprous. Now this disease is composed of three differences of diseases. First it consists of a distemper against nature, as that which at the beginning is hot and dry, and at length the ebullition of the humours ceasing, and the heat dispersed, it becomes cold and dry, which is the conjunct cause of this symptom. Also it consists of an evil composition or conformation, for that it depraves the figure and beauty of the parts. Also it consists of a solution of continuity, when as the flesh and skin are cleft in divers parts with ulcers and chaps: the leprosy hath for the most part 3. general causes, that is, the primitive, antecedent, & conjunct the primitive cause is either from the first conformation, or comes to them after they are born. It is thought to be in him from the first conformation, The primitive cause of a Leprosy. How they may be leprous from their first conformation. who was conceived of depraved & corrupt menstruous blood, & such as inclined to melancholy; who was begot of the leprous seed of one or both his parents, for leprous persons generate leprous, because the principal parts being tainted and corrupted with a melancholy and venenate juice, it must necessarily follow that the whole mass of blood and seed that falls from it, and the whole body should also be vitiated. This cause happens to those that are already born, by long staying & inhabiting in maritime countries, whereas the gross and misty air, in success of time, induceth the like fault into the humours of the body; for that, according to Hypocrates, such as the air is, such is the spirit, and such the humours. Also long abiding in very hot places, because the blood is torrified by heat, but in cold places, for that they incrassate, and congealing the spirits, do after a manner stupefie, may be thought the primitive causes of this disease. Thus in some places of Germany there are divers leprous persons, but they are more frequent in Spain and overall Africa, then in all the world beside, and in Languedoc, Provence and Guyenne, are more than in whole France besides. Familiarity, copulation, and cohabitation with leprous persons, may be reckoned amongst the causes thereof, because they transfer this disease to their familiars by their breath, sweat and spittle left on the edges of the pots or cups. This disease is also caused by the too frequent use of salt, spiced, acride and gross meats, as the flesh of Swine, Asses, Bears, Pulse, milke-meats; so also gross and strong wines, drunkenness, gluttony, a laborious life, full of sorrow and cares, for that they incraslate, and as it were burn the blood. But the retention of melancholy excrements, as the suppression of the haemorrhoids, courses, small pocks and meazells, as also a quartashe fever acoustomed to come at set times; the drying up of old ulcers, for that they defile the mass of the blood with a melancholy dross and filth. Now you must understand that the cause of the leprofic by the retention of the superfluities, happens because the corrupt blood is not evacuated, but regurgitates over the whole body, and corrupts the blood that should nourish all the members; wherefore the assimulative faculty cannot well assimilate by reason of the corruption and default of the juice, and thus in conclusion the Leprosy is caused. The antecedent causes are the humours disposed to adustion and corruption into melancholy by the torride heat; for in bodies possessed with such heat, The antecedent cause of a Leprosy. the humours by adustion easily turn into melancholy, which in time acquiring the malignity and corruption of a virulent and venenate quality, yields a beginning and essence to the leprosy. The conjunct causes are the melancholy humours which are now partakers of a venenate and malign quality, and spread over the whole The conjunct cause. How it comes to be deadly. habit of the body, corrupting and destroying it first by a hot and dry distemper, and then by a cold and dry, contrary to the beginnings of life. For hence inevitable death must ensue, because our life consists in the moderation of heat and moisture. CHAP. VII. The signs of a Leprosy, breeding, present, and already confirmed. THe disposition of the body and humours to a Leprosy is showed by the change of the native and fresh colour of the face, by that affect of the face, which is commonly called Gutta rosacea, red & blackish suffusions and pustles, the falling away of the hairs, a great thirst, and a dryness of the mouth both by night & day, a stinking breath, little ulcers in the mouth, the change of the voice to hoarseness, a desire of venery above nature and custom. Now there are four times of this disease, the beginning, increase, state and declension. The beginning is when as the malignity hath not yet gone further than the inner parts and bowels, The beginning of a Leprosy. whereupon the strength must needs be more languid. The increase is when as the virulency comes forth, & the signs & symptoms are every day increased in number & The increase. strength. The state is when as the members are exulcerated. The declension is, when as the aspect of the face is horrid, the extreme parts fall away by the profundity The state. The declension. and malignity of the ulcers, so that none, no not of the common sort of people, can doubt of the disease. According to the doctrine of the Ancients, we must in searching out of the signs of this disease being present, have chief regard to the head. For the signs of diseases more properly and truly show themselves in the face, by reason of the softness and rarity of the substance thereof, and the tenuity of the skin that covers it; wherefore a black and adust humour diffused thereunder, easily shows itself, and that not only by the mutation of the colour, but also of the Character and bulk, and oft times by manifest hunting it. Wherefore you must observe in the head whether it have scaules, and whether in the place of those hairs that are fallen away, others more tender, short and rare grow up, which is likely to happen through defect of fit nourishment to preserve and generate hairs, through corruption of the hairy scalp that should be stored with such nourishment, and of the habit itself, and through the unfitness thereof to contain hairs; lastly by the acrimony of the vapours sent up from the adust humours and entrailes, fretting asunder the roots of the hairs. But if not only the hair, but also some portion of the skin The first sign of the Leprosy. and flesh about the roots of the hair, come away by pulling, it is an argument of perfect corruption: let this therefore be the first sign of a leprosy. A second & very certain sign is, a numerous & manifest circumscription of round and hard bushes II. or pustles under the kickshaws, & behind the ears and in several places of the face, resembling round and hard kernels, occasioned by the default of the assimulating faculty. The cause of this default is the grossness of the flowing nourishment, by which means it being impact, and stopping in the straightness of the way, it grows round at it were compassed about in the place whereas it sticks, and by the means of the crudity, for that it is not assimulated, and by delay, it is further hardened. The third sign is, the more contract and exact roundness of the ears, their grossness, and as it were grainy spissitude or densenesse, the cause of their roundness is the consumption of the flappes & fleshy part through want of nourishment, and excess of heat; but the occasion of their grainy spissitude is the grossness of the earthy nourishment flowing thither. The fourth sign is a lion-like wrinkling of the forehead, which is the four Why it is called morbus leoninus. reason that some term this disease morbus leoninus; the cause hereof is the great dryness of the habit of the body, which also is the reason that the bark of an old oak is rough and wrinkled. The fifth is, the exact roundness of the eyes, and their fixed and V. immovable steadiness; verily the eyes are naturally almost round, yet they appear obtuse and somewhat broad on the foreside, but end in a Conus on the hind part, by reason of the concourse and figure of the muscles and fat investing them. Therefore these being consumed either through defect of laudable nourishment, or else by the acrimony of the flowing humour, they are restored to their proper figure & roundness. Now the muscles which moved the eyes being consumed, and the fat which facilitated their motion wasted, it comes to pass that they stand stiff and unmoveable, being destitute of the parts yielding motion, and the facility thereof. The sixth sign VI is, the nostrils flat outwardly, but inwardly straight and contracted, that is, an earthy & gross humour forced from within outwards, which swells the sides or edges of the nostrils; whence it is, that the passages of the nose appear as it were obstructed by the thickness of this humour; but they are depressed and flatted by reason of the rest of the face and all the neighbouring parts swollen more than their wont; add hereto that the partition is consumed by the acrimony of the corroding and ulcerating humour sent thither, which makes them necessarily to be depressed, & send forth bloody scabs. The seventh, is the lifting up, thickness and swelling of the lips, the filthiness, stink VII. and corrosion of the gums by acride vapours rising to the mouth; but the lips of Leprous persons are more swollen by the internal heat burning and incrassating the humours, as the outward heat of the Sun doth in the moors. The eighth sign is the VIII. swelling & blackness of the tongue, and as it were varicous veins lying under it; because the tongue, being by nature spongious and rare, is easily stored with excrementitious humours, sent from the inner parts unto the habit of the body: which same is the cause why the grandules placed about the tongue above and below, are swollen hard & round, no otherwise than scrofulous or meazled swine. Lastly, all their face riseth in red bunches or bushes, and is overspread with a dusky and obscure redness; the eyes are fiery, fierce and fixed, by a melancholic chachectick disposition of the whole body, manifest signs whereof appear in the face by reason of the forementioned causes; yet some leprous persons have their faces tinctured with a yellowish, others with a whitish colour, according to the condition of the humour, which serves for a Basis to the leprous malignity. For hence Physicians affirm that there are three sorts of Leprosies, one of a reddish black colour, consisting in a melancholic humour; another of a yellowish green, in a choleric humour; another in a whitish yellow, grounded upon adust phlegm. The ninth sign is a stinking of the breath, as also of IX. all the excrements proceeding from leprous bodies, by reason of the malignity conceived in the humours. The tenth is, a hoarseness, a shaking, harsh and obscure voice X. coming as it were out of the nose, by reason of the lungs, recurrent nerves, and muscles of the throttle tainted with the grossness of a virulent and adust humour; the forementioned constriction & obstruction of the inner passage of the nose; and lastly, the asperity and inequality of the weazon by immoderate dryness, as it happens to such as have drunk plentifully of strong wines without any mixture. This immoderate dryness of the muscles serving for respiration makes them to be trouled with a difficulty of breathing. The eleventh sign is very observable, which is a XI. Morphew or defaedation of all the skin, with a dry roughness and grainy inequality, such as appears in the skins of plucked geese, with many tetters on every side, a filthy scab, and ulcers not casting off only a branlike scurf, but also scailes and crusts. The cause of this dry scab, is the heat of the burning bowels & humours, unequally contracting and wrinkling the skin, no otherwise than as leather is wrinkled by the heat of the Sun or fire. The cause of the filthy scab & serpiginous ulcers, is the eating and corroding condition of the melancholy humour, and the venenate corruption, it also being the author of corruption, so that it may be no marvel if the digestive faculty of the liver being spoilt, the assimulative of a malign and unfit matter sent into the habit of the body cannot well nor fitly perform that which may be for the bodies good. The twelfth is, the sense of a certain pricking, as it were of goads or needles XII. over all the skin, caused by an acride vapour hindered from passing forth, and intercepted by the thickness of the skin. The thirteenth is a consumption and emaciation XIII. of the muscles which are between the thumb and forefinger, not only by reason that the nourishing and assimulating faculties want fit matter wherewith they may repair the loss of these parts, for that is common to these with the rest of the body, but because these muscles naturally rise up unto a certain mountainous tumour, therefore their depression is the more manifest. And this is the cause that the shoulders of leprous persons stand out like wings; to wit, the emaciation of the inner part of the muscle Trapezites. The fourteenth sign is the diminution of sense, or a numbness XIIII. over all the body by reason that the nerves are obstructed by the thickness of the melancholic humour hindering the free passage of the animal spirit, that it cannot come to the parts that should receive sense, these in the interim remaining free which are sent into the muscles for motions sake, and by this note I chiefly make trial of leprous persons, thrusting a somewhat long and thick needle somewhat deep into the great tendon endued with most exquisite sense, which runs to the heel, which, if they do not well feel, I conclude, that they are certainly leprous. Now, for that they thus lose their sense, their motion remaining entire, the cause hereof is that the nerves which are disseminated to the skin are more affected, and those that run into the muscles are not so much; & therefore when as you prick them somewhat deep, they feel the prick, which they do not in the surface of the skin. The fifteenth is the corruption XV. of the extreme parts possessed by putrefaction and a gangrene, by reason of the corruption of the humours sent thither by the strength of the bowels, infecting with the like tainture the parts wherein they remain: add hereto that the animal sensitive faculty is there decayed, and as often as any faculty hath forsaken any part, the rest presently after a manner neglect it. The sixteenth is, they are troubled with terrible XVI. dreams, for they seem in their sleep to see devils, serpents, dungeons, graves, dead bodies, and the like, by reason of the black vapours of the melancholy humour troubling the fantasy with black and dismal visions, by which reason also such as are bitten of a mad dog fear the water. The seventeenth is, that at the beginning and XVII. in the increase of the disease they are subtle, crafty and furious by reason of the heat of the humours & blood; but at length in the state and declension they become crafty and suspicious, the heat and burning of the blood and entrailes decaying by little and little; therefore then fearing all things whereof there is no cause, & distrusting of their own strength they endeavour by craft, maliciously to circumvent those with whom they deal, for that they perceive their powers to fail them. The eighteenth is, XVIII. a desire of venery above their nature, both for that they are inwardly burned with a strange heat, as also by the mixture of flatulencies therewith (for whose generation the melancholic humour is most fit) which are agitated, & violently carried through the veins and genital parts by the preternatural heat; but at length when this heat is cooled, and that they are fallen into a hot and dry distemper, they mightily abhor venery, which then would be very hurtful to them, as it also is at the beginning of the disease, because they have small store of spirits and native heat, both which are dissipated by venery. The nineteenth is, the so great thickness of their gross and livide XIX. blood, that if you wash it, you may find a sandy matter therein, as some have found by experience, by reason of the great adustion and assation thereof. The twentieth is, the languidnesse & weakness of the pulse (by reason of the oppression of the XX. vital and pulsifick faculty by a cloud of gross vapours). Herewith also their urine sometimes is thick and troubled, like the urine of carriage beasts, if the urenary vessels be permeable and free; otherwise it is thin, if there be obstruction, which only suffers that which is thin to flow forth by the urenary passages; now the urine is oftentimes of a pale ash-colour, and ofttimes it smells like as the other excrements do in this disease. Verily there are many other signs of the Leprosy, as the slowness of the belly by reason of the heat of the liver, often belchings by reason that the stomach is troubled by the reflux of a melancholy humour, frequent sneesing by reason of the fullness of the brain; to these, this may be added most frequently, that the face and all the skin is unctuous or greasy, so that water poured thereon, will not in any place adhere Why their faces seem to be greasy. thereto: I conceive it is by the internal heat dissolving the fat that lies under the skin, which therefore always looks as if it were greased or anointed therewith in leprous persons. Now of these forementioned signs, some are univocal, that is, which truly and necessarily show the Leprosy: othersome are equivocal or common, that is, which conduce as well to the knowledge of other diseases as this. To conclude, that assuredly is a Leprosy which is accompanied with all, or certainly the most part of these forementioned signs. CHAP. VIII. Of Prognostics in the Leprosy; and how to provide for such as stand in fear thereof. THe Leprosy is a disease which passeth to the issue, as contagious almost as Why the Leprosy is uncurable. the plague, scarce curable at the beginning, uncurable when as it is confirmed, because it is a Cancer of the whole body; now if some one Cancer of some one part shall take deep root therein, it is judged uncurable. Furthermore the remedies which to this day have been found out against this disease, are judged inferior and unequal in strength thereto. Besides, the signs of this disease do not outwardly show themselves before that the bowels be seized upon, possessed and corrupted by the malignity of the humour, especially in such as have the white Leprosy, sundry of which you may see about Bordeaux, & in little Britain, who notwithstanding inwardly burn with so great heat, that it will suddenly wrinkle and wither an apple held a short while in their hand, as if it had laid for many days in the Sun. There is another thing that increaseth the difficulty of this disease, which is an equal pravity of the three principal faculties whereby life is preserved. The deceitful and terrible visions in the sleep, and numbness in feeling, argue the depravation of the animal faculty; now the weakness of the vital faculty is showed by the weakness of the pulse, the obscurity of the hoarse and jarring voice, the difficulty of breathing, and stinking breath; the decay of the natural is manifested by the depravation of the work of the liver in sanguification, whence the first and principal The cure. cause of this harm ariseth. Now because we cannot promise cure to such as have a confirmed Leprosy; and that we dare not do it to such as have been troubled therewith but for a short space, it remains that we briefly show how to free such as are ready to fall into so fearful a disease. Such therefore must first of all shun all things in diet and course of life whereby the blood and humours may be too vehemently heated, Their diet. whereof we have formerly made some mention. Let them make choice of meats of good or indifferent juice, such as we shall describe in treating of the diet of such as are sick of the plague; purging, bleeding, bathing, cupping, to evacuate the impurity of the blood, and mitigate the heat of the liver, shall be prescribed by some learned Gelding good against the Leprosy. Physician Valesius de Tarenta much commends gelding in this case, neither do I think it can be disliked. For men subject to this disease may be effeminated by the amputation of their testicles, and so degenerate into a womanish nature, and the heat of the liver boiling the blood, being extinguished, they become cold & moist, which temper is directly contrary to the hot & dry distemper of Leprous persons; besides the Leprous being thus deprived of the faculty of generation, that contagion of this disease is taken away which spreadeth and is diffused amongst mankind by the propagation of their issue. The End of the Twentieth Book. OF POISONS, AND OF THE BITING OF A MAD DOG, AND THE BITINGS AND STINGING OF OTHER VENOMOUS CREATURES. THE ONE AND TWENTIETH BOOK. CHAP. I. The cause of writing this Treatise of Poisons. FIVE reasons have principally moved me to undertake to write this Treatise of poisons, according to the opinion of the Ancients. The first is, that I might instruct the Surgeon what remedies must presently be used to such as are hurt by poisons, in the interim whilst greater means may be expected from a Physician. The second is, that he may know by certain signs and notes such as are poisoned or hurt by poisonous means, and so make report thereof to the Judges, or to such as it may concern. The third is, that those Gentlemen and others who live in the Country, and far from Cities and store of greater means, may learn something by my labours by which they may help their friends bitten by an Adder, mad Dog, or other poisonous creature, in so dangerous, sudden and usual a case. The fourth is, that every one may beware of poisons, and know their symptoms when present, that being known, they may speedily seek for a remedy. The fifth is, that by this my labour all men may know what my goodwill is, and how well minded I am towards the common wealth in general, and each man in particular, to the glory of God. I do not here so much arm malicious and wicked persons to hurt, as Surgeons to provide to help and defend each man's life against poison; which they did not understand, or at least seemed not so to do, which taking this my labour in evil part, have maliciously interpreted my meaning. But now at length, that we may come to the matter; I will begin at the general division of poisons, and then handle each species thereof severally: but first let us What is to be accounted poison. give this rule; That, Poison is that which either outwardly applied or struck in, or inwardly taken into the body, hath power to kill it, no otherwise, than meat well dressed is apt to nourish it. For Conciliator writes, that the properties of poison are contrary to nourishments in their whole substance, for as nourishment is turned into blood, and in each part of the body whereto it is applied to nourish, by perfect assimulation is substituted in the place of that portion which flows away each moment. Thus on the contrary poison turns our bodies into a nature like itself and venenate, for as every agent imprints the force and qualities thereof in the subject patient, thus poison by the immoderation of faculties in their whole nature contrary to us, changeth our substance into its nature, no otherwise than fire turneth chaff in a moment into its own nature, and so consumes it. Therefore it is truly delivered by the Ancients, who have diligently pried into the faculties of natural things, that it is Poison that may kill men by destroying and corrupting their temper, and the composure and conformation of the body. Now all poisons are said to proceed either The differences of poisons. from the coruptaire, or from living creatures, plants and minerals, or by an artificial malignity in distilling, subliming and diversely mixing of poisonous and fuming things. Hence ●risesundry differences of poisons; neither do they all work after the same manner; for some corrupt our nature by the unmeasurableness of the manifest and elementary qualities whereof they consist, others from a specific and occult property. Hence it is that some kill sooner than othersome; neither is it true, that all of them presently assail the heart, but others are naturally at deadly strife All poisons have not a peculiar Antipathy with the heart. with other parts of the body, as Cantharideses with the bladder, the sea Hare with the lungs, the Torpedo with the hands, which it stupefieth, though the fisher's rod be betwixt them. Thus of medicines, there are some which are apt presently to comfort and strengthen the heart; others the brain, as staechas; others the stomach, as Cinnamon; Also there are some poisons which work both ways, that is, by manifest and occult qualities, as Euphorbium; for that both by the excessive heat and the whole substance, or the discord of the whole substance with ours, corrupts our nature. An argument hereof is, that Treacle, which by its quality is manifestly hot, infringeth the force thereof, as also of all others of an occult property. Poisons which work by an occult and specific property, do not therefore do it, because they are too immoderately hot, cold, dry, moist; but for that they are absolutely such, and have that essence from the stars and celestial influence, which is apt to dissolve and destroy the strength of man's body, because being taken, but even in a small quantity, yet are they of so pernicious a quality, that they kill almost in a moment. Now poisons do not only kill being taken into the body, but some being put or applied outwardly; neither do venomous creatures only harm by their stinging and biting, but also by their excrements, as spittle, blood, the touch and breath. CHAP. II. How poisons being small in quantity, may by their only touch cause so great alterations. IT seemeth strange to many, how it may come to pass, that poison, taken or admitted in a small quantity, may almost in a moment produce so pernicious effects over all the body, and all the parts, faculties, and actions, so that being admitted but in a little quantity, it swells up the body into a great bigness. Neither ought it to seem less strange, how Anridotes and Counter-poisons, which are opposed to poison, can so suddenly break and weaken the great and pernicious effects thereof, being it is not likely that so small a particle of poison or Antidote can divide itself into so many, and so far severed particles of our body. There are some (saith Galen) who think that Cap. 5. lib 6. de locis affect. somethings by touch only, by the power of their quality, may alter those things which are next to them, and that this appears plainly in the sea Torpedo, as that which hath so powerful a quality, that it can send it alongst the fisher's rod to the hand, and so make it become torpide or numb. But on the contrary, Philosophers teach, that accidents, such as qualities are, cannot without their subjects remove and diffuse themselves into other subjects. Therefore Galens other answer is more agreeable to reason, that so many and great affects of poisons and remedies arise either from a certain spirit or ●…le huminity; not truly, for that this spirit and subtle humidity may be dispersed over the whole body and all the parts thereof which it affects, but that little, which is entered the body, as cast in by the stroke of a Spider, The true reason of the wondrous effects of poisons. or the sting of a Scorpion, infects and corrupts all the next parts by contagion with the like quality, these others that are next to them, until from an exceeding small portion of the blood, if the stroke shall light into the veins, it shall spread over the whole mass of blood; or of phlegm, if the poison shall chance to come to the stomach, and so the force thereof shall be propagated and diffused over all the humours and bowels. The doubt of Antidotes is less, for these being taken in greater quantity, when they shall come into the stomach, warmed by the heat of the place, they become hot, & send forth vapours, which suddenly diffused over the body by the subtlety of their substance, do by their contrary forces dull and weaken the malignity of the poison. Wherefore you may often see when as Antidotes are given in less quantity than is fit, that they are less prevalent, neither do they answer to our expectation in overcoming the malignity of the poison; so that it must necessarily follow that these must not only in qualities, but also in quantity be superior to poisons. CHAP. III. Whether there be any such poisons as will kill at a set time? TO the propounded question; whether there may be poisons which within No poisons kill in a set time. a certain and definite time (put case a month or year) may kill men, Theophrastus thus answers; of poisons, some more speedily perform their parts, others more slowly, yet may you find no such as will kill in set limits of time, according to the will and desire of men. For that some kill sooner or later than others; they do not this of their own or proper nature, as Physicians rightly judge, but because the subject upon which they light, doth more or less resist or yield to their efficacy. Experience showeth the truth hereof; for the same How poisons come to kill sooner or later. sort of poison in the same weight and measure given to sundry men of different tempers and complexions, will kill one in an hour, another in six hours, or in a day, and on the contrary will not so much as hurt some third man. You may also observe the same in purging medicines. For the same purge given to divers men in the same proportion, will purge some sooner, some later, some more sparingly, others more plentifully, and othersome not at all; also with some it will work gently, with othersome with pain and gripings. Of which diversity there can no other cause be assigned, than men's different natures in complexion & temper, which no man can so exactly know and comprehend, as to have certain knowledge thereof, as how much and how long the native heat can resist and labour against the strength of the poison, or how pervious or open the passages of the body may be whereby the poison may arrive at the heart and principal parts. For in such (for example sake) as have the passages of their arteries more large, the poison may more readily and speedily enter into the heart together with the air that is continually drawn into the body. CHAP. four Whether such creatures as feed upon poisonous things be also poisonous, and whether they may be eaten safely and without harm? Duck's, Storks, Hernes, Peacocks, Turkeys, and other birds, feed upon Toads, Vipers, Asps, Snakes, Scorpions, Spiders, Caterpillars, & other venomous things. Wherefore it is worthy the questioning, whether such like creatures nourished with such food, can kill or poison such persons as shall afterward eat them? Matthiolus writes that all late Authors, Such things as feed upon poison may be eaten without danger. who have treated of poisons, to be absolutely of this opinion, That men may safely and without any danger feed upon such creatures, for that they convert the beasts into their nature after they have eaten them, and on the contrary, are not changed by them. This reason though very probable, yet doth it not make these beasts to be wholly harmless, especially if they be often eaten or fed upon. Dioscorides and Galen seem to maintain this opinion, whereas they write, that the milk, which is nothing else than the relented blood, of such beasts as feed upon scammony, hellebore, and spurge, purgeth violently. Therefore Physicians, desirous to purge a sucking child, give purges to the nurses, whence their milk becoming purging, becomes both meat and medicine to the child. The flesh of Thrushes, which feed upon Juniper berries, favours of Juniper. Birds that are fed with wormwood or Garlic, either taste bitter, or have the strong sent of Garlic. Whiting taken with garlic, so smell thereof, that they will not forgo that smell or taste by any salting, frying or boiling, for which sole reason, many who hate garlic, are forced to abstain from these fishes. The flesh of Rabbits that feed upon pennyroyal and Juniper, favour of them; Physicians wish that Goats, Cows, and Asses, whose milk they would use for Consumptions or other diseases, should be fed some space before, and every day with these or these herbs which they deem fit for the curing of this or that disease. For Galen affirms that he doubts not, but that in success of time the flesh of creatures Lib de simp. facult. will be changed by the meats where on they feed, and at length favour thereof. Therefore I do no allow that the flesh of such things as feed upon venomous things should be eaten for food, unless it be some long space after they have disused such repast, and that all the venom be digested and overcome by the efficacy of their proper heat, so that nothing thereof may remain in taste, smell or substance, but be all vanished away. For many dye suddenly, the cause of whose deaths are unknown, The occasion of sudden death in many. which peradventure was from nothing else, but the sympathy and antipathy of bodies, for that these things cause death and disease to some, that nourish othersome [according to our vulgar English proverb; That which is one man's meat is another man's Poison.] CHAP. V. The general signs of such as are poisoned. WE will first declare what the general signs of poison are, and then will we descend to particulars, whereby we may pronounce that one is poisoned with this or that poison. We certainly know Common signs of such as are poisoned. that a man is poisoned, when as he complains of a great heaviness of his whole body, so that he is weary of himself; when as some horrid and loathsome taste sweats out from the orifice of the stomach to the mouth and tongue, wholly different from that taste that meat, howsoever corrupted, can send up: when as the colour of the face changeth suddenly, somewhiles to black, sometimes to yellow, or any other colour, much differing from the common custom of man; when nauseousness with frequent vomiting, troubleth the patient, and that he is molested with so great unquietness, that all things may seem to be turned upside down. We know that the poison works by the proper, and from the whole substance, when as without any manifest sense of great heat or coldness, the patient sows often with cold sweats, for usually such poisons have no certain and distinct part wherewith they are at enmity, as cantharides have with the bladder. But as they work by their whole substance, and an occult propriety of form; so do they presently and directly assail the heart, our essence and life, and the fortress and beginning of the vital faculty. Now will we show the signs whereby poisons, that work by manifest and elementary qualities, may be known. Those who exceed in heat, burn or make an impression of heat in Signs of hot poisons. the tongue, the mouth, throat, stomach, guts, and all the inner parts, with great thirst, unquietness, and perpetual sweats. But if to their excess of heat they be accompanied with a corroding and putrefying quality, as Arsenic, Sublimate, Roseager or Ratsbane, Verdegreace, Orpiment, and the like, they then cause in the stomach and guts intolerable pricking pains, rumblings in the belly, and continual and intolerable thirst. These are succeeded by vomitings, with sweats somewhiles hot, somewhiles cold, with swoon, whence sudden death ensues. Poisons that kill by too great coldness, induce a dull or heavy sleep, or drowsiness, Signs of cold poisons. from which you cannot easily rouse or waken them; sometimes they so trouble the brain, that the patients perform many undecent gestures and antic tricks with their mouths and eyes, arms and legs, like as such as are frantic; they are troubled with cold sweats, their faces become blackish or yellowish, always ghastly, all their bodies are benumbed, and they dye in a short time unless they be helped; poisons of this kind are Hemlock, Poppy, Nightshade, Henbane, Mandrake. Dry poisons are usually accompanied by heat with moisture, for although sulphur be Signs of dry poisons. hot and dry, yet hath it moisture, to hold the parts together, as all things which have a consistence have, yet are they called dry, by reason that dryness is predominant in them: such things make the tongue and throat dry and rough, with unquenchable thirst; the belly is so bound, that so much as the urine cannot have free passage forth; all the members grow squallide by dryness, the patients cannot sleep; poisons of this kind are Lytharge, Ceruse, Lime, Scailes of Brass, Filings of Lead, prepared antimony. On the contrary, moist poisons induce a perpetual sleep, a flux or scouring, the resolution of all the nerves and joints, so that not so much as the Signs of moist poisons. eyes may be faithfully contained in their orbs, but will hang as ready to fall out; the extreme parts, as the hands, feet, nose and ears corrupt & putrefy, at which time they are also troubled with thirst by reason of their strong heat, always the companion of putrefaction, & oft times the author thereof: now when this cometh to pass, death is at hand. Very many deny that there can be any moist poisons found, that is, such as may kill by the efficacy of their humidity, because there are no such things to be found, as may come to the fourth degree of moisture. Yet there is an example that avers the contrary, which was of one, who sleeping on the night, was bitten by a Serpent, as Gilbertus Anglicus affirmeth; for dying thereof, when as his servant, desirous to awaken his Master out of his sleep, took him by the arm, all the flesh being A history. putrefied, fell off, and presently the bones also fell asunder, being deprived of their flesh, which could not happen, unless by excess of the venomous humidity which lay hid in the teeth and spittle of the serpent. Also we have found it noted by Hypocrates, that in a rainy, humid, and southerly constitution of the year, it happened by the malign violence of the venenate and putrefying humidity, that Sect. 3. lib. 3. epid. the flesh of the arms and legs becoming rotten, fell away by piecemeal, and the bones remained bare; yea also and the bones themselves in some, putrefyed and fell away: neither certainly doth the Lues venerea kill by any other means, than The Lues venenerea kills by excess of moisture. by a fretting and putrefying force of humidity, by whose efficacy the solidity of the bones is dissolved; then much more the flesh may be tainted and consumed by putrefaction. To these and such poisons which work by a manifest and elementary faculty, when as they shall be received into the body after what manner soever, you shall forthwith oppose their contraries, and if by chance it be not manifest, what, and of what distinct kind of poison that is, you must know that such poisons as work by occult properties, it is not by reason as yet found out how they will affect the body, but only by experience. Therefore to these you must oppose their like antidotes, which may by their whole substance strengthen the heart and vital faculty, and withstand the strength of the poison. But to this our distinction of poisons, working All poisons are not cold. by a manifest and elementary quality, their opinion is contrary, who affirm that the venom of all poisonous beasts are therefore cold, for that such as are bitten or stung with them, are forthwith felt to be colder than a stone. And that serpents for fear of cold, when as winter is at hand, keep themselves in holes and dens under ground, or else as vipers use to do, lie under stones, under which, you may often find them stiff and numb, and so unapt for motion, that you may easily take them up in your hand. But the coldness that is perceived or felt in such as are bitten or stung, is not occasioned by the coldness of the poison, but by the absence of the natural heat, withdrawing itself in the very instant of the stroke, from the surface into the centre of the body, both for the defence of the heart, as the principal part, as also for that there is nothing, which so much dissipates, or so much oppugnes Why such as are poisoned or stung, are cold. the vital heat, as poison (of what kind soever it be) doth. CHAP. VI How, or by what means to shun, or eschew Poisons. IT is a matter of much difficulty to avoid poisons, because such as at this time temper them, are so throughly prepared for deceit and mischief, that they will deceive even the most wary and quicksighted; for they so qualify their ingrate taste and smell, by the admixture of sweet and well smelling things, that they cannot easily be perceived even by the skilful. Therefore such as fear poisoning, aught to take heed of meats cooked with much art, very sweet, salt, What such as fear poisoning must observe in their diet. sour, or notably endued with any other taste. And when they are oppressed with hunger or thirst, they must not eat nor drink too greedily, but have a diligent regard to the taste of such things as they eat or drink; besides, before meat let them take such things as may weaken the strength of the poisons; such as is the fat broth of good nourishing flesh meats; in the morning let them arm themselves with treacle or mithridate, and conserve of roses, or the leaves of rue, a walnut and dry figs; besides, let him presently drink a little draught of Muskedine or some other good wine; when one suspects he hath taken any poison in meat or drink, let him forbear sleeping. For besides that the force of poison is oft times so rapid, that it consumes our life in a short space, as fire doth stubble, as also for that it is drawn more Why sleep i● hurtful. in wardly into the secret passages of the body by sleep. Wherefore in such a case it is better to procure vomit by drinking Hydraeleum warm, or butter dissolved in Why and how vomit must be procured. warm oil, or a decoction of line, or fenugreeke seeds, or fat broth, for thus the received poison is also cast forth therewith, or else the acrimony thereof retunded, and the belly loosed. You may see this by daily experience, for caustics, vesicatories, and the like acrid things being applied to an anointed part, will not blister nor exulcerate the part. Neither doth the vomit conduce only in this, that it excludeth the poison, but it shows either by the taste, smell, or colour, the kind of the taken poison; so that then by using the proper Antidote, it may be the more easily and speedily resisted, yet not withstanding if you conceive that the poison have descended deeper into the Guts, you may with a clyster draw away the rest thereof which adheres to the coats of the Guts. But if the patient cannot vomit, then shall some purging medicine be given him forthwith, and such as are thought more particularly to resist poison, When and where with they shall be purged. such as are Agaricke, Aloes, the lesser Centaury, Rhubarb and other things, according to the direction of the learned Physician. Then shall you administer glisters made with Cassia, fatty decoctions, sheep's suet, or butter or Cow's milk, with the mucilages of Line seed, psilium seeds, quince seeds, and other such things as are usually given in a Dysentery, or bloody flux, that such things may hinder the adhesion of the poison to the coats of the guts, and by their unctuousness retunde the acrimony of the poison, and mitigate if any thing shall already be ulcerated, and absolutely defend the sound parts from the malign effects of the poison. But let this be a perpetual rule, That the poison be speedily drawn back by the same way it entered into the body; as, if it entered by smelling in at the nostrils, let it be drawn The cure of poisoned wounds. back by sneesing; if by the mouth into the stomach, let it be excluded by vomit; if by the fundament into the belly, then by glister; if by the privities into the womb, then by metrenchites or injections made thereinto; if by a bite, sting or wound, let revulsion be made by such things as have a powerful attractive faculty; for thus we make diversions, that by these we may not only hinder the poison from assailing the heart, but also that by this means we may draw it from within outwards. Wherefore strong ligatures cast about the arms, thighs and legs, are good in this case. Also large cupping glasses applied with much flame to sundry parts of the body, are good. Also baths of warm water, with a decoction of such things as resist poison, as southern wood, calamint, rue, betony, horehound, penny royal, bays, scordium, smallage, scabious, mints, valerian, and the like, are good in this case. Also sweats are good, being provoked so much as the strength of the patient can endure. But if he be very wealthy, whom we suspect poisoned, it will be safer to put him into the belly of an ox, horse or mule, and then presently into another as soon as the former is cold, that so the poison may be drawn forth by the gentle and vaporous heat, of the new killed beast; yet do none of these things without the advice of a Physician, if it may conveniently be had. CHAP. VII. How the corrupt or venomous Air may kill a Man. THE air is infected and corrupted by the admixture of malign vapours, either arising from the unburied bodies of such as are slain in great conflicts, By how many, and what means the air may be infected or exhaling out of the earth after earthquakes, for the air, long penned up in the cavities and bowels of the earth, and deprived of the freedom and commerce of the open air, is corrupted, and acquires a malign quality, which it presently transferreth unto such as meet therewith. Also there is a certain How thunders and lightnings may infect the air. malignity of the air which accompanieth thunders, and lightnings, which favoures of a sulphureous virulency, so that whatsoever wild beasts shall devour the creatures killed therewith, they become mad, and dye immediately; for the fire of lightning hath a far more rapid, subtle, and greater force than other fires, so that it may rightly be termed a Fire of Fires. An argument hereof is, that it melteth the head of a spear, not harming the wood, and silver and gold, not hurting the purse wherein it is contained. Also the air is infected by fumigations, which presently admitted into the body and bowels by the mouth and nose in respiration, by the skin and arteries in perspiration, doth easily kill the spirits and humours being first infected, and then within a short space after, the solid substance of the principal parts, & chiefly of the heart being turned into their nature, unless the man be first provided for by sneesing, vomiting, sweeting, purging by the belly, or some other excretion. For that poison which is carried into Whether the vapour that ariseth from a burnt thing may poison one. the body by smell is the most rapid & effectual, by so much as a vapour or exhalation is of more subtle & quicklier piercing essence than an humour. Yet not withstanding, wilt thou say, it is not credible, that any can be killed by any vapour raised by the force of fire, as of a Torch, or a Warming-pan, for that the venenate quality of the thing that is burnt, is dissipated and consumed by the force of the fire, purging and cleansing all things. This reason is falsely feigned to the destruction of the lives of careless people; for sulphureous brands kindled at a clear fire, do notwithstanding cast forth a sulphureous vapour. Whether do not Lignum aloes and Juniper, when they are burnt in a flame, smell less sweetly? Pope Clement, the seventh of that name, the Uncle of our King's Mother, was poisoned by the fume of a poisonous Torch that was carried lighted before him, A history. and died thereof. Mathiolus telleth, that there were two Mountebanks in the market place of Sicnna, the one of which, but smelling to a poisoned gillyflower given him by the other, fell down dead presently. A certain man not long ago, when he had put to his nose, and smelled a little unto a pomander, which was secretly poisoned, was presently taken with a Vertigo, and all his face swelled, and unless that he had gotten speedy help by sternutatories and other means, he had died shortly after of the same kind of death that Pope Clement did. The safest preservative against such poisons, is not to smell to them: moreover, some affirm, that there are prepared some poisons of such force, that being anointed but on the saddle, they will kill the rider, & others, that if you but anoint the stirrups therewith, they will send so deadly poisonous a quality into the rider, through his boots, that he shall die thereof within a short time after: which things, though they be scarce credible, because such poisons touch not the naked skin, yet have they an example in nature, whereby they may defend themselves. For the Torpedo sends a narcoticke, and certainly deadly force, into the arm, and so into the body of the Fisher, the cords of the net being between them. CHAP. VIII. That every kind of Poison hath its proper and peculiar Signs and Effects. AS poisons are distinct in species, so each species differs in their signs and effects; neither is it possible to find any one kind of poison, which may be accompanied or produce all the signs and effects of all poisons, otherwise Physicians should in vain have written of the signs and effects of each of them, as also of their proper remedies & antidotes. For what kind of poison shall that be, which shall cause a burning heat in the stomach, belly, liver, bladder & kidneys, which shall cause a hicketting, which shall cause the whole body to tremble and shake, which shall take away the voice and speech, which shall cause convulsions, shall weaken the pulsificke faculty, which shall intercept the freedom of breathing, which shall stupesie and cast into a dead sleep, which shall together, and at once cause a Vertigo in the head, dimness in the sight, a strangling, or stoppage of the breath, thirst, bleeding, fever, stoppage of the urine, perpetual vomiting, redness, lividnesse, and paleness of the face, resolution of the powers, and many other things, all which are caused by all sorts of poison. Lastly, no body will deny, but that hot poisons may kill more speedily than cold, for that they are more speedily actuated Hot poisons kill sooner than cold. by the native heat. CHAP. IX. The Effects of Poisons from particular venomous things, and what Prognostics may thence be made. IT is the opinion of Cornelius Celsus, and almost of all the ancients, That the bite of every beast had some virulency, but yet some more than othersome. They are most virulent that are inflicted by venomous beasts, as Asps, Vipers, Water-snakes, and all kinds Lib. 2. cap. 27. The bites of all wild beasts are virulent. of Serpents, Basilisks, Dragons, Toads, Mad dogs, Scorpions, Spiders, Bees, Wasps, and the like. They are less malign, which are of creatures wanting venom, as of Horses, Apes, Cats, Dogs not mad, and many other things, which though of their own nature they are without poison, yet in their bites there is something more dolorisicke and ill natured, than in common wounds inflicted by other occasions: I believe that in their slaver or sanies, there is something, I know not how to term it, contrary to our nature, which imprints a malign quality in the ulcer, which also you may observe in the tearings or scratchings of such creatures as have sharp claws, as Lions and Cats. Moreover many affirm that they have found by experience, that the bites of men are not altogether without virulency, especially of such as are red haired and freckled, chiefly when as they are angered; it is probable that the bites of other persons want this malignity, The bites of a red haired man virulent. seeing that their spittle will cure small ulcerations. Wherefore if there shall happen difficulty of cure in a wound, caused by a man's biting, which is neither red haired nor freckled, neither angry; this happens not by means of the spittle, nor by any malign quality, but by reason of the contusion, caused by the bluntness of the teeth, not cutting, but bruising the part, for being not sharp, they cannot so easily enter the flesh, unless by bruising and tearing, after the manner of heavy and blunt strokes and weapons, wounds being occasioned by such are more hard to be cured, Contused wounds harder to heal than such as are cut. than such as are made by cutting and sharp weapons. But of the foresaid bitings of venomous creatures, there are few which do not kill in a short space, and almost in a moment, but principally if the poison be sent into the body by a live creature, for in such poison there is much heat; also there is therein a greater tenuity, which serves as vehicles thereto into what place or part soever of the body they tend, the which the poisons taken from dead creatures are detective of. Wherefore some of these kill a man in the space of an hour, as the poison of Asps, Basilisks and Toads; others not unless in two or three day's space, as of water Snakes; a Spider, and Scorpion require more time to kill, yet all of them admitted but in the least quantity, do in a short space cause great and deadly mutations in the body, as if they had breathed in a pestiferous air, and with the like violence, taint and change into their own nature all the members and bowels, by which these same members do in the time of perfect health change laudable meats into their nature and substance. The place whereas these poisonous creatures live, & the time, conduce to the perniciousness of the poison, for such as live in dry, mountainous and sunburnt places kill more speedily than such as be in moist and marish grounds; also they are more hurtful in winter than in summer; and the poison is more deadly which proceeds from hungry, angry and fasting creatures, than that which comes from such as are full and quiet; as also that which proceeds from young things, chiefly when as they are stimulated to venery, is more powerful than that which comes from old & decrepit; from females worse than from males; from such as have fed upon other venomous things, rather than from such as have abstained from them, as from snakes which have devoured toads, vipers which have fed upon scorpions, spiders & Caterpillars. Yet the reason of the efficacy of poisons depends from their proper, that is, their subtle or gross consistence, & the greater or less aptness of the affected body to suffer. For hot men that have larger & more open veins & arteries, yield the poison freer passage to the heart. Therefore those which have more cold & strait vessels, are longer ere they die of the like poison; such as are full, are not so soon harmed as those that are fasting: for meats, besides that by filling the vessels, they give not the poison so free passage, they also strengthen the heart by the multiplication of spirits, so that it more powerfully resists pernicious venom. If the poison work by an occult and specific property, it causeth the cure and prognostic to be difficult, and then must we have recourse to Antidotes, as these which in their whole substance resist poisons, but principally to treacle, because there enter into the composition thereof medicines which are hot, Why treacle retunds the force of all simple poisons. cold, moist and dry: whence it is, that it retunds and withstands all poisons, chiefly such as consist of a simple nature, such as these which come from venomous creatures, plants and minerals; and which are not prepared by the detestable art of empoisoners. CHAP. X. What cure must be used to the bitings and stingings of venomous beasts. CUre must speedily be used without any delay to the bites and stingings of venomous beasts, which may by all means disperse the poison, and keep it from entering into the body; for when the principal parts are possessed, it boots nothing to use medicines afterwards. Therefore the A double indication in the cure of venomous bites Ancients have propounded a double indication to lead us to the finding out of medicines in such a case, to wit, the evacuation of the virulent and venenate humour, and the change or alteration of the same and the affected body. But seeing evacuation is of two sorts, to wit, universal, which is by the inner parts, and particular, which is by the outward parts. We must begin at the particular, by such to pick medicines as are fit to draw out, and retund the venom; for we must not always begin a cure with general things, as some think, especially in external diseases, as wounds, fractures, dislocations, venomous bites and punctures. Wherefore hereto as speedily as you may, you shall apply remedies fit for the bites & punctures of venomous beasts, as for example, the wounds shall be presently washed with urine, Lotions fit for venomous bites. with sea-water, aquavitae, or wine, or vinegar wherein old treacle or mustard shall be dissolved. Let such washing be performed very hot, and strongly chafed in, ●●d then leave upon the wound and round about it, linen rags, or lint steeped in the same liquor. There be some who think it not fit to lay treacle thereto, because, as they say, it drives the poison in. But the authority of Galen convinceth that opinion, Lib. de theriaca. for he writeth that if treacle be applied to this kind of wounds before that the venom shall arrive at the noble parts, it much conduceth. Also reason confutes it; for viper's flesh enters the composition of treacle which attracts the venom by the similitude of substance, as the Loadstone draweth iron, or Amber straws. Moreover, the other simple medicines which enter this composition, resolve and consume the virulency and venom, and being inwardly taken, it defendeth the heart and other noble parts, and corroboratheth the spirits. Experience teacheth that mithridate five given in the stead of treacle worketh the like effect. The medicines that are taken Treacle outwardly applied and inwardly taken good against v●nemous bit●s. inwardly and applied outwardly for evacuation, must be of subtle parts, that they may quickly insinuate themselves into every part to retund the malignity of the poison; wherefore garlic, onions, leeks, are very good in this case, for that they are vaporous; also scordium, tue, dictamnus, the lesser Centaury, horehound, rocket, the milky juice of unripe figs, and the like, are good; there is a kind of wild bugloss amongst all other plants, which hath a singular force against venomous bites, whence it is termed Echium and viperinum, and that for two causes; the first is, because in the The force of E. 〈◊〉. purple flowers that grow amongst the leaves, there is a resemblance to the head of a viper or adder. Another reason is, because it heals the biting of a viper not only applied outwardly, but also helpeth such as are bitten, being drunk in wine, yea, and will not suffer those that have lately drunk thereof to be bitten at all. Wild time hath the like effect; though these ofttimes agree with the poison in quality as in heat, yet do they help in discussing and resolving it: yet, as much as we may, we must labour to have evacuation and alteration together. It is most convenient, if the part affected will permit, to apply large cupping-glasles with much flame and horns; also sucking is good, the mouth being first washed in wine wherein some treacle is dissolved, and with oil, lest any thing should adhere thereto, for it will hinder it, if so be the mouth be no where ulcerated. It is good also to apply horseleeches; some wish to apply to the wound, the fundaments of hens or turkeys that lay eggs, for that such are opener behind, first putting salt upon them that they may gape the wider, shutting their beaks and opening them now & then lest they should be stifled, and ever and anon to substitute others in stead of such as die or are suffocated; for thus it is thought the poison is drawn forth, and passeth into the bird by the fundament. There be others which had rather apply to the wound live birds cut asunder in the midst, and so laid to hot, for that they guess these resist poison by a natural discord. But certainly it is by their heat whereby they do not only digest toads, asps, vipers, scorpions and other venomous things, but also wear asunder and soften sand, stones, and most dry and stony seeds in their gizzards; wherefore we must think them very good to draw out the poison and dissipate it. But nothing is so forcible to disperse and retund the venom, as the impression of cauteries, especially The eff●…e of Cauteries against venomous bites. actual, for a hot iron works more effectually and speedily, and causeth an ulcer which will remain open a longer time. Wherefore to cause the speedier falling away of the eschar, you shall scarify it to the quick, and then plentifully anoint the place. For thus the poison will the sooner pass forth. But this must be done before the poison enters far into the body, for otherwise Cauteries will not only do no good, but further torment the patient, and weaken him to no purpose. Let drawing plasters be laid to the wound & neighbouring parts, made of Galbanum, turpentine, black pitch, and other gummy and resinous things. After the falling away of the Eschar, basilicon shall be applied, quickened with a little Precipitate, for it is The ●orce of Precipitate against venomous wounds. very effectual in these cases, for that it draweth forth the virulent sanies out of the bottom of the wound, neither doth it suffer the wound to be closed speedily. To which purpose they put in a piece of of a sponge, or a root of Gentian or Hermondactyll, or some acride medicine, as agyptiacum or Precipitate mixed with the powder of Al●me, or a caustick beaten to powder. But you must always observe this, that with your ointments you must always mix some Treacle or Mithridate, or the juice of hypericon, or the like, which have power to attract and disperse the poison, and cleanse the ulcer; yet if too vehement heat shall cause such pain as is likely to bring When hot things are not convenient for poisoned wounds. a gangrene by the dissipation of the spirits, then neglecting the cure of the proper disease for a time, we must labour to correct the symptom. But in this case you must observe this rule, that you let no blood, give no purging medicine, nor clyster, nor vomit, nor use no bath, nor other thing that may procure sweat, until three days be passed after the bite or sting. In the mean space, let the patient shun all manner of labour, but chiefly venery, lest by causing an agitation of the humours, the poison get sooner to the heart. Therefore than it is time to use universal evacuations, when as you shall suspect that the poison is diffused over the veins and whole inner part of the body besides. Before you shall give nothing, unless medicines of Treacle or Mithridate and the like things, which have a faculty to resist poison, and strengthen the whole body by their benign and vital vapour, although their substance go no further than the stomach. Thus pills when they are swallowed, though they go no further than the stomach, yet do they draw matter out of the joints and head; and strong glisters, though they pass no further than the guts, yet by their quality diffused Antidotes must be given in great quantities. further with the vapour, they draw from the most distant parts; yet you must give an Antidote, not only more powerful than the poison in quality, but also greater in quantity, that so it may the more easily overcome and expel the poison. Wherefore you must give it twice in a day, and continue it so long until you shall know that the strength of the poison is weakened and overcome by the remission and decay of the malign symptoms. Yet in the mean while, you must not neglect distemper caused in the part by the poison, but must rather correct it by the application of remedies contrary to the distemper, as by cold things, if great heat afflict the affected part and whole body; by hot things on the contrary, if it seem as cold as a stone, which ofttimes happens. And let thus much suffice for the general cure of poisons: now will we come to their particular cure. CHAP. XI. Why dogs sooner become mad than other creatures, and what be the signs thereof. Dogs become mad sooner than other creatures, because naturally Dogs naturally subject to madness. they enjoy that temper and condition of humours which hath an easy inclination to that kind of disease, and as it were a certain disposition, because they feed upon carrion and corrupt, putrid and stinking things, and lap water of the like condition; besides the trouble and vexation of losing their masters, makes them to run every way, painfully searching and smelling to every thing, and neglecting their meat. A heating of the blood ensues upon this pains, and by this heat it is turned into a melancholy, whence they become mad. But yet dogs do not always become mad by means of heat, but also by occasion of cold, that is, by contrary causes, for they fall into this disease not only in the dog-days, but also in the depth of winter. For dogs abound with melancholic humouts, to wit, cold and dry. But such humours as in the summer through excess of heat, so in the depth of Dogs become mad, not only in the heat of summer, but also in the depth of winter. winter by constipation and the suppression of fuliginous excrements, they easily turn into melancholy. Hence follows a very burning and continual fever, which causeth or bringeth with it a madness. Add hereto, that in the depth of winter the heat which is contained within is redoubled, and in like manner as the scorching heat in summer, it breeds and turns the humours into melancholy. Also dogs become mad by contagion, as such as are bitten by another mad dog. A mad dog hath sparkling and fiery eyes, with a fixed look, cruel and a squint, he carries his head heavily, hanging down towards the ground, and somewhat on one side, he gapes, and thrusts forth his tongue, which is livide and blackish; and being short breathed, casts forth much filth at his nose, and much foaming matter at his mouth; in his gate, as if he suspected and feared all things, he keepeth no one or certain path, but runs one while to this side, another while to that, and stumbling like one that is drunk, he ofttimes falleth down on the ground; he violently assails whatsoever he meets withal, whether it be man, tree, wall, dog, or any thing else; other dogs shun him, and presently sent him a far off. But if another unawares chance to fall foul on him, he yields himself to his mercy, fawns upon him, and privily labours to get from him, though he be the stronger & greater. He is unmindful of eating and drinking, he barks not, yet he bites all he meets without any difference, not sparing his master, as who at this time he knows not from a stranger or enemy. For it is the property of melancholy to disturb the understanding, so that such persons as are melancholic, do not only rage against, and use violence to their friends and Why melancholic p●rsons hurt themselves. parents, but also upon themselves. But when as he sees water, he trembles and shakes, and his hairs stands up on end. CHAP. XII. By what signs we may know a man is bitten of a mad dog. IT is not so easy at the first to know a man that is bitten with a mad dog; and principally for this reason, because the wound made by his teeth causeth no more pain than other wounds usually The bite of a mad dog not very painful at the first. do; contrary to the wounds made by the sting or bite of other poisonous creatures, as those which presently after they are inflicted, cause sharp pain, great heat, swelling and abundance of other malign accidents, according to the nature of the poison; but the malignity of the bite of a mad dog appears not before that the venom shall invade the noble parts. Yet when you are suspicious of such a wound, you may acquire a certain knowledge and experience thereof by putting a piece of bread into the quitture that comes from the wound. For if a hungry dog neglect, yea more fly from it, and dare not so much as smell thereto, it is thought to be a certain sign that the wound was inflicted by a mad dog. Others add, That if any give this piece of bread to hens, that they will die the same day they have eaten it; yet this Signs of the bite of a mad dog. latter, I making experiment thereof, failed, for devouring this virulent bread, they became not a jot the worse. Wherefore I think the former sign to be the more certain, for dogs have a wonderful and sure smelling faculty, whereby they easily sent and perceive the malignity of the like creature. But when as the raging virulency hath invaded the noble parts, than the patients, becoming silent and sorrowful, think of many things, and at the beginning make a noise with their teeth; they Signs by which you may gather that the noble parts are tainted. make no answer to the purpose, they are more testy than ordinary, and in their sleeps they are troubled with dreams, and strange fantasies, and fearful visions, and lastly, they become afraid of the water. But after that the poison hath fixed itself into the substance of the noble parts, than all their faculties are disturbed, all the light of their memory, senses, reason and judgement is extinguished. Wherefore becoming stark mad, they know not such as stand by them, not their friends, no nor themselves, falling upon such as they meet withal, & themselves with their teeth, & nails & feet. Often twitchings like convulsions do suddenly rise in their limbs; I judge them occasioned by extraordinary dryness, which hath as it were wholly drunk up all the humidity of the nervous parts; there is a great dryness of the mouth with intolerable thirst, yet without any desire of drink, because the mind being troubled, they become unmindful & negligent of such things as concern them, and are needful for them; the eyes look fiery & red, & all the face is of the same colour; they still think of dogs, and seem to see them, yea and desire to bark and bite just after the manner of dogs; I conjecture that the virulent humour hath changed all the humours & Why men becoming mad bark like dog●. the whole body into the like nature, so that they think themselves also dogs; whence their voice becomes hoarse by much endeavouring to bark, having forgot all decency, like impudent dogs, to the great horror of the beholders. For their voice grows hoarse by reason of the great dryness of the aspera arteria; they shun the light, as that Why they 〈◊〉 the light. which is enemy to melancholy, wherewith the whole substance of the brain is replenished; on the contrary, they desire darkness, as that which is like and friendly to them. But they are afraid of the water (though good to mitigate their great distemper Why they are afraid of the water. of heat and dryness) and they fly from looking-glasses, because they imagine they see dogs in them, whereof they are much afraid, by reason whereof they shun the water and all polite and clear bodies which may supply the use of a lookingglass; so that they throw themselves on the ground, as if they would hide themselves therein, lest they should be bitten again: for they affirm that he which is bitten by a mad dog, always hath a dog in his mind, and so remains fixed in that sad cogitation. Wherefore thinking that he sees him in the water, he trembles for fear, and therefore shuns the water. Others write that the body by madness becometh wondrous dry, wherefore they hate the water, as that which is contrary thereto, being absolutely the moistest element, and so they say that this is the reason of their fearing the water. Ruffus writes that madness is a kind of melancholy, and that fear is the proper symptom thereof, according to Hypocrates; wherefore Aphor. 25. sect. 6. this or that kind of melancholy begets a fear of these or these things, but chiefly of bright things, such as looking-glasses and water, by reason that melancholy persons seek darkness and solitariness, by reason of the black corruption of the humour wherewith they abound. They fall into cold sweats, a foamy, stinking and greenish matter flows from the ulcer, by reason of the heat of the antecedent cause and ulcerated part. The urine most commonly appears waterish, by reason that the strainers, as it were, of the kidneys, are straitened by the heat and dryness of the venom. Yet sometimes also it appears more thick and black, as when nature powerfully using the expulsive faculty, attempts to drive forth by urine the melancholy humour, the seat of the venom. Also sometimes it is wholly suppressed, being either incrassated by hot dryness, or else the mind being carried other ways, and forgetful of its own duty, The bite of a mad dog taken in hand in time, is for the most part curable. until at length the patients, vexed by the cruelty of so many symptoms, and overcome by the bitterness of pain, die frantic, by reason that medicines have not been speedily and firly applied. For few of those who have used remedies in time, have perished of this disease. CHAP. XIII. Prognostics. WE cannot so easily shun the danger we are incident to by mad dogs, as that The venom of a mad dog applied outwardly only, may cause madness. of other beasts, by reason he is a domestic creature, and housed under the same roof with us. The virulency that resides in his foam or slaver is hot and dry, malign, venenate and contagious, so that it causeth a distemper like itself, in the body whereto it shall apply itself, and spread itself over the whole body by the arteries; for it doth not only hurt when as it is taken in by a bite or puncture, but even applied to the skin, unless it be forthwith washed away with salt water or urine. Neither doth this venom hurt equally or at all times alike, for it harms more or less, according to the inclination of the air to heat or cold, the depth of the wound, the strength of the patient's body, and the ill humours thereof, and their disposition to putrefaction, the freedom and largeness of the passages. Now malign symptoms happen sooner ●…later, as in some about the fortieth day, in others about six months, and in others a year after. There Whether the Hydrophobia or fear of water beincurable. be some who thereupon are troubled with the falling sickness, and at length grow mad: such as fall into a fear of the water, never recover. Yet Avicen thinks their case is not desperate, if as yet they can know their face in a glass; for hence you may gather, that all the animal faculties are not yet overthrown, but that they stand in need of strong purgations, as we shall show hereafter. Aëtius tells that there was a certain A history. Philosopher, who taken with this disease and a fear of water, when as he descended with a great courage unto the bath, and in the water beholding the shape of the dog that bit him, he made a stand, but ashamed thereof, he forthwith cried out, Quid cani cum Balbeo? ay What hath a dog to do with a Bath? which words being uttered, he threw himself forcibly into the Bath, and fearelesly drank of the water thereof, and so was freed from his disease together with his erroneous opinion. It is a deadly sign to tumble themselves on the ground, to have a hoarse voice, for that is an argument that the weazon is become rough by reason of too excessive dryness. Finally, the principal parts being possessed, there is no recovery or life to be hoped for. Men may fall mad, though they be not bit by a mad dog. For as the humours are often inflamed of themselves, and cause a Cancer or Leprosy, so do they also madness in melancholy persons. The bites of vipers and other venomous creatures cause not like symptoms to these that come by the biting of a mad dog, because they die before such can come forth or show themselves. Great wounds made by mad dogs are not equally so dangerous as little, for from the former, great plenty of venomous matter flows out, but in the latter it is almost all kept in. CHAP. XIIII. What cure must be used to such as are bitten by a mad dog. THis case also requires speedy remedies, for such things are in vain which come long after the hurt. The Lawyer Baldus experienced this to his great A history. harm; for being by chance lightly bit in the lip by a little dog wherewith he was delighted, not knowing that he was mad, & neglecting the wound, by reason of the smallness thereof, after some four months space, he died mad, having then in vain assayed all manner of medicines. Wherefore observing these things both for evacuation, as also for alteration, which we have formerly mentioned in the general cure of wounds inflicted by the bite or sting of venomous creatures, and by all the means there specified, we must draw forth the venom; and if the wound be large, then suffer it to bleed long and much, for so some part of the poison will be exhausted; if it be not great, it shall be enlarged by scarification, or an occult cautery, neither shall it be healed or closed up at the soon, till forty days be passed. Sorrel The force of Sorrell. beaten and applied to the wound, and the decoction thereof taken inwardly, is very effectual in this case, as Aëtius affirms. To the same purpose you may with good success make a lotion and friction with mustard dissolved in urine or vinegar, leaving upon the wound a double cloth moistened in the same decoction: lastly, all acride, biting and very attractive medicines are convenient in this case. Wherefore some apply Rocket boiled and beaten with butter and salt; others take the flower of Orobus, and temper it with honey, salt and vinegar, and apply it hot. Horse-dung boiled in sharp vinegar, or brimstone beaten to powder and tempered with one's spittle, is good. Also black pitch melted with some salt, and a little Euphorbium mixed therewith and so applied, is good. Some write, that the hairs of the dog whose bite caused the madness, applied by themselves, by their sympathy or similitude of substance draw the venom from within outwards; for so a Scorpion beaten and applied to the place whereas it stung, by drawing out the poison that it sent in, restores the patient to health, both these by often experience are affirmed to have certain event. Others chaw unground wheat, and lay it upon the wound, others roast beans under hot embers, than husk them and cleave them, and so apply them. Also the wound may be wholesomely washed and fomented with a decoction The force of Docks. of Docks, and then the herb beaten may be applied thereto; also the patient may drink the decoction; and by this one remedy Aëtius affirms that he hath recovered divers; for thus it moves urine plentifully, which is thought much to conduce to the cure of this disease. There be some who apply the leaves of betony and nettles beaten with common salt; others make a medicine to the same purpose and after the same manner of an Onion, the leaves of Rue and salt. Yet the rest are exceeded by Treacle dissolved in aqua vitae or strong wine, and rubbed hard upon the part, so that the blood may follow, laying upon the wound when you have wiped it, clothes dipped in the same medicine, then presently apply garlic or onions beaten with common A history. salt and turpentine: by this only remedy I freed one of the daughters of Madamoiselle A history. de Gron from the symptoms of madness, and healed the wound, when as a mad dog had bit her grievously in the calf of the right leg. Also it is good presently to eat garlic with bread, and then to drink after it a draught of good wine, for garlic by its spirituous heat will defend the noble parts from poison. There be some who wish to eat the roasted liver of the dog that hurt them, or else the liver of a goat, of which remedies as yet I have had no experience. Others prescribe a dram of the seeds of Agnus castus to be drunk with wine and butter. Others the powder of river-crabs, burnt and drunk in wine. Or, ℞. gentianaeʒii. astacorum flaviatilium in fumo combust. & in pollinem redact. ʒiii. terrae sigil. ℥ ss. misce. give ʒi. of this same powder in the decoction of river crabs, & let them drink thereof oft at sundry times. Many have cast themselves into the sea, neither have they thence had any help against madness, as Ferrand Pozet the Cardinal testifieth in his book of poisons; Leaping into the sea n●ce●taine r●me●…y against madness. wherefore you must not rely upon that remedy, but rather you must have recourse to such things as are set down in the books of Physicians, and approved by certain and manifold experience. But seeing that no poison can kill, unless it be taken or admitted into the body, we must not fear any harm by sprinkling our bodies with the sanies of a mad dog, viper, toad, or any other such like venomous creature, if so be that it be presently wiped or washed clean away. CHAP. XV. What cure must be used to such as fear the water, but yet are able to know themselves in a glass. SUch as have not their animal faculty as yet o'ercome by the malignity of The force of Antimony against madness. the raging venom, must have strong purgations given them. Wherefore, if in any case Antimony be useful, then is it in this, as that which causeth sweats, looseth the belly, and procures vomiting. For it is a part of extreme and dangerous madness to hope to overcome the cruel malignity of this poison already admitted into the bowels, by gentle purging medicines. Assuredly, such and so great danger is never overcome without danger. Baths also conduce, which may disperse and draw forth the poison by causing sweats. Also many and frequent treacle potions are good, to retund the venom, and strengthen the bowels; also it will be fitting to give them water and all other liquid things, which they so much abhor, in a cup with a cover. Always let such as are poisoned, or bitten or stung, by a mad dog or other venomous beast, keep themselves in some warm and light place, that the poison which by coldness is forced in, may be the readilier drawn out by the means of heat, and the spirits be recreated by the brightness of the air, and therefore move from the centre to the circumference of the body, and let the room be perfumed with sweet things. To eat very hot and salted things presently at the beginning, as onions, leeks, all spiced meats, and strong wine not allayed, seems not to be besides reason; because such things by their spirituous heat hinder the diffusion of the poison over the body, and strengthen the filled entrailes. There be some also that would have them to feed upon gross and viscous meats, which by obstructing the vessels, may hinder the passage of the poison to the heart and other parts; and by the same reason it will be better to fill themselves with meat to satiety, than otherwise, because the malignity of humours is increased by hunger, than which, nothing can be more harmful to venomous wounds. Yet within a short while after, as within five or six days, they must return to a mediocrity, and use all things temperate, boiled meats rather than roasted, and that in a decoction of opening things, so to move urine. Lastly, they must keep such a diet as melancholic persons ought to do; neither shall they let blood, lest so the poison should be further drawn into the veins; but it is good that the patient's body be soluble from the very first. Let their drink be wine indifferently allayed with water, oxymel simplex, or the syrup of the juice of Citron with boiled water; or else this following Julep. ℞. succilimonum, & malorum citri, an. ℥ ss. suc. gran. acid. ℥ two. aquae acetosae, min. & ros. an. ℥ i. aq. font. coct. quantum sufficit, fiat Julep, ut artis est. Sleep is to be Why sleep is hurtful to such as are bitten by a mad dog, and all such as are poisoned. avoided until the force of the poison is abated, for by sleep the humours flow back into the bowels. All things that resist poison must be given any way whatsoever, as lemons, oranges, angelica roots, gentian, tormentil, burnet, vervine, carduus benedictus, borage, bugloss, and the like. Let all things that are afterwards set before the patient be meats of good juice, such as are veal, kid, mutton, partridge, pullets, capons, and the like. CHAP. XVI. Of the biting of a Viper or Adder, and the symptoms and cure thereof. THe remedies that were formerly mentioned against the bitings of mad dogs, the same may be used against all venomous bites and stings, yet nevertheless each poison hath his peculiar antidote. Vipers or Adders (as we vulgarly term them) have in their The bites of vipers how virulent. gums, or the spaces between their teeth, little bladders filled with a virulent sanies, which is pressed out into the part that they bite with their teeth. There forthwith ariseth a pricking pain, the part at the first The symptoms. is much swollen, and then the whole body, unless it be hindered: gross and bloody filth sweats out of the wound, little blisters rise round about it, as if it were burnt, the wound gnaws, and as it were feeds upon the flesh, great inflammation possesseth the liver and the gums, and the whole body becomes very dry, becoming of a yellowish or pale colour, with thirst unquenchable; the belly is gripped by fits, a choleric vomiting molesteth them, the stomach is troubled with a hicketting, the patients are taken with often sownings, with cold sweat, the forerunner of death, unless you provide by fit medicines for the noble parts, before the poison shall invade them. Mathiolus tells that he saw a countryman, who, as he was mowing a meadow, by chance cut an Adder in two with his scythe, which when he thought it A history. was dead, he took the one half whereon the head remained, without any fear in his hand, but the enraged creature, turning about her head, cruelly bit him by one of his fingers, which finger as men usually do (especially when as they think of no such thing) he put into his mouth, and sucked out the blood and poison, and presently fell down dead. When as Charles the ninth was at Montpelier, I went into the shop of one Farges an Apothecary, who then made a solemn dispensation of Treacle, where not satisfying A history. myself with the looking upon the vipers which were there in a glass, ready for the composition, I thought to take one of them in my hands, but whilst that I too curiously and securely handled her teeth which were in her upper jaw, covered with a skin, as it were a case to keep the poison in, the beast catched hold of the very end of my forefinger, and bit me in the space which is between the nail and the flesh; whence presently there arose great pain, both by reason of the part endued with most exquisite sense, as also by the malignity of the poison: forthwith I exceeding straight bound my finger above the wound, that so I might press forth the blood and poison, lest they should diffuse themselves further over the body. I dissolved old treacle in aqua vitae, wherein I dipped and moistened cotton, and so put it to the wound, and within a few days I throughly recovered by this only medicine. Remedies for the bite of a viper. You may use in stead of Treacle, Mithridate and sundry other things, which by reason of their heat are powerful drawers, as a squill roasted in hot embers, garlic and leeks beaten and applied, barley flower tempered with vinegar, honey, and goats dung, and so applied like a pultis. Some think it sufficient forthwith to wash and foment the wound with vinegar, salt, and a little honey. Galen writes that the poison inflicted by the bite of a viper, may be drawn forth by applying to the wound the head of a viper, but othersome apply the whole viper beaten to mash. CHAP. XVII. Of the Serpent called Haemorrhous. THE Serpent Haemorrhous is so called, because by his biting he causeth blood to drop out of all the passages of the wounded body; he is of a The Haemorrhous why so called. small body, of the bigness of a viper, with else burning with a certain fiery brightness, and a most beautiful skin. The back of him (as Avicen writes) is spotted with many black and white spots, his neck little and his tail very small: the part which he bites, forthwith grows blackish, by reason of the extinction of the native heat, which is extinguished by such poison which is contrary thereto in its whole substance. Then follows a pain of the stomach and heart, these parts being touched with the pestiferous quality of the poison. These pains are seconded by vomiting, the orifice of the ventricle being relaxed by a Diarrhaea, the retentive faculty of all the parts of the belly being weakened, and the veins which are spread through the guts, not being able to retain the blood contained in them. For the blood is seen to flow out, as in streams, from the nose, mouth, ears, fundament, privities, corners of the eyes, roots of the nail, and gums, which Wonderful bleedings. putrefy, the teeth falling out of them. Moreover there happens a difficulty of breathing, and stoppage of the urine, with a deadly convulsion. The cure is forthwith to scarify, and burn the bitten part, or else to cut it quite off, if that it may be done without danger of life, and then to use powerfully drawing Antidores. The figure of the serpent Haemorrhous. CHAP. XVIII. Of the Serpent called Seps. THe Serpent Seps is so called, because it causeth the part which it bites, The reason of the name, and description of the Seps. forthwith to putrefy, by reason of the cruel malignity of its poison. It is not much unlike the Haemorrhous, but that it curls or twines up the tail in divers circles. Pausanias writes that this serpent is of an ash-colour, a broad head, small neck, big belly, writhe tail, and as he goes, he runs aside like a crab. But his skin is variegated and spotted with several colours, like to Tapestry. By the cruelty of his caustic and putrefying venom, he burns the The symptoms. part which he hath bit, with most bitter pain; he causeth the shedding of the hairs, and as Aëtius addeth, the wound at the first casteth forth manifest blood, but within a little while after, stinking filth. The putrefyed affected parts wax white, and the body all over becomes of the colour of that scurf, which is termed Alphos, so that by the wickedness of this putrefactive poison, not only the spirits are resolved, but also the whole body consumed, as by fire, a pestilent carbuncle, and other putrid tumors, arising from a hot and humid or suffocating constitution of the air. Now for the remedies, they must be such as are formerly prescribed against the bitings of a viper. The Figure of the Serpent Seps. CHAP. XIX. Of the Basilisk or Cockatrice. THe Basilisk far exceeds all kinds of Serpents in the curstness of its poison. Therefore it is affirmed by Nicander, that into what place soever he comes, other venomous creatures do forthwith fly thence, for that The efficacy of 〈◊〉 the poison 〈◊〉 the Basilisk. none of them can so much as endure his hissing; for he is thought to kill all things even with this, & not with his biting and touch only; besides, if any of them hasten to get any meat or drink, and perceive that the Basilisk is not far from thence, he flies back, and neglects the getting of nourishment necessary for life. Galen writes, that the Basilisk is a yellowish serpent, with a sharp head, and three risings distinguished with white spots, and rising up in form of a crown, Lib. de theriac. by reason whereof he is styled the King of Serpents. Certainly the violence of his poison in kill men is so great, that he is therefore thought to kill men, and other Wh● the Basilisk is thought to kill by his 〈◊〉 sight. creatures by his sight only. Solinus affirms, that the body of a dead Basilisk hath wondrous faculties. Wherefore the inhabitants of Pergamum, in ancient times, gave a mighty price for one, to hang upon the joistes of the temple of Apollo, so to drive away the Spiders and Birds, lest they should there wove their webs, or the other build their nests in that sacred place. Verily no ravenous creature will touch their carcase; but if constrained by hunger they do touch it, than they forthwith fall down dead in the same place: and this happens not only by eating their body, but also by devouring the bodies of such beasts as are killed by their bitings. They kill 〈◊〉. lib. 8. ca●. 21. the trees and shrubs by which they pass, not only by their touch, but even with their breath. Amongst the western Aethiopians is the fountain Nigris, near which there is a serpent called Catablepas, small in body, and slow, having a great head; which it scarce can carry, but that it lies always upon the ground, otherwise it The 〈◊〉. 〈◊〉. would kill abundance of people, for it forthwith kills all that see the eyes thereof, the Basilisk hath the same force; he is bred in the province of Cyrene, of the length of some twelve fingers, with a white spot in his head, resembling a crown; he chaseth away all serpents with his hiss: Weasels are the destruction of such monsters: thus it pleased nature, that nothing should be without its equal; they assail them in their dens, being easily known by the barrenness or consumption of the soil. These kill them also by their scent, and they die, and the fight of nature is ended: thus Nothing in nature without its equal. nature to the magnanimous Lion, lest there should be nothing which he might fear, hath opposed the weak creature the Cock, by whose crowing only he is terrified and put to flight. Erasistratus writes, that a golden yellowness affects the bitten part of such as are hurt by a Basilisk, but a blackness and tumour possesseth the rest Sy●…. of the body, all the flesh of the muscles within a while after falling away piecemeal. An antidote against this must be made of a dram of Castoreum dissolved 〈◊〉. in wine and drunken, or else in the juice of poppy. But Aëtius thinks it superfluous to write remedies against the Basilisk, when as the sight and hearing only kills such as either see or hear her. The figure of a Basilisk. CHAP. XX. Of the Salamander. THe Salamander kills not only such as it bites by making a venomous impression, The malignity of a Salamander. but it also infects the fruits and herbs over which it creeps, with a spittle or gross moisture which sweats out of all the body, to the great danger of the health and life of such as eat these things at unawares: wherefore it need not seem strange, which is received by some late writers, that some families have all died by drinking water out of pits, whereinto a Salamander by accident was fallen. For if it shall creep upon a tree, it infects all the fruit with the The temper of her. qualities of cold and moist poison, wherein it yields not to Aconite. Aetius writes that such as are infected with the poison of a Salamander, certain parts of their body grow livide, so that they fall away often, being putrefyed. At Symptoms. the first there appear white spots over the body, then red, afterwards black with putrefaction, and the falling away of the hairs. The cure is, to procure vomit, to The cure. lose the belly with a clyster, and to give them Treacle and Mithridate in potions. Avicen prescribes the same things against this kind of poison as against opium, by reason of the cold nature of them both; the proper antidote is turpentine, styrax, nettle seeds, and cypress leaves. Dioscorides writes that the Salamander is a kind of Lizard Lib. 2. cap. 54. dull, variegated, and which is falsely reputed not to be burnt by fire. But Pliny saith she is so cold, that she extinguisheth the fire by her touch only, being laid upon hot coals. On the contrary, Mathiolus saith that cast into a great flame, they are quickly consumed. It is easy out of Aetius to reconcile these disagreeing opinions; How a Salamander may be said to live in the fire. This creature, saith he, passeth through a burning flame, and is not hurt, the flame dividing itself and giving her way, but if she continue any time in the fire, the cold humour being consumed in her, she is burnt. Now the Salamander is black, variegated, with yellow spots, starre-fashion. The figure of a Salamander. CHAP. XXI. Of the Torpedo. THe Torpedo hath his name from the effect, by reason that by his touch and power the members become torpid & numb; in muddy shores it lives upon fish, which she catcheth by craft. For lying in the mud, she so stupefyes those that are nigh her, that she easily preys upon them; The craft of the Torpedo. she hath the same power over men, for she sends a numbness not only into the arm of the fisherman, but also over all his body, although his fisher's pole His stupefying force. be between them. The effigies of a Torpedo. CHAP. XXII. Of the Bitings of Asps. THE wound which is made by an Asp is very small, as if a needle were thrust into the part, and without any swelling. These symptoms follow upon her bite, sudden darkness clouds their Symptoms. eyes, much agitation in all their bodies, but gentle notwithstanding; a moderate pain of the stomach troubles them, their foreheads are continually troubled with convulsive twitchings, their cheeks tremble, and their eyelids fall gently to rest and sleep; the blood which flows from the wound is little, but black; death no longer deferred than the third part of a day, will take them away by convulsions, unless you make resistance with fitting remedies. The male Asp makes two wounds, the female four, as it also happens in the bitings of vipers. Now for that the poison of Asps congeals the blood in the veins and arteries, therefore you must use against it such things as Cure. are hot & subtle of parts, as mithridate or treacle dissolved in aqua vitae, and the same poured into the wound; the patient must be warmed by baths, frictions, walking, and the like. When as the hurt part becometh purple, black or green, it is a sign that the native heat is extinct and suffocated by the malignity of the venom. Therefore than it is best to amputate the member, if the party be able to endure it, and there be nothing which may hinder. Vigo writes, that he saw a Mountebank at Florence, A history. who, that he might sell the more of his Antidotes, and at the better rate, let an Asp to bite him by the finger, but he died thereof some four hours after. To the same purpose you may read Mathiolus, whereas he writes that those Impostors or By what means Asps may be made less hurtful. Gal. lib. de Ther. ad pisonem. Mountebanks to cozen the better, and deceive the people, use to hunt and take vipers and asps long after the spring, that is, then whenas they have cast forth their most deadly poison; then they feed them with meats formerly unusual to them, so that by long keeping and care, at the length they bring it to pass, that they put off a great part of their venomous nature; neither being thus satisfied, they make them oftentimes to bite upon pieces of flesh, that so they may cast forth into them the venom which is contained in the membraine between their teeth and gums. Lastly, they force them to bite, lick and swallow down an astringent medicine, which they compose and carry about for the same purpose, that so they may obstruct the passages by which the venom used to flow out, for thus at length their bites will be harmless, or without great danger. This therefore is their art, that so they may sell their counterfeit treacle to the people at a high rate, as that which is a most safe remedy against all poisonous bites. Christopher Andrew in his book called ●●coiatria, writes, Against the bites of what serpents treacle doth no good. that the Lands of Spain are everywhere full and stored with serpents, asps, and all sorts of venomous beasts, against whose bites they never observed or found any benefit in treacle. But the efficacy of the following Antidote is so certain and excellent, and approved by so manifold experience, that in the confidence thereof, they will not be afraid to let themselves be bitten by an Asp. Now this medicine is A certain remedy against the bitings of Asps. composed of the leaves of Mullet, Avenes & red stock Gilly flowers in like quantity, which they boil in sharp vinegar and the urine of a sound man, and there with foment the wounded part. Yet if he have not taken nor used any thing of a good while after the wound, it will be better and more certain, if the patient drink three ounces of this decoction fasting two hours before meat. CHAP. XXIII. Of the biting of a Snake. I Have thought good in a true history to deliver the virulent malignity A historic. of the bite of a snake, and the remedies thereof. When as King Charles the ninth was at Moulins, Mousier Le Feure, the King's Physician, and I were called to cure the Cook of the Lady of Castelpers. Who gathering hops in a hedge to make a salad, was bit on the hand by a snake that there lay hid, he putting his had to his mouth, sucked the wound to ease the pain by sucking forth the venom. But his tongue forthwith swelled so big, that he could not speak his mind: besides his whole arm, even to his shoulder, was in like sort much swelled, his pain was so vehement, that it made him swoon twice in my presence, his face was wan and livid like to a dead body, and though I despaired of his recovery, yet not suffering him to be quite forsaken, I washed his mouth The cure. with treacle dissolved in white wine, and gave him some thereof to drink, adding thereto some aqua vitae. I opened his swollen arm with many and deep scarifications, especially in the place where he was hurt, I suffered the blood which was wholly serous and sanious, to flow more plentifully, I washed the wounds with treacle and mithridate dissolved in aqua vitae, and then I put him exceeding warm in bed, procuring sweat, and making him to lie awake, lest sleep should draw the poison inwards to the entrailes. I by these means so far prevailed, that on the day after he was freed from all his malign symptoms. Therefore I judged it only remained for a perfect cure, that the wound should be long kept open and washed with treacle, neither was I deceived, for within a few days he was perfectly recovered. CHAP. XXIV. Of the bitings of Toads. THough Toads want teeth, yet with their hard & rough gums they so straight press or pinch the part which they shall take hold on, that they will The bites of toads how harmful. force their poison thereinto, and so over the whole body by the pores of the pressed part. Moreover, they cast forth their venom by urine, spittle and vomit upon herbs, but chiefly upon Strawberries, the which they are reported greatly to affect. Hence many suddenly and ignorantly catch their deaths. I heard from a man of very good credit, that there were two merchants not far A history. from the City Tholouse, who whilst dinner was providing, walked into the garden that belonged to the Inn, where they gathered some sage leaves, and unwashed as they were, put them into their wine. They had not as yet dined, when being taken with a sudden Vertigo, the whole Inn seemed to run round, then losing their sight, The symptoms occasioned by the poison of toads. they fell into a swoon, intermixed now and then with convulsions. But they stammered with their lips and tongues becoming black; a froward and horrid look with continual vomiting, and a cold sweat, the forerunner of death, which presently seized upon them, their bodies becoming exceedingly much swollen. But the Justices of the place suspecting that they were poisoned, made the Innkeeper and the Guests to be apprehended, being examined, they all constantly & with one voice answered, that the dead parties ate of the same meat and drink which the rest did, but only that they put sage into their wine. A Physician was asked the question whether sage might be poisoned; he answered, it might: but to come to the purpose, that it must appear whether any venomous creature had poisoned the plant with her spittle or venomous sanies. This which was lightly pronounced, and only by conjecture, was by the eye found to be true. For at the root thereof there was found a hole in the ground full of Toads, who got out by putting in of warm water, made it credible that the plant was poisoned by their spittle and urine, whereby you may understand how unwisely they do, who devour herbs and fruits newly gathered without washing. Also we must take heed lest falling asleep in the fields, we lie not near the holes which toads or other venomous beasts of the like nature have made their habitation. For thence a venomous or deadly air may be drawn into the lungs. For the same cause we must abstain from eating of frogs in the month of May, because May frogs. than they engender with toads. Oxen in feeding sometimes lick up small toads together with the grass, which presently will breed their great harm, for thereupon the oxen swell so big, that they often burst withal. Neither is the venom of toads deadly only being taken inwardly, but even sprinkled upon the skin, unless they forthwith wipe the place, & wash it with urine, water & salt. Such as are poisoned by a toad turn yellow, swell over all their bodies, are taken with an Asthmaticke difficulty of breathing, a Vertigo, convulsion, swooning, and lastly by death itself. These so horrid symptoms are judged inherent in the poison of toads, not only by reason of the elementary qualities thereof, coldness & moisture, which are chiefly predominant therein; but much rather by the occult property which is apt to putrefy the humours of that body whereto it shall happen. Therefore it will be convenient to procure vomit, especially The cure. if the poison be taken by the mouth, to give gly sters, & to weaken the strength of the poison by hot and attenuating Antidotes, as treacle & mithridate dissolved in good wine; but in conclusion to digest it by baths, stoves, and much and great exercise. Rondeletius in his book de Piscibus, affirms the same ●…ings of the cursed venom of toads, as we have formerly delivered: yet that they seldom bite, but that they cast forth either their urine, the which they gather in a great quantity in a large bladder, or else their venomous spittle or breath against such as they meet withal, or assail; besides, the herbs which are tainted by their poisonous breath, but much more such as are sprinkled with their spittle or urine, are sufficient to kill such as eat them. The Antidotes are juice of betony, plantain, mugwort, as also the blood of Antidotes against the poison of toads. Tortoises made with flower into pills, and forthwith dissolved in wine, and drunken. Pliny writes that the hearts and spleens of toads resist poison. The vulgar opinion is false, who think that the toadstone is found in their heads, which is good against poison. CHAP. XXV. Of the stinging of a Scorpion. AScorpion is a small creature with a round body in form of an egg, The description of a Scorpion. His tail. with many feet, and a long tail consisting of many joints, the last whereof is thicker and a little longer than the rest, at the very end thereof is a sting, in some two, hollow and replete with cold poison, the which by the sting it casts into the obvious body; it hath five legs on each side forked with strong claws, not unlike to a Crab or Lobster, but the two foremost are bigger than the rest; they are of a blackish or sooty colour, they go aside, aside; and ofttimes fasten themselves with their mouths and feet so fast to men, that they can scarce be plucked therehence. There be some who have wings like the wings of Winged Scorpions. Locusts, wasting the corn & all green things with their biting and burning. Such are unknown in France. These flee over divers Countries like winged Ants. This is likely to be true by that which Mathiolus writes, that the husbandmen in Castille in Spain, in digging the earth ofttimes find a swarm of Scorpions, which betake themselves thither against winter. Pliny writes, that Scorpions laid waste a certain part of Aethiopia, by chase away the inhabitants. The Ancients made divers kinds of Scorpions, according to their variety or difference of colours, some being yellow, others brown, reddish, ashcoloured, green, whitish, black, dusky; some have wings, and some are without. They are more or less deadly according to the countries they inhabit. In Tuscanie and Scythia they are absolutely deadly, but at Trent and in the Island Pharos their stinging is harmless. The place stung by a Scorpion presently begins Symptoms, to be inflamed, it waxeth red, grows hard and swells, and the patient is again pained, he is one while hot, another while cold, labour presently wearies him, and his pain is somewhiles more and somewhiles less, he sweats and shakes as if he had an Ague, his hair stands upright, paleness discolours his members, and he feels a pain, as if he were pricked with needles over all his skin, wind flieth out backwards, he strives to vomit and go to stool, but doth nothing, he is molested with a continual fever and swooning, which at length proves deadly, unless it be remedied. Dioscorides writes, that a Scorpion beaten and laid to the place where he stung, is a remedy Lib. 2. cap. 10. & lib. 1. cap. 44. thereto, as also eaten roasted to the same purpose. It is an usual, but certain remedy to anoint the stung place with the oil of Scorpions. There be some who drop into the wound the milky juice of figs, others apply thereto Calamint beaten, othersome use barley meale-mixed with a decoction of Rue. Snails beaten together with their shells, and laid thereon presently assuage pain. Sulphur vivum mixed with turpentine, and applied plaster-wise, is good; as also the leaves of ●…ue beaten & laid thereto. In like sort also the herb Scorpioides, which thence took its name, is convenient, as also a bryony root boiled and mixed with a little sulphur and old oil. Discorides affirms Lib. 3. cap. 1. Agarick in powder or taken in wine to be an Antidote against poisons, verily it is exceeding good against the stingings or bite of serpents. Yet the continual use of a bath stands in stead of all these, as also sweat and drinking wine somewhat alaid. Now Scorpions may be chased away by a fumigation of Sulphur and Galbanum; Scorpions chased away with the juice of garlic or Radishes. also oil of Scorpions dropped into their holes, hinders their coming forth. Juice of radish doth the same. For they will never touch one that is besmeared with the juice of radish or garlic, yea verily, they will not dare to come near him. CHAP. XXVI. Of the stinging of Bees, Wasps, etc. BEes, Wasps, Hornets and such like, cause great pain in the skin wounded by their stinging, by reason of the curstness of the venom which they send into the body by the wound, yet are they seldom deadly, but yet if they set upon a man by multitudes, they may come to kill him. For thus they have sometimes been the death of horses. Wherefore because such as are stung by these, by reason of the cruelty of pain, may think they are wounded by a more virulent and deadly creature, I think it not amiss to set down what signs follow upon their stingings. Great pain presently ariseth, which continueth The symptoms. until the sting left in the part is taken forth, the part becomes red and swollen, and there riseth a push or little blister. The cure is, forthwith to suck the wound very The cute. hard, and thereby to draw forth the stings, which if they cannot thus be gotten out, the place, if nothing hinder, is to be cut, or else temper ashes with leven or oil, and so apply them: the part also may be very conveniently put into hot water, and there fomented for an hour's space, and at length washed in sea-water. Cresses beaten and applied, assuage the pain and discuss the humour causing the tumour. Ox dung macerated in oil and vinegar, and applied hot, doth the same. There are some who apply to the part the same creatures beaten, as we formerly said of Scorpions; beans chawed and laid to the part assuage pain. Vinegar, honey and salt applied exceeding hot, are good, if besides, you dip a cloth therein, and lay it upon the place; sulphur vivum tempered with spittle hath the same effect. The milky juice of unripe figs incorporated with honey, is judged very effectual, but it is much the better, mixed with treacle. Wasp's will not sting nor bite such as anoint their bodies with the juice of mallows mixed with oil. They may be quickly chased away with the fume of brimstone and such like things. A wasp is said, if she find a viper dead, to dip her sting in the others poison, and thence men learned to empoison the heads of their arrows. The rough and hairy worms, which are commonly called Bearwormes, The bites of Bearwormes. especially those which breed about a Pine tree, cause great itching, redness & swelling in the part which they bite, touch or grate upon very hard. A remedy hereof is onions beaten with vinegar, and the rest of the things formerly mentioned. CHAP. XXVII. Of the bite of a Spider. Spider's wove webs with various art, yet in these they always make a lurking hole, so to lie in wait to catch the entrapped flies, and so to pray upon them. There are many sorts of Spiders, one is Differences of Spiders. termed Rhagium, round and like a black berry, whence it taketh the name; it hath a very small mouth under the midst of the belly, and most short feet, as if they were imperfect, her bite is as painful as the sting of a Scorpion. Another is called Lupus or the Wolfe-spider, because she doth not only lie in wait to catch flies, but also bees and wasps, and all such things as may flee into her web. The third is named Myrmetion, it is larger than an Ant, but headed like one, the body thereof is black, and hath white spots or streaks running towards the back. The fourth kind may be called Vesparium, in other things resembling a Wasp, but that it wants the wings; of a reddish colour, and living only on herbs. The Ancients have thought their bitings to be venomous. Now their poison is therefore thought to be cold, because the symptoms thence arising are wind in the belly, refrigerations of the extreme parts of the body, numbness in the bitten part, with sense of cold and shaking. The wound must forthwith be washed with very hot vinegar; then must you lay thereto onions, and such like things beaten, then procure sweat by art, as by baths and stoves, yet nothing is more effectual than treacle and mithridate. CHAP. XXVIII. Of Cantharideses and Buprestes. Cantharideses shine as it were with a golden colour, acceptable to the eye, by The description of Cantharideses. reason of the commixture of a bluish or greenish colour therewith, yet their smell is ungrateful. They are hot and dry in the fourth degree, and so caustic, corrosive and venomous, not only by reason of their caustick quality, but because of a secret antipathy which they naturally have against the Enemies to the Bladder. urenary parts; which effects they produce not only if they be taken by the mouth into the body, but even applied outwardly to raise blisters. Such as have taken them Symptoms. inwardly, have the taste of pitch or some thing like cedria, or the rosin of Cedars, in their mouths, it is likely that this taste proceeds from the humours dissolved by the putredinous heat in the stomach, guts & liver, and the vapours that therehence arise; fortaken inwardly, they gnaw, exulcerate and burn all parts from the mouth even to the belly, whence ensueth a bloody flux, excrements flowing out, which resemble the washings of new killed flesh. Then follows a burning fever, vertigo, madness, restlessness, the brain being disturbed by the plenty of vapours lifted up from the corroded and burnt parts and humours, which therefore when as they appear, you may know the affect is uncurable. In the parts appointed for the receiving and conveyance of the urine they cause a burning inflammation, excoriation, strong and continual erection of the yard, whence ensues a bloody and painful strangury, in stead of which there ofttimes happens or succeeds an Ischary or stoppage of the water, whence a gangrene and mortification of the part, and so in conclusion of the whole body besides. When as Cantharideses are taken inwardly, the remedy is vomiting, drinking of Cows mike to correct the heat and dryness, good also to mitigate the ulcers and stay the dysentery; it is good also to inject it into the guts by clyster. In stead thereof salad oil, or oil of sweet almonds is convenient to retunde the acrimony of the poison fastened to the sides of the stomach. The rest and whole cure of this poison you may learn by the following history. A certain whore, the better A history, to enjoy the company of a young Abbot who loved her, entertained him with a banquet, and sprinkled divers of their cates with the powder of Cantharideses, to incite him the more to venery. The next day, when as the Abbot cast forth pure blood at his fundament and yard which stood very stiff, he called some Physicians, The cure, who presently by the forementioned symptoms, which were all very apparent in him, understood that he had Cantharideses given him: wherefore they purged him upwards with vomits, and downwards by glisters made with French barley, Rice, a decoction of mallows, seeds of line and foenugreek, oil of lilies, goats suet: then presently after they gave him a little treacle with a good quantity of conserve of violets, which might draw the poison outwards, they gave him milk to drink, and caused him to use injections into the urenary passage and guts made of refrigerating things, as the juice of lettuce, purslane, cucumbers, gourds, melons; of tough and viscide things, that so they might stick the more easily and long to the ulcerated parts, as the mucilages of psilium, mallows, quince-seeds, syrup of waterlillies, popies and violets, fresh butter, and oil of sweet almonds, and they made him drink only barley water, or the common ptisan; they let him feed on veal, ●…id, and pork boiled with lettuce, purslane, barley and violet leaves, the which by their humidity might relax the belly, and by their toughness lenify the roughness or asperity; they applied also refrigerating things to the loins, share and perinaeum to assuage the heat of the urine. At length they put him into a warm bath, and to conclude, they left nothing unattempted to draw forth or weaken the poison. But all their endeavours were in vain, for the Abbot died, not being destitute of remedies conveniently prescribed, but overcome by the contumacious malignity of the poison. The Physicians pains had far better success in a certain Gentlewoman against this kind of affect; her whole face was deformed with red, A history. fiery and filthy pustles, so that all shunned her company as if she had been troubled with a Leprosy, and were ready to forbid her the society of men; she came to Paris, and call Hollerius and Grealmus Physicians, me and Caballus being Surgeons, she made agrievous complaint, and besought us earnestly for some remedy against so great a deformity of her face; having diligently considered her case, we pronounced her free from a Leprosy; but we judged it fit to apply to her whole face a vesicatory of Cantharideses, three or four hours after the application whereof, Cantharideses applied to the head, ulcerate the bladder. the medicine being come to work its effect, her bladder began to burn exceedingly, and the neck of her womb to swell, with gripings, continual vomiting, making of water and scouring, a trouble some agitation of the body and members, a burning and absolutely fiery fever. I forthwith called the Physicians, it was decreed that she should drink wine plentifully, and that it should be injected by the fundament into the guts, and by the urenary passage into the bladder and the neck of the womb, and that she should keep herself, until the pain were mitigated, in a warm bath made of the decoction of Line-seeds, the roots and leaves of mallows, marshmallows, violets, henbane, purslane and lettuce; and her loins and genitals should be anointed with unguentum rosatum & populeon stirred and incorporated with oxycrate. By these means, all the symptoms were mitigated. Her face in the interim rose all in a A remedy against Leprous 〈◊〉. blister, and much purulent matter came out thereof, and so the deformity, wherewith she was formerly troubled, vanished away for ever, so that within a while after she was married, and had many children, and is yet living in perfect health. Buprestes also are of the kind of Cantharideses, being like unto them in shape and The reason of the name. faculty. If an Ox or Sheep or any other creature shall in feeding devour one of them, he will presently swell up like a Tun; whence also they take their name: if a man take them inwardly, he shall endure the like symptoms as in taking Cantharideses, and over and besides both his stomach and his whole belly shall be wonderfully puffed up, as if he had a Dropsy. It is probable that this inflation like a tympany happenneth by humours diffused and resolved into vapours by the fiery acrimony of the venom: They are to be cured after the same manner as such as have drunk Cantharideses. Lastly, as in all other poisons which are taken into the body, so also here, if the poison taken by the mouth be thought as yet to be in the stomach, you must then procure vomit. If it be gotten into the guts, then must it be drawn away by glisters; if diffused over all the body, then must you make use of such things as may drive the poison forth from the centre to the circumference, such as are baths and stoves. CHAP. XXIX. Of Horseleeches. Horseleeches are also venomous, especially such as live in muddy stinking ditches, for these are less hurtful which reside in clear & pure waters. What horsel●…es most virulent. Wherefore, before they are to be used in cas●s of Physic, they must be kept for some day's space in clean water, that so they may purge themselves; otherwise they may chance to leave ulcers hard to cure in the places whereto they shall be applied, and the rather, if they be violently plucked off, because they by that means leave their teeth fastened in the part. Now he which by chance hath swallowed a Horseleech, must be asked in what 〈◊〉 reme●…●…g 〈◊〉 diversity of the parts. part be feeleth her, that is, the sense of her sucking. For if she stick in the top of the Throat or Gullet, or in the midst thereof, the part shall be often washed with mustard dissolved in vinegar. If she be near the orifice of the ventricle, it is fit that the patient by little and little swallow down oil with a little vinegar. But if she fasten to the stomach, or the bottom of the ventricle, the patient by the plucking of the part shall perceive a certain sense of sucking, the patient will spit blood, and will for fear become melancholic. To force her thence, he shall drink warm water with oil; but if she cannot so be loosed, then shall you mix Aloes therewith, or some thing endued with the like bitterness, for she will by that means leave her hold, and so be cast forth by vomit. You may perceive this by such as are applied to the skin, on the external parts, for by the aspersion of bitter things, whether they be full or empty, they will forsake their hold. Then shall the patient take astringent things, which may stop the blood flowing forth of the bitten part, such is conserve of Roses, with terra sigillata, bowl armenic, and other more astringent things, if need so require. For if they shall adhereto some greater branch of some vein or artery, it will be more difficult to stop the flowing blood. But for that not the earth only, but the sea also produceth venomous creatures, we will in like sort treat of them, as we have already done of the other, beginning with the Lampron. CHAP. XXX. Of the Lampron. THE Lampron, called in Latin Muraena, is a sea fish something in shape The description of the Lampron resembling a Lamprey, but she is bigger and thicker, and hath a larger mouth, with teeth long, sharp and bending inwards, she is of a dusky colour, distinguished with whitish spots, and of some two cubit's length; the Ancients had them in great esteem, because they yield good nourishment, and may be kept long alive, in pools or ponds, and so taken as the owners please to serve their table, as it is sufficiently known by the history of the Roman Crassus. She by her biting induceth the same symptoms as the viper, and it may be helped by the same means. Verily the Lampron hath such familiarity with The natural friendship of the Lampron and Viper. the Viper, that leaving her natural element, the sea, she leapeth a shore, and seeketh out the Viper in her den to join with her in copulation, as it is written by AElian and Nicander. CHAP. XXXI. Of the Draco-marinus or sea-Dragon. THE sea-Dragon called by the French Viva, for his vivacity (and by the English a Viver, or as some say a Qua-viver) because being taken in fishing and drawn out of the sea, she is said long to survive. Her pricks are poisonous, but chiefly those that are at the edges of her gils. Which is the reason that Cooks cut off their heads before they serve them up to the table; and at Roven the fishermen lay them not upon their stalls to sell before they have cut off their heads. The wounded part of such as are hurt, pains them much, Symptoms. with inflammation, a fever, swooning, gangrene and deadly mortification, unless it be quickly withstood. Not very long ago the wife of Monsieur Fromaget, Secretary of the requests, was wounded with a prick of this fish in her middle finger, there followed a swelling and redness of the part, without much pain; but perceiving the swelling to increase, being made more wary by the mischance of her neighbour the wife of Monsieur Bargelonne Lieutenant particulier in the Chastelet of Paris, who died not long before by the like accident being neglected, sent for me; I A history. understanding the cause of her disease, laid to her pained finger and her whole hand, besides a pultis made of a great Onion roasted under the coals, leaven and a little treacle. The next day I wished her to dip her whole hand into warm water, so to draw forth the poison, than I divided the skin about it with much scarification, but only superficiarily; to the gashes I applied Leeches, which by sucking drawing a sufficient quantity of blood, I put thereto treacle dissolved in aqua vitae. The next Cure. day the swelling was assuaged, and the pain eased, and within a few days she was perfectly well. Dioscorides writes that this fish divided in the midst and applied to the wound, will cure it. CHAP. XXXII. Of the Pastinaca marina, or Sting-Ray, which some call the Fierce-claw. SUch as are stung by a Sting-Ray (as Aëtius hath written) the place of the wound doth manifestly appear; there ensues thereon lasting pain and The symptoms. the numbness of the whole body. And seeing that it hath a sharp and firm sting, whereby the nerves by the deepness of the stroke may be wounded, it so happens that some die forthwith, their whole bodies suffering convulsions. Moreover it will kill even the very trees into whose roots it is fastened. Yet Pliny affirms that it is good against the pain of the teeth, if the gums be Lib. 9 cap. 48. scarified therewith, yea, and it being made into powder with white hellebore, or of itself, will cause teeth to fall out without any pain, or any violence offered to them. This fish is good meat, the head and tail excepted; some of them have two stings, othersome but one; these stings are sharp like a Saw with the teeth turned towards their heads. Oppianus writes, that their stings are more poisonous than the Persians The virulency o● her sting. arrows, for the force of the poison remaineth, the fish being dead, which will kill not only living creatures, but plants also. Fishermen, when they catch this fish, presently spoil him of his sting, lest they should be hurt therewith. But if by chance they be hurt therewith, then take they forth his Liver and lay it to the wound; furthermore the fish being burnt and made into powder, is the true Antidote of his wound. The Sting-Ray lives in muddy places near the shore, upon the fishes that he hunteth and catcheth with his sting, having the teeth thereof turned towards his head for the same purpose. He is not unlike a Ray, and I have here given you his figure. The figure of a Sting-Ray. CHAP. XXXIII. Of the Lepus marinus, or Sea-hare. PLINY calls the Sea-hare, a mass or deformed piece of flesh. Galen saith that it is like a Snail taken forth of the shell. It is exceeding poisonous The description of the Sea-hare. in the judgement of the Ancients; wherefore it is not amiss to set down the description of it, left we might eat it at unawares, too earnestly view it, or smell thereto, as also that we may use it against the poison thereof; it is an inhabitant not only of the Sea, but also of Lakes of Sea-water, especially such as are muddy; it is of the same colour as the hair of the land-hare is, it hath a hole in the head, out of which he putteth a certain piece of flesh, and plucks it back again when as he is seen. Paulus, Aëtius, Pliny, Galen and Nicander, The earnest beholding of a Sea-hare will cause abortion. are of one opinion, and agree in this, that if a woman big with child do too earnestly look upon one, she will vomit & presently after abort. They which have drunk this poison, saith Dioscorides, are troubled with pain in the belly, and their urine is stopped. If they do make water, then is it bloody; they run down with stinking sweat, which smells of fish; a choleric vomiting sometimes mixed with blood ensues thereon. Aëtius writes that all their bodies turn yellow, their faces swell, and their feet, The symptoms. but chiefly their genital member, which is the cause they cannot make water freely. Galen writes that it is the property of the Sea-hare to exulcerate the Lungs. Their The Antidote. Antidote is Asses milk, Muskedine, or honeyed Wine continually drunken, or a decoction of the roots and leaves of Mallows. It is good for the falling away of the hair. I have here given you the figure thereof out of Rondeletius his book of fishes. The figure of a Sea-Hare. CHAP. XXXIV. Of the Poison of Cats. NOt only the brain of a Cat, being eaten, is poisonous and deadly to man, but also their hair, their breath, yea and their very presence to some prove deadly. For although any hair devoured unawares, may be A Cat's hair most subject to choke. enough to choke one, by stopping the instruments of respiration, yet the hairs of cat by a certain occult property, are judged most dangerous in this case: besides also, their breath is infected with a certain hurtful malignity. For Mathiolus saith that he knew some, who being so delighted with Cats, that they could never go to bed without them, have by so often drawing in the air with The breath of a Cat most hurtful to the lungs their breath, fallen into a consumption of the Lungs, which occasioned their death. Moreover, it is manifest that the very sight of their eyes is hurtful, which appears by this, that some but seeing or hearing them, presently fall down in a swoon; yet I would not judge that to happen by the malicious virulency of the Cat, but also by the peculiar nature of the party, and a quality generated with him, and sent from heaven. When as, saith Mathiolus, a certain german in winter time, came with us into a stove to supper, where as were divers of our acquaintance; a certain woman, A history. knowing this man's nature, lest that he should see her kitling which she kept, and so should go away in a chafe, she shut her up in a cupboard in the same chamber. But for all that he did not see her, neither heard her cry, yet within a little space, when he had drawn in the air, infected with the breath of the Cat, that quality A wonderful antipathy between a man and a Cat. of temperament, contrary, or enemy to Cats, being provoked, he began to sweat, to look pale, and to cry out (all of us admiring it) Here lies a Cat in some corner or other; neither could he be quiet until the Cat was taken away. But such as have eaten the brains of a Cat are taken with often Vertigoes, and now and then become foolish The Antidote against the brains of a Cat. and mad: they are helped by procuring vomit, and taking the Antidote against this poison, that is, half a Scruple of Musk, dissolved and drunk in wine. There be some who prescribe the confection Diamosch●m to be taken every morning, four hours before meat. By this you may gather that it is not so fabulous that the common sort report, that Cats will kill or harm children; for lying to their mouths Cat's dangerous for children. with the weight of their whole bodies, they hinder the passage forth of the fuliginous vapours, and the motion of the Chest, and infect and stifle the spirits of tender infants, by the pestiferous air and exhalation which they send forth. CHAP. XXXV. Of certain poisonous Plants. HAving described the poisons that come from living creatures, I come to speak of such as are from Plants, beginning with the Sardonian herb, which is also called Apium risus: this is a kind of Ranunculus or Crowfoote: Apium risus. (and, as it is thought, the round leaved water Crowfoote, called Marsh-crow-foote or spearewort) it taketh away the understanding of such as eat thereof, and by a certain distension of the nerves, contracts the cheeks, so that it makes them look as if they laughed; from this affect came that proverbial speech of the Sardonian laughter, taken in evil part. His Bezoar, as one may term it, is the His Antidote. juice of Balm. The juice, fruit, and substance of Napellus, taken inwardly, killeth a man the Napellus, or Monks-hood. same day, or at the furthest in three days: yea and such as escape the deadly force thereof by the speedy and convenient use of Antidotes, fall into a hectic fever, or consumption, or become subject to the falling sickness, as Avicen affirmeth. And hence it is that barbarous people poison their arrows therewith. For the lips are forthwith inflamed, and the tongue so swells, that by reason thereof it cannot be contained in the mouth, but hangs out with great horror; their eyes are inflamed, and stand forth of their head, and they are troubled with a Vertigo and swooning, they become so weak that they cannot stir their legs, they are swollen and puffed in their bodies, the violence of the poison is so great. The Antidote thereof is a certain little creature like a * Our Author is deceived by the Arabians, who (it may be) mistook the greek word, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and instead thereof read, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; for a Fly, a Mouse; for there is no Mouse to be found, but whole swarms of Flies, which feed thereon: you may find the description of an Antidote made with them in Labels Stirp. Advers. pag. 302. Mouse, which is bred, and lives on the root of Napellus, being dried and drunk in powder, to the weight of two dams. In want hereof, you may use the seed of Radish or Turnips to drink, and anoint the body also with the oil of Scorpions. Dorycinum and Solanum Manicum, or deadly nightshade, are not much different Dorycinum and Solanum manicum, or deadly Nightshade. in their mortal symptoms or effects. Dorycinum being drunk, resembleth milk in taste, it causeth continual hicketting, it troubleth the tongue with the weight of the humour, it causeth blood to be cast forth of the mouth, and certain mucous matter out of the belly, like that which cometh away in the bloody flux. A remedy hereto are all shell Fishes, as well crude as roasted, also sea-lobsters and crabs, and the broth or liquor wherein they are boiled, being drunk. Now the root of The symptoms. Solanum manicum drunk in the weight of one dram in wine, causeth vain and not unpleasing imaginations, but double this quantity causeth a distraction or alienation of the mind for three days; but four times so much, kills. The remedies are the same as these prescribed against Dorycinum. Henbane drunken, or otherwise taken inwardly by the mouth, causeth an alienation Henbane. of the mind like drunkenness; this also is accompanied with an agitation of the body, and exolution of the spirits like swooning. But amongst others, this is a notable symptom, that the patients so dote, that they think themselves to be whipped: whence their voice becomes so various, that sometimes they bray like an ass or mule, neigh like a horse, as Avicen writes. The Antidote is pistick nuts eaten in great plenty, The Antidote. treacle also and mithridate dissolved in sack, also wormwood, rue and milk. Of Mushrooms, some are deadly and hurtful of their own kind and nature, as Mushrooms. those, which broken, presently become of divers colours, and forth with putrefy: (such as Avicen saith those are which be found of a grayish or bluish colour) others though not hurtful in quality, yet eaten in greater measure than is fitting, become deadly; for seeing by nature they are very cold and moist, and consequently abound with no small viscosity, as the excrementitious phlegm of the earth or trees whereon they grow, they suffocate and extinguish the heat of the body, as overcome by their quantity, and strangle as if one were hanged, and lastly kill. Verily I cannot choose, but pitying Gourmondizers, who though they know that Mushrooms are the seminary and gate of death, yet do they with a great deal of do, most greedily devour them; I say, pitying them, I will show them, and teach them the art, how they may feed upon this so much desired dish, without the endangering of their health. Know therefore that Mushrooms may be eaten without danger, if that they be first boiled with wild pears: but if you have no wild pears, you may supply that Their Antidote defect with others which are the most harsh, either newly gathered, or dried in the sun. The leaves, as also the bark of the same Tree, are good, especially of the wild, for pears are their Antidote: yet Conciliator gives another, to wit, Garlic eaten crude, whereto in like sort vinegar may be fitly added, so to cut and attenuate the tough, viscous and gross humours, heaped up, and in danger to strangle one by the too plentiful eating of Mushrooms, as it is delivered by Galen. In 5. epidemis. Ephemerum, which some call Colchicum or Bulbus sylvestris, that is, meadow saffron, Colchicum or me●dow-saffron being taken inwardly, causeth an itching over all the body, no otherwise than those that are nettled, or rubbed with the juice of a Squill. Inwardly they feelegnawing, their stomach is troubled with a great heaviness, and the disease increasing, there are streaks of blood mixed with the excrements. The Antidote thereof is woman's milk, Asses or Cow's milk drunken warm, and in a large quantity. The Antidote Mandrake taken in great quantity, either the root or fruit causeth great sleepiness, sadness, resolution and languishing of the body, so that after many scritches and Mandrake. gripings, the patient falls asleep in the same posture as he was in, just as if he were in a Lethargy. Wherefore in times past they gave Mandrake to such as were to be dismembered. The apples, when as they are ripe, and their seeds taken forth, may be safely eaten, for being green and with their seeds in them, are deadly. For there ariseth an intolerable heat, which burns the whole surface of the body, the tongue and mouth wax dry, by reason whereof they gape continually, so to take in the cold air; in which case unless they be presently helped, they die with convulsions. But they may be easily helped, if they shall presently drink such things as are convenient The cure. therefore. Amongst which, in Conciliators opinion, excel radish seeds eaten with salt and bread for the space of three days. Sneesing shall be procured, if the former remedy do not quickly refresh them, and a decoction of Coriander or Pennyroyal in fair water shall be given them to drink warm. The ungrateful taste of the juice of black poppy, which is termed Opium, as also of Mandrake, easily hinders them from being put into meat or drink, but that Opium. Why not used in poison. they may be discerned, and chiefly for that neither of them can kill, unless they be taken in a good quantity. But because there is danger, lest they be given in greater quantity than is fitting by the ignorance of Physicians, or Apothecaries, you may by these signs find the error. There ensues heavy sleep, with a vehement itching, so that the patient oft times is forced thereby to cast off his dull sleep wherein he lay, yet keeps his eyelids The symptoms. shut, being unable to open them. But by this agitation there flows out sweat, which smells of Opium, the body waxeth pale, the lips burn, the Jawbone is relaxed, they breathe little and seldom. When as their eyes wax livid, unless they be drawn aside, and that they are depressed in their orb, we must know that death is at hand. The remedy against this is two dams of the powder of Castoreum given in wine. Hemlock drunken, causeth Vertigo's, troubleth the mind, so that the patients may be taken for mad men; it darkeneth the sight, causeth hicketting, and benumbs Hemlock. the extreme parts, & lastly strangles with convulsions, by supressing or stopping the The symptoms. breath of the Artery. Wherefore at the first, as in other poisons, you must endeavour to expel it by vomit; then inject glisters, to expel that is got into the guts; then use wine without mixture, which is very powerful in this case. Peter Aponensis thinks the Bezoar or Antidote thereof to be a potion of two drams of Treacle, with a decoction The Antidote. of Dictamnus or Gentian in wine. He which further desires to inform himself of the effects of Hemlock, let him read Mathiolus his commentary upon Dioscorides, where as he treats of the same subject. In lib. 6. diosc. Aconitum called so of Aconis a town of the Periendines, where as it plentifully grows. According to Mathiolus, it kills Wolves, Foxes, Dogs, Cats, Swine, Panthers, Aconitum. Leopards, and all wild beasts, mixed with flesh, and so devoured by them, but it kills mice by only smelling thereto. Scorpions, if touched by the root of Aconite, grow numb and torpid, and so die thereof; arrows or darts dipped therein, make uncurable wounds. Those who have drunk Aconite, their tongue forthwith waxeth sweet with a certain astriction, which within a while after turneth to bitterness; it causeth a Vertigo, and shedding of tears, and a heaviness or straightness of the chest and parts about the heart; it makes them break wind downwards, and makes all the body to tremble. Pliny attributes so great celerity and violence to this Lib. 27. cap. 2. poison, that if the genitals of female creatures be touched therewith, it will kill them the same day; there is no presenter remedy than speedy vomiting after the poison is taken. But Conciliator thinks Aristolochia to be the Antidote thereof. Yet some have made it useful for man by experimenting it against the stinging of Scorpions, Aconite good against the poison of Scorpions. being given warm in wine. For it is of such a nature, that it killeth the party unless it find something in him to kill, for than it strives therewith as if it had found an adversary. But this fight is only when as it finds poison in the body; and this is marvellous, that both the poisons being of their own nature deadly, should dye together, that man may by that means live. There are divers sorts thereof, one whereof hath a flower like an helmet, as if it were armed to man's destruction; but the other The differences here delineated hath leaves like to sowes-bread, or a cucumber, and a root like the tail of a scorpion. The figure of a certain kind of Aconite. Trees also are not without poison, as the Yew and Walnut tree may witness: The Yew. cattle, if they feed on the leaves of Yew, are killed therewith. * This is true in some countries, as in Provence. Italy, Greece, etc. but it is not so here with us in Eng●… as both ●…obell & daily exerienc● cantestifie, But men, if they sleep under it or sit under the shadow thereof, are hurt therewith, and ofttimes dye thereof. But if they eat it, they are taken with a bloody flux, and a coldness over all their bodies, and a kind of strangling or stoppage of their breath. All which things the Yew causeth not so much by an elementary and cold quality, as by a certain occult malignity, whereby it corrupteth the humours, and shaveth the guts. The same things are good against this, as we have set down against Hemlock; The Antidote. Nicander affirms, that good wine being drunken is a remedy thereto. There is also malignity in a Walnut-tree, which Grevinus affirms that he found by experience, The Walnut-tree. whilst he unawares sat under one & slept there in the midst of Summer. For waking, he had a sense of cold over all his body, a heaviness of his head, and pain that lasted six days. The remedies are the same as against the Yew. CHAP. XXXVI. Of Bezoar, and Bezoarticke medicines. FOR that we have made mention of Bezoar, in treating of the remedies of poisons, I judge I shall not do amiss, if I shall explain, what the What is poison. word means, and the reason thereof. Poison absolutely taken is that which kills by a certain specific antipathy contrary to our nature. So an Antidote or Counterpoison is by the Arabians in their mother tongue termed Bedezahar, as the preservers of life. This word is unknown to the greeks and Latins, and in use only with the Arabians and Persians, because the thing itself first came from them, as it is plainly showed by Garcias ab horto, Physician to the Viceroy of the Indies, in his history of the Spices and Simples of the East-Indies. In Persia (saith he) and a certain part of India is a certain kind of Goat called Pazain (wherefore in proper speaking, the stone should be termed Pazar, of the word Pazain, that signifies a Goat; but we corruptly term it Bezoar or Bezoar) the colour of this beast is commonly reddish, the height thereof indifferent, in whose stomach concretes the stone called Bezoar; it grows by little and little about a straw or some such like substance in scailes like to the scailes of an onion, A sign of true Bezoar. so that when as the first scaile is taken off, the next appears more smooth and shining as you still take them away, the which amongst others is the sign of good Bezoar and not adulterate. This stone is found in sundry shapes, but commonly it resembles an acorn or Date-stone; it is sometimes of a sanguine colour, and otherwhiles of a hony-like or yellowish colour, but most frequently of a blackish or dark green, resembling the colour of mad Apples, or else of a Civet Cat. This stone hath no heart nor kernel in the midst, but powder in the cavity thereof, which is also of the same faculty. Now this stone is light, & not very hard, but so that it may easily be scraped, or rasped like alabaster, so that it will dissolve, being long macerated in water; at first it was common amongst us, and of no very great price, because our people who trafficked in Persia, bought it at an easy rate. But after that the faculties thereof were found out, it began to be more rare and dear, and it was prohibited The use of Bezoar. by an Edict from the King of the country, that no body should sell a Goat to the stranger Merchants, unless he first killed him, and took forth the stone, & brought it to the King. Of the notes by which this stone is tried, (for there are many counterfeits brought hither) the first is already declared; the other is, it may be blown up by the breath, like an ox's hide; for if the wind break through, and do not stay in the density thereof, it is accounted counterfeit. They use it, induced thereto by our example, not only against poisons, but also against the bites of venomous beasts. The richer sort of the Country purge twice a year, to wit, in March and September; and then, five days together they take the powder of this stone macerated in Rose-water, the weight of ten grains at a time: for by this remedy they think their youth is preserved, as also the strength of their members. There be some who take the weight of thirty grains; yet the more wary exceed not twelve grains. The same author addeth that he useth it with very good success in inveterate melancholy diseases as the itch, scab, tetters & leprosy; therefore by the same reason it may well be given against a quartan fever. Besides, he affirmeth for certain that the powder contained in the midst of the stone, put upon the bites of venomous beasts, presently freeth the patient from the danger of the poison, as also applied to pestilent Carbuncles when they are opened, it draws forth the venom. But because the small pocks and measles are familiar in the Indies, and ofttimes dangerous, it is there given with good success, two grains each day in Rose-water. Mathiolus subscribeth Lib. 5. in Dios. cap. 73. to this opinion of Garcias, witnessing that he hath found it by frequent experience, that this stone by much exceeds not only other simple medicines of this kind, but also such as are termed theriacalias, and what other Antidotes soever. Hereto also consents Abdalanarach; We (saith he) have seen the stone which they call Bezahar, with the sons of Almirama the observer of the Law of God; with which stone he bought a stately and almost princely house at Corduba. Some years ago a certain Gentleman, who had one of these stones which he A history. brought out of Spain, bragged before King Charles then being at Clermont in Auverne, of the most certain efficacy of this stone against all manner of poisons. Then the King asked of me, whether there were any Antidote which was equally and in like manner prevalent against all poisons? I answered, that nature could No one thing can be an Antidote again●… all poison. not admit it; for neither have all poisons the like effects, neither do they arise from one cause; for some work from an occult and specific property of their whole nature, others from some elementary quality which is predominant. Wherefore each must be withstood with its proper and contrary Antidote, as to the hot, that which is cold, and to that which assails by an occult propriety of form, another which by the same force may oppugn it, and that it was an easy matter to make trial hereof on such as were condemned to be hanged. The motion pleased the King; there was a Cook brought by the Jailor who was to have been hanged within a while after for stealing two silver dishes out of his master's house. Yet the King desired first to know of him, whether he would take the poison on this condition, that if the Antidote which was predicated to have singular power against all manner of poisons, which should be presently given him after the poison, should free him from death, that then he should have his life saved. The Cook answered cheerfully, that he was willing to undergo the hazard, yea, and greater matters, not only for to save his life, but to shun the infamy of the death he was like to be adjudged to. Therefore he then had poison given him by the Apothecary that then waited, and presently after the poison, some of the Bezahar brought from Spain, which being taken down, within a while after he began to vomit, and to avoid much by stool with grievous torments, and to cry out that his inward parts were burnt with fire. Wherefore, being thirsty, and desiring water, they gave it him; an hour after, with the good leave of the Jailor, I was admitted to him; I find him on the ground going like a beast upon hands and feet, with his tongue thrust forth of his mouth, his eyes fiery, vomiting, with store of cold sweats, and lastly, the blood flowing forth by his ears, nose, mouth, fundament and yard. I gave him eight ounces of oil to drink, but it did him no good, for it came too late. Wherefore at length he died with great torment and exclamation, the seventh hour from the time that he took the poison being scarcely passed. I opened his body in the presence of the Jailor and four others, and I found the bottom of his stomach black and dry, as if it had been burnt with a The caustick force of sublimate. Cautery; whereby I understood he had sublimate given him; whose force the Spanish Bezahar could not repress, wherefore the King commanded to burn it. CHAP. XXXVII. Of Mineral Poisons. MInerals or metals are either so taken forth of the bowels of the earth, or else from fornaces. Of these many are poisonous, as arsenic, sublimate, plaster, ceruse, lytharge, verdegreace, orpiment, filings of Iron, brass, the loadstone, lime, and the like. Such as have taken sublimate, The symptoms of such as have taken sublimate. the tongue and jaws become straightened and rough, as if they drunk the juice of unripe services: you cannot amend this asperity with lenitive gargarisms but with much labour and time; for as soon as it descends into the stomach, it sticketh to it. Therefore presently after it frets and exulcerateth; it causeth unquenchable thirst, and unexplicable torments; the tongue is swollen, the heart faints, the urine is suppressed, the chest can scarce perform the office of breathing, the belly is gripped, and so great pains happen to the other extreme parts, that unless they be helped, the patient will die; for presently will grow upon them, unless it be speedily hindered, the devouring and fiery fury of the poison, rending or eating into the guts and stomach, as if they were seared with an hot iron, and blood sloweth forth of the ears, nose, mouth, urenarie passage and fundament, and then their case is desperate. These and who else soever shall take any corroding poison, shall be cured with the same remedies, as those that have taken Cantharideses. Verdegreace so stops the instruments of respiration, that it strangles such as have Verdegreace. taken it. The cure is performed by the same remedies as help those that have taken Arsenic. lethargy causeth a heaviness in the stomach, suppresseth the urine, makes the body lethargy. swelled and livide. We remedy this, by giving a vomit presently, then after it pigeons dung mixed in strong wine, and so drunken. Peter Aponensis wisheth to give oil of sweet almonds and figs. Also it is good to give relaxing and humecting glisters, and to anoint the belly with fresh butter, or oil of lilies. The scailes of brass drunk by troubling the stomach, cause a casting and scouring. The scailes of brass. The remedy is, if the patient forth with vomit, if he enter into a bath made of the decoction of snails, if he anoint his belly and breast with butter and oil of lilies, and inject laxative and humecting glisters. The Loadstone makes them mad that take it inwardly. The Antidote thereof is The Loadstone. the powder of gold and an emerald drunk in strong wine, and glisters of milk and oil of sweet almonds. The filings of lead, and the scailes or refuse of iron, cause great torment to such as Filings of Lead & 〈◊〉 of Iron. take them down. The which we help with much milk and fresh butter dissolved therein, or with oil of sweet almonds drawn without fire, with relaxing and hu●…cting glisters used until the pain be perfectly assuaged. Risagallum, Roseaker or Ratsbane, because it is of a most hot and dry nature, induces thirst and heat over all the body, and so great colliquation of all the humours, Arsenic, Roseaker or Ratsbane. that although the patients by medicines speedily given escape death, yet can they not during the residue of their lives, use their members as they formerly did, being destitute of their strength, by reason of the great dryness and contraction of the joints. The Antidote thereof is oil of pine kernels speedily given, and that to the quantity of half a pint; then procure vomit, then give much milk to drink, and glisters of the same, and let them sup up fat broths. Unquenched Lime and Auripigmentum, or Orpiment drunk, gnaw the stomach Unquenched Lim● and Orpiment. and guts with great tormenting pain, and cause unquenchable thirst, an asperity of the jaws and throat, difficulty of breathing, stoppage of the urine, and a bloody flux. They may be helped by all fat, humecting, and relaxing things which retund the acrimony, by lenitive potions, and such things as lubricate the belly; as also by creames, and the mucilages of some seeds, as with a decoction of the seeds of Line, mallows, marshmallows and other such things set down at large in the cure of Cantharideses. These exceeding acride and strong waters wherewith Goldsmiths and Chemists Aquasortis. separate gold from silver, being taken into the body, are hard to cure, because they are forthwith diffused over all the body, first burning the throat and stomach. Yet it may be helped by the means prescribed against unquenched Lime and Orpiment. Ceruse causeth hicketting and a cough, makes the tongue dry, & the extreme parts of the body numb with cold, the eyes heavy to sleep. The patients very often in Ceruse. the midst of the day see some vain fantasy or apparition, which in deed is nothing; they make a black and ofttimes bloody water, they die strangled unless they be helped. The Antidote, in the opinion of Aëtius and Avicen, is scammony drunk in new wine, or honey and wine, and other diuretic things, and such things as procure vomit, and purge by stool. Plaster, because it concreteth and becometh stony in the stomach, causeth Plaster. strangulation by straitening and stopping the instruments that serve for breathing. The patients receive cure by the same remedies, as those who have eaten mushrooms, or drunk Ceruse: you must add Goose-grease in the glisters, and anoint the belly with oil of lilies and butter. CHAP. XXXVIII. Of Quicksilver. Quicksilver is so called because it resembleth silver in the colour, and is in The reason why it is so called. perpetual motion, as if it had a spirit or living soul. There is a great controversy amongst authors concerning it. For most of them affirm it Lib. 4. simple. in 〈◊〉. practic. cap. 148. 3. ad Almaa. 4. Meteor. hot, amongst whom is Galen, Halyabas, Rhases, Aristotle, Constantine, Isaac, Platearius, Nicholas Massa: they maintain their opinion by an argument drawn from things helping and hurting; besides from this, that it is of such subtle parts, that it penetrates, dissolves, and performeth all the actions of heat upon dense and hard metals; to wit, it attenuateth, incideth, drieth, causeth salivation by the mouth, purgeth by the stool, moveth urine and sweat over all the body, neither doth it stir up the thinner humours only, but in like sort the gross, tough and viscous, as those which have the Lues Venerea find by experience, using it either in ointments or plasters. Others affirm it very cold and moist, for that put into emplasters and so applied, it assuageth pain by stupefaction, hindering the acrimony of pustles and choleric inflammations. But by its humidity it softeneth scirrhous tumors, dissolveth and dissipateth knots and tophous knobs; besides, it causeth the breath of such as are anointed therewith to stink, by no other reason, than that it putrefies the obvious humours by its great humidity. Avicens' experiment confirms this opinion, who affirmeth, that the blood of an Ape that drunk Quicksilver, was found concrete about the heart, the carcase being opened. Mathiolus, moved by these reasons, writes In l. 6. Dios. c. ●8. that Quicksilver killeth men by the excessive cold and humid quality, if taken in any large quantity, because it congeals the blood and vital spirits, and at length the very substance of the heart, as may be understood by the history of a cetaine Apothecary, A history. set down by Conciliator; who, for to quench his feverish heat, in stead of water, drunk off a glass of Quicksilver, for that came first to his hands: he died within a few hours after, but first he evacuated a good quantity of the Quicksilver by stool, the residue was found in his stomach being opened, and that to the weight of one pound; besides, the blood was found concrete about his heart. Others use another argument to prove it cold, and that is drawn from the composition thereof, because it consists of lead and other cold metals. But this argument is very weak. For unquenched Lime is made of flints and stony matter, which is cold, yet nevertheless it exceeds in heat. Paracelsus affirmeth that quicksilver is hot in the interior substance, Lib 4. de nat. rerum. but cold in the exterior, that is, cold as it comes forth of the mine. But that coldness to be lost as it is prepared by art, and heat only to appear and be left therein, so that it may serve in stead of a tincture in the transmutation of metals. And verily it is taken for a rule amongst Chemists, that all metals are outwardly cold, by reason of the watery substance that is predominant in them, but that inwardly they are very hot, which then appears when as the coldness together with the moisture is segregated, for by calcination they become caustick. Moreover many account quicksilver poison, yet experience denies it. For Marianus Sanctus Baralitanus Tract de 〈◊〉 & offen. tells that he saw a woman, who for certain causes and affects, would at several times drink one pound and an half of quicksilver, which came from her again by stool without any harm. Moreover he affirmeth that he hath known sundry who in a desperate Colic (which they commonly call miserere mei) have been freed from imminent death, by drinking three pounds of quicksilver with water only. For by the weight it opens and unfolds the twined or bound up gut, and thrusts forth the hard and stopping excrements; he addeth that others have found this medicine effectual against the colic, drunk in the quantity of three ounces. Antonius Musa writes, that he usually giveth quicksilver to children ready to dye of the worms. Avicen confirmeth this, averring that many have drunk quicksilver without any harm, wherefore he mixeth it in his ointments against scaules and scabs in children; whence came that common medicine amongst the country people to kill louse by anointing the head with quicksilver mixed with butter or axungia. Mathiolus affirmeth that many think it the last and chiefest remedy to give to women in Quicksilver good▪ or women in travail. travail that cannot be delivered. I protest, to satisfy myself concerning this matter, I gave to a whelp a pound of quicksilver, which being drunk down, it voided without any harm by the belly. Whereby you may understand that it is wholly without any venomous quality. Verily it is the only and true Antidote of the Lues Venerea, and also a very fit medicine for malign ulcers, as that which more powerfully impugns their malignity than any other medicines that work only by their first qualities. Besides, against that contumacious scab, which is vulgarly called Malum sancti manis, there is not any more speedy or certain remedy. Moreover Guido writes, that if a plate of lead be besmeared or rubbed therewith, and then for For the disease called Maum sancti manis. some space laid upon an ulcer, and conveniently fastened, that it will soften the callous hardness of the lips thereof, and bring it to cicatrisation, which thing I myself have oftimes found true by experience. Certainly before Guido, Galen much commended quicksilver against malign ulcers Lib 7. de comp. m●…▪ second loc. Against malign ulcers. & cancers. Neither doth Galen affirm that lead is poisonous (which many affirm poisonous, because it consists of much quicksilver) but he only saith thus much, that water too long kept in leaden pipes & cisterns, by reason of the drossiness that it useth to gather in lead, causeth bloody fluxes, which also is familiar to brass and copper. Otherwise many could not without danger bear in their bodies leaden bullets during the space of so many years, as usually they do. It is declared by Theodoricke Herey in the following histories, how powerful quicksilver is to resolve and assuage pains and inflammations. Not long since, (saith he) a certain Doctor of Physic his boy was troubled with parotides, with great swelling, heat, pain & Against the Parotides. beating; to him, by the common consent of the Physicians there present, I applied an anodine medicine, whose force was so great, that the tumour manifestly subsided at the first dressing, and the pain was much assuaged. At the second dressing all the symptoms were more mitigated. At the third dressing, I wondering at the so great effects of an Anodine Cataplasm, observed that there was quicksilver mixed therewith, and this happened through the negligence of the Apothecary, who mixed the simple Anodine medicine prescribed by us, in a mortar wherein but a while before he had mixed an ointment whereinto quicksilver entered, whose relics, and some part thereof yet remained therein. This which once by chance succeeded well, I afterwards wittingly and willingly used to a certain Gentlewoman troubled with the like disease, possessing all the region behind the ears, much of the throat, and a great part of the cheek, when as nature helped by common remedies, could not evacuate neither by resolution nor suppuration, the contained matter greatly vexing her with pain and pulsation. I to the medicine formerly used, by the consent of the Physicians, put some quicksilver, so within a few days, the tumour was digested and resolved. But some will say, it resolves the strength of the nerves and limbs, as you may see by such as have been anointed therewith for the Lues venerea, who tremble in all their limbs during the rest of their lives. This is true, if any use it too intemperately without measure, and a disease that may require so great a remedy; for thus we see that Gilders, Plumbers and such as dig in mines, by the continual ascent of the vapours of quicksilver to the brain, the fountain of the nerves, by resolving the spirits, and dissipating the radical and substantificke moisture, maketh them subject to the trembling of their joints. Verily if it be killed and incorporate with hog's grease, and a list besmeared therewith, which may encompass the body like a girdle, it will drive away louse, fleas and cimexes; and anointed about the navel, Against louse & fleas etc. The kinds thereof. it kills the worms in the guts. There are two sorts of quicksilver, the one natural, the other artificial. The natural is found running or flowing in the veins and bowels of the earth, and amongst metals, and in the fornaces of silver mines. The Artificial is made of minium (as it is in Vitruvius) and of the powder of Ivory. Also it is probable that by art it may be extracted out of all metals, but chiefly out of Lead and Cinnabaris. You may easily distinguish these kinds by the dull and blackish colour, tough and gross substance, which as it runs, leaves an impression like melted grease, being as it were the excrement of lead. The best quicksilver of all is pure, clear, thin and very white: it may be cleansed with the dross of Lead, and How to purify it. becomes more thin, being boiled in sharp vinegar, with sage, rosemary, time, lavender. Or else give it by a pound at a time to a whelp, to drink down, and being cast forth by it, boil it again in vinegar, for thus it hath wondrous faculties, and fitly given produceth marvellous effects; nothing is more contrary thereto than fire. For quicksilver, though of its own nature ponderous, flieth upwards by the force of the fire, and forsaketh gold by that means, than which nothing is more friendly to it. CHAP. XXXIX. Of the Unicorns Horn. THere are very many at this day who think themselves excellently well armed against poison and all contagion, if they be provided with some powder of Unicorns horn, or some infusion made therewith. Therefore I have thought it good to examine more diligently how much truth this inveterate, and grounded opinion hath. The better to perform this task, I will propound three heads, whereto I will direct my whole discourse. The first shall be of the signification of this word Unicorn. The second, whether there be any such thing really and truly so called, or whether it be not rather imaginary; like as the Chimaera and Tragelaphus? The third, whether that which is said to be the horn of such a beast, hath any force or faculty against poisons? For the first, that is, the name, it is somewhat more obscure what the word (being Licorne) in French may What the name imports. signify, than what the Latin or Greek word is. For the French name is further from the word and signification; but it is so clear and manifest, that this word Unicornis amongst the Latins signifieth a beast having but one horn, as it is vulgarly known, the same thing is meant by the Greek word Monoceros. But now for the second, I think That there is no such beast as an Unicorn. that beast that is vulgarly called & taken for an Unicorn, is rather a thing imaginary than really in the world. I am chiefly enduced to believe thus, by these conjectures. Because of those who have traveled over the world, there is not one that professeth that ever he did see that creature. Certainly the Romans conquering the world, & being most diligent searchers after all things which were rare and so excellent, if any where in any corner of the world, this beast could have been found, they would have found it out, and engraven it upon their coins, or Arms, as they did Crocodiles, Elephants, Eagles, Panthers, Lions, Tigers, and other creatures unknown to these countries. For these that have written of the Unicorn, either that they have heard, or that hath been delivered by tradition, or what they in their own minds and fancies have conceived, you shall scarce find two that agree together, either in the description of the body, or in the nature and condition of her. Pliny writes, that Unicorns Lib. 8. cap. ●1. are for the fashion of their bodies like to an horse; that is, as Cardane interprets it, of the bigness of a horse, with the head of an Hart, the feet of an Elephant, the tail of a Boar, with one black horn in the midst of his forehead, of the length of two cubits. Munster, who (as Mathiolus jests) never saw Unicorns besides painted Munster's opinion concerning Unicorns. ones, doth on the contrary affirm them not to be of the bigness of an horse, but of an hind calf of three months old, not with feet like an Elephant, but cleft like those of goats, with an horn not only of two, but oft times of three cubits long, of a weasel colour, with a neck not very long, nor very hairy, but having few and short hairs hanging to the one side of the neck, the legs are lean and small, the buttocks high, but very hairy. Cardane dissenting from both these, writeth, that he hath an horn in the midst of his forehead, but that it is only the length of three fingers. Andrew I hevet mentions an Unicorn seen by a certain Turkish Sangjach, which was of the bigness of a Bull of five or six months old, and had one Tom. 1. lib. 5. Cap. 5. cosmogr. horn, but that not in the midst of the forehead, but upon the top of the crown of the head; he was legged and footed like an Ass, but longer haired, and had ears not much unlike the Rangifer, a beast not unknown in the subpolare or northern countries. Thus various therefore is the report concerning the shape of this Beast. Neither is there less difference concerning her nature and conditions. For Pliny writes that the Unicorn is a most fierce beast, and hath a great bellowing voice, and that she cannot therefore be taken alive. Cardane renders a reason of this fierceness, Because (saith he) it inhabits the deserts of Aethiopia, a region squalide, and filthy, abounding with toads and such like venomous creatures. Others on the contrary affirm her to be of a most mild, amiable, and gentle nature of all others, unless one purposely offend her, or use her too harshly; for seeing she feeds not by stooping her head to the ground, because she is hindered therefrom by the length of her horn, she must necessarily feed upon the fruit that hangeth upon trees; out of cratches or man's hand she fearlessly and harmelesly takes all manner of fruits, herbs, sheaves of corn, apples, pears, oranges and pulse. And herein they have proceeded so far, that they feign they will love Virgins, enticed by their beauty, so that stayed in the contemplation of them, and alured by their enticements, they by this means are often taken by hunters. In this opinion is jews Vartoman, who denies that Unicorns are wild vartomans' ●p●n●on of the nature of the Unicorn. or fierce; for he saith that he saw two, which were sent out of Aethiopia to the Sultan, who kept them shut up in Pens, in Mecha, a city of Arabia foelix, renowned by the Sepulchre of Mahomet. Thevet travailing thither, tells that he diligently enquired of the inhabitants, what their opinion was of such a beast, yet could he never hear any tidings thereof. Whence it is easy to discern, that such beasts have neither been in our, nor in Vartomans' times. The so great variety of dissenting opinions, easily induceth me to believe that this word, Unicorn, is not the proper name of any beast in the world, and that it is a thing only feigned by Painters, and Writers of natural things, to delight the readers and beholders. For as there is but one right way, but many byways and windings, so the speech of truth is but one, and that always simple and like itself; but that of a lie is divers, and which may easily refel itself, by the repugnancy and incongruity of opinions, if one should say nothing. What therefore (will some say) of what creatures are these horns, which we see wholly different from others, if they be not of Unicorns? Thevet thinks them nothing What the ordinary Unicorns horns are. else than Elephant's bones turned and made into the fashion that we see them; for thus in the Eastern countries, some crafty merchants and cunning companions turn, hollow, and being softened, draw to what length they please the teeth of the fish Roharde, which lives in the ●ed and Aethiopian Sea, and being so handled, they sell them for Unicorns horn. Verily that which is termed Unicorns horn being burnt, sends forth a smell like to Ivory. Now Cardanus affirms that the teeth and bones of Elephants made soft by art, may be drawn forth, and brought into what form you please, like as Ox bones are. For what is there in the world which the thirsting desire of gold will not make men to adulterate and counterfeit? But it The Unicorns horn is not effectual against poison. is time that we come to the third scope. Grant there be Unicorns, must it therefore follow that their horns must be of such efficacy against poisons? If we judge by events, and the experience of things, I can protest thus much, that I have often made trial thereof, yet could I never find any good success in the use thereof against poisons, in such as I have had in cure. If the matter must be tried by witnesses and authorities, a great part of the Physicians of better note have long since bid it adieu, and have detracted from the divine and admirable virtues for which it formerly was so much desired. And this they have done, moved thereto by many just, but two especial reasons. The first is of Rondeletius, who in this case affirms that horns are endued Lib. depo●der. cap. 19 Horns and bones not effectual unless to dry. with no taste nor smell; and therefore have no effect in physic, unless it be to dry. Neither (saith he) am I ignorant that such as have them, much predicate their worth, so to make the greater benefit and gain by them, as of the shave or scrape of Unicorns horn, which they sell for the weight in gold, as that which is singular good against poisons and worms, which things I think Hartshorn and Ivory do no less effectually perform; which is the cause why for the same disease, and with the like success, I prescribe Ivory to such as are poor, and Unicorns horn to the rich, as that they so much desire. This is the opinion of Rondeletius, who without any difference was wont for Unicorns horn to prescribe not only Hartshorn or Ivory, but also the bones of Horses and Dogs, and the stones of Myrabalanes. Another reason is, that whatsoever resists poison is cordial, that is, fit to strengthen the heart, which is chiefly assailed by poisons; but nothing is convenient to strengthen the heart, unless it be by laudable blood or spirit, which two are only familiar to the heart, as being the workhouse of the arterious blood and vital spirits. For all things are preserved by their like, as they are destroyed by their contraries; for all things that generate, generate things like themselves. But Unicorns horn, as it contains no smell, so neither hath it any aery parts, but is wholly earthy and dry; neither can it be converted into blood by the digestive faculty, for as it is without juice, so is it without flesh. For as it cannot be turned into Chylus, so neither is it fit to become Chymus (that is) juice or blood. Therefore it is joined to the heart by no similitude nor familiarity. Furthermore, there is not a word in Hypocrates and Galen concerning the Unicorns horn, who notwithstanding have in so many places commended Hartshorn. Therefore D. Chapelaine, the chief Physician of King Charles the ninth, often used to say, that he would very willingly take away that custom of dipping a piece of Unicorns horn in the King's cup, but that he knew that opinion to be so deeply engrafted in the minds of men, that he feared, that it would scarce be impugned by reason. Besides (he said) if such a superstitious medicine do no good, so certainly it doth no harm, unless it be to their estates that buy it with gold, or else by accident, because Princes, whilst they rely more than is fitting upon the magnified virtues of this horn, neglect to arm themselves against poisons by other more convenient means, so that Death ofttimes takes them at unawares. When as upon a time I enquired of jews Duret the Kings Physician and Professor (by reason of the great opinion that all learned men justly had of his learning and judgement) what he thought of this horn. He answered, that he attributed no faculties thereto: for the confirmation whereof he rendered the second reason I have formerly given, but more largely and elegantly; neither feared he to affirm it aloud, & in plain words to his auditory of learned men, coming from all parts to hear him. But if at any time (o'ercome by the fault of the times & place) he prescribed this horn, that he did it for no other intent, than to help faintings or sownings that happen by In what cases good. the abundance of serous humours, floating in the orifice of the ventricle, which makes men ill disposed, because this mixed with other things endued with the like faculty, hath power to drink up the waterish humidity by its earthy dryness. But some will reply, that neither the Lemnian, nor Armenian earth, have any juice in them, neither any smell, nor aery spirit. It is granted, neither truly are such things truly and properly called cordial, but only by event and accident, for that by the excellent astrictive faculty they have, and stopping the passages of the vessels, they hinder the poison from entering into the heart. This is my opinion of Unicorns horn, which if any do not approve of, he shall do me a favour, if for the public good, he shall freely oppose his; but in the interim take this in good part which I have done. The End of the One and Twentieth Book. OF THE PLAGUE. THE TWENTY SECOND BOOK. CHAP. 1. The description of the Plague. THE Plague is a cruel and contagious disease, which every What the plague is. where, like a common disease, invading Man and Beast, kills very many; being attended, and as it were associated with a continual Fever, Botches, Carbuncles, Spots, Nauseousness, Vomitings, and other such malign accidents. This disease is not so pernicious or hurtful, by any elementary quality, as from a certain poisonous & venenate malignity, the force whereof exceeds the condition of common putrefaction. Yet I will not deny but that it is more hurtful in certain bodies, times and regions, as also many other diseases, of which Hypocrates makes mention. But from hence we Sect. 3. aphor. can only collect, that the force and malignity of the plague, may be increased, or diminished, according to the condition of the Elementary qualities concurring with it, but not the whole nature and essence thereof to depend thereon. This pestiferous poison principally assails the Vital spirit, the Storehouse and original whereof is the Heart, so that if the Vital Spirit prove stronger, it drives it far from the Heart; but if weaker, it being overcome and weakened by the hostile assault, flies back into the fortress of the Heart, by the like contagion infecting the How it comes to kill. heart, and so the whole Body, being spread into it by the passages of the Arteries. Hence it is, pestilent Fevers are sometime simple and solitary, otherwhiles associated with a troop of other affects, as Botches, Carbuncles, Blains, and Spots, of one or more colours. It is probable such affects have their original from the expulsive Faculty, whether The original Bubo's, Carbuncles, etc. in the plague. strong or weak, provoked by the malignity of the raging matter: yet assuredly divers symptoms and changes arise, according to the constitution of the body of the Patient, and condition of the humour in which the virulency of the plague is chiefly inherent, and lastly, in the nature of the efficient cause. I thought good, by this description, to express the nature of the plague, at this my first entrance into this matter, for we can scarce comprehend it in a proper definition. For although the force thereof be definite and certain in nature, yet it is not altogether certain and manifest in men's minds, because it never happens after one sort: so that in so great variety, it is very difficult to set down any thing general and certain. CHAP. II. Of the Divine causes of an extraordinary Plague. IT is a confirmed, constant, and received opinion in all Ages amongst Christians, that the plague and other diseases, which violently assail the life of man, are often sent by the just anger of God punishing our offences. The Prophet Amos hath long since taught it, saying, Shall there be affliction, shall there be evil in a City, Amos 3. Acts 17 and the Lord hath not done it? On which truly we ought daily to meditate, and that for two causes: The first is, that we always bear this in mind, that we enjoy health, live, move, and have our beings from God, and that it descends from that Father of Light: and for this cause we are always bound to give him great and exceeding thanks. The other is, that knowing the calamities, by sending whereof the Divine anger proceeds to revenge, we may at length repent, and leaving the way of wickedness, walk in the paths of godliness. For thus we shall learn to see in God, ourselves, the Heaven and Earth, the true knowledge of the causes of the plague, and by a certain Divine Philosophy teach, God to be the beginning and cause of the second causes, which cannot well without the first cause go about nor attempt, much less perform any thing. For from hence they borrow their force, order, and constancy of order; so that they The second causes have their power from God as the first cause. serve as Instruments for God, who rules and governs us, and the whole World, to perform all his works, by that constant course of order, which he hath appointed unchangeable from the beginning. Wherefore all the cause of a plague is not to be attributed to these near and inferior causes or beginnings, as the Epicures and Lucianists commonly do, who attributing too much, yea all things to nature, have left nothing to God's providence. On the contrary, we ought to think, and believe in all our things, That even as God by his omnipotent Power hath created all things of nothing, so he by his eternal Wisdom preserves and governs the same, leads and inclines them as he pleaseth, yea verily at his pleasure changeth their order, and the whole course of Nature. This cause of an extraordinary Plague, as we confess and acknowledge, so here we will not prosecute it any further, but think fit to leave it to Divines, because it exceeds the bounds of Nature, in which I will now contain myself. Wherefore let us come to the natural causes of the plague. CHAP. III. Of the Natural Causes of the Plague, and chiefly of the Seminary of the Plague by the corruption of the Air. THE general and natural causes of the Plague are absolutely two, that is, the infection of corrupt Air, and a preparation and fitness of corrupt The general causes of the plague. humours to take that infection; for it is noted before out of the doctrine of Galen, that our humours may be corrupted, and degenerate into such Lib. 6 de loc. affectis. an alienation which may equal the malignity of Poison. The Air is corrupted, when the four seasons of the year have not their seasonableness, or degenerate from themselves, either by alteration, or by alienation: as if the constitution of the whole year be moist and rainy by reason of gross and black Clouds; if the Winter be gentle and warm without any Northerly How the seasons of the year may be said to want their seasonableness. wind, which is cold and dry, and by that means contrary to putrefaction; if the spring which should be temperate, shall be faulty in any excess of distemper; if the Autumn shall be ominous by Fires in the Air, with stars shooting, and as it were falling down, or terrible comets, never seen without some disaster; if the summer be hot, cloudy and moist, and without winds, and the clouds fly from the South into the North. These and such like unnatural constitutions of the seasons of the year, were never better, or more excellently handled by any, than by Hypocrates in his books Epidemion. Therefore the Air from hence draws the seeds of corruption and the Pestilence, which at the length, the like excess of qualities being brought in, it sends into the humours of our bodies, chiefly such as are thin and serous. Although the pestilence doth not always necessarily arise from hence, but somewhiles some other kind of cruel and infectious disease. But neither is the air only corrupted by these superior causes, but also by putrid How the air may be corrupted. and filthy stinking vapours spread abroad through the Air encompassing us, from the Bodies and Carcases of things not buried, gapings and hollownesses of the earth, or sinks and such like places being opened: for the sea often overflowing the land in some places, & leaving in the mud or hollownesses of the earth (caused by earthquakes) the huge bodies of monstrous Fishes, which it hides in its waters, hath given both the occasion and matter of a plague. For thus in our time, a Whale cast upon the Tuscan shore, presently caused a plague over all that country. But as fishes infect and breed a plague in the air, so the air being corrupted often causeth a pestilence in the sea among fishes, especially when they either swim on the top of the Water, or are infected by the pestilent vapours of the Earth lying under them, & rising into the air through the body of the water, the latter whereof Aristotle saith, happeneth but seldom. But it often chanceth, that the plague raging in any country, Lib. 8. hist. a●i●. many fishes are cast upon all the coast, and may be seen lying on great heaps. But sulphureous vapours, or such as partake of any other malign quality, sent forth from places under the ground, by gapings and gulfs opened by earthquakes, not only corrupt the air, but also infect and taint the Seeds, Plants, and all the fruits which we eat, and so transfer the pestilent corruption into us, and those beasts on which we feed, together with our nourishment. The truth whereof Empedocles made manifest, who by shutting up a great Gulf of the earth, opened in a valley between two mountains, freed all Sicily from a plague caused from thence. If winds rising suddenly shall drive such filthy exhalations from those regions in which they were pestiferous, into other places, they also will carry the Plague with them thither. If it be thus, some will say, it should seem that wheresoever stinking and putrid exhalations arise, as about standing Pools, Sinkes and Shambles, there should the Plague reign, and strait suffocate with its noisome poison the people which work in such places: but experience finds this false. We do answer, that the putrefaction of the plague is far different, and of another kind than this common, as that which partakes of a certain secret malignity, Pestiferous putrefaction is ●ar different from ordinary putrefaction. and wholly contrary to our lives, and of which we cannot easily give a plain and manifest reason. Yet that vulgar putrefaction wheresoever it be, doth easily and quickly entertain and welcome the pestiferous contagion, as often as, and whensoever it comes, as joined to it by a certain familiarity, and at length, itself degenerating into a pestiferous malignity, certainly no otherwise than those diseases which arise in the plague time, the putrid diseases in our bodies, which at the first wanted virulency and contagion, as Ulcers, putrid Fevers, and other such diseases, raised by the peculiar default of the humours, easily degenerate into pestilence; presently In a pestilent constitution of the air, all diseases become pestilent. receiving the tainture of the plague, to which they had before a certain preparation. Wherefore in time of the plague, I would advise all Men to shun such exceeding stinking places, as they would the plague itself: that there may be no preparation in our bodies, or humours to catch that infection (without which, as Galen teacheth, Lib. 1. de differ feb. the Agent hath no power over the Subject, for otherwise in a plague time, the sickness would equally seize upon all) so that the impression of the pestiferous quality may presently follow that disposition. But when we say the air is pestilent, we do not understand that sincere, elementary, How the air may be said to putrefy. and simple as it is of its own nature, for such is not subject to putrefaction, but that which is polluted with ill vapours rising from the earth, standing waters, vaults, or sea, and degenerates, and is changed from its native purity & simplicity. But certainly amongst all the constitutions of the Air, fit to receive a pestilent corruption, there is none more fit than a hot, moist and still season: For the excess of such qualities easily causeth putrefaction. Wherefore the South wind reigning, which is hot and A Southerly constitution of the air is the fuel of the Plague. moist, and principally in places near the Sea, there flesh cannot long be kept, but it presently is tainted and corrupted. Further, we must know, that the pestilent malignity which riseth from the carcases or bodies of men, is more easily communicated to men; that which riseth from oxen, to oxen; and that which comes from sheep, to sheep, by a certain sympathy and familiarity of Nature: no otherwise than the Plague which shall seize upon some one in a Family, doth presently spread more quickly amongst the rest of that Family, by reason of the similitude of temper, than amongst others of another Family, disagreeing in their whole temper. Therefore the Air thus altered and estranged from its goodness of nature, necessarily drawn in by inspiration and transpiration, brings in the seeds of the Plague, and so consequently the Plague itself, into bodies prepared and made ready to receive it. CHAP. four Of the preparation of humours to putrefaction, and admission of pestiferous impressions. HAving showed the causes from which the Air doth putrefy, become corrupt, and is made partaker of a pestilent and poisonous constitution, we must now declare what things may cause the humours to putrefy, and make them so apt to receive and retain the pestilent Air and venenate quality. Humours putrefy either from fullness, which breeds obstruction, or by distemperate Three causes of the putrefaction of humours. excess, or lastly, by admixture of corrupt matter & evil juice, which ill feeding doth specially cause to abound in the body: For the Plague often follows the drinking of dead and musty Wines, muddy and standing waters, which receive the sinks and filth of a City; and fruits and pulse eaten without discretion in scarcity of other Corn, as Pease, Beans, Lentils, Vetches, Acorns, the roots of Fern, & Grass made into Bread. For such meats obstruct, heap up ill humours in the body, & weaken the strength of the faculties, from whence proceeds a putrefaction of humours, and in that putrefaction a preparation and disposition to receive, conceive and bring forth the Seeds of the Plague: which the filthy scabs, malign sores, rebellious ulcers, and putrid fevers, being all forerunners of greater putrefaction and corruption, do testify. Vehement passions of the mind, as anger, sorrow, grief, vexation and fear, Passions of the mind help forward the putrefaction of the humours. help forward this corruption of humours, all which hinder nature's diligence and care of concoction: For as in the dog-days, the Lees of wine subsiding to the bottom, are by the strength and efficacy of heat drawn up to the top, and mixed with the whole substance of the wine, as it were by a certain ebullition, or working: So melancholy humours, being the Dregs or Lees of the blood, stirred up by the passions of the mind, defile or taint all the blood with their feculent impurity. We found that some years agone by experience, at the battle of St. Dennis. For all wounds, by what weapon soever they were made, degenerated into great and filthy putrefactions & corruptions, with fevers of the like nature, & were commonly determined by death, what medicines, & how diligently soever they were applied; which caused many to have a false suspicion that the weapons on both sides were poisoned. But there were manifest signs of corruption and putrefaction in the blood let the same day that any were hurt, and in the principal parts dissected afterwards, that it was from no other cause, than an evil constitution of the Air, and the minds of the Soldiers perverted by hate, anger and fear. CHAP. V. What signs in the Air and Earth prognosticate a Plague. WE may know a Plague to be at hand and hang over us, if at any time the Air, and seasons of the year swarve from their natural constitution, after those ways I have mentioned before; if frequent and long continuing Meteors or sulphureous Thunders infect the Air; if fruits, seeds and pulse be worm-eaten; If Birds forsake their nests, eggs or Young, without any manifest cause; if we perceive women commonly to abort, by continual breathing in the vaporous Air, being corrupted and hurtful both to the Why Abortions are frequent in a pestilent season. Embryo and original of life, and by which it being suffocated, is presently cast forth and expelled. Yet notwithstanding, those airy impressions do not solely corrupt the Air, but there may be also others raised by the Sun from the filthy exhalations, and poisonous vapours of the earth and waters, or of dead carcases, which by their unnatural mixture, easily corrupt the Air, subject to alteration, as which is thin and moist, from whence divers Epidemial diseases, and such as everywhere seize upon the common sort, according to the sev●…l kinds of corruptions, such as that famous Catarrh with difficulty of breathing, which in the year 1510. went A Catarrh with difficulty of breathing killing many. almost over the World, and raged over all the Cities and Towns of France, with great heaviness of the head (whereupon the French named it Cuculla) with a straightness of the heart and lungs, and a Cough, a continual Fever, and sometimes raving. This, although it seized upon many more than it killed, yet because they commonly died who were either let blood, or purged, it showed itself pestilent by that violent and peculiar and unheard of kind of malignity. Such also was the English Sweating-sickness, or Sweating-feaver, which unusual, The english sweeting sickness. with a great deal of terror invaded all the lower parts of Germany, and the Low Countries from the year 1525. unto the year 1530. and that chiefly in Autumn. As soon as this pestilent disease entered into any City, suddenly two or three hundred fell sick on one day, than it departing thence to some other place. The people strucken with it languishing, fell down in a swoon, and lying in their beds, sweat continually, having a fever, a frequent, quick, and unequal pulse; neither did they leave sweeting till the disease left them, which was in one or two days at the most: yet freed of it, they languished long after, they all had a beating, or palpitation of the heart, which held some for two or three years, and others all their life after. At the first beginning it killed many, before the force of it was known: but afterwards very few, when it was found out by practice and use, that those who furthered and continued their sweats, and strengthened themselves with Cordials, were all restored. But at certain times many other popular diseases, sprung up, as putrid fevers, fluxes, bloudy-fluxes, catarrhs, coughs, frenzies, squinances, pleurisies, inflammations of the lungs, inflammations of the eyes, apoplexies, lithargies, small pocks and meazels, scabs, carbuncles, and malign pustles. Wherefore the plague is The Plague is not the definite name of one disease. not always, nor everywhere of one and the same kind, but of divers; which is the cause that divers names are imposed upon it, according to the variety of the effects it brings, and symptoms which accompany it, and kinds of putrefaction, and hidden qualities of the Air. They affirm, when the Plague is at hand, that Mushrooms grow in greater abundance What signs in the earth foretell a Plague. out of the earth, and upon the surface thereof many kinds of poisonous insecta creep in great numbers, as Spiders, Caterpillars, Butterflies, Grasshoppers, Beetles, Hornets, Wasps, Flies, Scorpions, Snails, Locusts, Toads, Worms, and such things as are the offspring of putrefaction. And also wild beasts tired with the vaporous malignity of their Dens and Caves in the earth, forsake them; and Moles, Toads, Vipers, Snakes, Lizzards, Asps and Crocodiles are seen to flee away, and remove their habitations in great troops. For these, as also some other creatures, have a manifest power by the gift of God, and the instinct of Nature, to presage changes of weather, as reins, showers, and fair weather; and seasons of the year, as the Spring, Summer, Autumn, Winter, which they testify by their singing, chirping, crying, flying, playing, and beating their wings, and such like signs: so also they have a perception of a Plague at hand. And moreover, the carcases of some of them which took less heed of themselves, suffocated by the pestiferous poison of the ill Air contained in the earth, may be every where found, not only in their dens, but also in the plain fields. These vapours corrupted not by a simple putrefaction, but an occult malignity, are drawn out of the bowels of the earth into the Air, by the force of the Sun and How pestilent vapours may kill plants and trees. Stars, and thence condensed into clouds, which by their falling upon corn, trees and grass, infect and corrupt all things which the earth produceth, and also kills those creatures which feed upon them; yet brute beasts sooner than men, as which stoop and hold their heads down towards the ground (the maintainer and breeder of this poison) that they may get their food from thence. Therefore at such times, skilful husbandmen, taught by long experience, never drive their cattle or Sheep to pasture, before that the Sun, by the force of his beams, hath wasted and diffipated into Air this pestiferous dew hanging and abiding upon boughs and leaves of trees, herbs, corn and fruits. But on the contrary, that pestilence which proceeds from some malign quality from above, by reason of evil and certain conjunction of the Stars, is more hurtful to men and birds, as those who are nearer to heaven. CHAP. VI By using what cautions in Air and Diet, one may prevent the Plague. HAving declared the signs foreshowing a Pestilence: now we must show by what means we may shun the imminent danger thereof, and Change of places the surest prevention of the Plague. defend ourselves from it. No prevention seemed more certain to the Ancients, than most speedily to remove into places far distant from the infected place, and to be most slow in their return thither again. But those, who by reason of their business or employments, cannot change their habitation, must principally have care of two things: The first is, that they Two things of chief account for prevention. strengthen their bodies, and the principal parts thereof against the daily imminent invasions of the poison, or the pestiferous and venenate Aire. The other, that they abate the force of it, that it may not imprint its virulency in the body; which may be done by correcting the excess of the quality inclining towards it, by the opposition of its contrary. For if it be hotter than is meet, it must be tempered with cooling things; if too cold, with heating things: yet this will not suffice. For we ought besides, to amend & purge the corruptions of the venenate malignity diffused through it, by smells and perfumes resisting the poison thereof. The body will be strengthened and more powerfully resist the infected Air, if it want excrementitious humours, which may be procured by purging and bleeding, and for the rest a convenient diet appointed, as shunning much variety of meats, and hot and moist things, and Diet for prevention of the Plague. all such which are easily corrupted in the stomach; and cause obstructions, such as those things which be made by Comfit-maker's; we must shun satiety and drunkenness, for both of them weaken the powers, which are preserved by the moderate use of meats of good juice. Let moderate exercises in a clear Air, and free from any venomous tainture, precede your meals. Let the belly have due evacuation either by Nature or Art. Let the heart, the seat of life, and the rest of the bowels be strengthened with Cordials and Antidotes applied and taken (as we shall hereafter show) in the form of epithemes, ointments, emplasters, waters, pills, powders, tablets, opiates, fumigations, and such like. Make choice of a pure Air & free from all pollution, & far remote from stinking places, for such is most fit to preserve life, to recreate and repair the spirits; where Discommodities of a cloudy or toggy air. as on the contrary, a cloudy or misty Air, and such as is infected with gross and stinking vapours, dulls the spirits, dejects the appetite, makes the body faint and ill coloured, oppresseth the heart, and is the breeder of many diseases. The Northern wind is healthful, because it is cold and dry. But on the contrary, the Southern wind, because it is hot and moist, weakens the body by sloth or dulness, Why the South wind is pestilent. opens the pores, and makes them pervious to the pestiferous malignity. The Western wind is also unwholesome, because it comes near to the nature of the Southern: wherefore the windows must be shut up on that side of the house on which they blow, but opened on the North and East side, unless it happen the Plague come from thence. Kindle a clear fire in all the lodging Chambers of the house, and perfume the The efficacy of fire against the Plague. whole house with Aromatic things, as Frankincense, Mirth, Benzoine, Laudanum, Styrax, Roses, Myrtle-leaves, Lavender, Rosemary, Sage, Savory, wild Time. Marjerome, Broome, Pineapples, pieces of Fir, Juniper berries, Cloves, Perfumes: and let your clothes be aired in the same. There be some, who think it a great preservative against the pestilent Air, to keep a Goat in their houses, because the capacity of the houses, filled with the strong sent which the Goat sends forth, prohibits the entrance of the venomous Air: which same reason hath place also in sweet smells; and besides, it argues, that such as are hungry Moderate repletion good for prevention. are apt to take the Plague, than those who have eaten moderately: for the body is not only strengthened with meat, but all the passages thereof are filled by the vapours diffused from thence, by which otherwise the infected Air would find a more easy entrance to the heart. Yet the common sort of People yield another reason for the Goat, which is, that one ill sent drives away another, as one wedge drives forth another; which calleth to my mind that which is recorded by Alexander Benedictus, that there was a Scythian A strange art to drive away the Plague. Physician, which caused a Plague, arising from the infection of the Air, to cease, by causing all the dogs, cats, & such like beasts which were in the City, to be killed, and cast their carcases up & down the streets, that so by the coming of this new putrid vapour as a stranger, the former pestiferous infection, as an old guest, was put out of its Lodging, & so the Plague ceased. For poisons have not only an antipathy with The antipathy of poisons with poisons. their Antidotes, but also with some other poisons. Whilst the Plague is hot, it is not good to stir out of door before the rising of the Sun: wherefore we must have patience, until he have cleansed the Air with the comfortable light of his Beams, and dispersed all the foggy and nocturnal pollutions, which commonly hang in the Air in dirty, and especially in low places and Valleys. All public and great meetings and assemblies must be shunned. If the Plague begin in Summer, and seem principally to rage, being helped forward Whether in the plague time one must travel by night or by day. by the summer's heat, it is the best to perform a journey begun, or undertaken for performance of necessary affairs, rather upon the night time, than on the day, because the infection takes force, strength and subtlety of substance, by which it may more easily permeate and enter in, by the heat of the Sun; but by night men's bodies are more strong, and all things are more gross and dense. But you must observe a clean contrary course if the malignity seem to borrow strength, and celerity from coldness. But you must always eschew the beams of the Moon, but especially Why the Moon is to be shunned. at the full: For than our bodies are more languid and weak, and fuller of excrementitious humours. Even as trees which for that cause must be cut down in their season of the Moon, that is, in the decrease thereof. After a little gentle walking in your Chamber, you must presently use some means that the principal parts may be strengthened by suscitating the heat & spirits, & that the passages to them may be filled, that so the way may be shut up from the infection coming from without. Such as by the use of garlic have not their heads troubled, Garlic good against the Plague. nor their inward parts inflamed, as Country people, and such as are used to it, to such there can can be no more certain preservative and antidote against the pestiferous fogs or mists, and the nocturnal obscurity, than to take it in the morning with a draught of good wine; for it being abundantly diffused presently over all the body, fills up the passages thereof, and strengtheneth it in a moment. For water, if the Plague proceed from the tainture of the Air, we must wholly What water to be made choice o● in the Plague time. shun and avoid rainwater, because it cannot but be infected by the contagion of the Air. Wherefore the water of Springs, and of the deepest Wells are thought best. But if the malignity proceed from the vapours contained in the earth, you must make choice of Rainwater. Yet it is more safe to digest every sort of water by boiling it, and to prefer that water before other, which is pure and clear to the sight, and without either taste or smell, and which besides suddenly takes the extremest mutation of heat and cold. CHAP. VII. Of the Cordial Remedies by which we may preserve our bodies in fear of the Plague, and cure those already infected therewith. SUch as cannot eat without much labour, exercise and hunger, and who are no lovers of Breakfasts, having evacuated their excrements, before they go from home must strengthen the heart with some Antidote against the virulency of the infection. Amongst which Aqua Theriacalis, or Treacle-water, two ounces, with the like quantity of Sack, is much Aqua theriacalis good against the Plague both inwardly taken & outwardly applied. commended being drunk, and rubbing the nostrils, mouth and ears with the same; for the Treacle-water strengthens the heart, expels poison, and is not only good for a preservative, but also to cure the disease itself: For by sweat it drives forth the poison contained within. It should be made in june, at which time all simple medicines, by the vital heat of the Sun, are in their greatest efficacy. The composition whereof is thus: Take the roots of Gentian, Cyperus, Tormentill, Diptam, or Fraxinella, Elecampaine, of each one ounce; the leaves of Mullet, Card●us The composition thereof. Benedictus, Divels-bit, Burnet, Scabious, Sheep's Sorrel, of each half a handful; of the tops of Rue a little quantity; Myrtle Berry's one ounce; of red Rose leaves, the flowers of bugloss, Borage, and St. John's wort, of each one ounce: let them be all cleansed, dried and macerated for the space of twenty four hours in one pound of white wine or Malmsey, and of Rose-water or Sorrel water; then let them be put in a vessel of glass, and add thereto of Treacle and Mithridate, of each four ounces: then distil them in Balneo Mariae, and let the distilled water be received in a glass vial, and let there be added thereto of Saffron two drams, of bowl Armenick, Terra Sigillata, yellow Sanders, shave of Ivory and Hartshorn, of each half an ounce, then let the glass be well stopped, and set in the Sun for the space of eight or ten days. Let the prescribed quantity be taken every morning so oft as shall be needful. It may be given without hurt to sucking children, and to women great with child. But that it may be the more pleasant, it must be strained through an Hippocras bag, adding thereto some sugar and cinnamon. Some think themselves sufficiently defended with a root of Elecampaine, Zedoary, or Angelica, rolled in their mouth, or chawed between their teeth. Others drink every morning one dram of the root of Gentian bruised, being macerated for the space of one night in two ounces of white-wine. Others take Wormwood wine. Others sup up in a rear egg one dram of Terra Sigillata, or of Hartshorn, with'a little Saffron, and drink two ounces of wine after it. There be some that do infuse bowl Armenicke, the roots of Gentian, Tormentill, Diptam, the Berries of Juniper, Cloves, Mace, Cinnamon, Saffron, and such like, in aqua vitae and strong white wine, and so distil it in Balneo Mariae. This Cordial water that followeth is of great virtue. Take of the roots of the A Cordial water. long and round Aristolochia, Tormentill, Diptam, of each three drams, of Zedoary two drams, Lignum Aloes, yellow Saunders, of each one dram, of the leaves of Scordium, St. John's wort, Sorrell, Rue, Sage, of each half an ounce, of Bay and Juniper berries, of each three drams, Citron seeds one dram, Cloves, Mace, Nutmegs, of each two drams, of Mastic, Olibanum, bowl Armenick, Terra Sigillata, shave of Hartshorn and Ivory, of each one ounce, of Saffron on scruple, of the conserveses of Roses, bugloss flowers, waterlillies, and old Treacle, of each one ounce, of Camphire half a dram, of aqua vitae half a pint, of white wine two pints and a half, make thereof a distillation in Balneo Mariae. The use of this distilled water is even as Treacle water is. The Electuary following is very effectual. Take of the best Treacle three ounces, A Cordial clectuary. Juniper berries and Carduus seeds of each one dram and a half, of bowl Armenicke prepared half an ounce, of the powder of the Electuary de Gemmis and Diamargariton frigidum, the powder of Hartshorn, and red Coral, of each one dram: mix them with the syrup of the rinds and juice of Pome-citrons as much as shall suffice, and make thereof a liquid Electuary in the form of an Opiate, let them take every morning the quantity of a Filberd, drinking after it two drams of the water of Scabious, Cherries, Carduus Benedictus, and of some such like cordial things, or of strong wine. The following Opiate is also very profitable, which also may be made into Tablets. An●…. Take of the roots of Angelica, Gentian, Zedoary, Elecampaine, of each two drams; of Cytron and Sorrell seeds, of each half a dram; of the dried rinds of Citrons, Cinnamon, Bay and Juniper berries, and Saffron, of each one scruple; of conferve of Roses and bugloss, of each one ounce; and fine hard Sugar as much as is sufficient: make thereof Tablets of the weight of half a dram, let him take one of them two hours before meat: or make thereof an Opiate with equal parts of conserveses of bugloss and Mel Anthosatum, and so adding all the rest dry and in powder. Or take of the roots of Valerian, Tormentill, Diptam, of the leaves of Rue, Another. of each half an ounce; of Saffron, Mace, Nutmegs, of each half a dram; of bowl Armenick prepared half an ounce; of conserve of Roses and syrup of Lemons as much as will be sufficient to make thereof an Opiate liquid enough. Or take of the Another. roots of both the Aristolochia's, of Gentian, Tormentill, Diptam, of each one dram and an half; of Ginger three drams; of the leaves of Rue, Sage, Mints and Pennyroyal, of each two drams; of Bay and Juniper berries, Cytron seeds, of each four scruples; of Mace, Nutmegs, Cloves, Cinnamon, of each two drams; of Lignum aloes, and yellow Saunders, of each one dram; of Male Frankincense, i. Olibanum, Mastic, shave of Hartshorn and Ivory, of each two scruples; of Saffron half a dram; of bowl Armenicke, Terra Sigillata, red Coral, Pearl, of each one dram; of conserveses of Roses, bugloss flowers, water-lillyes and old Treacle, of each one ounce; of loaf sugar one pound and a quarter: a little before the end of the making it up, add two drams of Confectio Alkermes, and of Camphire dissolved in Rose-water one scruple: make thereof an Opiate according to Art, the dose thereof is from half a dram to half a scruple. Treacle and Mithridate faithfully compounded, excel all Cordial medicines, adding for every half ounce of each of them, one ounce and a half of conserveses of Roses, or of bugloss, or of Violets, and three drams of bowl Armenicke prepared: Of these being mixed with stirring, and incorporated together, make a conserve: It must be taken in the morning the quantity of a Filberd: You must choose that Treacle that is not less than four years old, nor above twelve: that which is somewhat new, is judged to be most meet for choleric persons, but that which is old for phlegmatic and old men. For at the beginning the strength of the Opium that enters into the composition thereof, remains in its full virtue for a year: but afterwards the more years old it waxeth, the strength thereof is more abolished, so that at length the whole composition becometh very hot. The confection of Alkermes is very effectual both for a preservative against this disease, and also for the cure. The quantity of a Filberd of Rhubarb, with one Clove chawed or rolled in the mouth, is supposed to repel the coming of the pestilent Air: as also this composition following. Take of preserved Citron and Orange pills, of each one dram; of conserve of Roses, and of the roots of bugloss, of each three dams; of Citron seeds half an A consection to be taken in the morning against the pestilent Air. ounce; of anise seeds and Fennel seeds, of each one dram; of Angelica roots four scruples; sugar of Roses as much as sufficeth: Make a Confection, and cover it with leaves of Gold, and take a little of it out of a spoon before you go abroad every morning. Or take of Pineapple kernels, and Fistick nuts, infused for the space of six hours in the water of Scabious and Roses, of each two ounces; of Almonds blanched in A Marchpane. the forenamed waters half a pound: of preserved Citron and Orange pills, of each one dram and a half: of Angelica roots four scruples: make them according to art, unto the form of Marchpane, or of any other such like confection: and hold a little piece thereof often in your mouth. The Tablets following are most effectual in such a ease. Take of the roots of Diptam, Tormentill, Valerian, Elecampaine, Eringoes, of each half a dram; of bowl Armenick, Terra Sigillata, of each one scruple; of Camphire, Cinnamon, Sorrel seeds, and Zedoary, of each one scruple; of the Species of the Electuary Diamargariton Frigidum, two scruples; of conserve of Roses, bugloss, preserved Citron pills, Mithridate, Treacle, of each one dram; of fine sugar dissolved in Scabious and Carduus water, as much as shall suffice: Make thereof Tablets of the weight of a dram or half a dram: take them in the morning before you eat. The pills of Ruffus are accounted most effectual preservatives, so that Ruffus himself Pills of Ruffus. saith, that he never knew any to be infected that used them: the composition of them is thus. Take of the best Aloes half a dram; of Gum Ammoniacum two dams; of Myrrh two drams and an half; of Mastic two drams; of Saffron seven grains: Put them all together, and incorporate them with the juice of Citrons, or the syrup of Lemons, and make thereof a mass, and let it be kept in leather: Let the patient take the weight of half a dram every morning two or three hours before meat, & let him drink the water of Sorrel after it, which through its tartness, and the thinness of its parts, doth infringe the force and power of the malignity or putrefaction: For experience hath taught us, that Sorrell being eaten or chawed in the mouth, doth make the pricking of Scorpions unhurtfull. And for those ingredients which do enter into the composition of those pills, Aloes doth cleanse and purge, Myrrh resists putrefaction, Mastic strengthens, Saffron exhilarates and makes lively the spirits that govern the body, especially the vital and animal. Those pills that follow are also much approved. Take of Aloes one ounce; of Other pills. Myrrh half an ounce, of Saffron one scruple, of Agarick in Trochisces, two drams, of Rhubarb in powder one dram, of Cinnamon two scruples, of Mastic one dram and a half, of Citron seeds twelve grains: Powder them all as is requisite; and make thereof a mass with the syrup of Maidenhair: Let it be used as aforesaid. If the mass begin to wax hard, the pills that must presently be taken, must be mollified with the syrup of Lemons. Take of washed Aloes two ounces, of Saffron one dram, of Myrrh half an ounce, Other pills of Ammoniacum dissolved in white wine, one ounce, of honey of Roses, Zedoary, red Saunders, of each one dram, of bowl Armenick prepared two drams, of red Coral half an ounce, of Camphire half a scruple: make thereof pills according to Art. But those that are subject or apt to the haemorrhoids ought not at all, or very seldom to use those kinds of pills that do receive much Aloes. They say that King Mithridates affirmed by his own writing, that whosoever took the quantity of an hazel Nut of the preservative following, and drank a little wine after it, should be free from poison that day. Take two Walnuts, those that be very dry, two figs, twenty leaves of Rue, and three grains of salt: beat them, and incorporate them together, and let them be used as is aforesaid. This remedy is also said to be profitable for those that are bitten or st●ng by some venomous beast, and for this only, because it hath Rue, in the composition thereof. But you must forbid women that are with child the use of this medicine, for Rue is hot and dry in the third degree, and therefore it is said to purge the womb, and provoke the flowers, whereby the nourishment is drawn away from the child. Of such variety of medicines, every one may make choice of that that is most agreeable to his taste, and as much thereof as shall be sufficient. CHAP. VIII. Of local medicines to be applied outwardly. THose medicines that have proper and excellent virtues against the pestilence, are not to be neglected to be applied outwardly, or carried in the hand. And such are all aromatical, astringent, or spirituous things, which therefore are endued with virtue to repel the venomous and pestiferous air from coming and entering into the body, and to strengthen the heart and Of what n●…e the medicines outwardly used aught to be. the brain. Of this kind are Rue, Balm, Rosemary, Scordium, Sage, Wormwood, Cloves, Nutmegs, Saffron; the roots of Angelica, and Lovage, and such like, which must be macerated one night in sharp Vinegar and Aquavitae, and then tied in a knot as big as an egg: or rather let it be carried in a sponge, made wet or soaked in the said infusion. For there is nothing that doth sooner and better hold the spirituous virtue and strength of aromatic things, than a sponge. Wherefore it is of principal use either to keep or hold sweet things to the nose, or to apply Epithemes and Fomentations to the heart. Those sweet things ought to be hot or cold, as the season of the year, and kind of the pestilence is. As for example, in the Summer you ought to infuse and macerate Cinnamon and Cloves beaten together, with a little Saffron in equal parts, of Vinegar of Roses, and Rose water, into which you must dip a sponge, which rolled in a fair linen cloth, you may carry in your hand, and often smell to. Take of Wormwood half a handful, ten Cloves, of the roots of Gentian and Angelica, of each two dams, of Vinegar and Rose water, of each two ounces, of Treacle and Mithridate, of each one dram, beat and mix them all well together, and let a sponge be dipped therein, and used as abovesaid. They may also be enclosed in boxes made of sweet wood, as of Juniper, Cedar, or Cypress, and so carried for the same purpose. But there is nothing more easy to be carried than Pomanders: the form of which is thus. Take of yellow Saunders, Mace, Citron pills, Rose and Myrtle leaves, of each two dams, of Benzoin, Laudanum, Storax, of each half a dram, of Cinnamon, and Saffron, of each two Scruples, of Camphire and Amber Greece, of each one scruple, of Musk, three grains. Make thereof a Pomander, with Rose water, with Pomanders. the infusion of Tragacanth. Or take red Rose leaves, the flowers of Waterlillies, and Violets, of each one ounce, of the three Saunders, Coriander seeds, Citron pills, of each half an ounce, of Camphire, one dram, let them all be made into powder, and with Water of Roses and Tragacanth make a pomander. In the winter it is to be made thus: take of Storax, Benzoin, of each one dram and a half; of Musk, half a Scruple; of Cloves, Lavender, and Cyperus, of each two drams; of the root of Orris, i. Flower-de-Luce, and Calamus aromaticus, of each two drams and a half; of Amber Greece, three drams; of gum Tragacanth dissolved in Rose water & Aquavitae, as much as shall suffice: make thereof a Pomander. Sweet poude●… And for the same purpose you may also use to carry about with you sweet powders, made of Amber Greece, Storax, Orris, Nutmegs, Cinnamon, Mace, Cloves, Saffron, Benzoine, Musk, Camphire, Roses, Violets, Juncus odoratus, Margerum, & such like, of which being mixed together, Powders may be compounded & made. Take of the roots of Orris two drams, of Cyperus, Calamus Aromaticus, red Roses, of each half an ounce, of Cloves half a dram, of Storax one dram, of Musk eight grains: mix them, and make a powder for a bag: or take the roots of Orris two ounces, red Rose leaves, white Saunders, Storax, of each one ounce, of Cyperus one dram, of Calamus Aromaticus, one ounce, of Marjoram, half an ounce, of Cloves, three dams, of Lavender, half a dram, of Coriander seeds two dams, of good Musk, half a scruple, of Laudanum and Benzoin, of each a dram, of Nutmegs and Cinnamon, of each two dams: Make thereof a fine powder, and few it in a bag. It will be very convenient also to apply to the region of the heart, a bag filled with yellow Saunders, Mace, Cloves, Cinnamon, Saffron, and Treacle shaken together, Bags. and incorporated, and sprinkled over with strong vinegar and Rose water in Summer, and with strong wine and Muskedine in the Winter. These sweet Aromatic things that are so full of spirits, smelling sweetly and strongly, have admirable virtues to strengthen the principal parts of the body, and to stir up the expulsive faculty to expel the poison. Contrariwise, those that are stinking and unsavoury, procure a desire to vomit, and dissolution of the powers, by which it is manifest how foolish and absurd their persuasion is, that counsel such as are in a pestilent constitution of the air, to receive Unsavoury things to be eschewed. and take in the stinking and unsavoury vapours of sinks and privies, and that especially in the morning. But it will not suffice to carry those preservatives alone, without the use of any other thing, but it will be also very profitable to wash all the whole body in Vinegar of the decoction of Juniper & Bay berries, the roots of Gentian, Marigolds, S. john's Wort, and such like, with Treacle or Mithridate also dissolved in it. For vinegar is an enemy to all poisons in general, whether they be hot or cold: for it resisteth & hindereth putrefaction, because it is cold & dry: therefore in this, inanimate bodies, as flesh, Herbs, fruits, and many other such like things, may be kept a long time without putrefaction. Neither is it to be feared, that it should obstruct the pores, by reason of its coldness, if the body be bathed in it: for it is of subtle parts, and the spices boiled in it, have virtue to open. Whosoever accounteth it hurtful to wash his whole body therewith, let him wash only his armholes, the region of his heart, his temples, groins, parts of generation, as having great and marvellous sympathy with the principal and noble parts. If any mislike bathing, let him anoint himself with the following unguent. Take oil of Roses, four ounces; oil of Spike, two ounces; of the powder of Cinnamon An unguent. and Cloves, of each one ounce and a half; of Benzoin, half an ounce; of Musk, six grains; of Treacle, half a dram; of Venice Turpentine, one dram and a half; of Wax, as much as shall suffice: make thereof a soft unguent. You may also drop a few drops of oil of Mastic, of Sage, or of Cloves, and such like, into the ears, with a little Civet or Musk. CHAP. IX. Of other things to be observed for prevention, in fear of the Plague. VENERY is chiefly to be eschewed, for by it the powers are debilitated, the spirits dissipated, and the breathing places of the body diminished, Why venery is to be shunned. and lastly, all the strength of nature weakened. A sedentary life is to be shunned, as also excess in diet, for hence proceeds obstruction, the corruption of the juices, and preparation of the body to putrefaction and the pestilence. Women must be very careful that they have their courses duly, for stopping besides the custom, they easily acquire corruption, and draw by contagion the rest of the humours into their society. Such as have fistulous, or otherwise old ulcers, must not heal them up in a pestilent season, for it is then more convenient rather to make Running ulcers good in time of pestilence. new ones, and these in convenient and declining places; that as by these channels, the sink of the humours of the body may be emptied. The Haemorrhoids, bleedings, & other the like accustomed evacuations, must not be stopped, unless they exceed measure. Moreover, they must at such times take heed that they touch or handle not any of these things wherein the seeds or fuel of the pestilence may lie hid, such as are, hemp, flax, quilts and cover wherein such as have had the plague, have laid; skins and all leathern things, hangings and clothes. You must dwell far from churchyards, especially from those wherein the corpse of such as have died of the plague, are not buried deep in the ground, as in the church Places to be shunned in time of plague. of the Innocents in Paris, in which place by the same reason it sundry times happens that the buried bodies are plucked up, rend and torn by dogs. Also let them dwell far from places of execution, shambles of flesh and fish, from tannehouses, dyer's, tallow-chandlers, cloth-dressers, farrier's, skinner's, and from the places wherein metals are cast or wrought. The filth and dung, especially of Swine, Privies, standing and muddy waters, and lastly all things of the like evil smell, must be far remote from your habitation; the belly must not be emptied into those places, into which the excrements of such as have the plague are cast. The company of such as What company to be avoided. usually visit those sick of the plague, must be eschewed, as of Physicians, Apothecaries, Surgeons, Nurse-Keepers, Grave-makers and Bearers. For though they have not the plague, yet coming forth of a pestilent place, they may carry with them lying hid in their garments, the seeds thereof. You may gather this by such as have for a little while stayed in a perfumer's shop, for the perfume diffused in the air, bestows the smell upon the garments of such persons, so that gone from thence, such as meet them, will judge them to carry perfumes with them. They shall also shun You must do nothing in a pestilent season whereby you may grow too hot. long watchings, sound sleeping, all passions of the mind, especially anger, hunger, thirst, journeying in the sun, for that hath ofttimes occasioned a diary fever, which hath not seldom been seen to turn into a pestilent one, for by dilating the pores of the skin, they have given entrance to the pestilent air, which by that means hath easily taken hold of the humour disposed to putrefaction. CHAP. X. Of the office of Magistrates in the time of the Plague. MAgistrates ought to have a special care that no filth be heaped up, either in private or public places: let all things be kept neat in every house, and let all the streets be kept clean, the dung and filth be carried forth of the city, as also the dead carcases of killed dogs and cats, for because Why dogs and cats must be killed in a plague time. they ofttimes lick and devour the excrements of such as have the Sickness, therefore they may by their familiar entry into sound houses, there propagate the plague. Wherefore they must either be driven forth of the city, or killed, and so be carried forth and buried deep in the ground. Wells, springs, and rivers themselves, must be freed and cleansed from all impurity. Care must be had that musty corn, tainted flesh, nor stinking fish be not set to sale. Public baths and hothouses Why Baths and hothouses are not then to be allowed. must be prohibited, for that in these, men's bodies are weakened, and made more yielding and pervious to the pestiferous air. They shall commit the cure of such as have the plague, to learned, skilful and honest Physicians, Apothecaries, and Surgeons. Such as are known to have the plague, shall be separated from such as are free therefrom, and be sent to such fit places as shall be provided for them; for this is better and more humanely done, than to shut up every man in his own house. They shall provide and foresee that the householdstuff of such as have the plague be not set to sale. They shall set signs and noted marks upon the houses seized upon by this disease, lest they should unawares run into danger. Wherefore to the same purpose they shall procure that the Surgeons & others that visit the sick of the plague may be known by some conspicuous mark, that such as pass by them may be admonished of the danger; they shall also take care that the bodies of the dead be buried as speedily as may be. For they sooner & more grievously putrefy in a short time, Such as dye of the plague do quickly putrefy than the bodies of others of what death soever they die. Wherefore, neither birds nor ravenous beasts dare once touch their bodies, though unburied, for by tasting them they should quickly come to their deaths. The keepers of the gates of the city shall be admonished, that they take special care that such as are infected, or come from a visited place, do not enter into the city, for from one, the evil may come to spread itself further, for one spark may set a whole city on fire, and one scabby sheep infect a whole flock. And because there is nothing which may more perfectly purge the air, and cleanse it from all manner of noisomeness and infection, than fire, they shall command that there be kindled, and perpetually kept burning fires, made with odoriferous and strong smelling things, as Juniper, Turpentine, Broome, and the like. In stead hereof Levinus tells that the soldiers of the Garrison of Torney used in a Plague time to discharge their Cannons jaded only with Powder, turning their Lib. 2. de occult ●at. mirac. mouths upon the city, and that morning and evening, that by the vehemency of the moved air, the pestiferous fogs might be chased away, and by the heat of the burned powder, the venenate and noisome quality of the air might be amended. Lastly, I judge it fit to admonish Magistrates that they have their eics and minds The villainy of some ba●e people. attentive upon a murderous and impious kind of bearers and nurse-keepers, which alured with a desire of gain (which whilst the plague reigns, they get abundantly) anoint the walls, doors, thresholds, knockers of gates and locks with the filth and ointments taken from such as have the plague, that the plague within a while after seizing upon these also, the masters of them flying away, and the family dispersed, they may there reign alone, and freely and without punishment carry thence what they please, ofttimes strangling such as lie ready to die, lest recovering, they might be their accusers. This I remember happened at Lions, Anno Dom. 1565. CHAP. XI. What caution must beeused in choosing Physicians, Apothecaries and Surgeons, who may have care of such as are taken with the Plague. IT is the part of Magistrates in the so great necessity of the afflicted commonwealth, to appoint learned, skilful, and honest Physicians, Surgeons, and Apothecaries, and such as have more regard to the law of God than to gain, to have the care & cure of such as are visited. But principally let them not take Surgeons and Apothecaries called by proclamation with sound of trumpet, that if they will take this charge, they shall become free without examination or reward. But let them rather be alured by gifts and honest rewards, not only then when as necessity urgeth, but also after the plague is over. For such servant Surgeons and Apothecaries as are called by proclamation, so to gain freedom, are most commonly unskilful and unexperienced Dunces, who, conscious of their own ignorance, and fearing to undergo the examination of the Masters of their Companies, refuse no hazard, however dangerous, with desire to obtain their freedom. It is far worse and more dangerous to fall into the hands of such, than into the hands of thiefs and murderers, for these, by providence or strength, we may chance to escape; but we seek for and embrace the other, and having found them, lay our throats bare unto them, so by their unskilfulness to be burchered. Certainly by the fault of the times, and the neglect of Magistrates, it is almost come to this pass, that if any honest and learned Physicians and Surgeons shall undertake this cure, they are commonly forced thereto by the Magistrate for fear of banishment or fining. Therefore because they do it against their wills, they show themselves less vigilant, cheerful and painful about the sick. They come unwillingly and compelled hereto, because by the memory of the forepast time, they sufficiently know, how sordid and basely Magistrates, when the plague hath been overpast, have been in paying the promised reward to men of their condition, who have sloutly run into danger; for thence it happens that during the rest of their lives they may sit idle at home, for that they are infamous and feared by the people only for this, that a while agone they visited such as had the plague. Therefore I would have Magistrates prudent, faithful, and free in choosing honest, learned and skilful men, who may undergo this so difficult and dangerous a charge. CHAP. XII. How such as undertake the cure of the Plague ought to arm themselves. FIrst they must think and hold for certain, that they are not called Our lots are in the hands of the Lord. to this office by men, but by God, so directing the counsels and actions of men as he thinketh fit. Therefore they shall confidently enter into the cure thereof, for that our lot, life and death are in the hands of the Lord: but notwithstanding they ought not to neglect remedies, which are given to men for prevention, lest by neglecting the gifts of God, they may seem to neglect him also that is the giver of so many good and excellent benefits. Therefore first let them by purging and bleeding evacuate the humours subject to putrefaction, and to conceive the seeds of the pestilence. Let them make two fontanellas by application of Cauteries Where to make issues in the time of the Plague. to be as rivulets to evacuate the excrementitious humours which are daily by little and little heaped up in us; let one of them be in the right arm a little below the muscle Epomis, the other the space of three fingers under the knee on the inside of the left leg. This is found by experience a very certain means of prevention. Let them wash their whole bodies with the following lotion. ℞. aquae ros. aceti rosatis, aut sambucini, vini albi aut, malvatici, an. lb. vi. rad. enulae camp. angelicae, gentian. bistortae, Zedoar. an. ℥ iii baccar. juniperi, & hederae, an. ℥ two. salviae, rorismar. absinth. rutae, an. m. i corticis citri, ℥ ss. theriacae & mithridat. an ℥ i. conquassanda conquassent. bulliant lento igni, & serventur ad usum ante commemoratum. The Epithemes, unguents Cap 8. and bags formerly described shall be applied to the region of the heart. I have read it noted by John Baptist Theodosius, that amongst other things, Arsenic may be profitably Epist. 2. applied to the region of the heart, that so it may by little and little accustom itself to poisons, that afterwards it may be less harmed by their incursion, first making their assault upon it. Let their garments be made of Chamelet, Dutch sarge, Satin, Taffeta, or the like. What to wear. Or else if they cannot of these, let them be of some other handsome stuff, but not of cloth, frieze or the like, that may take the venenate Aire, and carry it with them to the infection of the sound. They shall ofttimes change their clothes, shirts and other How to visit your patients. linen, and perfume them with aromatic things; let them warily approach to the sick, more warily speak unto him, with their faces looking away from him, rather than towards him, so that thy may not receive the breath of his mouth, neither the vapour nor smell of any of his excrements. When as I upon a time being called to visit one that lay sick of the plague, came A history. too near and heedlessly to him, and presently by sudden casting off the clothes, laid him bare, that so I might the better view a Bubo that he had in his right groin, and two Carbuncles that were on his belly, then presently a thick, filthy and putrid vapour arising from the broken abscess of the Carbuncle, as out of a raked puddle, ascended by my nostrils to my brain, whereupon I fainted and fell down senseless upon the ground; raised up a little after, all things seemed to me to run round; and I was ready to fall again, but that I stayed myself by taking hold of the bed post. But one thing comforted me, that there appeared no signs that my heart was affected, either by pain or panting, or the strong and contumaciou failing of my powers. An argument that the animal spirits were only dissipated by a venenate vapour, and that the substance of the heart was no way wronged, was a sneesing which took me so violently, that I sneezed ten times, and then fell a bleeding at the nose; which excretion, I believe freed me from all the impression of the malignity. Let others warned by this mine example, learn to be wiser and more wary in this case, lest they come to a worse mishap than befell me. CHAP. XIII. Of the signs of such as are infected with the Plague. WE must not stay so long before we pronounce one to have the Plague, until there be pain and a tumour under his arm holes, or Whence certain signs of the Plague may be taken. in his groin, or spots (vulgarly called Tokens) appear over all the body, or carbuncles arise: for many die through the venenate malignity, before these signs appear. Wherefore the chiefest and truest signs of this disease are to be taken from the heart, being the mansion of life, which chiefly and first of all is wont to be assailed by the force of the poison. Therefore they that are infected with the Pestilence, are vexed with often swoon and fainting; their pulse is feebler and flower than others, but sometimes more frequent, but that is specially in the night season; they feel prickings over all their body, as if it were the pricking of needles; but their nostrils do itch especially by occasion of the malign vapours rising upwards from the lower and inner, into the upper parts, their breast burneth, their heart beateth with pain under the left dug, difficulty of taking breath, Phthisic, Cough, pain of the heart, and such an elation or puffing up of the Hypocondria or sides of the Belly, distended with the abundance of vapours raised by the force of the feverish heat, that the Patient will in a manner seem to have the Timpany. They are molested with a desire to vomit, The cause of such as have the Plague. and oftentimes with much and painful vomiting, wherein green and black matter is seen, & always of divers colours, answering in proportion to the excrements of the lower parts, the stomach being drawn into a consent with the heart, by reason of the vicinity and communion of the vessels; oftentimes blood alone, & that pure, is excluded & cast up in vomiting; and it is not only cast up by vomiting out of the stomach, but also very often out of the nostrils, fundament, and in women out of the womb; the inward parts are often burned, and the outward parts are stiff with cold, the whole heat of the Patient being drawn violently inward, after the manner of a Cupping-glass, by the strong burning of the inner parts; then the eyelids waxeblew, suddenly changed. as it were through some contusion, all the whole face hath a horrid aspect, and as it were the colour of lead, the eyes are burning red, & as it were, swollen or puffed up with Blood, or any other humour, shed tears; and to conclude, the whole habit of the body is somewhat changed and turned yellow. Many have a burning fever, which doth show itself by the Patients ulcerated jaws, unquenchable thirst, dryness and blackness of the tongue, and it causeth such a frenzy by inflaming the brain, that the patients running naked out of their beds, seek to throw themselves out of windows into the pits and rivers that are at hand. In some the joints of the body are so weakened, that they cannot go nor stand, from the beginning they are as it were buried in a long swoon and deep sleep, by reason Why some that ●e taken with the plague are ●eepy. that the fever sendeth up to the brain the gross vapours from the crude and cold humours, as it were from green Wood newly kindled to make a fire. Such sleeping doth hold him especially while the matter of the sore or Carbuncle is drawn together, and beginneth to come to suppuration. Oftentimes when they are awaked out of sleep, there do spots and marks appear dispersed over the skin, with a stinking sweat. But if those vapours be sharp that are stirred up unto the head, in stead of sleep they cause great waking, and always there is much diversity of accidents in the urine of those that are infected with the Plague, by reason of the divers temperature and condition of bodies: neither is the urine at all times, and in all men of the same consistence and colour: For sometimes they are like unto the urine of those that are sound and in health, that is to say, laudable in colour and substance, because that when the heart is affected by the venomous Air, that entereth in unto it, Why their urine are like those that are ●●und. the spirits are more greatly grieved and molested than the humours: but those, i. the spirits, are infected and corrupted when these do begin to corrupt. But Urines only show the dispositions of the humours or parts in which they are made, collected together, and through which they pass. This reason seemeth truer to me than theirs which say, that nature terrified with the malignity of the poison avoids contention, and doth not resist or labour to digest the matter that causeth the disease. Many have their appetites so overthrown, that they can abstain from meat for the space of three days together. And to conclude, the variety of accidents is almost infinite, which appear & spring up in this kind of disease, by reason of the diversity of the poison, and condition of the bodies and grieved parts: but they do not all appear in each man, but some in one, and some in another. CHAP. XIIII. What signs in the Plague are mortal. IT is a most deadly sign in the Pestilence, to have a continual and burning Fever, to have the tongue dry, rough, and black, to breathe with difficulty, and to draw in a great quantity of breath, but breathe out little; to talk idly; to have frenzy and madness together, with unquenchable thirst and great watching; to have Covulsions, the Hicket, heart-beating, and to swoon very often and vehemently; further, tossing and turning in the bed, with a loathing of meats, and daily vomits of a green, black and bloody colour; and the face pale, black, of a horrid and cruel aspect, bedewed with a cold sweat, are very mortal signs. There are some which at the very beginning have ulcerous and painful weariness, An ulcerous & painful weariness from the beginning showeth the Plague to be deadly. pricking under the skin, with great torment of pain; the eyes look cruelly and staringly, the voice waxeth hoarse, the tongue rough and stutting, and the understanding decaying, the Patient uttereth and talketh of frivolous things. Truly those are very dangerously sick, no otherwise than those whose urine is pale, black, and troubled like unto the urine of carriage beasts, or Lie, with divers coloured clouds or contents, as blue, green, black, fatty and oily, as also resembling in show a Spider's Web, with a round body swimming on the top. If the flesh of the carbuncle be dry and black, as it were feared with a hotiron, if the flesh about it be black and blue, if the matter do flow back, and turn in, if they have a laske with greatly stinking, liquid, thin, clammy, black, green or bluish ordure; if they avoid worms by reason of the great corruption of the humours, and yet for all this the patient is never the better; if the eyes wax often dim, if the nostrils be contracted or drawn together, if they have a grievous cramp, the mouth be drawn aside, the muscles of the face being drawn or contracted equally or unequally; if the nails be black; if they be often troubled with the Hicket, or have a Convulsion and resolution over all the body, than you may certainly prognosticate that death is at hand, and you may use Cordial medicines only, but it is too late to purge or let blood. CHAP. XV. Signs of the Plague coming by contagion of the Air without any fault of the humours. YOU shall understand that the Pestilence proceeds from the corruption of the air, if it be very contagious, and disperse itself into sundry places in a moment. If it kill quickly and many, so that whilst sundry persons go about their usual business, walk in the places of common resort and through the streets, they suddenly fall down and dye, no sign of the disease or harm appearing, nor any pain oppressing them; for the malignity of the corrupt Air is quick and very speedy in infecting our spirits, overthrowing the strength of the heart and killing the patient. The patients are not troubled with great agitation, because the spirits dissipated by the rapid malignity of the poison, Why they have no sores. cannot endure that labour; besides they are taken with frequent swooning, few of them have Bubo's, few have Blains come forth; and by the same reason their urines are like to those of sound men. CHAP. XVI. Signs of the Plague drawn into the body by the fault and putrefaction of humours. FOrmerly we have reckoned up the causes of the corruption of humours from plenitude, obstruction, distemper, and the ill juice of meats. Now must we deliver the signs of each corrupt humour which reigns in us, that it may be reduced to soundness and perfection of nature by the opposition of its contrary, or else be evacuated by physic. Therefore if the body be more yellow than usual, it is a sign of choler offending in quantity and S●gnes of choler. quality. If more black, then of melancholy; if more pale, then of phlegm; if more red, with the veins swollen up and full, then of blood. Also the colour of the rising blains, tumors and spots, express the colour of the predominant humour, as also the excrements cast forth by vomit, stool and otherwise; the heaviness and cheerfulness of the affected body; the manner of the present fever; the time of the year, age, region, diet. Such things as have a cutting, penetrating, attenuating, and cleansing faculty, take away obstruction. By means of obstruction fevers ofttimes accompany the Plague, and these not only continual, but also intermitting, like tertians or quartaines. Therefore that Plague that is fixed in the infection or corruption of a choleric humour, shows itself by the forementioned signs of predominating choler, to wit, the heat of the skin, blains and excrements, as also in the quickness of killing, and vehemency of the symptoms, bitterness of the mouth, a painful and continual endeavour of going to stool, by reason of the acrimony of choler stimulating and raking the guts in the passage forth. That which resides in the corrupt substance of gross humours, as of blood, showeth itself by many and plentiful sweats, by a scouring, by which are avoided many and various humours; and ofttimes also bloody matter that proceeds from corrupt phlegm, it invades with more sound sleep, & a causeless weariness of all the members; when they are awakened out of their sleep, they are not seldom troubled with a trembling over all their joints, the entrance and way of the spirits into the members being obstructed by the grossness of the humours. That which is seated in the corruption of a melancholy humour, is accompanied with heaviness and pain of the head, much pensiveness, a deep and small pulse. But the most certain sign of the Plague residing in the corruption of the humours, is to be taken from the urine. For the signs of the vitiated When the urine is to be looked upon. humours cannot but show themselves in the urines: therefore troubled urines, and such as are like those of carriage beasts, as also black and green, give certain notice thereof. But some are much troubled with thirst, others not at all, because choler or Phlegm sometimes only putrefy in the stomach or orifice of the ventricle, Why some are much troubled with thirst, others not at all. sometimes besides they will weaken the government of the natural faculties of the part, as of the appetite. But if the fever happen by the default and infection both of the Air and Humours, then will there be a great confusion of the forementioned signs and symptoms. CHAP. XVII. Of the Prognostication that is to be instituted in the Plague. YOU may well foretell the future motions and events of diseases, when you throughly know the nature of the disease, and accidents thereof, and the condition, function, and excellency of the body and grieved parts: Although that this may be spoken in general, That there is no certain No certain prediction in t●… Pla●…▪ prediction in pistilent diseases, either to health or death, for they have very unconstant motions, sometimes swift and quick, sometimes slow, and sometimes choking or suffocating in a moment, while one breathes in the venomous Air, as he is going about any of his necessary affairs, having pustles rising in the skin with sharp pain, and as though the whole body were pricked all over with needles, or the stings of Bees. Which I have seen with mine eyes in the Plague that was at Lions when Charles the French King lay there. It many times cometh to pass that the accidents that were very vehement and raging a little before, are suddenly assuaged, and the patients do think themselves better, or almost perfectly sound. Which happened A history. to Mary one of the Queen-mother her Maids, in that notable pestilent constitution of the Air, that year when Charles the French King lay at the Castle of Rossilion: For when she was infected, a great tumour or Bubo arose in her groin, and suddenly it went in again, so that the third day of her sickness, she said she was without any grief or disease at all, but that she was somewhat troubled with a difficulty of making water; and I think it was because the bladder was inflamed by the reflux of the matter; but she was sound in mind and body, and walked up and down the Chamber on the same day that she died. The strangeness of which thing made the King so fearful, that he hasted to depart thence. Although this disease doth spare no man, of what age, temperature, complexion, Why young men sooner take the Plague than old. diet and condition soever, yet it assaulteth young men that are choleric and sanguine, more often than old men that are cold and dry, in whom the moisture that is the nourisher of putrefaction by reason of their age is consumed, and the ways, passages and pores of the skin, whereby the venomous Air should enter and pierce in, are more straight and narrow. And moreover, because old men do always stay at home, but young men for their necessary business, and also for their delight and pleasure, are always abroad in the day time, in the Air, wherehence the pollution of the pestilence cometh more often. That pestilence that comes by the corruption of the humours, is not so contagious What Plague most contagious. as that which cometh by the default of the Air. But those that are phlegmatic and melancholy, are most commonly grieved with that kind of pestilence, because in them the humours are more clammy and gross, and their bodies more cold and less perspirable, for which causes the humours sooner and more speedily putrefy. Men that are of an ill juice are also most apt to this kind of pestilence, for in the naughty quality of the juice there is a great preparation of the humours unto putrefaction: You may know it by this, that when the pestilence reigneth, there are no other diseases among the common people, which have their original of any ill juice, but they all degenerate into the Plague. Therefore when they begin to appear and wander up and down, it is a token that the pestilence will shortly cease, or is almost at an end. But here also I would have you to understand those to be of an ill juice, which have no pores in their skin, by which, as it were by rivers, the evil juice which is contrary to nature, may be evacuated and purged. And I have noted and observed, Who least subject to take the Plague, that those are less in danger of the Pestilence which have cancerous ulcers and stinking sores in their noses, and such as infected with the French Pocks, have by reason thereof, tumors and rotten ulcers, or have the King's evil running upon them, the Leprosy or the Scab: and to conclude, all those that have fistulous and running ulcers in their bodies. I think those that have quartan Fevers are the better privileged for the same, because that by the Fit causing sweat, that cometh every fourth day, they avoid much of the evil juice that was engendered. This is more like to be true, than to think that the poison that cometh from without, may be driven away by that which lurketh within. chose, women that are great with child, as I have noted, because they have much ill juice, being prohibited from their accustomed evacuations, are very apt to Who subject thereto. take this disease, and do seldom recover after they are infected. Black or blue impostumes, and spots and pustles of the same colour, dispersed Signs that the disease is incurable. A good sign. over the skin, argue that the disease is altogether incurable and mortal. When the swelling or sore goeth or cometh before the fever, it is a good sign, for it declareth that the malignity is very weak and feeble, and that nature hath overcome it, which of itself is able to drive so great portion thereof from the inner pars. But if the sore or tumour come after the fever, it is a mortal and deadly sign, for it A deadly sign. is certain that it cometh of the venomous matter not translated, but dispersed, not by the victory of nature, but through the multitude of the matter, with the weight whereof nature is overcome. When the Moon decreaseth, those that are infected with the Pestilence are in great doubt and danger of death, because then the humours that were collected and gathered together before the full of the Moon, through delay and abundance, do swell the more, and the faculties by which the body is governed, become more weak and feeble, because of the imbecility of the native heat, which before was nourished and augmented by the light, and so consequently by the heat of the full Moon: For as it is noted by Aristotle, the wanings of the Moon are more cold and weak: and thence it is that women have their menstrual fluxes chiefly or most commonly at that time. In a gross and cloudy Air the pestilent infection is less vehement and contagious than in a thin and subtle Air; whether that thinness of the Air proceed from the In wh●t air most contagious. heat of the Sun, or from the North wind & cold. Therefore at Paris, where naturally, and also through the abundance of filth that is about the City, the Air is dark and gross, the pestilent infection is less fierce and contagious than it is in Province, for the subtlety of the Air stimulates or helps forward the Plague. But this disease is mortal and pernicious wheresoever it be, because it suddenly assaulteth the heart, which is the Mansion, or as it were the fortress or castle of life: but commonly not befo●… signs and tokens of it appear on the body: and yet you shall scarce find any man that thinketh of calling the Physician to help to preserve him from so great danger before the signs thereof be evident to be seen and felt: but then the heart is assaulted. And when the heart is so assaulted, what hope of life is there, or health to be looked for? Therefore because medicines come ofttimes too late, and this malady is as it were a sudden and winged messenger of our What effects fear and confidence produce in the Plague. death, it cometh to pass that so many die thereof. And moreover, because at the first suspicion of this so dire and cruel a disease, the imagination and mind (whose force in the diversely stirring up of the humours is great and almost incredible) is so troubled with fear of imminent death, and despair of health, that together with the perturbed humours, all the strength and power of nature falleth and sinketh down. This you may perceive and know, by reason that the keepers of such as are sick, and the bearers which are not fearful, but very confident, although they do all the basest offices which may be for the sick, are commonly not infected, and seldom dye thereof if infected. CHAP. XVIII. How a pestilent fever comes to be bred in us. THe Plague ofttimes findeth fuel in our bodies, and ofttimes allurements, to wit, the putrefaction of humours, or aptness to putrefy: but it never thence hath its first original, for that comes always from the defiled air; The original of the Plague always from the Air. therefore a pestilent fever is thus bred in us: The pestilent Air drawn by inspiration into the lungs, and by transpiration into the utmost mouths of the veins and arteries spread over the skin, the blood or else the humours already putrefying or apt to putrefy therein, are infected and turned into a certain kind of malignity resembling the nature of the agent. These humours, like unquenched lime when it is first sprinkled with water, send forth a putrid vapour, which carried to the principal parts and heart especially, infecteth the spirituous blood boiling in the ventricles thereof, and therewith also the vital spirits; and hence proceeds a certain feverish heat. This heat diffused over the body by the arteries, together with a malign quality, taints all, even the solid parts of the bones with the pestiferous venom, and besides, causeth divers symptoms, according to the nature thereof, and the condition of the body and humours wherein it is. Then is the conflict of the malignity assailing, & nature defending, manifest, in which if nature prevail, it, using the help of the expulsive faculty, will send & drive it far from the noble parts, either by sweats, vomits, bleeding, evacuation by stool or urine, buboes, carbuncles, pustles, spots, and other such kinds of break out over the skin. But on the contrary, if the Signs that natuee is o●●come. malignity prevail, and nature be too weak, and yield, and that first he be troubled with often panting or palpitation of the heart, then presently after with frequent faintings, the patient then at length will dye. For this is a great sign of the Plague or a pestilent Fever, if presently at the first, with no labour, nor any evacuation worth the speaking of, their strength fail them, and they become exceeding faint. You may find the other signs mentioned in our preceding discourse. CHAP. XIX. Into what place the Patient ought to betake himself so soon as he finds himself infected. WE have said that the perpetual and first original of the pestilence Change of the Air ●ondu●●●h to the cure of the Plague. cometh of the Air, therefore so soon as one is blasted with the pestiferous Air, after he hath taken some preservative against the malignity thereof, he must withdraw himself into some wholesome Air, that is, clean and pure from any venomous iufection or contagion, for there is great hope of health by the alteration of the Air; for we do most frequently and abundantly draw in the Air of all things, so that we cannot want it for a minute of time: therefore of the Air that is drawn in, dependeth the correction, amendment, or increase of the Poison or malignity that is received, as the Air is pure, sincere or corrupted. There be some that do think it good to shut the patient in a close Chamber, shutting the windows to prohibit the entrance of the Air as much as they are able: But I think it more convenient that those windows should be open from whence that wind bloweth that is directly contrary unto that which brought in the venomous Air: For although there be no other cause, yet if the Air be not moved, or Air pen● up is apt to putre●…. agitated, but shut up in a close place, it will soon be corrupted. Therefore in a close and quiet place that is not subject to the entrance of the Air, I would wish the patient to make wind, or to procure Air with a thick and great cloth dipped or macerated in water and vinegar mixed together, and tied to a long Staff, that by tossing it up and down the close chamber, the wind or air thereof may cool and recreate the patient. The patient must every day be carried into a fresh chamber, and the beds and the linen clothes must be changed: there must always be a clear and bright fire in the patient's chamber, and especially in the night, whereby the air may be made more pure, clean, and void of nightly vapours, and of the filthy and pestilent breath proceeding from the patient, or his excrements. In the mean time, lest (if it be in hot weather) the patient should be weakened or made more faint by reason that the heat of the fire doth disperse and waste his spirits, the Floor or ground of the chamber must be sprinkled or watered with vinegar and water, or strewed with the branches of vines made moist in cold water, with the leaves and flowers of Water-lillyes, or Poplar, or such like. In the fervent heat of summer he must abstain from Fumigations that do smell too strongly, because that by assaulting the head, they increase the pain. If the patient could go to that cost, it were good to hang all the chamber where he lieth, and also the Bed, with thick or coarse linen clothes moistened in vinegar and water of Roses. Those linen clothes ought not to be very white, but somewhat brown, because much and great whiteness doth disperse the sight, and by wasting the spirits, doth increase the pain of the head: for which cause also the Chamber ought not to be very lightsome. chose, on the night season there ought to be fires and perfumes made, which by their moderate light, may moderately call forth the spirits. Sweet fires may be made of little pieces of the wood of Juniper, Broom, Ash, Tamarisk, of the rind of Oranges, Lemons, Cloves, Benzoin, gum Arabic, Orris The materials for sweet fires. roots, Myrrh, grossly beaten together, and laid on the burning coals put into a chafing dish. Truly the breath or smoke of the wood or berries of Juniper, is thought to drive serpents a great way from the place where it is burnt. The virtue of the Ash-tree against venom is so great, as Pliny testifieth, that a serpent will not come under the shadow thereof, no not in the morning nor evening, when the shadow of any Lib 16. cap 13. thing is most great and long, but she will run from it. I myself have proved that if a circle or compass be made with the boughs of an Ash-tree, and a fire made in the midst thereof, and a serpent put within the compass of the boughs, that the serpent will rather run into the fire than through the Ash boughs. There is also another means to correct the Air. You may sprinkle vinegar of the decoction of Rue, Sage, Rosemary, Bay berries, Juniper berries, Cyperus nuts, & such like, on stones or bricks made red hot, and put in a pot or pan, that all the whole chamber where the patient lieth may be perfumed with the vapour thereof. Also fumigations may be made of some matter that is more gross and clammy, that by the force of the fire the fume may continue the longer, as of Laudanum, Perfumes. Myrrh, Mastic, Rosine, Turpentine, Storax, Olibanum, Benzoin, Bay berries, Juniper berries, Cloves, Sage, Rosemary, and Marjoram, stamped together, and such like. Those that are rich and wealthy may have Candles and Fumes made of wax, or Tallow mixed with some sweet things. Sweet candles. A sponge macerated in Vinegar of Roses, and Water of the same, and a little of the decoction of Cloves, and of Camphire added thereto, ought always to be ready at the patient's hand, that by often smelling unto it, the animal spirits may be recreated and strengthened. The water following is very effectual for this matter. Take of Orris, four ounces; of Zedoary, Spikenard, of each six dams; of Storax, Benzoin, Cinnamon, A sweet water to smell to. Nutmegs, Cloves, of each one ounce and a half; of old Treacle, half an ounce: bruise them into a gross powder, and macerate them for the space of twelve hours in four pound of white and strong wine, then distil them in a Limbeck of glass on hot ashes, and in the distilled liquor wet a sponge, and then let it be tied in a linen cloth, or closed in a box, and so often put unto the nostrils. Or take of the vinegar and water of roses, of each four ounces; of Camphire, six grains; of Treacle, half a dram: let them be dissolved together, and put into a vial of glass, which the patient may often put unto his nose. This Nodula following is more meet for this matter. Take of Rose leaves, two A Nodula to smell to. pugils; of Orris half an ounce; of Calamus Aromaticus, Cinnamon, Cloves, of each two dams; of Storax and Benzoin, of each one dram and a half; of Cyperus, half a dram: beat them into a gross powder, make thereof a Nodula between two pieces of Cambric or Lawn of the bigness of an hand-ball, then let it be moistened in eight ounces of Rose water, and two ounces of Rose vinegar, and let the patient smell unto it often. These things must be varied according to the time: For in the Summer you must use neither Musk nor Civet, nor such like hot things: and moreover women that are subject to fits of the Mother, and those that have Fevers or the headache, ought not to use those things that are so strong smelling & hot, but you must make choice of things more gentle: Therefore things that are made with a little Camphire and Cloves bruised and macerated together in Rose water & vinegar of Roses, shall be sufficient. CHAP. XX. What Diet ought to be observed, and first of the choice of Meat. THe order of diet in a pestilent disease ought to be cooling and drying; not slender, but somewhat full. Because by this kind of disease there cometh wasting of the spirits, and exolution of the faculties, which inferreth often swooning, therefore that loss must be repaired as soon Why such as have the plague may feed more fully. as may be with more quantity of meats that are of easy concoction and digestion. Therefore I never saw any being infected with the pestilence that kept a slender diet, that recovered his health, but died; and few that had a good stomach, and fed well, died. Sweet, gross, moist and clammy meats, and those which are altogether, and exquisitely of subtle parts, are to be avoided; for the sweet do easily take fire, and are soon inflamed; the moist will putrefy; the gross and clammy obstruct, and therefore engender putrefaction; those meats that are of subtle parts, overmuch attenuate the humours, and inflame them, and do stir up hot and sharp vapours into the brain, whereof cometh a Fever. Therefore we must eschew Garlic, Onions, Mustard, salted and spiced Meats, and all kind of Pulse must also be avoided, because Pulse must be shunned. they engender gross winds, which are the authors of obstruction: but the decoction of them is not always to be refused, because it is a provoker of urine. Therefore The manner of diet. let this be their order of diet: let their bread be of Wheat or Barley, well wrought, well leavened and salted, neither too new nor too stale: let them be fed with such meat as may be easily concocted and digested, & may engender much laudable juice, and very little excremental, as are the flesh of Wether-lambs, Kids, Leverets, Pullet's, Pattridges, Pigeons, Thrushes, Larks, Quails, Blackbirds, Turtle-Doves, Moor-Hennes, Pheasants, and such like, avoiding water-Fowles. Let the Flesh be moistened in Ver-juice of unripe Grapes, Vinegar, or the juice of Lemons, Oranges, Citrons, tart Pomegranates, Barberries', Goose-berries, or red Currants, or of garden, & wild sorrel: for all these sour things are very wholesome in this kind of disease, for they do stirreup the appetite, resist the venomous quality and putrefaction of the humours, restrain the heat of the Fever, and prohibit the corruption of the meats in the stomach. Although that those that have a more weak stomach, and are endued with a more exact sense, and are subject to the Cough and diseases of the Lungs, must not use these, unless they be mixed with Sugar and Cinnamon. If the patient at any time be fed with sodden meats, let the broths be made with Lettuce, Purslane, Succory, Borage, Sorrell, Hops, bugloss, Cresses, Burnet, Marigolds, chervil, the cooling Seeds, french Barley and Oatmeal, with a little Saffron, for Saffron doth engender many spirits, and resisteth poison. To these opening roots may be added for to avoid obstruction; yet much broth must be refused by reason of moisture. The fruit of Capers eaten in the beginning of the Meal provoke the appetite, and prohibit obstructions, but they ought not to be seasoned with overmuch Oil and Salt, they may also with good success be put into Broths. Fishes are altogether to be avoided, because they soon corrupt in the Stomach: but if the patient be delighted with them, those that live in stony places must be chosen, that is to say, those that live in pure and sandy water, & about rocks and stones, as are Trout, Pikes, Perches, Gudgeons, and Cravises boiled in milk, Wilks, and such like. And concerning Sea-fish, he may be fed with Giltheads, Gurnarts, with all the kinds of Codfish, Whiting not seasoned with salt, and Turbuts. Eggs potched and eaten with the juice of Sorrell, are very good. Likewise Barley water seasoned with the grains of a tart Pomegranate, and if the Fever be vehement, with the seeds of white Poppy. Such Barley water is easy to be concocted and digested, it cleanseth greatly, and moistens and mollifieth the belly. But in some it procures an appetite to vomit, and pain of the head, and those must abstain from it. But instead of barley water they may use pap, and bread crumbed in the decoction of a Capon. For the second course, let him have raisins of the Sun newly sodden in Rose water with Sugar, sour Damask Prunes, tart Cherries, Pippins, and Katherine For the second course. Pears. And in the latter end of the Meal, Quinces roasted in the Embers, Marmelate of Quinces, and conserveses of bugloss or of Roses, and such like, may be taken: or else In the end of the meal▪ this powder following. Take of Coriander seeds prepared, two drams; of Pearl, Rose leaves, shave of Hatts-horne and Ivory, of each half a dram; of Amber two scruples; of Cinnamon one scruple; of Unicorns horn, and the bone in a Stag's heart, of each half a scruple; of Sugar of Roses, four ounces: Make thereof a powder, and use it after meats. If the patient be somewhat weak, he must be fed with Jelly made of the flesh of a Capon, and Veal sodden together in the water of Sorrell, Carduus benedictus, with a little quantity of Rose vinegar, Cinnamon, Sugar, and other such like, as the present necessity shall seem to require. In the night season for all events and mischances, the patient must have ready prepared broth of meats of good digestion, with a little of the juice of Citrons or Pomegranates. This restaurative that followeth may serve for all. Take of the conserve of bugloss, Borage, Violets, Waterlillies, and Succory, of each two ounces; of the powder A restaurative drink. of the Electuary Diamargaritum Frigidum, of the Trochisces of Camphire, of each three drams: of Citron seeds, Carduus seeds, Sorrel seeds, the roots of Diptamnus, Tormentill, of each two dams; of the broth of a young Capon, made with Lettuce, Purslane, bugloss and Borage boiled in it, six pints,; put them in a Limbeck of glass with the flesh of two Pullet's, of so many Partridges, and with fifteen leaves of pure gold: make thereof a distillation over a soft fire. Then take of the distilled liquor, half a pint, strain it through a woollen bag, with two ounces of white Sugar, and half a dram of Cinnamon: let the patient use this when he is thirsty. Or else put the flesh of one old Capon, and of a leg of Veal, two minced Partridges, and two dams of whole Cinnamon without any liquor, in a lemb●●ke of glass, well luted and covered, and so let them boil in Balneo Mariae unto the perfect concoction. For so the flesh's will be boiled in their own juice, without any hurt of the fire; then let the juice be pressed out therehence with a press: give the patient for every dose, one ounce of the juice with some cordial waters, some Trisantalum, and Diamargaritum frigidum. The preserves of sweet fruits are to be avoided, because that sweet things turn into choler; but the confection of tart prunes, Cherries, and such like may be fitly used. But because there is no kind of sickness that so weakens the strength, as the plague; it is always necessary, but yet sparingly and often, to feed the patient, still having respect unto his custom, age, the region, and the time: for through emptiness there is great danger, lest that the venomous matter that is driven out to the superficial parts of the body, should be called back into the inward parts, by an hungry stomach, and the stomach itself should beefilled with choleric, hot, thin, and sharp excremental humours, whereof cometh biting of the stomach, and gripings in the guts. CHAP. XXI. What drink the Patient infected aught to use. IF the fever be great and burning, the patient must abstain from wine, unless that he be subject to swooning: and he may drink the Oxymel following in stread thereof. Take of fair water, three quarts, wherein boil four ounces An Oxymel▪ of honey until the third part be consumed, scumming it continually; then strain it, and put it into a clean vessel, and add thereto four ounces of vinegar, and as much cinnamon as will suffice to give it a taste. Or else a sugared water, as followeth. Take two quarts of fair water, of hard sugar, six ounces, of cinnamon, two ounces, strain it through a woollen bag or cloth without any boiling; and when the patient will use it, put thereto a little of the juice of Citrons. The syrup of the juice of Citrons excelleth amongst all others that are used against the pestilence. The use of the Julep following is also very wholesome. Take of the juice of Sorrell A Julep. well clarified, half a pint, of the juice of Lettuce so clarified, four ounces, of the best hard sugar, one pound, boil them together to a perfection, let them be strained and clarified, adding a little before the end a little vinegar, let it be used between meals with boiled water, or with equal portions of the water of Sorrell, Lettuce, Scabious and bugloss: or take of this former described Julep strained and clarified four ounces, let it be mixed with one pound of the forenamed cordial waters, and boil them together a little. And when they are taken from the fire, put thereto of yellow Sanders one dram, of beaten Cinnamon half a dram, strain it through a cloth: when it is cold let it be given the patient to drink with the juice of Citrons. Those that have accustomed to drink Cider, Perry, Beer or Ale, aught to use that drink still, so that it be clear, transparent, and thin, and made of those fruits that are somewhat tart; for troubled & dreggish drink doth not only engender gross humours, but also crudities, windiness, and obstructions of the first region of the body, whereof comes a fever. Oxycrate being given in manner following, doth assuage the heat of the fever, The commodities of oxycrate. and repress the putrefaction of the humours, and the fierceness of the venom, and also expelleth the water through the veins, if so be that the patients are not troubled To whom hurtful, with spitting of blood, cough, yexing, and altogether weak of stomach: for such must avoid all tart things. Take of fair water, one quart; of white or red vinegar three ounces; of fine Sugar, four ounces; of syrup of Roses, two ounces: boil them a little, and then give the patient there of to drink. Or take of the juice of Lemons & Citrons, of each half an ounce; of juice of sour Pomegranates, two ounces; of the water of Sorrell and Roses, of each one ounce; of fair water boiled, as much as shall suffice: make thereof a Julep, and use it between meals. Or take of Syrup of Lemons and of red Currants, of each one ounce; of the water of lilies, four ounces; of fair water boiled, half a pint; make thereof a Julep. Ortake of the syrups of water Lilies, and vinegar, of each half an ounce, dissolve it in five ounces of the water of Sorrell; of fair water one pint: make thereof a Julep. But if the patient be young, and have a strong and good stomach, and choleric The drinking of cold water, to whom & when profitable. by nature, I think it not unmeet for him to drink a full and large draught of fountain water cold; for that is effectual to restrain and quench the heat of the Fever, and chose, they that drink cold water often, and a very small quantity at a time, as the Smith doth sprinkle water on the fire at his Forge, do increase the heat and burning, and thereby make it endure the longer. Therefore by the judgement of Celsus, when the disease is in the chief increase, and the patient hath endured thirst for Lib. 3. cap. 7. the space of three or four days, cold water must be given unto him in great quantity, so that he may drink past his satiety, that when his belly and stomach are filled beyond measure, and sufficiently cooled, he may vomit. Some do not drink so much thereof as may cause them to vomit, but do drink even unto satiety, and so use it for a cooling medicine; but when either of these is done, the patient must be covered with many clothes, and so placed that he may sleep; and for the most part, after long thirst and watching, and after long fullness, and long and great heat, sound sleep cometh, by which great sweat is sent out, and that is a present help. But thirst must sometimes be quenched with little pieces of Melons, Gourds, Cucumbers, with the leaves of Lettuce, Sorrell, and Purslane, made moist or soaked in cold water, or with a little square piece of a Citron, Lemmon, or Orange macerated in Rose water, & sprinkled with Sugar, and so held in the mouth, and then changed. But if the patient be aged, his strength weak, phlegmatic by nature, & given to wine, when the state of the Fever is somewhat past, and the chief heat beginning to assuage, he may drink wine very much allayed at his meat, for to restore his strength, and to supply the want of the wasted spirits. The patient ought not by any means to suffer great thirst, but must mitigate it by drinking, or else allay it by washing his mouth with oxycrate and such like, and he may therein also wash his hands and his face, for that doth recreate the strength. If the flux or lask trouble him, he may very well use to drink steeled water, and also boiled milk, wherein many stones coming red hot out of the fire have been many times quenched. For the dryness and For dryness or roughness of the mouth. roughness of the mouth, it is very good to have a cooling, moistening and lenifying lotion of the mucilaginous water of the infusion of the leeds of Quinces, psilium, id est, Flea-wort, adding thereto a little Camphire, with the Water of Plantain and Roses; then cleanse and wipe out the filth, and then moisten the mouth, by holding therein a little oil of sweet Almonds mixed with a little syrup of Violets. If the roughness breed or degenerate into Ulcers, they must be touched with the water of For the Ulcers thereof. the infusion of sublimate, or Aqua fortis. But because we have formerly made frequent mention of drinking of water, I have here thought good to speak somewhat of the choice and goodness of waters. The choice of waters is not to be neglected, because a great part of our diet depends thereon, for besides that we use it either alone, or mixed with wine for drink, we also The choice of waters. knead bread, boil meat, and make broths therewith. Many think that rain water which falls in summer, and is kept in a cistern well placed and made, is the wholesomest of all. Then next thereto they judge that spring water which runs out of the tops of mountains, through rocks, cliffs and stones: in the third place they put Well water, or that which riseth from the feet of hills. Also the river water is good that is taken out of the midst or stream. Lake or pond water is the worst, especially if it stand still; for such is fruitful of and stored with many venomous creatures, as Snakes, Toads, and the like. That which comes by the melting of Snow and Ice is very ill, by reason of the too refrigerating faculty and earthy nature. But of spring and well waters these are to be judged the best, which are insipid, without smell, & colour; such as are clear, warmish in winter, and cold in summer, which are quickly hot and quickly cold, that is, which are most light, in which all manner pulse, turnips, and the like, are easily and quickly boiled. Lastly, when as such as usually drink Hip. sect. 5. aphor. 26. thereof, have clear voices and shrill, their chests sound, and a lively and fresh colour in their faces. CHAP. XXII. Of Antidotes to be used in the Plague. NOw we must treat of the proper cure of this disease, which must be used as soon as may be possible, because this kind of poison in swiftness exceedeth the celerity of the medicine. Therefore it is better to err in this, that you should think every disease to be pestilent in a pestilent season, and to cure it as the Pestilence: because that so long as the Air is polluted with the seeds of the Pestilence, the humours in the body are soon infected with the vicinity of such an air, so that then there happeneth no disease void of the Pestilence, that is to say, which is not pestilent from the beginning by his own nature, or which is not made pestilent. Many begin the cure with blood-letting, some with purging, and some with Antidotes. The beginning of the cu●… must be by antidotes. We, taking a consideration of the substance of that part that is assaulted, first of all begin the cure with an Antidote, because that by its specific property, it defends the heart from poison, as much as it is offended therewith. Although there are also other Antidotes which preserve & keep the heart & the patient from the danger of Poison and the Pestilence, not only because they do infringe the power of the poison in their whole substance, but also because they drive and expel it out of all the body by sweat, vomiting, scouring, and such other kinds of evacuations. The Antidote must be given in such a quantity as may be sufficient to overcome In what quantity they must be taken. the poison; but because it is not good to use it in greater quantity than needeth, lest it should overthow our nature, for whose preservation only it is used, therefore that which cannot be taken together and at once, must be taken at several times, that some portion thereof may daily be used so long, until all the accidents, effects and impressions of the poison be past, and that there be nothing to be feared. Some of Why poisonous things are put into Antidotes. those Antidotes consist of portions of venomous things, being tempered together, and mixed in an apt proportion with other medicines, whose power is contrary to the venom: as Treacle, which hath for an ingredient the flesh of Vipers, that it being thereto mixed may serve as a guide to bring all the antidote unto the place where the venenate malignity hath made the chief impression; because by the similitude of nature and sympathy, one poison is suddenly snatched and carried unto another. There are other absolute poisonous, which nevertheless are Antidotes one unto another: Some poison's Antidotes to othersome. as a Scorpion himself cureth the prick of a Scorpion. But Treacle and Mithridate excel all other Antidotes: for by strengthening the noblest part, and the mansion of life, they repair and recreate the wasted Spirits, and overcome the poison, not only being taken inwardly, but also applied outwardly to the region of the heart, Botches and Carbuncles: for by an hidden property they draw the poisons unto them, as Amber doth Chaff, and digest it when it is drawn, and spoil and rob it of all its deadly force; as it is declared at large by Galen, in his book de Theriaca ad Pisonem, by most true reasons and experiments. But you will say that these things are hot, and that the Plague is often accompanied with a burning Fever. But thereto I answer, there is not so great danger in the Fever as in the Pestilence, although in the giving of Treacle, I would not altogether seem to neglect the Fever, but think it good to minister or apply it mixed with cordial cooling medicines, as with the Trochisces of Camphire, syrup of Lemons, of water Lilies, the water of Sorrell, and such like. And for the same cause we ought not to choose old Treacle, but that which is of a middle age, as of one or two years old: to those that are stung, you may give half a dram, and to those that are more weak, a dram. The patient aught to walk presently after that he hath taken Treacle, Mithridate, How to walk after the taking of an Antidote. or any other Antidote; but yet as moderately as he can: not like unto many, which when they perceive themselves to be infected, do not cease to course and run up and down, until they have no strength to sustain their bodies, for so they dissolve nature, so that it cannot suffice to overcome the contagion. After moderate walking, the patient must be put warm to bed, and covered with many clothes, & warm brickbats or tiles applied to the soles of his feet; or in stead thereof you may use swine's bladders filled with hot water, and apply them to the groins and armholes, to provoke sweat: for sweeting in this disease is a most excellent remedy, both for to evacuate the humours in the Fever, and also to drive forth the malignity in the Pestilence, although every sweat brings not forth the fruit of health. For George Agricola saith, that he saw a woman at Misnia in Germany, that did sweat so for the space of three days, that the blood came forth at her head and breast, & yet nevertheless she died. This potion following will provoke sweat. Take the roots of China shaved in thin pieces one ounce and half; of Guajacum two ounces; of the bark of Tamariske A sudorific potion. one ounce; of Angelica roots two drams; of the shaving of Hats-horne one ounce; of Juniper berries three drams; put them into a vial of glass that will contain six quarts, put thereto four quarts of running or river water that is pure and clear, macerate them for the space of one whole night on the hot ashes: and in the morning boil them all in Balneo Mariae, until the half be consumed, which will be done in the space of six hours; then let them be strained through a bag, and then strained again, but let that be with six ounces of sugar of Roses, and a little Treacle: let the patient take eight ounces or fewer of that liquor, and it will provoke sweat. The powder following is also very profitable. Take of the leaves of Dictamnus, A sudorific powder. the roots of Tormentill, Betony, of each half an ounce, of bowl Armenicke prepared one ounce, of Terra Sigillata three drams, of Aloes and Myrrh, of each half a dram, of Saffron one dram, of Mastic two drams: powder them all according to art, and give one dram thereof dissolved in Rose-water, or the water of wild sorrel, and let the patient walk so soon as he hath taken that powder; then let him be laid in his bed to sweat as I have showed before. The water following is greatly commended against poison. Take the roots of A distilled water against the Plague. Gentian & Cyperus, of each three drams; of Carduus benedictus, Burnet, of each one handful; of Sorrell seeds and Divels-bit, of each two pugils; of Ivy and Juniper berries, of each half an ounce; of the flowers of bugloss, Violets and red Roses, of each two pugils: powder them somewhat grossly, then soak or steep them for a night in white wine and Rose water: then add thereto of bowl Armenick one ounce, of Treacle half an ounce, distil them all in Balneo Mariae, and keep the distilled liquor in a vial of glass well covered or close stopped for your use: let the patient take six ounces thereof with Sugar and a little Cinnamon & Saffron: then let him walk, and then sweat as is aforesaid: the Treacle and cordial water formerly prescribed are very profitable for this purpose. Also the water following is greatly commended. Take of Sorrel six handfuls, of Rue one handful: dry them & macerate them in vinegar for the space of four and twenty hours, adding thereto four ounces of Another. Treacle: make thereof a distillation in Balneo Mariae, and let the distilled water be kept for your use; and so soon as the patient doth think himself to be infected, let him take four ounces of that liquor, then let him walk and sweat. He must leave sweeting when he beginneth to wax faint and weak, or when the humour that What mean to be used in sweeting runs down his body begins to wax cold, than his body must be wiped with warm clothes, and dried. The patient ought not to sweat with a full stomach, for so the heat is called away from performing the office of concoction: also he must not sleep when he is in his sweat, lest the malignity go in wardly with the heat and spirits unto the principal parts; but if the patient bee much inclined to sleep, he must be kept from it with hard rubbing, and bands tied about the extreme parts of his body, and with much noise of those that are about him, and let his friends comfort him with the good hope that they have of his recovery; but if all this will not keep him from sleep, dissolve Castoreum in tart Vinegar, and Aqua vitae, and let it be injected into his nostrils: and let him be kept continually waking the first day, and on the second and third, even unto the fourth; that is to say, unto the perfect expulsion of the venom; and let him not sleep above three or four hours on a day and night. In the mean time let the Physician that shall be present consider all things by his strength: for it is to be feared, that great watchings will dissolve the strength, and make the patient weak: you must not let him eat within three hours after his sweeting; in the mean season, as his strength shall require, let him take the rind of a preserved Citron, conserve of Roses, bread toasted and steeped in wine, the meat of a preserved Myrabolane, or some such like thing. CHAP. XXIII. Of Epithemes to be used for the strengthening of the principal parts. THere are also some topic medicines to be reckoned amongst Antidotes, Whereof they must be made. which must be outwardly applied as speedily as may be, as cordial and hepaticke Epithemes for the safety of the noble parts, and strengthening of the faculties, as those that drive the venenate air far from the bowels: they may be made of cordial things not only hot, but also cold, that they may temper the heat, and more powerfully repercusse. They must be applied warm with Repercussives not fit to be applied to Carbuncles. a scarlet, or a double linen cloth, or a soft sponge dipped in them, if so be that a Carbuncle do not possess the regions of the noble parts, for it is not fit to use repercussives to a Carbuncle. You may make Epithemes after the following forms; ℞. aquar. ros. plantag. & solan. an ℥ iv. aquae acetoes. vini granat. & aceti, an. ℥ iii santal. rub. & coral. rub. pulveris. an. ʒiii. theriac. vet. ℥ ss. camph. ℈ two. croci ℈ i. carioph. ʒss. misce, fiat epithema. Or else, R. aqu. ros. & plantag. an. ℥ x. aceti ros. ℥ iv. carioph. saint. rub. coral. rub. pulveris. pull. diamargarit. frigid. an. ʒiss. caphurae & moschi an. ℈ i. fiat epithemae. Or, ℞. aquar. rosar. & melissae, an. ℥ iv. aceti ros. ℥ iii saint. rub. ʒi. caryophyl. ʒss. croci. ℈ two. caphurae ℈ i. boli arm. terraesigil. & zedoar. an. ʒi. fiat epithema. Or else, ℞. aceti rosat. & aquae rosat. an lb. ss. caphuraeʒss. theriac. & mithridat. an. ʒi. fiat epithema. Or else, aqu. rosar. nenuph. buglos. acetosae, aceti rosar. an. lb. ss. saint. rub. ros. rub. an. ʒiii. flor. nenuph. violar. caphur. an. ʒss. mithrid. & theriac. an. ʒii. terantur & misceantur simul omnia. When you intent to use them, take some portion of them in a vessel by its self, wherewith let the affected bowel be fomented warm. CHAP. XXIIII. Whether purging and blood-letting be necessary in the beginning of pestilent diseases. SO soon as the heart is strengthened & corroborated with cordials & antidotes, Reasons for and against blood-letting in the Plague. we must come to phlebotomy & purging. As concerning blood-letting in this case, there is a great controversy among Physicians. Those that wish it to be used, say or affirm that the pestilent Fever doth infix itself in the blood, and therein also the pestilent malignity taketh its seat; and therefore it will soon infect the other humours; unless that the blood be evacuated, & the infection that remaineth in the blood be thereby taken away. chose, those that do not allow phlebotomy in this case, allege, that it often cometh to pass that the blood is void of malignity when the other humours are infected with the venomous contagion. If any man require my judgement in this doubtful question, I say, that the pestilence sometimes doth depend on the default of the air: This default being drawn through the passages of the body, doth at length The composing of this controversy. pierce unto the entrails, as we may understand by the abscesses which break out one while behind the ears, sometimes in the armholes, and sometimes in the groins, as the brain, heart or liver are infected. And hereof also come Carbuncles, and other collections of matter, and eruptions, which are seen in all parts of the body, by reason that nature using the strength of the expulsive faculty, doth drive forth whatsoever is noisome or hurtful. Therefore if the Physician will follow this motion of nature, he must neither purge nor let blood, lest that by a contrary motion, that is, by drawing in from without, the motion of nature which proceeds outwardly from within, should be troubled. So we often see in those who are purged or let blood for such Buboes as come through unlawful copulation, that the matter is thereby made contumacious, and by drawing it inwardly, it speedily causeth the French Pocks. Wherefore, when Buboes, Carbuncles and other pestilent eruptions appear, which come through the default of the Air, we ought to abstain from purging and phlebotomy; but it is sufficient to forearm the heart inwardly and outwardly with Antidotes that are endued with a proper virtue of resisting the poison. For it is not to be doubted, but that when nature is debilitated with both kinds of evacuation, and when the spirits together with the blood are exhausted, the venomous Air will soon pierce, and be received into the empty body, where it exerciseth its tyranny to the utter destruction thereof. In the year of our Lord God 1565. in which year there was great mortality A history. throughout all France, by reason of the pestilence and pestilent diseases, I earnestly & diligently enquired of all the Physicians & Chirurgeons of all the Cities (through which King Charles the ninth passed in his progress unto Bayon) what success their patients had after they were let blood and purged, whereunto they all answered alike, that they had diligently observed, that all that were infected with the Pestilence, and were let bleed some good quantity of blood, or had their bodies somewhat strongly purged, thence forwards waxed weaker and weaker, and so at length died; but others which were not let blood nor purged, but took cordial Antidotes inwardly, and applied them outwardly, for the most part escaped and recovered their health: for that kind of Pestilence took its original of the primitive and solitary default of the Air, and not of the corruption of the humours. The like event was noted in the hoarseness that we spoke of before: that is to say, When purging and bleeding may be used. that the patients waxed worse and worse by purging and phlebotomy; but yet I do not disallow either of those remedies, if there be great fullness in the body, especially in the beginning, and if the matter have a cruel violence, whereof may be feared the breaking in unto some noble part. For we know that it is confirmed by Hypocrates, that what disease soever is caused by repletion, must be cured by evacuation; Aph. 22 sect 2. Aph. 10. sect. 4. and that in diseases that are very sharp, if the matter do swell, it ought to be remedied the same day, for delay in such diseases is dangerous; but such diseases are not caused orinflicted upon man's body by reason or occasion of the pestilence, but of the diseased bodies, and diseases themselves commixed together with the Pestilence; therefore then peradventure it is lawful to purge strongly, and to let a good quantity of blood, l●st that the pestilent venom should take hold of the matter that is prepared, and so infect it with a contagion, whereby the Pestilence taketh new and farregreater strength; especially as Celsus admonisheth us, where he saith; that, By Cap. 7. lib 3. how much the sooner those sudden invasions do happen, by so much the sooner remedies must be used, yea or rather rashly applied; therefore if the veins swell, the face wax fiery red, if the arteries of the temples beat strongly, if the patient can very hardly breathe by reason of a weight in his stomach, if his spittle be bloody, then ought he to be let blood without delay, for the causes before mentioned. It seems best to open the liver veino on the left arm, whereby the heart and the spleen may Why blood must 〈◊〉 let on th' ●…me in the Plague. be better discharged of their abundant matter; yet blood-letting is not good at all times, for it is not expedient when the body beginneth to wax stiff by reason of the coming of a Fever; for then by drawing back the heat and spirits inwardly, the outward parts being destitute of blood, wax stiff and cold; therefore blood cannot be let then without great loss of the strength, and perturbation of the humours. And it is to be noted, that when those plethoric causes are present, there is one Indication of blood-letting in a simple pestilent Fever, and another in that which hath a Bubo, idest, a Botch or a Carbuncle joined there with. For in one or both of these, being joined with a vehement & strong burning Fever, blood must be let by opening the vein that is nearest into the tumour or swelling against nature, keeping the straightness of the fibres, that this being open, the blood might be drawn more directly from the part affected; for all and every retraction of putrefied blood unto the noble parts, is to be avoided, because it is noisome and hurful to nature, and to the patient. Therefore, for example sake, admit the patient be plethoric by repletion, which is called Advasa, idest, unto the vessels, and Advires, idest, unto the strength: and there withal he hath a tumour that is pestilent in the parts belonging unto his head or neck, the blood must be let out of the cephalick or median vein, or out of one of their branches dispersed in the arm on the grieved side. But if through occasion of fat, or any other such like cause, those veins do not appear in the arm, there be some that give counsel in such a case to open the vein that is between the forefinger and the thumb, the hand being put into warm water, whereby that vein may swell and be filled with blood, gathered thither by means of the heat. If the tumour be under the armhole, or about those places, the liver vein, or the median must be opened which runneth alongst the hand: if it be in the groin, the vein of the ham, or Saphena, or any other vein above the foot that appeareth well, but always on the grieved side. And phlebotomy must be performed before the third day: for this disease is of the kind or nature of sharp diseases; because that within four and twenty hours it runneth past help. In letting of blood you must have consideration of the strength. You may perceive that the patient is ready to swoon, when that his forehead waxeth moist, with a small sweat suddenly arising, by the aching or pain at the stomach, with an appetite to vomit, and desire to go to stool, gaping, blackness of the lips, and sudden alteration of the face unto paleness: and lastly most certaincly by a small and slow pulse: and then you must lay your finger on the vein, and stop it until the patient come to himself again, either by nature, or else restored by art; that is to say, by giving unto him bread dipped in wine, or any other such like thing: then, if you have not taken blood enough, you must let it go again, and bleed so much as the greatness of the disease, or the strength of the patient will permit or require: which being done, some one of the Antidotes that are prescribed before will be very profitable to be drunk, which may repair the strength, and infringe the force of the malignity. CHAP. XXV. Of purging medicines in a pestilent disease. IFyou call to mind the proper indications, purging shall seem necessary in this kind of disease, and that must be prescribed as the present What purges fit in thel lague. case and necessity requireth; rightly considering that the disease is sudden, and doth require medicines that may with all speed drive out of the body the hurtful humour wherein the noy some quality doth lurk and is hidden; which medicines are divers by reason of the diversity of the kind of the humour, and the condition or temperature of the patient. For this purpose six grains of Scammony beaten into powder, or else ten grains are commonly ministered to the patient with one dram of Treacle. Also pills may be made in Pills. this form: Take of Treacle and Mithridate, of each one dram; of Sulphur vivum finely powdered half a dram; of Diagridium four grains: make thereof Pills. Or, Take three drams of Aloes; of Myrrh and Saffron, of each one dram; of white Hellebore and Asarabacca, of each four scruples: make thereof a mass with old Treacle, and let the patient take four scruples thereof for a dose, three hours before meat. Ruffus' his pills may be profitably given to those that are weak. The ancient Physicians have greatly commended Agarick for this disease, because it doth draw the noisome humours out of all the members: and the virtues thereof are like unto those of Treacle; for it is thought to strengthen the heart, and to draw out the malignity by purging. To those that are strong the weight of two drams may be given, and to those that are more weak, half a dram. It is better to give the infusion in a decoction, than in substance; for being elected and prepared truly into Trochises, it may be called a most divine kind of medicine. Antimonium is highly praised by the experience of many; but because I know the use thereof is condemned by the council and decree of the School of Physicians at Paris, I will here cease to speak of it. Those medicines that cause sweats are thought to excel all others, when the Pestilence cometh of the venomous Air: among whom the efficacy of that which followeth hath been proved, to the great good of many in that Pestilence which was lately throughout all Germany, as Mathias Rodler Chancellor to Duke George the Count Palatine signified unto me by letters. They do take a bundle of Mugwort, and of the ashes thereof after it is burnt, they An effectual sudorific and also purging medicine. make a lie with four pints of water; then they do set it over the fire, and boil it in a vessel of earth well leaded, until the liquor be consumed, the earthy dregges falling unto the bottom like unto salt, whereof they make Trochisces of the weight of a crown of gold: then they dissolve one or two of those Trochisces, according to the strength of the patient, in good Muskadine, and give it the patient to drink, and let him walk after that he hath drunk it for the space of half an hour; then lay him in his bed, and there sweat him two or three hours, and then he will vomit, and his belly will be loosed as if he had taken Antimony; and so they were all for the most part cured, especially all those that took that remedy betimes, and before the disease went unto their heart, as I myself have proved in some that were sick at Paris, with most happy success: Truly Mugwort is highly commended by the The virtues of Mugwort. ancient Physicians, being taken and applied inwardly or outwardly against the bitings of venomous creatures, so that it is not to be doubted but that it hath great virtue against the Pestilence. I have heard it most certainly reported by Gilbertus Heroaldus Physician of Mompilier, that eight ounces of the pickle of Anchovies, drunk at one draught, is a most Vide Rondelet. Lib. 7. de p●s. c. 3. certain and approved remedy against the Pestilence, as he and many other have often found by experience. For the plague is no other thing but a very great putrefaction; for the correction and amendment whereof, there is nothing more apt or fit than this pickle or substance of the Anchovies, being melted by the sun and force of the salt that is strawed thereon. There be some which infuse one dram of Walewort seed in white wine, and affirm that it drunken will perform the like effect as Antimony. Others dissolve a little weight of the seed of Rue being bruised in Muskadine, with the quantity of a Bean of Treacle, and so drink it. Others beat or bruise an handful of the leaves or tops of Broome in half a pint of white wine, and so give it to the patient to drink, to cause him to vomit, lose his belly, and make him to sweat. Truly those that are wounded or bit with venomous beasts, if they bind broom above the wound, it will prohibit or hinder the venom from dispersing itself, or going any further: therefore a drink made thereof will prohibit the venom from going any nearer the heart. Some take of the root of Elecampaine, Gentian, Tormentill, Kermes berries and broom; of the powder of Ivory and Hartshorn, of each half a dram: they do bruise and beat all these, and infuse them for the space of four and twenty hours in white wine and Aqua vitae on the warm embers, and then strain it, and give the patient three or four ounces thereof to drink; this provokes sweat, and infringeth the power of the poison: and the potion following hath the same virtue. Take good Mustard half an ounce, of Treacle or Mithridate the weight of a Bean, dissolve them in white wine, and a little Aqua vitae, and let the patient drink it, and 〈◊〉 Potion. sweat thereon with walking. You may also roast a great Onion made hollow, and filled with half a dram of Treacle and Vinegar under the embers; and then strain it, and mix the juice that is pressed out of it with the water of Sorrell, Carduus Benedictus, or any other cordial thing, and with strong wine, and give the patient to drink thereof to provoke sweat, and to repel the malignity. Or else take as much Garlic as the quantity of a big Nut; of Rue and Celandine, of each twenty leaves, bruise them all in white wine and a little Aqua vitae; then strain it, and give the patient thereof to drink. There be some that do drink the juice that is pressed out of Celandine and Mallows, with three ounces of Vinegar, and half an ounce of the oil of Walnuts, and then by much walking do unburthen their stomach and belly upwards and downwards, and so are helped. When the venomous air hath already crept into and infected the humours, one dram of the dried leaves of the Bay tree macerated for the space of two days in Vinegar and drunk, is thought to be a most sovereign medicine to provoke sweat, looseness of the belly, and vomiting. Mathiolus in his Treatise de Morbo Gallico writeth, that the powder of Mercury The effects of mercury & copperas against the Plague. ministered unto the patient with the juice of Carduus Benedictus, or with the electuary de Gommis, will drive away the Pestilence before it be confirmed in the body, by provoking vomit, looseness of the belly & sweat: one dram of Calchanthum or white Copperas dissolved in Rose-water, performeth the like effect in the same disease. Some do give the patient a little quantity of the oil of Scorpions with white wine to expel the poison by vomit, & therewithal they anoint the region of the heart, the breast and the wrists of the hands. I think these very meet to be used often in bodies that are strong and well exercised, because weaker medicines do evacuate little or nothing at all, but only move the humours, whereby cometh a Fever. When a sufficient quantity of the malignity is evacuated, than you must minister things that may strengthen the belly and stomach, and withhold the agitation or working of the humours: and such is the confection of Alkermes. CHAP. XXVI. Of many Symptoms which happen together with the Plague: and first of the pain of the head. IF the malignity be carried into the brain, and nature be not able to expel The cause of frenzy in the Plague. it, it inflames not only it, but also the membranes that cover it: which inflammation doth one while hurt, trouble, or abolish the imagination, another while the judgement, and sometimes-the memory, according to the situation of the inflammation, whether it be in the former, hinder or middle part of the head; but hereof cometh always a Frenzy, with fiery redness of the eyes and face, and heaviness and burning of the whole head. If this will not be amended with Clysters, and with opening the Cephalic vein in the arm, the arteries of the temples must be opened, taking so much blood out of them, as the greatness of the Symptoms and the strength of the patient shall require and permit. Truly the incision that is made in opening of an artery will close and join together as readily, and with as little difficulty, as the incision of a vein. And of such an incision of an artery, cometh present help, by reason that the tensive The benefit of opening an artery. and sharp vapours do plentifully breathe out together with the arterious blood. It were also very good to provoke a flux of blood at the nose, if nature be apt to exonerate herself that way. For, as Hypocrates saith, when the head is grieved, or generally Aph. 10. sect. 6. acheth, if matter, water, or blood flow out at the nostrils, mouth or ears, it presently cures the disease. Such bleeding is to be provoked by strong blowing, or striving to cleanse the nose, by scratching or picking of the inner sides of the nostrils, by pricking with an horse hair, and long holding down of the head. The Lord of Fontains, a Knight of the Order, when we were at Bayon, had a bleeding A history. at the nose, which came naturally for the space of two days, and thereby he was freed of a pestilent Fever which he had before, a great sweat rising therewithal, and shortly after his Carbuncles came to suppuration, and by God's grace he recovered his health being under my cure. If the blood do flow out and cannot be stopped To stay bleeding. when it ought, the hands, arms, and legs must be tied with bands, and sponges wet in Oxycrate must be put under the armholes, cupping-glasses must be applied unto the dugs, the region of the liver and spleen; and you must put into the nostrils, the down of the willow tree, or any other astringent medicine, incorporated with the hairs plucked from the flank, belly or throat of a Hare, bowl Armenicke, Terra Sigillata, the juice of Plantain and Knotgrass mixed together; and furthermore the patient must be placed or laid in a cool place. But if the pain be nothing mitigated not withstanding all these fluxes of blood, we must come to medicines that procure sleep, whose forms are these. Take of green Lettuce one handful, flowers of water Lilies and Violets, of each two pugils, one head of white Poppy bruised, of the four cold seeds, of each two Medicines to ●●ocuresleep. drams, of Liquorice and Raisins, of each one dram: make thereof a decoction, and in the straining dissolve one ounce and an half of Diacodion: make thereof a large potion to be given when they go to rest. Also a Barley-cream may be prepared in the water of waterlillies and of Sorrell, of each two ounces, adding thereto six or eight grains of Opium: of the four cold seeds, and of white Poppy seeds, of each half an ounce, and let the same be boiled in broths with Lettuce and Purslane; also the Pills de Cynoglosso, id est, Hound's tongue may be given. Clysters that provoke sleep must be used, which may be thus prepared: Take of Barleywater, half a pint; oil of Violets and waterlillies, of each two ounces; of the water of Plantain and Purslane, or rather of their juices, three ounces; of Camphire seven grains, and the whites of three eggs: make thereof a Clyster. The head must be fomented with Rose-vinegar, the hair being first shaved away, leaving a double cloth wet therein on the same, and often renewed. Sheep's lungs taken warm out of the bodies, may be applied to the head, as long as they are warm. Cupping-glasses with and without scarification, may be applied to the neck and shoulderblades. The arms and legs must be strongly bound, being first well rubbed to divert the sharp vapours and humours from the head. Frontals may also be made on this manner. Take of the oil of Roses and waterlillies, of each two ounces, of the oil of Poppy half an ounce, of Opium one dram, of Rose-vinegar one ounce, of Camphire half a dram; mix them together. Also Nodules may be made of the flowers of Poppies, Henbane, waterlillies, Mandrakes beaten in Rose-water with a little Vinegar, and a little Camphire, and let them be often applied to the nostrils: for this purpose Cataplasms also may be laid to the forehead. As, Take of the mucilage of the seeds of Psilium, id est, Flea-wort, and Quince seeds extracted in Rose-water, three ounces; of Barley-meal four ounces; of the powder of Rose-leaves, the flowers of waterlillies and Violets, of each half an ounce; of the seeds of Poppies and Purslane of each two ounces; of the water and vinegar of Roses, of each three ounces: make thereof a Cataplasm, and apply it warm unto the head. Or take of the juice of Lettuce, waterlillies, Henbane, Purslane, of each half a pint; A Cataplasm. of Rose-leaves in powder, the seeds of Poppy, of each half an ounce; oil of Roses three ounces; of Vinegar two ounces; of Barley-meal as much as shall suffice: make thereof a Cataplasm in the form of a liquid Pultis. When the heat of the head is mitigated by these medicines, and the inflammation of the brain assuaged, we must come unto digesting and resolving fomentations, which may disperse the matter of the vapours. But commonly in pain of the head, they do use to bind the forehead and hinder part of the head very strongly, which in this case must be avoided. CHAP. XXVII. Of the heat of the Kidneys. THe heat of the kidneys is tempered by anointing with unguent. refrigerans Galen. newly made, adding thereto the whites of eggs well beaten, that so the ointment may keep moist the longer; let this lineament be renewed every quarter of an hour, wiping away the relics of the old. Or, ℞. aq. ros. lb. ss. sucti plant. ℥ iv. alb. ovorum iv. olei An ointment for the reins. rosacei, & nenuph. an. ℥ two. aceti ros. ℥ iii misce ad usum. When you have anointed the part, lay thereon the leaves of waterlillies or the like cold herbs, & then presently thereupon a double linen clothe dipped in oxycrate & wrung out again, and often changed; the patient shall not lie upon a feather bed, but on a quilt stuffed with the chaff of oats, or upon a mat with many doubled clothes or Chamelet spread thereon. To the region of the heart may in the mean time be applied a refrigerating and alexiteriall medicine, as this which followeth. ℞. ung. rosat. ℥ iii olei nenupharini, ℥ two. aceti ros. & aquaerosar. an. ℥ i. theriacae, ʒi. An ointment for the heart. croci, ʒ ss. Of these melted and mixed together make a soft ointment, which spread upon a scarlet cloth may be applied to the region of the heart. Or, ℞. theriacae oped. ʒi ss. succi citri acidi, & limonis, an. ℥ ss. coral. rub. & sem. rosar. rub. an. ʒ ss. caphurae, & croci, an. gra. iiii. let them be all mixed together, and make an ointment or lineament. At the head of the patient as he lies in his bed, shall be set an Ewer or cock with a basin under it to receive the water, which by dropping may resemble rain. Let the The noise of dropping water draws on sleep. soles of the feet and palms of the hands be gently scratched, and the patient lie far from noise, and so at length he may fall to some rest. CHAP. XXVIII. Of the Eruptions and Spots, which commonly are called by the name of Purples and Tokens. THE skin, in pestilent fevers, is marked and variegated in divers places with spots, like unto the bitings of Fleas or Gnats, which are not always The differences of the spots in the plague. simple, but many times arise in form like unto a grain of millet. The more spots appear, the better it is for the patient: they are of divers colours according to the virulency of the malignity, and condition of the matter, as red, yellow, brown, violet, or purple, blue and black. And because for the most part they are of a purple colour, therefore we call them Purples. Others call Their several names, and the reasons of them. them Lenticulae, because they have the colour and form of lentils. They are also called Papiliones (i) Butterflies, because they do suddenly seize or fall upon divers regions of the body, like unto winged Butterflies, sometimes the face, sometimes the arms and legs, and sometimes all the whole body; often times they do not only affect the upper part of the skin, but go deeper into the flesh, specially when they proceed of matter that is gross and adust. They do sometimes appear great and broad, affecting the whole arm, leg or face, like unto an Erysipelas: to conclude, they are divers according to the variety of the humour that offends in quality or quantity. If they are of a purple or black colour, with often swooning, and sink in suddenly without any manifest cause, they foreshow death. When signs of death. The cause of the breaking out of those spots, is the working or heat of the blood, by reason of the cruelty of the venom received, or admitted. They often arise at the beginning of a pestilent fever: many times before the breaking out of the Sore, or Botch, or Carbuncle, and many times after: but then they show so great a corruption of the humours in the body, that neither the Sores, nor Carbuncles will suffice to receive them, and therefore they appear as forerunners of death. Sometimes they break out alone, without a Botch or Carbuncle; which if they be red, and have no evil symptoms joined with them, they are not wont to prove deadly: they appear, for the most part, on the third or fourth day of the disease, and sometimes later, and sometimes they appear not before the patient be dead, because the working or heat of the humours being the offspring of putrefaction, is not as yet restrained and ceased. Wherefore then principally the putrid heat, which is greatest a little before the Why they sometimes appear after the death of the patient. death of the patient, drives the excremental humours, which are the matter of the spots unto the skin; or else because nature in the last conflict hath contended with some greater endeavour than before (which is common to all things that are ready to dye) a little before the instant time of death, the pestilent humour being presently driven unto the skin; and nature thus weakened by this extreme conflict, falleth down prostrate, and is quite overthrown by the remnant of the matter. CHAP. XXIX. Of the Cure of Eruptions and Spots. YOU must first of all take heed lest you drive in the humour that is coming outwards with repercussives: therefore beware of cold, all purging things, Phlebotomy, and drowsy or sound sleeping. For all such things They are to be cured by driving ●orth. do draw the humours inwardly, and work contrary to nature. But it is better to provoke the motion of nature outwardly, by applying of drawing medicines outwardly and ministering medicines to provoke sweat inwardly, for otherwise by repelling & stopping the matter of the eruptions, there will be great danger lest the heart be oppressed with the abundance of the venom flowing back; or else by turning into the belly, it infers a mortal bloody flux: which discommodities that they may be avoided, I have thought good to set down this remedy, whose efficacy I have known and proved many times, and on divers persons, when by reason of the weakness of the expulsive faculty, and the thickness of the skin, the matter of the spots cannot break forth, but is constrained to lurk under the skin, lifting it up into bunches and knobs. I was brought unto the invention of this remedy, by comparison of the like. For when I understood that the essence of the French pocks (and likewise of the pestilence) The indication of curing taken 〈◊〉 the like. consisted in a certain hidden virulency, and venomous quality, I soon descended unto that opinion, that even as by the anointing of the body with the unguent compounded of Quicksilver, the gross and clammy humours which are fixed in the bones, and unmoveable, are dissolved, relaxed, and drawn from the centre into the superficial parts of the body, by strengthening and stirring up the expulsive faculty, and evacuated by sweeting and fluxing at the mouth; that so it should come to pass in pestilent Fevers, that nature being strengthened with the same kind of unction, might unloade herself of some portion of the venomous and pestilent humour, by opening the pores and passages, and letting it break forth into spots and pustles, and into all kind of eruptions. Therefore I have anointed many in whom nature seemed to make passage for the venomous matter very slowly, first losing their belly with a Clyster, and then giving them Treacle water to drink, which might defend the vital faculty of the heart, but yet not distend the stomach, as though they had had the French pocks, and I obtained my expected purpose: in stead of the Treacle water you may use the decoction of Guajacum, which doth heat, dry, provoke sweat, and repel putrefaction, adding thereto also vinegar, that by the subtlety thereof, it may pierce the better, and withstand the putrefaction. This is the description of the unguent. Take of Hogs-greace, one pound, boil it a little with the leaves of Sage, Time, An ointment to draw them forth when as they appear too slowly. Rosemary, of each half an handful, strain it, and in the straining extinguish five ounces of Quicksilver, which hath been first boiled in vinegar with the forementioned herbs; of Sal Nitrum, three dams; the yolks of three eggs boiled until they be hard; of Treacle and Mithridate, of each half an ounce; of Venice Turpentine, oil of Scorpions and Bays, of each three ounces; incorporate them altogether in a mortar, and make thereof an unguent, wherewith anoint the patient's armholes and groins, avoiding the parts that belong to the head, breast and backbone: then let him be laid in his bed and covered warm, and let him sweat there for the space of two hours, and then let his body be wiped and cleansed, and if it may be let him be laid in another bed, and there let him be refreshed with the broth of the decoction of a Capon, rear eggs, and with such like meats of good juice that are easy to be concocted and digested; let him be anointed the second and third day, unless the spots appear before. If the patient flux at the mouth, it must not be stopped: when the spots and pustles do all appear, and the patient hath made an end of sweeting, it shall be convenient to use diuretic medicines, for by these the remnant of the matter of the spots, which happily could not all breath forth, may easily be purged and avoided by urine. If any noble or gentlemen refuse to be anointed with this unguent, let them be enclosed in the body of a Mule or Horse that is newly killed, and when that is cold, let them be laid in another, until the pustles and eruptions do break forth, being drawn by that natural heat. For so Mathiolus writeth that Valentinus, the son of Pope Alexander the sixth, was delivered from the danger of most deadly poison In pro●…. 〈◊〉 Di●s●. which he had drunk. CHAP. XXX. Of a pestilent Bubo, or Plague-sore. APestilent Bubo is a tumour at the beginning long and movable, and in the What a pestilent Bubo is. state, and full perfection copped, and with a sharp head, unmoveable and fixed deeply in the glandules, or kernels; by which the brain exonerates itself of the venomous and pestiferous matter into the kernels that are behind the ears, and in the neck: the heart, into those that are in the armholes; and the liver, into those that are in the groin; that is, when all the matter is gross and clammy, so that it cannot be drawn out by spots and pustles breaking out on the skin; and so the matter of a Carbuncle is sharp, and so fervent, that it maketh an Eschar on the place where it is fixed. In the beginning, while the Bubo is breeding, it maketh the patient to feel, as it were, a cord or rope stretched in the place, or a hardened nerve with pricking pain: & shortly after the matter is raised up as it were into a knob, and by little and little it groweth bigger, and is inflamed, these accidents before mentioned accompanying it. If the tumour be red, and increase by little and little, it is a good and salutary sign: but if it be livid or black, and come very slowly The sign of Bubo's salutary and deadly. unto his just bigness, it is a deadly sign: It is also a deadly sign if it increase suddenly, and come unto his just bigness as it were with a swift violence, and as in a moment, have all the symptoms in the highest excess, as pain, swelling and burning. Buboes or Sores appear sometimes of a natural colour, like unto the skin, and in all other things like unto an oedematous tumour, which notwithstanding will suddenly bring the patient to destruction, like those that are livide and black, wherefore it is not good to trust too much to those kinds of tumors. CHAP. XXXI. Of the cure of Buboes, or Plague-sores. SO soon as the Bubo appears, apply a Cupping-glass with a great The use of cupping glasses in curing a Bubo. flame unto it, unless it be that kind of Bubo which will suddenly have all the accidents of burning and swelling in the highest nature; but first the skin must be anointed with the oil of lilies, that so it being made more loose, the Cupping-glass may draw the stronger and more powerfully; it ought to stick to the part for the space of a quarter of an hour, & be renewed and applied again every three quarters of an hour, for so at length the venom shall be the better drawn forth from any noble part that is weak, and the work of suppuration or resolution, whichsoever nature hath assayed, will the better and sooner be absolved and perfected: which may be also done by the application of the following ointment. Take of Uuguentum Dialthaea one ounce and a half; oil of Scorpions half an A lineament ounce; of Mithridate dissolved in Aquavitae, half a dram; this lineament will very well relax and loosen the skin, open the pores thereof, & spend forth portion of that matter which the Cupping-glass hath drawn thither: in stead thereof mollifying fomentations may be made, and other drawing and suppurating medicines, which shall be described hereafter. A Vesicatory applied in a meet place below the Bubo profits them very much but not above; as for example. If the Bubo be in the throat, the Vesicatory must be applied unto the shoulderblade on the same side; if it be in the armholes, it must be applied in the midst of the arm, or of the shoulder-bone, on the inner side: if in the groin, in the midst of the thigh on the inner side, that by the double passage that is open for to draw out the matter, the part wherein the venom is gathered together, may be the better exonerated. Spurge, Crowfoot, Arsemart, Beare-foot, Bridny, the middle bark of Travellers-joy, the rinds of Mullet, Flammula or upright Virgins-bower, are fit for raising blisters. If you cannot come by those simple medicines, you may apply this which followeth, which may be prepared at all times. Take Cantharideses, Pepper, Euphorbium, Pellitory of Spain, of each half a dram; of sour leaven, two dams; of Mustard one dram, and a little Vinegar; the A compound 〈◊〉. vinegar is added thereto to withhold or restrain the vehemency of the Cantharideses; but in want of this medicine it shall suffice to drop scalding oil or water, or a burning candle, or to lay a burning coal on the place: for so you may raise blisters, which must ptesently be cut away, and you must see that you keep the ulcers open & flowing as long as you can, by applying the leaves of red coleworts, Beets, or Ivy dipped in warm water, and anointed with oil or fresh butter. Some apply Cauteties, Why vesicatories are better than cau●… in a pestilent 〈◊〉. but Vesicatories work with more speed: for before the Eschar of the Cauteries will fall away, the patient may dye: therefore the ulcers that are made with Vesicatories will suffice to evacuate the pestilent venom, because that doth work rather by its quality than its quantity. Let the abscess be fomented as is showed before: and then let the medicine following, which hath virtue to draw, be applied. Fill a great onion, being hollowed, with Treacle and the leaves of Rue, then roast it under the hot Embers, beat it with a little Leaven, and a little Swine's grease, and Strong drawing 〈◊〉. so apply it warm unto the abscess or sore; let it be changed every six hours. Or Take the roots of Marshmallows and Lilies, of each half a pound; of Line, Foenugreek, and Mustard seeds, of each half an ounce; of Treacle one dram; ten Figs, and as much H●gges grease as shall suffice: make thereof a cataplasm according to Art. Or, take of Onions and Garlic roasted in the embers, of each three ounces: bruise them with one ounce of sour leaven, adding thereto Unguentum Basilicon, one ounce; Treacle one dram; Mithridate half a dram; of old Hog's grease one ounce; of Cantharideses in powder one scruple; of Pigeons dung two drams: beat them and mix them together into the form of a cataplasm. Hereunto old Rennet is very profitable, for it is hot, and therefore attractive, being mixed with old Leaven and Basilicon: you ought to use these until the abscess be grown unto its full ripeness and bigness; but if presently after the beginning there be great inflammation, with sharp pain, as it often happeneth, especially when the abscesses be of the kind of Carbuncles, we must abstain from those remedies that are hot and attractive, and also from those that are very emplastic and clammy; because they do altogether close the pores of the skin, or because they resolve the thinner part of the collected matter, which if it might remain, would bring the other sooner to suppuration: or else because they may perchance draw more quantity of the hot matter than the part can bear, whereof cometh rather corruption than maturation: and last of all because they increase the fever and pain, which inferreth danger of a convulsion or mortal Gangrene. Therefore in such a case it is best to use cold and temperate local medicines, as the leaves of Henbane and Sorrel roasted under the coals, Galens pultis, and such like. There are many that for fear of death, have with their own hands pulled away the Bubo with a pair of Smiths Pincers: others have digged the flesh round about Against such as cut away plague 〈◊〉. it, and so gotten it wholly out. And to conclude others have become so mad, that they have thrust an hot iron into it with their own hand, that the venom might have a passage forth: of all which I do not allow one; for such abscesses do not come from without, as the bitings of virulent beasts, but from within, and moreover because pain is by these means increased, and the humour is made more malign and fierce. Therefore I think it sufficient to use medicines that relax, open the pores of the skin, and digest portion of the venom by transpiration, as are these that follow. Take the roots of Marshmallows and Lilies, of each six ounces; of Chamomill A digestive fomentation. and Melilote flowers, of each half a handful; of Linseeds half an ounce; of the leaves of Rue half a handful: boil them and strain them, dip sponges in the straining, and therewith let the tumour be fomented a long time. Or, Take the crumb of hot bread, and sprinkle it with Treacle-water, or with aqua vitae, and Cow's An anodine Cataplasm. milk or Goat's milk, and the yolks of three eggs, put them all one stupes or flax, and apply them warm unto the place. Or, Take of sour Rye leaven four ounces; of Basilicon two ounces; three yolkes of eggs; oil of Lilies two ounces; Treacle one dram: let it be received on stupes, and applied in like manner. Or, Take of Diachylon and Basilicon, of each two ounces; oil of Lilies one ounce and an half: let them be melted and mixed together, and let it be applied as is abovesaid. When you see, feel and know, according to reason, that the Bubo is come to perfect suppuration, it must be opened with an incision knife, or an actual or potential Cautery, but Why it is best to open a Plague-sore with a potential cautery. it is best to be done with a potential Cautery, unless that happily there be great inflammation, because it doth draw the venom from beneath unto the superficial parts, and maketh a larger orifice for the matter that is contained therein: neither must it be looked for, that nature should open it of herself, for than it were danger that lest while nature doth work slowly, a venomous vapour should be stirred up, which striking the heart by the arteries, the brain by the nerves, and the liver by the veins, should cause a new increase of the venomous infection. For fear whereof there be some that will not expect the perfect maturation and suppuration, but as it were in the midst of the crudity and maturity will make an orifice for it to pass forth at: yet if it be done before the tumour be at his perfect maturity, pain, a Fever, and all accidents are stirred up and enraged, whereof cometh a malign ulcer that often degenerats into a Gangrene. For the most part about the tenth or eleventh day the work of suppuration seemeth perfected and finished; but it may be sooner or later by reason of the application of medicines, the condition of the matter, and state of the part: when the matter cometh forth, you must yet use suppurative and mollifying medicines, to maturate the remains thereof; in the mean while cleansing the ulcer by putting mundificatives into it, as we shall declare in the cure of Carbuncles. But if the tumour seem to sink in or hide itself again, it must be revoked and procured How to draw forth a sore that seems to go in again. to come forth again, by applying of Cupping-glasses with scarification, and with sharp medicines, yea, and with Cauteries both actual and potential. When the Cauteries are applied, it shall be very good to apply a vesicatory a little below it, that there may be some passage open for the venom while the Eschar is in falling away. For so they that are troubled with the French Pocks, so long as they have open and flowing ulcers; so long are they void of any pain that is worth the speaking of; which ulcers being closed and cicatrized, they do presently complain of great pain. If you suspect that the Bubo is more malign by reason that it is of a green, or black and inflamed colour, as are those that come of a melancholy humour by adustion, turned into a gross and rebellious melancholy humour, so that by the more copious influx thereof into the part, there is danger of a gangrene and mortification; then the places about the abscess must be armed When repercussives may be applied. with repercussives, but not the abscess itself: and this may be the form of the repercussives: Take of the juice of houseleek, Purslane, Sorrell, Nightshade, of each two ounces, of Vinegar one ounce, the whites of three eggs, of oil of Roses and waterlillies, of each two ounces and a half: stir them together, and apply it about the Bubo, and renew it often: or boil a pomegranate in vinegar, beat it with Unguentum Rosatum, or Populeon newly made, and apply it as is aforesaid. If these things do not stop the influx of other humours, the abscess itself and the places about it must be scarified round about, if the part will permit it; that the part exonerated of portion of the venom may not stand in danger of the extinction of the proper and natural heat, by the greater quantity and malignity of the humours that flow unto it. In scarifying you must have care of the great vessels, for fear of an irrepugnable Why too much bleeding is to be feared. flux of blood, which in this case is very hard to be stayed or resisted; both because the part itself is greatly inflamed, and the humour very fierce; for the expulsion whereof, nature, careful for the preservation of the part and all the body besides, seemeth to labour and work. But yet you must suffer so much of the blood & humour to flow out as the patient is able to abide without the loss of his strength. Moreover, you may spend forth the superfluous portion of the malignity, with relaxing, mollifying and resolving fomentations: as, Take the roots of Marshmallows, Lilies and Elicampaine, of each one pound, of Linseeds and Faenugreek, of each one ounce, of Fennell-seeds and Aniseeds, of each half an ounce, of the leaves of Rue, Sage, Rosemary, of each one handful, of Chamomill and Melilote flowers, of each three handfuls; boil them all together, and make thereof a decoction for a fomentation; use it with a sponge according to Art. Also after the aforesaid scarification, we may put Hens, or Turkeys that lay eggs (which therefore have their fundaments more wide and open, and for the same purpose put a little salt into their fundaments) upon the sharp top of the Bubo, that by shutting their bills at several times they may draw and suck the venom into their bodies, far more strongly and better than cupping-glasses, because they are endued with a natural property against poison, for they eat and concoct Toads, Efts, and such like virulent beasts: when one hen is killed with the poison that she hath drawn into her body, you must apply another, and then the third, fourth, fifth and sixth within the space of half an hour. There be some that will rather cut them, or else use whelps cut asunder in the midst, and applied warm unto the place, that by the heat of the creature that is yet scarce dead, portion of the venom may be dissipated and exhaled. But if nevertheless there be any fear of a Gangrene at hand, you must cut the flesh with a deeper scarification, not only avoiding the greater vessels, but also the nerves, for fear of convulsion: and after the scarification and a sufficient flux of blood, you must wash it with Aegyptiacum, Treacle and Mithridate dissolved in sea-water, Aquavitae and Vinegar. For such a lotion hath virtue to stay putrefaction, repel the venom, and prohibit the blood from concretion: but if the Gangrene cannot be avoided so, cauteries may be applied to the part: especially actual, because they do more effectually repel the force of the poison, & strengthen the part. Presently after the impression of the hot iron, the eschar must be cut away even unto the quick flesh, that the venomous vapours and the humours may have a free passage forth, for it is not to be looked for that they L●●iments to hasten the falling way of the Eschar. will come forth of themselves. With these inunctions they are wont to hasten the falling away of the Eschar. Take of the mucilage of Marshmallows and Linseeds, of each two ounces, fresh butter or Hogs-grease one ounce, the yolks of three eggs, incorporate them together, and make thereof an ointment: butter, Swine's grease, oil of Roses, with the yolks of eggs, perform the self same thing. When the Eschar is fallen away, we must use digestives. As take of the juice of Plantain, waterbettony, and Smallage, of each three ounces, honey of Roses four ounces, Venice Turpentine five ounces, Barly-slower three drams, Aloes two drams, oil of Roses four ounces, Treacle half a dram, make a mundificative according to Art. Or, Take Venice Turpentine four ounces, Syrup of dried Roses and Wormwood, of each one ounce, of the powder of Aloes, Mastic, Mirth, Barly-flower, of each one dram, of Mithridate half an ounce, incorporate them together. This unguent that followeth Against ●ating ulcers. is very meet for putrefied and corroding ulcers: Takered Orpiment one ounce, of unquenched Lime, burnt Alum, pomegranate pills, of each six drams, of Olibanum, Galls, of each two drams, of Wax and Oil as much as shall suffice, make thereof an unguent. This doth mundify strongly, consume putrefied flesh, and dry up virulent The praise of Aegyptiacum. humidities that engender Gangrenes. But there is not a more excellent unguent than Aegyptiacum increased in strength, for besides many other virtues that it hath, it doth consume and waste the proud flesh, for there is neither oil nor wax that goeth into the composition thereof, with which things the virtue of sharp medicines convenient for such ulcers, is delayed, and as it were dulled and hindered from their perfect operation so long as the ulcer is kept open. There have been many that being diseased with this disease, have had much matter & venomous filth come out at their abscesses, so that it seemed sufficient, and they have been thought well recovered, yet have they died suddenly. In the mean while when these things are in doing, cordial medicines are not to be omitted to strengthen the heart. And purgations must be renewed at certain seasons, that nature may be every way unloaded of the burden of the venenate humours. CHAP. XXXII. Of the Nature, Causes and Signs of a pestilent Carbuncle. APestilent Carbuncle is a small tumour, or rather a malign pustle, hot What a Carbuncle is. and raging, consisting of blood vitiated by the corruption of the proper substance. It often cometh to pass through the occasion of this untameable malignity, that the Carbuncle cannot be governed or contained The signs of a Carbuncle. within the dominion of nature. In the beginning it is scarce so big as a seed or grain of Millet or a Pease, sticking firmly unto the part and immovable, so that the skin cannot be pulled from the flesh; but shortly after it increaseth like unto a Bubo unto a round and sharp head, with great heat, pricking pain, as if it were with needles, burning and intolerable, especially a little before night, and while the meat is in concocting; more than when it is perfectly concocted. In the midst thereof appeareth a bladder puffed up and filled with sanious matter. If you cut this bladder, you shall find the flesh under it parched, burned and black, as if there had been a burning coal laid there, whereby it seemeth that it took the name of Carbuncle; When so called, but the flesh that is about the place is like a Rainbow, of divers colours, as red, dark, green, purple, livid, and black; but yet always with a shining blackness, like unto stone pitch, or like unto the true precious stone which they call a Carbuncle, whereof some also say it took the name. Some call it a Nail, because it inferreth like pain as a nail driven into the flesh. There are many Carbuncles which take their beginning with a crusty ulcer without a pustle, like to the burning of a hot iron: and these are of a black colour, they increase quickly, according to the condition of the matter whereof they are made. All pestilent Carbuncles have a Fever Symptoms of Carbuncles. joined with them, and the grieved part seemeth to be so heavy, as if it were covered or pressed with lead tied hard with a ligature: there cometh mortal swoon, faintings, tossing, turning, idle-talking, raging, gangrenes and mortifications, not only to the part, but also to the whole body, by reason (as I think) of the oppression of the spirits of the part, & the suffocation of the natural heat, as we see also in many that have a pestilent Bubo. For a Bubo and Carbuncle are tumors of a near affinity, so that the one doth scarce come without the other, consisting of one kind How the matter of a Bubo & Carbuncle differ. of matter, unless that which maketh the Bubo is more gross and clammy, and that which causeth the Carbuncle more sharp, burning and raging, by reason of its greater subtlety, so that it maketh an Eschar on the place where it is, as we noted before. CHAP. XXXIII. What Prognostics may be made in pestilent Buboes and Carbuncles. SOme having the Pestilence have but one Carbuncle, and some more in divers parts of their body, and in many it happeneth that they have the Bubo and Carbuncle before they have any Fever; which giveth better hope of health, if there be no other malign accident therewith: for it is a sign that nature is the victor, and hath gotten the upper hand, which excluded the pestilent venom before it could come to assault the heart. But if a Carbuncle and Bubo come after the Fever, it is mortal; for it is a token that the Why it is deadly to have a sore come after the Fever. heart is affected, moved and incensed with the furious rage of the venom; whereof presently cometh a feverish heat or burning, and corruption of the humours, sent as it were from the centre unto the superficies of the body. It is a good sign when the patient's mind is not troubled from the beginning until the seventh day; but when the Bubo or Carbuncle sinketh down again shortly after that it is risen, it is a mortal sign, especially if ill accidents follow it. If after they are brought to suppuration they presently wax dry without any reason thereof, it is an ill sign: Those Carbuncles that are generated of blood have a greater Eschar than those that are 〈◊〉 choler, because that blood is of a more gross consistence, and therefore oc●… 〈◊〉 ●●eater room in the flesh: chose, a choleric humour is more small 〈◊〉 〈◊〉 and thin, and it taketh little room in the upper part of the flesh only, as you may see in an Erysipelas. And I have seen Carbuncles whose Eschars were as broad and as large as half the back: also I have seen others, which going up by the shoulders to the throat, did so eat away the flesh that was under them, that the rough artery or windpipe might be seen bare, when the Eschar was fallen away: I had once a Carbuncle which was in the midst of my belly, so that when the Eschar was fallen away, I might very plainly see the Piritonaeum or Rim: & the cicatrice that remaineth is as broad as my hand: but they do not spread themselves so far without the great danger or death of the patient. There are also some Carbuncles which beginning at the parts under the chin, disperse themselves by little & little unto the patel bones, and so strangle the patient. So in many, the Buboes in the groin arise above a great part of the muscles of the Epigastrium. Truly of those abscesses that are Huge postilent Abscesses commonly deadly. so large & great in quantity, & so terrible to be seen, there is great danger of death to the patient, or at least to the grieved part. For after the consolidation, the part remaineth as if it were leprous, which abolisheth the action of the part, as I have seen in many. Oftentimes also the corruption of the matter is so great, that the flesh leaveth the bones bare: but Carbuncles often leave the joints and ligaments quite resolved through the occasion of the moisture that is soaked & sunk in unto them; for they often cast out putrefied & virulent sanious matter: whereby eating and creeping ulcers are bred, many blisters & pustles arising up in the parts round about it; which shortly breaking into one, make a great ulcer. These come very seldom and slowly unto suppuration, or at least to cast out laudable matter, especially if thy have their original of choler, because the matter is sooner burned with heat, than suppurated. Therefore then, if they can be brought to suppuration by no medicines, if the tumour still remain black, if when they are opened nothing at all, or else a very little sharp moisture Deadly Carbuncles. doth come forth, they are altogether mortal: and there is scarce one of a thousand who hath these accidents that recovereth health: dispersed small blisters, coming of vapours stirred up by the matter that is under the skin, and are there stayed and kept from passage forth, do not necessarily foreshow death in Carbuncles. But if the part be swollen or puffed up, if it be of a green or black colour, and if it feel neither pricking nor burning, it is a sign of a mortal Gangrene. Buboes or Carbuncles seldom or never come without a Fever: but the Fever is more vehement when they are in the emunctories, or nervous parts, than when they are in the fleshy parts, yet it is less, and all Symptoms are less, and more tolerable in a man that is strong and of a good temperature: Carbuncles not only affect the outward, but also the inward parts, and oftentimes both together. If the heart be vexed in such sort with a Carbuncle that nothing thereof appeareth forth on the superficial parts, all hope of life is past, and those die suddenly, eating, drinking or walking, and not thinking any thing of death. If the Carbuncle be in the mid driffe or lungs, they are soon suffocated: If it be in the brain, the patient becometh frantic, and so dyeth. If it be in the parts appointed for the passage of the urine, they die of the suppression of their water, as it happened in the Queen mother's waiting maid at the Castle of Rossilion, of whom I spoke before. If it be in the stomach, it inferreth the accidents that are showed in this history following. While I was Surgeon in the Hospital of Paris, a young and strong Monk of the A history. order of St. Victor, being overseer of the women that kept the sick people of that place, fell into a continual Fever very suddenly with his tongue black, dry, rough, (by reason of the putrefied and corrupted humours, and the vapours rising from the whole body unto that place) and hanging out like unto an hounds, with unquenchable thirst, often swooning and desire to vomit. He had convulsions over all his body through the vehemency and malignity of the disease, and so he died the third day: wherefore those that kept the sick people in the Hospital, thought that he had been poisoned, for the certain knowledge whereof the Governors of the Hospital commanded his body to be opened. I therefore calling to me a Physician and Surgeon, we found in the bottom of his stomach a print or impression, as if it had been made with an hot Iron or potential Cautery, with an Eschar or crust as broad as one's nail, all the rest of his stomach was greatly contracted and shrunk up together, and as it were horny; which we considering, and especially the Eschar which was deep in the substance of the stomach, we all said with one voice that he was poisoned with Sublimate or Arsenic. But behold while I was sowing up his belly, I perceived many black spots dispersed diversely throughout the skin: then I asked my company what they thought of those spots; truly (said I) it seemeth unto me that they are like unto the purple spots or marks that are in the pestilence. The Physician and the Chirurgeon denied it, and said that they were the bitings of fleas. But I persuaded them to consider How to distinguish purple spots from flea-bite. the number of them over all the whole body, and also their great depth and depression into the flesh; for when we had thrust needles deep into the flesh in the midst of them, and so cut away the flesh about the needle, we found the flesh about the needle to be black: moreover his nostrils, nails and ears were livid, and all the constitution of his body was contrary, and far unlike to the bodies of those that died of other sicknesses or diseases. Also it was credibly reported unto us by those that kept him, that his face was so altered a little before he died, that his familiar friends could hardly know him. We persuaded by these proofs, revoked our former opinion and sentence, and made a certificate to be sent unto the Governors and Masters of the Hospital, setting our hands and seals unto it, to certify them that he died of a pestilent Carbuncle. CHAP. XXXIIII. Of the cure of a pestilent Carbuncle. BY the forenamed signs of a pestilent Carbuncle, and especially by the Why Emplastic, very hot, and great drawers are not good for a carbuncle. bitterness of the pain, malignity of the venomous matter, and by the burning Fever that is therewithal annexed, I think it manifest, that very hot, emplastic, and drawing medicines should not be applied to this kind of tumour; because they prohibit or hinder the exhalation, or wasting forth of the venenate malignity; because that by stopping the pores of the skin, they increase and cause a greater heat in the part than there was before. Therefore it is better to use resolving medicines, which may assuage heat, and resolve the pores of the skin. Therefore first the place must be fomented with water and oil mixed together, wherein a little Treacle hath been dissolved, leaving thereon stupes wet therein: you may also use the decoction of Mallows, the roots of Lilies, Linseeds, Figs, with oil of Hypericon, for to make the skin thin, and to draw forth the matter; and the day following you must apply the Cataplasm following. Take the leaves of Sorrell and Henbane, roast them under the hot ashes; afterwards A Cataplasm for a pestilent Carbuncle. beat them with four yolks of eggs, two drams of Treacle, oil of Lilies, three ounces, Barley-meal as much as shall suffice: make thereof a Cataplasm in the form of a liquid pultis; this assuageth heat, and furthereth suppuration. Or, Take the roots Another. of Marshmallows and Lilies, of each four ounces, Linseeds half an ounce, boil them, beat them, and then strain them through a searse, adding thereto of fresh butter one ounce and an half, of Mithridate one dram, of Barley-meal as much as shall suffice: make thereof a Cataplasm according to Art: those Cataplasms that follow are most effectual to draw the venomous matter forth, and to make a perfect suppuration, especially when the flux of the matter is not so great, but that the part may bear it. Take the roots of white Lilies, Onions, Leaven, of each half an ounce; Other Cataplasms. Mustardseeds, Pigeon's dung, Soap, of each one dram; six snails in their shells; of fine Sugar, Treacle and Mithridate, of each half a dram; beat them all together, and incorporate them with the yolks of eggs, make thereof a Cataplasm, & apply it warm. Or, Take the yolkes of six eggs; of salt powdered one ounce; of oil of Lilies and Treacle, of each half a dram; Barley-meal as much as shall suffice: make thereof a Cataplasm. Take of ordinary Diachylon four ounces; of Unguentum Basilicon two ounces; oil of Violets half an ounce: make thereof a medicine. Many ancient The effect of Scabious against a pestilen. Carbuncle. Professors greatly commend Scabious ground or brayed between two stones, and mixed with old hog's grease, the yolkes of eggs, and a little salt; for it will cause suppuration in Carbuncles: also an egg mixed with Barley-meal, and oil of Violets doth mitigate pain and suppurate. A Radish root cut in slices, and so the slices A Radish root draws out the venom powerfully. laid one after one unto a Carbuncle or pestilent tumour, doth mightily draw out the poison. The juice of Colt's foot doth extinguish the heat of Carbuncles: the herb called Divels-bit being bruised, worketh the like effect: I have often used the medicine following unto the heat of Carbuncles, with very good success; it doth also assuage pain and cause suppuration. Take of the soot scraped from a chimney four ounces, of common salt two ounces, beat them into small powder, adding thereto the yolkes of two eggs, and stir them well together until it come to have the consistence of a pultis, and let it be applied warm unto the Carbuncle. In the The top of a Carbuncle when, why and with what to be ●urne●. beginning the point or head of the Carbuncle must be burned, if it be black, by dropping thereinto scalding hot oil, or Aquafortis: for by such a burning the venom is suffocated as touched by lightning, and the pain is much lessened, as I have proved oftentimes: neither is it to be feared lest that this burning should be too painful, for it toucheth nothing but the point of the Carbuncle, which by reason of the Eschar that is there, is void of sense. After this burning, you must go forward with the former described medicines, until the Eschar seemeth to separate The falling of the Eschar promises health. itself from the flesh round about it, which is a token of the patient's recovery, for it signifieth that nature is strong and able to resist the poison. After the fall of the Eschar you must use gentle mundificatives, as those which we have prescribed in a pestilent Bubo, not omitting sometimes the use of suppurative and mollifying medicines, that while the gross matter is cleansed, that which is as yet crude may be brought to suppuration; for then the indication is twofold, the one to suppurate that which remains as yet crude and raw in the part, and the other to cleanse that which A twofold indication. remains concocted and perfectly digested in the ulcer. CHAP. XXXV. Of the itching and inflammation happening in pestilent ulcers, and how to cicatrise them. THE parts adjoining to a pestilent ulcer ofttimes are superficiarily Why the adjacent parts are troubled with 〈◊〉. excoriated by reason of ulcerous pustles, which here and there with burning and great itching prick and vellicate the part. The cause may happen either externally or internally; internally by a thin and biting sanies, which sweeting from the ulcer, moistens the neighbouring parts. But externally by the constipation of the pores of the skin induced by the continual application of medicines. To remedy this, the place must be fomented with discussing and relaxing A fomentation for this itch. things, as aquafortis, which the Goldsmiths have used for separating of metals, alum water, the water of Lime, Brine and the like. But ulcers left by Carbuncles Why these ulcer●ate hard to be●ica●●i●ed. and pestilent Buboes, are difficulty cicatrized by reason of the corroding sanies, proceeding from the choleric, or phlegmatic and salted blood, which being in fault by the corruption of the whole substance causeth the abscess. Besides, such ulcers are commonly round, and therefore more hard to be cicatrized, for that the quitture hath no free passage forth; so the sanies, of its own nature acride and corroding, doth by delay acquire greater acrimony and intrositie, so that by its burning touch dissolving the adjacent flesh, it hinders the conjunction and unition of the lips of the ulcer; but in the interim the lips of the ulcer become callous, which, unless they be helped by cutting, or eating medicines, the ulcer cannot be healed, for that by their density they hinder the sweeting out of a sufficient quantity of the dewy glue to heal up the ulcer. Now the ulcer being plained and brought equal to the other Two sorts of Epuloticks. flesh, we must use Epuloticks, that is, such things as have a faculty to cicatrise ulcers by condensing and hardening the surface of the flesh, of these there are two kinds; for some without much biting bind and dry, such are pomegranate pills, oak bark, Tutia, lethargy, burnt bones, scailes of brass, galls, cypress nuts, Minium, antimony, bolearmenicke, the burnt and washed shells of oysters, Lime nine times washed, and many metalline things. Others are next to these, by which proud flesh is consumed, but such must be sparingly used: of this kind is washed Vitriol, burnt Alum, which excelleth other Epuloticks, by reason of the excellent drying and astringent faculty consolidating the flesh, which by being moistened by an excrementitious humour, grows lank. For that the scar which is made, is commonly unsightly in Remedies against the deformity of scars. this kind of ulcers, as red, livide, black, swollen, rough, by reason of the great adustion imprinted in the part, as by a burning coal, therefore I have thought good here to set down some means by which this deformity may be corrected or amended. If the scar be too big or high, it shall be plained by making convenient ligation and straight binding to the part a plate of lead rubbed over with quicksilver; but you may whiten it by anointing it with Lime nine times washed (that so it may be more gentle and lose the acrimony) and incorporated with oil of Roses. Some take two pound of Tartar or Argole, burn it, and then powder it, put it in a cloth, and so let it hang in a moist vault or cellar, and set a vessel under it to receive the dropping liquor, which is good to be rubbed for a good space, upon the scar. The same faculty is thought to be in that moisture of eggs which sweats through the shell, whilst they are roasted at the coals; as also unguent. citrinum, and Emplast. de cerussa newly made: The three following compositions are much approved. ℞. Axungiae suillae nonies lotae in Ointments to attenuate and take away scars. aceto acerrimo ℥ iv. cinab. succi titri, & alum. usti, an. ℥ ss. sulphur. vivi ignem haud experti, ʒii. caph. ℈ two. fiat pulvis; then let them all be incorporated together, and make an ointment; it attenuates the skin and cleanseth spots. ℞. olei hyos. olei semin. cucurb. an. ℥ i. olei tartar. ℥ ss. cerae alb. ʒiii. liquefiant simul lento igne, deinde add spermat. ceti ʒvi. removeantur predicta ab igne àonec infrigid. postea add troch. alb. Rhasis pull. ʒiii. caph. ʒi. tandem cum mali cirei succo omnia diligenter commisce, fiat linmentum. Or else, ℞. rad. serpent. ℥ i. bulliat in aq. come lb i. ad dimid. deinde add sulph. vivi ignem non experti, & alum. crudi, pulveris. an. ʒiss. colent. predict. & addatur caph. ʒi. succi hyoscyami ʒiss. Let this medicine be kept in a lead or glass vessel, and when you would use it, dip linen clothes therein, and lay them to the part. You may also use these medicines against the redness of the face, and you may fetch them off in the morning by washing the face with warm water and bran. CHAP. XXXVI. Of sundry kinds of Evacuations, and first of sweeting and vomiting. THe pestilent malignity is not only evacuated and sent forth by the eruption Why the pestilent malignity is not carried away by one way, but by many. of pustles and spots, but also by sweat, vomit, bleeding at nose, at the haemorrhoids, by the courses, a flux of the belly, and other ways, so that nature by every kind of excretion may be freed from the deadly poison, especially that which is not as yet arrived at the heart. But chief regard must be had We must have chief regard to the motion of nature. to the inclination of nature, and we must attend what way it chiefly aims at, and what kind of excretion it affects. Yet such evacuations are not always critical, but usually symptomatical, for that ofttimes nature is so irritated by the untameable malignity of the matter, that it can no way digest it, but is forced by any means to send it away crude as it is. Wherefore if nature may seem by the moistness of the Signs of future sweat. skin, the suppression of urine, & other signs to affect a crisis and excretion by sweat, you then shall procure it by the formerly mentioned means. It is delivered by the Ancients that all sweats in acute diseases are salutary, which happen upon a Critical day, which are universal and hot, and signified before the critical day. But in this A Crises must not be expected in the Plague, rapid and deadly disease of the Plague, we must not expect a Crisis, but as soon as we can, and by what means we may to free nature from so dire and potent an enemy. But oft times the tough and gross excrementitious humours may be purged by vomit, which could not be evacuated by strong purges. Therefore also by this manner of excretion may we hope for the exclusion of the pestilent venom, if there be nothing which may hinder; and nature by frequent nauseousness may seem to affect this way: the endeavour thereof shall be helped by giving some half a pint of warm water to be drunk with four ounces of common oil, an ounce of vinegar, and a How to procure vomit. little juice of radish, after the taking of the potion it is fit to thrust into the throat a goose quill dipped in the same oil, or else a branch of Rosemary, or else by thrusting in the fingers so to procure vomit, also a potion of eight ounces of the mucilaginous water of the decoction of Line seeds will procure vomit. Or else, ℞. rad. raph. in taleol. sect. vel sem. ejus, & sem. antriplicit, an. ʒiii. bulliant in aquae come. quod sufficit pro dosi, in colatura dissolve oxym. & syr. acet. an. ℥ ss. exhibeatur potio larga & tepida. Or clse, ℞. oxym. Gal. ℥ vi. ol. come. ℥ two. paretur potio tepid. But nature must not be forced, unless of its own accord it undertake this motion; for forced and violent vomiting, Why vomit must not be forced. distends the nervous fibers of the ventricle, dejects the strength, breaks the vessels of the Lungs, whence proceeds a deadly spitting of blood. Wherefore if the stomach shall trouble itself with a vain and hurtful desire to vomit; it shall rather be strengthened with bags of roses, wormwood and Saunders, using inwardly the juice of Quinces and Berberies, and broths made for the same purpose. CHAP. XXXVII. Of spitting, Salivation, Sneesing, Belching, Hicketting, and making of Water. THat long evacuations may be made by spitting and salivation, you may learn by the example of such as have a pleurisy, for the matter of the The effect of spitting in pestilent diseases. pleurisy being turned into pus, the purulent matter sucked up by the rare and spongeous substance of the lungs, and thence drawn into the Aspera Arteria, is lastly cast out by the mouth. There is none ignorant, how much such as have the Lues venerea are helped by salivation and spitting. But these shall be procured by Masticatories of the roots of Ireos, The force of salivation. Pellitory of Spain, Mastic, and the like, the mucilage of Line seeds held in the mouth will work the same effect. That such as have a moist brain may expel their superfluous humours by sneesing and blowing their noses, the brain by the strength of the expulsive faculty, being The force of sneesing. stirred up to the exclusion of that which is harmful, may be known by the example of old people and children which are daily purged by their noses; the brain is stirred up to both kinds of excretion from causes either internal or external: from the internal, as by a phlegmatic and vaporous matter, which contained in the brain, offends it; externally, as by receiving the beams of the sun in the nostris, or by tickling them with a feather, or blowing into them the powder of Hellebore, Euphorbium, Pyrethrum, Mustard seed, and the like sternutamentories. For then the brain is straitened by its own expulsive faculty, to the excretion of that which is troublous unto it. Sneesing breaketh forth with noise, for that the matter passeth through straits, to wit, by the straining passages of the Os cribrosum, which is seated at the roots of the nostrils. It is not fit to cause sneesing in a body very plethoric, unless you have first premised general medicines, lest the humours should be more powerfully drawn into the brain, and so cause an Apoplexy, Vertigo, or the like symptoms. By belching the flatulencies contained in the ventricle, being the offspring of The commodities of belching. crudity, or flatulent meats, are expelled, these by their taste and smell, pleasing, stinking, sweet, bitter or tart, show the condition and kind of crudity of the humours from whence they are raised: now vomiting freeth the stomach of crudities, but the distemper must be corrected by contraries, as altering things to be prescribed by the Physician. Hicketting is a contraction and extension of the nervous fibers of the stomach, to cast forth such things as are too contumaciously impact in the coats thereof; yet repletion only is not the cause thereof, but sometimes inanition also; so oft times a putrid vapour, from some other place, breaking into the stomach, as from a pestilent Bubo, or Carbuncle; also all acide and acride things, because they prick, vellicate & provoke the tunicles of the ventricle, as vinegar, spiced things, and the like; often & contumacious hicketting after purging, a wound or vomiting, is ill; but if a convulsion presently happen thereon, it is deadly. Several remedies must be used according to the variety of the causes: for repletion helps that hicketing that proceeds from inanition, & evacuation that which happens by repletion: that which proceeds from a putrid and venomous vapour, is helped by Treacle and Antidotes; that which is occasioned by acide and acrid things, is cured by the use of gross, fatty, and cold things. Now the whole body is oft times purged by urine, and by this way the feavourish The whole body purged by urine. matter is chiefly and properly accustomed to be evacuated: not a few, being troubled with the Lues venerea, when as they could not be brought to salivation by unction, have been cured by the large evacuation of urine caused by diuretic medicines. Diuretics' wherewithal you may move urine, are formerly described in treating of the stone. But we must abstain from more acride diuretics, especially when as inflammation is in the bladder; for otherwise the noxious humours are sent to the affected When we ought to abstain from diuretics. part, whence there is danger of a deadly Gangrene. Therefore than it is better to use diversion by sweat. CHAP. XXXVIII. Of the Menstrual and haemorrhoidal purgation. NOt only reason, but also manifold experience induceth us to believe that women, by the benefit of their menstrual purgation, escape and are freed from great, pestilent, and absolutely deadly diseases; wherefore it must be procured by remedies, both inwardly taken, and outwardly applied: these may be taken inwardly How to provoke the courses. with good success, Cassia lignea, Cinnamon, the bark of the root of a Mulberry, Saffron, Agricke, Nutmeg, Savine, Diagridium, and divers others. But if the affect require more vehement medicines, the roots of Tithymel, Antimony, Cantharideses (taken in small quantity) move the courses most powerfully; frictions and ligatures made upon the thighs and legs conduce hereto, as also cupping in the inner and middle part of the thighs, the opening of the vein Saphena, leeches applied to the orifice of the neck of the womb, pessaries, nodulas, glisters, baths, fomentations made of odoriferous things, which by the fragrancy of their odor, How atomatick things provoke the courses. or rather by their heat, may attenuate & cut gross humours, open the obstructed orifices of the veins, such are the roots of Marshmallows, Orris, Parsly, Fennell, Kneholne, the leaves and flowers of St. john's Wort, Asparagus, Rocket, Balm, Chervile, Mugwort, Mints, Pennyroyal, Savory, Rosemary, Rue, Time, Sage, Bay berries, Broome, Ginger, Cloves, Pepper, Nutmegs, and the like; the vapour of the boiling whereof, let the woman, sitting upon a perforated seat, receive by a funnel into the neck of her womb, covering herself warm on all sides, that so nothing may otherwise breathe forth. Of the samethings may be made baths, as well general as particular. Also pessaries are good made after this manner. ℞. theriac. Pessaries to provoke the retms. mithrid. an. ʒss. castor. gum. ammoniac. an. ʒi. misce cum bombace in succo mercurialis tincto, fiat pessarium. Or else, ℞. rad. petroselin. & foenug. sub cineribus coctas, deinde contusas cum pull. staphysag. pyreth. croco & oleo liliorum, so make a pessary in the form of a suppository or nodula. Or, ℞. pulv. myrrh. & aloes, an. ʒi. fol. sabin. nigel. arthemis. an. ʒii. rad. Helleb. nigr. ʒi. croci, ℈ i. cumsucco mercur. & melle communi: make a pessary in Cotton. This which follows is more effectual. ℞. succirut. absinth. an. ʒii. myrrh. euphorb. castor. sabin. diacrid. terebinth. galban. theriac. an. ʒi. make a pessary according to art; let a thread hang out of the one end of the pessaries, that so you may easily draw them forth as you please. But if this menstruous flux once provoked, flow too immoderately, it must be stopped by using meats of grosser and more viscide juice, by opening a vein in the arm, How to stop the courses flowing too immoderately. application of cupping glasses under the dugs, frictions and ligations of the upper parts, as the arms, putting up of pessaries, application of refrigerating and astringent plasters, to the lower belly, share and loins, laying the woman in a convenient place, and not upon a featherbed. This following injection stoppeth the blood flowing out of the womb, ℞. aquae plant. & fabror. an. lb i nucum cupres. gallar. immatur. an. ʒii. berber. sumach. ballast. vitriol. rom. alum. roch. an. ʒii. bulliant omnia simul, & fiat decoctio: of this make injection into the womb. In the performance of all these things, I would have the Surgeon depend upon the advice of a Physician, as the occasion and place shall permit. But if nature endeavour to free itself of the pestilent matter by the hoemorrhoides, you may provoke them by frictions and strong ligatures in the lower parts, as How to provoke the haemorrhoides. if the thighs or legs were broken, by ventoses applied with great flame to the inner side of the thigh, by application of hot and attractive things to the fundament, such as are fomentations, emplasters, unguents, such as is usually made of an onion roasted under the embers, and incorporated with Treacle, and a little oil of Rue: after the hoemorrhoid veins, by these means, come to show themselves, they shall be rubbed with rough linen clothes, or fig leaves, or a raw onion, or an ox gall mixed with some powder of Coloquintida: lastly you may apply horseleeches, or you may open them with a Lancet, if they hang much forth of the fundament, and be swollen with much blood. But if they flow too immoderately, they may be stayed by the same means as the courses. CHAP. XXXIX. Of procuring evacuation by stool, or a flux of the belly. NAture often times, both by itself, of its own accord, as also helped by laxative and purging medicines, casts into the belly and guts, as into the sink of the body, the whole matter of a pestilent disease, whence are caused Diarrhaea's, Lienteries, and Dysenteries; you may distinguish these kinds of fluxes of the belly, by the evacuated excrements. For if they be thin and sincere, that is, retain the nature of one, and that a simple humour, as of choler, melancholy or phlegm, and if they be cast forth in a great quantity, without the ulceration or excoriation of the guts, vehement or fretting pain, than it is a Diarrhaea, which some also call fluxus humoralis. It is called a Lienteria, when as by the resolved retentive faculty of the stomach and guts caused What a Diarrhaea is. by ill humours, either there collected, or flowing from some other place, or by a cold & moist distemper, the meat is cast forth crude, & almost as it was taken. A Dysenteria What a Dysenteria is. is when as many and different things, and oft times mixed with blood, are cast forth with pain, gripings, and an ulcer of the guts, caused by acride choler, fretting insunder the coats of the vessels. But if in any kind of disease, certainly in a pestilent one, fluxes of the belly happen immoderate in quantity, and horrible in the quality of their contents, as liquid, viscous, frothy as from melted grease, yellow, red, purple, green, ashcoloured, black, and exceeding stinking. The cause is various, and many sorts of ill humours, The cause of various, and stinking excrements in the plague. which taken hold of by the pestilent malignity, turn into divers species, differing in their whole kind both from their particular, as also from nature in general, by reason of the corruption of their proper substance, whose inseparable sign is stinch, which is oft times accompanied by worms. In the camp at Amiens a pestilent Dysentery was overall the Camp, in this the strongest Soldiers purged forth mere blood: I dissecting some of their dead bodies, A history. observed the mouths of the Mesaraike Veins and Arteries, opened and much swollen, and whereas they entered into the guts, were just like little Catyledones, out of which, as I pressed them, there flowed blood. For both by the excessive heat of the summer's sun, and the minds of the enraged soldiers, great quantity of acride and choleric humour was generated, and so flowed into the belly: but you shall know whether the greater or the lesser guts be ulcerated, better by the mixture of the blood with the excrements, than by the site of the pain, therefore in the one you must rather work by Glisters, but in the other, by Medicines taken by the mouth. Therefore if by gripings, a tenesmus, the murmuring and working of the guts, you suspect in a pestilent disease, that nature endeavours to disburden itself by the lower parts, neither in the mean while do it succeed to your desire, then must it be helped forward by art, as by taking a potion of ℥ ss. of hiera simplex, and a dram of Diaphaenicon A potion. dissolved in wormwood water. Also Glisters are good in this case, not only for that they assuage the gripings and pains, and draw by continuation or succession from the whole body, but also because they free the mesaraike veins and guts from obstruction and stuffing, so that by opening and as it were unlocking of the passages, nature may afterwards more freely free itself from the noxious humours. In such glisters they also sometimes mix two or three dams of Treacle, that by one and the same labour they may retunde the venenate malignity of the matter. There may also be made for the same purpose suppositories of boiled honey ℥ i. of higher a picra and common salt, of each ʒss. or that they may be the stronger, of honey Suppositories. ℥ iii of ox gall ℥ i. of Scammony, euphorbium and coloquintida powdered, of each ʒss. The want of these may be supplied by nodulas made in this form. ℞. vitell. ovor. nu. three fellis bubuli, & mellis, an. ℥ ss. salis come. ʒss. let them be stirred together, and well incorporated, and so parted into linen rags, and then bound up into nodulas, of the bigness of a filbert, and so put up into the fundament, you may make them more acride by adding some powder of Euphorbium or Coloquintida. CHAP. XL. Of stopping the flux of the belly. VIolent and immoderate scour, for that they resolve the faculty, and lead the patient into a consumption and death, therefore if they shall appear to be such, they must be stayed in time by things taken and injected by the mouth and fundament. To this purpose may a pudding be made of wheat flower boiled in the water of the decoction of one pomegranate, A hasty pudding to stay the lack. berberies, bowl armenick, terra figillata, and white poppy seeds, of each ʒi. The following Almond milk strengthens the stomach, and mitigates the acrimony of the choleric humour, provoking the guts to excretion. Take sweet Almonds boiled in the water of barley, wherein steel or Iron hath been quenched, beat them in a marble motter, and so with some of the same water make them into an Almond milk, whereto adding ʒis. of Diarhodon Abbat is you may give it to the patient to drink. This following medicine I learned of Dr. Chappelaine the King's chief physician, who received it of his father, and held it as a great secret, & was wont to prescribe it with happy success to his patients: It is thus, ℞. boli àrmen. terrae sigil. lapid. haemat. D. Chappelaines' medicine to stay a scouring. an. ʒi. picis navalis, ʒiss. coral rub. marg. elect. corn. cervi ust. & loti in aq. plant. an. ℈ i. sacchar. ros. ℥ two. fiat pulvisc. of this let the patient take a spoonful before meat, or with the yolk of an egg. Christopher Andrew in his oecoiatria much commendeth dog's dung, when as the dog hath for three days before been fed only with bones. Quinces roasted in embers, or boiled in a pot, the conserve of cornelian cherries, preserved berberies and myrabalans, roasted nutmeg taken before meat, strengthen the stomach and stay the laske; the patient must feed upon good meats, and these rather reasted than boiled. His drink shall be chalibeate water of the docoction of a some pomegranate beaten, or of the decoction of a quince, medlars, cervices, mulberries, 〈◊〉. bremble berries, and the like things, endued with a faculty to bind and waste the excrementitious humidities of the body: these waters shall be mixed with syrup of red currance, Julep of roses, and the like. Let the region of the stomach and belly be anointed with oil of mastic, Moschatelinum, myrtles and quinces. Also a crust of bread newly drawn forth of the oven Ointments. and steeped in vinegar and rose water, may be profitably applied; or else a cataplasm of red roses, sumach, berberies, myrtles, the pulp of quinces, mastic, bean flower, and honey of roses made up with calibeate water. Anodyne, abstergent, astringent, consolidating and nourishing glisters shall be injected. These following retund the acrimony of humours, and assuage pain. ℞. fol. lactuc. hyosc. acetoes. portul. an. m. i. flor. violar. & nenuph. an. p i. fiat decoctio ad Glisters to stay ●…. lb i in colatura dissolve cassiae fistul. ʒvi. olei rosat. & nenuph. an. ℥ iss. fiat clyster. Or else, ℞. ros. rub. hord. mund. sem. plant, an. p i. fiat decoctio, in colatura adde olei ros. ℥ two. vitel. ovor. two. fiat clyster. Or, ℞. decoctionis Capi, crur. vitellin. & capit. vervicin. una cum pelle, lb two. in qua coquantur fol. violar. malu. mercur. plantag. an. m i. hord. mund. ℥ i. quatuor sem. frigid. major. an. ℥ ss. in colaturae lb ss. dissolve cass. recenter extract. ℥ i. ol. viol. ℥ iv. vitellor. ovor. two. sach. rub. ℥ i. fiat clyster. Or, ℞. flor. chamaem. melil. aneth. an. p i. rad. bismal. ℥ i. fiat decoctio in lacte; colaturae add mucag. sem. lin. foenugr. extract. in aqua malu. ℥ two. sacchar. rub. ℥ i. olei cham. & aneth. an. ℥ iss. vitellor. ovor. two. fiat clyster. Such glisters must be long kept that they may more readily mitigate pain. When shave of the guts appear in the stools, it is an argument that there is an ulcer in the guts; therefore than we must use detergent and consolidating glisters, as this which follows. ℞. hordei integr. p two. ros. rub. flor. chamoem. plantag. apii, an. p i. fiat decoctio, in colatura dissolve mellis rosat. & syr. de absinth. an. ℥ iss. vitel. ovor. two. This following A clyster for ulcerated guts. clyster consolidateth. ℞. succi plantag. centinod. & portulac. nu ℥ two. bol. armen. sang. dracon. amyl. an. ʒi. sebi hircini dissoluti, ʒiii. fiat clyster. Also cow's milk boiled with plantain and mixed with syrup of roses is an excellent medicine for the ulcerated guts. This following clyster binds. ℞. caud. equin. plant. polygon. an. m i. fiat decoctio in lacte ustulato ad quart. iii & in colatura adde boli arm. terrae sigil. sang. dracon. an. ʒii. A very astringent glystar. albumina duor. ovor. fiat clyster. Or else, ℞. suc. plant. arnoglos. centinod. portulac. residentia facta depuratorum quantum sufficit pro clystere, addendo pull. boli armeni, terrae sigil. sang. dracon. an. ʒi. ol. myrthin. & rosat. an. ℥ two. fiat clyster. If pure blood flow forth of the guts, I could wish you to use stronger astrictives. To which purpose I much commend a decoction of pomegranate pills, of cypress nuts, red rose leaves, sumach, alum, and vitriol made with smith's water, and so made into glisters, without any oil. It will be good with the same decoction to foment the fundament, perinaeum, and the whole belly. Astringent glisters ought not to be used before that the noxious humours be drawn away and purged by purging medicines, otherwise by the stoppage hereof, the body may chance to be oppressed. If the patient be so weak that he cannot take or swallow any thing by mouth, nutritive glisters shall be given him. ℞. decoctionis capi pinguis, & cruris vitulini, A nourishing clyster. coct. cum acetosa, buglosso, boragine, pimpinella, lactuca, ℥ x. vel xii. in quibus dissolve vitellos ovorum, num iii sacchari rosatis, & aquae vitae, an. ℥ i. butyri recentis non saliti, ʒii. fiat clyster. CHAP. XLI. Of evacuation by insensible transpiration. THe pestilent malignity as it is oft times drawn by the pores, by transpiration into the body, so oft times it is sent forth invisibly the same way again. For our native heat that is never idle in us, disperseth the noxious humours attenuated into vapours and air through the unperceivable breathing places of the skin. An argument hereof is, we see that the tumors and abscesses tumors are ofttimes discussed by the force of nature after they are suppurated. against nature, even when they are come to suppuration, are oft times resolved and discussed by the only efficacy of nature, and heat, without any help of art. Therefore there is no doubt, but that nature being prevalent, may free itself from the pestilent malignity by Transpiration, some Abscess, Bubo or Carbuncle being come forth, and some matter collected in some certain part of the body. For when as nature and the native heat are powerful and strong, nothing is impossible to it, especially when as the passages are also in like manner free and open. CHAP. XLII. How to cure Infants and Children taken with the Plague. IF that it happen that sucking or weaned children be infected with the pestilence, they must be cured after another order than is yet described. The Nurse of the sucking child must govern herself so in diet and The nurse must be dicted when as the child is sick. the use of medicines, as if she were infected with the pestilence herself: Her diet consisteth in the use of the six things not natural. Therefore let it be moderate, for the fruit or profit of that moderation in diet cannot choose but come unto the Nurse's milk, and so unto the infant who liveth only by the milk. And the infant itself must keep the same diet as near as he can in sleep, waking, and expulsion, or avoiding of superfluous humours and excrements of the body. Let the Nurse be fed with those things that mitigate the violence of the feverish heat: as cooling broths, cooling herbs, and meats of a moderate temperature: she must wholly abstain from wine, and anoint her nipples, as often as she giveth the infant suck, with water, or juice of sorrel tempered with sugar of roses. But the infant's heart must be fortified against the violence of the increasing venom, by giving it one scruple of treacle in the Nurse's milk, the broth of a pullet, or some other cordial water. It is also very necessary to anoint the region of the heart, the emunctories, and both the wrists with the same medicine: neither were it unprofitable to smell often unto Treacle dissolved in rose water, vinegar of roses and a little aqua vitae, that so nature may be strengthened against the malignity of the venom. When the Medicines may be given to such as are weaned. children are weaned, and somewhat well grown, they may take medicines by the mouth, for when they are able to concoct and turn into blood meats that are more gross and firm than milk, they may easily actuate a gentle medicine. Therefore a potion must be prepared for them of twelve grains of treacle, dissolved with a little of the syrup of succory in some cordial water, or the broth of a capon: unless that any had rather give it with conserve of roses, in form of a bowl: but treacle must be given to children in very small quantity, for if it be taken in any large quantity, there is great danger lest that by inflaming the humours, it infer a fever. Furthermore, broth may be prepared to be taken often, made of a capon seasoned with sorrel, lettuce, purslane and cooling seeds, adding thereto bowl armenick and terra sigillata, of each one ounce, being tied in a rag, and sometimes pressed out from the decoction. For bowl armenic, whether it be by its marvellous faculty of drying, or by some hidden property, hath this virtue, that being drunken (according as Galen witnesseth) Lib. 9 simp. cap. 7. it cureth those that are infected with the pestilence, if so be that they may be cured by physic: so that those that cannot be cured with bowl armenick, cannot be preserved by any other medicines. But because the bodies of children are warm, moist and vaporous, they are easily delivered of some portion of the venenate matter The benefit sweat. through the pores of the skin by provoking sweat, with a decoction of parsley seeds, prunes, figs, and the roots of sorrel, with a little of the powder of Heart's horn, or Ivory. But that the sweat may be more abundant and copious, apply sponges dipped & pressed out in the hot decoction of sage, rosemary, lavender, bays, chamomil, melilote and mallows, or else swine's bladders half filled with the same decoction, to the armholes, and to the groins. In the time that they sweat, let their faces be fanned to cool them. Also let a nodule of Treacle, dissolved in vinegar and water of Roses, be appled to the nostrils; but always use a moderation in sweeting, because that children are of a substance that is easy to be dissipated and resolved: so that oftentimes although they do not sweat, yet they feel the commodities of sweeting, the matter of the venom being dissipated by the force of the heat through the pores of the skin. But in the sweeting while the face is fanned, and sweet & cordial things applied to the nostrils, nature must be recreated and strengthened, which otherwise would be debilitated through sweeting, that it may be better able to expel the venom. After that the sweat is wiped away, it is very profitable to take a potion of conserve of Roses, with the powder of Heart's horn or of Ivory dissolved in the waters of bugloss and Sorrel, the better to cool and defend the heart. If there appear any tumour under the armholes or in the groin, let it be brought to maturation with a mollifying, relaxing, drawing, and then with a suppurative fomentation, or Cataplasm; always using and handling it as gently as you may, considering the tender age of the infant. If you have need to purge the patient, the purgation following may be prescribed with great profit. Take of Rhubarb in powder one dram, infuse it in the water of Carduus Benedictus, with one scruple of Cinnamon, in the straining The form of a purge to be given to a child. dissolve two drams of Diacatholicon, of syrup of Roses laxative three drams; make thereof a small potion. This is the cure of the Pestilence and of the pestilent Fever, as far as I could learn from the most learned Physicians, and have observed myself by manifold experience by the grace and permission of God: of whom alone, as the Author of all good things that mortal men enjoy, the true and certain preservatives against the pestilence are to be desired and hoped for. The End of the Twenty second Book. OF THE MEANS AND MANNER TO REPAIR OR SUPPLY THE NATURAL or accidental defects or wants in man's body. THE TWENTY THIRD BOOK. CHAP. I. How the loss of the natural or true eye may be covered, hidden or shadowed. HAving at large treated in the former Books of tumors, wounds, ulcers, fractures and luxations, by what means things dissolved and dislocated might be united, things united separated, and superfluities consumed or abated: Now it remains that we speak The fourth duty of a Surgeon. of the fourth office or duty of the Chirurgeon, which is to supply or repair those things that are wanting by nature, through the default of the first conformation, or afterwards by some mischance. Therefore, if that through any mischance, as by an inflammation, any man's eye happen to be broken or put out, & the humours spilt or wasted, or if it be strucken out of his place or cavity wherein it was naturally placed, by any violent stroke, or if it waste or consume by reason of a consumption of the proper substance, than there is no hope to restore the sight or function of the eye, yet you may cover the deformity of the eye so lost (which is all you can do in such a case) by this means: If that when you have perfectly cured and healed the ulcer, you may put another eye artificially made of gold or silver, counterfeited and enameled, so that it may seem to have the brightness, or gemmie decency of the natural eye, into the place of the eye that is so lost. The forms of eyes artificially made of gold or silver, polished and enamelled, showing both the inner and outer side. But if the patient be unwilling, or by reason of some other means cannot wear this eye so prepared, in his head, you may make another on this wise. You must have a string or wiar, of iron bowed or crooked, like unto women's eare-wiars, made to bind the head harder or loser as it pleaseth the patient, from the lower part of the head behind above the ear, unto the greater corner of the eye, this rod or wiar must be covered with silk, and it must also be somewhat broad at both the ends, lest that the sharpness thereof should pierce or prick any part that it cometh unto. But that end wherewith the empty hollowness must be covered, aught to be broader than the other, and covered with a thin piece of leather, that thereon the colours of the eye that is lost may be shadowed or counterfeited. Here followeth the figure or portraiture of such a string or wiar. The form of an iron wiar wherewith the deformity of an eye that is lost may be shadowed or covered. CHAP. II. By what means a part of the nose that is cut off, may be restored; or how in stead of the nose that is cut off, another counterfeit nose may be fastened or placed in the stead. WHen the whole nose is cut off from the face, or portion of the nostrils from the nose, it cannot be restored or joined again: for it is not in men as it is in plants. For plants have a weak and feeble Why the parts of plants being cut off, may grow again, but those of man cannot. heat, and furthermore it is equally dispersed into all the substance of the plant or tree, neither is it easy to be consumed or wasted, for when the boughs or branches of trees are broken, torn, or cut away, they live nevertheless, and will grow again when they are set or grafted; neither is there any seat for the heart rightly prepared in them from whence the heat must necessarily run, and disperse itself continually into all the parts thereof. But chose, the separated parts of more perfect living creatures, as of men, are incontinently deprived of life, because they have their nourishment, life, sense, and whole sustentation not of themselves, by faculties flowing or coming unto them from some other parts, neither are they governed by their own heat as plants, but by a borrowed heat, so that above or beside the natural faculty of the liver, another vital faculty cometh unto it from the heart. Wherefore in stead of the nose cut away or consumed, it is requisite to substitute another made by Art, because that nature cannot supply that defect: this nose so artificially made, must be of gold, silver, paper or linen clothes glued together, it must be so coloured, counterfeited and made both of fashion, figure and bigness, that it may as aptly as is possible, resemble the natural nose: it must be bound or stayed with little threads or laces unto the hinder part of the head or the hat. Also if there be any portion of the upper lip cut off with the nose, you may shadow it with annexing some such thing that is wanting unto the nose, and cover it with the hair on his upper lip, that he may not want any thing that may adorn or beautify the face. Therefore I have thought it necessary to set down the figure or form of both these kinds. The form of a nose artificially made, both alone by itself, and also with the upper lip, covered at it were with the hair of the beard. There was a Surgeon of Italy of late years which would restore or repair the A strange cure for a cut off nose portion of the nose that was cut away after this manner. He first scarified the callous edges of the maimed nose round about, as is usually done in the cure of hare-lips: then he made a gash or cavity in the muscle of the arm, which is called Biceps, as large as the greatness of the portion of the nose which was cut away did require: And into that gash or cavity so made, he would put that part of the nose so wounded, & bind the patient's head to his arm as if it were to a post, so fast that it might remain firm, stable and immovable, and not lean or bow any way, and about forty days after, or at that time when he judged the flesh of the nose was perfectly agglutinated with the flesh of the arm, he cut out as much of the flesh of the arm, cleaving fast unto the nose, as was sufficient to supply the defect of that which was lost, & then he would make it even, & bring it, as by licking, to the fashion & form of a nose, as near as art would permit, & in the mean while he did feed his patient with pomadoes, jellies, & all such things as were easy to be swallowed & digested. And he did this work of curing the place where the flesh was so cut out, only with certain balms & agglutinative liquors. A younger brother of the family of St. Thoan, being weary of a silver A history. nose, which being artificially made, he had worn in the place of his nose that was cut off, went to this Chirurgeon into Italy, & by the means of the forenamed practice he recovered a nose of flesh again, to the great admiration of all those that knew him before. This thing truly is possible to be done, but it is very difficult both to the patient suffering, and also to the Chirurgeon working. For that the flesh that is taken out of the arm, is not of the like temperature as the flesh of the nose is, also the holes of the restored nose cannot be made as they were before. CHAP. III. Of the Placing of teeth artificially made in stead of those that are lost or wanting. IT often times happeneth that the fore teeth are moved, broken or stricken out of their places by some violent blow, which causeth deformity of the mouth, and hinders plain pronunciation. Therefore when the jaw is restored (if it were luxated or fractured) and the gums brought unto their former hardness, other teeth artificially made of bone or Ivory may be put in the place of those that are wanting, and they must be joined one fast unto another, and also so fastened unto the natural teeth adjoining, that are whole; and this must chiefly be done with a thread of gold or silver, or for want of either, with a common thread of silk or flax, as it is declared at large by Hypocrates, and also described in this figure following. Sect. 〈◊〉. lib. de art. sent. ●5. The figure of teeth bound or fastened together. CHAP. four Of filling the hollowness of the Pallat. MAny times it happeneth that a portion or part of the bone of the palate, The causes and hurt that ensues of the lost palate. being broken with the shot of a gun, or corroded by the virulency of the Lues venerea, falls away, which makes the patients to whom this happeneth, that they cannot pronounce their words distinctly, but obscurely and snuffling: therefore I have thought it a thing worthy the labour to show the means how it may be helped by art. It must be done by filling the cavity of the palate with a plate of gold or silver a little bigger than the cavity its self is. But it must be as thick as a French Crown, and made like unto a dish in figure, and on the upper side, which shall be towards the brain, a little sponge must be fastened, which, when it is moistened with the moisture distilling from the brain, will become more swollen and puffed up, so that it will fill the concavity of the palate, that the artificial palate cannot fall down, but stand fast and firm, as if it stood of itself. This is the true figure of those instruments, whose certain use I have observed not by once or twice, but by manifold trial in the battels fought beyond the Alpes. The figure of plates to fill or supply the defects of the Pallat. The figure of another plate for the palate, on whose upper side there is a button which may be turned when it is put into the place, with a small Raven's bill, like this whose figure is here expressed. CHAP. V. How to help such as cannot speak by reason of the loss of some part of the tongue. CHance gave place and authority to this remedy, as to many other in our art. A remedy found out by accident. A history. A certain man dwelling in a village named Yvoy le Chastean, being some twenty four miles from Bourges, had a great piece of his tongue cut off, by which occasion he remained dumb some three years. It happened on a time that as he was in the fields with reapers, he drinking in a wooden dish, was tickled by some of the standers by, not enduring the tickling, he suddenly broke out into articulate and intelligible words. He himself wondering thereat, and delighted with the novelty of the thing, as a miracle, put the same dish to his mouth just in the same manner as before, and then he spoke so plainly and articulately, that he might be understood by them all. Wherefore a long time following he always carried this dish in his bosom, to utter his mind, until at length necessity, the mistress of arts and giver of wit, inducing him, he caused a wooden instrument to be neatly cut and made for him, like this which is here delineated, which he always carried hanging at his neck, as the only interpreter of his mind, and the key of his speech. An instrument made to supply the defect of the speech when the tongue is cut off. The use of the Instrument is this. A. showeth the upper part of it which was of the thickness of a ninepences, which he did so hold between his cutting teeth, that it could not come out of his mouth, nor be seen. B. showeth the lower part, as thick as a sixpences, which he did put hard to the rest of his tongue, close to the membranous ligament which is under the tongue. That place which is depressed and somewhat hollowed, marked with the letter C. is the inner part of the instrument. D. showeth the outside of the same. He hanged it about his neck with the string that is tied thereto. Textor the Physician of Bourges showed me this instrument: and I myself made trial thereof on a young man whose tongne was cut off, and it succeeded well, and took very good effect. And I think other Surgeons in such cases may do the like. CHAP. VI Of covering or repairing certain defects or defaults in the face. IT oftentimes happeneth, that the face is deformed by the sudden flashing of Gunpowder, or by a pestilent Carbuncle, so that one cannot behold it without great horror. Such persons must be so trimmed and ordered, that they may come in seemly manner into the company of others. The lips if they be either cut off with a sword, or deformed with the erosion or eating of a pestilent Carbuncle or ulcerated Cancer, so that the teeth may be seen to lie bare with great deformity. If the loss or consumption of the lip be not very great, it may be repaired by that way which we have prescribed in the cure of hare, lips, or of an ulcerated Cancer. But if it be great, then must there be a lip of gold made for it, so shadowed and counterfeited, that it may not be much unlike in colour to the natural lip, and it must be fastened and tied to the hat or cap that the patient weareth on his head, that so it may remain stable and firm. CHAP. VII. Of the defects of the ears. SUch as want their ears, either naturally or by misfortune, as through a wound, carbuncle, cancer, or the biting of wild beasts: if so be that the ear be not wholly wanting, wasted, consumed, or torn away, but that some portion thereof doth yet remain, then must it not be neglected, but must have many holes made therein with a bodkin, and after that the holes are cicatrized, let some convenient thing, made like unto the piece of the ear that is lost, be tied or fastened unto it by these holes. But if the ear be wholly wanting, another must be made of paper artificially glued together, or else of leather, and so fastened with laces, from the top or hinder part of the head, that it may stand in the appointed place, and so the hair must be permitted to grow long, or else some cap worn under the hat which may hide or cover the deformity, unless you had rather have it to be shadowed and counterfeited by some Painter, that thereby it may resemble the colour of a natural ear, and so retain it in the place where it ought to stand, with a rod or wiar coming from the top or hinder part of the head, as we have spoken before in the loss of the eye; and the form thereof is this. CHAP. VIII. Of amending the deformity of such as are crooke-backt. THe bodies of many, especially young maids or girls (by reason that they are more moist and tender than the bodies of boys) are made crooked in process of time, especially by the wrenching aside and crookedness of the backebone. It hath many causes, that is to say, in the first conformation Causes of crookedness. in the womb, and afterwards by misfortune, as a fall, bruise, or any such like accident, but especially by the unhandsome and undecent situation of their bodies, when they are young and tender, either in carrying, sitting or standing (and especially when they are taught to go too soon) saluting, sewing, writing, or in doing any such like thing. In the mean while, that I may not omit the occasion of crookedness, that happens seldom to the country people, but is much incident to the inhabitants of great towns and cities, which is by reason of the straightness and narrowness of the garments that are worn by them, which is occasioned by the folly of mothers, who while they covet to have their young daughter's bodies so small in the middle as may be possible, pluck and draw their bones awry, and make them crooked. For the ligaments of the backbone being very tender, soft and moist at that age, cannot stay it straight, and strongly, but being pliant, easily permits the spondels to slip awry inwards, outwards, or sidewise, as they are thrust or forced. The remedy for this deformity is to have breastplates of iron, full of holes all over them, whereby they may be lighter to wear; and they must be so lined with bombast, that they may hurt no place of the body. Every three months new plates must be made for those that are not yet arrived at their full growth, for otherwise by the daily afflux of more matter, they would become worse. But these plates will do them small good that are already at their full growth. The form of an iron Breastplate, to amend the crookedness of the Body. CHAP. IX. How to relieve such as have their urine flow from them against their wills, and such as want their yards. IN those that have the strangury, of what cause soever that malady cometh, the urine passeth from them by drops, against their wills and consent. This accident is very grievous and troublesome, especially to men that travail: and for their sakes only I have invented the instrument here beneath described. It is made like unto An instrument for such as cannot hold their water. a close breech or hose, it must be of latin, & to contain some four ounces; it must be put into the patient's hose, between his thighs, unto which it must be tied with a point by the ring. Into the open and hollow mouth of this instrument, which is noted with the letter C. the patient must put his yard, & into this concavity or hollowness goeth a stay somewhat deep, it is marked with the letter B. and made or placed there, both to hold or bear the end of the yard, and also by his close joint that it must have unto the vessel, to stay the urine from going back again, when it is once in. But the letters A. and D. do signify all the instrument; that the former part, and this the hinder part thereof. Now this is the shape thereof. The figure of an instrument, which you may call A Basin, or receptacle for the Urine. Those that have their yards cut off close to their bellies, are greatly troubled in making of urine, so that they are constrained to sit down like women, for their ease. I have devised this pipe or conduit, having an hole through it as big as one's finger, which may be made of wood, or rather of latin. A. and C. do show the bigness and length of the pipe. B. showeth the brink on the broader end. D. showeth the outside of the brink. This instrument must be applied to the lower part of ospectinis: on the upper end it is compassed with a brink for the passage of the urine, for thereby it will receive the urine the better, and carry it from the patient, as he standeth upright. The description of a pipe, or conduit, serving instead of the yard in making of water, which therefore we may call an artificial Yard. CHAP. X. By what means the perished function or action of a thumb or finger may be corrected and amended. WHen a sinew or tendon is cut clean asunder, the action in that part, whereof it was the author, is altogether abolished, so that the member cannot bend or stretch out itself, unless it be holpen by art: which thing I performed in a certain gentleman belonging to Annas of Montmorency, A history. general of the French Horsemen, who in the battle of Dreux received so great a wound with a backsword, upon the outside of the wrist of the right hand, that the tendons that did erect or draw up the thumb were cut clean insunder, & also when the wound was throughly whole and consolidated, the thumb was bowed inwards, and fell into the palm of the hand, so that he could not extend or lift it up, unless it were by the help of the other hand, and then it would presently fall down again; by reason whereof he could hold neither sword, spear, nor Javeline in his hand, so that he was altogether unprofitable for war, without which he supposed there was no life. Wherefore he consulted with me about the cutting away of his thumb, which did hinder his griping, which I refused to do, and told him that I conceived a means how it might be remedied without cutting away. Therefore I caused a case to be made for it of Latin, whereinto I put the thumb: this case was so artificially fastened by two strings that were put into two Rings, made in it above the joint of the hand, that the thumb stood upright, and strait out, by reason whereof he was able afterwards to handle any kind of weapon. The form of a thumb or finger-stall of iron or latin, to lift up or erect the thumb, or any other finger that cannot be erected of itself. If that in any man the finewes or tendons which hold the hand upright, be cut asunder with a wound, so that he is not able to lift up his hand, it may easily be erected or lifted up with this instrument that followeth, being made of an equal, straight, thin, but yet strong plate of latin, lined on the inner side with silk, or any such like soft thing, and so placed in the wrist of the hand, that it may come unto the palm, or the first joints of the fingers, and it must be tied above with convenient stays, and so the discommodity of the depression, or hanging of the hand, may be avoided; therefore this instrument may be called the Erector of the hand. The Erector of the Hand. CHAP. XI. Of helping those that are Vari or Valgi, that is, crooke-legged or crooke-footed, inwards or outwards. THose are said to be Varous, whose feet or legs are bowed or crooked inwards. What varus is. This default is either from the first conformation in the womb, through the default in the mother, who hath her legs in like manner crooked; or because that in the time when she is great with child, she commonly sits with her legs a cross: or else after the child is born, & that, either because his legs be not well swathed, when he is laid into the cradle, or else because they be not well placed in carrying the infant, or if he be not well looked unto by the nurse when he learneth to go, for the bones of infants are very tender, and almost as flexible as Wax. But chose, those are called valgi, whose legs are crooked or bowed out-wards. What valgus is. This may come through the default of the first conformation, aswell as the other, for by both, the feet and also the knees may be made crooked; which thing, whosoever will amend, must restore the bones into their proper and natural place, so that in those that are varous he must thrust the bones outwards, as though he would make them valgous, and in those that are valgous, he must thrust the bones inwards, as though he would make them varous: neither is it sufficient to thrust them so, but they ought also to be retained there in their places after they are so thrust, for otherwise they being not well established, would slip back again. They must be stayed in their places by applying of collars and bolsters on that side whereunto the bones do lean and incline themselves; for the same purpose boots may be made of leather, of the thickness of a testone, having a slit in the former part all along the bone of the leg, and also under the sole of the foot, that being drawn together on both sides, they may be the better fitted, and sit the closer to the leg. And let this medicine following be applied all about the leg. ℞. thuris, mastic. A plaster to hold fast rest. red bones. aloës, boli armeni, an. ℥ i. aluminis roch. resinae pini siccae, subtilissimè pulveris. an. ʒiii. farinae volat. ℥ iss. album. ovor. q. s. make thereof a medicine. You may also add a little turpentine, lest it should dry sooner, or more vehemently than is necessary. But you must beware, and take great heed lest that such as were of late varous or valgous should attempt or strain themselves to go before that their joints be confirmed, for so the bones that were lately set in their places, may slip aside again. And moreover, until they are able to go without danger, let them wear high shoes tied close to their feet, that the bones may be stayed the better and more firmly in their places, but let that side of the sole of the shoe be underlayed whither the foot did incline before it was restored. The form of little boots, whereof the one is open and the other shut. CHAP. XII. By what means arms, legs, and hands may be made by art, and placed in stead of the natural arms, legs, or hands that are cut off and lost. NEcessity oftentimes constrains us to find out the means whereby we may help and imitate nature, and supply the defect of members that are perished and lost. And hereof it cometh that we may perform the functions of going, standing and handling with arms and hands made by art, and undergo our necessary flexions and extensions with both of them. I have gotten the forms of all those members made so by art, and the proper names of all the engines and instruments whereby those artificially made are called, to my great cost and charges, of a most ingenious & excellent Smith dwelling at Paris, who is called of those that know him, and also of strangers, by no other name than the little Lorraine, and here I have caused them to be portrayed or set down, that those that stand in need of such things, after the example of them, may cause some Smith, or such like workman to serve them in the like case. They are not only profitable for the necessity of the body, but also for the decency and comeliness thereof. And here followeth their forms. The form of an hand made artificially of iron. This figure following showeth the backside of an hand artificially made, and so that it may be tied to the arm or sleeve. The form of an arm made of iron very artificially. The description of legs made artificially of iron. The form of a wooden Leg made for poor men. A. showeth the stump or stock of the wooden leg. BB. showeth the two stays which must be on both sides of the leg, the shorter of them must be on the inner side. CC. showeth the pillow or bolster whereon the knee must rest in the bottom between the two stays, that so it may rest the softer. DD. showeth the thongs or girths with their round buckles, put through the two stays on either side to stay the knee in his place firm and immovable, that it slip not aside. E. showeth the thigh itself, that you may know after what fashion it must stand. It happens also many times, that the patient, that hath had the nerves or tendons of his leg wounded, long after the wound is whole and consolidated, cannot go but with very great pain and torment, by reason that the foot cannot follow the muscle, that should draw it up. That this malady, may be remedied you aught to fasten a linen band made very strong, unto the shoe that the patient weareth on that his pained foot, and at the knee it must have a slit where the knee may come forth in bowing of the leg, & it must be trussed up fast unto the patients middle, that it may the better lift up and erect the foot in going. This band is marked in the figure following with the letters AA. CHAP. XIII. Of amending or helping lameness or halting. HAlting is not only a great deformity, but also very troublesome and grievous. Therefore if that any man be grieved therewith by reason that one of his legs is shorter than the other, it may be holpen by putting under his short foot this sitting crutch, which we are now about to describe. For by the help of this, he shall not only go upright, but also more easily and with little labour or no pain at all. It was taught me by Nicholas Picard Chirurgeon to the Duke of Lorraine. The form thereof is this. A. showeth the staff or stilt of this crutch, which must be made of wood. B. showeth the seat of iron whereon the thigh resteth, just under the buttock. C. showeth a prop which stayeth up the seat whereon all the weight of the patient's body resteth. D. showeth the stirrup, being made of iron, and bowing crooked upwards, that the foot may stand firm, and not slip off it when the patient goeth. E. showeth the prop that stayeth or holdeth up the stirrup to strengthen it. F. showeth the foot of the stilt or crutch made of iron with many pikes, and compassed with a ring or ferule, so to keep it from slipping. G. The cross or head of the crutch which the patient must put under his armhole to lean upon, as it is to be seen in the figure. The End of the Twenty third Book. OF THE GENERATION OF MAN. THE TWENTY FOURTH BOOK. THE PREFACE. GOD, the Creator and maker of all things, immediately after The distinction of male and female. the Creation of the world, of his unspeakable counsel and inestimable wisdom not only distinguished mankind, but all other living creatures also, into a double sex, to wit, of male and female; that so they being moved and enticed by the allurements of lust, might desire copulation, thence to have procreation. For this bountiful Lord hath appointed it as a solace unto every living The cause of this distinction. creature against the most certain & fatal necessity of death: that for as much as each particular living creature cannot continue for ever, yet they may endure by their species or kind by propagation and succession of creatures, which is by procreation, so long as the world endureth. In this conjunction or copulation, replenished with such delectable pleasure, which God hath chiefly established by the law of Matrimony, the male and female yield forth their seeds, which presently mixed and conjoined, are received and kept in the females womb. For, What seed is. the seed is a certain spumous or foamy humour replenished with vital spirit, by the benefit whereof, as it were by a certain ebullition or fermentation, it is puffed up and swollen bigger, and both the seeds being separated from the more pure blood of both the parents, are the material and formal beginning of the issue, for the seed of the male being cast and received into the womb, is accounted the principal and efficient cause, but the seed of the female is reputed the subjacent matter, or the matter whereon it worketh. Good and laudable seed ought The conditions of good seed. to be white, shining, clammy, knotty, smelling like unto the elder or palm, delectable to bees, and sinking down to the bottom of water being put into it, for that which swimmeth on the water is esteemed unfruitful; for a great portion cometh from the brain, yet some thereof falls from the whole body, & from all the parts both firm and 〈◊〉 thereof. For unless it come from the whole body, & Seed falleaf from all the parts of the body. every part thereof, all & every part of the issue cannot be form thereby: because like things are engendered of their like: and therefore it cometh that the child resembleth the parents, not only in stature and favour, but also in the conformation and proportion of his limbs and members, and complexion and temperature of his inward parts, so that diseases are oft times hereditary, the weakeness of this or that entrall being translated from the parent to the child. There are Wherefore many diseases are hereditary. some which suppose this falling of the seed from the whole body not to be understood according to the weight and matter, as if it were a certain portion of all How feed is to be understood to fall from the whole body. the blood separated from the rest; but according to the power and form, that is to say the animal, natural, and vital spirits, being the framers of formation and life, and also the formative faculty to fall down from all the parts into the seed, that is wrought or perfected by the Testicles, for proof and confirmation whereof, they allege that many perfect, sound, absolute, and well proportioned children, are borne of lame and decrepit parents. CHAP. I. Why the generative parts are endued with great pleasure. A Certain great pleasure accompanieth the function of the parts appointed for generation, and before it, in living creatures that are of a lusty age, when matter aboundeth in those parts, there goeth a certain fervent or furious desire: the causes thereof are many, of which the chiefest is, That the kind may be preserved and kept for ever, by the propagation and substitution of other living creatures of the same kind. For brute beasts which want reason, and therefore cannot be solicitous for the preservation of their kind, never come to carnal copulation, unless they be moved thereunto by a certain vehement provocation of unbridled lust, and as it were by the stimulation of venery. But man, that What moveth a man to copulation. is endued with reason, being a divine and most noble creature, would never yield nor make his mind subject to a thing so abject and filthy as is carnal copulation, but that the venerous tickle, raised in those parts, relax the severity of his mind, or reason admonish him that the memory of his name ought not to end with his life, but to be preserved unto all generations, as far as may be possible, by the propagation of his seed or issue. Therefore by reason of this profit or commodity, nature hath endued the genital parts with a far more exact or exquisite sense than the Why the genital, are endued with a whayish moisture. other parts, by sending the great sinews unto them, and moreover she hath caused them to be bedewed or moistened with a certain whayish humour, not much unlike the seed sent from the glandules or kernels called prostatae, situated in men at the beginning of the neck of the bladder, but in women at the bottom of the womb: this moisture hath a certain sharpness or biting, for that kind of humour of all others can chiefly provoke those parts to their function or office, and yield them a delectable pleasure, while they are in the execution of the same. For even so whayish and sharp humours, when they are gathered together under the skin, if they wax warm, tickle with a certain pleasant itching, and by their motion infer delight: but the nature of the genital parts or members is not stirred up or provoked to the expulsion of the seed with these provocations of the humours, abounding either in quantity or quality only, but a certain great and hot spirit or breath contained in those parts, doth begin to dilate itself more and more, which causeth a certain incredible excess of pleasure or voluptuousness, ●…erewith the genitals being replete, are spread forth or distended every way unto their full greatness. T●… yard is given to men whereby they may cast out their seed directly or straightly into the woman's womb, and the neck of the womb to women, whereby they may receive that seed so cast forth, by the open or wide mouth of the same neck, and also that they may cast forth their own seed, sent through the spermaticke vessels unto their testicles; these spermaticke vessels, that is to say, the vein lying above, and The cause of the foldings of the sper maticke vessels. the artery lying below, do make many flexions or windings, yet one as many as the other, like unto the tendrils of vines diversely plaited or foided together, and in these folds or bend the blood and spirit which are carried unto the testicles, are concocted a longer time, and so converted into a white seminal substance. The lower of these flexions or bowings do end in the stones or testicles. But the testicles, for as much as they are loose, thin, and spongeous or hollow, receiving the humour which was begun to be concocted in the forenamed vessels, concoct it again themselves: but the testicles of men concoct the more perfectly for the procreation of the issue; & the testicles of women more imperfectly, because they are more cold, less, weak and women's testcles more imperfect. feeble, but the seed becometh white by the contact or touch of the testicles, because the substance of them is white. The male is such as engendereth in another, and the female in herself, by the spermaticke vessels which are implanted in the inner capacity of the womb. But out of all doubt unless nature had prepared so many allurements, Why many men and women abhor renercous copulation. baits, and provocations of pleasure, there is scarce any man so hot or delighted in venereous acts, which considering and marking the place appointed for humane conception, the loathsomeness of the filth which daily falleth down unto it, and wherewithal it is humected and moistened, and the vicinity and nearness of the great gut under it, and of the bladder above it, but would shun the embraces of women. Nor would any woman desire the company of man, which once premeditates or forethinkes with herself on the labour that she shall sustain in bearing the burden of her child nine months, and of the almost deadly pains that she shall suffer in her delivery. Men that use too frequent copulation, oftentimes in stead of seed cast forth a crude Why the strangury ensueth immoderate copulation. and bloody humour, and sometimes also mere blood itself; and oft times they can hardly make water but with great pain, by reason that the clammy and oily moisture, which nature hath placed in the glandules called prostatae, to make the passage of the urine slippery, & to defend it against the sharpness of the urine that passeth through it, is wasted, so that afterward they shall stand in need of the help of a Surgeon to cause them to make water with ease & without pain, by injecting a little oil out of a syringe into the conduit of the yard. For generation it is fit the man cast forth his seed What things necessary unto generation. into the womb with a certain impetuosity, his yard being stiff and distended, and the woman to receive the same without delay into her womb, being wide open, lest that through delay the seed wax cold, and so become unfruitful by reason that the spirits are dissipated and consumed. The yard is distended or made stiff, when the nervous, spongeous, and hollow substance thereof is replete and puffed up with a flatulent spirit. The womb allures or draws the masculine seed into itself by the mouth thereof, and it receives the woman's seed by the horns from the spermatick vessels, which come from the woman's testicles into the hollowness or concavity of the womb, that so it may be tempered by conjunction, commistion & confusion with the man's seed, and so reduced or brought unto a certain equality: for generation or conception cannot follow without the concourse of two feeds, well and perfectly wrought in the very same moment of time, nor without a laudable dispo●… the womb both in temperature and complexion: if in this mixture of ●… man's seed in quality and quantity exceed the woman's, it will be a man chil●…, a woman child, although that in either of the kinds there is both the man's and woman's Why a male, & why a female is engendered. seed, as you may see by the daily experience of those men who by their first wives have had boys only and by their second wives had girls only: the like you may see in certain women, who by their first husbands have had males only, and by their second husband's females only. Moreover, one and the same 〈◊〉 is not always like affected to get a man or a woman child, for by reason of his age, temperature and diet, he doth sometimes yield forth seed endued with a masculine virtue, and sometimes with a feminine or weak virtue, so that it is no marvel if men get sometimes men, and sometimes women children. CHAP. II. Of what quality the seed is, whereof the male, and whereof the female is engendered. MAle children are engendered of a more hot and dry seed, and women of a more cold and moist: for there is much less strength in cold than in heat, and likewise in moisture than in dryness; and that is the cause why it will be longer before a girl is form in the womb than a boy. Why men children are sooner form in the womb than women. The seed is that in power from whence each ●…ing cometh 〈…〉 floweth. In the seed lieth both the procreative and the formative power: as for example; In the power of the Melon seed are situate the stalks, branches, leaves, flowers, fruit, the form, colour, smell, taste, seed and all. The like reason is of other seeds; so Apple grafts engrafted in the stock of a Pearetree, bear Apples; and we do always find and see by experience, that the tree (by virtue of grafting) that is grafted, doth convert itself into the nature of the Sions wherewith it is grafted. But although the child that is borne doth resemble or is very like unto the father or the mother, as his or her seed exceedeth in the mixture, yet for the most part it happeneth Why the children are most commonly like unto their fathers. that the children are more like unto the father than the mother, because that in the time of copulation, the mind of the woman is more fixed on her husband, than the mind of the husband on, or towards his wife: for in the time of copulation or conception, the forms, or the likenesses of those things that are conceived or kept in mind, are transported and impressed in the child or issue; for so they affirm that there was a certain Queen of the Aethiopians who brought forth a white child, the reason was (as she confessed) that at the time of copulation with her King, she thought on a marvellous white thing, with a very strong imagination. Therefore Hesiod advertiseth all married people not to give themselves to carnal copulation when they return from burials, but when they come from feasts and plays, lest that When children should be begotten. their sad, heavy, and pensive cogitations, should be so transfused and engrafted in the issue, that they should contaminate or infect the pleasant joyfulness of his life, with sad, pensive and passionate thoughts. Sometimes it happeneth, although very seldom, the child is neither like the father nor the mother, but in favour resembleth Why often times the child resembleth the Grandfather. his Grandfather, or any other of his kindred, by reason that in the inward parts of the parents, the engrafted power and nature of the grandfather lieth hidden: which when it hath lurked there long, not working any effect, at length breaks forth by means of some hidden occasion: wherein nature resembleth the Painter, making the lively portraiture of a thing, which as far as the subject matter will permit, doth form the issue like unto the parents in every habit; so that often times the diseases of the parents are transferred or participated unto the children, as it were by a certain hereditary title: for those that are crooke-backt get crooke-backt children, those that are lame, lame; those that are leprous, leprous; those that have the stone, children having the stone; those that have the phthisic, children having the ptisick; and those that have the gout, children having the gout: for the seed follows the power, nature, temperature, and comnlexion of him that engendereth it. Therefore of those Why sometime those that are ●…ased do get ●…d children. that are in health and sound, ●…thy and sound; and of those that are weak and diseased, weak and diseased children are begotten, unless happily the seed of one of ●…ents that is sound doth correct or amend the diseased impression of the o●…t is diseased, or else the temperate and sound womb as it were by the gen●… pleasant breath thereof. CHAP. III. What is the cause why the Females of all brute beasts, being great with young, do neither desire, nor admit the males, until they have brought forth their Young. THe cause hereof is, that, forasmuch as they are moved by sense only, Why the sense of venereous acts is given to brute beasts. they apply themselves unto the thing that is present, very little, or nothing at all perceiving things that are past, and to come. Therefore after they have conceived, they are unmindful of the pleasure that is past, and do abhor copulation: for the sense or feeling of lust is given unto them by nature, only for the preservation of their kind, and not for voluptuousness, or delectation. But the males Why of brute beasts, the males raging with lust, follow after the females. raging, swelling, and as it were stimulated by the provocations of the heat, or fervency of their lust, do then run unto them, follow and desire copulation, because a certain strong odour or smell cometh into the air from their secret or genital parts, which pierceth into their nostrils, and unto their brain, and so inferreth an imagination, desire, and heat. chose, the sense and feeling of venereous actions seemeth to be given by nature to women, not only for the propagation of issue Wherefore a woman when she is with child, desireth copulation. and for the conservation of mankind, but also to mitigate and assuage the miseries of man's life, as it were by the enticements of that pleasure: also the great store of hot blood that is about the heart, wherewith men abound, maketh greatly to this purpose, which by impulsion of imagination, which ruleth the humours, being driven by the proper passages, down from the heart and entralls into the genital parts, doth stir up in them a new lust. The males of brute beasts, being provoked or moved by the stimulations of lust, rage, and are almost burst with a Tentigo or extension of the genital parts, and sometimes wax mad, but after that they have satisfied their lust with the female of their kind, they presently become gentle, and leave off such fierceness. CHAP. four What things are to be observed, as necessary unto generation in the time of copulation. WHen the husband cometh into his wife's chamber he must entertain her with all kind of dalliance, wanton behaviour, and allurements How women may be moved to venery and conception. to venery: but if he perceive her to be slow, and more cold, he must cherish, embrace, and tickle her, and shall not abruptly, the nerves being suddenly distended, break into the field of nature, but rather shall creep in by little and little, intermixing more wanton kisses with wanton words and speeches, handling her secret parts and dugs, that she may take fire and be inflamed to venery, for so at length the womb will strive and wax fervent with a desire of casting forth its own seed, and receiving the man's seed to be mixed together therewith. But if all these things will not suffice to inflame the woman, for women for the most part are more slow and slack unto the expulsion or yielding forth of their seed, it shall be necessary first to foment her secret parts with the decoction of hot herbs made with Muscadine, or boiled in any other good wine, and to put a little musk or civet into the neck or mouth of the womb: and when she shall perceive the efflux of her seed to approach, by reason The meeting of the seeds most necessary for generation. of the tickling pleasure, she must advertise her husband thereof, that at the very instant time or moment, he may also yield forth his seed, that by the concourse or meeting of the seeds, conception may be made, and so at length a child form and borne. And that it may have the better success, the husband must not presently separate himself from his wife's embraces, lest the air strike into the open womb, and so corrupt the seeds before they are perfectly mixed together. When the man departs, let the woman lie still in quiet, lying her legs or her thighs across, one upon another, and raising them up a little, lest that by motion or downward situation, the seed should be shed or spilt: which is the cause why she ought at that time not to talk, especially chiding, nor to cough, nor sneeses, but give herself to rest and quietness, if it be possible. CHAP. V. By what signs it may be known whether the woman have conceived or not. IF the seed in the time of copulation, or presently after be not spilt, if in the meeting of the seeds the whole body do somewhat shake, that is to say, the womb drawing itself together for the compression & entertainment thereof, if a little feeling of pain doth run up and down the lower belly and about the navel, if she be sleepy, if she loathe the embracings of a man, and if her face be pale, it is a token that she hath conceived. In some, after conception spots or freckles arise in their face, their eyes are depressed and sunk in, the white of their eyes waxeth pale, they wax giddy in the head, Spots or speeks in the faces of those that are with child. by reason that the vapours are raised up from the menstrual blood that is stopped, sadness & heaviness grieve their minds, with loathing and way wardness, by reason that the spirits are covered with the smoky darkness of the vapours: pains in the teeth and gums, and swooning often times cometh, the appetite is depraved or overthrown, with aptness to vomit, and longing, whereby it happeneth that they loath meats of good juice, and long for and desire illaudable meats, and those that are contrary to nature, as coals, dirt, ashes, stinking saltfish, sour, austere and Why many women being great with child refuse laudable meats, and desire those that are illaudable & contrary to nature. ta●t fruits, pepper, vinegar, and such like acride things, and other, altogether contrary to nature and use, by reason of the condition of the suppressed humour abounding & falling into the orifice of the stomach. This appetite so depraved or overthrown, endureth in some until the time of childbirth; in others it cometh in the third month after their conception, when hairs do grow on the child, and lastly it leaveth them a little before the fourth month, because that the child, being now greater and stronger, consumes a great part of the excremental and superfluous humour. The suppressed or stopped terms in women that are great with child, are divided into three parts: the more pure portion maketh the nutriment for the child, the second The suppressed terms divided into three parts. ascendeth by little and little into the dugs, and the impurest of all remaineth in the womb about the infant, and maketh the secundine or afterbirth, wherein the in fant lieth as in a s●…ed. Those women are great with child whose urine is more sharp, fervent, and somewhat bloody, the bladder not only waxing warm by the compression of the womb, servant by reason of the blood contained in it, but also the thinner portion of the same blood being expressed, and sweeting out into the bladder. A swelling and hardness of the dugs, and veins that are under the dugs in Hip. 1. de morb. mul. the breasts and about them, and milk coming out when they are pressed, with a certain stirring motion in the belly, are certain infallible signs of greatness with child. Neither in this greatness of child bearing, the veins of the dugs only, but of all the whole body, appear full and swelled up, especially the veins of the thighs and legs, so that by their manifold folding and knitting together, they do Aph. 41. sect. 5. appear varicous, whereof cometh fluggishnesse of the whole body, heaviness & impotency or difficulty of going; especially when the time of deliverance is at hand. Lastly, if you would know whether the woman have concerved or not, give unto her when she goeth to sleep, some meed or honeyed water to drink, and if she have agriping in her guts or belly, she hath conceived, if not, she hath not conceived. CHAP. VI That the womb, so soon as it hath received the seed, is presently contracted or drawn together. AFter that the seeds of the male and female have both met, and are mixed together in the capacity of the womb, than the orifice thereof doth draw itself close together, lest the seeds should fall out. There the females seed goeth and turneth into nutriment Why the female seed is nutriment for the male seed. and the increase of the males seed, because all things are nourished and do increase by those things that are most familiar and like unto them. But the similitude and familiarity of seed with seed is far greater than with blood, so that when they are perfectly mixed and eoagulated, and so wax warm by the strait and narrow enclosure of the womb, a certain thin skin doth grow about it, like unto that that will be over unscimmed milk. Moreover, this concretion or congealing of the seed, is like unto an egg laid before the time that it should: that is to say, whose membrane or tunicle that compasseth it about, hath not as yet increased or grown into a shelly hardness about it; in folding-wise are seen many small threads dividing themselves, overspread with a certain clammy, whitish or red substance, as it were with black blood. In the midst under it appeareth the navel, from whence that small skin is produced. But a man may understand many things that appertain unto the conception A compendious way to understand humane conception. of mankind by the observation of twenty eggs, setting them to be hatched under an Hen, and taking one every day and breaking it, and diligently considering it; for in so doing, on the twentieth day you shall find the Chick perfectly form with the navel. That little skin that so compasseth the infant in the womb is called the secundine or Chorion. but commonly the afterbirth. This little skin is perfectly made within six days, according to the judgement of Hypocrates, as profitable and necessary not only to contain the seeds so mixed Lib. de nat. puer. together, but also to suck nutriment through the orifices of the vessels ending in the womb. Those orifices the greeks do call Cotyledones, and the Latins Acetabula, What the Cotylidones are. for they are as it were hollowed eminences, like unto those, which may be seen in the feet or snout of a Cuttle fish many times in a double order, both for the working and holding of their meat. Those eminences called Acetabula do not so greatly appear in women as in many brute beasts. Therefore by these the secundine cleaveth on every side unto the womb, for the conservation, nutrition, and increase of the conceived seed. CHAP. VII. Of the generation of the navel. AFter the woman hath conceived, to every one of the aforesaid eminencies groweth presently another vessel, that is to say, a vein to the vein, and an artery to the artery: these soft and yet thin vessels, are framed with a little thin membrane, which being spread under, sticketh to them, for to them it is in stead of a membrane, and a ligament and a tunicle or a defence, and it is doubled with the others, and made of the vein and artery of the navel, to compass the navel. These new small vessels of the infant, with their orifices, do answer directly one to one to the cotyledones or eminences of the womb, they are very swall and little, as it were the hairy fibres that grow upon roots that are in the earth, and when they have continued so a longer time, they are combined together, that of two they are made one vessel, until that by continual connexion, all those vessels go and degenerate into two other great vessels, called the umbilical vessels, or the vessels of the navel, because they do make the navel, and do enter into the child's body by the hole of the navel. Here Galen doth admire the singular providence of God and Nature, because that in such a multitude of vessels, and The vein never joineth itself with the artery. in so long a passage or length that they go or are produced, the vein doth never confound itself nor stick to the artery, nor the artery to the vein, but every vessel joineth itself to the vessel of its own kind. But the umbilical vein or navel vein, entering into the body of the child, doth join itself presently to the hollow part of the liver, but the artery is divided into two, which join themselves to the two iliack arteries along the sides of the bladder, & are presently covered with the peritonaum, & by the benefit thereof are annexed unto the parts which it goes unto. Those small veins and arteries are as it were the roots of the child, but the vein and artery of the navel are as it were the body of the tree, to bring down the nutriment to nourish the child. For first we live in the womb the life of a plant, and then next the life of a sensitive creature; and as the first tunicle of the child is called Chorion or Allantoides, so the other is called Amnios or Agnina, which doth compass the seed or child about on every side. These membranes are most thin, yea for their thinness like unto the spider's web, woven one upon another, and also connexed in many places by the extremities of certain small and hairy substances, which at length by the adjunction of Hypocrates calleth all the membranes that compass the infant in the womb, according to the judgement of 〈◊〉 in his book de usu partium, by the name of the secundines. their like do get strength; whereby you may understand, what is the cause why by divers and violent motions of the mother in going and dancing or leaping, and also of the infant in the womb, those membranes are not almost broken. For they are so conjoined by the knots of those hairy substances, that between them nothing, neither the urine nor the sweat can come, as you may plainly and evidently perceive in the dissection of a woman's body that is great with child, not depending on any other man's opinion, be it never so old or inveterate: yet the strength of those membranes is not so great but that they may be soon broken in the birth by the kicking of the child. CHAP. VIII. Of the umbilical vessels, or the vessels belonging to the navel. MAny of the ancient Writers have written that there are five vessels found in the navel. But yet in many, nay all the bodies I sought An old opinion confuted. in for them, I could never find but three, that is to say, one vein, which is very large, so that in the passage thereof it will receive the tag of a point, and two arteries, but not so large, but much narrower, because the child wanteth or standeth in need of much more blood for his conformation and the nutriment or increase of his parts, than of vital spirit. These vessels making the body of the navel, which, as it is thought, is form within nine or ten days, by their doubling and folding, make knots like unto the To what use the knots of the child's navel in the womb serveth. knots of a Franciscan Friars girdle, that staying the running blood in those their knotty windings, they might more perfectly concoct the same: as may be seen in the ejaculatory spermatick vessels, for which use also the length of the navel is half an ell, so that in many infants that are somewhat grown, is is found three or four times doubled about their neck or thigh. As long as the child is in his mother's womb, he taketh his nutriment only by the navel, and not by his mouth, neither doth he enjoy the use of eyes, ears, nostrils The child in the womb taketh his nutriment by his navel, not by his mouth. or fundament, neither needeth he the functions of the heart. For spirituous blood goeth unto it by the arteries of the navel, and into the iliack arteries, and from the iliack arteries unto all the other arteries of the whole body, for by the motion of these only the infant doth breathe. Therefore it is not to be supposed that air is carried or drawn in by the lungs unto the heart, in the body of the child, but chose How the child breatheth. from the heart to the lungs. For neither the heart doth perform the generation or working of blood, or of the vital spirits. For the issue or infant is contented with them as they are made and wrought by his mother. Which, until it hath obtained a full, perfect and whole description of his parts and members, cannot be called a child, but rather an embryo, or an imperfect substance. CHAP. IX. Of the ebullition or swelling of the seed in the womb, and of the concretion of the bubbles or bladders, or the three principal entralls. IN the six first days of conception the new vessels are thought to be made and brought forth of the eminences or cotylidons of the mother's vessels, and dispersed into all the whole seed, as they were fibres or hairy strings. Those as they pierce the womb, so do they equally and in like manner penetrate the tunicle Chorion. And it is carried this way, being a passage not only necessary for the nutriment and conformation of the parts, but also into the veins diversely woven and dispersed into the skin Chorion. For thereby it cometh to pass that the seed itself boileth, and as it were fermenteth or swelleth, not only through occasion of the place, but also of the blood and vital spirits that flow unto it, and then it riseth into the bubbles or bladders, like unto the bubbles which are occasioned by the rain falling into a river or channel full of water. These three bubbles or bladders, are certain rude or new forms or concretions of The three bladders. the three principal entrails, that is to say, of the liver, heart and brain. All this former time it is called seed, and by no other name; but when those bubbles arise, it is When the seed is called an embryo. called an embryo, or the rude form of a body until the perfect conformation of all the members: on the fourth day after that the vein of the navel is form, it sucketh grosser blood, that is, of a more fuller nutriment out of the Cotylidons. And this blood, because it is more gross, easily congeals & curdles in that place, where it ought to prepare the liver fully & absolutely made. For than it is of a notable great Why the live called Parenchyma. bigness above all the other parts, & therefore it is called parenchymas, because it is but only a certain congealing or concretion of blood brought together thither or in that place. From the gibbous part thereof springeth the greater part or trunk of the hollow vein, called commonly vena cava, which doth disperse his small branches, which are like unto hairs, into also the substance thereof: and then it is divided into two branches, whereof the one goeth upwards, the other downwards unto all the particular parts of the body. In the mean season the Arteries of the navel suck spirituous blood out of the eminences or Cotylidons of the mother's arteries, whereof, that is to say, of the more servant and spirituous blood, the heart is form in the second bladder or bubble, being endued with a more fleshy, sound and thick substance, as it behooveth that vessel to be, which is the fountain from whence the heat floweth, and hath a continual motion. In this the virtue formative hath made two hollow places, one on the right side, another on the left. In the right, the root of the hollow vein is infixed or ingraffed, carrying thither necessary nutriment for the heart; in the left is form the stamp or root of an artery, which presently doth divide itself into two branches, the greater whereof goeth upwards to the upper parts, and the wider unto the lower parts, carrying unto all the parts of the body life and vital heat. CHAP. X. Of the third bubble or bladder, wherein the head and the brain is form. THe far greater portion of the seed goeth into this third bubble, that is to say, yielding matter for the conformation of the brain and all the head. For a greater quantity of seed ought to go unto the conformation of the head and brain, because these parts are not sanguine Why the greater portion of goeth into generation of the head and brain. or bloody as the heart and liver, but in a manner without blood; bonny, marrow, cartilaginous, nervous and membranous, whose parts, as the veins, arteries, nerves, ligaments, panicles, and skin, are called spermaticke parts, because they obtain their first conformation almost of seed only: although that afterwards they are nourished with blood, as the other fleshy and musculous parts are. But yet the blood when it is come unto those parts, degenerateth and turneth into a thing somewhat spermatick, by virtue of the assimulative faculty of those parts. All the other parts of the head, form and fashion themselves unto the form of the brain when it is form, and those parts which are situated and placed about it for defence especially, are hardened into bones. The head as the seat of the senses, and mansion of the mind and reason, is situated Why the head is placed on the top of the body. in the highest place, that from thence, as it were from a lofty tower or turret, it might rule and govern all the other members and their functions and actions, that are under it, for there the soul or life which is the rectress or governess is situated; and from thence it floweth and is dispersed into all the whole body. Nature hath framed these three principal entrails as props and sustentations for the weight of all the rest of the body: for which matter also she hath framed the bones. The first bones that appear to be form, or are supposed to be conformed, are the bones called ossa Ilium, connexed or united by spondils that are between them: then all the other members are framed & proportioned by their concavities & hollownesses, which generally are seven, that is to say, two of the ears, two of the nose, one of the mouth, and in the parts beneath the head, one of the fundament, and another of the yard or conduit of the bladder; and furthermore in women, one of the neck of the womb, without the which they can never be made mothers or bear children. When all these are finished, nature, that she might polish her excellent work in all sorts, hath covered all the body and every member thereof with skin. Into this excellent work or Microcosmos so perfected, God, the author of nature and all things, infuseth or ingrafteth a soul or life: which St. Augustine proveth by this sentence Exod. 20. qu. 52. of Moses: If any man smite a woman with child, so that there by she be delivered before her natural time, and the child be dead, being first form in the womb, let him die the death: but if the child hath not as yet obtained the full proportion and conformation of his body and members, let him recompense it with money. Therefore it is not to be thought that the life is derived, propagated or taken from Adam or our parents, as it were an haereditary thing distributed unto all mankind by their parents; but we must believe it to be immediately created of God, even at the very instant time when the child is absolutely perfected in the lineaments of his body, and so given unto it by him. So therefore the rude lumps of flesh called molae that engender in women's The molae in the womb liveth not as the child. wombs, and monsters of the like breeding and confused bigness, although by reason of a certain quaking and shivering motion, they seem to have life, yet they cannot be supposed to be endued with a life or a reasonable soul: but they have their motion, nutriment and increase wholly of the natural and infixed faculty of the womb, and of the generative or procreative spirit that is engrafted naturally in the seed. But even as the infant in the womb obtaineth not perfect conformation before the thirtieth day, so likewise it doth not move before the sixtieth day: at which time it is most commonly not perceived by women, by reason of the smallness of the motion. But now let us speak briefly of the life or soul, wherein consisteth the principal original of every function in the body, and likewise of generation. CHAP. XI. Of the life or soul. THE soul entereth into the body, so soon as it hath obtained a perfect The life goeth not into the mass of seed that doth engender the child, before the body of the child and each part thereof hath his perfect proportion and form. Why the life or soul doth not presently execute all his offices. and absolute distinction and conformation of the members in the womb: which in male children, by reason of the more strong and forming heat which is engrafted in them, is about the fortieth day, and in females about the forty fifth day, in some sooner, and in some later, by reason of the efficacy of the matter working, and plyantnesse or obedience of the matter whereon it worketh. Neither doth the life or soul being thus inspired into the body presently execute or perform all his functions, because the instuments that are placed about it cannot obtain a firm and hard consistence necessary for the lively, but especially for the more divine ministeries of the life or soul, but in a long process of age or time. Those instruments of the soul are vitiated either in the first conformation, as when the form or fashion of the head is sharp upwards or piramydall, as was the head of Thersites, that lived in the time of the Trojan war, and of Triboulet and Tonin, that lived in later years; or also by some casualty, as by the violent handling of the midwife, who by compression, by reason that the scull is then tender and soft, hath caused the capacity of the ventricles that be under the brain to be too narrow for them: or by a fall, stroke, disorder in diet, as by drunkenness, or a fever, which inferreth a lethargy, excessive sleepiness, or a frenzy. Presently after the soul is entered the body, God endueth it with divers and sundry 1 Cor. c. 12. gifts: hereof it cometh that some are endued with wisdom by the spirit; others with knowledge by the same spirit; others with the gift of healing by the same spirit; others with power, dominion and rule; others with prophecy; others with diversities of tongues; and to others other endowments, as it hath pleased the divine providence and bounty of God to bestow upon them, against which no man ought to contend or speak. For it is not meet that the thing form should say unto him that form it, why hast thou made me on this fashion? hath not the Potter power to make of the same lump of clay one vessel to honour and another to dishonour? it is not my purpose, neither belongeth it unto me or any other humane creature to search out the reason of those things, but only to admire them with all humility: But yet I dare affirm this one thing, that a noble and excellent soul neglecteth elementary and transitory things, and is ravished and moved with the contemplation of celestial, which it cannot freely enjoy before it be separated from this earthly enclosure or prison of the body, and be restored unto its original. Therefore the soul is the inward Entelechia or perfection, or the primative cause What the soul or life is. of all motions and functions both natural and animal, and the true form of man. The Ancients have endeavoured to express the obscure sense thereof by many descriptions. For they have called it a celestial spirit, and a superior, incorporeal, invisible, an immortal essence, which is to be comprehended of its self alone, that is, of the mind or understanding. Others have not doubted but that we have our souls inspired by the universal divine mind, which as they are alive, so they do bestow life on the bodies unto whom they are annexed or united. And The life is in all the whole bodies and in every portion thereof. The life or soul is simple and indivisible. although this life be dispersed into all the whole body, and into every portion of the same, yet is it void of all corporal weight or mixtion, and it is wholly and alone in every several part, being simple and indivisible, without all composition or mixture, yet endued with many virtues and faculties, which it doth utter in divers parts of the body: For it feeleth, imagineth, judgeth, remembreth, understandeth, and ruleth all our desires, pleasures and animal motions; it seeth, heareth, smelleth, tasteth, toucheth: and it hath divers names of these so many and so great functions which it performeth in divers parts of the body. It is called the soul or life, because it maketh the body live, which of itself is dead. It is called the spirit or breath, because it inspireth our bodies. It is called reason, because it discerneth truth from falsehood, as it were by a certain divine rule. It is termed the mind, because Divers names, and the reason of divers names that are given to humane forms. it is mindful of things past, in recalling and remembering them: and it is called the vigour or courage, because it giveth vigour and courage to the sluggish weight or mass of the body. And lastly it is called the sense & understanding, because it comprehendeth things that are sensible and intelligible. Because it is incorporeal it cannot occupy a place by corporeal extension, although notwithstanding it filleth the whole body. It is simple, because it is but one in essence, not increased nor diminished: for it is no less in a Dwarf than in a Giant, and it is like perfect and great in an infant as in a man, according to its own nature. But there are three kinds of bodies informed by a soul whereby they live: the Three kinds of living bodies. first being the most imperfect, is of plants, the second of brute beasts, and the third of men. The plants live by a vegitative, beasts by a sensitive, and men by an intellective The superior soul containeth in itself all the powers of the inferior. soul. And as the sensitive soul of brute beasts is endued with all the virtues of the vegetative, so the humane intellective comprehendeth the virtues of all the inferior, not separated by any division, but by being indivisibly united with reason and understanding, into one humane form and soul whereon they depend. But because we have said a little before, that divers functions of the life are resident, and appear in divers parts of the body, here in this place, omitting all others, we will prosecute those only which are accounted the principal. The principal functions of a humane soul, according to the opinion of many, are four in number, proceeding from so many faculties, and consequently from one soul; they are these: The common Sense, Imagination, Reasoning, and Memory. And they think that the common or interior sense doth receive the forms What the common sense is. and images of sensible things, being carried by the spirit through the passage of the The function of the common sense is double. nerves, as an instrument of the external senses, as it were a messenger to go between them; and it serves not only to receive them, but also to know, perceive and discern them. For the eye, wherein the external sense of seeing consisteth, doth not know white or black. Therefore it cannot discern the differences of colours, as neither the tongue tastes, nor the nose savours, nor the ears sounds, nor lastly, the hands their touching quality: yea, the eye doth not of itself perceive that it seeth, nor the nose that it smelleth, nor the ears that they hear, nor the tongue that it tasteth, nor the hands that they touch. For all these things are the offices and functions of the common sense; for this sense knoweth that the eye hath seen some thing, either white, black, red, a man, horse, sheep, or some such like material thing, yea, even when the sight is gone and passed; and so likewise the nose to have smelled this or that savour, the ear to have heard this or that sound, the tongue to have tasted this or that taste, and the hand to have touched this or that thing, be they never so divers. For all the external senses, and all the functions thereof do end and are referred to the common sense, as it were the lines of a circle from the circumference into the centre, as it is expressed in this figure. For which cause it is called the common or principll sense, for that therein the For what cause the internal sense is called the common sense. primitive power of feeling or perceiving is situated, for it useth the ministry or service of the external senses to know many and divers things, whose differences it doth discern and judge, but simple things, that are of themselves, and without any The common sense understandeth or knoweth those things that are simple only. composition and connexion, which may constitute any thing true or false, or any argumentation, belongeth only to the mind, understanding or reason. For this was the counsel of nature, that the external senses should receive the forms of things superficially, lightly and gently only, like as a glass, not to any other end but that they should presently send them unto the common sense, as it were unto their centre and prince, which he (that is to say the common sense) at length delivereth to be collected unto the understanding or reasoning faculty of the soul, which Avicen and Averrois have supposed to be situated in the former part of the brain. Next unto the common sense followeth the fantasy or imagination, so called, What Imagination is. because of it arise the forms and Ideas that are conceived in the mind, called of the Geekes Phantasmata. This doth never rest but in those that sleep: neither always in them, for ofttimes in them it causeth dreams, and causeth them to suppose they see and perceive such things as were never perceived by the senses, nor which the nature of things, nor the order of the world will permit. The power of this faculty of the mind is so great in us, that often it bringeth the whole body in subjection unto it. For it is recorded in history, that Alexander the Great sitting at Table, and hearing Timotheus the Musician sing a martial Sonnet unto his Cithern, that he presently leapt from the table, and called for arms; but when again the Musician mollifyed his tune, he returned to the Table and sat down as before. The power of Imagination caused by musical harmony, was so great, that it subjected to it the courage of the World's conqueror, by whose various motion, it would now as it were cause him to run headlong to arms, and then pacify and quiet him, and so cause him to return to his chair and banqueting again. And there was one whosoever it was, who some few years agone, seeing the Turk dance on a rope on high, with both his feet fastened in a basin, turned his eyes from so dangerous a sight or spectacle, although he came to the place of purpose to see it, and was stricken with such fear, that his body shook and heart quaked, for fear lest that by sudden falling down headlong he should break his neck. Many looking down from an high and lofty place, are so stricken with fear, that suddenly they fall down headlong, being so overcome and bound with the imagination of the danger, that their own strength is not able to sustain them. Therefore it manifestly appeareth that God hath dealt most graciously and lovingly with us, who unto this power of imagination, hath joined another, that is, the faculty or power of reason and understanding; which discerning false dangers and perils from true, doth sustain and hold up a man that he may not be overthrown by them. After this appeareth and approacheth to perform his function, the faculty of What Reason is. Reason, being the Prince of all the principal faculties of the soul; which bringeth together, composeth, joineth and reduceth all the simple and divided forms or images of things into one heap, that by dividing, collecting and reasoning it might discern and try truth from falsehood. This faculty of Understanding or Reason is subject to no faculty or instrument The functions of Reason. of the body, but is free, and penetrateth into every secret, intricate and hidden thing, with an incredible celerity: by which a man seeth what will follow, perceiveth the originals and causes of things, is not ignorant of the proceedings of things, he compareth things that are passed with those that are present and to come, decreeing what to follow, and what to avoid. This bridleth and withholdeth the furious motions of the mind, bridleth the overhasty motions of the tongue, and admonisheth the speaker that before the words pass out of his mouth, he ought with diligence and discretion to ponder and consider the thing whereof he is about to speak. After Reason and Judgement followeth Memory, which keeping and conserving What Memory is. all forms and images that it receiveth of the senses, and which Reason shall appoint, and as a faithful keeper and conserver, receiveth all things, and imprinteth and sealeth them as well by their own virtue and power, as by the impulsion and adherence of those things in the body of the brain, without any impression of the matter; that when occasion serveth, we may bring them forth therehence as out of a treasury or store-house. For otherwise, to what purpose were it to read, hear and note so many things, unless we were able to keep and retain them in mind by the care and custody of the Memory or Brain? Therefore assuredly God hath given us this one only remedy and preservative against the oblivion and ignorance of things, which although of itself and of its own nature it be of greater efficacy, yet by daily and often meditation it is trimmed and made more exquifite and perfect. And hence it was that the Ancients termed wisdom the daughter of memory Wisdom the daughter of memory and experience. and experience. Many have supposed that the mansion or seat of the Memory, is in the hinder part, or in the ventricle of the Cerebellum; by reason that it is apt to receive the forms of things, because of the engrafted dryness and hardness thereof. CHAP. XII. Of the natural excrements in general, and especially of those that the child or infant being in the womb excludeth. BEfore I declare what excrements the infant excludeth in the womb and by what passages, I think it good to speak of the excrements which What an excrement is. all men do naturally void. All that is called an excrement which nature is accustomed to separate and cast out from the laudable and nourishing juice. There are many kinds of those excrements. The first is of the first concoction, which is performed in the stomach, which The excrement of the fist concoction. The excrement of the second concoction is triple. being driven down into the intestines or guts, is voided by the fundament. The second cometh from the liver, and it usually is threefold, or of three kinds; one choleric, whereof a great portion is sent into the bladder of the gall, that by sweeting out there hence, it might stir up the expulsive faculty of the guts to expel and exclude the excrements. The other is like unto whey, which goeth with the blood into the veins, and is as it were a vehicle thereto to bring it unto all the parts of the body, and into every Capillar vein for to nourish the whole body; and after it hath performed that function, it is partly expelled by sweat, and partly sent into the bladder, and so excluded with the urine. The third is the melancholic excrement, which being drawn by the milt, the purer and thinner part thereof goeth into the nourishment of the milt, and after the remnant is partly purged out downwards by the haemorrhoidal veins, and partly sent to the orifice of the stomach, to instimulate and provoke the appetite. The last cometh of the last concoction, which is absolved in the habit of the body, and breatheth out, partly by insensible The excrement of the third concoction is triple. transpiration, is partly consumed by sweeting, and partly floweth out by the evident and manifest passages that are proper to every part: as it happeneth in the brain before all other parts; for it doth unloade itself of this kind of excrement by the passages of the nose, mouth, ears, eyes, palate bone and sutures of the scull. Therefore if any of those excrements be stayed altogether, or any longer than it is meet they should, the default is to be amended by diet and medicine. Furthermore, there are other sorts of excrements not natural, of whom we have entreated at large in our book of the pestilence. When the infant is in the mother's womb, until he is fully and absolutely form The use of the navellstring. in all the liniments of his body, he sends forth his urine by the passage of the navel or urachus. But a little before the time of childbirth, the urachus is closed, and then the man child voideth his urine by the conduit of the yard, and the woman child by the neck of the womb. This urine is gathered together and contained in the coat Chorion or Allantoides, together with the other excrements, that is to say, sweat, & such whayish superfluities of the menstrual matter, for the more easy bearing up of the floating or swimming child. But in the time of childbirth, when The signs of speedy and easy deliverance. the infant by kicking breaketh the membranes, those humous run out, which when the mydwives perceive, they take it as a certain sign that the child is at hand. For if the infant come forth together with those waters, the birth is like to be more easy, and with the better success; for the neck of the womb and all the genitals are so by their moisture relaxed and made slippery, that by the endeavour and stirring of the infant the birth will be the more easy, and with the better success: contratiwise, if the infant be not excluded before all these humours be wholly flowed out and gone, but remaineth as it were in a dry place, presently through dryness the neck of the womb and all the genitals will be contracted and drawn together, so that the birth of the child will be very difficult and hard, unless the neck of the womb, to amend that default, be anointed with oil, or some other relaxing liquor. Moreover, when the child is in the womb, he voideth no excrements by the fundament, unless it be when at the time of the birth, the proper membranes and receptacles are burst by the striving of the infant, for he doth not take his meat at the mouth, wherefore the stomach is idle then, and doth not execute the office of turning the meats into Chylus, nor of any other concoction; wherefore nothing can go down from it into the guts. Neither have I seldom seen infants borne without Children born without a passage in their fundament. any hole in their fundament, so that I have been constrained with a knife to cut in sunder the membrane or tunicle that grew over and stopped it. And how can such excrements be engendered, when the child being in the womb, is nourished with the more laudable portion of the menstrual blood? therefore the issue or child is wont to yield or avoid two kinds or sorts of excrements, so long as he is in the womb, that is to say, sweat and urine, in both which he swims; but they are separated by themselves, by a certain tunicle called Allantoides, as it may be seen in kids, dogs, sheep, and other brute beasts; for as much as in mankind the tunicle Chorion and Allantoides or Farciminalis be all one membrane. If the woman be great of a Aph. 42. sect. 5. man child, she is more merry, strong, and better coloured, all the time of her child bearing, but if of a woman child, she is ill coloured because that women are not so hot as men. The males begin to stir within three months and an half, but females after: if a woman conceive a male child, she hath all her right parts stronger to every work: wherefore they do begin to set forwards their right foot first in going, & when they Aph. 47. sect. 3. arise they lean on the right arm, the right dug will sooner swell and wax hard; the male children stir more in the right side than in the left, and the female children rather in the left than in the right side. CHAP. XIII. With what travel the Child is brought into the world, and of the cause of this labour and travel. WHen the natural prefixed and prescribed time of childbirth is come, the child being then grown greater, requires a greater quantity of food: which when he cannot receive in sufficient measure by his navel, with great labour and striving he endeavoureth to get forth: therefore then free is moved with a stronger violence, and doth break the membranes wherein he is contained. Then the womb, because it is not able to endure such violent motions, nor to sustain or hold up the child any longer, by reason that the conceptacles of the membranes are broken asunder, is relaxed. And then the child Why the infant is borne sometimes with his head forwards. pursuing the air which he feeleth to enter in at the mouth of the womb, which then is very wide and gaping, is carried with his head downwards, and so cometh into the world, with great pain both unto itself, and also unto his mother, by reason of the tenderness of his body, & also by reason of the extension of the nervous neck o●… mother's womb, and separation of the bone called Os Ilium from the bone cal●… Os sacrum. For unless those bones were drawn in sunder, how could In the time of child birth the bones of Ilium and Os sacrum are drawn & extended one from another. not only twins that cleave fast together, but also one child alone, come forth at so narrow a passage as the neck of the womb is? Not only reason, but also experience confirmeth it; for I have opened the bodies of women presently after they have died of travel in childbirth, in whom I have found the bones of Ilium to be drawn the breadth of ones finger from Os sacrum: and moreover, in many unto whom I have been called being in great extremity of difficult and hard travel, I have not only heard, but also felt the bones to crackle and make a noise, when I laid my hand upon the coccyx or rump, by the violence of the distension. Also honest matrons have declared unto me that they themselves, a few days before the birth, have felt and heard the noise of those bones separating themselves one from another with great pain. Also a long time after the birth, many do feel great pain and ache about the region of the coccix and Os sacrum, so that when nature is not able to repair the dissolved continuity of the bones of Ilium, they are constrained to halt all the days of their life after. But the bones of the share called Ossa pubis, I have never seen to be separated, as many do also affirm. It is reported that in Italy they break An Italian fable. the coccyx or rump in all maidens, that when they come to be married they may bear children with the lesser travail in childbirth; but this is a forged tale, for that bone being broken, is naturally and of its own accord repaired, and joined together again with a Callus, whereby the birth of the child will be more difficult and hard. CHAP. XIV. Of the situation of the infant in the womb. REASON cannot show the certain situation of the infant in the womb, for I have found it altogether uncertain, variable and divers both in living The situation of the infant in the womb is divers. and dead women: in the dead by opening their bodies presently after they were dead, and in the living by helping them by the industry of my hand, when they have been in danger of perishing by travel of childbirth: for by putting my hand into the womb, I have felt the infant coming forth, sometimes with his feet forwards, sometimes with his hands, and sometimes with his hands and feet turned backwards, and sometimes forwards, as the figure following plainly describeth. I have often found them coming forth with their knees forwards, and sometimes with one of the feet, and sometimes with their belly forwards, their hands and feet being lifted upwards, as the former figure showeth at large. Sometimes I have found the infant coming with his feet downwards striding awide, and sometimes headlong, stretching one of his arms downward out at length, and that was an Hermaphrodite, as the figure following plainly declareth. One time I observed in the birth of twins, that the one came with his head forwards, and the other with his feet, according as here I have thought good to describe them. In the bodies of women that died in travail of child I have sometimes found children no bigger than if they had been but four months in the womb, situated in a round compass like a hoop, with their head bowed down to the knees, with both their hands under the knees, and their heels close to their buttocks. And moreover, I protest before God that I found a child being yet alive in the body of his mother (whom I opened so soon as she was dead) lying all along stretched out, with his face upwards, and the palms of his hands joined together, as if he were at prayer. CHAP. XV. Which is the legitimate and natural, and which the illegitimate or unnatural time of child birth. TO all living creatures, except man, the time of conception and bringing Mankind hath no certain time of bringing forth young. forth their young is certain and definite; but the issue of man cometh into the world, sometimes in the seventh, sometimes in the eighth, and sometimes, which is most frequent, in the ninth month, sometimes in the tenth month, yea sometimes in the beginning of the eleventh month. Massurius reports that Lucius Papyrius the Praetor, the second heir commencing a suit, gave the possession of the goods away from him, seeing the mother of the child affirmed that she went thirteen months therewith, being there is no certain definite time of childbirth. The child that is borne in the sixth month cannot be long lived, because that at that time all his body or members are not perfectly finished or absolutely form. In the seventh month it is proved by reason and experience that the infant Why the child is scarce alive in the eight month. may be long lived. But in the eight month it is seldom or never long lived: the reason thereof is, as the Astronomers suppose, because that at that time Saturn ruleth, those coldness and dryness is contrary to the original of life: but yet the physical reason is more true; for the physicians say that the child in the womb doth often times in the seaventh month strive to be set at liberty from the enclosure of the womb, and therefore it contendeth and laboureth greatly, and so with labouring and striving it becometh weak, that all the time of the eight month it cannot recover his strength again, whereby it may renew his accustomed use of striving, and that some by such labouring and striving, hurt themselves, and so dye. Yet some strong and lusty women are thought to bring forth their children, being lively and strong, on the eight month, as Aristotle testifieth of the Egyptians, the Poets of the inhabitants of the Isle of Naxus, and many of the Spaniards. Furthermore, I cannot Lib. 4. de hist. anim. cap. 7. sufficiently marvel, that the womb, which all the time of child-bearing is so closed together, that one can scarce put a probe into it, unless it be happily by reason of superfoetation, or when it is open for a short time to purge itself, that presently before the time of childbirth, it should gape and wax so wide, that the infant may pass through it, and presently after it to close again as if it had never been opened. But because that the travel of the first time of childbirth, is wont to be very difficult and grievous, I think it not unmeet that all women, a little before the time of their first travel, anoint and relax their privy parts with the unguent here described. ℞. sper. ceti, ℥ two. ol. amygd. dull. ℥ iv. cerae alb. & medul. cervin. ℥ iii axung. ans. & gallin. an. ℥ i. tereb. venet. ℥ two. make thereof an ointment to anoint the thighs, share, privy parts and genitals. Furthermore, it shall not be unprofitable; to make a truss or girdle of most thin and gentle dog-skinne, which being also anointed with the same unguent, may serve very necessarily for the better carrying of the infant in the womb. Also baths that are made of the decoction of mollifying herbs, are also very profitable to relax the privy parts a little before the time of the birth. That is supposed to be a natural and easy birth, when the infant cometh forth The natural & easy child birth with his head forwards, presently following the flux of the water; and that is more difficult, when the infant cometh with his feet forwards: all the other ways are most difficult. Therefore Midwives are to be admonished that as often as they shall perceive the infant to be coming forth none of those ways, but either with his belly or his back forwards, as it were double, or else with his hands and feet together, or with his head forwards, and one of his hands stretched out, that they should turn it, and draw it out by the feet; for the doing whereof, if they be not sufficient, let them crave the assistance and help of some expert Chirurgeon. CHAP. XVI. Signs of the birth at hand. THere will be great pain under the navel, and at the groins, and spreading therehence towards the Vertebrae of the loins, and then especially when they are drawn back from the Os sacrum, the bones Ilia and the Coccix are thrust outward, the genitals swell with pain, and a certain feaver-like shaking invades the body, the face waxeth red by reason of the endeavour of nature, armed unto the expulsion of the infant. And when these signs appear let all things be prepared ready to the childbirth. Therefore first of all let How the woman that traveleth in childbirth must be placed in her bed. the woman that is in travel be placed in her bed conveniently, neither with her face upwards, nor sitting, but with her back upwards and somewhat high, that she may breathe at more liberty, and have the more power or strength to labour. Therefore she ought to have her legs wide one from another, and crooked, or her heels somewhat bowed uptowards her buttocks, so that she may lean on a staff that must be placed overthwart the bed. There are some that do travel in a stool or chair made for the purpose: others standing upright on their feet, and leaning on the post or pillar of the bed. But you must take diligent heed that you do not exhort or persuade the woman in travel to strive or labour to expel the birth before the forenamed signs thereof do manifestly show that it is at hand. For by such labour or pains she might be wearied or so weakened, that when she should strive or labour, she shall have no power or strength so to do. If all these things do fall out well in the childbirth, the business is to be committed to nature and to the Midwife. And the woman with child must only be admonished that when she feeleth very strong pain, that she presently therewith strive with most strong expression, shutting her mouth and nose if she please, and at the same time let the midwife with her hands force the infant from above downwards. But if the birth be more difficult and painful, by reason An unction to supply the defect of the waters that are flowed out too long before the birth. that the waters wherein the infant lay are flowed out long before, and the womb be dry, this ointment following is to be prepared. ℞. butyri recentis sine sale in aqua artemesiae loti ℥ two. mucaginis ficuum, semin. lini & altheae cum aqua sabinae extractae, an. ℥ ss. olei liliorum ℥ i. Make thereof an ointment, wherewith let the midwife often anoint the secret parts. Also this powder following may be prepared. ℞. cinnamon. cort. cassiae fistul. dictamni an. ʒiss. sacch. albi ad pondus omnium: make thereof a most subtle and fine powder. Let the woman that is in extremity by reason of difficult A powder to cause speedy deliverance in childbirth. and painful travel in childbirth, take half an ounce thereof at a time, with the decoction of linseed, or in white wine, for it will cause more speedy and easy deliverance of the child. Moreover, let the midwife anoint her hands with this ointment following as often as she putteth them into the neck of the womb, and therewith also anoint the parts about it. ℞. olei ex seminibus lint ℥ i. ss. olei de castoreo ℥ ss. moschataeʒiii. Aph. 35. & 45. sect. 5. ladaniʒi. make thereof a lineament. Moreover, you may provoke sneesing, by putting a little pepper or white hellebore in powder into the nostrils. Linseed beaten, and given in a potion, with the water of Mugwort and Savine, is supposed to cause speedy deliverance. Also the medicine following is commended for the same purpose. A potion causing speedy deliverance. ℞. corticis cassiae fistul. conquassatae ℥ two. cicer. rub. m. ss. bulliant cum vino albo & aqua sufficienti, sub finem addendo sabinae, ʒii. cinamomiʒss. crocigr. vi. make thereof a potion, which being taken, let sneesing be provoked, as it is abovesaid, and let her shut or close her mouth and nostrils. Many times it happeneth that the infant cometh into the world ou● of the womb, having his head covered or wrapped about with portion of the ●…dine or tunicle wherein it is enclosed, especially when by the much, strong, and happy striving of the mother, he cometh forth together with the water wherein it lieth in the womb, and then the mydwives prophesy or foretell that the child shall be happy, because he is borne as it were with a hood on his head. But I suppose that it doth betoken health of body both to the infant and also to his mother; for it is a token of easy deliverance. For when the birth is difficult and painful, the child never bringeth that membrane out with him, but it remaineth behind in the passage of the genitals or secret parts, because they are narrow. For even so the Snake or Adder when she would cast her skin thereby to renew her age, creepeth through some narrow or strait passage. Presently after the birth, the woman so delivered must What a woman in travel must take presently after her deliverance. take two or three spoonfuls of the oil of sweet almonds extracted without fire, and tempered with sugar. Some will rather use the yolks of eggs with sugar, some the wine called hippocras, others culliss or jelly: but always divers things are to be used, according as the patient or the woman in childbed shall be grieved, and as the Physician shall give counsel, both to cease and assuage the furious torments and pain of the throws, to recover her strength and nourish her. Throws come presently after the birth of the child, because that then the veins The cause of the after-throwes. (nature being wholly converted to expulsion) cast out the relics of the menstrual matter that hath been suppressed for the space of nine months, into the womb with great violence, which because they are gross, slimy and dreggish, cannot come forth without great pain both to the veins from whence they come, and also unto the womb whereinto they go: also then by the conversion of that portion thereof that remaineth into wind, and by the undiscreete admission of the air in the time of the childbirth, the womb and all the secret parts will swell, unless it be prevented with some digesting, repelling or mollifying oil, or by artificial rolling of the parts about the belly. CHAP. XVII. What is to be done presently after the child is borne. PResently after the child is borne, the midwife must draw away the secundine or after birth, as gently as she can: but if she cannot, let her Why the secundine or afterbirth must be taken away presently after the birth of the child. put her hands into the womb, and so draw it out, separating it from the other parts; for otherwise if it should continue longer, it would be more difficult to be gotten out, because that presently after the birth, the orifice of the womb is drawn together and closed, and then all the secundine must be taken from the child. Therefore the navel string must be tied with a The binding of the child's navel-string after the birth. double thread an inch from the belly. Let not the knot be too hard, lest that part of the navel string which is without the knot should fall away sooner than it ought, neither too slack or loose, lest that an exceeding and mortal flux of blood should follow after it is cut off, and lest that through it (that is to say, the navel string) the cold air should enter into the child's body. When the knot is so made, the navell-string must be cut in sunder the breadth of two fingers beneath it with a sharp knife. Upon the section you must apply a double linen clothe dipped in oil of Roses, or of sweet almonds, to mitigate the pain; for so within a few days after, that which is beneath the knot will fall away, being destitute of life and nourishment, by reason that the vein and artery are tied so close, that no life nor nourishment can come unto it: commonly all mydwives do let it lie unto the bare belly of the infant, whereof cometh grievous pain and griping, by reason of the coldness thereof, which dyeth by little and little, as destitute of vital heat. But it were far better to roll it in soft cotton or lint, until it be mortified, and so fall away. Those mydwives do unadvisedly, who so soon as the infant is borne, do presently tie the navel string and cut it off, not looking first for the voiding of the secundine. When all these things are done, the infant must be wiped, cleansed and rubbed from all filth and excrement with oil of Roses or Myrtles. For thereby the pores of the skin will be better shut, and the habit of the body the more strengthened. There be some that wash infants at that time in warm water and red wine, and afterwards anoint them with the forenamed oils. Others wash them not with wine alone, but boil therein red Roses and the leaves of Myrtles, adding thereto a little salt; and then using this lotion for the space of five or six days, they not only wash away the filth, but also resolve and digest, if there be any hard or contused place in the infant's tender body, by reason of the hard travel and labour in childbirth. Their toes and fingers must be handled, drawn asunder and The defaults that are commonly in children newly borne. bowed, and the joints of the arms and legs must be extended and bowed for many days and often; that thereby that portion of the excremental humour that remaineth in the joints, by motion may be heated and resolved. If there be any default in the members, either in conformation, construction or society with those that are adjoining to them, it must be corrected or amended with speed. Moreover, you must look whether any of the natural passages be stopped, or covered with a membrane, as it often happeneth. For if any such cover or stop the orifices The defaults of conformation must be speedily amended. of the ears, nostrils, mouth, yard or womb, it must be cut in sunder by the Chynurgion, and the passage must be kept open by putting in of tents, pessaries or desels, lest otherwise they should join together again after they are cut. If he have one finger more than he should naturally, if his fingers do cleave close together, like unto the feet of a Goose or Duck, if the ligamental membrane their is under the tongue be more short and stiffer than it ought, that the infant cannot suck, nor in time to come, speak, by reason thereof; and if there be any other thing contrary to nature, it must be all amended by the industry of some expert Chirurgeon. Many times in children newly borne, there sticketh on the inner side of their mouth and on their tongue, a certain chalky substance, both in colour & consistence; this affect proceeding from the distemperature of the mouth, the Frenchmen call it the white Cancer. It will not permit the infant to suck, & will shortly breed & degenerate Remedies for the cancer in a child's mouth. into ulcers that will creep into the jaws, and even unto the throat, and unless it be cleansed speedily, will be their death. For remedy whereof, it must be cleansed by detersives, as with a linen cloth bound to a little stick, and dipped in a medicine of an indifferent consistence made with oil of sweet almonds, honey and sugar. For by rubbing this gently on it, the filth may be mollified, and so cleansed or washed away. Moreover it will be very meet and convenient to give the infant one spoonful of oil of almonds, to make his belly loose and slippery, to assuage the roughness of the weasand and gullet, and to dissolve the tough phlegm, which causeth a cough, and sometimes difficulty of breathing. If the eye lids cleave together, or if they be joined together, or agglutinated to the coats cornea or adnata; if the watery tumour called hydrocephalos affect the head, then must they be cured by the proper remedies formerly prescribed, against each disease. Many from their birth have spots or marks, which the common people of France call Signs, that is, marks or signs. Some of these are plain and equal with the skin, others are raised up into little tumors, and like unto warts, some have hairs upon them, many times they are smooth, black or pale, yet for the most part red. When they arise in the face, they spread abroad thereon many times with great deformity. Many think the cause thereof to be a certain portion of the menstrual matter cleaving to the sides of the womb, coming of a fresh flux, if happily the man do yet use copulation with the woman, or else distilling out of the veins into the womb, mixed and concorporated with the seeds at that time when they are congealed, infecting this or that part of the issue, being drawn out of the seminal body, with their own colour. Women refer the cause thereof unto their longing when they are with child; which may imprint the image of the thing they long for or desire, in the child or issue that is not as yet form (as the force or power of imagination in humane bodies is very great:) but when the child is form, no imagination is able to leave the impression of any thing in it, no more than it could cause horns to grow on the head of King Chypus as he slept An old fable of King Chypus. presently after he was returned from attentively beholding Bulls fight together. Some of those spots be curable, others not; as those that are great, and those that are on the lips, nostrils, and eye lids. But those that are like unto warts, because Which uncurable. they are partakers of a certain malign quality and melancholic matter, which may be irritated by endeavouring to cure them, are not to be meddled with at all, for being troubled and angered, they soon turn into a Cancer (which they call Noli me tangere). Those that are curable are small, and in such parts as they Which and how they are curable. may be dealt withal without danger. Therefore they must be pierced through by the roots with a needle and a thread, and so being lifted up by the ends of the thread, they must be cut away, and the wound that remaineth must be cured according to the general method of wounds. There are some that suppose the red spots that are raised up into little knobs and bunches, may be washed away and consumed by rubbing and anointing them often with menstrual blood, or the blood of the secundine or afterbirth. Those that are hairy and somewhat raised up like unto a Want or Mouse, must be pierced through the roots in three or four places, and straightly bound, so that at length being destitute of life and nutriment, they may fall away: after they are fallen away, the ulcer that remaineth must be cured as other ulcers are. If there be any superfluous flesh remaining, it must be taken away by applying Aegyptiacum, or the powder of mercury, and such like: but if it be doubted that it cometh from the root of the tumour that may happily remain, it must be burned away by the root with oil of vitriol or aqua fortis. There is also an other kind or sort of spots, of a livide or violet colour, coming especially in the face about the lips, with a soft, slack, lax, thin, and unpainefull tumour, and the veins as if they were varicous round about it. This kind of tumour groweth greater when it ariseth on children that are wayward and crying, and in men of riper years that are choleric and angry, and then it will be of a divers colour, like unto a lappet or flap of flesh that hangeth over the Turkey-cocks bill. When they have done crying, or ceased their anger, the tumour will return to his own natural colour again. But you must not attempt to cure it in people that are of these conditions. CHAP. XVIII. How to pull away the secundine or afterbirth. I Suppose that they are called secundines, because they do grieve the woman that is with child the second time, as it were a second birth: Why it is called the secundines. for if there be several children in the womb at once, and of different sexes, they then have every one their several secundines, which thing is very necessary to be known by all mydwives. For they do many times remain behind in the womb when the child is borne, either by reason The causes of the staying of the secundines. of the weakness of the woman in travel, which by contending and labouring for the birth of her child, hath spent all her strength: or else by a tumour rising suddenly in the neck of the womb, by reason of the long and difficult birth, and the cold air unadvisedly permitted to strike into the orifice of the womb. For so the liberties of the ways or passages are stopped and made more narrow, so that nothing can come forth: or else because they are doubled and folded in the womb, and the waters gone out from them with the infant, so that they remain as it were in a dry place: or else because they yet stick in the womb by the knots of the veins and arteries, which commonly happeneth in those that are delivered before their time. For even as apples which are not ripe, cannot be pulled from the tree but by violence; but when they are ripe, they will fall off of their own accord: so the secundine before the natural time of the birth can hardly be pulled away but by violence; but at the prefixed natural time of the birth, it may easily be drawn away. Many and grievous accidents follow the staying of the secundine; as suffocation Accidents that follow the staying of the secandines. of the womb, often swooning, by reason that gross vapours arise from the putrefaction unto the midriff, heart and brain: therefore they must be pulled away with speed from the womb, gently handling the navel, if it may be so possibly done. But if it cannot be done so, the woman must be placed as she was wont The manner of drawing out the 〈…〉 that 〈…〉 after the birth. when that the child will not come forth naturally, but must be drawn forth by art. Therefore the midwife having her hand anointed with oil, must put it gently into the womb, and finding out the navel string, must follow it until it come unto the secundine, and if it do as yet cleave to the womb by the cotylidons, she must shake and move it gently up and down, that so when it is shaked and loosed, she may draw it out gently; but if it should be drawn with violence, it were to be feared lest that the womb should also follow: for by violent attraction some of the vessels, and also some of the nervous ligaments, whereby the womb is fastened on each side, may be rend, whereof followeth corruption of blood shed out of the vessels, and thence cometh inflammation, an abscess or a mortal gangrene. Neither is there less danger of a convulsion by reason of the breaking of the nervous The cause of the falling down of the womb. bodies, neither is there any less danger of the falling down of the womb. If that there be any knots or clods of blood remaining together with the secundine, the midwife must draw them out one by one, so that not any may be left behind. Some women have veyded their secundine, when it could not be drawn forth by any means, long after the birth of the child, by the neck of their womb, piecemeal, Thr accidents that come of the 〈◊〉 pulling 〈…〉 the womb, together 〈◊〉 〈◊〉 secundine. rotten and corrupted, with many grievous and painful accidents. Also it shall be very requisite to provoke the endeavour of the expulsive faculty by sternutatories, aromatic fomentations of the neck of the womb, by mollifying injections: and chose, by applying such things to the nostrils as yield a rank savour or smell, with a potion made of mugwort and bay berries taken in honey and wine mixed together, or with half a dram of the powder of savine, or with the hair of a woman's head, burnt and beaten to powder, and given to drink; and to conclude, with all things that provoke the terms or courses. CHAP. XIX. What things must be given to the infant by the mouth, before he be permitted to suck the Teat or Dug. IT will be very profitable to rub all the inner side of the child's To draw phlegm from the child's mouth. mouth and palate gently with treacle and honey, or the oil of sweet almonds extracted without fire, and if you can, to cause it to swallow some of those things: for thereby much phlegmatic moisture will be drawn from the mouth, and also will be moved or provoked to be vomited up from the stomach; for if these excremental humours should be mixed with the milk that is sucked, they would corrupt it, and then the vapours that arise from the corrupted milk unto the brain would infer most pernicious accidents. And you may know that there are many excremental things in the stomach and guts of children by this, because that so soon as they come into the world, and often before they suck milk or take any other thing, they void downwards many excrements diversely coloured, as yellow, green, and black. Therefore many, that they may speedily evacuate the matter that causeth the fretting of the guts, do not only minister Milk soon corrupted in a phlegmatic stomach. those things forenamed, but also some laxative syrup, as that that is made of damask Roses. But before the infant be put to suck the mother, it is fitting to press some milk out of her breast into its mouth, that so the fibres of the stomach may by little and little accustom themselves to draw in the milk. CHAP. XX. That mothers ought to nurse or give suck unto their own children. THat all mothers would nurse their own children were greatly The mother's milk is most similiar for the child. to be wished: for the mother's milk is far more familiar nourishment for the infant than that of any other nurse: for it is nothing else but the same blood made white in the dugs, wherewith before it was nourished in the womb. For the mother ought not to give the child suck for the space of a few days after the birth, but first to expect the perfect expurgation and avoiding of the excremental humours. And in the mean time let her cause her breasts to be sucked of another, or many other children, or of some wholesome or sober maid, whereby the milk may be drawn by little and little unto her breasts, and also by little and little purified. For a certain space after the birth, the milk will be troubled, and the humours of the body moved: so that by long staying in the dugs, it will seem to degenerate from its natural goodness, as the grossness of it is somewhat congealed, the manifest heat in touching, and the yellow colour thereof testifieth evidently. Therefore it is necessary that others should come in place thereof when it is sucked The disease of the nurse is participated unto the child. out, wherewith the infant may be nourished. But if the mother or the nurse chance to take any disease, as a Fever, Scouring, or any such like, let her give the child to another, to give it suck, lest that the child chance to take the nurse's diseases. And moreover, mothers ought to nurse their own children, because for the most part they are far more vigilant and careful in bringing up and attending their children, than hired and mercenary nurses, which do not so much regard the infant, as the gain they shall have by the keeping of it, for the most part. Those that do not nurse their own children, cannot rightly be termed mothers: for they do not absolutely perform the duty of a mother unto their child, as Marcus Aurelius Gel. lib. 12. ca 1. the Roman Emperor was wont to say. For this is a certain unnatural, imperfect and half kind of a mother's duty, to bear a child, and presently to abandon or put it away as if it were forsaken: to nourish and feed a thing in their womb (which they neither know nor see) with their own blood, and then not to nourish it when they see it in the world alive, a creature or reasonable soul, now requiring the help and sustentation of the mother. CHAP. XXI. Of the choice of Nurses. MAny husbands take such pity on their tender wives, that they provide nurses for their children, that unto the pains that they have sustained in bearing them, they may not also add the trouble of nursing them: wherefore such a nurse must be chosen which hath had two or three children. For the dugs which have been already sucked and accustomed to be filled, have the veins and arteries more large and capable to receive the more milk. In the choice of a nurse there are ten things to be considered very diligently: as, her age, the habit of her body, her behaviour, the condition of her milk, the form, not only of her dugs or breasts, but also of her teats or nipples, the time from her childbirth, the sex of her last infant or child, that she be not with child, that she be sound and in perfect health. As concerning her age, she ought not to be under twenty five years, nor above thirty five: the The best age of a nurse. time that is between is the time of strength, more temperate, and more wholesome and healthy, and less abounding with excremental humours. And because her body doth not then grow or increase, she must of necessity have the more abundance of blood. After thirty five years in many the menstrual fluxes do cease, and therefore it is to be supposed that they have the less nutriment for children. The nurse must also be of a good habit, or square or well set body, her breast broad, her colour lively, not fat, nor lean, but well made, her flesh not soft and tender, but The best habit of body in a autse. thick, and hard or strong, whereby she may be the more able to endure watching & taking of pains about the child; she must not have a red or freckled face, but brown or somewhat shadowed or mixed with redness: for truly such women are more hot than those that are red in the face, by reason whereof they must needs concoct and turn their meat the better into blood. For according to the judgement of Sextus Cheronensis, as blackish or brown ground is more fertile than the white; even so a Lib. de inf. nutr. brown woman hath more store of milk. You must look well on her head, lest she should have the scurf or running sores; see that her teeth be not foul or rotten, nor her breath stinking, nor no ulcer nor sore about her body, and that she be not borne of gouty or leprous Parents. She ought to be quick and diligent in keeping the child neat and clean, Of what behaviour the nurse must be. chaste, sober, merry, always laughing and smiling on her infant, often singing unto it, and speaking distinctly and plainly, for she is the only mistress to teach the child to speak. Let her be well mannered, because the manners of the nurse are participated unto the infant together with the milk. For the welpes of dogs, if they do suck Wolves or Lionesses, will become more fierce and cruel than otherwise they would. chose, the Lion's whelps will leave their savageness and fierceness, if that they be brought up and nourished with the milk of any Bitch, or other tame beast. If a Coat give a Lamb suck, the same Lamb's wool will be more hard than others: chose, if a Sheep give a Kid suck, the same Kyds' hair will be more soft than another Kyds' hair. She ought to be sober, and the rather for this cause, because many nurses being overloaden with wine & banqueting, often set their children unto their breasts to suck, and then fall asleep, and so suddenly strangle or choke them. She must abstain from copulation: for copulation troubleth and moveth the Why the nurse must abstain from copulation. humours and the blood, and therefore the milk itself; and it diminisheth the quantity of milk, because it provoketh the menstrual flux, and causeth the milk to have a certain strong and virous quality, such as we may perceive to breathe from them that are incensed with the fervent lust and desire of venery. And moreover, because that thereby they may happen to be with child, whereof ensueth discommodity both to her own child that is within her body, and also to the nurse child: to the nurse child, because that the milk that it sucketh will be worse and more depraved than otherwise it would be, by reason that the more laudable blood after the conception remaineth about the womb, for the nutriment and increasing of the infant in the womb; and the more impure blood goeth into the dugs, which breedeth impure or unclean milk: but to the conceived child, because it will cause it to have scarcity of food; for, so much as the sucking child sucketh, so much the child conceived in the womb, wanteth. Also she ought to have a broad breast, and her dugs indifferently big, not What dugs a nurse ought to have. slack or hanging; but of a middle consistence, between soft and hard; for such dugs will concoct the blood into milk the better, because that in firm flesh the heat is more strong and compact. You may by touching try whether the flesh be solid and firm, as also by the dispersing of the veins, easily to be seen by reason of their swelling and blueness, through the dugs, as it were into many streams or little rivelers; for in flesh that is loose and slack, they lie hidden. Those dugs that are of a competent bigness, receive or contain no more milk than is sufficient to nourish the infant. In those dugs that are great and hard, the milk is as it were suffocated, stopped or bound in, so that the child in sucking can scarce draw it out: and moreover, if the dugs be hard, the child putting his mouth to the breast, may strike his nose against it, and so hurt it, whereby he may either refuse to suck, or if he doth proceed to suck, by continual sucking, and placing of his nose on the hard breast, it may become flat, and the nostrils turned upwards, to his great deformity, when he shall come to age. If the teats or nipples of the dugs do stand somewhat low or depressed inwards on the tops of the dugs, the child can hardly take them between its lips, therefore his sucking will be very laborious. If the nipples or teats be very big, they will so fill all his mouth, that he cannot well use his tongue in sucking or in swallowing the milk. We may judge of or know the nature and condition of the milk, by the quantity, What is to be observed in the milk. quality, colour, savour and taste: when the quantity of the milk is so little, that it will not suffice to nourish the infant, it cannot be good and laudable; for it argueth some distemperature either of the whole body, or at least of the dugs, especially a hot and dry distemperature. But when it superaboundeth, and is more than the infant can spend, it exhausteth the juice of the nurse's body; and when it cannot all be drawn out by the infant, it cluttereth, and congealeth or corrupteth in the dugs. Yet I would rather wish it to abound, than to be defective, for the superabounding quantity may be pressed out before the child be set to the breast. That milk that is of a mean consistence between thick and thin, is esteemed The laudable consistence of milk. to be the best. For it betokeneth the strength and vigour of the faculty that engendereth it in the breasts. Therefore if one drop of the milk be laid on the nail of ones thumb, being first made very clean and fair, if the thumb be not moved, and it run off the nail, it signifieth that it is watery milk: but if it stick to the nail, although the end of the thumb be bowed downwards, it showeth that it is too gross and thick: but if it remain on the nail so long as you hold it upright, and fall from it when you hold it a little aside or downwards by little and little, it showeth it is very good milk. And that which is exquisitely white, is best of all. For the milk is no other thing than blood made white. Therefore, if it be of any other colour, it argueth a default in the blood: so that Why the milk ought to be very white. if it be brown, it betokeneth melancholy blood; if it be yellow, it signifieth choleric blood; if it be won and pale, it betokeneth phlegmatic blood; if it be somewhat hat red, it argueth the weakness of the faculty that engendereth the milk. It ought to be sweet, fragrant, and pleasant in smell; for if it strike into the nostrils with a certain sharpness, as for the most part the milk of women that have red Why a woman that hath red hair, or freckles on her face cannot be a good nurse. hair and little freckles on their faces doth, it prognosticates a hot and choleric nature: if with a certain sourness, it portendeth a cold and melancholy nature. In taste it ought to be sweet, and as it were sugared, for the bitter, saltish, sharp, and styptic, is naught. And here I cannot but admire the providence of nature, which hath caused the blood wherewith the child should be nourished to be turned into milk: which unless it were so, who is he that would not turn his face from, and abhor so grievous and terrible a spectacle of the child's mouth so imbrued and besmeared with blood? What mother or nurse would not be astonished or amazed at every moment with the fear of the blood so often shed out, or sucked by the infant for his nourishment? Moreover, we should want two helps of sustentation, that is to say, butter and cheese. Neither ought the child to be permitted to suck within five or six days after it is borne, both for the reason before alleged, and also because he hath need of so much time to rest quiet, and ease himself after the pains he hath sustained in his birth: in the mean season the mother must have her breasts drawn by some maid that drinketh no wine, or else she may suck or draw them herself with an artificial instrument which I will describe hereafter. That nurse that hath borne a man child is to be preferred before another, because Why that nurse that hath borne a man child is to be preferted before another. her milk is the better concocted, the heat of the male child doubling the mother's heat. And moreover, the women that are great with child of a male child, are better coloured, and in better strength, and better able to do any thing all the time of their greatness, which proveth the same: and moreover the blood is more laudable, and the milk better. Furthermore, it behoveth the Nurse to be brought on bed, or to travel at her just and prefixed or natural time: for when the Why she cannot be a good nurse whose child was born before the time. child is born before his time of some inward cause, it argueth that there is some default lurking and hidden in the body and humours thereof. CHAP. XXII. What diet the Nurse ought to use, and in what situation she ought to place the infant in the cradle. BOth in eating, drinking, sleeping, watching, exercising and resting, the nurse's diet must be divers, according as the nature of the child both in habit and temperature shall be: as for example, if the child be altogether of a more hot blood, the nurse both in feeding and ordering herself aught to follow a cooling diet. In general, let her eat meats of good juice, moderate in quantity and quality, let her live in a pure and clear air, let her abstain from all spices, and all salted and spiced meats, and all sharp things, wine, especially that which is not allayed or mixed with water, and carnal copulation with a man, let her avoid all perturbations of the mind, but anger especially, Anger greatly hurteth the nurse. The exercise of the arms is best for the nurse. How the child should be placed in the cradle. let her use moderate exercise, unless it be the exercise of her arms and upper parts, rather than the legs and lower parts, whereby the greater attraction of the blood, that must be turned into milk, may be made towards the dugs. Let her place her child so in the cradle that his head may be higher than all the body, that so the excremental humours may be the better sent from the brain unto the passages that are beneath it. Let her swath it so as the neck and all the backbone may be strait and equal. As long as the child sucketh, and is not fed with stronger meat, it is better to lay him always on his back, than any other way, for the back is, as it were the Keel in a ship, the groundwork and foundation of all the whole body, whereon the infant may safely and easily rest. But if he lie on the side, it were danger lest that the bones of the ribs being soft and tender, not strong enough, and united with slack bands, should bow under the weight of the rest, and so wax crooked, whereby the infant might become crookebacked. But when he beginneth to breed teeth, and to be fed with more strong meat, and also the bones and connexion's of them begin to wax more firm and hard, he must be laid one while on this side, another while on that, and now and then also on his back. And the more he groweth, the more let him be accustomed to lie on his sides; and as he lieth in the cradle, let him be turned unto that place whereat the light cometh in, lest that otherwise he might become poore-blind, for the eye of its own nature is bright and light-some, and therefore always desireth the light, and abhorreth darkness, for all things are most delighted with their like, and shun their contraries. Therefore unless the light come directly into the child's face, he turneth himself every way being very sorrowful, and striveth to turn his head and eyes that he may have the light; and that often turning and rolling of his eyes at length groweth into a custom that cannot be left: and so it cometh to pass that the infant doth either become poore-blind, if he set his eyes steadfastly on one thing, or else his eyes do become trembling, always turning and unstable, if he cast his eyes on many things that are round about him: which is the reason that nurses, being taught by experience, Why an arch of wickers must be made over the child's head lying in the cradle. Why a squinteyed nurse causeth the child to be squinteyed. cause over the head of the child lying in the cradle, an arch or vault of wickers covered with cloth to be made, thereby to restrain, direct, and establish the uncertain and wandering motions of the child's eyes. If the nurse be squinteyed, she cannot look upon the child but sideways, whereof it cometh to pass that the child being moist, tender, flexible and prone to any thing with his body, and so likewise with his eye, by a long and daily custom unto his nurse's sight, doth soon take the like custom to look after that sort also, which afterwards he cannot leave or alter. For those evil things that we learn in our youth, do stick firmly by us, but the good qualities are easily changed into worse. In the eyes of those that are squinteyed, those two muscles which do draw the eyes to the greater or lesser corner, are chiefly or more frequently moved. Therefore either of these being confirmed in their turning aside by long use, as the exercise of their proper office increaseth the strength, soon overcomes the contrary or withstanding muscles, called the Antagonists, and brings them into their subjection, so that will they nill they, they bring the eye unto this or that corner as they list. So children become lefthanded, How children become lefthanded. when they permit their right hand to languish with idleness and sluggishness, and strengthen their left hand with continual use and motion to do every action therewithal, and so bring by the exercise thereof, more nutriment unto that part. But if men (as some affirm) being of ripe years and in their full growth, by daily society and company of those that are lame and halt do also halt, not minding so to do, but it cometh against their wills and when they think nothing thereof, why should not the like happen in children, whose soft and tender substance is as flexible and pliant as wax unto every impression? Moreover, children, as they become lame and crook-backt, so do they also become squinteyed by the hereditary default of their parents. CHAP. XXIII. How to make pap for children. Pap is a most meet food or meat for children, because they require moist nourishment, and it must be answerable in thickness to the Three laudable conditions of pap How the meal must be prepared to make the pap withal. Why the meal wherewith the pap must be made, must first be boiled or baked. milk, that so it may not be difficult to be concocted or digested. For pap hath these three conditions, so that it be made with wheaten flower, and that not crude but boiled: let it be put into a new earthen pot or pipkin, and so set into an oven at the time when bread is set thereinto to be baked, and let it remain there until the bread be baked and drawn out; for when it is so baked it is less clammy and crude. Those that mix the meal crude with the milk, are constrained to abide one of these discommodities or other, either to give the meal gross & clammy unto the child, if that the pap be only first boiled over the fire in a pipkin or skillet so long as shall be necessary for the milk; hence come obstructions in the mesaraike veins, and in the small veins of the liver, fretting and worms in the guts, and the stone in the reins. Or else they give the child the milk, despoiled of its butterish and whayish portion, and the terrestrial and cheeselike or curdlike remaining, if the pap be boiled so long as is necessary for the meal: for the milk requireth not so great, neither can it suffer so long boiling as the meal. Those that do use crude meal, and have no hurt by it, are greatly bound to nature for so great a benefit. But Galen willeth children to be nourished only with the nurse's milk, so long as the nurse hath enough to nourish 1. de sanit. 〈◊〉. and feed it. And truly there are many children that are contented with milk only, and will receive no pap until they are three months old. If the child at any time be costive, and cannot void the excrements, let him have a cataplasm made with one dram of Aloes, of white and black Hellebore, of each fifteen grains, being A cataplasm to relax the child's belly. all incorporated in as much of an ox gall as is sufficient, and extended or spread on cotton like unto a pultis, as broad as the palm of ones hand, and so apply it upon the navel warm: moreover, this cataplasm hath also virtue to kill the worms in the belly. Many times children have fretting of the guts, that maketh them to cry, For the fretting of the guts in children. which cometh of crudity. This must be cured by applying unto the belly sweaty or moist wool, macerated in oil of chamomile. If when the child's teeth begin to grow, he chance to bite the nipple of the nurse's breast, there will be an ulcer very contumacious and hard to be cured, because that the sucking of the child, and the rubbing of the clothes do keep it always raw; it For the ulcers of the nipples or teats. must be cured with fomenting it with allome water, and then presently after the fomentation putting thereupon a cover of lead, made like unto a hat, as they are here described, with many holes in the top, whereat both the milk, and also the sanious matter that cometh from the ulcers may go out, for lead itself will cure ulcers. The figure of leaden Nipples to be put upon the Nipple or Teat of the Nurse when it is ulcerated. Children may be caused to cease their crying four manner of ways, that is to say, by giving them the teat, by rocking them in a cradle, by singing unto them, and by changing the clothes and swaths wherein they are wrapped. They must not be rocked too violently in the cradle, lest that the milk that is sucked should be corrupted by the too violent motion, by reason whereof they must not be handled violently any other way, and not altogether prohibited or not suffered to cry. For by crying the breast and lungs are dilated and made bigger and wider, the natural parts What moderate crying worketh in the infant. the stronger, and the brain, nostrils, the eyes and mouth are purged, by the tears and filth that come from the eyes and nostrils. But they must not be permitted What immoderate crying causeth. to cry long or fiercely, for fear of breaking the production of the Peritonaum, and thereby causing the falling down of the guts into the cod, which rupture is called of the greeks Enterocele, or of the call, which the greeks call Epiplocele. CHAP. XXIIII. Of the weaning of children. MAny are weaned in the eighteenth month, some in the twentieth, but all, or the most part, in the second year, for then their teeth appear, When children must be weaned by whose presence nature seemeth to require some harder meat than milk or pap, wherewith children are delighted, and will feed more earnestly thereon. But there is no certain time of weaning of children. For the teeth of some will appear sooner, and some later; for they are prepared of nature for no other purpose than to chaw the meat. If children be weaned before Why children must not be weaned before their 〈◊〉▪ appear. their teeth appear, and be fed with meat that is somewhat hard and solid, according to the judgement of Avicen, they are incident to many diseases coming through crudity, because the stomach is yet but weak, and wanteth that preparation of the meats which is made in the mouth by chawing; which men of ripe years cannot want without offence: when the child is two years old, and the teeth appear, How children must be weaned. if the child more vehemently desire harder meats, and doth feed on them with pleasure & good success, he may be safely weaned, for it cannot be supposed that he hath this appetite of hard meats in vain, by the instinct of nature. Yet he may not be weaned without such an appetite, if all other things be correspondent, that is to say, his teeth and age, for those things that are eaten without an appetite, cannot profit. But if the child be weak, sickly, or feeble, he ought not to be weaned. And when the meet time of weaning cometh, the nurse must now and then use him to the teat, whereby he may leave it by little and little, and then let the teat be anointed or rubbed with bitter things, as with Aloes, water of the infusion of Colocynthus, or wormwood, or with mustard, or soot steeped in water, or such like. Children What children are strong and found of body. that are scabby in their heads, and over all their bodies and which void much phlegm at their mouth and nostrils, and many excrements downwards, are like to be strong and sound of body; for so they are purged of excremental humours: chose, those that are clean and fair of body, gather the matter of many diseases in their bodies, which in process of time will break forth and appear. Certainly by the An often cause of sudden crookedness. sudden falling of such matters into the backebone, many become crookebackt. CHAP. XXV. By what signs it may be known whether the child in the womb be dead or alive. IF neither the Chirurgeons hand, nor the mother can perceive the A most certain sign of the child dead in the womb. infant to move, if the waters be flowed out, and secundine come forth, you may certainly affirm that the infant is dead in the womb, for this is the most infallible sign of all others: for because the child in the womb doth breathe but by the artery of the navel, and the breath is received by the Cotyledon of the arteries of the womb, it must of necessity come to pass that when the secundine is separated from the infant, no air or breath can come unto it. Wherefore so often as the secundine is excluded before the child, you may take it for a certain token of the death thereof: when the child is dead, it will be more heavy to the mother than it was before when it was alive, because it is now no more sustained by the spirits and When the child is dead in the womb he is more heavy than he was before being alive. faculties wherewith before it was governed and ruled, for so we see dead men to be heavier than those that are alive, & men that are weak through hunger and famine to be heavier than when they are well refreshed, and also when the mother inclines her body any way, the infant falleth that way also even as it were a stone. The mother is also vexed with sharp pain from the privities even to the navel, with a perpetual desire of making water, and going to stool, because that nature is wholly busied in the expolsion or avoidance of that which is dead: for that which is alive will expel That which is alive will not suffer that which is dead. the dead so far as it can from itself, because the one is altogether different from the other; but likeness, if any thing, conjoins and unites things together: the genitals are cold in touching, and the mother complaineth that she feeleth a coldness in her womb, by reason that the heat of the infant is extinguished, wherewith before her heat was doubled: many filthy excrements come from her, and also the mother's breath stinketh, she swouneth often, all which for the most part happen within three days after the death of the child: for the infant's body will sooner corrupt in the mother's womb than it would in the open air, because that, according to the judgement of Galen, all hot and moist things, being in like manner enclosed in a hot Lib. de tumorib. and moist place, especially if by reason of the thickness or straitness of the place they cannot receive the air, will speedily corrupt. Now by the rising up of such vapours from the dead unto the brain and heart, such accidents may soon follow, her face will be clean altered, seeming livid and ghastly, her dugs fall and hang loose and lank, and her belly will be more hard and swollen than it was before. In all bolies so putrefying, the natural heat vanisheth away, and in place thereof succeedeth Why the belly of a woman will be more big when the child is dead within her, than it was before, when it was alive. a preternatural, by the working whereof the putrefyed and dissolved humours are stirred up into vapours, and converted into wind, and those vapours, because they possess and fill more space and room (for naturalists say that of one part of water ten parts of air are made) do so puff up the putrefyed body into a greater bigness. You may note the same thing in bodies that are gangrenate, for they cast forth many sharp vapours, yet nevertheless they are swollen and pufted up. Now so soon as the Chirurgeon shall know that the child is dead by all these forenamed signs, he shall with all diligence endeavour to save the mother so speedily as he can, and if the Physicians cannot prevail with potions, baths, fumigations, sternutatories, vomits, and liniments appointed to expel the infant, let him prepare himself to the work following; but first let him consider the strength of the woman, for if he perceive that she be weak and feeble by the smallness of her The signs of a woman that is weak. pulse, by her small, seldom and cold breathing, and by the altered and deathlike colour in her face, by her cold sweats, and by the coldness of the extreme parts, let him abstain from the work, and only affirm that she will dye shortly; chose, if her strength be yet good, let him with all confidence and industry deliver her on this wise from the danger of death. CHAP. XXVI. Of the v extraction of the child from the womb either dead or alive. THerefore first of all the air of the chamber must be made temperate, and reduced unto a certain mediocrity, so that it may neither After what sort the woman in travel must be placed when the child, being dead in her womb, must be drawn out. be too hot nor too cold. Then she must be aptly placed, that is to say, overthwart the bed side, with her buttocks somewhat high, having a hard stuffed pillow or bolster underthem, so that she may be in a mean figure of situation, neither sitting altogether upright, nor altogether lying along on her back; for so she may rest quietly, and draw her breath with ease, neither shall the ligaments of the womb be extended so as they would if she lay upright on her back, her heels must be drawn up close to her buttocks, and there bound with broad and soft linen rulers. The rowler must first come about her neck, and then crossewise over her shoulders, How she must be bound. and so to the feet, and there it must cross again, and so be rolled about the legs and thighs, and then it must be brought up to the neck again, and there made fast, so that she may not be able to move herself, even as one should be tied when he is to be cut of the stone. But that she may not be wearied, or lest that her body should yield or sink down as the Chirurgeon draweth the body of the infant from her, and so hinder the work, let him cause her feet to be set against the side of the bed, and then let some of the strong standers by hold her fast by the legs and shoulders. How the Chirurgeon ought to prepare himself and his patient to the drawing out of the child from the womb. Then that the air may not enter into the womb, and that the work may be done with the more decency, her privy parts & thighs must be covered with a warm double linen cloth. Then must the Chirurgeon, having his nails closely pared, and his rings (if he wear any) drawn off his fingers, and his arms naked, bare, and well anointed with oil, gently draw the flappes of the neck of the womb asunder, and then let him put his hand gently into the mouth of the womb, having first made it gentle and slippery with much oil; and when his hand is in, let him find out the form and situation of the child, whether it be one or two, or whether it be a Mole or not. And when he findeth that he cometh naturally, with his head toward the How the infant that is dead in the womb must be turned, bound and drawn out. mouth or orifice of the womb, he must lift him up gently, and so turn him that his feet may come forwards, and when he hath brought his feet forwards, he must draw one of them gently out at the neck of the womb, and then he must bind it with some broad and soft or silken band a little above the heel with an indifferent slack knot, and when he hath so bound it, he must put it up again into the womb, than he must put his hand in again, and find out the other foot, and draw it also out of the womb, and when it is out of the womb, let him draw out the other again whereunto he had before tied the one end of the band, and when he hath them both out, let him join them both close together, & so by them by little & little let him draw all the whole body from the womb. Also other women or Midwives may help the endeavour of the Chirurgeon, by pressing the patient's belly with their hands downwards as the infant goeth out: and the woman herself by holding her breath, and closing her mouth and nostrils, and by driving her breath downwards with great violence, may very much help the expulsion. I wish him to put back the foot into the womb again after he hath tied it, because if that he should permit it to remain in the neck of the womb, it would hinder the entrance of his hand when he putteth it in to draw out the other. But if there be two children in the womb at once, let the Chirurgeon take heed lest that he take not of either of them a leg, for by drawing them so, he shall profit nothing at all, and yet exceedingly hurt the woman. Therefore that he may not be so deceived, when he hath drawn out one foot and tied it, and put it up again, let him with his hand follow the band wherewithal the foot is tied, and so go unto the foot, and then to the groin of the child, and then from thence he may soon find out the other foot of the same child: for if it should happen otherwise, he might draw the legs and the thighs out, but it would come no further, neither is it meet that he should come out with his arms along by his sides, or be drawn out on that sort, but one of his arms must be stretched out above his head, and the other down by his side, for otherwise the orifice of the womb when it were delivered of such a gross trunk, as it would be when his body should A caution to avoid strangling of the infant in drawing out the body. be drawn out with his arms along by his sides, would so shrink and draw itself when the body should come unto the neck, only by the accord of nature requiring union, that it would strangle and kill the infant, so that he cannot be drawn there-hence unless it be with a hook put under, or fastened under his chin, in his mouth, or in the hollowness of his eye. But if the infant lieth as if he would come with his hands forwards, or if his hands be forth already, so that it Why the child must not be drawn out with his hands forwards. A history. may seem he may be drawn forth easily that way, yet it must not be so done; for so his head would double backwards over his shoulders, to the great danger of his mother. Once I was called unto the birth of an infant, whom the midwives had assayed to draw out by the arm, so that the arm had been so long forth that it was gangrenate, whereby the child died; I told them presently that his arm must be put in again, and he must be turned otherwise. But when it could not be put back by reason of the great swelling thereof, and also of the mother's genitals, I determined to cut it off with an incision knife, cutting the muscles as near as I could to the shoulder, yet drawing the flesh upwards, that when I had taken off the bone with a pair of cutting pincers, it might come down again to cover the shivered end of the bone, lest otherwise when it were thrust in again into the womb, it might hurt the mother. Which being done, I turned him with his feet forwards, and drew him out as is before said. But if the tumour either naturally or by some accident, that is to say, by putrefaction, which may perchance come, be so great that he cannot be turned according to the Surgeon's intention, nor be drawn out according as he lieth, the tumour must be diminished, and then he must be drawn out as is aforesaid, and that must be done at once. As for example, To diminish the wind wherewith the infant being dead in the womb, swolleth & is pufted up that he cannot be gotten out of the womb. if the dead infant appear at the orifice of the womb, which our mydwives call the Garland, when it gapeth, is open and dilated, but yet his head being more great and puffed up with wind so that it cannot come forth, as caused to be so through that disease which the Greeks call Mucrophisocephalos, the Chirurgeon must fasten a hook under his chin, or in his mouth, or else in the hole of his eye, or else, which is better and more expedient, in the hinder part of his head. For when the scull is so opened, there will be a passage whereat the wind may pass out, and so when the tumour falleth and decreaseth, let him draw the infant out by little and little, but not rashly, lest he should break that whereon he hath taken hold: the figure of those hooks is thus. The form of hooks for drawing out the infant that is dead in the womb. But if the breast be troubled with the like fault, the hooks must be fastened about the channel bone: if there be a Dropsy or a Tympany in the belly, the hooks must be fastened either in the short ribs, that is to say, in the muscles that are between the ribs, or especially, if the disease do also descend into the feet, about the bones that are above the groin; or else putting the crooked knife here pictured i●…he womb with his left hand, let him make incision in the child's belly, and so get out all his entrails by the incision, for when he is so bowelled, all the water that caused the dropsy will out. But the Chirurgeon must do none of all these things but when the child is dead, and the woman that traveleth in such danger that she cannot otherwise be holpen. But if by any means it happeneth that all the infant's members be cut away by How the head of the infant, if it remain in the womb separated from the body, may be drawn out. little and little, and that the head only remaineth behind in the womb, which I have sometimes against my will, and with great sorrow seen, than the left hand being anointed, with oil of Lilies or fresh butter must be put into the womb, wherewith the Chirurgeon must find out the mouth, putting his fingers into it; then with his right hand he must put up the hook, according to the direction of the left hand, gently, & by little & little, and so fasten it in the mouth, eye, or under the chin, and when he hath firmly fixed or fastened it, he must therewith draw out the head by little and little, for fear of loosening or breaking the part whereon he hath hold. In stead of this hook you may use the instruments that are here described, which therefore I have taken out of the Chirurgery of Francis Dalechamps, for they are so made, that they may easily take hold of a spherical and round body with the branches, as with fingers. Griffins Talons, that is to say, instruments made to draw out the head of a dead infant that is separated in the womb from the rest of the body. But it is not very easy to take hold on the head when it remaineth alone in the Why the head being alone in the womb, is more difficult to be drawn out. womb, by reason of the roundness thereof, for it will slip and slide up and down, unless the belly be pressed down, and on both sides, thereby to hold it unto the instrument, that it may with more facility take hold thereon. CHAP. XXVII. What must be done unto the woman in travel presently after her deliverance. THere is nothing so great an enemy to a woman in travel, especially to Cold an enemy to women in travel. her whose child is drawn away by violence, as cold: wherefore with all care and diligence she must be kept and defended from cold. For after the birth, her body being void and empty, doth easily receive the air that will enter into every thing that is empty, and hence she waxeth cold, her womb is distended and puffed up, and the orifices of the vessels thereof are shut and closed, whereof cometh suppression of the afterbirth, or other after purgations. And thereof cometh many grievous accidents, as hysterical suffocation, What accidents follow the taking of cold in a woman that is delivered of child. painful fretting of the guts, fevers, and other mortal diseases. What woman soever will avoid that discommodity, let her hold her legs or thighs across, for in so doing, those parts that were separated will be joined and close together again. Let her belly be also bound or rolled with a ligature of an indifferent breadth and length, which may keep the cold air from the womb, and also press the blood out that is contained in all the substance thereof. Then give her some Capon broth or Caudle, with Saffron, or with the powder called Secundines must be laid to the region of the womb whilst they be warm. Pulvis ducis, or else bread toasted and dipped in wine wherein spice is brewed, for to restore her strength, and to keep away the fretting of the guts. When the secundine is drawn out, and is yet hot from the womb, it must be laid warm unto the region of the womb, especially in the winter, but in the summer, the hot skin of a Weather newly killed must be laid unto all the whole belly, and unto the region of the loins. But then the curtains of the bed must be kept drawn, and all the windows and doors of the chamber must be kept shut with all diligence, that no cold air may come unto the woman that traveleth, but that she may lie and take her rest quietly. The Wether's skin must be taken away after that it hath lain five or six hours, and then all the region of her belly must be anointed with the ointment following. ℞. spermatis Ceti, ℥ two. olei amygdal. dulcium & hypericon. an. ℥ iss. sevihircini. ℥ i. Uugaents for the woman in travel that the region of the belly may not be wtiakled. olei myrtillor. ℥ i. cerae novae quantum sufficit; make thereof an ointment, wherewith let her be anointed twice in the day: let a plaster of Galbanum be applied to the navel, in the midst whereof put some few grains of Civet or Musk, so that the smell of the plaster may not strike up into her nostrils. Then let this medicine following be applied, commonly called Tela Gualterina. ℞. cer ae novae ℥ iiii. spermatis Ceti. ℥ iss. terebinth. venetaein aqua rosacea lotae ℥ two. olei amygdal. dulcium & The medicine called Tela Gualterina. hypericonis an. ℥ i. olei mastic. & myrtini, an. ℥ ss. axungiae cervi ℥ iss. melt them all together, and when they are melted, take it from the fire, and then dip a linen cloth therein, as big as may serve to fit the region of the belly, whereunto it is to be applied. These remedies will keep the external region of the belly from wrinkling. But of all other, the medicine following excelleth. ℞. limacum rub. lb i florum anthos quart. iii let them be cut all in small pieces, and put into an earthen pot well nealed with lead, and close stopped, then let it be set in the dung of horses for the space of forty days, and then be pressed or strained, and let the liquor that is strained out be kept in a glass well covered, and set in the sun for the space of three or four days, and therewith anoint the belly of the woman that lieth in childbed. If she be greatly tormented with throws, let the powder following be given unto her. ℞. anisi conditi ℥ two. nucis moschat. cornu cervi ust. an. A powder for the fretting of the guts. ʒi. ss. nuclcorum dactyllor. ʒiii. ligni aloës & cinamomis an. ʒii. make thereof a most subtle powder, let her take ʒi. thereof at once with white wine warm. Or, ℞. rad. confolidae major. ʒiss. nucleorum persicorum, nucis moschat. an. ℈ two. carab. ℈ ss. ambrae graezoe gra. iiii. make thereof a powder, let her take one dram thereof at a time with white wine, or, if she have a fever, with the broth of a Capon. Let there be hot bags applied to the genitals, belly and raynes; these bags must be made of millet and oats fried in a frying pan with a little white wine. But if through the violence of the excraction the genital parts be torn, as ancient writers affirm it hath come to pass, so that the two holes, as the two holes of the What must be done when the groin is torn in childbirth. privy parts and of the fundament have been torn into one, then that which is rend must be stitched up, and the wound cured according to art. Which is a most unfortunate chance for the mother afterwards, for when she shall travel again, she cannot have her genital parts to extend and draw themselves in again by reason of the scar. So that then it will be needful that the Chirurgeon shall again open the place that was cicatrized, for otherwise she shall never be delivered, although she strive and contend never so much. I have done the like cure in two women that dwelled in Paris. CHAP. XXVIII. What cure must be used to the Dugs and Teats of those that are brought to bed. IF great store and abundance of milk be in the breasts, and the woman be not willing to nurse her own child, they must be anointed with the unguent following, to repel the milk, and cause it to To drive the milk downwards. be expelled through the womb. ℞. olei ros. myrtini an. ℥ iii aceti rosat. ℥ i. incorporate them together, and therewith anoint thè dugs four times a day, and presently after the anointing besprinkle them with the powder of myrtils, and then apply the plaster following. ℞. pulv. mastichini, nucis moschat. an. ʒii. cupressiʒiii. ballast. myrtill. an. ʒiss. Ireos, florent. ℥ ss. olei myrtini ℥ iii terebinth. veneta ℥ two. cerae novae quantum sufficit, make thereof a soft plaster. The leaves of brookelime, cresses and box boiled together in urine and vinegar, are thought a present remedy for this purpose, that is to say, to draw the milk from the breasts. And others take the clay that falleth down into the bottom of the trough wherein the grindstone, whereon swords are ground, turneth, and mix it with oil of roses, and apply it warm unto the dugs, which in short space, as it is thought, will assuage the pain, stay the inflammation, and drive the milk out of the dugs. The decoction of ground Ivy, Peruwincle, Sage, red Roses and roach Alum being prepared in oxycrate, and used in the form of a fomentation, is thought to perform the like effect: the like virtue have the lees of red wine, applied to the dugs with vinegar, or the distilled water of unripe Pineapples applied to the breasts with linen clothes wet therein, or hemlock beaten and applied with the young and tender leaves of a gourd. This medicine following is approved by use: Take the leaves of Sage, Smallage, By what reason, and which way cupping-glasses, being fastened on the groin or above the navel, do draw the milk out of the breasts. Rue, and chervil, and cut or chop them very small, and incorporate them in vinegar and oil of Roses, and so apply it warm to the breast, and renew it thrice a day. In the mean time let Cupping-glasses be applied to the inner side of the thigh and groin, and also above the navel. For this is very effectual to draw the milk out of the breasts into the womb by the veins, whereby the womb communicateth with the breasts. Moreover, they may let children or little welpes suck their breasts, whereby they may draw out the milk that is fixed fast in their dugs, in steed whereof we have invented this instrument of glass, wherewith, when the broader orifice is fastened or placed on the breast or dug, and the pipe turned upwards towards her mouth, she may suck her own breasts herself. The form of a little glass, which being put on the nipple, the woman may suck her own breasts. In steed of this instrument, a viol of glass being first made warm, and the mouth thereof applied to the nipple or teat, by reason of the heat and wideness thereof will draw the milk forth into the bottom thereof, as it were by a certain sucking. The after purgations being first evacuated, which is done for the most part within twenty days after the birth, if the woman be not in danger of a fever, nor have any other accident, let her enter into a bath, made of marjerome, mints, sage, rosemary, mugwort, agrimony, pennyroyal, the flowers of chamomile, melilote, dill, being boiled in most pure and clear running water. All the day following let another such like bath be prepared, whereunto let these things following be added. ℞. farini fabarum & aven. an. lb. iii farin. orobi, lupinor. & gland. an. lb. i aluminis roch. ℥ iiii. salis come. lb. two. gallarum, nucum cupressi, an. ℥ iii rosar. rub. m. vi. chariophyl. nucum moschat. an. ʒ iii boil them all in common water, then sew them all in a clean linen cloth, as it were in a bag, and cast them therein into the bath wherein Iron red hot hath been extinguished, and let the woman that hath lately traveled sit down therein so long as she pleaseth, and when she cometh out, let her be laid warm in bed, and let her take some preserved Orange pill, or bread toasted and dipped in hippocras, or in wine brewed with spices, and then let her sweat, if the sweat will come forth of its own accord. On the next day let astringent fomentations be applied to the genitals on this Astringent fomentations for the privy parts. wise prepared. ℞. gallar. nucum Cupressi, corticum granat. an. ℥ i. rosar. rub. mi. thymi, majoran. an. m. ss. aluminis rochae, salis come. an. ʒii. boil them all together in red wine, and make thereof a decoction for a fomentation, for the forenamed use. The distilled liquor following is very excellent and effectual to confirm and to A distilled liquor for to draw together the dug that are loose and slack. draw in the dugs, or any other loose parts. ℞. charyophyl. nucis moschat. nucum cupressi. an. ℥ i ss. mastic. ℥ two. alumin. roch. ℥ i ss. glandium & corticis querni, an. lb ss. rosar. rubr. m. i. cort. granat. ℥ two. terrae sigillat. ℥ i. cornu cervi usti ℥ ss. myrtillor. sanguinis dracon. an. ℥ i. boli armeni. ℥ two. ireos florent. ℥ i. sumach. berber. Hyppuris, an. m. ss. conquassentur omnia, & macerentur spatio duorum dierum. in lb i ss. aquae rosarum lb two. prunorum syvestr. mespilorum, pomorum quernorum, & lb ss. aquae fabrorum, aceti denique fortiss. ℥ iv. afterward distil it over a gentle fire, and keep the distilled liquor for your use, wherewith let the parts be fomented twice in a day. And after the fomentation, let woollen clothes or stupes of linen cloth be dipped in the liquor, and then pressed out and laid to the place. When all these things are done and passed, the woman may again keep company with her husband. CHAP. XXIX. What the causes of difficult and painful travel in childbirth are. THe fault dependeth sometimes on the mother, and sometimes on the infant The causes of the difficult childbirth that are in the women that traveleth. or child within the womb. On the mother, if she be more fat, if she be given to gurmundize or great eating, if she be too lean or young, as Savanarola thinketh her to be, that is great with child at nine years of age, or unexpert, or more old, or weaker than she should be, either by nature or by some accident: as by diseases that she hath had a little before the time of childbirth, or with a great flux of blood. But those that fall in travel before the full and prefixed time, are very difficult to deliver, because the fruit is yet unripe, and not ready or easy to be delivered. If the neck or orifice of the womb be narrow, either from the first conformation, or afterwards by some chance, as by an ulcer cicatrized: or more hard and callous, by reason that it hath been torn before at the birth of some other child, and so cicatrized again, so that if the cicatrizeed place be not cut even in the moment of the deliverance, both the child and the mother will be in danger of death; also the rude handling of the midwife may hinder the free deliverance of the child. Oftentimes women are The pas●ions of ●…hin●●r the ●●th. letted in travel by shamefacedness, by reason of the presence of some man, or hate to some woman there present. If the secundine be pulled away sooner than it is necessary, it may cause a great flux of blood to fill the womb, so that then it cannot perform his exclusive faculty, no otherwise than the bladder when it is distended by reason of overabundance of water that is therein, cannot cast it forth, so that there is a stoppage of the urine. But the womb is much rather hindered, or the faculty of child-bith is stopped or delayed, if together with the stopping of the secundine, there be either a mole or some other body contrary to nature in the womb. In the secundines of two women whom I delivered of two children that were dead in their bodies, I found a great quantity of sand like unto that that is found about the banks of rivers, so that the gravel or sand that was in each secundine was a full pound in weight. Also the infant may be the occasion of difficult childbirth, as, if too big, if it The causes of difficult childbirth that are in the infant. come overthwart, if it come with its face upwards, and its buttocks forwards, if it come with its feet and hands both forwards at once, if it be dead and swollen by reason of corruption, if it be monstrous, if it have two bodies or two heads, if it be manifold or sevenfold, as Albucrasis affirmeth he hath seen, if there be a mole annexed thereto, if it be very weak, if when the waters are flowed out, it doth not move or stir, or offer its self to come forth. Yet notwithstanding, it happeneth The external causes of difficult childbirth. sometimes that the fault is neither in the mother nor the child, but in the air, which being cold, doth so bind, congeal and make stiff the genital parts, that they cannot be relaxed: or, being chose too hot, it weakeneth the woman that is in travel, by reason that it wasteth the spirits, wherein all the strength consisteth: or in the ignorant and unexpert midwife, who cannot artificially rule and govern the endeavours of the woman in travel. The birth is wont to be easy, if it be in the due and prefixed natural time, if the Which is an easy birth. child offer himself lustily to come forth with his head forwards, presently after the waters are come forth, and the mother in like manner lusty and strong: those What causeth easiness of childbirth. which are wont to be troubled with very difficult childbirth, ought a little before the time of the birth, to go into an half tub filled with the decoction of mollifying roots and seeds, to have their genitals, womb, and neck thereof to be anointed with much oil, and the intestines that are full and loaded must be unburthened of the excrements, and then the expulsive faculty provoked with a sharp clyster, that the tumors and swelling of the birth concurring therewith, the more easy exclusion may be made. But I like it rather better, that the woman in travel should be placed in a chair that hath the back thereof leaning backwards, than in her bed, but the chair must have a hole in the bottom, whereby the bones that must be dilated in the birth, may have more freedom to close themselves again. CHAP. XXX. The causes of Abortion or untimely birth. ABortion or untimely birth is one thing, and effluxion another. They What Abortion is. call abortion the sudden exclusion of the child already form and alive, before the perfect maturity thereof. But that is called effluxion, What Effluxion is. which is the falling down of seeds mixed together and coagulated but for the space of a few days, only in the forms of membranes or tunicles, congealed blood, and of an unshapen or deformed piece of flesh; the mydwives of our country call it a false branch or bud. This effluxion is the cause Women are in more pain by reason of the effluxion than at the true birth. The causes of Abortion. of great pain and most bitter and cruel torment to the woman: leaving behind it weakness of body far greater than if the child were borne at the due time. The causes of abortion or untimely birth, whereof the the child is called an abortive, are many, as a great scouring, a strangury joined with heat and inflammation, sharp fretting of the guts, a great and continual cough, exceeding vomiting, vehement labour in running, leaping, and dancing, and by a great fall from on high, carrying of a great burden, riding on a trotting horse, or in a Coach, by vehement, often and ardent copulation with men, or by a great blow or stroke on the belly. For all these & such like vehement and inordinate motions dissolve the ligaments of the womb, and so cause abortion or untimely birth. Also whatsoever presseth or girdeth in the mother's belly, and therewith also the Girding of the belly may cause untimely birth. womb that is within it, as are those Ivory or Whale-bone busks, which women wear on their bodies, thereby to keep down their bellies; by these and such like things the child is letted or hindered from growing to his full strength, so that by expression, or as it were by compulsion, he is often forced to come forth before the legitimate and lawful time. Thundering, the noise of the shooting of great Ordnance, the sound, and vehement noise of the ringing of Bells constrain women to fall in travel before their time, especially women that are young, whose bodies are soft, slack and tenderer than those that be of riper years. Long and great fasting, a great flux of blood, especially when the infant is grown some what great: but if it be but two months old, the danger is not so great, because than he needeth not so great quantity of nourishment, also a long disease of the mother, which consumeth the blood, causeth the child to come forth being destitute of store of nourishment before the fit time. Moreover, fullness, by reason of the eating great store of meats, often maketh or causeth untimely birth; because it depraveth the strength, and presseth down the child: as likewise the use of meats that are of an evil juice, which they lust or long for. But baths, because they relax the ligaments How baths & hot houses cause untimely birth. of the womb, and hot houses, for that the fervent and choking air is received into the body, provoke the infant to strive to go forth to take the cold air, and so cause abortion. What women soever, being indifferently well in their bodies, travel in the second Hippias. 53. & 37 sect 5. Hipaph 45. se 5. or third month without any manifest cause, those have the Cotylidones of their womb full of filth and matter, and cannot hold up the infant, by reason of the weight thereof, but are broken: Moreover, sudden or continual perturbations of the mind, whether they be through anger or fear, may cause women to travel before their time, and are accounted as the causes of abortions, for that they cause great and vehement trouble in the body. Those women that are like to travel before their time, their dugs will wax little: therefore when a woman is great with child, if her dugs suddenly wax small or slender, it is a sign that she will travel before her time; the cause of such shrinking of the dugs is, that the matter of the milk is drawn back into the womb, by reason that the infant wanteth nourishment to nourish and succour it withal. Which scarcity the infant not long abiding, striveth to go forth to seek that abroad which he cannot have within, for among the causes which do make the infant to come out of the womb, those are most usually named with Hypocrates, Hip. aph. 〈◊〉 se. 5. the necessity of a more large nutriment and air. Therefore if a woman that is with child have one of her dugs small, if she have two children, she is like to travel of one of them before the full and perfect time: so that if the right dug be small, it is a man child, but if it be the left dug it is a female. Women are in far more pain when they bring forth their children before the time Women are in more pain at the untimely birth than at the due time of birth. than if it were at the full and due time, because that whatsoever is contrary to nature, is troublesome, painful, and also oftentimes dangerous. If there be any error committed at the first time of childbirth, it is commonly seen that it happeneth always after at each time of childbirth. Therefore, to find out the causes of that error, The error of the first childbirth continues afterwards. you must take the counsel of some Physician, and after his counsel endeavour to amend the same. Truly this plaster following being applied to the reins doth confirm the womb, and stay the infant therein. ℞. ladaniʒii. galang. ℥ i. nucis moschat. nucis cupressi, boli armeni, terrae sigil. sanguine. dracon. ballast. an. ʒss. acatiae, A plaster staying the infant in the womb. psidiorum, hypocistid. an. ℥ i. mastic. myrrhae, an. ʒii. gummi arabic. ʒi. terebinth. venet. ʒii. picis naval. ℥ i. ss. ceraequantum sufficit, fiat emplast. secundem artem; spread it for your use upon leather. if the part begin to itch, let the plaster be taken away, & in stead thereof use unguent. rosat. or refrig. Galen. or this that followeth. ℞. olei myrtini, mastic. cydonior. an. ℥ i. hypocist. boli armen. sang. dracon. acatiae, an. ʒi. saint. citrini ℥ ss. cerae quant. suf. make thereof an ointment according unto art. There are women that bear the child in their womb ten or eleven whole months, and such What children are ten or eleven months in the womb. children have their conformation of much and large quantity of seed: wherefore they will be more big, great and strong, and therefore they require more time to come to their perfection and maturity; for those fruits that are great will not be so soon ripe as those that are small. But children that are small and little of body do often come to their perfection and maturity in seven or nine months: if all other things are correspondent in greatness and bigness of body, it happeneth for the most part that the woman with child is not delivered before the ninth month be done, or at the least wise in the same month. But a male child will be commonly borne at the beginning, or a little before the beginning of the same month, by reason of his engrafted A male will be borne sooner than a female. heat which causeth maturity and ripeness. Furthermore, the infant is sooner come to maturity and perfection in a hot woman than in a cold, for it is the property of heat to ripen. CHAP. XXXI. How to preserve the infant being in the womb, when the mother is dead. IF all the signs of death appear in the woman that lieth in travel, and cannot be delivered, there must then be a Chirurgeon ready and at hand, which may open her body so soon as she is dead, whereby the infant may be preserved in safety; neither can it be Why it is not sufficient to preserve life in the child to hold open the mouth and privy parts of the mother so soon as the is dead and the child alive in her body. supposed sufficient if the mother's mouth and privy parts be held open; for the infant being enclosed in his mother's womb, and compassed with the membranes, cannot take his breath, but by the contractions and dilatations of the artery of the navel. But when the mother is dead, the lungs do not execute their office and function: therefore they cannot gather in the air that compasseth the body by the mouth or aspera arteria into their own substance, or into the arteries that are dispersed throughout the body thereof, by reason whereof it cannot send it unto the heart by the veiny artery which is called arteria venalis: for if the heart want air, there cannot be any in the great artery which is called arteria aorta, whose function it is to draw it from the heart; also by reason thereof it is wanting in the arteries of the womb, which are as it were the little conduits of that great artery, whereinto the air that is brought from the heart is derived, and floweth in unto these little ones of all the body, and likewise of the womb. Wherefore it must of necessity follow that the air is wanting to the cotyledons of the secundines, to the artery of the infant's navel, the iliacke arteries also, and therefore unto his heart, and so unto all his body: for the air being drawn by the mother's lungs, is accustomed to come to the infant by this continuation of passages. Therefore because death maketh all the motions of the mother's body to cease, How the body of the woman that death in travel must be cut open to save the child. it is far better to open her body so soon as she is dead, beginning the incision at the cartelage, Xiphoides, or breast-blade, and making it in a form semicircular, cutting the skin, muscles and peritonaeum, not touching the guts: then the womb being lifted up, must first be cut, lest that otherwise the infant might perchance be touched or hurt with the knife. You shall oftentimes find the child unmoveable, as though he were dead; but not because he is dead indeed, but by reason that he, being destitute of the access of the spirits by the death of the mother, hath contracted a great weakness: yet you How it may be known whether the infant be ●…live of not. may know whether he be dead indeed or not, by handling the artery of the navel, for it will beat and pant if he be alive, otherwise not; but if there be any life yet remaining in him, shortly after he hath taken in the air, and is recreated with the access thereof, he will move all his members, and also all his whole body. In so great a weakness or debility of the strength of the child, the secundine must not be separated as yet from the child, by cutting the navel string, but it must rather be laid close to the region of the belly thereof, that thereby the heat (if there be any jor remaining) may be stirred up again. But I cannot sufficiently marvel at the insolency of those that affirm that they have seen women whose bellies and womb have been more than once cut, and the infant taken out, when it could no otherwise be gotten forth, and yet notwithstanding alive; which thing there is no man can persuade me can be done, without the death of the mother, by reason of the necessary greatness of the wound that must be made in the muscles of the belly, and substance of the womb, for the womb of a woman that is great with child, by reason that it swelleth, and is distended with much blood, must needs yield a great flux of blood, which of necessity must be mortal. And to conclude, when that the wound or incision of the womb is cicatrized, it will not permit or suffer the womb to be dilated or extended to receive or bear a new birth. For these and such like other causes, this kind of cure, as desperate and dangerous, is not (in mine opinion) to be used. CHAP. XXXII. Of superfoetation. SUperfoetation is when a woman doth bear two or more children at one time in her womb, and they be enclosed each in his several What superfoetation is. secundine: but those that are included in the same secundine, are supposed to be conceived at one and the same time of copulation, by reason of the great and copious abundance of seed, and these have no number of days between their conception & birth, but all at once. For as presently after meat the stomach which is naturally of a good temper, is contracted or drawn together about the meat, to comprehend it on every side, though small in quantity, as it were by both hands, so that it cannot roll neither unto this or that side; so the womb is drawn together unto the conception about both the seeds, as soon as they are brought into the capacity thereof, and is so drawn in unto it on every side, that it may come together into one body, not permitting any portion thereof to go into any other region or side, so that by one time of copulation the seed that is mixed together, cannot engender more children than one, which are divided by their secundines. And moreover, because there are no such cells in the wombs of women, as are supposed, or rather known to be in the A woman's womb is not 〈◊〉 into divers cells. wombs of beasts, which therefore bring forth many at one conception or birth. But now if any part of the woman's womb doth not apply and adjoine itself closely to the conception of the seed already received, lest any thing should be given by nature for no purpose, it must of necessity follow that it must be filled with air, which will alter and corrupt the seeds. Therefore the generation of more than one infant at a time, having every one his several secundine, is on this wise. If a woman conceive The reason of superfoetation by copulation with a man as this day, and if that for a few days after the conception, the orifice of the womb be not exactly shut, but rather gape a little, and if she do then use copulation again, so that at both these times of copulation there may be an effusion or perfect mixture of the fertile seed in the womb, there will follow a new conception, or superfoetation. For superfoetation is no other thing than a certain second conception, when the woman already with child, again useth copulation with a man, and so conceiveth again, according to the judgement of Hypocrates. Lib. de superfoetation●…. 〈◊〉 the womb 〈◊〉 the conception of the seed. doth ma 〈◊〉 ●imes afterwards open. But there may be many causes alleged why the womb which did join and close doth open and unlose itself again. For there be some that suppose the womb to be open at certain times after the conception, that there may be an issue out for certain excremental matters that are contained therein, and therefore that the woman that hath so conceived already, and shall then use copulation with a man again, shall also conceive again. Others say that the womb of itself, and of its own nature is very desirous of seed or copulation, or else being heated or inflamed with the pleasant motion of the man moving her thereto, doth at length unclose itself to receive the man's seed: for likewise it happeneth many times that the orifice of the stomach being shut after eating, is presently unloosed again, when other delicate meats are offered to be eaten: even so may the womb unclose itself again at certain seasons, whereof come manifold issues, whose time of birth and also of conception are different. For as Pliny writeth, Lib. 7. cap. 11. when there hath been a little space between two conceptions, they are both hastened, as it appeared in Hercules and his brother Iphicles; and in her, which having two children at a birth, brought forth one like unto her husband, and another like unto the adulterer. And also in the Procomesian slave or bondwoman, who by copulation on the same day brought forth one like unto her master, and another like unto his steward: and in another who brought forth one at the due time of childbirth, and another at five months end. And again in another, who bringing forth her burden on the seventh month, brought forth two more in the months following. But this is a most manifest argument of superfoetation, that as many children as are in the womb (unless they be twins of the same sex) so many secundines are there, as I have often seen myself. And it is very likely that if they were conceived in the same moment of time, that they should all be included in one secundine. But when a woman hath more children than two at one burden, it seemeth to be a monstrous thing, because that nature hath given her but two breasts. Although we shall hereafter rehearse many examples of more numerous births. CHAP. XXXIII. Of the tumour called Mola, or a Mole growing in the womb of Women. OF the greek word Mile, which signifieth a Millstone, this tumour The reason of the name. called Mola hath its name: for it is like unto a Millstone both in the round or circular figure, and also in hard consistence, for the which self same reason the whirle-bone of the knee is called of the Latins mola, and of the Greeks Mile. But the tumour called Mola, whereof we here entreat, is nothing else but a certain false conception of deformed flesh, round What a mola is. and hard, conceived in the womb as it were rude and unperfect, and not distinguished into members, coming by corrupt, weak, and diseased seed, and of the immoderate flux of the terms, as it is defined by Hypocrates. This is enclosed in no secundine, but as it were in its own skin. Lib. de sterile. There are some that think the Mola to be engendered of the concourse or mixture of the woman's seed and menstrual blood, without the communication of the man's seed. But the opinion of Galen is, that never any man saw a woman conceive either a Mola, or any other such thing, without copulation of man, as an hen layeth Cap. 7. lib. 4. de usu part. eggs without a cock: for the only cause and original of that motion is in the man's seed, and the man's seed doth only minister matter for the generation thereof. Of the same opinion is Avicen, who thinketh the Mola to be made by the confluxion of How the mola is engendered. the man's seed that is unfertile, with the woman's; when as it, because unfruitful, only puffs up or makes the woman's seed to swell as leaven into a greater bigness, but not into any perfect shape or form. Which is also the opinion of Fernelius, by the decrees of Hypocrates and Avicen: for the immoderate fluxes of the courses are conducing to the generation of the mola, which overwhelming the man's seed, being now unfruitful and weak, doth constrain it to desist from its enterprise of conformation already begun, as vanquished or wholly overcome: for the generation of the mola cometh not of a simple heat working upon a clammy and gross humour, as worms are generated; but of both the seeds, by the efficacy of a certain spirit, after a sort prolifical, as may be understood by the membranes wherein the mola is enclosed, by the ligaments whereby many times it is fastened or bound to the true conception or child, engendered or begotten by superfoetation; and finally, by the increase, and great and sluggish weight. If all men were not persuaded that the conflux of a man's seed must of necessity concur to the generation of the mola, it would be no small cloak or cover to women to avoid the shame and reproach of their light behaviour. CHAP. XXXIIII. How to discern a true conception from a false conception or Mola. WHen the mola is enclosed in the womb, the same things appear as in the The signs of a mola enclosed in the womb. true and lawful conception. But the more proper signs of the mola are these: there is a certain pricking pain, which at the beginning troubleth the belly as if it were the colic, the belly will swell sooner than it would if it were the true issue, and will be distended with greater hardness, and is more difficult and troublesome to carry, because it is contrary to nature, and void of soul or life. Presently after the conception the dugs swell and puff up, but shortly they fall and become lank and lax; for nature sendeth milk thither in vain, because there is no issue in the womb that may spend the same. The mola will move before the third month, although it be obscurely, but the true conception will not: but this motion of the mola is not of the intellectual soul, but of the faculty By what faculty the womb moveth. of the womb, and of the spirit of the seed dispersed through the substance of the mola; for it is nourished and increaseth after the manner of plants, but not by reason of a soul or spirit sent from above, as the infant doth. Moreover, that motion that the infant hath in its due and appointed time, differeth much from the motion of the mola; How the motion of the mola differeth from the motion of the infant in the womb. for the child is moved to the right side, to the left side, and to every side gently, but the mola, by reason of its heaviness, is fixed, and rolleth in manner of a stone, carried by the weight thereof unto what side soever the woman declineth herself. The woman that hath a mola in her womb doth daily wax leaner and leaner in all her members, but especially in her legs, although notwithstanding towards night The mola doth turn to each side of the womb, as the situation of the body is. they will swell, so that she will be very slow or heavy in going, the natural heat forsaking the parts remote from the heart by little and little; and moreover, her belly swells, by reason that the menstrual matter resteth about those places, and is not consumed in the nourishment of the mola: she is swollen as if she had the dropsy, but that it is harder, and doth not rise again when it is pressed with the fingers. The navel doth not stand out as it will do when the true issue is contained in the womb, neither do the courses flow as they sometimes do in the true conception; but sometimes great fluxes happen, which ease the weight of the belly. In many when the mola doth cleave not very fast, it falleth away within three or four months, being not as yet come unto its just bigness; and many times it cleaveth to the sides of the womb and Cotyledons' very firmly, so that some women carry it in their wombs five or six years, and some as long as they live. The wife of Guiliam Roger Pewterer, dwelling in S. Victor's street, bore a mola in her womb seventeen years, who being of the age of fifty years, died; and I having A history. opened her, found the body of her womb to be almost loosed, and not tied or bound by its accustomed ligatures, but as it were hanging only by the neck, and furthermore cleaving to the Kall adjoining to it, having but only one testicle, and that on the right side, and that somewhat broader and loser than usual: the horns were not to be seen except it were on that side, the vessels were on the neck only, and there very manifest and puffed up, it was as big as a man's head. When I had taken it out of her body, I brought it home unto my house, that at my leisure I might find out what was contained in it so long, therefore on a certain day, calling together the chief Physicians of Paris, as Massilaeus, Alexis, Vigour, de S. Pont. Feure, Brovet, Violais, Grealmus, Ravine, Marescotius, Milotus, Hautin, Riolan, Lusson; and Chirurgeons, as Brun, Cointerell, Guillemean: all these being present, I opened the womb, and I found it in all the body thereof and in the proper tunicle, so schirrhous, and so hard, The description of a mola carried seventeen years in the womb. that I could hardly cut or make a knife to enter into it: the body thereof was three fingers thick. In the midst of the capacity thereof I found a jump of flesh as big as both my fists, like unto a Cow's udder, cleaving to the sides of the womb but in certain places, of a very thick, unequal and cloddish substance, with many bodies therein, even as are commonly found in wens and gristles, dispersed through it as if it were bones. The judgement of all that were present was, that this great tumour at the first was a mola, which in process of time degenerated into a schirrous body, together with the proper substance of the womb. Moreover, in the middle of the neck of the womb, we found a tumour as big as a Turkey's egg, of substance hard, cartilaginous and bonny, filling all the whole neck, but especially the inward orifice of the womb, which the common people of France do call the Garland, so that by that passage nothing could go out, or enter into the womb: all that tumour weighed nine pounds and two ounces, which I, by reason of the novelty of the thing, keep in my closet, and here I have described it. The external form and description of the forenamed womb. A. showeth the body of the womb. B. The testicle. C. The neck of the womb, wherein that little tumour was contained. D. showeth the end of the neck of the womb that was plucked in sunder, and also the vessels whereby it drew the nutriment unto it. E. showeth the band. FFF. The vessels dispersed thorough the womb. The description of the womb being open, and showing the Mola contained therein. AA. Show the external and superficial part of the womb. BSBB. Show the thickness of the body or proper substance of the womb. C. showeth the Mola. DD. Show that concavity wherein the mola was contained or enclosed in the womb. As long as the woman carried this Mola in her womb, she felt most sharp pain in her belly, the region of her belly was marvellous hard, distended and large, as if it were a woman that had many children at once in her womb, so that many Physicians when the time of childbirth was past, supposed that swelling of the belly to come of the dropsy, and assayed to cure it as they would the dropsy, but for all the medicines they could use, the belly became never the lesser. Oftentimes the urine was stopped for the space of three days, and then the making of urine was very painful unto her, and many times also her excrements were stopped for the space of a week, by reason that the guts were pressed by the weight of the Mola. At certain seasons, as every third month, there came exceeding great fluxes, the matter thereof could not be carried through the capacity of the womb, as we said before, because it was exactly shut and stopped, but through the vessels by which virgins, and also certain other women great with child evacuate their menstrual matter. If the Mola be expelled or cast out in the first or second month, as many times it so happeneth, it is called of women an unprofitable or false conception. Sometimes there A vain or unprofitable conception. are found in one womb two or three moles separated one from another, and sometimes bound or tied to the sound and perfect infant. As it happened in the wife of Vallcriola the Physician, which was delivered of a Mola which she had carried in her womb twelve months, annexed with a child of four months old, which had deprived the infant both of its room and nutriment. For it is always to be certainly The mola 〈…〉 the infant in the 〈…〉 it is fastened unto it. supposed, that the Mola, as a cruel beast, by its society, and keeping it from its nutriment and place, kills the infant that is joined unto it. I remember once I opened the body of a dead woman, which had a Mola in her womb as big as a goose egg, which when nature had assayed by many vain endeavours to cast out, remained notwithstanding, and at length putrefied, and therewith infected the whole womb, whereof she died. There be some which judging themselves great with child, do about the ninth or tenth month expel no other thing but sounding blasts of wind; whereby the womb suddenly falling down and waxing more slender, they are said in a mockery to have been delivered of a fart. To conclude, whatsoever resembles being with child, if it be not excluded at the due and lawful time of childbirth by its own accord or by the strength of nature, then must it be expelled by art. CHAP. XXXV. What cure must be used to the Mola. ALL things that provoke the flowers and secundines, and exclude the infant being dead, are to be prescribed, given inwardly, put up, and applied There things that provoke the flowers forcibly due also 〈…〉 or wast the mola. outwardly, as the trochisces of myrrha, hermodactils, and such like, first having fomentations that are relaxing and mollifying always applied to the places. You must use these medicines and phlebotomy, diet and baths then & so long as it shall seem necessary to the Physician that is present. But if it happens that the mola is separated or loosed from the womb, and nature cannot expel it when it is so loosed, let the Chirurgeon place the woman in that situation that we The Chirurgeon all 〈…〉 of the mola. said she was to be put in, when the child was to be drawn from her. Then opening her genital parts, let him take hold on it by putting an instrument into it, which by reason of the likeness thereof, is called a Griffins Talon, for it cannot be taken hold on otherwise, by reason of the roundness thereof, for it hath no place whereon it may be taken hold of: therefore, when one taketh hold on it with his hand, it cannot be holden fast by reason of the slipperiness thereof, but will run and slip back into the hollowness of the womb, like unto a bowl or great ball; but it may be more easily taken hold on with the Griffins Talon, if the belly be pressed on both sides that it may remain still while the Griffins Talon takes hold on it, for when it hath taken good hold on it, it may be easily drawn out. When the mola is drawn out, the same cure must be used to the woman, as is used to a woman after that she is delivered of child. The figure of an instrument called a Griffins Talon, to draw out the Mola when it is loose in the womb. CHAP. XXXVI. Of tumors or swellings happening to the Pancreas or sweetbread, and the whole Mesentery. THe tumors of other places and parts in the belly ought diligently to be distinguished from the mola, and other tumors of the womb. For when tumors arise in the glandula called Pancreas, and in all the whole Mesenterium, many unskilful Surgeons take them for molas or scirrhous tumours of the womb, and so go erroneously about to cure them, as shall appear by those histories following. Isabel Rolant the wife of John Bony dwelling in Paris in the street Moncey near A history. to St. Gervise his Church, being threescore years of age, departed this life in the year of our Lord God 1578. on the twenty second day of October: and her body being opened in the presence of Doctor Milot the Physician, he when the Mesentery was taken out of the body, caused it to be carried home to his house, that at his leisure he might find out the cause of this mortal disease, which was always suspected to be in the Mesentery. Therefore on a time calling Varadeus, Brove, chapel, Marescotius, Arragonius, Baillutius, Reburtius and Riolan, all Doctors of Physic, and me and Pineus Surgeons, to his house to see the same. Where we found all the Mesentery and the Pancreas in the Mesentery swollen and puffed up with a marvellous and almost incredible tumour, so that it weighed ten pound and an half, altogether scirrhous on the out side, cleaving on the hinder part only to the vertebres of the loins: but on the fore part to the Peritonaeum, being also scirrhous and wholly cartilaginous. Moreover, there were infinite other abscesses in the same Mesentery, Apostumes of divers kinds in the Mesenterium. every one closed in his several cyst, some filled with a hony-like, some with a tallow-like, some with an albugineous, and some with a waterish liquor or humour, whereof some also were like unto pap, and to conclude, look how many abscesses there were, so many kinds or differences of matters there were. It was then eight The accidents that come when the Mesentertum is separated from the bodies adjoining. years since that tumour began to grow by little and little without feeling and pain unto such a greatness, because that the Mesentery itself was without pain in a manner. For the woman herself could do all the faculties of nature almost as well as if she had been sound and whole, except that two months before she died, she was constrained to keep her bed, because she had a continual fever, which endured so long as she lived, and also because that the Mesentery, being as it were separated or torn from its roots or seat, did roll up and down in the belly, not without the feeling of grievous pain: for, as we said before, it did stick but only to the vertebres of the loins and Peritonaeum, and nothing at all to the guts and other parts whereunto it is as it were naturally knit or joined. Therefore because the weight and heaviness thereof depressed the bladder, it caused a great difficulty in her making of water, and also because it rested on the guts, it made it very painful for her to go to stool, so that the excrements would not come down except she took a sharp clyster to cause them: and as concerning glisters, they could not be put up high enough, by reason of the greatness of the tumour which enclosed and shut the way; and suppositories did no good at all. It was also very difficult for her to take breath, by reason that the midriff or diaphragma was compressed with the tumour. There were some that did suspect it to be a mola, others thought that it came by reason of the dropsy. Assuredly this disease The dropsy coming of a tumour of the Mesenterium. caused the dropsy to ensue; neither was the cause thereof obscure, for the function of the liver was quite frustrated by reason that the concoction or alteration of the Chylus was intercepted by occasion of the tumour: and moreover, the liver itself had a proper disease, for it was hard and scirrhous, and had many abscesses both within and without it, and all over it. The milt was scarce free from putrefaction, the guts and Kall were somewhat blue and spotted, and to be brief, there was nothing sound in the lower belly. There is the like history to be read, written by Philip Ingrassias, in his book of Tom. 1. 〈◊〉 1. c. 1. tumors, of a certain Moor that was hanged for theft, for (saith he) when his body was publicly dissected, in the Mesenterium were found seventy scrofulous tumors, and so many abscesses were contained or enclosed in their several cysts or skins, and sticking to the external tunicle, especially of the greater guts: the matter contained in them was divers, for it was hard, knotty, clammy, glutinous, liquid and waterish, but the entrails, especially the liver and the milt, were sound and free from all manner of tainture, because (as the same Author allegeth) nature being strong, had sent all the evil juice, and the corruption of the entrails into the Mesentery: and verily this Moor, so long as he lived, was in good and perfect health. Without doubt the corruption of superfluous humours for the most part is so great (as it is noted by Fernelius) Lib 6. part. morb. cap. 7. that it cannot be received in the receptacles that nature hath appointed for it; therefore than no small portion thereof falleth down into the parts adjoining, and especially into the Mesentery and pancreas, which are as it were the sink of the whole body. In those bodies which through continual and daily gluttony abound with The Mesenterium is the sink of the body. choler, melancholy and phlegm, if it be not purged in time, nature being strong and lusty, doth depel and drive it down into the pancreas and the Mesentery, which are as places of no great repute, and that especially out of the liver and milt by those veins or branches of the vena porta which end or go not into the guts, but are terminated in the Mesentery and pancreas. In these places divers humours are heaped together, which in process of time turn into a loose and soft tumour, & then if they grow bigger, into a stiff, hard and very scirrhous tumour. Whereof Fernelius affirmeth that in those places he hath found the causes of choler, melancholy, fluxes, dysenteries, cachexias, atrophia's, consumptions, tedious and uncertain fevers, and lastly of many hidden diseases, by the taking away whereof some have received their health, that have been though past cure. Moreover Ingrassias affirmeth out of Julius The Scrophulaes' in the Mesenterium. Pollux that Scrophulaes' may be engendered in the Mesentery, which nothing differs from the mind & opinion of Galen, who saith that Scrophulaes' are nothing else but indurate & scirrhous kernels. But the Mesenterium with his glandules being great and many, making the Pancreas, doth establish, strengthen and confirm the divisions of the vessels. Also the scirrhus of the proper substance of the womb is to be distinguished A scirrhus of the womb. from the mola: for in the bodies of some women that I have opened, I have found the womb annoyed with a scirrhous tumour as big as a man's head, in the curing whereof Physicians nothing prevailed, because they supposed it to be a mola contained in the capacity of the womb, and not a scirrhous tumour in the body thereof. CHAP. XXXVII. Of the cause of barrenness in men. THere are many causes of barrenness in men, that is to say, the too hot, cold, dry or moist distemper of the seed, the more liquid and flexible consistence thereof, so that it cannot stay in the womb, but will presently flow out again: for such is the seed of old men and striplings, and of such as use the act of generation too often and immoderately: for thereby the seed becometh How the seed is unfertile. crude and waterish, because that it doth not remain his due and lawful time in the testicles, wherein it should be perfectly wrought and concocted, but is evacuated by wanton copulation. Furthermore, that the seed may be fertile, it must of necessity be copious in quantity, but in quality well concocted, moderately thick, clammy, and puffed up with the abundance of spirits; both these conditions are wanting in the seed of them that use copulation too often: and moreover, because the wives of those men never gather a just quantity of seed laudable both in quality and consistence in their testicles, whereby it cometh to pass that they are the less provoked or delighted with venereous actions, and perform the act with less alacrity, so that they yield themselves less prone to conception. Therefore let those that would be parents of many children use a mediocrity in the use of venery. The woman may perceive that the man's seed hath some distemperature in it, if How the cutting of the veins behind the ears maketh men barren. when she hath received it into her womb, she feeleth it sharp, hot or cold, if the man be more quick or slow in the act. Many become barren after they have been cut for the stone, and likewise when they have had a wound behind the ears, whereby certain branches of the jugular veins and arteries have been cut, that are there, so that after those vessels have been cicatrized, there followed an interception of the seminal matter downwards, and also of the community which ought of necessity to be between the brain and the testicles, so that when the conduits or passages are stopped, the stones or testicles cannot any more receive, neither matter nor lively spirits from the brain in so great quantity as it was wont, whereof it must of necessity follow, that the seed must be lesser in quantity, and weaker in quality. Those that have their testicles cut off, or else compressed or contused by violence, cannot beget children, because that either they want the help that the testicles should minister in the act of generation, or else because the passage of the seminal matter is intercepted or stopped with a Callus: by reason whereof they cannot yield forth seed, but a certain clammy humour contained in the glandules called prostatae (yet with some feeling of delight). Moreover the defects or imperfections of the yard may cause barrenness: as, if it The defaults of the yard. be too short, on if it be so unreasonable great, that it renteth the privy parts of the woman, and so causeth a flux of blood, for than it is so painful to the woman, that she cannot void her seed, for that cannot be excluded without pleasure and delight, also if the shortness of the ligament that is under the yard doth make it to be crooked, and violate the stiff straightness thereof, so that it cannot be put directly or straightly in the woman's privy parts. There be some that have not the orifice of the conduit of the yard rightly in the end thereof, but a little higher, so that they cannot ejaculate or cast out their seed directly into the womb. Also the particular palsy of the yard is numbered among the causes of barrenness; The sign of the palsy in the yard. and you may prove whether the palsy be in the yard by dipping the genitals in cold water: for except they do draw themselves together or shrink up after it, it is a token of the palsy, for members that have the palsy, by the touching of cold water, do not shrink up, but remain in their accustomed laxity and looseness: but in this case the genitals are endued with small sense; the seed cometh out without pleasure or stiffness of the yard; the stones in touching are cold; and to conclude, those that have their bodies daily waxing lean through a consumption, or that are vexed with an evil habit or disposition, or with the obstruction of some of the entrails, are barren and unfertile, and likewise those in whom some noble part necessary to life and generation exceedeth the bounds of nature with some great distemperature, and lastly those who by any means have their genital parts deformed. Here I omit those that are withholden from the act of generation by enchantment, Magic bands and enchanted knots. magic, witching, and enchanted knots, bands and ligatures, for those causes belong not to physic, neither may they be taken away by the remedies of our art. The Doctors of the Cannon's laws have made mention of those magic bands which may have power in them, in the particular title De frigidis, maleficiatis, impotentibus & incantatis: also St. August. hath made mention of them, Tract. 7. in Joan. CHAP. XXXVIII. Of the barrenness or unfruitfulness of women. A Woman may become barren or unfruitful through the obstruction of the passage of the seed, or through straightness or narrowness of the The cause why the neck of the womb is narrow. neck of the womb, coming either through the default of the formative faculty, or else afterwards by some mischance, as by an abscess, scirrhus, warts, chaps, or by an ulcer, which being cicatrized, doth make the way more narrow, so that the yard cannot have free passage thereinto: Moreover, the membrane called Hymen, when it groweth in the midst or in the bottom The membrane called Hymen. of the neck of the womb, hinders the receiving of the man's seed. Also if the womb be over slippery, or moreloose, or slack, or over wide, it maketh the woman to be barren, so doth the suppression of the menstrual fluxes, or the too immoderate flowing of the courses or whites: which cometh by the default of the womb or some entrall, or of the whole body, which consumeth the menstrual matter, and carrieth the seed away with it. The cold and moist distemperature of the womb, extinguishes and suffocates the The cause of the flux of women. man's seed, and maketh it that it will not stay or cleave unto the womb, and stay till it be conconcted: but the more hot and dry doth corrupt for want of nourishment, for the seeds that are sown either in a marish or sandy ground cannot prosper well: also a mola contained in the womb, the falling down of the womb, the leanness of the woman's body, ill humours bred by eating crude and raw fruits, or great or overmuch drinking of water, whereof obstructions and crudities follow, which hinder her fruitfulness. Furthermore, by the use of stupefactive things, the seminal matter is congealed and restrained, and though it flow and be cast out, yet it is deprived of the prolificke power, and of the lively heat and spirits, the orifices or cotylidones of the veins and arteries are stopped, and so the passage for the menstrual matter into the womb, is stopped. When the Kall is so fat that it girdeth in the womb narrowly, it hindereth the fruitfulness of the woman, because it will not permit the man's seed to enter into the womb. Moreover the fat and fleshy habit of the man or woman hinder generation. For it hindereth them that they cannot join their genital parts together: and by how much the more blood goeth into fat, by so much the Apb 36. sect. 5. Gal. lib. 14. de usu par cap. 9 Arist. in prob. sect. de star. quae. 3. & 4. less is remaining to be turned into seed & menstrual blood, which two are the originals & principals of generation. Those women that are speckled in the face, some what lean, & pale, because they have their genitals moistened with a saltish, sharp and tickling humour, are more given to venery than those that are red & fat. Finally, Hypocrates sets down four causes only why women are barren and unfruitful. The first is, because they cannot receive the man's seed, by reason of the default of the neck of the womb; the second, because when it is received into the womb, they cannot conceive it; the third is, because they cannot nourish it; the fourth, because they are not able to carry or bear it until the due and lawful time of birth. These things are necessary to generation, the object, will, faculty, concourse of the seeds, and the remaining or abiding thereof in the womb, until the due and appointed natural time. CHAP. XXXIX. The signs of a distempered womb. THat woman is thought to have her womb too hot, whose courses The signs of a hot womb. come forth sparingly and with pain, and exulcerate by reason of their heat, the superfluous matter of the blood being dissolved or turned into wind by the power of the heat: whereupon that menstrual blood that floweth forth is more gross and black. For it is the property of heat, by digesting the thinner substance, to thicken the rest, and by adustion to make it more black. Furthermore, she that hath her genitals itching with the desire of copulation, will soon exclude the seed in copulation, and she shall feel it more sharp as it goeth through the passages. That woman hath too cold a womb whose flowers are either stopped, or The signs of a cold womb. flow sparingly, and those pale and not well coloured. Those that have less desire of copulation, have less delight therein, and their seed is more liquid and waterish, and not staining a linen cloth by sticking thereunto, and it is sparingly and slowly cast forth. That womb is too moist that floweth continually The signs of a moist womb. with many liquid excrements, which therefore will not hold the seed, but presently after copulation suffereth it to fall out, which will easily cause abortion. The signs of too dry a womb appear in the little quantity of the courses, in the The signs of a dry womb. profusion of a small quantity of seed, by the desire of copulation, whereby it may be made slippery by the moisture of the seed, by the fissures in the neck thereof, by the chaps and itching, for all things for want of moisture will soon chap, even like unto the ground, which in the summer by reason of a great drought or dryness, will chap and chink this way and that way, and on the contrary, with moisture it will close and join together again as it were with glue. A woman is thought to have all opportunities unto conception when her courses A meet time for conception. or flowers do cease, for then the womb is void of excremental filth, and because it is yet open, it will the more easily receive the man's seed, and when it hath received it, it will better retain it in the wrinkles of the cotylidones yet gaping as it were in rough and unequal places. Yet a woman will easily conceive a little before the time that the flowers ought to flow: because that the menstrual matter falling at first like dew into the womb, is very meet and fit to nourish the seed, and not to drive it out again, or to suffocate it. Those which use copulation when their courses fall down abundantly, will very hardly or seldom conceive, and if they do conceive, the child will be weak and diseased, and especially if the woman's blood that flows out be unfound; but if the blood be good and laudable, the child will be subject to all plethoric diseases. There are some women in whom presently after the flux of the terms, the orifice of the womb will be closed, so that they must of necessity use copulation with a man when their menstrual flux floweth, if at lest they would conceive at all. A woman may bear children from the age of fourteen until forty or fifty: which time whosoever doth exceed, will bear until threescore years, because the menstrual fluxes are kept, the prolifical faculty is also preserved: therefore many women have brought forth children at that age, but after that time no woman can bear, as Aristotle Arist. l. 7. de hist. anim. c. 2. &. c. 5. writeth. Yet Pliny saith that Cornelia (who was of the house of the Scipios) being in the Lib. 7. cap. 14. sixty second year of her age, bare Volusius Saturnius, who was Consul; Valescus Lib. 6. cap. 12. the Tarenta also affirmeth, that he saw a woman that bore a child on the sixty second year of her age, having borne before on the sixtieth and sixty first year. Therefore it is to be supposed that by reason of the variety of the air, region, diet and temperament, the menstrual flux and procreative faculty ceaseth in some sooner, in some later; which variety taketh place also in men. For in them although the seed Lib. 7. de hist. c. nim. c. 1. &. c. 6. be genitable for the most part in the second seventh year, yet truly it is unfruitful until the third seventh year. And whereas most men beget children until they be threescore years old, which time if they pass, they beget till seventy: yet there are some known that have begot children until the eightieth year. Moreover, Pliny writeth that Masinissa the King begot a son when he was fourscore and six lib. 7. cap. 14. years of age, and also Cato the Censor after that he was fourscore. CHAP. XL. Of the falling down, or perversion, or turning of the womb. THe womb is said to fall down and be perverted, when it is moved out of its proper and natural place; as when the bands and ligatures thereof What is the falling down of the womb. being loosed and relaxed, it falleth down unto one side or other, or into its own neck, or else passeth further, so that it comes out at the neck, and a great portion thereof appears without the privy parts. Therefore what things soever resolve, relax, or burst the ligaments or bands whereby the The causes. womb is tied, are supposed to be the causes of this accident. It sometimes happens by vehement labour or travel in childbirth, when the womb with violence excluding the issue and the secundines, also follows and falls down, turning the inner side thereof outward. And sometimes the foolish rashness of the midwife, when she draweth away the womb with the infant, or with the secundine cleaving fast thereunto, and so drawing it down and turning the inner side outward. Furthermore, a heavy bearing of the womb, the bearing or the carriage of a great burden, holding or stretching of the hands or body upwards in the time of greatness with child, a fall, contusion, shaking, or jogling by riding, either in a waggon or a coach, or on horse back, or by leaping or dancing, the falling down of a more large and abundant humour, great griping, a strong and continual cough, a Tenesmus, or often desire to go to stool, yet not voiding any thing, sneezing, a manifold and great birth, difficult bearing of the womb, an asthmatical and orthopnoicall difficulty of breathing, whatsoever doth waightily press down the Diaphragma or Midriff, or the muscles of the Epigastrium, the taking of cold air in the time of travel with child, or in the flowing of the menstrual flux, sitting on a cold marble stone, or any other such like cold thing, are thought often times to be the occasion of these accidents, because they may bring the womb out of its place. It falls down in many (saith Aristotle) by reason of the desire of copulation that 〈…〉 lib. 7. de histor.. 〈◊〉 cap. 〈◊〉. they have, either by reason of the lustiness of their youth, or else because they have abstained a long time from it. You may know that the womb is fallen down by the pain of those parts wherehence The signs. it is fallen, that is to say by the entrails, loins, os sacrum, and by a tractable tumour at the neck of the womb, and often with a visible hanging out, of a divers greatness, according to the quantity that is fallen down. It is seen sometimes like unto a piece of red flesh, hanging out at the neck of the womb, of the The prognostications. bigness and form of a Goose egg; if the woman stand upright, she feeleth the weight to lie on her privy parts, but if she sit or lie, than she perceiveth it on her back, or go to the stool, the strait gut called intestinum rectum will be pressed or loaden as it were with a burden, if she lie on her belly, than her urine will be stopped, so that she shall fear to use copulation with a man. When the womb is newly relaxed in a young woman, it may be soon cured, but if it hath been long down in an old woman, it is not to be helped. If the palsy of the ligaments thereof have occasioned the falling, it scarce admits of cure, but if it fall down by means of putrefaction, it cannot possibly be cured. If a great quantity thereof hang out between the thighs, it can hardly be cured; but it is corrupted by taking the air, and by the falling down of the urine and filth, and by the motions of the thighs in going it is ulcerated, and so putrefies. I remember that once I cured a young woman who had her womb hanging out 〈◊〉 history. at her privy parts as big as an egg, and I did so well perform and perfect the cure thereof, that afterwards she conceived, and bare children many times, and her womb never fell down. CHAP. XLI. The cure of the falling down of the Womb. BY this word, falling down of the womb, we understand every motion Remedies for the ascension of the womb. of the womb out of its place or seat: therefore if the womb ascend upwards, we must use the same medicines as in the strangulation of the womb. If it be turned towards either side, it must be restored and drawn back to its right place, by applying and using cupping glasses. But if it descend and fall down into its own neck, but yet not in great quantity, the woman must be placed so that her buttocks may be very high, and her legs across; then cupping glasses must be applied to her navel and Hypogastrium, and when the womb is so brought into its place, injections that bind and dry strongly must be injected into the neck of the womb, stinking fumigations must be used unto the privy parts, and sweetthings used to the mouth and nose. But if the womb hang For the falling down of the womb, properly so called. down in great quantity between the thighs, it must be cured by placing the woman after another sort, and by using other kind of medicines. First of all she must be so laid on her back, her buttocks and thighs so lifted up, and her legs so drawn back as when the child or secundine are to be taken or drawn from her; then the neck of the womb, and whatsoever hangeth out thereat, must be anointed with oil of lilies, fresh butter, capon's grease, and such like, than it must be thrust gently with the fingers up into its place, the sick or pained woman in the mean time helping or furthering the endeavour by drawing in of her breath as if she did sup, drawing up as it were that which is fallen down. After that the womb is restored unto its place, whatsoever is filled with the ointment must be wiped with a soft and clean cloth, lest that by the slipperiness thereof the womb should fall down again; the genitals must be fomented with an astringent decoction, made with pomegranate pills, cypress nuts, galls, roach allome, horse-tail, sumach, berberies, boiled in the water wherein Smiths quench their irons; of these materials make a powder, wherewith let those places be sprinkled: let a pessary of a competent bigness be put in at the neck of the womb, but let it be eight or nine fingers in length, according to the proportion of the grieved patients body. Let them be made either with latin, or of cork covered with wax, of an oval form, having a thread at one end, whereby they may be drawn back again as need requires. The forms of oval pessaries. A. showeth the body of the Pessary. B. showeth the thread wherewith it must be tied to the thigh. When all this is done, let the sick woman keep herself quiet in her bed, with her buttocks lying very high, and her legs across, for the space of eight or ten days: in the mean while the application of cupping glasses will stay the womb in the right place and seat after it is restored thereunto: but if she hath taken any hurt by cold air, let the privy parts be fomented with a discussing and heating fomentation, on this wise. ℞. fol. alih. sal●v. lavend. rorismar. artemis. flor. chamoem. melilot●…. A discussing & hearing fomentation. m ss. sem. anis. foenugr. an. ℥ i. let them be all well boiled in water and wine, and make thereof a decoction for your use. Give her also glisters, that when the guts are emptied of the excrements, the womb may the better be received into the void and empty capacity of the belly: for this reason the bladder is also to be emptied, for otherwise it were dangerous lest that the womb lying between them both being full, should be kept down and cannot be put up into its own proper place by reason thereof. Also vomiting is supposed to be a singular remedy to draw up the womb that is fallen down: furthermore also it purgeth out the phlegm which did moisten and How vomiting is profitable to the falling down of the womb. relax the ligaments of the womb; for as the womb in the time of copulation at the beginning of the conception is moved downwards to meet the seed, so the stomach, even of its own accord, is sifted upwards when it is provoked by the injury of anything that is contrary unto it, to cast it out with greater violence, but when it is so raised up, it draws up together therewith the peritonaeum, the womb, and also the body or parts annexed unto it. If it cannot be cured or restored unto its place by these prescribed remedies, and that it be ulcerated and so putrefyed that it cannot The cutting away of the womb when it is patrefyed. be restored unto his place again, we are commanded by the precepts of art to cut it away, and then to cure the womb according to art, but first it should be tied, and as much as is necessary must be cut off, and the rest seared with a cautery. There are some women that have had almost all their womb cut off, without any danger of their life, as Paulus testifieth. Lib. 6. John Langius Physician to the Count Palatine, writeth that Carpus the Chirurgeon Epist.. 3●. lib. 2. Epist.. 〈…〉. took out the womb of a woman of Bononia, he being present, and yet the woman lived and was very well after it. Antonius Benivenius Physician of Florence, writeth that he was called by Ugolius the Physician to the cure of a woman whose womb ●ract. de mirand. morbor. cause. was corrupted and fell away from her by pieces, and yet she lived ten years after it. There was a certain woman, being found of body, of good repute, and about the age of thirty years, in whom shortly after she had been married the second time, A history. which was in Anno 1571. having no child by her first husband, the lawful signs of a right conception did appear: yet in process of time there arose about the lower part of her privities the sense or feeling of a weight or heaviness, being so troublesome unto her by reason that it was painful, and also for that it stopped her urine, that she was constrained to disclose her mischance to Christopher Mombey a Chirurgeon her neighbour dwelling in the suburbs of S. Germane; who having seen the tumour, or swelling in her groin, assuaged the pain with mollifying and anodine fomentations and cataplasms; but presently after he had done this, he found on the inner side of the lip of the orifice of the neck of the womb, an apostume rotten & running as if it had been out of an abscess newly broken, with sanious matter, somewhat red, yellow, & pale, running out a long time. Yet for all this the feeling of the heaviness or weight was nothing diminished, but did rather increase daily, so that from the year of our Lord 1573. she could not turn herself being in bed on this or that side, unless she laid her hand on her belly to bear and ease herself of the weight, and also she said when she turned herself, she seemed to feel a thing like unto a bowl to roll in her body unto the side whereunto she turned herself, neither could she go to stool, or avoid her excrements standing or sitting, unless she lifted up that weight with her hands towards her stomach or midriff: when she was about to go she could scarce set forwards her feet, as if there had something hanged between her thighs, that did hinder her going. At certain seasons that rotten apostume would open, or unclose of itself, and flow or run with its wont sanious matter, but then she was grievously vexed with pain of the head, and all her members, swooning, loathing, vomiting, and almost choosing, so that by the persuasion of a foolish woman she was induced and contented to take Antimonium; the working Antimonium taken in a potion doth cause the womb to fall down. and strength thereof was so great and violent, that after many vomits, with many frettings of the guts and watery dejections or stools, she thought her fundament fell down; but being certified by a woman that was a familiar friend of hers, unto whom she showed herself, that there was nothing fallen down at or from her fundament, but it was from her womb, she called, in the year of our Lord 1575. Chirurgeons, as myself, James Guillemeau, and Antony Vieux, that we might help her in this extremity. When we had diligently and with good consideration weighed the whole estate The signs of the substance of the womb drawn out. of her disease, we agreed with one consent, that that which was fallen down should be cut away, because that by the black colour, stinking, and other such signs it gave a manifest testimony of a putrefyed and corrupted thing. Therefore for two days we drew out the body by little and little, and piecemeal, which seemed unto the Physicians that we had called, as Alexius, Gaudinus, Feureus, and Violaneus, and also to ourselves, to be the body of the womb, which thing we proved to be so, because one of the testicles came out whole, and also a thick membrane or skin, being the relic of the mola, which being suppurated, and the abscess broken, came out by little and little in matter; after that all this body was so drawn away, the sick woman began to wax better and better, yet notwithstanding for the space of nine days before it was taken away, she voided nothing by siege, and her urine also was stopped for the space of four days. After this all things became as they were before, and she lived in good health three months after, and then died of a Pleurisy that came on her very suddenly, and I having opened her body, observing and marking everything very diligently, could not find the womb at all, but instead thereof there was a certain hard and callous body, which nature, who is never idle, had framed in stead thereof to supply the want thereof, or to fill the hollowness of the belly. CHAP. XLII. Of the tunicle or membrane called Hymen. IN some virgins or maidens in the orifice of the neck of the womb Whether there be a membrane called Hymen. there is found a certain tunicle or membrane called of ancient writers Hymen, which prohibiteth the copulation of a man, and causeth a woman to be barren; this tunicle is supposed by many, and they not of the common sort only, but also learned Physicians, to be, as it were, the enclosure of the virginity or maidenhead. But I could never find it in any, seeking of all ages from three to twelve, of all that I had under my hands in the Hospital of Paris. Yet once I saw it in a virgin of seventeen years, whom her mother had contracted to a man, and she knew nevertheless there was something in her privy parts A history. that hindered her from bearing of children, who desired me to see her; and I found a certain very thin nervous membrane a little beneath the nymphae, near unto the orifice of the neck of the womb; in the midst there was a very little hole whereout the terms might flow: I seeing the thickness thereof, cut it in sunder with my sizzers, and told her mother what she should do afterwards: and truly she married shortly after and bore children. Realdus Columbus is of my opinion, and saith that Lib. 11. cap. 16. this is seen very seldom, for these are his words: under the nymphae in many, but not in all virgins, there is another membrane, which when it is present (which is but seldom) it stoppeth, so that the yard cannot be put into the orifice of the womb; for it is very thick above towards the bladder; it hath an hole by which the courses flow out. And he also addeth that he observed it in two young virgins, and in one elder maid. Avicen writeth that in virgins in the neck of the womb there are tunicles composed Lib. 3. sent 21. fract. 1. cap. 〈◊〉. of veins and ligaments very little, rising from each part of the neck thereof, which at the first time of copulation are wont to be broken, and the blood to run out. Almansor writeth that in virgins, the passage or neck of the womb is very wrinkled, or narrow and strait, and those wrinkles to be woaven or stayed together with many little veins and arteries, which are broken at the first time of copulation. These are the judgements of Physicians of this membrane: Midwives will certainly The 〈◊〉 of midwives about the membrane called Hymen. affirm that they know a virgin from one that is deflowered, by the breach or soundness of that membrane. But by their report too credulous Judges are soon brought to commit an error. For that Midwives can speak nothing certainly of this membrane, may be proved by this, because that one saith that the situation thereof is in the very entrance of the privy parts, others say it is in the midst of the neck of the womb, and others say it is within at the inner orifice thereof, and some are of an opinion that they say or suppose that it cannot be seen or perceived before the first birth. But truly of a thing so rare, and which is contrary to nature, there cannot be any thing spoken for certainty. Therefore the blood that cometh out at the first time of copulation, comes not always by the breaking of that membrane, but by the breaking and violating or renting of the little veins which are woaven and bespread all over the superficial & inward parts of the womb and neck thereof, descending into the wrinkles, whichin those that have not yet used the act of generation, are closed as if they were glued together: although that those maids that are at their What virgins at the first time of copulation do not bleed at their privy parts. Lib. 3. due time of marriage, feel no pain nor no flux of blood, especially if the man's yard be answerable to the neck of the womb; whereby it appears evidently how greatly the inhabitants of Fez, the metropolitan city of Mauritania, are deceived: for Leo the African writeth that it is the custom among them, that so soon as the married man and his spouse are returned home to their house from the church where they have been married, they presently shut themselves into a chamber, and make fast the door, while the marriage dinner is preparing: in the mean while some old or grave matron standeth waiting before the chamber door, to receive a bloody linen clothe the new married husband is to deliver her there, which when she hath received, she brings it into the midst of all the company of guests, as a fresh spoil and testimony of the married wives virginity, and then for joy thereof they all fall to banqueting solemnly. But if through evil fortune it happeneth that in this time of copulation the spouse bleedeth not in the privy parts, she is restored again unto her parents, which is a very great reproach unto them, and all the guests depart home sad, heavy, and without dinner. Moreover, there are some, that having learned the most filthy and infamous arts of bawdry, prostitute common harlots to make gain thereof, making men that are The filthy de●… of bawds & harlots. naughtily given to believe that they are pure virgins, making them to think that the act of generation is very painful and grievous unto them, as if they had never used it before, although they are very expert therein indeed; for they do cause the neck of the womb to be so wrinkled and shrunk together, so that the sides thereof shall even almost close or meet together; then they put thereinto the bladders of fishes, or galls of beasts filled full of blood, and so deceive the ignorant and young lecher, by the fraud and deceit of their evil arts, and in the time of copulation they mix sighs with groans, and womanlike cry, and the crocodiles tears, that they may seem to be virgins, and never to have dealt with man before. CHAP. XLIII. A memorable history of the membrane called Hymen. JOhn Wierus writeth that there was a maid at Camburge, who in the midst Lib. deprost. daemon. cap. 38. of the neck of the womb, had a thick and strong membrane growing overthwart, so that when the monthly terms should come out, it would not permit them, so that thereby the menstrual matter was stopped and flowed back again, which caused a great tumour and distension in the belly, with great torment, as if she had been in travel with child: the mydwives being called, and having seen and considered all that had been done, and did appear, did all with one voice affirm, that she sustained the pains of childbirth, although that the maid herself denied that she ever dealt with man. Therefore then this foresaid Author was called, who, when the mydwives were void of help and counsel, might help this wretched maid, having already had her urine stopped now three whole weeks, and perplexed with great watchings, loss of appetite, and loathing: and when he had seen the grieved place, and marked the orifice of the neck of the womb, he saw it stopped with a thick membrane; he knew also that that sudden breaking out of blood into the womb and the vessels thereof, and the passage for those matters that was stopped, was the cause of her grievous and tormenting pain. And therefore he called a Chirurgeon presently, and willed him to divide the membrane that was in the midst, that did stop the flux of the blood, which being done, there came forth as much black congealed and putrefied blood as weighed some eight pounds. In three days after she was well and void of all disease and pain. I have thought it good to set down this example here, because it is worthy to be noted, and profitable to be imitated, as the like occasion shall happen. CHAP. XLIIII. Of the strangulation of the womb. THe strangulation of the womb, or that cometh from the womb, is an What is the strangulation of the womb. interception or stopping of the liberty in breathing or taking wind, because that the womb, swollen or puffed up by reason of the access of gross vapours and humours that are contained therein, and also snatched as it were by a convulfive motion, by reason that the vessels and ligaments distended with fullness, are so carried upwards against the midriff and parts of the breast, that it maketh the breath to be short, and often as if a thing lay upon the breast and pressed it. Moreover, the womb swelleth, because there is contained or enclosed in it a certain Why the womb swelleth. substance, caused by the defluxion either of the seed or flowers, or of the womb or whites, or of some other humour, tumour, abscess, rotten apostume, or some ill juice, putrefying, or getting or engendering an ill quality, and resolved into gross vapours. These, as they affect sundry or divers places, infer divers and sundry accidents, as rumbling and noise in the belly, if it be in the guts, desire to vomit, after The accidents that come of the strangling of the womb. (with seldom vomiting) cometh weariness and loathing of meat, if it trouble the stomach. Choking with strangulation, if it assail the breast and throat; swooning, if it vex the heart; madness, or else that which is contrary thereto, sound sleep or drowsiness, if it grieve the brain: all which oftentimes prove as malign as the biting of a mad dog, or equal the stinging or bite of venomous beasts. It hath been observed, that more grievous symptoms have proceeded from the Why the strangulation that cometh of the corruption of the seed is more dangerous than that that comes of the corruption of the blood. corruption of the seed, than of the menstrual blood. For by how much every thing is more perfect and noble, while it is contained within the bounds of the integrity of its own nature, by so much it is the more grievous and perilous, when by corruption it hath once transgressed the laws thereof. But this kind of accident doth very seldom grieve those women which have their menstrual flux well and orderly, and do use copulation familiarly; but very often those women that have not their menstrual flux as they should, and do want, and are destitute of husbands, especially if they be great eaters, and lead a solitary life. When the vessels and ligaments The cause of the divers turning of the womb into divers parts of the body. of the womb are swollen and distended as we said before, so much as is added to their latitude or breadth, so much is wanting in their length: and therefore it happeneth that the womb, being removed out of its seat, doth one while fall to the right side towards the liver, sometimes to the left side towards the milt, sometimes upwards unto the midriff and stomach, sometimes downwards, and so forwards unto the bladder, whereof cometh an Ischury and strangury; or backwards, whereof cometh oppression of the strait gut, and suppression of the excrements, and the Tenesmus. But although we acknowledge the womb to decline to those parts which we named, yet it is not by accident only, as when it is drawn by the proper and common ligaments and bands, when they are contracted or made shorter, being distended with fullness, but also of its self, as when it is forced or provoked through the grief of something contrary to nature that is contained therein: it wandreth sometimes unto one side, and sometimes unto another part with a plain and evident natural motion, like unto the stomach which embraceth any thing that is gentle and The womb is not so greatly moved by an accident, but by itself. mild, but avoideth any thing that is offensive and hurtful; yet we deny that so great accidents may be stirred up by the falling of it alone unto this or that side, for than it might happen, that women that are great with child, whose wombs are so distended by reason that the child is great, that it doth press the midriff, might Whereof come such divers accidents of strangulation of the womb. be troubled with a strangulation like unto this; but much rather by a venomous humour breathing out a malign and gross vapour, not only by the veins and arteries, but also by the pores that are invisible, which pollutes the faculties of the parts which it toucheth with its venomous malignity & infection, and intercepts the functions thereof. Neither doth the variety of the parts receiving only, but also of the matter received, cause variety of accidents. For, some accidents come by suppression of the terms, others come by corruption The cause of sleepiners in the strangulation of the womb. of the seed, but if the matter be cold, it bringeth a drowsiness, being lifted up unto the brain, whereby the woman sinketh down as if she were astonished, and lieth without motion, and sense or feeling, and the beating of the arteries, and the breathing are so small, that sometimes it is thought they are not at all, but that the woman is altogether dead. If it be more gross, it inferreth a convulsion; if it participate of the nature of a gross melancholic humour, it bringeth such heaviness, fear, and sorrowfulness, that the party that is vexed therewith shall think that she shall die presently, and cannot be brought out of this mind by any means or reason: if The cause of a drowsy madness. of a choleric humour, it causeth the madness called furor uterinus, and such a prattling, that they speak all things that are to be concealed; and a giddiness of the head, by reason that the animal spirit is suddenly shaken by the admixtion of a putrefied vapour and hot spirit: but nothing is more admirable, than that this disease taketh the patient sometimes with laughing, and sometimes with weeping, for some at the first will weep and then laugh in the same disease and state thereof. But it exceedeth all admiration which Hollerius writeth usually happened to two A hisrie. of the daughters of the Provost of Roven. For they were held with long laughter for an hour or two before the fit, which neither for fear, admonition, nor for any other means they could hold; and their parents chid them, and asked them wherefore they did so, they answered, that they were not able to stay their laughter. The ascension of the womb is diligently to be distinguished from the strangulation The ascension of the womb is to be distinguished from the stangulation. thereof; for the accidents of the ascension and of the strangulation are not one, but the woman is only oppressed with a certain pain of the heart, difficulty of breathing, or swooning, but yet without fear, without raving or idle talking, or any other greater accident. Therefore often times contrary causes infer the ascension: that is, overmuch dryness of the womb, labouring through the defect of moisture, whereby it is forced after too violent and immoderate evacuations of the flowers, and in childbed, and such like, and laborious and painful travel in childbirth, through which occasion it waxeth hot, contrary to nature, and withereth and turneth itself with a certain violence unto the parts adjoining, that is to say, unto the liver, stomach and midriff: if happily it may draw some moisture therehence unto it. I omit that the womb may be brought unto its place upwards by often smelling to aromatic things, yet in the mean while it infers not the strangulation that we described before. CHAP. XLV. The signs of imminent strangulation of the womb. BEfore that these forenamed accidents come, the woman thinks that a certain painful thing ariseth from her womb unto the orifice of the stomach and heart, and she thinketh herself to be oppressed and choked, she complaineth herself to be in great pain, and that a certain lump or heavy thing climbs up from the lower parts unto her throat, and stoppeth her wind, her heart burneth and panteth. And in many the womb and vessels of the womb so swell, that they cannot stand upright on their legs, but are constrained to lie down flat on their bellies, that they may be the less grieved with the pain, and to press that down strongly with their hands, that seemeth to arise upwards, although that not the womb itself, but the vapour ascendeth from the The womb itself doth not so well make the ascension as the vapour thereof. womb, as we said before: but when the fit is at hand, their faces are pale on a sudden, their understanding is darkened, they become slow and weak in the legs, with unableness to stand. Hereof cometh sound sleep, foolish talking, interception of the senses, and breathe as if they were dead, loss of speech, the contraction of their legs, and the like. CHAP. XLVI. How to know whether the woman be dead in the strangulation of the womb or not. I Have thought it meet (because many women not only in ancient times, Women living taken for dead. but in our own and our father's memory have been so taken with this kind of symptom, that they have been supposed and laid out for dead, although truly they were alive:) to set down the signs in such a case which do argue life and death. Therefore first of all it may be proved, whether she be alive or dead, by laying or holding a clear and smooth lookingglass before her mouth and nostrils. For, if she breathe, although it be never so obscurely, the thin vapour that cometh out will stain or make the glass dusky. Also a fine downish feather taken from under the wing of any bird, or else a fine flock being held before the mouth, will by the trembling or shaking motion thereof, show that there is some breath, and therefore life remaining in the body. But you may prove most certainly whether there be any spark of life remaining in the body, by How women that have the suffocation of the womb, live only by transpration without breathing. blowing some sneesing powders of pellitory of Spain, & ellebore into the nostrils. But though there no breath appear, yet must you not judge the woman for dead, for the small vital heat, by which, being drawn into the heart, she yet liveth, is contented with transpiration only, and requires not much attraction, which is performed by the contraction & dilatation of the breast and lungs unto the preservation of its self. For so flies, gnats; pismires and such like, because they are of a cold temperament, How flies, gnats and pismires do live all the winter without breathing. live unmovably enclosed in the caves of the earth, no token of breathing appearing in them, because there is a little heat left in them, which may be conserved by the office of the arteries and heart, that is to say, by perspiration, without the motion of the breast, because the greatest use of respiration is that the inward heat may be preserved by refrigeration and ventilation. Those that do not mark this, fall int●…ha● error which almost cost the life of him who in our time first gave life to anotomicall administration, that was almost decayed and neglected. For he being called in Spain to open the body of a noble woman which was supposed A history. dead through strangulation of the womb, behold at the second impression of the incision knife, she began suddenly to come to herself, and by the moving of her members and body, which was supposed to be altogether dead, and with crying, to show manifest signs that there was some life remaining in her. Which thing struck such an admiration & horror into the hearts of all her friends that were present, that they accounted the Physician, being before of a good fame and report, as infamous, odious and detestable, so that it wanted but little but that they would have scratched out his eyes presently: wherefore he thought there was no better way for him, if he would live safe, than to forsake the country. But neither could he so also avoid the horrible prick and inward wound of his conscience (from whose judgement no offender can be absolved) for his inconsiderate dealing, but within few days after, being consumed with sorrow, he died, to the great loss of the common wealth, and the art of physic. CHAP. XLVII. How to know whether the strangulation of the womb comes of the suppression of the flowers, or the corruption of the seed. THere are two chief causes especially, as most frequently happening of the . strangulation of the womb: but when it proceedeth from the corruption of the seed, all the accidents are more grievous and violent: difficulty of breathing goes before, and shortly after comes deprivation thereof; the whole habit of the body seemeth more cold than a stone: the woman is a widow: or else hath great store or abundance of seed, and hath been used to the company of a man, by the absence whereof she was before wont to be pained with heaviness of the head, to loathe her meat, and to be troubled with sadness and fear, but chiefly The 〈…〉 when i●… of the suppossion 〈◊〉 the flowers. with melancholy. Moreover when she hath satisfied, and every way fulfilled her lust, and then presently on a sudden begins to contain herself. It is very likely that she is suffocated by the supprossion of the flowers, which formerly had them well and sufficiently, which formerly hath been fed with hot, moist, and many meats, and therefore engendering much blood, which sitteth much, which is grieved with some weight and swelling in the region of the belly, with pain in the stomach, and a desire to vomit, and with such other accidents as come by the suppression of the flowers. Those who are freed from the fit of the suffocation of the womb, either by nature . or by are, in a short time their colour cometh into their faces by little and little, and the whole body beginneth to wax strong, and the teeth, that were set and closed fast together, begin (the jaws being loosed) to open and unclose again, and lastly, some moisture floweth from the secret parts with a certain tickling pleasure; but in some women, as in those especially in whom the neck of the womb is tickled with the mydivives singer, in stead of that moisture comes thick and gross seed, which moisture or seed when it is fallen, the womb being before as it were raging, is restored unto its own proper nature and place, and by little and little all symptoms vanish away. Men by the suppression of their seed have not the like symptoms as women have, because man's seed is not so cold and moist, but far more perfect and better digested, Why the supprossion the 〈…〉 ●eri 〈◊〉 or deadly ●●men. and therefore more meet to resist putrefaction, and whiles it is brought or drawn together by little and little, it is dissipated by great and violent exercise. CHAP. XLVIII. Of the cure of the strangulation of the womb. SEeing that the strangulation of the womb is a sudden and sharp disease, it therefore requireth a present and speedy remedy, for if it be neglected The pulling the hair of the lower parts both for this malady and for the cause of the same. it many times causeth present death. Therefore, when this malady cometh, the sick woman must presently be placed on her back, having her breast and stomach lose, and all her clothes & garments slack & lose about her, whereby she may take breath the more easily; and she must be called on by her own name, with a loud voice in her ears, and pulled hard by the hairs of the temples and neck, but yet especially by the hairs of the secret parts, that by provoking or causing pain in the lower parts, the patient may not only be brought to herself again, but also that the sharp and malign vapour ascending upwards, may be drawn downwards: the legs and arms must be bound and tied with painful ligatures, all the body must be rubbed over with rough linen clothes besprinkled with salt and vinegar, until it be very sore and red, and let this pessary following be put into the womb. ℞. succi mercurial. artemis. an. ℥ two. in quibus dissolve pull. bened. A Pessary. ʒiii. pull. radic. enulae camp. galang. minor. an. ʒi. make thereof a pessary. Then let the soles of her feet be anointed with oil of days, or with some such like oil, let a great cupping-glass with a greatflame be applied to the belly below the navel, to the inner part of the thigh, and to the groin, whereby both the matter that climbs upwards, and also the womb itself running the same way, may be brought downwards or drawn back. There may be made a fumigation of spices to be received up into the womb, which, that it may be the easier done, the womb may be held open by putting in this instrument here described into the neck thereof. Let it be made of gold, silver or latin into the form of a pessary; at the one end thereof, that is to say, that end which goeth up into the neck of the womb, let there be made many holes on each side, but at the lower end let it be made with a spring, that it may open and shut as you will have it. Also it must have two laces or bands by which it must be made fast unto a swath or girdle tied about the patient's belly. The form of a Pessary to be put into the neck of the womb to hold it open. The description of a vessel made with a funnel or pipe for to fumigate the womb. The matter and ingredients of sweet and aromatic fumigations, are cinnamon, callam. aromat. lig. aloes, laudanum, benzoin, thyme, pepper, cloves, lavender, calaminth, The matter of sweet fumigations. mugwort, penniroyall, alepta moschat. nutmegs, musk, moss, amber, squinant, and such like, which for their sweet smell and sympathy, allure or entice the By what power sweet fumigations do restore the womb unto its own nature and place. Stinking smells to be applied to the nostrils. womb downwards, by their heat consume and digest the thick vapours, and putrefied ill juice. chose, let the nostrils be perfumed with foetide and rank smells, and let these be made with gum. galbanum, sagapenum, ammoniacum, assa foetida, bitumen, oil of Jet, snuff of a tallow candle when it is blown out, with the fume of birds feathers, especially of Partridges and Woodcocks, of man's hair or goat's hair, of old leather, of horse hooves, and such like things burned, whose noisome or offensive savour the womb avoiding, doth return unto its own place or seat again. Moreover it shall be very necessary to procure vomit by thrusting a goose feather down into the throat, or else the hairs of the patients own head. Shortly after she must use a potion of fifteen grains of black pepper bruised and dissolved in Avicens' secret for suffocation of the womb. hydromel, or water and honey mixed together, or in some strong wine, which remedy Avicen holdeth for a secret. Also in stead thereof three hours before meat ʒss. of treacle dissolved in ℥ i. of the water of wormwood may be given her: Also it is thought that one drop of the oil of Jet dropped on the tongue, is a very profitable remedy. There be some that allow a potion of half a dram of Castoreum dissolved in white wine, or in the Castoreum drunken. broth of a capon: also it is profitable not only to give her treacle to drink, but also to inject it into the womb, being first dissolved in aqua vitae, and in the mean time to drop two drops of oil of sage, or some such chemical oil into the ears. Expressions into the womb. If she be drowsy or sleepy, she must be awaked or kept waking with sneesing powders of white ellebore and pellitory. It is also requisite to inject glisters both into the fundament and secret parts, which must be made of the decoction of things that discuss wind, as of calamint, The matter of pessaries. mugwort, lavender, pennyroyal, chamomel, melilote, and such like; and let pessaries or suppositories be made of laudanum, ginger, gallia moschat. treacle, mithridate, civet and musk, of the oil of cloves, anniseeds, sage, rosemary, and such like, chemically drawn; this following is a convenient description of a clyster. ℞. radic. enulae, A clyster scattering gross vapours. camp. Ireos, ebuli, aristoloch. an. ℥ i. fol. absynth. artemesiae, matricar. puleg. origani, an. m. i baccarum lauri, juniperi & sambuc. an. p. i sem. amios, cymini, rutae an. ʒii. florum sloechadoes, rorismarin. salviae, centaur. minor. an. p. two. fiat decoctio, cape colaturae lb. i in qua dissolve mellis anthosatis, sacch. rubr. & bened. an. ℥ i. diacharth. ʒii. olei aneth. nard. an. ℥ iss. make thereof a clyster, and apply this plaster following to the belly. ℞. mass. empl. oxycrocei, & melilot. an. ℥ iii olei nard. as much as shall suffice to make it conveniently soft, make thereof a plaster, and spread it on leather, and apply it to the region of the belly when the fit is ended: if she be married, let her forthwith use A quick, certain & a pleasant remedy for the suffocation of the womb. Tickling of the neck of the womb. copulation, and be strongly encountered by her husband, for there is no remedy more present than this. Let the midwife anoint her fingers with oleum nardinum or moschetalinum, or of cloves, or else of spike mixed with musk, ambergreese, civet, and other sweet powders, and with these let her rub or tickle the top of the neck of the womb which toucheth the inner orifice; but her secret parts must first be warmed by the applying of warm linen clothes, for so at length the venomous matter contained in the womb, shall be dissolved and flow out, and the malign, sharp and flatulent vapours, whereby the womb is driven as it were into a fury or rage, shall be resolved and dissipated, and so when the conjunct matter of the disease is scattered and wasted, the womb, and also the woman shall be restored unto themselves again. Some hold it for a secret to rub the navel with the juice of garlic boiled and mixed with aloes. CHAP. XLIX. Of women's monthly flux or courses. USually they call the flux of blood, that issueth from the secret parts of The reason of the names of the monthly flux of women. women, monthly flowers or courses, because it happeneth to them every month so long as they are in health. There be some which call them terms, because they return at their usual time. Many of the French men call it sepmaines, because in such as sit much, and are given to plentiful feeding, it endureth almost for the space of seven days. Some call them purgations, because that by this flux all a woman's body is purged of super fluous humours. There be some also that call those fluxes the flowers, because that as in plants the flower buddeth out before the fruits, so in women kind this flux goeth before the issue, or the conception thereof. For the courses flow not before a woman be able to conceive: for how should the seed being cast into the womb have his nourishment and increase, and how should the child have his nourishment when it is form of the seed, if this necessary humour were wanting in the womb? yet it may be some women may conceive What women do conceive this flux not appearing at all. without this flux of the courses: but that is in such as have so much of the humour gathered together, as is wont to remain in those which are purged, although it be not so great a quantity that it may flow out, as it is recorded by Aristotle. But as it is in some very great, and in some very little, so it is in some seldom, and in some very often. There are some that are purged twice, and some thrice in a month, but it is altogether in those who have a great liver, large veins, and are filled and fed with many and greatly nourishing meats, which sit idly at home all day, which having What women have this menstrual flux often, abundantly & for a longer space than others. slept all night, do notwithstanding lie in bed sleeping a great part of the day also, which live in a hot, moist, rainy and southerly air, which use warm baths of sweet waters and gentle frictions, which use and are greatly delighted with carnal copulation: in these and such like women the courses flow more frequently and abundantly. But chose, in those that have small and obscure veins, in those that have What women have t●● flux more seldom, less, and a far more shorrtime than others. their bodies more furnished and big either with flesh or with fat, are more seldom purged, and also more sparingly, because that the superfluous quantity of blood useth to go into the habit of the body. Also tender, delicate and fair women are less purged than those that are brown and endued with a more compact flesh, because that by the rarity of their bodies, they suffer a greater wasting or dissipation of their substance by transpiration. Moreover, they are not so greatly purged with this kind of purgation, which have some other solemn or accustomed evacuation in any other place of their body, as by the nose or hemorrhoids. And as concerning their age, old women are purged when the Moon is old, and Why young women are purged in the new of the Moon. young women when the Moon is new, as it is thought. I think the cause thereof is, for that the Moon ruleth moist bodies, for by the variable motion thereof the Sea floweth and ebbeth, and bones, marrow and plants abound with their genital humour. Therefore young people which have much blood, and more fluxible, and their bodies more fluxible, are soon moved unto a flux, although it be even in the first quarter of the Moon's risingor increasing: but the humours of old women, because Why old women are purged in the wane of the Moon. they wax stiff as it were with cold, & are not so abundant, and have more dense bodies and straighter vessels, are not so apt to a flux, nor do they so easily flow, except it be in the full of the Moon, or else in the decrease; that is to say, because the blood that is gathered in the full of the Moon falls from the body even of its own weight, for that by reason of the decreasing or wane of the Moon this time of the month is more cold and moist. CHAP. L. The causes of the monthly flux or courses. BEcause a woman is more cold, and therefore hath the digestive faculty more weak, it cometh to pass, that she requireth and desireth more The material cause of the monthly flux. meat or food than she can digest or concoct: And because that superfluous humour that remaineth is not digested by exercise, nor by the efficacy of strong and lively heat, therefore by the providence or benefit of nature it floweth out by the veins of the womb, by the power of the expulsive faculty, at its own certain and prefixed season or time. But then especially When the monthly flux begins to flow. it beginneth to flow, and a certain crude portion of blood to be expelled, being hurtful and malign otherwise in no quality, when nature hath laid her principal foundations of the increase of the body, so that in greatness of the body, she hath come as it were in a manner to the highest top, that is to say, from the thirteenth to the fiftieth year of our age. Moreover, the child cannot be form in the womb, nor have his nutriment or increase without this flux: therefore this is another final cause of the monthly The final cause. flux. Many are persuaded that women do far more abound with blood than men, A woman exceeds a man in quantity of blood. considering how great an abundance of blood they cast forth of their secret parts every month, from the thirteenth to the fiftieth year of their age: how much women great with child, of whom also many are menstrual, yield unto the nutriment and increase of the child in their wombs, and how much Physicians take from women that are with child by opening of a vein, which otherwise would be delivered before their natural and prefixed time; how great a quantity thereof they avoid in the birth of their children, and for ten or twelve days after, and how great a quantity of milk they spend for the nourishment of the child when they give suck, which milk is none other thing than blood made white by the power of the kernels that are in the dugs, which doth suffice to nourish the child, be he great or little; yet notwithstanding many nurses in the mean while are menstrual: and as that may be true, so certainly this is true, that one dram (that I may so speak) of a man's blood, is of more efficacy to nourish and increase, than two pounds of woman's A man execedeth a woman in the quality of his blood. blood, because it is far more perfect, more concocted, wrought, and better replenished with abundance of spirits: whereby it cometh to pass that a man endued with a more strong heat, doth more easily convert what meat soever he eateth A man is more hot than a woman, and therefore not menstrual. unto the nourishment & substance of his body; & if that any superfluity remains, he doth easily digest and scatter it by insensible transpiration. But a woman being more cold than a man, because she taketh more than she can concoct, doth gather together more humours, which because she cannot disperse, by reason of the unperfectness and weakness of her heat, it is necessary that she should suffer, and have her monthly purgation, especially when she groweth unto some bigness; but there is no such need in a man. CHAP. LI. The causes of the suppression of the courses or menstrual flux. THe courses are suppressed or stopped by many causes, as by sharpvehement, and long diseases, by fear, sorrow, hunger, immoderate labours, watchings, fluxes of the belly, great bleeding, hoemorrhoides, fluxes of blood at the mouth, and evacuations in any other part of the body whatsoever, often opening of a vein, great sweats, ulcers flowing much and long, scabbiness of the whole skin, immoderate grossness and clamminess of the blood, and by eating of raw fruits, and drinking of cold water, by sluggishness and thickness of the vessels, and also the obstruction of them by the defaults and diseases of the womb, by distemperature, an abscess, an ulcer, by the obstruction of the inner orifice thereof, by the growing of a Callus, caruncle, cicatrise of a wound or ulcer, or membrane growing there, by injecting of astringent things into the neck of the The foolish endeavour of making the orifice of the womb narrow, is rewarded with the discommodity of stopping of the flowers. What women are called viragines. Lib. 6. epidem. sect. 7. womb, which place many women endeavour foolishly to make narrow: I speak nothing of age, greatness with child, & nursing of children, because these causes are not besides nature, neither do they require the help of the Physician. Many women, when their flowers or terms be stopped, degenerate after a manner into a certain manly nature, whence they are called Viragines, that is to say, stout, or manly women; therefore their voice is more loud and big, like unto a man's, and they become bearded. In the city Abdera (saith Hypocrates) Phaethusa the wife of Pytheas at the first did bear children and was fruitful, but when her husband was exiled, her flowers were stopped for a long time: but when these things happened, her body became manlike and rough, and had a beard, and her voice was great and shrill. The very same thing happened to Namysia the wife of Gorgippus in Thasus. Those virgins that from the beginning have not their monthly flux, and yet nevertheless enjoy their perfect The women that are called viragines are barren. health, they must necessarily be hot and dry, or rather of a manly heat and dryness, that they may so disperse and dissipate by transpiration, as men do, the excrements that are gathered, but verily all such are barren. CHAP. LII. What accidents follow the suppression or stopping of the monthly flux or flowers. WHen the flowers or monthly flux are stopped, diseases affect the womb, and from thence pass into all the whole body. For thereof cometh suffocation of the womb, headache, swooning, beating of the heart, and swelling of the breasts and secret parts, inflammation of the womb, an abscess, ulcer, cancer, a fever, nauseousness, vomitings, difficult and slow concoction, the dropsy, strangury, the full womb pressing upon the orifice of the bladder, black and bloody Why the strang●… or bloodiness of the urine followeth the suppression of the flowers. urine, by reason that portion of the blood sweateth out into the bladder. In many women the stopped matter of the monthly flux is excluded by vomiting, urine, and the hoemorrhoides, in some it groweth into varices. In my wife, when she was a maid, the menstrual matter was excluded and purged by the nostrils. The wife Histories of such as were purged of their menstrual flux by the nose and dugs. of Peter Feure of Casteaudun, was purged of her menstrual matter by the dugs every month, and in such abundance, that scarce three or four clothes were able to dry it and suck it up. In those that have not the flux monthly to evacuate this plenitude by some part or place of the body, there often follows difficulty of breathing, melancholy, madness, the gout, an ill disposition of the whole body, dissolution of the strength of the whole body, want of appetite, a consumption, the falling sickness, an apoplexy. Those whose blood is laudable, yet not so abundant, do receive no other discommodity by the suppression of the flowers, unless it be that the womb burns or itcheth with the desire of copulation, by reason that the womb is distended with hot and itching blood, especially if they lead a sedentary life. Those women that have been accustomed to bear children, are not so grieved and evil at ease when To what women the suppression of the months is most grievous their flowers are stopped by any chance contrary to nature, as those women which did never conceive, because they have been used to be filled, and the vessels by reason of their customary repletion and distension, are more large and capacious: when the courses flow, the appetite is partly dejected, for that nature, being then wholly applied to expulsion, cannot throughly concoct or digest, the face waxeth pale, and without its lively colour, because that the heat with the spirits, go from without inwards, so to help and aid the expulsive faculty. CHAP. LIII. Of provoking the flowers or courses. THe suppression of the flowers is a plethoric disease, and therefore must be cured by evacuation, which must be done by opening the vein called Saphena which is at the ankle, but first let the basilike vein of the arm be opened, especially if the body be plethoric, lest that there Why the vein called basilica in the arm must be opened before the vein saphena in the foot. Horseleeches to be applied to the neck of the womb. should a greater attraction be made into the womb, and by such attraction or flowing in, there should come a greater obstruction. When the veins of the womb are distended with so great a swelling that they may be seen, it will be very profitable to apply horseleeches to the neck thereof: pessaries for women may be used; but fumigations of aromatic things are more meet for maids, because they are bashful and shamefaced. Unguents, liniments, emplasters, cataplasms, that serve for that matter, are to be prescribed and applied to the secret parts, ligatures and frictions of the thighs and legs are not to be omitted, fomentations and sternutatories are to be used, and cupping glasses are to be applied to the groins, walking, dancing, riding, often and wanton copulation with her husband, and such like exercises, provoke the flowers. Of plants, the flowers of St. John's wort, the roots of fennel, and asparagus, bruscus or butcher's broom, of parsley, brookelime, basil, balm, betony, Plants that provoke the flowers garlic, onions, crista marina, costmary, the rind or bark of cassia fistula, calamint, origanum, pennyroyal, mugwort, thyme, hissope, sage, marjoram, rosemary, horehound, rue, savine, spurge, saffron, agaric, the flowers of elder, bay berries, the berries of Ivy, scammony, Cantharideses, pyrethrum or pellitory of Spain, suphorbium. The aromatic things are amomum, cinnamon, squinanth, nutmegs, calamus Sweet things. aromaticus, cyperus, ginger, cloves, galangall, pepper, cubibes, amber, musk, spikenard, and such like; of all which let fomentations, fumigations, baths, broths, boles, potions, pills, syrupes, apozems, and opiates be made as the Physicians shall think good. The apozem that followeth is proved to be very effectual. ℞. flo. & flor. dictam. An apozem to provoke the flowers. an. pii. pimpinel. m ss. omnium capillar. an. p i. artemis. thymi, marjor. origan. an. m ss. rad. rub. major. petroselin. faenicul. an. ℥ i ss. rad. paeon. bistort. an. ʒ ss. cicerum rub. sem. paeon. faenicul. an. ʒ ss. make thereof a decoction in a sufficient quantity of water, adding thereto cinnamon ʒ iii in one pint of the decoction dissolve (after it is strained) of the syrup of mugwort, and of hissope, an. ℥ two. diarrhod. abbot. ʒ i let it be strained through a bag, with ʒ two. of the kernels of dates, and let her take ℥ iiii. in the morning. Let pessaries be made with galbanum, ammoniacum, and such like mollifying things, beaten into a mass in a mortar with a hot pestle, and made into the form of a pessary, and then let them be mixed with oil of Jasmine, euphorbium, an oxegall, the juice of mugwort, and other such like, wherein there is power to provoke the flowers, as with scammony in powder: let them be as big as one's thumb, six fingers long, and rolled in lawn, or some such like thin linen cloth; of the same things nodulas may be made. Also pessaries may be prepared with honey boiled, adding thereto convenient powders, as of scammony, pellitory, and such like. Neither ought these to stay long in the neck of the womb, lest they should exulcerate, and they must be pulled back by a thread that must be put through them, and then the orifice of the womb must be fomented with white wine of the decoction of pennyroyal or mother-wort. But it is to be noted, that if the suppression of the flowers happeneth through the What causes of the stopping of the flowers must be cured before the discase itself. default of the stopped orifice of the womb, or by inflammation, these maladies must first be cured before we come unto those things that of their proper strength and virtue provoke the flowers: as for example, if such things be made and given when the womb is inflamed, the blood being drawn into the grieved place, and the humours sharpened, and the body of the womb heated, the inflammation will be increased. So if there be any superfluous flesh, if there be any Callus of a wound or ulcer, or if there be any membrane shutting the orifice of the womb, and so stopping the flux of the flowers, they must first be consumed and taken away before any of those things be administered. But the opportunity of taking and applying of things, The fittest time to provoke the flowers. must be taken from the time wherein the sick woman was wont to be purged before the stopping, or if she never had the flowers, in the decrease of the moon; for so we shall have custom, nature, and the external efficient cause to help art. When these Why hot houses do hurt those in whom the flowers are to be provoked. medicines are used, the women are not to be put into baths or hot houses, as many do, except the malady proceed from the density of the vessels, and the grossness and clamminess of the blood. For sweats hinder the menstrual flux, by diverting and turning the matter another way. CHAP. LIIII. The signs of the approaching of the menstrual flux. WHen the monthly flux first approacheth, the dugs itch and become more swollen and hard than they were wont, the woman is more desirous of copulation, by reason of the ebullition of the provoked blood, What women ●…and what women due loath the act of generation when the months are stopped. and the acrimony of the blood that remaineth, her voice becometh bigger, her secret parts itch, burn, swell, and wax red. If they stay long, she hath pain in her loins and head, nauseousness and vomiting troubleth the stomach: notwithstanding, if those matters which flow together in the womb, either of their own nature, or by corruption, be cold, they loathe the act of generation, by reason that the womb waxeth feeble through sluggishness and watery humours filling the same, and it floweth by the secret parts very softly. Those maids that are marriageable, although they have the menstrual flux very well, yet they With what accidents those that are manageable and 〈◊〉 mar●●●, a●… troubled. are troubled with head ache, nauseousness, and often vomiting, want of appetite, longing, an ill habit of body, difficulty of breathing, trembling of the heart, swooning, melancholy, fearful dreams, watching, with sadness and heaviness, because that the genital parts burning & itching, they imagine the act of generation, whereby it cometh to pass that the seminal matter, either remaining in the testicles in great abundance, or else poured into the hollowness of the womb, by the tickling of the genitals, is corrupted, and acquireth a venomous quality, and causeth such like accidents as happens in the suffocation of the womb. Maids that live in the country are not so troubled with those diseases, because there is no such lying in wait for their maidenheads, and also they live sparingly and hardly, and spend their time in continual labour. You may see many maids so full of juice, that it runneth in great abundance, as if they were not menstrual, into their dugs, and is there converted into milk, which they have in as great quantity as nurses, as we read it recorded by Hypocrates. If a woman which is neither great with Aph. 36. sect. 5. child, nor hath born children, hath milk, she wants the menstrual fluxes; whereby you may understand that that conclusion is not good which affirmeth that a woman which hath milk in her breasts, either to be delivered of child, or to be great with child: for Cardanus writeth that he knew one Antony Buzus at Genua, who being Lib. 2. de subt. thirty years of age, had so much milk in his breasts as was sufficient to nurse a child; for the breeding and efficient cause of milk proceeds not only from the engrafted faculty of the glandulous substance, but much rather from the action of the man's The efficient cause of the milk is to be noted. seed; for proof whereof you may see many men that have very much milk in their breasts, and many women that almost have no milk, unless they receive man's seed. Also women that are strong and lusty like unto men, which the Latins call Viragines, that is to say, whose seed cometh unto a manly nature, when the flowers are stopped, concoct the blood, and therefore when it wanteth passage forth, by the likeness of the substance it is drawn into the duggs, and becometh perfect milk: those that have the flowers plentifully and continually for the space of four or five days, are better purged and with more happy success than those that have them for a longer time. CHAP. LV. What accidents follow immoderate fluxes of the flowers or courses. IF the menstrual flux floweth immoderately, there also follows many accidents; for the cocoction is frustrated, the appetite overthrown, then follows coldness throughout all the body, exolution of all the faculties, an ill habit of all the body, leanness, the dropsy, a hectic fever, convulsion, swooning, and often sudden death: if any have them too exceeding immoderately, the blood is sharp and burning, and also stinking, the sick woman is troubled with a continual fever, and her tongue will be dry, ulcers arise in the gums and all the whole mouth. In women the flowers do flow by the veins By what pores the flowers due flow in a woman and in a maid. and arteries which rise out of the spermaticke vessels, and are ended in the bottom and sides of the womb, but in virgins and in women great with child, whose children are sound and healthful, by the branches of the hypogastrick vein and artery, which are spread and dispersed over the neck of the womb. The cause of this immoderate flux is in the quantity or quality of the blood, in both the fault is unreasonable The causes of an unteasionable flute of blood. copulation, especially with a man that hath a yard of a monstrous greatness, and the dissolution of the retentive faculty of the vessels: oftentimes also the flowers flow immoderately by reason of a painful & a difficult birth of the child or the afterbirth, being pulled by violence from the cotyledons of the womb, or by reason that the veins and arteries of the neck of the womb are torn by the coming forth of the infant with great travel, and many times by the use of sharp medicines, and exulcerating pessaries. Often times also nature avoides all the juice of the whole body critically by the womb after a great disease, which flux is not rashly or suddenly The critical flux of the flowers. The signs of blood dowing from the womb or neck of the womb. to be stopped. That menstrual blood that floweth from the womb is more gross, black, and clotty, but that which cometh from the neck of the womb is more clear, liquid and red. CHAP. LVI. Of stopping the immoderate flowing of the flowers or courses. YOu must make choice of such meats and drinks as have power to incrassate the blood, for as the flowers are provoked with meats that are hot, and of subtle parts, so they are stopped by such meats as are cooling, thickening, astringent and styptic, as are barley waters, sodden rice, the extreme parts of beasts, as of oxen, calves, sheep, either fried or sodden with sorrel, purslane, plantain, shepherd's purse, sumach, the buds of brambles, berberries, and such like. It is supposed that a heart's horn burned, washed, and taken in astringent water, will stop all immoderate fluxes; likewise sanguis draconis, terra sigillata, bolus armenus, lapis haematites, coral beaten into most subtle powder and drunk in steeled water; also pap made with milk, wherein steel hath often times been quenched, and the flower of wheat, barley, beans or rice, is very effectual for the same. Quinces, cervices, medlars, cornelian berries, or cherries may likewise be eaten at the second course, Juleps are to be used of steeled waters, with the syrup of dry roses, pomegranates, sorrel, myrtles, quinces, or old conserveses of red roses, but wine is to be avoided: but if the strength be so extenuated that they require it, you must choose gross and astringent wine tempered with steeled water; exercises are to be shunned, especially venereous exercises, anger is to be avoided, a cold air is to be chosen, which, if it be not so naturally, must be made so by sprinkeling The institution or order of 〈◊〉. cold things on the ground, especially if the summer or heat be then in his full strength; sound sleeping stays all evacuations except sweeting. The opening of a vein in the arm, cupping glasses fastened on the breasts, bands, and painful frictions of the upper parts are greatly commended in this malady. But if you perceive that the cause of this accident lieth in a choleric ill juice mixed with the blood, the body must be purged with medicines that purge choler and Purging water, as Rhubarb, Myrobalanes, Tamarinds, Sebestens, and the purging syrup of roses. CHAP. LVII. Of local medicines to be used against the immoderate flowing of the Courses. ALso unguents are made to stay the immoderate flux of the terms, and likewise injections and pessaries. This or such like may be the form of an unguent. ℞. ol. mastic. & myrt. an. ʒii. nucum cupres. olibani, myrtil. an. ʒii. succi rosar. rubr. ℥ i. pulv. mastichin. ℥ two. boli armen. terrae sigillat. An unguent. an. ʒss. cerae quantum sufficit, fiat unguentum. An injection may be thus made. ℞. aq. An astringent injection. plantag. rosar. rubrar. bursae pastor. centinodii, an. lb ss. corticis querni, nucum cupressi, gallar. non maturar. an. ʒii. berberis, sumach. ballast. alumin. roch. an. ʒi. make thereof a decoction, and inject it with a syringe blunt pointed into the womb, lest if it should be sharp it might hurt the sides of the neck of the womb; also snails beaten with their shells and applied to the navel, are very profitable. Quinces roasted under the coals, and incorporated with the powder of myrtills, and bowl armenick, and put into the neck of the womb, are marvellous effectual for this matter. The form of a pessary may be thus. ℞. gallar. immaturar. combust. & in aceto extinctar. ʒii. ammo. ʒss. sang. dracon. pull. rad. symphyt. sumach. mastic. succi acaciae, cornu cer. Astringent pes●…. ust. colophon, myrrhae, scoriae ferri, an. ʒi. caphur. ℈ two. mix them, and incorporate them all together with the juice of knotgrass, syngreen, nightshade, henbane, water lilies, plantain, of each as much as is sufficient, and make thereof a pessary. Cooling things, as oxycrate, unguentum rosatum, and such like, are with great profit used to the region of the loins, thighs, and genital parts: but if this immoderate flux do come by erosion, so that the matter thereof continually exulcerateth the neck of the womb, let the place be anointed with the milk of a she Ass, with barley water, or binding and astringent mucelages, as of psilium, quinces, gum trugacanth, arabic, and such like. CHAP. LVIII. Of women's fluxes, or the Whites. BEsides the forenamed flux, which by the law of nature happeneth to women monthly, there is also another called a woman's flux, because The reason of the name. it is only proper and peculiar to them: this sometimes wearieth the woman with a long and continual distillation from the womb, or The differences through the womb, coming from the whole body without pain, no otherwise than when the whole superfluous filth of the body is purged by the reins or urine; sometimes it returneth at uncertain seasons, and sometimes with pain and exulcerating the places of the womb: it differeth from the menstrual flux, because that this for the space of a few days, as it shall seem convenient to nature, casteth forth laudable blood, but this woman's flux yieldeth impure ill juice, sometimes sanious, sometimes serous and livide, otherwhiles white and thick, like unto barley cream, proceeding from phlegmatic blood: this last kind thereof is most frequent. Therefore we see women that are phlegmatic, and of a soft and loose habit of body, What women are apt to this flux. to be often troubled with this disease, and therefore they will say among themselves that they have the whites. And as the matter is divers, so it will stain their smocks with a different colour. Truly if it be perfectly red and sanguine, it is to be thought that it cometh by erosion, or the exolution of the substance of the vessels of the womb, or of the neck thereof: therefore it cometh very seldom of women's flux cometh very seldom of blood. blood, and not at all except the woman be either great with child, or cease to be menstrual for some other cause; for then in stead of the monthly flux there floweth a certain whayish excrement, which staineth her clothes with the colour of water wherein flesh is washed. Also it very seldom proceeds of a melancholy humour, and then for the most part it causeth a cancer in the womb. But often times the purulent and bloody matter of an ulcer lying hidden in the womb, deceiveth the unskilful Chirurgeon or Physician: but it is not so hard to know these diseases one from the other; for the matter that floweth from an ulcer, because (as it is said) it is purulent, it is By what signs an ulcer in the womb may be known from the white flowers. also lesser, grosser, stinking, and more white. But those that have ulcers in those places, especially in the neck of the womb, cannot have copulation with a man without pain. CHAP. LIX. Of the causes of the Whites. SOmetimes the cause of the whites consisteth in the proper weakness of the womb, or else in the uncleanness thereof, and sometimes by the default of the principal parts. For if the brain or the stomach be cooled, or the liver stopped or schirrous, many crudities are engendered, which if they run or fall down into the womb that is weak by nature, they cause the flux of the womb, or whites: but if this flux be moderate and How a woman flux is wholesome. How it causeth diseases. not sharp, it keepeth the body from malign diseases; otherwise it useth to infer a consumption, leanness, paleness, and an oedematous swelling of the legs, the falling down of the womb, the dejection of the appetite and all the faculties, and continual sadness and sorrowfulness; from which it is very hard to persuade the sick woman, because that her mind and heart will be almost broken, by reason of the shame that she taketh because such filth floweth continually; it hindereth conception, because it either corrupteth, or driveth out the seed when it is conceived. How it letteth the conception. Often times, if it stoppeth for a few months, the matter that stayeth there causeth an abscess about the womb in the body or neck thereof, and by the breaking of the abscess there followeth rotten and cancerous ulcers, sometimes in the womb, sometimes in the groin, and often in the hips. This disease is hard to be cured, not only by reason of itself, as because all the whole filth and superfluous excrements of a woman's body floweth down into the Why it is hard to be cured. womb, as it were into a sink, because it is naturally weak, hath an inferior situation, many vessels ending therein; and last of all, because the courses are wont to come through it; as also by reason of the sick woman, who often times had rather dye than to have that place seen, the disease known, or permit local medicines to be applied thereto: for so saith Montanus, that on a time he was called to a noble woman A history. of Italy who was troubled with this disease, unto whom he gave counsel to have cleansing decoctions injected into her womb, which when she heard, she fell into a swoon, and desired her husband never thereafter to use his counsel in any thing. CHAP. LX. The cure of the Whites. IF the matter that floweth out in this disease be of a red colour, it If the flux● of a woman be red, wherein it differeth ●ro● the ●…uall flux. differeth from the natural monthly flux in this only, because it keeps no order or certain time in its returning. Therefore phlebotomy and other remedies which we have spoken of, as requisite for the menstrual flux when it floweth immoderately, is here necessary to be used. But if it be white, or doth testify or argue the ill juice of this or that humour by any other colour, a purgation must be prescribed of such things as are proper to the humour that offends: for it is not good to stop such A woman's flux is not suddenly to be stopped. a flux suddenly; for it is necessary, that so the body should be purged of such filth or abundance of humours: for they that do hasten to stop it, cause the dropsy, by reason that this sink of humours is turned back into the liver; or else a cancer in the womb, because it is stayed there; or a fever, or other diseases, according to the condition of the part that receiveth it. Therefore we must not come to local detersives, de●i●catives, restrictives, unless we have first used universal remedies according to art. Alom baths, baths of brimstone, and of bitumen, or iron, are convenient for the whites that come of a phlegmatic humour; instead whereof baths may be made What baths are profitable. of the decoction of herbs that are hot, dry, and endued with an aromatic power, with alum and pebbles, or flintstones red hot thrown into the same. Let this be the form of a cleansing decoction and injection. ℞. fol. absynth. agrimon. centinod. burrs. past. an. mss. boil them together, and make thereof a decoction, in which An astringent injection. dissolve mellis rosar. ℥ two. aloes, myrrhae, salis nitri, an. ʒi. make thereof an injection, the woman being so placed on a pillow under her buttocks that the neck of the womb being more high, may be wide open: when the injection is received, let the woman ●et her legs across, and draw them up to her buttocks, and so she may keep that which is injected. They that endeavour to dry and bind more strongly, add the juice of acatia, green galls, the rinds of pomegranates, roch alum, roman vitriol, and they boil them in Smiths water and red wine; pessaries may be made of the like faculty. If the matter that cometh forth be of an ill colour or smell, it is like that there is a rotten ulcer; therefore we ought to inject those things that have power to correct The signs of a putrefyed ulcer in the womb. the putrefaction: among which aegyptiacum, dissolved in lie or red wine, excelleth. There are women which when they are troubled with a virulent Gonorrhaea, or an The virulent Gonorrhaea is like unto the duxe of women. involuntary flux of the seed, cloaking the fault with an honest name, do untruly say that they have the whites, because that in both these diseases a great abundance of filth is voided. But the Chirurgeon may easily perceive that malady by the rottenness of the matter that floweth out, and he shall persuade himself that it will not be cured without salivation or fluxing at the mouth, and sweats. In the mean while let him put in an instrument made like unto a pessary, and cause the sick woman to hold it there: this instrument must have many holes in the upper end, through which the purulent matter may pass, which by staying or stopping might get a sharpness; as also that so the womb may breathe the more freely, and may be kept more temperate and cool by receiving the air, by the benefit of a spring whereby this instrument, being made like unto a pessary, is opened and shut. The form of an instrument made like unto a pessary, whereby the womb may be ventilated. A. showeth the end of the instrument, which must have many holes therein. B. showeth the body of the instrument. C. showeth the plate whereby the mouth of the instrument is opened and shut, as wide and as close as you will, for to receive air more freely. D. showeth the spring. EE show the laces and bands to tie about the patient's body, that so the instrument may be stayed and kept fast in his place. CHAP. LXI. Of the hoemorrhoides and warts of the neck of the womb. LIke as in the fundament, so in the neck of the womb there are hoemorrhoides, and as it were varicous veins, often times flowing The differences of the hoemorrhoides of the neck of the womb. with much blood, or with a red and stinking whayish humour. Some of these by reason of their redness and great in equality as it were of knobs, are like unripe mulberries, and are called vulgarly venae morales, that is to say, the veins or hoemorrhoides like unto mulberries; others are like unto grapes, and therefore are named uvales; other some are like unto warts, and therefore are called venae verrucales: some appear & show themselves with a great tumour, others are little and in the bottom of the neck of the womb, others are in the side or edge thereof. Achrochordon is a kind of What an Acrochordon is. wart with a callous bunch or knot, having a thin or slender root, and a greater head, like unto the knot of a rope, hanging by a small thread; it is called of the Arabians, verruc● botoralis. There is also another kind of wart, which because of his great roughness and unequality is called thymus, as resembling the flower of Thyme. All such diseases are What a thymus is. exasperated and made more grievous by any exercise, especially by venereous acts: many times they have a certain malignity, and an hidden virulency joined with them, by occasion whereof they are aggravated even by touching only, because they have their matter of a raging humour: therefore to these we may not rightly use a true, but only the palliative cure, as they term it: the Latins call them only ficus, but the French men name them with an adjunct, St. Fiacrius figs. St. Fiacrius figs. CHAP. LXII. Of the cure of the Warts that are in the neck of the womb. THe warts that grow in the neck of the womb, if they be not malign, What warts of the womb must be bound and so cut off. are to be tied with a thread, and so cut of●. Those that lie hid more deep in the womb, may be seen and cured by opening the matrix with a dilater made for the purpose. Divers Specula matricis, or Dilators for the inspection of the matrix. An other form of a dilater or Speculum matricis, whereof the declaration followeth. A. showeth the screw which shutteth and openeth the dilater of the matrix. B. B. show the arms or branches of the instrument, which ought to be eight or nine fingers long. But these dilaters of the matrix ought to be of a bigness correspondent to the patient's body; let them be put into the matrix when the woman is placed as we have said, when the child is to be drawn out of her body. That instrument is most meet to tie the warts, which we have described in the relaxation of the palate or Uuula: let them be tied harder and harder every day until they fall away. Therefore for Three s●op●● of the cure of wa●ts in the womb. the curing of warts there are three chief scopes, as bands, sections, cauteries; and lest they grow up again, let oil of vitriol be dropped on the place, or aqua fortis, or some of the lie wherewith potential cauteries are made. This water following is most effectual to consume and waste warts. ℞. aq. plantag. ℥ vi. virid. aeris, ʒii. alum. An effectual water to consume warts. roch. ʒiii. sal. come. ℥ ss. vit. rom. & sublim. an. ʒss. beat them all together, and boil them; let one or two drops of this water be dropped on the grieved place, not touching any place else; but if there be an ulcer, it must be cured as I have showed before. A certain man, studious of physic, of late affirmed to me that ox dung tempered Unguents to consume war●●. with the leaves or powder of savine, would waste the warts of the womb, if it were applied thereto warm; which whether it be true or not, let experience, the mistress of things, be ●udge: verily cantharides put into unguents, will do it, and (as it is likely) more effectually; for they will consume the callousnesse which groweth between the toes or fingers. I have proved by experience that the warts that grow on the hands, may be cured by applying of purslain beaten or stamped in its own juice. The leaves and flowers of marigolds do certainly perform the self same thing. CHAP. LXIII. Of chaps, and those wrinkled and hard excrescences which the greeks call Condylomata. Chaps or fissures, are cleft and very long little ulcers, with pain very What 〈◊〉 ar●. sharp and burning, by reason of the biting of an acride, salt and drying humour, making so great a contraction, and often times narrowness in the fundament and the neck of the womb, that scarcely the ●oppe of ones finger may be put into the orifice thereof, like unto pieces of lea●●er or parchment, which are wrinkled and parched by holding of them to the fire. They rise sometimes in the mouth, so that the patient can neither speak, eat, nor open his mouth, so that the Chirurgeon is constrained to cut it. In the cure The 〈◊〉 thereof, all sharp things are to be avoided, and those which mollify are to be used, and the grieved part or place is to be moistened with fomentations, liniments, cataplasms, emplasters, and if the malady be in the womb, a dilater of the matrix or pessary must be put thereinto very often, so to widen that which is over hard, & too much drawn together or narrow, and then the cloven little ulcers must be cicatrized. Condylomata are certain wrinkled and hard bunches, and as it were excrescences of What co●dyl●mat● ar●. flesh, rising especially in the wrinkled edges of the fundament and neck of the womb. Cooling and relaxing medicines ought to be used against this disease, such as are oil of eggs, and oil of linseed, take of each of them two ounces, beat them together The cure. a long time in a leaden mortar, and therewith anoint the grieved part; but if there be an inflammation, put thereto a little camphire. CHAP. LXIV. Of the itching of the womb. IN women, especially such as are old, there often times cometh an itching What the itch of the womb i●. in the neck of the womb, which doth so trouble them with pain and a desire to scratch, that it taketh away their sleep. Not long since a woman asked my counsel, that was so troubled with this kind of malady, that she was constrained to extinguish or stay the itching burning of her secret parts by sprinkling cinders of fire, and rubbing them hard on the place; I counselled her to take egypt. dissolved in sea-water or lie, & inject it into her secret parts with a syringe, and to wet stupes of flax in the same medicine, and put them up into the womb, and so she was cured. Many times this itch cometh in the fundament or testicles of aged men, by reason of the gathering together or confluxe of salt flagme, which when it falleth into the eyes, it causeth the patient to have much ado to refrain scratching: when this matter hath dispersed itself into the whole habit of the body, it causeth a burning or itching scab, which must be cured by a cooling and a moistening diet, by phlebotomy and purging of the salt humour, by baths and horns applied, with scarification and anointing of the whole body with the unction following. ℞. axung. porcin. recent. lb i ss. sap. nig. vel gallici, salis nitri, assat. tartar. staphisag. an. ℥ ss. sulph. viv. ℥ i. argent. viv. ℥ two. acet. ros. quart. i. in conporate them all together, and make thereof a lineament according to art, and use 〈◊〉 is said before: unguentum enulatum cum mercurio is thought to have great force, not without desert, to assuage the itch, and dry the scab. Some use this that followeth. ℞. alum. spum. nitr. sulph. viv. an. ʒ vi. staphis. ℥ i. let them all be dissolved in vi●…gar of roses, adding thereto butyr. recent. q. s. make thereof a lineament for the forenamed use. CHAP. LXV. Of the relaxation of the great gut or intestine, which happeneth to women. MAny women that have had great travel and strains in childbirth, have the great intestine (called of the Latins crassum intestinum) or gut, relaxed and slipped down; which kind of affect happeneth much to children, by reason of a phlegmatic humour moistening the sphincter muscle of the fundament, and the two others called levatores. For the cure thereof, first of all the gut called rectum intestinum or the strait gut, is to be forented with a decoction of heating and resolving herbs, as of sage, rosemary, lavender, thyme, and such like; and then of astringent things, as of roses, myrtills, the ●●ds of pomegranates, cypress nuts, galls, with a little alum, than it must be sprinkied with the powder of things that are astringent without biting, and last of all it is to be restored and gently thrust into its place. That is supposed to be an effectual and singular remedy for this purpose, which is made of twelve red snails put into a put with ℥ ss. of alum, and as much of salt, and shaken up and down a long time, for so at length when they are dead there will remain an humour, which must be put upon cotton, and applied to the gut that is fallen down. By the same cause (that is in say of painful childbirth in some women) there ariseth a great swelling in the Thdifferences and signs. navel; for when the peritonaeum is relaxed or broken, sometimes the Kall, and sometimes the guts slip out: many times flatulencies come thither: the cause, as I now showed, is over great straining or stretching of the belly, by a great burden carried in the womb, and great travail in childbirth: if the fallen down guts make that tumour, pain joined together with that tumour doth vex the patient, and if it be pressed you may hear the noise of the guts going back again: if it be the Kall, than the tumour is soft, and almost without pain, neither can you hear any noise by compression: if it be wind, the tumour is loose and soft, yet it is such as will yield to the pressing of the finger with some sound, and will soon return again: if the tumour be great, it cannot be cured unless the peritonaeum be cut, as it is said in the cure of ruptures. In the church-porches of Paris I have seen begger-women, who by the falling down of the guts, have had such tumors as big as a bowl, who notwithstanding could go, and do all other things as if they had been sound and in perfect health: I think it was because the faeces or excrements, by reason of the greatness of the tumour, and the bigness or wideness of the intestines, had a free passage in and out. CHAP. LXVI. Of the relaxation of the navel in children. OFten times in children newly borne, the navel swelleth as big as an egg, because it hath not been well cut or bound, or because the whayish humours are flowed thither, or because that part hath extended itself too much by crying, by reason of the pains of the fretting of the child's guts, many times the child bringeth that tumour joined with an abscess with him from his mother womb: but let not the Chirurgeon assay to open that abscess, for if it be opened, the guts come out through the incision, as I An abscess not to be opened. have seen in many, and especially in a child of my Lord Martigues; for when Peter of the Rock, the Chirurgeon, opened an abscess that was in it, the bowels ran out at the incision, and the infant died; and it wanted but little that the Gentlemen of my Lord's retinue that were there, had strangled the Chirurgeon. Therefore when John Gromontius the Carver desired me, and requested me of late that I would do A history. the like in his son, I refused to do it, because it was in danger of its life by it already, and in three days after the abscess broke, and the bowels gushed out, and the child died. CHAP. LXVII. Of the pain that children have in breeding of teeth. CHildren are greatly vexed with their teeth, which cause great pain when they begin to break, as it were, out of their shell or sheath, and begin to The time of breeding of the teeth. come forth, the gums being broken, which for the most part happeneth about the seventh month of the child's age. This pain cometh with itching and scratching of the gums, an inflammation, flux of the belly, whereof many times cometh a fever, falling of the hair, a convulsion, and at length death. The cause of the pain is the solution of the continuity of the gums by the coming The cause of the pain in breeding teeth. The signs. forth of the teeth. The signs of that pain is an unaccustomed burning, or heat of the child's mouth, which may be perceived by the nurse that giveth it suck, a swelling of the gums and cheeks, and the child's being more wayward and crying than it was wont, and it will put its fingers to its mouth, and it will rub them on its gums as though it were about to scratch, and it slavereth much. That the The cure. Physician may remedy this, he must cure the nurse as if she had the fever, and she must not suffer the child to suck so often, but make him cool and moist when he thirsteth by giving him at certain times syrupus alexandrinus, syrup. de limonibus, or the syrup of pomegranates with boiled water; yet the child must not hold those things that are actually cold long in his mouth, for such by binding the gums, do in some sort stay the teeth that are newly coming forth; but things that lenify and mollify are rather to be used, that is to say, such things as do by little and little relax the loose flesh of the gums, and also assuage the pain. Therefore the nurse shall often times rub the child's gums with her fingers, anointed or besmeared with oil of sweet almonds, fresh butter, honey, sugar, mucilage of the seeds of psilium, or of the seeds of marsh mallows extracted in the water of pellitory of the wall. Some think that the brain of a hare, or of a sucking pig roasted or sodden, through a secret property, are effectual for the same: and on the outside shall be applied a cataplasm of barley meal, milk, oil of roses, and the yolks of eggs. Also a stick of liquorice shaved and bruised and anointed with honey, or any of the forenamed syrupes, and often rubbed in the mouth or on the gums, is likewise profitable: so What power scratching of the gums hath to assuage the pain of them. is also any toy for the child to play withal, wherein a wolves tooth is set, for this by scratching doth assuage the painful itching, and rarify the gums, and in some weareth them that the teeth appear the sooner. But many times it happeneth that all these and such like medicines profit nothing at all, by reason of the contumacy of the gums, by hardness or the weakness of the child's nature: therefore in such a cause, before the forenamed mortal accidents come, I would persuade the Chirurgeon to open the gums in such places as the teeth bunch out with a little swelling, with a knife or lancet, so breaking and opening a way for them, notwithstanding that a little flux of blood will follow by the tension of the gums: of which kind of remedy I have with prosperous and happy success made trial in some of mine own children, in the presence of Feureus, Altinus, and Cortinus, Doctors of Physic, and Guillemeau the King's Chirurgeon, which is much better and more safe than to do as some nurses do, who taught only by the instinct of nature, with their nails and scratching, break and tear, or rend the children's gums. The Duke of Nevers had a son of eight months old, which died of late, and when we, with A history. the Physicians that were present, diligently sought for the cause of his death, we could impute it unto nothing else, than to the contumacious hardness of the gums, which was greater than was convenient for a child of that age; for therefore the teeth could not break forth, nor make a passage for themselves to come forth: of which our judgement this was the trial, that when we cut his gums with a knife, we found all his teeth appearing as it were in an array, ready to come forth, which if it had been done when he lived, doubtless he might have been preserved. The End of the twenty fourth Book. OF MONSTERS AND PRODIGIES. THE TWENTY FIFTH BOOK. THE PREFACE. We call Monsters, what things soever are brought forth contrary to the common decree and order of nature. So we term what a monste is. that infant monstrous, which is borne with one arm alone, or with two heads. But we define Prodigies, those things which happen contrary to the whole course of nature, that is, altogether What a prodigy is. differing and dissenting from nature: as, if a woman should be delivered of a Snake, or a Dog. Of the first sort are thought all those, in which any of those things, which ought, and are accustomed to be, according to nature, is wanting, or doth abound, is changed, worn, covered or defended, hurt, or not put in his right place: for sometimes some are born with more fingers than they should, other some but with one finger: some with those parts divided which should be joined, others with those parts joined which should be divided: some are borne with the privityes of both sexes, male and female. And Aristotle saw a Goat with a horn upon her knee. No living creature was ever Lib. 4. cen. anim. cap. 4. borne which wanted the Heart, but some have been seen wanting the Spleen, others with two Spleens, and some wanting one of the Reins. And none have been known to have wanted the whole Liver, although some have been found that had it not perfect and whole: and there have been those which wanted the Gall, when by nature they should have had it: and besides, it hath been seen that the Liver, contrary to his natural site, hath lain on the left side, and the Spleen on the right. Some women also have had their privities closed, and not perforated, the membranous obstacle, which they call the Hymen, hindering. And men are sometimes borne with their fundaments, ears, noses, and the rest of the passages shut, and are accounted monstrous, nature erring from its intended scope. But to conclude, those Monsters are thought to portend some ill, which are much differing from their nature. CHAP. I. Of the cause of Monsters; and first of those Monsters which appear for the glory of God, and the punishment of men's wickedness. THere are reckoned up many causes of monsters; the first whereof is the glory of God, that his immense power may be manifested to those which are ignorant of it, by the sending of those things which happen contrary to nature: for thus our Saviour Christ answered the Disciples (ask whether he or his parents had offended, who, being born blind, received his sight from him) that neither he nor his parents had committed any fault so great, but this to have happened only that the glory and majesty of God should be divulged by that miracle, and such great works. Another cause is, that God may either punish men's wickedness, or show signs of punishment at hand, because parents sometimes lie and join themselves together without law and measure, or luxuriously and beastly, or at such times as they ought to forbear by the command of God and the Church, such monstrous, horrid and unnatural births do happen. At Verona Anno Dom. 1254. a mare foaled a colt, with the perfect face of a man, but all the rest of the body like an horse: a little after that, the war between the Florentines and Pisans began, by which all Italy was in a combustion. The figure of a Colt with a man's face. About the time that Pope Julius the second raised up all Italy, and the greatest part of Christendom, against Lewis the twelfth the King of France, in the year of our Lord 1512. (in which year, upon Easter day, near Ravenna was fought that mortal battle, in which the Pope's forces were overthrown) a monster was borne in Ravenna, having a horn upon the crown of his head, and besides, two wings, and one foot alone, most like to the feet of birds of prey, and in the knee thereof an eye, the privities of male and female, the rest of the body like a man, as you may see by the following figure. The figure of awinged Monster. The third cause is, an abundance of seed & overflowing matter. The fourth, the same in too little quantity, and deficient. The fifth, the force and efficacy of imagination. The sixth, the straightness of the womb. The seaventh, the disorderly site of the party with child, and the position of the parts of the body. The eighth, a fall, strain or stroke, especially upon the belly of a woman with child. The ninth, hereditary diseases, or affects by any other accident. The tenth, the confusion and mingling together of the seed. The eleventh, the craft and wickedness of the devil. There are some others which are accounted for monsters, because they have their original or essence full of admiration, or do assume a certain prodigious form by the craft of some begging companions; therefore we will speak briefly of them in their place in this our treatise of monsters. CHAP. II. Of monsters caused by too great abundance of seed. SEeing we have already handled the two former and truly final causes of monsters, we must now come to those which are the matereall, corporeal, and efficient causes, taking our beginning from that we call the too great abundance of the matter of seed. It is the opinion of those Philosophers which have written of monsters, that if at any time a creature bearing one at once, as man, shall cast forth more seed in copulation than is necessary to the generation of one body, it cannot be that only one should be begot of all that; therefore from thence either two or more must arise: whereby it cometh to pass, that these are rather judged wonders, because they happen seldom, and contrary to common custom. Superfluous parts happen by the same cause, that twins, and many at one birth, contrary to nature's course, do chance, that is, by a larger effusion of seed than is required for the framing of that part, that so it exceeds either in number or else in greatness. So Austin tells that in his time in the East an infant was borne, having all the parts from the belly upwards double, but from thence downwards single and simple: for it had two heads, four eyes, two breasts, four hands, in all the rest like to another child, and it lived a little while. Caelius Rhodiginus saith he saw two monsters in Italy, the one male, the other female, handsomely & neatly made through all their bodies, except their heads, which were double; the male died within a few days after it was borne; but the female (whose shape is here delineated) lived 20. five years, which is contrary to the common custom of monsters; for they for the most part are very Monste. seldom lo●. lived. short lived, because they both live and are born, as it were, against nature's consent; to which may be added, they do not love themselves, by reason they are made a scorn to others, and by that means lead a hated life. The effigies of a maid with two heads. But it is most remarkable which Lycosthenes telleth of this woman-monster, for excepting her two heads, she was framed in the rest of her body to an exact perfection: her two heads had the like desire to eat and drink, to sleep, to speak, and to do every thing; she begged from door to door, every one giving to her freely. Yet at length she was banished Bavaria, lest that by the frequent looking upon her, the imaginations of women with child, strongly moved, should make the like impression in the infants they bore in their wombs. The effigies of two girls whose backs grew together. In the year of our Lord 1475. at Verona in Italy, two Girls were borne with their backs sticking together from the lower part of the shoulders unto the very buttocks. The novelty and strangeness of the thing moved their parents, being but poor, to carry them through all the chief towns in Italy to get money of all such as came to see them. In the year 1530. there was a man to be seen at Paris, out of whose belly another, perfect in all his members except his head, hanged forth as if he had been grafted there. The man was forty years old, and he carried the other implanted or growing out of him, in his arms, with such admiration to the beholders, that many ran very earnestly to see him. The figure of a man with another growing out of him. The effigies of the horned or hooded monster. At Quires, a small village some ten miles from Turine in Savoy, in the year 1578. upon the seventeenth day of January, about eight a clock at night, an honest matron brought forth a child having five horns, like to Rams horns, set opposite to one another upon his head: he had also a long piece of flesh, like in some sort to a French-hood which women used to wear, hanging down from his forehead by the nape of his neck almost the length of his back: two other pieces of flesh, like the collar of a shirt, were wrapped about his neck: the fingers ends of both his hands somewhat resembled a Hawks talons, and his knees seemed to be in his hams: the right leg and the right foot were of a very red colour; the rest of the body was of a tawny colour: it is said he gave so terrible a screech when he was brought forth, that the Midwives, and the rest of the women that were at her labour, were so frighted that they presently left the house and ran away. When the Duke of Savoy heard of this monster, he commanded it should be brought to him, which performed, one would hardly think what various censures the Courtiers gave of it. The shape of a monster found in an egg. The monster you see here delineated, was found in the middle and innermost part of an egg, with the face of a man, but hairs yielding a horrid representation of snakes; the chin had three other snakes stretched forth like a beard. It was first seen at Autun, at the house of one Bancheron a Lawyer, a maid breaking many eggs to butter: the white of this egg given a Cat, presently killed her. Lastly, this monster coming to the hands of the Baron Senecy, was brought to King Charles the ninth being then at Metz. The effigies of a monstrous child, having two heads, two arms & four legs. In the year 1546. a woman at Paris in her sixth month of her account, brought forth a child having two heads, two arms and four legs: I dissecting the body of it, found but one heart, by which one may know it was but one infant. For you may know this from Aristotle, whether the monstrous birth be one or more joined together, by the principal Arist. in problem. part: for if the body have but one heart, it is but one, if two, it is double by the joining together in the conception. The portraiture of Twins joined together with one head. In the year 1569. a certain woman of Towers was delivered of twins joined together with one head, and mutually embracing each other. Renatus Ciretus the famous Chirurgeon of those parts, sent me their Sceleton. The effigies of two girls, being Twins, joined together by their foreheads. Munster writes that in the village Bristant, not far from Worms, in the year 1495. he saw two Girls perfect and entire in every part of their bodies, but they had their foreheads so joined together that they could not be parted or severed by any art: they lived together ten years; then the one dying, it was needful to separate the living from the dead: but she did not long outlive her sister, by reason of the malignity of the wound made in parting them asunder. In the year 1570. the twentieth of July, at Paris, in the street Gravilliers, at the sign 〈◊〉 the Bell, these two infants were borne, distering in sex, with that shape of body ●●at you see expressed in the figure. They were baptised in the Church of St. Nicklas of the fields, and named Ludovicus and Ludovica, their father was a Mason, his n●me was Peter German, his surname Petit Dieu (ay) little-God, his mother's name was Mathea Petronilla. The shape of the infants lately borne at Paris. The figure of two girls joined together in their breasts and belly. In the year 1572. in Pont de See, near Angers a little town, were borne upon the tenth day of July, two girls, perfect in their limbs, but that they had but four fingers apiece on their left hands: they clavae together in their 〈◊〉 parts, from their chin to the navel, which 〈◊〉 but one, as their heart was also but one; their 〈◊〉 was divided into four lobes: they lived ha●● an hour, and were baptised. The figure of a child with two heads, and the body as big as one of fore months old. Caelius Rhodiginus tells that in a ●wn of his country called Sarzano, Italy being roubled 〈◊〉 3. with civil wars, there was born monster of unusual bigness; for he had two heads, having all his limbs answerable in gr●ness & tallness to a child of four months old: between his two heads, which were bo●h alike, at the setting on of the shoulder, 〈◊〉 had a third hand put forth, which did not ●●ceed the ears in length, for it was not all ●…n: it was born the 5. of the Ides of March 〈◊〉 14. The figure of one with four legs and as manyarmes. Jovianus Pontanus tells in the year 1529. the ninth day of January, there was a man child borne in Germany, having four arms and as many legs. The figure of a man out of whose belly another head showed itself. In the year that Francis the first King of France entered into league with the Swisses, there was borne a monster in Germany, out of the midst of whose belly there stood a great head; it came to man's age, and this lower, and as it were inserted head, was nourished as much as the true and upper head. In the year 1572. the last day of February, in the parish of Viaban, in the way as you go from Carnuta to Paris, in a small village called Boards, one called Cypriana Girandae the, wife of James Merchant a husbandman, brought forth this monster whose shape you see here delineated, which lived until the Sunday following, being but of one only sex, which was the female. The shape of two monstrous Twins, being but of one only Sex. In the year 1572. on Easter Monday at Metz in Lorraine, in the Inn whose sign is the Holy-Ghost, a Sow pigged a pig, which had eight legs, four ears, and the head of a dog; the hinder part from the belly downward was parted in two as in twins, but the foreparts grew into one; it had two tongues in the mouth, with four teeth in the upper jaw, and as many in the lower. The sex was not to be distinguished, whether it were a Boar or Sow pig, for there was one slit under the tail, and the hinder parts were all rent and open. The shape of this monster, as it is here set down, was sent me by Borgesius the famous Physician of Metz. The shape of a monstrous Pig. CHAP. III. Of women bringing many children at one birth. WOman is a creature bringing usually but one at a birth: but the 〈…〉 been some who have brought forth two, some three, some fou●… six, or more at one birth. Empedocles thought that the abund●…e of seed was the cause of such numerous births: the Stoikes affirm●…e divers cells or partitions of the womb to be the cause: for the se●… being variously parted into these partitions, and the conception divided, there are more children brought forth; no otherwise than in rivers, the water beating against the rocks, is turned into divers circles or rounds. But Aristotle saith there is no reason to think so, for in women that parting of the womb into cells, as in dogs and sows, 4. de gen. anim. cap. 4. taketh no place; for women's wombs have but one cavity, parted into two recesses, the right & left, nothing coming between, except by chance distinguished by a certain line; for often twins lie in the same side of the womb. Aristotle's opinion is, that a woman cannot bring forth more than five children at one birth. The maid of Augustus Caesar brought forth five at a birth, & a short while after, she & her children died. In the year 1554. at Bearn in Switzerland, the wife of Dr. John Gelinger brought forth five children at one birth, three boys and two girls. Albucrasis, affirms a woman to have been the mother of seven children at one birth; & another, who by some external injury did abort, brought forth fifteen perfectly shaped in all their parts. Pliny reports that it was extant in the writings of Physicians, that twelve children were borne at one birth; and that there was another in Peloponnesus which four several Lib. 7. cap. 11. Cap. 3. times was delivered of five children at one birth, and that the greater part of those children lived. It is reported by Dalechampius that Bonaventura the slave of one Savill, a Gentleman of Sena, at one time brought forth seven children, of which four were baptised. In our time, between Sarte and Maine, in the parish of Seaux, not far from Chambellay, there is a family and noble house called Maldemeure; the wife of the Lord of Maldemeure, the first year she was married brought forth twins, the second year she had three children, the third year four, the fourth year five, the fifth year six, and of that birth she died: of those six one is yet alive, and is Lord of Maldemeure. In the valley of Beaufort, in the county of Anjou, a young woman the daughter of Mace Channiere, when at one perfect birth she had brought forth one child, the tenth day following she fell in labour of another, but could not be delivered until it was pulled from her by force, and was the death of the mother. Martin Cromerus the author of the Polish history, writeth that one Margaret, a woman The ninth book of the Polish history. sprung from a noble and ancient family near Cracovia, and wife to Count Virboslaus, brought forth at one birth thirty five live children, upon the twentieth day of January, in the year 1296. Franciscus Picus Mirandula writeth that one Dorothy an Italian had twenty children at two births, at the first nine, and at the second eleven, and that she was so big, that she was forced to bear up her belly, which lay upon her knees, with a broad and large scarf tied about her neck, as you may see by the following figure. The picture of Dorothy, great with child with many children. And they are to be reprehended here again, who affirm the cause of numerous births to consist in the variety of the cells of the womb, for they feign a woman's womb to have seven cells or partitions, three on the right side for males, three on the left side for females, and one in the midst for Hermaphrodites or Scrats: and this untruth hath gone so far, that there have bnene some that affirmed every of these seven cells to have been divided into ten partitions, into which the seed dispersed, doth bring forth a divers and numerous increase, according to the variety of the cells furnished with the matter of seed; which though it may seem to have been the opinion of Hypocrates, in his book De natura Pueri, notwithstanding it is repugnant to reason, and to those things which are manifestly apparent to the eyes and senses. The opinion of Aristotle is more probable, who saith twins and more at one birth, are begot and brought forth by the same cause that the sixth finger groweth on Lib. 4. de gen. anim. cap. 4. the hand, that is, by the abundant plenty of the seed, which is greater and more copious than can be all taken up in the natural framing of one body: for if it all be forced into one, it maketh one with the parts increased more than is fit, eith●… greatness or number; but if it be, as it were, cloven into divers parts, it ca●… more than one at one birth. CHAP. IU. Of Hermaphrodites of Scrats. ANd here also we must speak of Hermaphrodites, because they draw the cause of their generation and conformation from the plenty and abundance of seed, and are called so because they are of both sexes, the woman yielding as much seed as the man. For hereupon it cometh to pass that the forming faculty (which always endeavours to produce something like itself) doth labour both the matters almost with equal force, and is the cause that one body is of both sexes. Yet some make four differences of Hermaphrodites; the first of which is the male Hermaphrodite, who is a perfect and absolute male, and hath only a slit in the Perinaeum not perforated, and from which neither urine nor seed doth flow. The second is the female, which besides her natural privity, hath a fleshy and skinny similitude of a man's yard, but unapt for erection and ejaculation of seed, and wanteth the cod and stones; the third difference is of those, which albeit they bear the express figures of members belonging to both sexes, commonly set the one against the other, yet are found unapt for generation, the one of them only serving for making of water: the fourth difference is of those who are able in both sexes, and throughly perform the part both of man and woman, because they have the genitals of both sex's complete and perfect, and also the right breast like a man, and the left like a woman: the laws command those to choose the sex which they will use, and in which they will remain and live, judging them to death if they be found to have departed from the sex they made choice of, for some are thought to have abused both, and promiscuously to have had their pleasure with men and women. There are signs by which the Physicians may discern whether the Hermaphrodires are able in the male or female sex, or whether they are impotent in both: these signs are most apparent in the privities and face; for if the matrix be exact in all its dimensions, and so perforated that it may admit a man's yard, if the courses flow that way, if the hair of the head be long, slender, and soft, and to conclude, if to this tender habit of the body a timide and weak condition of the mind be added, the female sex is predominant, and they are plainly to be judged women. But if they have the Perinaeum and fundament full of hairs (the which in women are commonly without any) if they have a yard of a convenient largeness, if it stand well & readily, and yield seed, the male sex hath the pre-eminence, and they are to be judged men. But if the conformation of both the genitals be alike in figure, quantity, and efficacy, it is thought to be equally able in both sexes: although by the opinion of Aristotle, those who have double genitals, the one of the male, the other of the female, the one of them is always perfect, the other imperfect. Lib. 4. de generanim. cap. 5. The figure of Hermaphrodite twins cleaving together with their backs. Anno Dom. 1486. In the Palatinate, at the village Robach, near Heidelberg, there were twins, both Hermaphrodites, borne with their backs sticking together. The effigies of an Hermaphrodite, having four hands and feet. The same day the Venetians and Genoeses entered into league, there was a monster borne in Italy having four arms and feet, and but one head; it lived a little after it was baptised. james Ruef a Helvetian Chirurgeon saith he saw the like, but which besides had the privities of both sexes, whose figure I have therefore here set forth. CHAP. V. Of the changing of Sex. AMatus Lusitanus reports that in the village Esquina, there was a maid named Maria Pateca, who at the appointed age for her courses to flow, had in stead of them a man's yard, lying before that time hid and covered, so that of a woman she became a man, and therefore laying aside her woman's habit, was clothed in man's, and changing her name, was called Emanuel; who when he had got much wealth by many and great negotiations and commerce in India, returned into his country, and married a wife: but Lusitanus saith he did not certainly know whether he had any children, but that he was certain he remained always beardless. Anthony Loqueneux, the King's keeper or receiver of his rents of St. Quintin at Vermandois, lately affirmed to me that he saw a man at Rheims, at the Inn having the sign of the swan, in the year 1560. who was taken for a woman until the fourteenth year of his age; for than it happened as he played somewhat wantonly with a maid which lay in the same bed with him, his members (hitherto lying hid) started forth and unfolded themselves: which when his parents knew (by help of the Ecclesiastic power) they changed his name from joan to John, and put him in man's apparel. Some years agone, being in the train of King Charles the ninth, in the French Glass-house, I was showed a man called German Garnierus, but by some german Maria (because in former times when he was a woman he was called Mary) he was of an indifferent stature, and well set body, with a thick and red beard; he was taken for a girl until the fifteenth year of his age, because there was no sign of being a man seen in his body, and for that amongst women, he in like attire did those things which pertain to women: in the fifteenth year of his age, whilst he somewhat earnestly pursued hogs given into his charge to be kept, who running into the corn, he leapt violently over a ditch, whereby it came to pass that the stays and foldings being broken, his hidden members suddenly broke forth, but not without pain; going home, he weeping complained to his mother that his guts came forth: with which his mother amazed, calling Physicians and Surgeons to counsel, heard he was turned into a man; therefore the whole business being brought to the Cardinal the Bishop of Lenuncure, an assembly being called, he received the name and habit of a man. Pliny reports that the son of Cassinus of a girl became a boy, living with his parents; but by the command of the Soothsayers he was carried into a desert Isle, because they thought such monsters did always show or portend some monstrous thing. Certainly women have so many and like parts lying in their womb, as men have hanging forth; only a strong and lively heat seems to be wanting, which may drive forth that which lies hid within: therefore in process of time, the heat being increased and flourishing, and the humidity (which is predominant in childhood) overcome, it is not impossible that the virile members, which hitherto sluggish by defect of heat, lay hid, may be put forth, especially if to that strength of the growing heat some vehement concussion or jactation of the body be joined. Therefore I think it manifest by these experiments and reasons, that it is not fabulous that some women have been changed into men: but you shall find in no history men that have degenerated into women; for nature always intends and goes from the imperfect to the more perfect, but not basely from the more perfect to the imperfect. CHAP. VI Of monsters caused by defect of seed. IF, on the contrary, the seed be any thing deficient in quantity, for the conformation of the infant or infants, some one or more members will be wanting, or more short and decrepit. Hereupon it happens that nature intending twins, a child is borne with two heads, and but one arm, or altogether lame in the rest of his limbs. The effigies of a monstrous child, by reason of the defect of the matter of seed. Anno Dom. 1573. I saw at St. Andrew's Church in Paris, a boy nine years old, borne in the village Parpavilla, six miles from Guise; his father's name was Peter Renard, and his mother, Marquete: he had but two fingers on his right hand, his arm was well proportioned from the top of his shoulder almost to his wrist, but from thence to his two fingers ends it was very deformed, he wanted his legs and thighs, although from the right buttock a certain unperfect figure, having only four toes, seemed to put itself forth; from the midst of the left buttock two toes sprung out, the one of which was not much unlike a man's yard, as you may see by the figure. In the year 1562. in the Calends of November, at Villa-franca in Gascony, this monster, a headless woman, whose figure thou here seest, was borne, which figure Dr. John Altinus the Physician gave to me when I went about this book of Monsters, he having received it from Fontanus the Physician of Angolestre, who seriously affirmed he saw it. The figure of a monstrous woman without a head, before and behind. A few years agone there was a man of forty years old to be seen at Paris, who although he wanted his arms, notwithstanding did indifferently perform all those things which are usually done with the hands, for with the top of his shoulder, head and neck, he would strike an Axe or Hatchet with as sure and strong a blow into a post, as any other man could do with his hand; and he would lash a coachman's whip, that he would make it give a great crack, by the strong refraction of the air: but he ate, drunk, played at cards, and such like, with his feet. But at last he was taken for a thief and murderer, was hanged and fastened to a wheel. Also not long ago there was a woman at Paris without arms, which nevertheless did cut, sew, and do many other things, as if she had had her hands. We read in Hypocrates, that Attagenis his wife brought forth a child all of flesh Sect. 2. lib. 2. epidem. without any bone, and notwithstanding it had all the parts well form. The effigies of a man without arms, doing all that is usually done with hands. The effigies of a monster with two heads, two legs, and but one arm. CHAP. VII. Of monsters which take their cause and shape by imagination. THe ancients having diligently sought into all the secrets of nature, have marked and observed other causes of the generation of monsters: for, understanding The force of 〈◊〉 upon the body and humours. the force of imagination to be so powerful in us, as for the most part, it may alter the body of them that imagine, they soon persuaded themselves that the faculty which formeth the infant may be led and governed by the firm and strong cogitation of the Parents begetting them (often deluded by nocturnal and deceitful apparitions) or by the mother conceiving them, and so that which is strongly conceived in the mind, imprints the force into the infant conceived in the womb: which thing many think to be confirmed by Moses, because he tells that Jacob increased and bettered the part of the sheep granted to him by Laban, Gen. chap. 30. his wife's father, by putting rods, having the bark in part pulled off, finely stroaked with white and green, in the places where they used to drink, especially at the time they engendered, that the representation apprehended in the conception, should be presently impressed in the young; for the force of imagination hath so much power over the infant, that it sets upon it the notes or characters of the thing conceived. We have read in Heliodorus that Persina Queen of Aethiopia, by her husband Hidustes, being also an Aethiope, had a daughter of a white complexion, because in the embraces of her husband, by which she proved with child, she earnestly fixed her eye and mind upon the picture of the fair Andromeda standing opposite to her. Damascene reports that he saw a maid hairy like a Bear, which had that deformity by no other cause or occasion than that her mother earnestly beheld, in the very instant of receiving and conceiving the seed, the image of St. John covered with a camels skin, hanging upon the posts of the bed. They say Hypocrates, by this explication of the causes, freed a certain noble woman from suspicion of adultery, who being white herself, and her husband also white, brought forth a child as black as an Aethiopian, because in copulation she strongly and continually had in her mind the picture of the Aethiope. The effigies of a maid all hairy, and an infant that was black by the imagination of their Parents. There are some who think the infant once form in the womb, which is done at the utmost within two & forty days after the conception, is in no danger of the mother's imagination, neither of the seed of the father which is cast into the womb; because when it hath got a perfect figure, it cannot be altered with any external form of things; which whether it be true, or no, is not here to be enquired of: truly I think it best to keep the woman, all the time she goeth with child, from the sight of such shapes and figures. The effigies of a horrid Monster, having feet, hands, and other parts like a Calf. In Stecquer a village of Saxony, they say, a monster was borne, with four feet, eyes, mouth, and nose like a calf, with a round and red excrescence of flesh on the forehead, and also a piece of flesh like a hood hung from his neck upon his back, and it was deformed with its thighs torn and cut. The figure of an infant with a face like a Frog. Anno Dom. 1517. in the parish of Kings-wood, in the forest Biera, in the way to Fontain-Bleau, there was a monster borne, with the face of a Frog, being seen by John Bellanger, Chirurgeon to the King's Engineers, before the Justices of the town of Harmoy; principally John Bribon the King's procurator in that place. The father's name was Amadaeus the Little, his mothers, Magdalene Sarbucata, who troubled with a fever, by a woman's persuasion, held a quick frog in her hand until it died, she came ●hus to bed with her husband and conceived; Bellanger, a man of an acute wit, thought this was the cause of the monstrous deformity of the child. CHAP. VIII. Of Monsters caused by the straightness of the womb. WE are constrained to confess by the event of things, that monsters are bred and caused by the straightness of the womb; for so That the straightness or littleness of the womb may be the occasion 〈◊〉 monsters. apples hanging upon the trees, if before they come to just ripeness, they be put into straight vessels, their growth is hindered. So some whelps which women take delight in, are hindered from any further growth by the littleness of the place in which they are kept. Who knows not that the plants growing in the earth, are hindered from a longer progress and propagation of their roots, by the opposition of a flint, or any other solid body, and therefore in such places are crooked, slender and weak, but on the other part, where they have free nourishment, to be straight and strong? for seeing that by the opinion of Naturalists, the place is the form of the thing placed; it is necessary that those things that are shut up in straighter spaces, prohibited of free motion, should be lessened, depraved and lamed. Empedocles and Diphilus acknowledged three causes of monstrous births: The too great or small matter of the seed; the corruption of the seed; and depravation of growth by the straightness or figure of the womb: which they thought the chiefest of all; because they thought the case was such in natural births, as in forming of metals and fusible things, of which statues being made, do less express the things they be made for, if the moldes or forms into which the matter is poured, be rough, scabrous, too straight, or otherwise faulty. CHAP. IX. Of monsters caused by the ill placing of the mother, in sitting, lying down, or any other site of the body in the time of her being with child. WE often too negligently and carelessly corrupt the benefits and corporal endowments of nature in the comeliness and dignity of conformation: it is a thing to be lamented and pitied in all, but especially in women with child, because that fault doth not only hurt the mother, but deforms and perverts the infant which is contained in her womb: for we moving any manner of way, must necessarily move whatsoever is within us. Therefore they which sit idly at home all the time of their being with child, or crosslegged, those which holding their heads down, do sow or work with the needle, or do any other labour, which press the belly too hard with clothes, breeches or swaths, do produce children wrie-necked, stooping, crooked and disfigured in their feet, hands, and the rest of their joints, as you may see in the following figure. The effigies of a child, who from the first conception, by the site of the mother, had his hands and feet standing crooked. CHAP. X. Of monsters caused by a stroke, fall, or the like occasion. THere is no doubt but if any injury happen to a woman with child, by reason of a stroke, fall from on high, or the like occasion, the hurt also may extend to the child. Therefore by these occasions the tender bones may be broken, wrested, strained, or depraved after some other monstrous manner; and more, by the like violence of such things, a vein is often opened or broken, or a flux of blood, or great vomiting is caused by the vehement concussion of the whole body, by which means the child wants nourishment, and therefore will be small and little, and altogether monstrous. CHAP. XI. Of monsters which have their original by reason of hereditary diseases. BY the injury of hereditary diseases, infants grow monstrous, that is, monstrously deformed: for crooke-backt produce crooke-backt, and often times so crooked, that between the bunch behind and before, the head lies hid, as a Tortoise in her shell: so lame produce lame, flat nosed their like, dwarves bring forth dwarves, lean bring forth lean, and fat produce fat. CHAP. XII. Of monsters by the confusion of seed of divers kinds. THat which followeth is a horrid thing to be spoken; but the chaste mind of the Reader will give me pardon, and conceive that, which not only the Stoikes, but all Philosophers, who are busied about the search of the causes of things, must hold, That there is nothing obscene or filthy to be spoken. Those things that are accounted obscene may be spoken without blame, but they cannot be acted or perpetrated without great wickedness, fury and madness; therefore that ill which is in obscenity consists not in word, but wholly in the act. Therefore in times passed there have been some, who nothing fearing the Deity, neither Law, nor themselves, that is, their soul, have so abjected and prostrated themselves, that they have thought themselves nothing different from beasts: wherefore Atheists, Sodomites, Outlaws, forgetful of their own excellency and divinity, & transformed by filthy lust, have not doubted to have filthy and abominable copulation with beasts. This so great, so horrid a crime, for whose expiation all the fires in the world are not sufficient, though they, too maliciously crafty, have concealed, and the conscious beasts could not utter, yet the generated misshapen issue hath abundantly spoken and declared, by the unspeakable power of God, the revengerand punisher of such impious & horrible actions. For of this various and promiscuous confusion of seeds of a different kind, monsters have been generated and borne, who have been partly men and partly beasts. The like deformity of issue is produced, if beasts of a different species do copulate together, nature always affecting to generate something which may be like itself: for wheat grows not but by sowing of wheat, nor an apricocke but by the setting or grafting of an apricocke; for nature is a most diligent preserver of the species of things. The effigies of a monster half man and half dog. Anno Dom. 1493. there was generated of a woman and a dog, an issue, which from the navel upwards perfectly resembled the shape of the mother, but therehence downwards the sire, that is, the dog. This monster was sent to the Pope that then reigned, as Volaterane writeth: also Cardane mentions it; wherefore I have here given you the figure thereof. 〈◊〉 〈◊〉▪ cap. 64. C●lius Rhodiginus writes that at Sibaris, a herdsman called Chrathis fell in love with a Goat, and accompanied with her, and of this detestable and brutish copulation an infant was born, which in legs resembled the dam, but the face was like the fathers. The figure of a monster in face resembling a man, but a Goat in his other members. Anno Dom. 1110. In a certain town of Liege (as saith Lycosthenes) a sow farrowed a pig with the head, face, hands, and feet of a man, but in the rest of the body resembling a swine. The figure of a pig, with the head, face, hands, and feet of a man. Anno Dom. 1564. at Brussels, at the house of one Joest Dictzpeert, in the street Warmoesbroects, a sow farrowed six pigs, the first whereof was a monster representing a man in the head, face, fore feet and shoulders, but in the rest of the body another pig, for it had the genitals of a sow pig, and it sucked like the other pigs. But the second day after it was farrowed, it was killed of the people together with the sow, by reason of the monstrousness of the thing. Here followeth the figure thereof. The effigies of a monster half man and half swine. Anno Dom. 1571. at Antwerp, the wife of one Michael a Printer, dwelling with one John Molline a Graver or Carver, at the sign of the Golden Foot, in the Camistrate, on St. Thomas his day, at ten of the clock in the morning, brought forth a monster wholly like a dog, but that it had a shorter neck, and the head of a bird, but without any feathers on it. This monster was not alive, for that the mother was delivered before her time; but she giving a great screech in the instant of her deliverance, the chimney of the house fell down, yet hurt nobody, no not so much as any one of four little children that sat by the fire side. The figure of a monster like a dog, but with a head like a bird. Lewis Celleus writeth that he hath read in an approved author, that an Ewe once brought forth a Lion, a beast of an unlike and adverse nature to her. Anno Dom. 1577. in the town Blandy, three miles from Melon, there was lambed a Lamb, having three heads, the middlemost of which was bigger than the rest, when one bleated they all bleated. John Bellanger the Chirurgeon of Melon affirmed that he saw this monster, and he got it drawn, and sent the figure thereof to me, with that humane monster that had the head of a Frog, which we have formerly described. The figure of a threeheaded Lamb. There are some monsters in whose generation by this there may seem to be some divine cause, for that their beginnings cannot be derived or drawn from the general cause of monsters, that is, nature, or the errors thereof, by reason of some of the forementioned particular causes; such are these monsters that are wholly against all nature, like that which we formerly mentioned, of a Lion yeaned by an Ewe. Yet Astrologers (lest there should seem to be any thing which they are ignorant of) refer the causes of these to certain constellations and aspects of the Planets and Stars, according to Aristotle's saying in his Problems; in confirmation whereof they tell this tale. It happened in the time of Albertus Magnus, that in a certain village, a Cow brought forth a Calf, which was half a man: the townsmen apprehended the herdsman, and condemned him as guilty of such a crime, to be presently burnt together with the cow, but by good luck Albertus was there, to whom they gave credit by reason of his much and certain experience in Astrology, that it was not occasioned by any humane wickedness, but by the efficacy of a certain position of the stars, that this monster was borne. CHAP. XIII. Of monsters occasioned by the craft and subtlety of the Devil. IN treating of such monsters as are occasioned by the craft of the Devil, we crave pardon of the courteous Reader, if peradventure going further from our purpose, we may seem to speak more freely and largely of the existence, nature, and kinds of Devils Therefore first it is manifest that there are Conjurers, There are sorcerers, and how they come so to be. Charmers, and Witches, which whatsoever they do, perform it by an agreement & compact with the Devil, to whom they have addicted themselves: for none can be admitted into that society of Witches, who hath not forsaken God the Creator, and his Saviour, and hath not transferred the worship due to him above, upon the Devil, to whom he hath obliged himself. And assuredly, whosoever addicts himself to these magical vanities and witchcrafts, What induceth them thereto. doth it, either because he doubts of God's power, promises, study and great good will towards us: or else for that he is madded with an earnest desire of knowing things to come; or else because disdaining poverty, he affects and desires from a poor estate to become rich on the sudden. It is the constant opinion of all, both ancient and modern, as well Philosophers as Divines, that there are some such men; which when they have once addicted themselves to impious and devilish arts, can by the wondrous craft of the Devil, do many strange things, and change and corrupt bodies, and the health & life of them, and the condition of all mundane things. Also experience forceth us to confess the same, for punishments are ordained by the laws against the professors and practisers of such arts; but there are no laws ordained against those things which neither ever have been, nor ever came into the knowledge of men: for such things are rightly judged and accounted for impossibilities, which have never been seen nor heard of. Before the birth of Christ there have been many such people, for you may find in Exodus and Leviticus laws made against such persons by Moses, by whom God gave the law to his people. The Lord gave the sentence of death to Ochasias by his Exod. cap. 22. Levit. cap. 19 Prophet, for that he turned into these kind of people. We are taught by the scriptures that there are good and evil spirits, and that the former are termed Angels, but the latter Devils; for the law is also said to be given by the ministry of Angels: and it is said that our bodies shall rise again at the sound of a trumpet, and the voice Hebr. 1. 14. Galat. 3. 19 〈◊〉 Thes. 4. 16. of an Archangel. Christ said that God would send his Angels to receive the elect into the heavens. The history of Job testifieth that the Devil sent fire from heaven, and killed his sheep and cattle, and raised winds that shook the four corners of the house, and overwhelmed his children in the ruins thereof. The history of Achab mentioneth John 13. Mar. 16. 34. a certain lying spirit in the mouth of the false Prophets. Satan entering into Judas, moved him to betray Christ. Devils, who in a great number possessed the body of a man, were called a Legion, and obtained of Christ that they might enter into swine, whom they carried headlong into the Sea. In the beginning God created a great number of Angels, that those divine and incorporeal spitits might inhabit heaven, and as messengers, signify God's pleasure to men, and as ministers or servants, perform his commands, who might be as overseers and protectors of humane affairs. Yet of this great number there were some who were blinded by pride, and thereby also cast down from the presence, and heavenly habitation of God the creator. These harmful and crafty spirits delude men's minds by divers juggling tricks, and are always contriving something to The power of evil spirits over mankind. our harm, and would in a short space destroy mankind, but that God restrains their fury; for they can only do so much as is permitted them: Expelled heaven, some of them inhabit the air, others, the bowels of the earth, there to remain until The differences of devils. God shall come to judge the world: and as you see the clouds in the air somewhiles to resemble centaurs, otherwhile serpents, rocks, towers, men, birds, fishes, and other shapes: so these spirits turn themselves into all the shapes and wondrous forms of things; as oft times into wild beasts, into serpents, toads, owls, lapwings, crows or ravens, goats, asses, dogs, cats, wolves, bulls, and the like. Moreover, they oft times assume and enter humane bodies, as well dead as alive, whom they torment and punish, yea also they transform themselves into angels of light. They feign themselves to be shut up and forced by magical rings, but that is only their deceit and craft, they wish, fear, love, hate, and oft times as by the appointment The delusions of devils. and decree of God they punish malefactors: for we read that God sent evil angels into Egypt, there to destroy. They howl on the night, they murmur & rattle, as if they were bound in chains, they move benches, tables, counters, props, cupboards, children in the cradles, play at tables and chess, turn over books, tell money, walk up & down rooms, and are heard to laugh, to open windows & doors, cast sounding vessels, as brass and the like, upon the ground, break stone pots and glasses, and make other the like noises. Yet none of all these things appear to us when as we arise in the morning, neither find we any thing out of its place or broken. They are called by divers names; as, Devils, evil Spirits, Incubi, Sucubis, Hobgoblines, Their titles & names. Fairies, Robin-good-fellowes, evil Angels, Satan, Lucifer, the father of lies, Prince of darkness and of the world, Legion, and other names agreeable to their offices and natures. CHAP. XIV. Of the subterrene Devils, and such as haunt Mines. LEwis Lavater writes, that by the certain report of such as work in Mines, that in some Mines there are seen spirits, who in the What the devils in Mines do. shape and habit of men, work there, and running up and down seem to do much work, when as notwithstanding they do nothing indeed. But in the mean time they hurt none of the bystanders, unless they be provoked thereto by words, or laughter. For than they will throw some heavy or hard thing upon him that hurt them, or injure them some other way. The same author affirms that there is a silver Mine in Rhetia, out of which Peter Briot, the Governor of the place, did in his time get much silver. In this Mine there was a Devil, who chiefly on Frie-dayes, when as the Miners put the mineral they had digged into tubs, kept a great quarter, and made himself exceeding busy, and poured the mineral, as he listed, out of one tub into another. It happened one day that he was more busy than he used to be, so that one of the Miners reviled him, and bade him be gone on a vengeance to the punishment appointed for him. The Devil offended with his imprecation and sco●●e, so wrested the Miner, taking him by the head, that twining his neck about, he set his face behind him, yet was not the workman killed therewith, but lived, and was known by divers for many years after. CHAP. XV. By what means the Devils may deceive us. OUr minds involved in the earthy habitation of our bodies, may be deluded by the Devil's divers ways; for they excel in purity and subtlety of essence, and in the much use of things: besides, they challenge a great pre-eminence, as the Princes of this world, over all sublunary Devil's are spirits, and from eternity. bodies. Wherefore it is no marvel if they, the teachers and parents of lies, should cast clouds and mists before our eyes from the beginning, & turn themselves into a thousand shapes of things and bodies, that by these juggle and tricks they may shadow and darken men's minds. CHAP. XVI. Of Sucubis and Incubi. Powerful by these forementioned arts and deceits, they have sundry times accompanied with men in copulation, whereupon such as have had to do with men, were called Sucubis, those which made use of women, The reason of the name. Lib. 15. de civet Dei, cap. 22. & 23. Incubi. Verily St. Augustine seemeth not to be altogether against it, but that they, taking upon them the shape of man, may fill the genitals, as by the help of nature, to the end, that by this means they may draw aside the unwary, by the flames of lust, from virtue and chastity. John Ruef in his book of the conception and generation of man, writeth that in his time, a certain woman of monstrous lust, and wondrous impudence, had to do by A history. night with a Devil, that turned himself into a man, and that her belly swollen up presently after the act; and when as she thought she was with child, she fell into so grievous a disease, that she voided all her entrailes by stool, medicines nothing at all prevailing. The like history is told of the servant of a certain Butcher, who thinking too attentively on venereous matters, a Devil appeared to him in the shape of a woman, Another. with whom (supposing it to be a woman) when as he had to do, his genitals so burned after the act, that becoming inflamed, he died with a great deal of torment. Neither doth Peter Paludanus, and Martin Arelatensis think it absurd to affirm An opinion confuted. that Devils may beget children, if they shall ejaculate into the woman's womb seed taken from some man, either dead or alive. Yet this opinion is most absurd and full of falsity, man's seed consisting of a seminal or sanguineous matter, and much spirit: if it run otherways than into the womb from the testicles, and stay never so little a while, it loseth its strength and efficacy, the heat and spirits vanishing away; for even the too great length of a man's yard, is reckoned amongst the causes of barrenness, by reason that the seed is cooled by the length of the way. If any in copulation, after the ejaculation of the seed, presently draw themselves from the woman's embraces, they are thought not to generate, by reason of the air entering into theyet open womb, which is thought to corrupt the seed. By which it appears how false that history in Averrois is, of a certain woman that said she conceived with child by a man's seed shed in a bath, and so drawn into her womb, she entering the bath presently Averrois his history convict of falsehood. after his departure forth. It is much less credible that Devils can copulate with women, for they are of an absolute spirituous nature, but blood and flesh are necessary for the generation of man. What natural reason can allow that the incorporeal Devils can love corporeal women? And how can we think that they can generate, who want the instruments of generation? How can they who neither eat nor drink be said to swell with seed? Now where the propagation of the species is not necessary to be supplied by the succession of Individuals, Nature hath given no desire of venery, neither hath it imparted the use of generation; but the devils once created were made immortal by God's appointment: If the faculty of generation should be granted to devils, long since all places had been full of them. Wherefore if at any time women with child by the familiarity of the devil, seem to travel, we must think it happens by those arts we mentioned in the former chapter, to The illusions of the devils. wit, they use to stuff up the bodies of living women with old clouts, bones, pieces of iron, thorns, twisted hairs, pieces of wood, serpents, and a world of such trumpery, wholly dissenting from a woman's nature: who afterwards, the time, as it were, of their delivery drawing nigh, through the womb of her that was falsely judged with child, before the blinded, and, as it were, bound up eyes of the by-standing women, they give vent to their impostures. The following history, recorded in the writings of many most credible authors, may give credit hereto. There was at Constance a fair damosel called Margaret, who served a wealthy A history. Citizen: she gave it out every where that she was with child by lying with the devil on a certain night. Wherefore the Magistrates thought it fit she should be kept in prison, that it might be apparent both to them and others, what the end of this exploit would be. The time of deliverance approaching, she felt pains like those which women endure in travel; at length, after many throws, by the midwives' help, in stead of a child, she brought forth iron nails, pieces of wood, of glass, bones, stones, hairs, tow, and the like things, as much different from each other, as from the nature of her that brought them forth, and which were formerly thrust in by the devil to delude the too credulous minds of men. Our sins are the cause that the devils abuse us. The Church acknowledgeth that devils, by the permission and appointment of God punishing our wickedness, may abuse a certain shape, so to use copulation with mankind. But that a humane birth may thence arise, it not only affirms to be false, but detests as impious, as which believes that there was never any man begot without the seed of man, our Saviour Christ excepted. Now what confusion and perturbation of creatures should possess this world (as Cassianus saith) if devils could conceive by copulation with men? or if women should prove with child by accompanying them, howmany monsters would the devils have brought forth from the beginning of the world? how many prodigies by casting their seed into the wombs of wild and brute beasts? for by the opinion of Philosophers, as often as faculty and will concur, the effect must necessarily follow: now the Devils never have wanted will to disturb mankind, and the order of this world: for the devil, as they say, is our enemy from the beginning; and as God is the author of order, and beauty, so the devil, by pride, contrary to God, is the causer of confusion and wickedness. Wherefore if power should accrue equal to his evil mind and nature, and his infinite desire of mischief and envy, who can doubt but a great confusion of all things and species, and also great deformity would invade the decent and comely order of this universe, monsters arising on every side? But seeing that devils are incorporeal, what reason can induce us to believe that they can be delighted with venereous actions? and what will can there be where as there is no delight, nor any decay of the species to be feared? seeing that by God's appointment they are immortal, so to remain for ever in punishment: so what need they succession of individuals by generation? wherefore if they neither will nor can, it is a madness to think that they do commix with man. CHAP. XVII. Of Magic and supernatural diseases and remedies. THat I may refresh the mind of the Reader, invited to these histories of monsters, raised up by the art of the devil, witches, and conjurers, his servants, I have thought good to add the following histories of certain diseases, and remedies supernatural, and wholly magical, out of Fernelius. There are diseases, which as they are sent Lib. 2. de abdit. cause. cap. 16. amongst men by God being offended, so they cannot expect cure otherwise than from God, from whence they are thought supernaturally to have their essence and cure. Thus the air ofttimes, yet chiefly in the time of King David, being defiled with the pestilence, killed sixty odd thousand persons. Thus Ezechias was struck with a grievous disease: Job was defiled with filthy ulcers by Satan at God's command. And as the Devil, the cruel enemy of mankind, commonly useth by God's permission to afflict those, so wicked persons by the wondrous subtlety of the devil, offer violence, and do harm to many. Some Witches hurt by the devil's assistance. invoke I know not what spirits, and adjure them with herbs, exorcisms, imprecations, incantations, charms: others hang about their necks, or otherwise carry certain writings, characters, rings, images, and other such impious stuff. Some use songs, sounds or numbers: sometimes potions, perfumes, and smells; sometimes gestures and juggling. There be some that make the portraiture of the absent party in wax, and boast that they can cause or bring a disease into what soever part thereof they prick, by the force of their words and stars, into the like part of the party absent; and they have no few other tricks to bring diseases. We know for certain that magicians, witches, and conjurers, have by charms so bound some, that they could not have to do with their wives; and have made others so impotent, as if they had been gelt or made eunuchs. Neither do wicked men only send diseases into man's body, but also devils themselves. These truly are soon distracted with a certain fury, but in this one thing they differ from simple madness, for that they speak things of great difficulty, tell things past and hid, disclose the secrets of such as are present, and revile them many ways, and are terrified, tremble or grow angry by the power of divine words. One not very long agone, being by reason of heat exceeding dry in the night time, A history. rising out of his sleep, and not finding drink, took an apple that he found by chance, and eating it, he thought his jaws were shut and held fast as by ones hands, and that he was almost strangled: and also, now possessed of a Devil entering into him, he seemed in the dark to be devoured of a huge exceeding black dog, which he, afterwards restored to his former health, orderly related to me. There were divers, who by his pulse, heat, and the roughness of his tongue, thought him to be in a fever, and by his watching, and the perturbation of his mind, thought him only to rave. Another young Nobleman, some few years since, was troubled at set times with a shaking of the body, and as it were, a convulsion, wherewith one while he A history. would move only his left arm, another while the right arm, and also sometimes but one finger only, somewhiles but one leg, sometimes the other, and at other times the whole trunk of his body, with such force and agility, that lying in his bed, he could scarce be held by four men; his head lay without any shaking, his tongue and speech was free, his understanding sound, and all his senses perfect even in the height of his fit. He was taken at the least ten times a day, well in the spaces between, but wearied with labour: it might have been judged a true Epilepsy, if the understanding and senses had failed. The most judicious Physicians who were called to him, judged it a convulsion, cousin-german to the falling sickness, proceeding from a malign and venomous vapour impact in the spin of the back, whence a vapour dispersed itself over all the nerves, which pass from the spin every way into the limbs, but not into the brain. To remove this, which they judged the cause, frequent glisters are ordained, and strong purges of all sorts, cupping glasses are applied to the beginnings of the nerves, ●omentations, unctions, emplasters, first to discuss, then to strengthen and wear away the malign quality: These things doing little good, he was sweated with baths, stoves, and a decoction of Guajacum, which did no more good than the former, for that we were all far from the knowledge of the true cause of his disease: for in the third month, a certain Devil was found to be the author of all this ill, bewraying himself by voice, & unaccustomed words and sentences, as well latin as greek (though the patient were ignorant of the greek tongue): he laid open The devil shows himself by speaking of greek. many secrets of the bystanders, but chiefly of the Physicians, deriding them for that he had abused them to the patients great harm, because they had brought his body so low by needless purgations. When his father came to visit him, he would cry out long before he came at him, or saw him, drive away this visitant, & keep him from coming in here, or else pluck his chain from about his neck: for on this (as it is the custom of the French order of Knights) there hangs the image of St. Michael. If holy or divine things were read before him, he shook and trembled more violently. When his fit was over, he remembered Devils wax angry, and are terrified by divine things. all that he had done, and affirmed that he did it against his will, and that he was sorry for it. The devil, forced by ceremonies and exorcisms, denied that he was damned for any crime, and said that he was a spirit: being asked who he was, and by what means and power he did these things, he said that he had many habitations into which he could betake himself, and in the time of his rest, he could torment others: that he was cast into this body by a certain person whom he would not name, and that he entered by his feet up to his neck, and that he would go forth again the same way, when as his appointed time was come. He spoke of sundry other things, as others which are possessed use to do. Now I speak not these things as new or strange, but that it may appear that devils sometimes entering into the body, do somewhiles torment it by divers and uncouth ways; other whiles they do not enter in, but either agitate the good humours of the body, or draw the ill into the principal parts, or with them obstruct the veins or other passages, or change the structure of the instruments, from which causes innumerable diseases proceed: of these, Devils are the authors, and wretched and forlorn persons the ministers: and the reason of these things is beyond the search of nature. Pliny tells that the Emperor Nero in his time, found magical arts most vain and false: but what need we allege profane writers, when as those things that are recorded in scripture of the pythonisse, of the woman speaking in her belly, of King Nebuchodonozor, of the Magicians of Pharaoh, and other such things not a few, prove that there both is, and hath been Magic? Pliny tells of Denarc●us, that he tasting of the entrailes of a sacrificed child, turned himself into a Wolf. We read in Homer that Circe's, in the long wandering of Ulysses, changed his companions into beasts, with an enchanted cup or potion: and in Virgil, that the growing corn may be spoiled or carried away by enchantments: which things, unless they were approved and witnessed by many men's credits, the wisdom of Magistrates and Lawyers, would not have made so many Laws against Magicians, neither would there have been a mulct imposed upon their heads by the law of the twelve tables, who had enchanted other men's corn. But as in magical arts the devil doth not exhibit things themselves, as those which he cannot make, but only certain shows or appearances of things: so in these which are any ways accommodated to the use of Physic, the cure is neither certain, nor safe, but deceitful, captious, and dangerous. I have seen the Jaundice, over the whole body, cured in one night, by a written It is but a deceitful cure that is performed by the devil. scroll hanged about the neck: also I have seen Agues chased away by words and such ceremonies, but within a short while after they returned again and became much worse. Now there are some vain things, and verily the fancies of old women, which because they have long possessed the minds of men, weakened with too much superstition, we term them superstitious. These are such as we cannot truly say of them, wherefore and whence they have the faculties ascribed to them: for they neither arise from the temperament, neither from other manifest qualities, neither from the whole substance, neither from a divine or magical power, from which two last mentioned, all medicines beyond nature, and which are consequently to be used to diseases, whose essence are supernatural, must proceed. Such like old wives medicines Old wives superstitious medicines against divers diseases. and superstitious remedies are written figures and characters, rings, where neither the assistance of God or Spirits is implored. Let me ask you, is it not a superstitious medicine to heal the falling sickness, to carry in writing the names of the three Kings, Gaspar, Melchior, and Balthasar, who came to worship Christ? To help the tooth ache, if one whilst Mass is in saying, touch his teeth, saying these words, Os non comminuet is ex co? To stay vomiting with certain ceremonies and words, which they absent pronounce, thinking it sufficient if that they but only know the patient's name. I saw a certain fellow that with murmuring a few words, and touching the part, would staunch blood out of what part soever it flowed: there be some who to that purpose say this, De latere ejus exivit Sanguis & Aqua. How many prayers or charms are carried about to cure agues? some taking hold of the patient's hand, say, Aequè facilis tibi Febris haec sit, atque Mariae virgini Christi partus. Another washeth his hands with the patient before the fit, saying to himself that solemn Psalm, Exalt●bo te Deus meus Rex, etc. If one tell an Ass in his ear that he is stung by a Scorpion, they say that the danger is immediately over. As there are many superstitious words, so there are many superstitious writings also. To help sore eyes, a paper wherein the two greek letters, Π and A▪ are written must be tied in a thread, and hanged about the neck. And for the tooth ache this ridiculous saying, Strigiles, falcesque dentatae, dentium dolorem persanate. Also oft times there is no small superstition in things that are outwardly applied. Such is that of Apollonius in Pliny, to scarify the gums in the t●…▪ ache with the tooth of one that died a violent death: to make pills of the skull of one hanged, against the bitings of a mad dog: to cure the falling sickness by eating the flesh of a wild beast, killed with the same iron wherewith a man was killed: that he shall be freed from a quartan ague who shall drink the wine whereinto the sword that hath cut off a man's head, shall be put: and he, the parings of whose nails shall be tied in a linen cloth to the neck of a quick Eel, and the Eel let go into the water again. The pain of the Milt to be assuaged, if a beasts Milt be laid upon it, and the Physician say that he cures or makes a medicine for the Milt. Any one to be freed from the cough, who shall spit in the mouth of a Toad, letting her go away alive. The halter wherein one hath been hanged put about the temples, to help the head ache. This word Abracadabra, written on a paper, after the manner described by Serenus, and hanged about the neck, to help agues or fevers, especially semitertians. What truth can be in that which sundry affirm, that a leaf of Lathyris, which is a kind of Spurge, if it be plucked upwards, will cause vomit, but broken downwards, will move to stool? You may also find many other superstitious fictions concerning herbs, such as Galen reports that Andreas and Pamphilus writ, as incantations, transformations, and herbs dedicated to conjurers and devils. Lib. 6. de simp. I had thought never in this place to have mentioned these and the like, but that there may be every where found such wicked persons, who leaving the arts and means, which are appointed by God to preserve the health of man's body, fly to the superstitious & ridiculous remedies of sorcerers, or rather of devils, which notwithstanding the devil sometimes makes to perform their wished for effects, that so he may still keep them ensnared & addicted to his service. Neither is it to be approved which many say, that it is good to be healed by any art or means, for that healing is a good work. This saying is unworthy of a Christian, and savours rather of him that trusts more in the devil than in God. Those Empirics are not of the society of Sorcerers and Magicians, who heal simple wounds with dry lint, or lint dipped in water: this cure is neither magical nor miraculous, as many suppose, but wholly natural, proceeding from the healing fountains of nature, wounds & fractures, which the Chirurgeon may heal by only taking away the impediments, that is, pain, defluxion, inflammation, an abscess and gangrene, which retard and hinder the cure of such diseases. The following examples will sufficiently make evident the devil's maliciousness, always wickedly and craftily plotting against our safety and life. A certain woman at Florence (as Langius writes) having a malign ulcer, and being Lib. epist. 38. ep. troubled with intolerable pain at the stomach, so that the Physicians could give her no ease: behold on a sudden she vomited up long and crooked nails, and brass needles, wrapped up with wax and hairs, and at length a great gobbit of flesh, so bi●ge that a Giants jaws could scarce swallow it. But that which happened in the year of our redemption 1539. in a certain town called Fugenstall, in the Bishopric of Eistet, exceeds all credit, unless there were eye-witnesses of approved integrity yet living. In this town, one Ulrich Neusesser a husbandman, was tormented with grievous pain in the one side of his belly, he suddenly got hold of an iron key with his hand under the skin, which was not hurt, the which the Barber-Chirurgian of the place cut out with his razor; yet for all this the pain ceased not, but he grew every day worse than other: wherefore expecting no other remedy but death, he got a knife and cut his throat. His dead body was opened, and in his stomach were found a round and longish piece of wood, four steel knives, part sharp, and part toothed like a saw, and two sharp pieces of iron, each whereof exceeded the length of a span, there was also as it were a ball of hair. All these things were put in by the craft and deceit of the devil. Thus far Langius. CHAP. XVIII. Of the Cozenages and crafty Tricks of Beggars. HAving treated of Monsters, it follows that we speak of those things which either of themselves, by reason of their nature full of admiration, have some kind of monstrousness in them; or else from some other ways, as by the craft and cozenage of men. And because to the last mentioned crafts of the Devil, the subtle devices of begging companions are sowewhat alike, therefore I will handle them in the next place, that the Chirurgeon being admonished of them, may be more cautious and cunning in discerning them when he meets with them. Anno Dom. 1525. when I was at Anjou, there stood a crafty beggar begging at A history of a counterfeit arm. the Church door, who tying and hiding his own arm behind his back, showed in steed thereof, one cut from the body of one that was hanged, and this he propped up and bound to his breast, and so laid it open to view, as if it had been all inflamed, so to move such as passed by unto greater commiseration of him. The cozenage lay hid, every one giving him money, until at length his counterfeit arm not being surely fastened, fell upon the ground, many seeing and observing it: he being apprehended and laid in prison, by the appointment of the Magistrate, was whipped through the town, with his false arm hanging before him, and so banished. I had a brother called John Parey, a Chirurgeon, who dwelled at Vitre in Brittany; he Another of a cancrous breast. once observed a young woman begging, who showed her breast, as if it had a cancrous ulcer thereon, looking fearfully by reason of much and fordid filth, wherewith it seemed to defile the cloth that lay under it. But when as he had more diligently beheld the woman's face, and the fresh colour thereof, as also of the places about the ulcer, and the good habit of the whole body agreeable to that colour (for she was somewhat fat, and of a very good habit of body) he was easily hereby induced to suspect some roguery and deceit. He acquainted the Magistrate with this his suspicion, and got leave that he might carry her home to his house, so to search her more narrowly. Where opening her breast, he found under her armepit, a sponge moistened with a commixture of beasts blood and milk, and carried through an elder pipe to the hidden holes of her counterfeit cancer. Therefore he foments her breast with warm water, and with the moisture thereof looseth the skins of black, green, and yellow frogs, laid upon it, and stuck together with glue, made of bowl armenick, the white of an egg, and flower; and these being thus fetched off, he found her breast perfectly sound. The beggar being cast for this into prison, confessed that she was taught this trick by a beggar that lay with her, who himself also, by putting about his leg an ox's Milt, and perforating it in sundry places, that so the forementioned liquor might drop out, counterfeited an ulcer of a monstrous bigness and malignity, covering A counterfeit ulcer of the leg the edges of the Milt on every side with a filthy cloth. This beggar was diligently enquired after, but could not be found; and so she was whipped and banished. Within less than a year after there came into the same city another notable crafty Of one feigning himself eleprous. companion, who presently taking up the church doors, laid open his wares, to wit, a Kercher with some small pieces of money lying thereon, a wooden Barrel, and * Clicquets' are things made somewhat resembling a small wool-card, but have two or three little pieces of boards so fastened together with leather, that they will make a great noise with them, and these are used by the French beggars. Cliquets, wherewith he would evernow and then make a great noise: his face was spread over with great thick pustles, being of a blackish red colour, and made with glue like those that have the Leprosy: this his ghasty look made him to be pitied by all men, which was the cause that every one gave him money. Then my brother came somewhat nearer him, and asked him how long he had been troubled with this so cruel disease; he answered with an obscure and hoarse voice, that he was borne a Leper from his mother's womb, and that his parents both died of this wicked disease, so that their members fell away piecemeal. Now he had a woollen swath about his chaps, wherewith (having his left hand under his cloak) he so straitened his chaps, that much black blood rose into his face, and made him so hoarse that he could scarce speak; yet he could not contain himself, but that in speaking he ever now and then slackened the swath with his hand, the freelier to draw his breath: which when my brother had observed, suspecting some cozenage, he obtained leave of the Magistrate to search and examine the man whether he were truly leprous, or no. First therefore he took away his swath or rowler that was about his neck, then washed his face with warm water, so that the counterfeit glued pustles were dissolved, and his face, free from all tainture, showed itself of a good and natural colour and shape. Then he laid bare his whole body, and diligently viewed each part, and found no sign of a leprosy, one or other. Which when the Magistrate once heard, he made him to be put in prison, and to be thrice whipped through the streets of the city, with his barrel hanging before him, and his cliquets behind him, adding thereto the punishment of perpetual banishment. It happened that as he was whipped the third market day, the people cried out to the hangman in jest, that he should not fear to lash him sound, for being leprous he could not feel it: the executioner incited by this cry of the people, did so belabour him, that the wretch died of his whipping within a short while after, having a just reward for his wickedness. For these impostors, besides that they live like drones, feigning this or that disease, and so being idle, enjoy the fruits of others labours; they also divers times conspiring together, take away the lives and goods of honest and substantial citizens, and other people: for there are some of them, that in an evening, as men that have no habitation, desire lodging for a night, and it being granted them, they, when as the master of the house and his family are asleep, open the doors to their comrades, men as wicked as themselves, and kill and carry away all they can. Certainly we may justly affirm that this crafty begging is the mother and school of all dishonesty: for how many acts of bawdry and poisoning every where corrupt A multitude of beggars hurtful to the city. the wells and public fountains? how many places have been burnt under the show of begging? where can you get more fit spies? where more sit undertakers and workers of all manner of villainy, than out of the crew of these beggars? Some of them there are, who besmear their faces with soot laid in water, so to seem to have the Jaundice. But you may at the first sight find out the deceit, by the How to discover such as counterfeit the Jaundice. native whiteness of the utter coat of the eye, called Adnata, which in such as truly have the Jaundice, useth to be died and overcast with a yellowish colour; also you may be more certain thereof, if you wet a cloth in water or spittle, and so rub the face, for the adventitious yellowness will quickly vanish, and the true native colour show itself. Some there be, who not content to have mangled, and filthily exulcerated their limbs with caustic herbs, and other cauteries; or to have made their bodies more swollen, or else lean, with medicated drinks; or to have deformed themselves some other way, but from good and honest Citizens, who have charitably relieved them, they have stolen children, have broken or dislocated their arms and legs, have cut out their tongues, have depressed the chest, or whole breast, that with these, as their own children, begging up and down the country, they may get the more relief, pitifully complaining that they came by this mischance by thunder, or lightning, or some other strange accident. Lastly they part the kingdom amongst themselves as into Provinces, & communicate by letters one to another, what news or new acquaint devises there are to conceal or advance their roguery: to which purpose they have invented a new language only known to themselves, so to discourse together and not be understood by others. [We hear vulgarly term it Canting]. Dr. Flecelle, a Physician of Paris, entreated me to bear him company to his country house at Champigny, four miles from Paris. Where as soon as we arrived, Of one counterfeiting the falling of the fundament. and were walking in the Court, there came presently to us a good lusty well fleshed manly woman, begging alms for St. Fiacre sake, and taking up her coat and her smock, she showed a great gut hanging down some half a foot, which seemed as if it had hanged out of her fundament, whereout there dropped filth like unto pus, which had all stained her legs and smock, most beastly and filthy to look upon. Flecelle asked her how long she had been troubled with this disease: she answered that it was four years since she first had it. Hence he easily gathered that she played the counterfeit: for it was not likely that such abundance of purulent matter came forth of the body of so well fleshed and coloured a woman; for she would rather have been very lean and in a consumption. Wherefore provoked with just anger, by reason of the wickedness of the deceit, he run upon her and threw her down upon the ground, and trod her under his feet, and hit her divers blows upon the belly, so that he made the gut which hung at her, to come away, and by threatening her with more grievous punishment, made her confess the cozenage, and that it was not her gut, but of an ox, which being filled with blood and milk, and tied at both ends, she put the one of them into her fundament, and let the filth flow forth at very little holes. Not very long ago, a woman equally as shameless, offered herself to the overseers Of one feigning the falling down of the womb. of the poor of Paris, entreating that she might be entered for one of their Pensioners, for that her womb was fallen down by a dangerous and difficult birth, wherefore she was unable to work for her living. Then they commanded that she should be tried and examined, according to the custom, by the Chirurgeons which are therefore appointed. Who seeing how the whole business was carried, made report she was a counterfeit; for she had thrust an ox's bladder, half blown and besmeared with beastly blood by the neck, whereto she had fastened a little sponge, into the neck of her womb, for the sponge being filled and swollen up by the accustomed moisture of the womb, so held up the ox's bladder that hanged thereat, that she might safely go without any fear of the falling of it out, neither could it be pulled forth but with good force. For this her device she was put into Prison, and being first whipped, was after banished. Their cozenage is not much unlike this, who by fitly applying a sheep's paunch to their groin, sergeant themselves to be bursten. Anno Dom. 1561. there came to Paris a lusty, stout, and very fat Norman woman, Of a beggar that feigned herself to have a snake in her belly. being about some thirty years old, who begging from door to door, did cast to meet with rich women, and very familiarly and pitifully would relate unto them her misfortune, saying she had a snake in her belly, which crept in at her mouth as she slept in an hempe-land: she would let one feel her stir, by putting their hand unto her belly, adding also that she was troubled day & night with its uncessant gnawing of her guts. The novelty of this sad chance, moved all to pity & admiration, wherefore as much as they could, they assisted her with means & counsel. Amongst the rest, there was a woman of great devotion and charity, who sending for Dr. Hollerius, cheval, and me, asked us if this snake could by any means be gotten forth. Hollerius gave her a strong purgation, hoping that by stirring up the expulsive faculty, the serpent might be cast forth, together with the noxious humours. But this hope had no such success. Wherefore when as we met again, we thought it fit to put a Speculum matricis into the neck of her womb, so to see if we could discern either her head or tail: but I making large dilatation of her womb, could see no such thing, only we observed a certain voluntary motion, whereof she herself was the author, by contracting and dilating the muscles of the lower belly. Which when as we had observed, perceiving the deceit and imposture, we thought good so to terrify her and make her confess the deceit, to tell her that she must take another, but that a more strong purgation, that what we could not do by the former, as more gentle, we might attain to by the latter, as far stronger. She dissembling all fear, and conscious of her craft and dissimulation, after we were gone in the evening, packing up her stuff, and a great deal more than her own, she secretly stole away, not bidding her hostess farewell: and thus at length the fraud was apparent, to the loss of the honest Gentlewoman. I saw this baggage, six days after, sitting lustily upon a Packhorse, at the gate Mont-martre, and laughing heartily with such as brought Sea-fish to town; and she was returning (as it was most likely) into her country, seeing her cozenage was discovered here. Such as feign themselves dumb, draw back and double their tongues in their mouths. Such as falling down counterfeit the falling sickness, bind straight both The craft of such asfaigne themselves to have the falling sickness. their Wrists with plates of iron, tumble and roll themselves in the mire, sprinkle and defile their heads and faces with beasts blood, and shake their limbs and whole body. Lastly by putting soap into their mouths, they foam at the mouth like those that have the falling sickness. Othersome with flower make a kind of glue, wherewith Of such as feign themselves leprous. they besmear their whole bodies, as if they had that Leprosy or Scab, that is vulgarly termed, Malum sancti manis. Neither must we think this art of counterfeiting, and cheating begging to be new, and of late invention, for long ago it flourished in Asia, even in the time of Hypocrates, as may appear by his book De Aëre, Locis, & Aquis. But by how much this disease hath taken more deep root, and grown more inveterate by process of time, by so much it must more diligently and carefully be looked to and prevented, by cruelly punishing such counterfeits: for that by this feigned begging, as the nourisher of sloth and shop of all dishonesty, that which is taken from the good is bestowed upon the ill, and one wicked & counterfeit beggar hurts all other wretched people. CHAP. XIX. Of strange or monstrous accidents in Diseases. WHat monstrousness soever was in the last mentioned parties, it was made up by the craft of beggars for filthy gain. But if there be any monstrousness in the following narrations, it is of nature, but working, as it were, miraculously, by some secret and occult means; for thus there are oft times monsters in diseases. Before the town of St. John de Angeley, a soldier called Francis, of the Monsters happen also in diseases. A bullet shot into the belly came forth at the fundament. company of Captain Muret, was wounded with a Harquebuze-shot on the belly, between his navel and sides; the bullet was not taken out, because the Chirurgeons, who searched him diligently, could not find it: wherefore he was troubled with grievous and tormenting pains, until the ninth day after he received the wound, the bullet came forth at his fundament: wherefore within three weeks after he was perfectly whole. He was healed by Simon Crinay, the Chirurgeon of the French companies. James Pope, Lord of St. Albans in Dauphine, was wounded at the skirmish at A bullet sticking to the throat and patient recovering. Chasenay, having three harquebus bullets entering into his body, one whereof pierced under his throat, where it buncheth out as with a knot, near to the pipe of his lungs, even to the beginning of the vertebrae of the neck, in which place the leaden bullet stuck, and as yet doth remain. Hereupon he was afflicted with many and fearful symptoms, as a fever, and a great swelling of his whole neck, so that for ten whole days he could swallow nothing but broths and liquid things. Yet he recovered, and remaineth well at this present, by the cure of James Dalam the Chirurgeon. Alexander Benedictus makes mention of a certain countryman, who, shot into the back with a dart, drawing out the shaft, the head was left behind, being in Lib. 3. anatom. cap 9 A crooked iron shot into the back came forth at the fundament. length about the breadth of two fingers, but hooked and sharp on the sides. When as the Chirurgeon had carefully and diligently sought for it, and could by no means find it, he healed up the wound, but two months after this crooked head came forth at his fundament. The same author telleth that at Venice a virgin swallowed a needle, which some two years after she voided by urine, covered over with a stony matter, gathered about A swallowed needle voided by urine. viscous humours. Catherine Perlan, the wife of William Guerrier, a Draper of Paris, dwelling in the Jewry, as she road on horseback into the country, a needle out of her pin cushion, A needle running in at the buttock came forth at the groin. which got under her by accident, ran so deep into her right buttock, that it could not by any art or force be plucked forth. Four months after she sent for me to come to her, and she told me that as often as she had to do with her husband, she suffered extreme pricking pain i● her right groin; putting my hand thereto, as I felt it, my fingers met with something sharp and hard: wherefore I used the matter so, that I drew forth the needle all rusty: this may be counted a miracle, that steel, naturally heavy, should rise upwards, from the buttock to the groin, and pierce the muscles of the thigh, without causing an abscess. Anno Dom. 1566. the two sons of Laurence Collo (men excellent in cutting for the stone) took forth a stone of the bigness of a walnut, in the midst whereof was A needle in the midst of a stone taken forth of the bladder. a needle, just like those that shoemaker's use: the patient's name was Peter Cocquin, dwelling in the street Galand, at the place called Maubert at Paris, and I think he is yet living. This stone was showed to King Charles the ninth, for the monstrousness of the thing, I being then present, which being given me by the Chirurgeon, I preserve amongst my other rarities. Anno Dom. 1570. the Duchess of Ferrara at Paris, sent for John Collo, to take a stone out of a Confectioner. This stone, though it weighed nine ounces, and was as thick as one's fist, yet was it happily taken out, the patient recovering, Francis Rousset, and Joseph Javelle, the Duchess Physicians, being present. Yet not long after this Confectioner died by the stoppage of his water, by reason of two other little stones, which about to descend from the kidneys to the bladder, stayed in the midway of the Ureters. The figure of the extracted stone was this. The figure of a stone taken forth of the Bladder of a Confectioner. Anno Dom. 1566. Laurence Collo the younger, took three stones out of the bladder of one dwelling at Marly, called commonly Tire-vit: because being troubled with the stone from the tenth year of his age, he continually scratched his yard, each of the stones were as big as an Hen's egg; of colour white, they all together weighed twelve ounces. When they were presented to King Charles, then lying at Saint Maure des Faussez, he made one of them to be broken with a hammer, and in the midst thereof there was found another, of a chestnut colour, but otherwise much like a Peach stone. These three stones, bestowed on me by the brethren, I have here represented to the life. The effigies of the three forementioned stones, whereof one is broken. I have in the dissecting of dead bodies, observed divers stones, of various forms and figures, as of pigs, whelps, and the like. Dalechampius telleth that he saw a man, which by an abscess of his loins, which turned to a Fistula, voided many stones out of his kidneys, and yet notwithstanding could endure to ride on horseback, or in a coach. John Magnus, the Kings most learned and skilful Physician, having in cure a woman, troubled with cruel torment and pains of the belly and fundament, sent for me, that by putting a Speculum into the fundament, he might see if he could perceive any discernible cause of so great and pertinacious pain: and when as he A stone by the force of purging medicines voined by the fundament. could see nothing which might further him in the finding out of the cause of her pain (following reason as a guide) by giving her often glisters and purgations, he brought it so to pass, that she at length voided a stone at her fundament of the bigness of a Tennis ball: which once avoided, all her pains ceased. Hypocrates tells that the servant of Dyseris in Larissa, when she was young, in using venery was much pained, and yet sometimes without pain, yet she never conceived. 5. Epid. But when as she was sixty years old, she was pained in the afternoon as if she had been in labour. When as she one day before noon had eaten many leeks, afterward she was taken with a most violent pain, far exceeding all her former, A stone coming out of the neck of the womb. and she felt a certain rough thing rising up in the orifice of her womb. But she falling into a swoon, another woman putting in her hand, got out a sharp stone of the bigness of a whirl, and then she forthwith became well, and remained so. In a certain woman, who, as Hollerius tells, for the space of four months was troubled with an incredible pain in making water, two stones were found in her Lib. 〈◊〉. cap. de palp. cond. heart, with many abscesses, her kidneys and bladder being whole. Anno Dom. 1558. I opened in John Bourlier a Tailor, dwelling in the street of St. Honoré, a watery abscess in his knee, wherein I found a stone, white, hard, and smooth, of the thickness of an Almond; which being taken out, he recovered. Certainly there is no part of the body wherein stones may not breed and grow. Anthony Benevenius a Florentine Physician writes, that a certain woman swallowed No part of the body wherein stones may not be found. A needle swallowed, came forth as the navel some two years after. a brass needle without any pain, and continued a year after without feeling or complaining of it: but at the end thereof she was molested with great pains in her belly; for helping of which she asked the advice of all the Physicians she could, making, in the interim, no mention of the swallowed needle. Wherefore she had no benefit by all the medicines she took; and she continued in pain for the space of two years, until at length the needle came forth at a little hole by her navel, and then she recovered her health. A Scholar named Chambelant, a native of Bourges, a student in Paris, in the College of Press, swallowed a stalk of grass, which came afterwards whole out between A sprig of grass swallowed, came forth whole again between the ribs. two of his ribs, with the great danger of the scholars life. For it could not come there unless by passing or breaking through the lungs, the encompassing membrane, and the intercostal muscles, yet he recovered, Fernelius and Huguet having him in cure. Cabrolle Chirurgeon to Mounsieur, the Marshal of Anvil, told me that Francis Guillenet the Chirurgeon of Sommiers, a small village some eight miles from Mompelier, A knife swallowed, came forth at an abscess in the groin. had in cure, and healed a certain shepherd, who was forced by thiefs to swallow a knife of the length of half a foot, with a horn handle of the thickness of ones thumb: he kept it the space of half a year, yet with great pain, and he fell much away, but yet was not in a consumption, until at length an abscess rising in his groin, with great store of very stinking quitture, the knife was there taken forth in the presence of the Justices, and left with Joubert the Physician of Mompelier. Mounsieur the Duke of Rohan had a Fool called Guido, who swallowed the point The point of a sword swallowed came forth at the fundament. of a sword of the length of three fingers, and he voided it at his fundament on the twelfth day following, yet with much ado: there are yet living many Gentlemen of Brittany, who were eye-witnesses thereof. There have been sundry women with child, who have so cast forth piecemeal Wonderful excretions of infants cut of the womb. children that have died in their wombs, as that the bones have broke themselves a passage forth at the navel, but the flesh, dissolved as it were into quitture, flowed out by the neck of the womb and the fundament, the mother's remaining alive, as Dalechampius observes out of Albucrosis. Is it not very strange that there have been women, who troubled with a fit of the Women troubled with the Mother laid out for dead. Mother, have lain three whole days without motion, without breathing, or pulse that were any way apparent, and so have been carried out for dead? A certain young man, as Fernelius tells, by somewhat too vehement exercise, was taken with such a cough, that it left him not for a moment of time, until he An imposthume spit out, of the bigness of a Pigeon's egg. therewith had cast forth a whole imposthume of the bigness of a pigeons' egg, wherein, being opened, there was found quitture exquisitely white and equal. He spit blood two days after, had a great fever, and was much distempered: yet notwithstanding he recovered his health. Anno Dom. 1578. Stephana Chartier, dwelling at St. Maure des Faussez, a widow Worms cast up in the fit of an Ague. of forty years old, being sick of a tertian Fever, in the beginning of her fit vomited up a great quantity of choler, and together therewith three hairy worms, in figure, colour, and magnitude like the worms called Beare-wormes, yet somewhat blacker; they lived eight whole days after without any food: the Chirurgeon of this town brought them to Dr. Milot, who showed them to Feure, Le Gros, Marescot and Courtin Physicians, and to me also. This following history, taken out of the Chronicles of Monstrele, exceeds all admiration. This narration exceeds not only all admiration, but also belief. A certain Franck-Archer of Meudon, four miles from Paris, was for robbery condemned to be hanged: in the mean time it was told the King by the Physicians, that many in Paris at that time were troubled with the stone, and amongst the rest the Lord of Boscage, and that it would be for the good of many, if they might view and discern with their eyes the parts themselves wherein so cruel a disease did breed, and that it might be done much better in a living than in a dead body, and that they might make try all upon the body of the Franck-Archer, who had formerly been troubled with these pains. The King granted their request; wherefore opening his body they viewed the breathing parts, and satisfied themselves as much as they desired, and having diligently and exactly restored each part to its proper place, the body, by the King's command, was sewed up again, and dressed and cured with great care. It came so to pass, that this Franck-Archer recovered in a few days, and getting his pardon, got good store of money besides. Alexander Benedictus tells that he saw a woman called Victoria, who having lost Pract. lib. 64. cap. 1. all her teeth, and being bald, yet had others came up in their places, when as she was fourscore years old. Stephen Tessier a Chirurgeon of Orleans, told me that not long ago he cured one Charles Veriguell, a Sergeant of Orleans, of a wound received in his ham, whereby the two tendons bending the ham, were quite cut in sunder. He took this order in the cure; he caused the patient to bend his leg, than he sewed together the ends of the cut rendons, then placed the member in that site, and handled it with that art. that at length he healed the wound, the patient not halting at all. Truly this is very memorable thing, and carefully and heedfully to be imitated by the young Chirurgeon. How many have I seen, who wounded and thrust through the body with swords, arrows, pikes, bullets, have had portion of the brain cut off by a wound of the head, an arm or leg taken away by a cannon bullet, yet have recovered? and how many on the contrary, have died of light and small wounds, not worth the speaking of? A certain man was shot in near to his groin with an arrow, whom we have seen, saith Hypocrates, and he recovered beyond all men's expectation; The arrow head 5. Epidem. was not taken forth, for it was very deep in, neither did the wound bleed very much, neither was it inflamed, neither did he halt: but we found the head, and took it forth six years after he was hurt. Now Hypocrates gives no other reason of its so long stay, but that he saith it might be suspected it lay hid between the nerves, and that no vein nor artery was cut thereby. CHAP. XX. Of the wonderful original, or breeding of some creatures. WE have read in Boistey, that a certain workman of Avignion, when as he lived in that city, opened a leaden coffin, wherein a dead body Boist. in histor. prodig. lay, that was so closely soudered, that the air could not get in; and as he opened it, he was bitten by a serpent that lay therein, with so venomous and deadly a bite, that it had near to have cost him his life. Yet the original of this creature is not so prodigious as he supposeth, for it is an usual It is a common thing for a serpent to breed of the dead corpse of a man. A live serpent in a solid Marble. thing for a Serpent to breed of any putrefyed carcase, but chiefly of a man's. Baptista Leo writes, that in the time of Pope Martin the fifth, there was a live serpent found enclosed in a vast, but solid Marble, no chink appearing in such dense solidity, whereby this living creature might breathe. Whilst in my vine-yard, that is at Meudon, I caused certain huge stones to be broken to pieces, a Toad was found in the midst of one of them. When as I much admired thereat, because there was no space wherein this creature could be generated, increase or live, the Stone-cutter wished me not to marvel thereat, for it was a common thing, and that he saw it almost every day. Certainly it may come to pass that from the more moist portion of stones, contained in places moist and under The cause of such wonderful generations. ground, and the celestial heat mixing and diffusing itself over the whole mass of the world, the matter may be animated for the generation of these creatures. CHAP. XXI. Of the wondrous nature of some marine things, and other living creatures. THE last mentioned creatures were wonderful in their original, or rather in their growth: but these which follow, though they be not wonderful of themselves, as those that consist of their own proper nature, and that working well and after an ordinary manner; yet they are wondrous to us, or rather monstrous, for that they are not very familiar to us. For the rarity and vastness of bodies, is in some sort monstrous. Of this sort there are many, especially in the Sea, whose secret corners and receptacles are not pervious to men: as Triton's, which from the middle upwards are reported to have the shape of men. And the sirens, Nercides or Mermaids, who (according to Pliny) Lib. 9 cap. 5. have the faces of women, and scaly bodies, yea where as they have the shape of man: neither yet can the forementioned confusion and conjunction of seeds take any place here, for, as we lately said, they consist of their own proper nature. When Mena was Precedent of Egypt, and walked on the banks of Nilus, he saw a Sea-monster in the shape of a man, coming forth of the waters: his shape was just like a man even to the middle, with his countenance composed to gravity, his hairs yellow, yet intermixed with some grey, his stomach bony, his arms orderly made and jointed, his other parts ended in a fish. Three days after in the morning there was seen another Sea-monster, but with the shape or countenance of a woman, as appeared by her face, her long hair, and swollen breasts: both these monsters continued so long above water that any one might view them very well. The effigies of the Triton and Siren of Nilus. In our times, saith Rondeletius, in Norway was a monster taken in a tempestuous sea, the which as many as saw it, presently termed a Monk, by reason of the shape which you may see here set forth. The figure of a fish resembling a Monk. Anno Dom. 1531. there was seen a sea-monster in the habit of a Bishop, covered over with scailes: Rondeletius and Gesner have described it. The figure of a fish in the habit or shape of a Bishop. Gesner professeth that he received from Jerome Cardane this monster, having the head of a Bear, the feet and hands of an Ape. The effigies of a Sea-monster headed like a Bear. Not long before the death of Pope Paul the third, in the midst of the Tyrrhene sea, a monster was taken, and presented to the successor of this Paul: it was in shape and bigness like to a Lion, but all scaily, and the voice was like a man's voice. It was brought to Rome to the great admiration of all men, but it lived not long there, being destitute of its own natural place and nourishment, as it is reported by Philip Lib. 5. chron. Forrest. The effigies of a Lion-like scaily Sea-monster. Anno Dom. 1523. the third day of November, there was seen at Rome this sea-monster, of the bigness of a child of five years old, like to a man even to the navel, except the ears; in the other parts it resembled a fish. The effigies of a Sea-monster with a man's face. Gesner makes mention of this Sea-monster, and saith that he had the figure thereof from a Painter, who took it from the very fish, which he saw at Antwerp. The head looks very ghastly, having two horns, prick ears, and arms not much unlike a man, but in the other parts it was like a fish. It was taken in the Illyrian Sea, as it came a shore out of the water to catch a little child: for being hurt by stones cast by fishermen that saw it, it returned a while after to the shore from whence it fled, and there died. The effigies of a Sea Devil. Gesner tells that a Sea-monster with the head, mane, and breast of a horse, and the rest of his body like a fish, was seen and taken in the ocean Sea, brought to Rome, and presented to the Pope. Olaus Magnus tells that a Sea-monster taken at Bergen, with the head and shape of a Calf, was given him by a certain English Gentleman. The like of which was presented lately to King Charles the ninth, and was long kept living in the waters at Fountainebleau, and it went oft times ashore. This is much different from the common Sea-calf or Seal. The effigies of a monstrous * This here figured is the sea-Morse, taken commonly by our men in their Greene-land voyages: and I judge the sea●ore and Elephant to be the same, but that, the Painter ha●… showed his skill too much in ●e one: and the other is an old ●orse, as this ●ere figured i a young one. Sea-calf. This great monster was seen in the Ocean sea, with the head of a Boar, but longer tusks, sharp and cutting, with scailes set in a wonderful order, as you may see by this figure. The effigies of a Sea-bore. Olaus Magnus writes that this monster was taken at Thyle an Island of the North, Anno Dom. 1538. it was of a bigness almost incredible, as that which was seventy two foot long, and fourteen high, and seven foot between the eyes: now the liver was so large that therewith they filled five hogsheads, the head resembled a swine, having as it were a half moon on the back, and three eyes in the midst of his sides, his whole body was scaily. The effigies of a monstrous Sea-swine. The Sea Elephant is bigger than the land Elephant, as Hector Boëtius writes in his description of Scotland; it is a creature that lives both in the water and a shore, having two teeth like to elephants, with which as oft as he desires to sleep, he hangs himself upon a rock, and then he sleeps so sound, that Mariners seeing him at sea, have time to come ashore, and to bind him, by casting strong ropes about him. But when as he is not awaked by this means, they throw stones at him, and make a great noise; with which awakened, he endeavers to leap back into the sea with his accustoned violence, but finding himself fast, he grows so gentle, that they may deal with him as they please. Wherefore they then kill him, take out his fat, and divide or cut his skin into thongs, which because they are strong and do not rot, are much esteemed of. The effigies of a Sea-Elephant. The Arabians of Mount Mazovan, which runs alongst the Red Sea, chiefly feed on a fish called Orobone, which is very terrible and much feared by other fish, being nine or ten foot long, and of a breadth agreeable thereto, and it is covered with scailes like a Crocodile. A Crocodile is a vast creature, coming sometimes to be fifteen cubits long, and seeing it is a creature that doth not bring forth young, but eggs, it useth at the most to lay some sixty eggs, no bigger than Goose eggs, rising to such bigness from so small beginnings (for the hatched young one is proportionable to the egg): she is very long lived. It hath so small and useless a tongue, that it may seem to have none at all. Wherefore seeing it lives both on land and water; as it lives on land it is to be taken for a tongue, but as it lives part of the life in the water it hath no use of a tongue, and therefore is not to be reputed one. For fishes either wholly want tongues, or else have them so impedite and bound, that they serve for little use. The Crocodile only of all other things moves the upper jaw, the lower remaining unmoveable: for her feet, they are neither good to take nor hold any thing; she hath eyes not unlike those The Crocodile only moves the upper jaw. of swine, long teeth standing forth of the mouth, most sharp claws, a scaily skill, so hard that no weapon can pierce it. Of the land Crocodile (resembling this both land and water one) is made the medicine Crocodilea, most singular for sore eyes, being Expende diligenter Plinii locum lib. 23. cap. 8. anointed with the juice of leeks, it is good against suffusions or dimness of the sight; it takes away freckles, pustles, and spots; the Gall anointed on the eyes, helps Cataracts, but the blood clears the sight. Thevet saith they live in the fountains of the river Nilus, or rather in a lake flowing Cosmographtom. 1. lib. 2. cap. 8. How they, take Crocodiles. from the same fountains, and that he saw some that were six paces long, and a yard cross the back, so that their very looks were formidable. They catch them thus; when as the water of Nilus falls, the Egyptians let down a line, having thereto fastened an iron hook of some three pound weight, made very large and strong, upon this hook they put a piece of the flesh of a Camel or some other beast; which when as he sees, he presently falls upon it, and devours it hook and all, wherewith when he finds himself to be cruelly pulled and pinched, it would delight you to see how he frets and leaps aloft; then they draw him thus hooked, by little and little to the shore, and fasten the rope surely to the next tree, lest he should fall upon them that are about him; then with prongs, and such things they so belabour his belly, where as his skin is soft and thin, that at length they kill him, and uncasing him, they make ready his flesh, and eat it for delicious food. John Lereus, in his history of Brasil, writes that the Savages of that country willingly feed upon Crocodiles, cap. 10. and that he saw some who brought into their houses young ones, wherewith the children gathering about it, would play without receiving any harm thereby. True (saith Pliny) is that common opinion, Whatsoever is brought forth in any Lib. 9 cap. 1. part of Nature, that also is in the sea, and many other things over and above, that are in no other place. You may perceive that there are not only the resemblances of living creatures, but also of other things; if you look upon the sword, saw, cowcumber, like in smell and colour to that of the earth, that you may less wonder at the Sea feather and grape, whose figures I have given you out of Rondeletius. The sea feather is like those feathers of birds, which are worn in hats for ornament, after they are trimmed and dressed for that purpose. The fishermen call them sea-prickes, for that one end of them resembleth the end of a man's yard, when the prepuce is drawn off it. As long as it is alive it swells, and becomes sometimes bigger and sometimes lesser; but dead, it becomes very flaccide and lank: it shines bright on the night like a star. You may by this gather, that this which we here express is the Grape whereof Pliny makes mention, because in the surface and upper part thereof it much resembles a fair bunch of Grapes; it is somewhat longish, like a misshapen club, and hangs upon a long stalk. The inner parts are nothing but confusion, sometimes distinguished with little glandules, like that we have here figured alone by itself. The figures of the Sea Feather and Grape. In the Sea near the Island Hispaniola in the West Indies, there may be seen many monstrous fishes, amongst which Thevet in his Cosmography thought this most rare and observable, which in the vulgar language of the natives is termed Aloes. For it is just like a goose, with a long and strait neck, with the head ending sharp, or in a Cone, not much unlike a sugar-peare, it is no bigger than agoose, it wanteth scailes, it hath four fins under the belly for swimming, when it is above water you would say that it were a goose. The Sarmatian, or Eastern german Ocean contains fishes unknown to hot countries, and very monstrous. Such is that which resembling a snail, equals a barrel in magnitude of body, and a stag in the largeness and branches of her horns: the ends of her horns are rounded as it were into little balls, shining like unto pearls, the neck is thick, the eyes shining like to lighted candles, with a roundish nose set with hairs like to a cats, the mouth wide, whereunder hangs a piece of flesh very ugly to behold. It goes on four legs, with so many broad and crooked feet, the which with a long-tail, and variegated like a Tiger, serves her for fins to swim withal. This creature is so timorous, that though it be an Amphibium, that is, which lives both in the water and ashore, yet usually it keeps itself in the sea, neither doth it come ashore to feed unless in a very clear season. The flesh thereof is very good and grateful meat, and the blood medicinable for such as have their livers ill affected, or their lungs ulcerated, as the blood of great Tortoises is good for the Leprosy. The blood of great sortoises good for the leprosy. Tom. 2. lib. 20. Thevet in his Cosmography affirmeth that he saw this in Denmark. In a deep lake of fresh water, upon which stands the great city or town of Themistitan, in the Kingdom of Mexico, which is built upon piles, like as Venice is, there is found a fish of the bigness of a Calf, called by the southern Savages, Andura, but by those of the place, and the Spaniards the conquerors of that place, Hoga. It is headed and eared almost like a swine; from the chaps hang five long bearded appendices, of the length of some half a foot, like the beard of a Barbell. It hath flesh very grateful and good to eat. It bringeth forth live young like as the Whale. As it swims in the waters, it seems green, yellow, red, and of many colours, like a Chameleon: it is most frequently conversant about the shore sides of the lake, and there it feeds upon the leaves of the tree called Hoga, whence also the fish hath its name. It is a fearfully toothed and fierce fish, killing and devouring such as it meeteth withal, though they be biggerthan herself: which is the reason why the Fishermen chiefly desire to kill her, as Thevet affirmeth in his Cosmography. The monstrous fish Hoga. Andrew Thevet in his Cosmography writes that as he sailed to America, he saw infinite store of flying fishes, called by the savages Bulampech, who rising out of the water, fly some fifty paces, escaping by that means from other greater fish that think to devour them. This kind of flying fish exceeds not the bigness of a Mackerel, is round headed, with a bluish back, two wings which equal the length of almost all their body. They oft times fly in such a multitude, that they fall foul upon the sails of ships, whilst they hinder one another's sight, and by this means they fall upon the decks, and become a prey to the Sailors: which same we have read confirmed by John Lereus in his history of Brasil. In the Venetian gulf, between Venice and Ravenna, two miles above Quioza, anno Dom. 1550. there was taken a flying fish, very horrible and monstrous, being four foot long, it had a very great head, with two eyes standing in a line, and not one against another, with two ears, and a double mouth, a snout very fleshy and green, two wings, five holes in her throat, like those of a Lamprey, a tail an ell long, at the setting on whereof there were two little wings. This monster was brought alive to Quioza, and presented to the chief of the city, as a thing whereof the like had not been formerly seen. The figure of a monstrous flying Fish. There are so many and different sorts of shells to be found in the Sea, that it may be truly said, that Nature, the handmaid of the Almighty, desports itself in the framing of them. In so great diversity I have chiefly made choice of three to treat of here, as those that are worthy of the greatest admiration. In these lie hid certain little fishes, as snails in their shells, which Aristotle calls Cancelli, and he affirmeth 4. de hist. anim. cap. 4. them to be the common companions of the * By crusted is meant Crabs, Lobsters, Shrimps, and such like. The description of the Hermire crayfish. crusted and shell fishes, as those which in their species or kind are like to Lobsters, and use to be bred without shells; but as they creep into shells, and there inhabit, they are like to shell fishes. It is one of these that is termed the Hermit. He hath two somewhat long and slender horns, under which are his eyes, always standing out of his head, as those which he cannot pluck and draw in, as Crabs can. His fore-feets have claws upon them, where with he defends himself, and carries meat to his mouth, having two other on each side, and a third being lesser, the which he useth in going. The female lays eggs, which hang forth at her back part as if they were put upon a thread, being joined together by certain little membranes. Lastly, in the opinion of Aelian, the Lib. 7. cap. 31. Cancellus or small Crayfish is borne naked and without a shell, but within a while after, she of many which she finds empty, makes choice of a fit one, and when as grown bigger, she cannot be contained or dwell any longer therein, or else being They change their habitation for two causes. stimulated with a natural desire of copulation, she removes into a more capacious and convenient one. These little Cray-fish oft times fight together for their habitation, and the stronger carries away the empty shell, or else makes the weaker to quit possession. Now the shell is either of a Nerita, or Turbo, and oft times of a small Purple; and entering into possession, she carries it about, there feeds and grows, and ●…en seeks a more capacious one as Aristotle saith in the formerly cited place. The effigies of the empty shells whereinto the Cancelli use to creep to dwell. The effigies of Bernard the Hermit housed in his shell. The figure of him out of his Cell. Somethinke that this Bernard the Hermit is that kind of Cancellus which is by Pliny termed Pinnoter; but in truth the Pinnoter is not a kind of Cancellus or Crayfish, but of a little Crab. Now in Aristotle there is much difference between Cancellus and Cancer parvus, though Pliny may seem to confound them; for he is bred What the Pinnoter, or dwaf crab is. naked, having his crust only, but without a shell: wherefore seeing that by nature he wants it, he diligently searches for it, and dwells in it, when as he hath found it: But the Pinnoter is not bred by itself alone, but in Pinna and some others, and he changeth not his habitation, because (as Aristotle thinks) being of the kind of dwarf Crabs, it never grows big, neither dwells it in empty shells. Now the Pinna, What the Pinna is. or Pime is a kind of shellfish, it breeds in muddy places, and is always open, neither is it at any time without a companion, which they therefore call the Pinnoter, or Pinnophylax (i e.) the Pin-keeper, as Pliny saith. Verily that these things are thus, you may plainly perceive by these words of Athenaeus. Chrysippus Solensis 5. de Honest. Lib. 9 cap. 42. Lib. 3. Deipne. & Volupt. saith the Pinna and Pinnoter assist and further each other, neither can they liveasunder. The Pinna may be referred to the kinds of oysters, but the Pinnoter is a dwarf Crabbe: the Pinna opens her shell for the little fishes to enter thereinto; the Pinnoter stands by, observing if any come in, which if they do, he gives the Pin The familiarity and craft of the Pinna and Pinnoter, noise thereof by biting, who presently thereupon shuts her shell, and so they feed together upon that they catch by this means. Thus Athenaeus. She is also for this her craft mentioned by Plutarch in his writings. The Pinnoter is sometimes called by Pliny, Cancer dapis assectator. But that which by these authors is attributed to the dwarf Crabbe, the same by Cicero is ascribed to the little shrimp: now the Pinna (saith he) opening her two Lib. 2. de ●at. decrum. large shells, enters into confederacy with the little shrimp for getting of food, wherefore when little fishes swim into her gaping shell, than the Pinna, admonished by the shrimps biting her, shuts her shell; thus two unlike creatures get their livings together. But Plutarch seems to make the Pinna to be the Pearl Oyster, in that work of his, whereas he enquireth whether the craft of Water or Land beasts be the greater. But amongst the most miraculous fishes may fitly be placed the Nautilos, or Sailor, Psin. lib. 9 cap. 29. of some called Pompylos (it is thought to be a kind of Polypus) it comes with the face upwards to the top of the Sea, raising itself by little and little, that casting forth all the water by a pipe, as if it had a Pump, it easily floats; then putting back the two first tendrils or arms, it extends between them a membrane of wondrous fineness or thinness, which gathering air like as a sail, and she rowing with the rest of her arms, she guides herself with her tail in the midst, as a Rudder. Thus she sails along in imitation of Pinnaces, and if any thing affright her, she presently takes in water, and sinks herself. The shape of the Nautilus, or Sayler-fish. The better to store this treatise of Monsters, abusing the name with the Poets, we will reckon up the whale amongst the Sea-monsters, by reason of his monstrous and How the Whale may be reckoned amongst monsters. wondrous magnitude. Now the Whale is the greatest by much of all the fishes of the Sea, for most commonly this beast is thirty six cubits long, eight high, the slit of his mouth is eighteen foot long, teeth they have none, but in stead thereof in each Jaw horny black excrescences or fins [which we vulgarly term Whale bones] which by little and little end in small hairs like to a swine's bristles, which coming and standing out of his mouth, are in stead of Guides, lest whilst he swims with a blind and rapide violence, he might run against a rock. His eyes are distant one from the other the space of four else, which outwardly appear small, but inwardly they are bigger than a man's head; wherefore they are deceived that say that they are no bigger than an Ox's eyes: his nose is short, but in the middle of his forehead he hath a pipe whereat he draws in the air, and casts forth a whole shower or river of water, that therewith he will even sink the vessels or boats of the Mariners; when he hath filled himself beyond measure, he cries or roars with so great or strong a voice, that he may be heard two miles off. He hath two very large sins upon his sides wherewith he swims, and under which in time of danger he hides his young; he hath none upon his back. His tail in site is like to the tails of Dolphines, neither is it much unlike in shape, which when he moves, he so tosseth the Sea, that he drowns and overturnes the boats that he toucheth. You may by dissecting them find that a Whale brings forth live young, and gives them suck; or A whale brings forth young, & sueklesthem. the male hath testicles and a yard, but the female a womb and dugs. They are taken in divers places about winter, but chiefly about the coast of Aquitaine, a●a small town which is vulgarly called Biarris, some six miles distant from Bayon: whereunto I being sent by King Charles the ninth when he was at Bayon, to cure the Prince of Roche Sur-You, I was an eye witness how they are caught; and also I confirmed that which I had formerly read to that purpose, in that excellent and most true history of fishes set forth by Rondeletius. Now at that town there is a little hill, in the top whereof there is a Tower of very great antiquity, from which as from a How they are caught. watch-Tower they keep watch whether or no any Whales swim that way. Wherefore the watchmen from the tower, either seeing, or by the horrible noise hearing a Whale to pass by that way, they give warning thereof to the inhabitants by the beating of Drums, and ringing a Bell: which sign once given, they all run forthwith, as to extinguish the city if it were on fire, being furnished with weapons and all things fitting for that purpose. For the people of that country are very diligent and expert in catching the Whale. Wherefore in each of the boats furnished with all things either to assail or fly, there are put ten lusty rowers, and divers others furnished with harping-irons to strike the Whale; which being cast and fastened in her, they lose out huge long ropes fastened to them, until such time as he be dead, then together with the ropes, and assisted by the waves of the sea, they draw the Whale (wearied with running and labouring, and fainting by reason of the magnitude and multitude of his wounds, being in the time of their conflict diligently chased and driven toward the shore) a land; & merrily part the prey, each whereof hath his share, according to the number of the irons thrown, the magnitude of the wound, and the necessity and excellency of the wounded part for life: each of their harping-irons are known by their peculiar marks. In the heat of the skirmish many stand up and down in boats, only for this purpose, to take up such as chance to fall into the Sea, lest they should be drowned. The males are caught with more difficulty, the females more easily, especially if their young ones be with them; for Why the females are more easily caught than the males. whilst they linger to help and succour them, they lose the occasion of escaping. The flesh is of no esteem, the tongue only is commendable; for being very large, and of a very lax substance, it is powdered, and by most Gentlemen accounted for a dainty. The lord is dispersed over many countries, to be boiled & eaten with fish in the time of Lent, that Gourmandizers may have something to serve them instead of flesh which is then forbidden. There is great store of fat in them in the parts under the skin and belly, which melted, concretes not again, by reason of the subtlety of the parts, they keep it to burn in lamps, and to use about their ships. The houses of the fish-eaters are builded with their bones; also orchards in the coast of Aquitaine are fenced with these bones. The fins that stand forth of their mouths, which are commonly called Whalebones, being dried and polished, serve to make Whalebone. busks for women, whip-staves, and little staves, as also to stiffen garments. Many make seats or stools of the vertebrae, or spondyls of the backebone. The manner of the cutting up of the Whale. In the river Scaled, ten miles from Antwerp, Anno Dom. 1577. the second day of July, there was a Whale taken, of a blackish blue colour, she had a spout hole in the top of her head, out of which she cast great store of water: she was fifty eight foot long, and sixteen foot high: hertaile was fourteen foot broad; from the eye to the end of her nose was some sixteen foot. Her lower jaw was six foot on each side, she had twenty five teeth, which she could hide in her upper jaw, there being holes for them, it being wholly toothless; for which one thing this Whale may be judged monstrous, for that nature hath denied them teeth, and for that in creatures that are not horned, it is so ordained by nature, that when they have teeth in their lower jaw, they should have others also in the upper to answer to them, so to chaw their meat. The longest of these teeth exceeded not six inches. There is (as Pliny reports) a very small fish accustoméd to live about rocks, it is Lib. 9 cap. 25. & lib. 32. ca 1. called Echencis, never exceeding the length of a foot; it is thought that ships go more slowly if this stick to them: wherefore the Latins have also given it the name of Remora, for that a ship being under sail with a good wind, may by the Echeneis seizing on her as if she would devour her, be stayed against the Sailor's wills, and The wondrous power of the Remora. stand still as if she were in a safe harbour. Wherefore she is said in the Actium fight to have stayed the ship of Marcus Antonius, hastening to go about and encourage his souldierś, so that he was forced to enter into another ship, and thereupon Caesar's navy came upon them too hastily, and before they were provided. She also stayed the ship of the Emperor Caius, coming from Astura to Ants, his ship of all the naive making no way; neither did they long wonder at this stay, the cause being presently known; some forthwith leaping into the Sea to find the cause thereof, there found her about the ship, even sticking to the Rudder, and they showed her to Caius, being wrath that this so small a thing should stop him, and countermand the endeavour of forty Rowers. Therefore this little fish tames and infringes the violence and madness of the world, & that with no labour, not with holding or any other way, but only by sticking thereto. Certainly how ever it comes to pass, who from this example of holding of ships, can doubt of any power or effect of nature, in medicines which grow naturally? Yea & without this example, the Torpedo out of the sea also may be sufficient, The wondrous force of the Torpedo. who a far off, and at a distance, if it be touched with a spear or rod, will benumb even the strongest arms, and retard the feet, how ever nimble to run away. CHAP. XXII. Of the admirable nature of Birds, and of some Beasts. THAT there be divers things not only in the Sea, but also in the air, and earth, which by the wonderful condition of their nature may equal that of Monsters, the only Ostrich may serve for a witness. It is the biggest of Birds, though indeed it partly resembles a bird, and partly a beast (and it is familiar to Africa and Aethiopia) as which contrary to the nature of The Ostrich is Between a bird and a beast. beasts hath feathers, and against the custom of birds, cannot fly aloft; for it hath not feathers fit to fly, but like unto hairs, yet will it outrun a horse. The natural force of the stomach in concocting is miraculous, as to which nothing is untameable: The wondrous force of her stomach. she lays eggs of a wondrous largeness, so that they may be framed into cups: their feathers are most beautiful, as you may perceive by this following figure. The figure of an Ostrich. Any one may easily gather of what a prodigious magnitude an Ostrich is, by the greatness of his bones. Three of these birds were kept at the King's charge, by the Mareschall de Rets: one whereof dying, it was bestowed upon me, whereof I have with great diligence made a Sceleton. The delineation of the Sceleton of an Ostrich. A. Shows the head, which was somewhat thicker than the head of a Crane, of the length of ones hand, plain from the crown even to the beak; the beak being divided to the middle region of the eye, being roundish at the end thereof. B. The neck, a yard long, consisting of seventeen vertebrae, each whereof on each side is furnished with a transverse process looking downwards, of some finger's length, excepting the two which are next the head, as which want these, and are joined together by Ginglymos. C. The back is of a feet length, consisting of seven Vertebrae. D, The holybone of two foot long, in whose top there is a transverse process, under which there lies a great hole. E. Three more, but less. F. G. H. After which there follows the cavity or socket, whereinto the head of the thighbone is received and hid. This externally and on the side produceth a perforated bone, noted with the letter, I. perforated I say at the beginning, for it is presently united at the letter, K. then is it forked and divided into two other bones, whereof one is bigger than the other. The less is noted with the letter, L. then are they both united at the letter M. each of them is half a foot and four inches long. But from that part whereas they first begun to be divided, to that whereas they are united, there is a hole some four fingers broad, but the length of ones hand, or more, and it is noted with the letter, N. The residue of the bone is like to a pruning knife three inches broad, but six in length: at the end whereunder is the letter, O. it is joined by coalition. P. The rump consisting of nine vertebrae, like to a man's. The thigh-bones are two, whereof that which is noted with the letter Q. is of the length of a foot, and of thickness equal to a horses thigh. The other next under (which peradventure you may call the legge-bone) noted with R. is a foot and half long: it hath joined thereto the Fibula, or lesser focile of the like length, but which grows smaller as it comes lower. S. Is the leg, to which the foot adheres, being one foot and a half long, divided at the end into two claws, the one bigger, the other less, whereof each consists of three bones. T. Eight ribs, which are inserted into the Sternon, the three middlemost of these have a bony production like to a hook. V. Is the Sternon, consisting of one bone of some foots length, representing a buckler, to this there is joined another bone, which stretched over the three first ribs, is in stead of clavicles or collar-bones. X. The first bone of the wing, which is one foot and half long. Y, Two bones under this, equivalent to the ell and wand, under which there are six other bones composing the point of the wing, noted with Z. This whole Sceleton is seven foot long, and so many foot or more high from the feet to the beak: there are many other observable things in her composure, but I have thought fit to omit them for brevity's sake. Jerome Cardane in his books De subtilitate, writes that in the Hands of the Molucca's, The description of the bird of Paradise. you may sometimes find lying upon the ground, or take up in the waters, a dead bird called a Manucodiata, that is in Hebrew, the bird of God, it is never seen alive. It lives aloft in the air, it is like a Swallow in body and beak, yet distinguished with divers coloured feathers: for those on the top of the head are of a golden colour, those of the neck like to a Mallard, but the tail and wings like Peacocks; * Whosoever desires to know more of the truth of this bird, let him read Clusius in the Auctarium ad lib. 5. cap. 1. exoticorum. it wants feet: Wherefore if it become weary with flying, or desire sleep, it hangs up the body by twining the feathers about some bough of a tree. It passeth through the air, wherein it must remain as long as it lives, with great celerity, and lives by the air and dew only. The cock hath a cavity depressed in the back, wherein the hen lays and sits upon her eggs. I saw one at Paris which was presented to King Charles the ninth. The effigies of a Manucodiata, or bird of Paradise. We have read in Thevets' Cosmography, that he saw a bird in America, which in Tom. 2. lib. 21. cap. 12. that country speech is called Touca, in this very monstrous & deformed, for that the beak in length and thickness, exceeds the bigness of the rest of the body; it feeds on pepper, as the blackbirds and felfires with us do upon Ivy berries, which are not less hot than pepper. A certain Gentleman of Provence brought a bird of this kind from that country, to present it to King Charles the ninth, but dying in the way he could not present it alive. Wherefore the King wished the Marshal de Rets to give her to me, that I might take forth her bowels and embalm her, that she might be kept amongst the King's rarities. I did what I could, yet not long after she rotten: she resembled a crow in body and feathers, but had a yellowish beak, clear, smooth, and toothed like a saw, and of such length and thickness as we formerly mentioned. I keep it yet as a certain monstrous thing. Thevet writes that in the Island Zocetera there is frequently found a certain wild beast called Hulpalis, of the bigness of an Aethiopian Monkey. It is a very monstroas Tom. 1. cap. 11. lib. 4. creature, but in nothing more, than that it is thought to live upon the air only; the skin, as if it were died in grain, is of a scarlet colour, yet is it in some places spotted & variegated: it hath a round head like to a bowl, with feet round, broad, and wanting hurtful nails. The moors kill it and use to eat the flesh of it, being first bruised, that so it may be the more tender. In the Realm of Camota, of Ahob, of Benga, and other mountains of Cangipa, Plimatique and Catagan, which are in the inner India, beyond the river of Ganges, Thevet tom. 1. lib. 11. cap. 13, some five degrees beyond the Tropic of Cancer, is found a beast, which the western Germans call Giraffe. This beast in head, ears, and cloven feet, is not much unlike our do; it hath a very slender neck, but it is some six foot long, and there are few beasts that exceed him in the length of their legs: his tail is round, but reacheth no further than his hams, his skin is exceeding beautiful, yet somewhat rough, having hair thereon somewhat longer than a Cow, it is spotted and variegared in some places with spors of a middle colour, between white and chestnut, so as Leopards are: for which cause by some greek Historians it is called a Cameleopardalis: it is so wild before it be taken, that with the goodwill it will not so much as be seen. Therefore it inhabits and lives only in desert and secret places, unknown to the rest of the beasts of that region. He presently flies away at the sight of a man, yet is he taken at length, for that he is not very speedy in his running away; once taken, he is as easily and speedily tamed as any wild beast whatsoever. He hath above his crown two strait horns covered with hairs, and of a feet length. When as he holds up his head and neck he is as high as a Lance. He feeds upon herbs, and the leaves and boughs of trees, yea and he is also delighted with bread. The effigies of a Giraffa. Such as sail in the red sea alongst the coast of Arabia, meet with an Island called by the Arabians Cademota; in that part thereof where the river Plata runs, is found a wild beast, called by the barbarous inhabitants Parassoupi, being of the bigness of a Mule, headed not unlike one, yet rough and haired like to a Bear, but not of so dark a colour, but inclining to yellow, with cloven feet like a Hart: she hath two long horns on her head, but not branched, somewhat resembling those so much magnifyed horns of Unicorns. For the natives of the place, bitten by the venomous tooth of either beast or fish, are presently helped and recover by drinking the water wherein such horns have been infused for six or seven days space, as Thevet in his Cosmography reports. In one of the Lands of the Molucca's there is found a Beast living both on land and water like as a Crocodile; it is called Camphurch, it is of the bigness of an Hart, it hath one horn in the forehead, movable after the fashion of the nose of a Turkey-cock: it is some three foot and an half long, and never thicker than a man's arm; his neck is covered over with hair of an ash colour, he hath two feet like to a goose's feet, wherewith he swims both in fresh and salted waters. His fore feet are like to a stags, he lives upon fish. Many have persuaded themselves that this beast is a kind of Unicorn, and that therefore his horn should be good against poisons. The King of the Island loves to be called by the name of this beast; and so also other Kings take to themselves the names of the wild beasts, fishes, or fruits, that are most precious and observable in their dominions, as Thevet reports. Mauritania and Aethiopia, and that part of Africa that is beyond the deserts and syrtes, bring forth Elephants; but those of India are far larger. Now although in the largeness of their body they exceed all four footed beasts, yet may they be The Indian Elephants are bigger than the African. more speedily and easily tamed than other beasts. For they may be taught to do many things above the common nature of beasts. Their skin is somewhat like to a Buffles, with little hair upon it, but that which is, is ash coloured, his head large, his neck short, his ears two handfuls broad, his nose or trunk very long, and hanging down almost to the ground, hollow like as a trumpet, the which he useth in stead of an hand, his mouth is not far from his beast, not much unlike a swine, from the upper part whereof two large teeth thrust forth themselves, his legs are thick and strong, not consisting of one bone as many formerly have falsely believed (for they kneel to admit their Rider, or to be laden, and then rise up again of themselves) his feet are round like a quoit some two or three hands breadth, and divided into five clefts. He hath a tail like a Buffle, but not very rough, some three hands breadth long, wherefore they would be much troubled with flies and wasps, but How they keep flies from them. that nature hath recompensed the shortness of their tails by another way; for when they find themselves molested, they contract their skin so strongly, that they suffocate and kill these little creatures taken in the wrinkles thereof; they overtake a man running by going only, for his legs are proportionable to the rest of his body. They feed upon the leaves and fruits of trees, neither is any tree so strong or well rooted, which they cannot throw down and break. They grow to be sixteen handfuls high, wherefore such as ride upon an Elephant are as much troubled as if they went to sea. They are of so unbridled a nature, that they cannot endure any headstall or reins, therefore you must suffer them to take the course and way they please. Yet do they obey their country men without any great trouble; for they seem after some sort to understand their speech, wherefore they are easily governed by their known voices and words. They throw down a man that angers them, first taking him up with their Trunk and lifting him aloft, and then letting him fall, Lib. 9 de list. anim. cap. 27. they tread him under foot, and leave him not before he be dead. Aristotle writes that Elephants generate not before they be twenty years old: they know not adultery, neither touch they any female but one, from which they also diligently abstain It is not known how long an Elephant goes with young. when they know she hath once conceived. It cannot be known how long they go with young; the reason is for that their copulation is not seen, for they never do it but in secret. The females bring forth resting upon their hind legs, and with pain like women, they lick their young, and these presently see and go, and suck with their mouths, and not with their Trunks. You may see Elephants teeth of a monstrous and stupendious bigness, at Venice, Rome, Naples, and Paris; they term it Ivory, and it is used for Cabinets, Harps, Combs, and other such like uses. The figure of an Elephant. We have read in Thevet, that in Florida there are great Bulls, called in that country tongue Beautrol, they have horns of a foot long, a bunch on their back like a Tom. 2. lib. 23. cap. 2. Camel, their hair long and yellow, the tail of a Lion; there is scarce any creature more fierce or wild, for it can never be tamed unless it be taken from the dam. The Savages use their Hides against the cold, and their horns as an Antidote against Their horns good against poisons. Tom. 1. lib. 2. cap. 10. poison. The same author affirms that whilst he sailed in the red sea, he saw a monster in the hands of certain Indian merchants, which in bigness and shape of his limbs was not unlike a Tiger, yet had the face of a man, but a very flat nose: besides, his fore feet were like a man's hands, but the hind like the feet of a Tiger, he had no tail, he was of a dun colour: to conclude, in head, ears, neck, and face it resembled a man, but in the blackish and curled hair, a More; for the other parts they were like a Tiger; they called it Thanacth. The figure of a beast called Thanacth. This following monster is so strange that it will scarce be believed, but by those that have seen it: it is bred in America, and by the Savages called Haiit, of the bigness of a Monkey, with a great belly, almost touching the ground, and the head and face of a child: being taken, it mourns and sighs like to a man that is troubled and perplexed; it is of an ash colour, hath the feet divided into three claws, four fingers long, and sharper than those of a Lion: it climbs trees, and lives there more frequently than upon the ground, the tail is no longer than the breadth of three fingers. It is strange and almost monstrous that these kind of creatures have never been seen to feed upon or eat any thing: for the savages have kept them long in their houses to make trial thereof, wherefore they think them to live by the air. The figure of a beast called Haiit. I have taken this following monster out of Leo's African history; it is very deformed, being round after the manner of a Tortoise, two yellow lines crossing each other at right angles, divide his back, at every end of which he hath one eye, and also one ear, so that such a creature may see on every side with his four eyes, as also hear by his so many ears: yet hath he but one mouth, and one belly to contain his meat; but his round body is encompassed with many feet, by whose help he can go any way he please without turning of his body, his tail is something long and very hairy at the end. The inhabitants affirm that his blood is more effectual in healing of wounds than any balsam. Blood as good as balsam. It is strange that the Rhinoceros should be a born enemy to the Elephant; wherefore he whets his horn, which grows upon his nose, upon the rocks, and so prepares Plin. lib. 8. cap. 29. himself for fight, wherein he chiefly assails the belly, as that which he knows to be the softest: he is as long as an Elephant, but his legs are much shorter, he is of the colour of box, yet somewhat spotted, Pompey was the first that showed one at Rome. The effigies of a Rhinoceros. The figure of a Chameleon. Africa produceth the Chameleon, yet is it more frequent Plin. lib. 8. cap. 33. in India: he is in shape and greatness like a Lizard, but that his legs are strait, and higher, his sides are joined to the belly as in fish, & Arist. lib. 2. hist. anim. cap. 12. his back stands up after the same manner, his nose stands out not much unlike a swine, his tail is long, and endeth sharp, and he folds it up in a round, like a serpent, his nails are crooked, his pace slow like as the Tortoise, his body rough, he never shuts his eyes, neither doth he look about by the moving of the apple, but by the turning of the whole eye. The nature of his colour is very wonderful, for he changeth The strange nature of the colour of the Chamelcon. it now and then in his eyes and tail, and whole body beside; and he always assimulates that which he is next to, unless it be red or white. His skin is very thin, and his body clear; therefore the one of these two, either the colour of the neighbouring things in so great subtlety of his clear skin, easily shines as in a glass; or else various humours diversely stirred up in him, according to the variety of his affections, represent divers colours in his skin, as a Turkey-cock doth in those flethy excrescences under his throat, and upon his head: he is pale when he is dead. Mathiolus writes that the right eye taken from a living Chameleon takes away the white spots which are upon the horny coat of the eye; his body being beaten, and mixed with Goat's milk, and rubbed upon any part, fetcheth off hairs; his gall discusseth the Cataracts of the eye. CHAP. XXIII. Of celestial Monsters. PEradventure it hath not been strange that monsters have been generated upon the earth and in the Sea: but for monsters to appear in heaven, and in the upper region of the air, exceeds all admiration. Yet have we often read it written by the ancients, that the face of heaven hath been deformed, by bearded, tailed, and haired Comets; by meteors representing burning Torches, and lamps, pillars, darts, shields, troops of clouds, hostilely assailing each other; Dragons, two Moons, Suns, and the like monsters and prodigies. Antiquity hath not seen any thing more prodigious than that Comet which appeared with bloody hair in Uvestine, upon the ninth day of October, 1528. for it A Comet with bloody hair. was so horrible and fearful a spectacle, that divers died with fear, and many fell into grievous diseases; going from the East to the South, it endured no longer than one hour and a quarter: in the top thereof was seen a bending arm holding a great sword in a threatening hand; at the end thereof appeared three stars, but that over which the point of the sword directly hanged was more bright and clear than the rest: on each side of this Comet were seen many spears, swords, and other kinds of weapons died with blood, which were intermixed with men's heads, having long and terrible hair and beards, as you may see in the following figure. The figure of a fearful Comet. Also there have been seen great and thick bars of Iron to have fallen from heaven, which have presently been turned into swords and rapiers. At Sugolia in the borders of Hungaria, a stone fell from heaven with a great noise, the seventh day of September, anno Dom. 1514. it weighed two hundred and fifty pound: the Citizens hanged it up with a great iron chain put through it, in the midst of the Church of their City, and used to show it, as a miracle, to travellers of better note that past that way. Pliny reports that the clashing of armour, and the sound of a trumpet were Lib. 2. cap. 57 heard from heaven often, before and after the Cimbrian war. The same author also writes that in the third Consulship of Marius, the Amarines and Tudortines saw the heavenly armies coming from East and West; and so joining, those being vanquished which came from the East. Which something was seen in Lusalia, at a town called Jubea, two hours after midnight, anno Dom. 1535. But in anno Dom. 1550. upon the nineteenth day of July, in Saxony, not far from Wittenberg, there appeared in the air a great stag, encompassed with two armed hosts, making a great noise in their conflict, and at the same instant it reigned blood in great abundance, the sun seemed to be cloven into two pieces, and the one of them to fall upon the earth. A little before the taking of Constantinople from the Christians, Presages of the taking of Constantinople. there appeared a great army in the air appointed to fight, attended on with a great company of dogs and other wild beasts. Julius Obsequius reports that in anno Dom. 458. it reigned flesh in Italy, in greater and lesser pieces, part of which were devoured Monstrous rains by the birds before they fell upon the earth: that which fell upon the earth kept long unpurrefyed, and unchanged in colour and smell. Anno Dom. 989. Otho the third being Emperor, it reigned corn in Italy. Anno Dom. 180. it reigned milk and oil in great abundance, and fruitbearing trees brought forth corn. Lycosthenes tells that in the time of Charles the fifth, whilst Maidenberg was besieged, three suns first appeared about seven a clock in the morning, and then were seen for a whole day, whereof the middlemost was the brightest, the two others were reddish and of a bloody colour; but in the night time there appeared three moons. The same appeared in Bavaria, anno Dom. 1554. But if so prodigious and strange things happen in the heavens besides the common Earthquakes. order of nature, shall we think it incredible that the like may happen in the earth? Anno Dom. 542. the whole earth quaked, mount Aetna cast forth flames and sparks of fire, with which many houses of the neighbouring villages were burnt. Anno Dom. 1531. in Portugal there was an earthquake for eight days, and it quaked seven or eight times each day; so that in Lisbon alone it cast down a thousand and fifty houses, and more than six hundred were spoiled. Ferrara lately was almost wholly demolished by a fearful earthquake. Above all which ever have been heard is that prodigy which happened in the time of Pliny, at the death of Nero the Lib. 2. cap. 73. Emperor in the Marucine field, the whole Olive-field of Vectius Marcellus a Roman Knight going over the high way, and the fields which were against it coming into the place thereof. Why should I mention the miracles of waters, from whose depth and streams, fires and great flames have oft broke forth? They tell out of St. Augustine, that the fire of the sacrifice, which for those seventy years of the Babylonian captivity endured under the water, was extinguished, Antiochus selling the priesthood to Jason. What miracle is this, that the fire should live in the water, above its force and natural efficacy, and that the water should forget the extinguishing faculty! Verily Philosophers truly affirm that the elements, which are understood to be contrary, and to fight in variety among themselves, are mutually joined and tied together by a marvellous confederacy. The End of the Twenty fifth Book. OF THE FACULTIES OF SIMPLE MEDICINES, AS ALSO OF THEIR COMPOSItion and Use. THE TWENTY six BOOK. THE PREFACE. AMongst the causes which we term healthful, and other remedies which pertain to the health of man, and the expelling of Diseases, Medicines easily challenge the prime place; which (as it is delivered by Solomon) God hath produced out of the earth, and they are not to be abhorred by a wise man; for there is The excellency of Medicines. nothing in the world, which sconer, and as by a miracle, assuageth the horrid torments of diseases. Therefore Herophilus called them fittingly administered, The hands of the Gods. And hence it was that such Physicians as excelled in the knowledge of Medicines, have amongst the Ancients acquired an opinion of Divinity. It cannot by words be expressed what power they have in healing. Wherefore the knowledge of them is very necessary not only for the prevention, but also for the driving away of Diseases. CHAP. I. What a Medicine is, and how it differeth from nourishment. WE define a medicine to be, That which hath power to change the body according to one or more qualities; and that such as cannot be changed into our nature: contrary whereto we term that nourishment which may be converted into the substance of our bodies. But we define them by the word power, because they have not an absolute nature, but as by relation and depending upon the condition of the bodies by whom they are taken. For that which is medicine to one, is meat to another, and that which is meat to this, is medicine to that. Thus for example, Hellebore is nourishment to the Quail, but a medicine to man: Hemlock is nourishment to a Sterling, but poison to a Goose: the Ferula is food to an Ass, but poison to other cattle. Now this diversity is to be attributed to the different natures of creatures. It is recorded in history, that the same by long use may happen in men. They report that a maid was presented to Alexander the great, who, nourished with Napellus, and other poisons, had by long use made them familiar to her, so that the very breath she breathed was deadly to the bystanders. Therefore it ought to seem no marvel, if it at any time happen, that medicines turn into the nature and nourishment of our bodies: for we commonly may see birds and swine feed upon serpents and toads without any harm: and lastly, — Serpenti Ciconia pullos Nutrit, & per devia rura lacerta: Illi eadem sumptis quaerunt animalia pennis. The Stork with Serpents and with Lizards caught, In wayless places nourisheth her brood: And they the same pursue, when as they're taught To use their wing, to get their wished for food. CHAP. II. The differences of Medicines in their matter and substance. EVen as the concealed glory of worldly riches lieth hid in the bowels of the earth, and depths of the sea and waters, as gold, silver, and all The earth the mother of riches and medicines. sorts of metals, gems and precious stones, furnished with admirable virtues; so we may behold the superficies of this earth clothed with almost an infinite variety of trees, shrubs, and herbs: where we may contemplate and wonder at the innumerable diversities of roots, leaves, flowers, fruits, gums, their smells, pleasant tastes and colours, but much more at their virtues. This same mother Earth, as with her breasts, nourisheth marvellous distinct kinds of living creatures, various in their springing, increase and strength. Wherein the immense goodness of God, the great Architect and framer of all things, doth most clearly appear towards man, as who hath subjected to our government, as a patrimony, so ample and plentiful provision of nature for our delight in nourishment, and necessity of healing. Therefore the ancient Physicians have rightly delivered, that all sorts of medicines may be abundantly had from living creatures, plants, the earth, water and air. Medicines are taken from living creatures either whole and entire, or else the what medicines taken from living creatures. parts and excrements of them. We oft times use in Physic whole creatures, as foxes, whelps, hedgehogs, frogs, snails, worms, crabs, and other living creatures. We also make use of some parts of them, as the liver of a wolf or goat, the lungs of the fox, the bone of the stags' heart, Cranium humanum, fat, blood, flesh, marrow, the cod of the Castor or Beaver, which is therefore termed Castoreum, and such other particles that are useful in Physic. We know also that there are some medicines taken from excrements, as horns, nails, hairs, feathers, skin; as also from urine, dung, spittle, honey, eggs, wax, milk, wool, sweat, and others of this kind, under which we may comprehend musk, civet, pearl, oesipus, and sundry others of this nature. We take medicines from plants, both whole, and also from their parts, whether trees, shrubs, or herbs. For we oft times use succory, marshmallows, mallows, What from plants. plantain, and the like, whole: but otherwhiles only the roots of plants, their pith, wood, bark, shoots, stalks, leaves, flowers, seeds, fruits, juices, gums, rosines, mosses, and the like. Things taken from the earth for the use and matter of medicine, are either earth's, What from the earth. stones, or minerals. The sorts of earth are Bole armenic, Terra sigillata, fullers earth, chalk, potters clay, and such like. Stones are the pumice, Marchisite of gold, silver, brass, marble, the loadstone, plaster, chalk, sulphur vivum, lapis specularis, and others. Metals and minerals are gold, silver, tin, lead, brass, iron, steel, antimony, ceruse, brimstone, cinnaber, litharge of gold and silver, tutty, true Pompholix, verdigreece, alum, roman vitriol, coprose white and green, salts of sundry kinds, both the Arsenickes, and such like. The following medicines are from fresh water, rain water, spring water, river What from the water. water, and all things thence arising, as water lentile, common flags, water lilies, water mints, and all the creatures that live therein. From the salt water are taken salt, Alcyonium, all sorts of coral, shells of fish, as also cuttle bones, sponges, and all creatures of the sea. From waters mixed of salt and fresh, the herb Androsace (which grows in plenty in the marshes at Fontignan and Cape de Sete) Asphaltum, which is found in the dead sea. From the air proceeds Manna, therefore called melaërium (i. e.) honey of the air, What from the air. and also all other kinds of dew that are useful in Physic by reason of the virtues they receive from the sun which raiseth them up, from the air, whereas they make some stay, as also from the plants, whereupon they fall and reside. CHAP. III. The differences of simples in their qualities and effects. ALL the mentioned sorts of simples are endued with one or more of the four faculties, whereof I now purpose to treat. The first faculty common to all the rest, and as it were their foundation, flows from the four first qualities of the prime bodies or elements, that is, heat, coldness, dryness, and moisture, and this either simple or compound, as one or two of these prime qualities exceed in the temper of the medicine, as it may appear by the following tables. The simple quality is either to Heat, Coole, Humect, Dry. The compound, arising from two joined qualities, either Heats and dries, Heats and moistens, Cools and dries, Cools & moistens. Heat, which is moderate, Heats, Attenuates, Rarifyes, Opens the passages, Digests, Suppurates. immoderate Inflames and burns, Bites, whence follows Violent attraction, Rubrification, Consumption, Colliquation, An eschar, Mortification. Cold, which is moderate, Cooleth, Condenseth, Obstructeth. immoderare, Congeals, Stupefyes, Mortifyes. Moisture, which is moderate, Humects, Lubricates, Levigates and mitigates, Glues. immoderate, Obstructs, Lifts up into a flatulent tumour, especially if it be a vaporous humidity. Dryness, which is moderate, Dries, Rarifyes, Attenuates. immoderate, Binds, Contracts or shrinks, Causeth chaps and scailes. The effect of these qualities is distinguished, and as Galen observes, digested into these orders, which we term Degrees; so that by a certain proportion and measure, 5. ●●●p. & 1. de aliment. they may serve to oppugn diseases, as the same Galen affirms. For to a disease (for example) hot in the second degree, no other medicine must be used than that which is cold in the like degree: Wherefore all simple medicines are, Hot, Cold, Moist, Dry, in the Beginning, Middle, Extreme, of the first, second, third, fourth, degree. The Heat, of the first, degree, is Obscure, The Coldness, of the second, degree, is Manifest, The Moisture, of the third, degree, is Vehement, The Dryness of the fourth degree, is Excessive. An example of heat distinguished thus by degrees, may be thus, Warm water is temperate; that which is a little hotter, is in the first degree of heat; if manifestly Examples 'of the degrees of heat. hot, it is in the second degree; but if it heat more vehemently, it may be thought to come to the third; but if it scald, than we know that it hath arrived to the fourth degree of heat. Such also is the distinction of coldness, moisture, and dryness, by their degrees. Wherefore it will be worth our labour, to give you examples of certain medicines, distinguished in their order and degree, by which you may the more easily give conjecture of the rest. Simple Medicines hot in the First degree. Absinthium. Althaea. Amygdala dulcia. Beta. Brassica. Chamaemelum. Laudanum. Semen Lini. Saccharum. Ervum, sive Orobus. Vinum novum: For old is judged hot in the second or third degree, as it is more or less years old. Second degree. Ammoniacum. Artemisia. Anethum. Foenugraecum. Mastiche. Salvia Marrubium. Melissa. Pix utraque tum arida corporibus particulisque solidioribus aptior, tum liquida delicatioribus. Scylla. Sarcocolla. Bryonia. Apium. Chamaepytis. Crocus. Ficus. Thus. Myrrhae. Mel. Nux moschata. Sal. Opopanax. Ammi. Simples hot in the Third degree. Abrotanum. Agnus castus. Anisum. Asarum. Aristolochia. Chamaedrys'. Sabina. Calamintha. Cinamomum. Iris. Juniperus. Hyssopus. Origanum. Sagapenum. Chelidonium majus. Ruta saliva. Fourth degree. Allium. Caepa. Euphorbium. Nasturtium. Pyrethrum. Sinapi. Tithymalli. Anacardi. Chelidonium minus, Galeno. Yet ours, by reason of the gentleness of the air, & moisture of our soil, is not so acride. Ruta sylvestris. This, as all wild and not cultivated things, becomes more strong and acride than the Garden Rue. Simples cold in the First degree. Atriplex. Hordeum. Cydonia mala. Malva. Pyra. Pruna. Rosa. Viola. Second degree. Acacia. Cucurbita. Cucumis. Malagranata acida, dulcia enim temperata sunt potius. Plantago. Polyganum. Solanum hortense, nam id quod somniferum dicitur, vi refrigerandi ad papaver accedit. Third degree. Hyoscyamus. So●anum somniferum. Fourth degree. Cicuta. Papaveris genera omnia, excepto Cornicula. Portulaca. Sempervivum. Mandragora. to, huic enim incidendi & abstergendi vim attribuit Gal. Certè nitrosum & salsum gustu percipitur, quo fit ut calida & siccae sit naturae. Opium. Simples moist in the First degree. Buglossum. Viola. Malva. Rapum. Spinacia. Second degree. Ammoniacum. Lactuca. Cucurbita. Cucumis. Melones. Portulaca. Simples dry in the First degree. Thus. Chamaemelum. Brassica. Sarcocolla. Crocus. Faba. Faenugraecum. Hora●●m integrum. Second degree. Artemisia. Orobus. Balaustia. Lens. Mastiche. Mel. Sal. Anethum. Myrrah. Pix arida. Plantago. Nux moschata. Third degree. Abrotonum ustum. Absinthium. Acetum. Milium. Sanguis draconis. Galla. Myrtus. Aloe. Cuminum. Sabina. Fourth degree. Piper. Allium. Nasturtium. Sinapi. Euphorbium. Those we have mentioned have of themselves and their own nature all such qualities, The effects of the first qualities by accident. yet do they produce far other effects by accident, and besides their own nature in our bodies, by reason of which they are termed accidental causes. This shall be made manifest by the following examples. external heat by accident refrigerates the body within, because it opens the passages and pores, and calls forth the internal heat, together with the spirits and humours by sweats: whence it follows, that the digestion is worse, and the appetite is diminished. The same encompassing heat also humects by accident, whilst it diffuses the humours concrete with cold: for thus Venery is thought to humect. The like may be said of Cold, for that it heats not by its proper and native, but by an adventitious force: whereof you may make trial in Winter, when as the ambient cold, by shutting the pores of the body, hinders the breathing forth and dissipation of the native heat. Whence it is inwardly doubled, and the concoction better performed, and the appetite strengthened. This same cold also dries by accident, when as it by accident repercusses the humour that was ready to flow down into any part, and whilst it concretes that which is gathered in the part: for thus by the immoderate use of repercussers, an oedematous tumour, proceeding from gross and viscide phlegm, degenerates into a scirrhus. Dryness and moisture, because they are more passive qualities, show their effects by not so manifest operations, as heat and cold do; but in comparison of them they are rather to be judged as matter or a subject. CHAP. IU. Of the second faculties of Medicines. We term those the second faculties of Medicines, which have dependence upon the first, which are formerly mentioned, as it is the part Of Heat to Rarefie, Attract, Open, Attenuate, Levigate, Cleanse. Of Cold to Condense, Repercusse, Shut up, Incrassate, Exasperate, Constipate. Of Moisture to Soften, Relax. Of Dryness to Harden, Stiffen. Hence we term that an attractive medicine, which hath an attractive faculty, as on the contrary, that a repercussive, that repels; a detergent, that which cleanses viscous matter. We call that an Emplastic medicine, which not only shuts up the pores of the body, but reduces the liquid bodies therein contained to a certain equality of substance. Thus also emollients, relaxers, and the rest, have their denominations from their effects, as we shall declare hereafter. CHAP. V. Of the third faculties of Medicines. THe third faculty of medicines depends for the most part upon the first and second faculties, sometimes conjoined, otherwhiles separate. Also sometimes it follows neither of these faculties, but a certain property and inexplicable quality, which is only known by experience. Now the operations of this third faculty are to agglutinate, to fill with flesh, to cicatrise, to assuage pain, to move or stay the urine, milk, seed, the courses, sweats, vomits, and perform such like operations in or about the body. Thus the generation of flesh is produced by the concourse of two faculties, that is, of drying and cleansing. But dryness and astriction produce a glutinating and cicatrizing faculty. A hot and attenuating faculty causeth sweats, moves urine, the courses, and the like in the body; but contrary faculties retard and stop the same. To mitigate pain, proceeds only from the first faculty, to wit, from heat, or a moderately heating faculty; to procure rest, from cold only, or coldness joined with some moisture. But to procure vomit, proceeds neither from the first nor second faculty, but from a certain occult and essential property, which is naturally implanted in Agaricke, and other nauscous and vomitory medicines. CHAP. VI Of the fourth faculty of Medicines. THe fourth faculty of medicines is not of the same condition with those The fourth faculty of medicines depends only upon an occult property. that are formerly mentioned; for it depends not upon them, or any other manifest or elementary quality, but on an occult property of the whole substance, by means whereof, it works rather upon this than that part, upon this rather than that humour. Wherefore Physicians cannot by any reason find out this faculty, but only by experience, as we have said a little before of medicines procuring vomit. Hence it is, that names are given to those medicines from those parts that they chiefly respect: For they are termed Cephalicks, which respect the head, as Betony, Marjerome, Sage, Rosemary, Staechas: Pneumonicks, which respect the Lungs, as Liquorice, sweet Almonds, Orris, Elecampane. Cordials, that strengthen the heart, as Saffron, Cinnamon, Citrons; but chiefly their rinds, bugloss, Coral, Ivory. stomatical, which respect the stomach, and the orifice thereof, as Nutmegs, Mint, Anise, Mastic, Pepper, Ginger. Hepaticks, which respect the Liver, as Wormwood, Agrimony, Spikenard, Succory, Sanders. Spleniticks, which have relation to the spleen, as Time, Epithymum, Broome flowers, Cetrach, Capers, the bark of their roots, the bark of Tamariske. Diuretics, such as respect the kidneys and urenary passages, as the roots of Smallage, Asperagus, Fennell, Butcher's broom, the four greater cold seeds, Turpentine, Plantain, Saxifrage. Arthniticks, or such as strengthen the joints, as Cowslips, Chamaepytis, Elecampane, calamint, Hermodactiles, and the like. To this rank may be referred purging medicines, which, furnished with a specific property, show their efficacy on one humour more than another humour, and that impact more in one part than in another. For thus Agricke chiefly draws phlegm from the head and joints, Rhubarb draws choler chiefly from the Liver, and hurts the kidneys. But let us here forbear the consideration of such things, as not appertaining to Surgery. But some medicines of this kind are furnished with one simple faculty, othersome with more, and those contrary, whereof your taste may give you sufficient notice: for Rhubarb at the first touch of the tongue is found acride and hot; but when you come to chaw and throughly to taste it, you shall find it to partake of an earthy astriction. Therefore because tastes give notice of the faculties of medicines, therefore I have thought good to treat of them briefly. CHAP. VII. Of Tastes. TAste, as Galen delivers according to Aristotle and Theophrastus, is a Lib. 1. simple. certain concoction of moisture in dryness, caused by means of heat, which we know or discern by the tongue well tempered, and fittingly furnished with spittle and his nerves. There are nine differences of tastes; for there are three judged hot, to wit, the acride, Differences of tastes. bitter, and salt: three cold, the acide, austere, and ac●rbe: three temperate, the sweet, the oily or fat, and the insipid. Now they are thought so many, according to the different degrees of concoction; for it appears greater in hot tastes, and as it were a certain assation, but less in cold, but indifferent, and as it were an elixation in things temperate: therefore Nature observes this order in the concoction of sapide bodies, that at the first the acerbe taste should take place, than the austere, and lastly, the acide; from these (as it were) rudiments of concoction, arises an insipid, than an oily, than a sweet perfectly concocted and temperate. This concoction exceeding the bounds of mediocrity, there arises a salt taste, than a bitter, and then an acride with the highest excess, of almost a fiery heat. Yet I would be thus understood, that all things that are by nature sapide, do not always ascend to the height of sweetness by the degrees of acerbity, austerity, and acidity, as though it were of absolute necessity, that all things that are sweet, they should first be acerbe, austere, and acide. For there are many things found, especially in plants and their fruits, which when they shall arrive to their perfection and maturity, are acide, bitter, or salt, but being yet unripe, and not come to full perfection, they have a certain sweetness, which afterwards, by a further digestion, or perfection and concoction, acquire a bitter, austere, or acide taste. For thus bitterness in Wormwood and Aloes, acrimony in Pepper or Pellitory, is a perfection of nature, a full ripeness and perfect concoction, and not an excess of heat in that species. Also acerbity and austerity is a perfection of nature, and not a rudiment in Services and Cornelians; acidity or tartness is also so in verjuice. But in very many things it so falls out, that the sweet or fatty taste become so, and acquire their perfection by concoction, as in Grapes, Figs, Pears, Apples, and almost all other such fruits, as we usually feed upon. Therefore I will now treat of each of them in order, first beginning with the cold tastes. The acerbe taste is cold and terrestrial, and of a substance absolutely gross, being The acerbe taste. less humid than the austere, but much less than the acide. It notably cools and dries, it condensats, binds, repels, especially from the superficies, and it also exasperates; this taste resides, and may be found in Pomegranate pills, Galls, Sumach, and Cypress nuts. The austere is nighest in temper and effects to the acerbe, but somewhat moisture; The austere. for the acerbe absolutely consists in a terrestrial & cold substance. Wherefore this, increased by a degree of concoction, acquires more store either of heat alone, or else of moisture alone, or else of both together: moisture, I say, and that is either eyrie, or else watery. Therefore if these fruits, which before their maturity are acerbe, have an accession of heat, then do they become sweet, as you perceive by Chestnuts; but if there be an accession of moisture only, and that more gross, of acerbe they become austere: for both the tastes are in the like degree of cold, but the austere is the moisture. But if to the same frigidity remaining in fruits, a certain subtle humidity accrue, then is there caused an acide taste. But if they have an accession of a waterish moisture and heat, they will acquire a sweet taste, or else oily, if the humidity accrueing with the heat be eyrie. I have judged it requisite to admonish you hereof, that you might know by what means sapide bodies mitigated become sweet of acerbe, as it were by these interposed degrees of austerity, acidity, and oiliness, as they acquire a various accession of heat and moisture separately, or conjunctly. Now by all that we have delivered, you may gather, that all acerbe and austere things are cold and dry; and as they are cold, they repel and hinder defluxions: as they are dry and terrestrial, they condensate, incrassate, constipate, and straiten the passages; yea, and they also cicatrise: but acerbe things perform this far more powerfully, as those which are absolutely terrene, cold, and dry, not partaking of moisture, or water. Now austere things consist (as it were) in a middle matter, that is, in a more dilute terrene body, as it is apparent in Services, unripe Grapes, Cornelians, Medlars, Crabs, wild Pears, and all sorts of unripe fruits, whence it is termed a crude taste. The acide taste is of a cold and waterish nature, but most subtle, by benefit whereof The acide taste. it penetrates, and divides almost as powerfully as the acride. It incides, or divides, attenuates, bites, cleanses, opens obstructions, repels and dries. For by the means of the deep piercing cold, it repels all defluxions; and by the drying faculty, which is strong even in its watery consistence, it stays and stops all bleedings, the haemorrhoides and dysenteries. The force thereof is chiefly manifest in Vinegar, as also in the juice of Citrons, Sorrell, Cherries, Berberries', and the like. And this is the nature of cold tastes, now it is time we speak of such as are temperate. The insipid is unproperly termed a taste, as that which is rather a privation of The insipid. tastes, it is in some sort cold, and of a very waterish and gross nature, it inspissates, constipates, and stupifies. This kind of taste is chiefly manifest in water, and next in Gourds, Citruls, and many such like things. The oily taste is hot, humid, and eyrie; therefore it humects, relaxates, mollifies, The oily. lubricates. Of this kind are oil, butter, fat which is not raucide by age, nor acride by nature, as that of Lions and Foxes. The sweet taste is made by a moderate and well concocting heat, consisting in a The sweet. matter more tenuious and hot than the insipid, but in somewhat more gross than the oily, from which in the first qualities it doth not differ; therefore it is of a hot, eyrie, and temperate nature. Therefore every sweet thing detergeth, levigates, concocts, ripens, relaxes, and assuageth pain. Examples of this taste may be had in Sugar, Honey, Manna, sweet Almonds, Milk, and other like. Now let us come to hot tastes. The salt taste is hot and astringent, less earthy than the bitter, as that which resides The salt. as it were in a middle matter. For it proceeds from an earthy dryness, which is formerly torrified & attenuated by the force of heat in a watery humidity. Wherefore that which is salt contracts the pores, cuts, cleanses, digests, or rather dries up the humours by the dryness thereof, without any manifest sense of heat, whence it is, that it vindicates from putrefaction. Under this kind are contained all sorts of salt, as salt-Peter, niter, sal Ammoniacum, sal gemmae, common salt, sea water, and such other like. The bitter taste is hot, earthy, and drying; for the matter thereof is gross and The bitter. earthy, which the abounding heat hath torrified and dried up. Wherefore bitter things taken in wardly, purge and carry away superfluous humours: and outwardly applied, they mundify and deterge ulcers, they open the mouths and passages of the veins ofttimes by their abstergent faculty; whence it is that they move the courses and haemorrhoides. The principal things endued with this taste are Aloes, Gall, Wormwood, Gentian, the lesser Centaury, Coloquintida, Fumitory, Soot, and such like. The acride taste is hot, of a subtle and fiery nature; for it is kindled of a hot, subtle, The acride. and dry matter, neither can it consist in any other. Therefore that which is acride, heats, pricks or bites the mouth by the acrimony, it heats, and ofttimes burns, it penetrates, opens the passages, attenuates, attracts and draws forth gross humours, evacuates and sends forth urine, the courses, and sweat: besides it ofttimes is septicke, blistering, and escharotick; and lastly, burning, and caustic. The septicke & putrefactive things are sublimate, Chamaelea, the juice of Thapsia. The vesicatories are Dittander, Cantharideses, Crowfoot, Mustard, Pellitory of Spain, Euphorbium. But the caustic and escharoticke are Lime, Oak ashes, and the like. But we know medicines not only by the taste, but also by our other senses, as touch, sight, hearing, smell. And as by the taste, so also by these we judge of and try the goodness of medicines, and distinguish the true legitimate from the adulterate. The touch judges what are hot and cold, moist and dry, rough and gentle, or smooth, hard and soft, brittle or friable, glutinous and viscide, dry or slippery. We approve of the goodness of medicines by their colour, brightness, or duskiness, whereof the eye is judge; for we commend that Senna which is somewhat greenish, but dislike the whitish: as also we like well of such Cassia as is black both within and without, shining and full, and not dry and shrunk up. Yet the judgement of the first qualities, by the colour is deceitful, or none at all; for such things as are white, or of the colour of Snow, are not therefore cold: for sundry of them are hot, as Lime. Neither are red things to be therefore judged hot; for Roses cool. Also medicines are chosen by the smell; for such as have a good, fresh, and natural smell, are commonly hot, and in their perfect vigour. On the contrary, things that want smell are for the most part cold and evanide. By hearing we distinguish things full from such as are empty: thus we choose Cassia, which shaken, makes no noise with the grains or seeds rattling in it. Hitherto we have explained the first, second, third, and fourth faculties of medicines in general, & have showed how they may be found out: now must we more particularly treat of their second and third faculties, because by reason of these they chiefly come into use in Surgery: Yet let me first briefly show by what means and arts they may be prepared. CHAP. VIII. Of the preparation of medicines. To prepare medicines, is nothing else, than by art to make them more commodious for use and composition, whereby they are either made More gentle. All which are performed By bruising, as when medicines are broken by striking and rubbing or grinding in a mortar, & that either of Brass, Iron, Led, Glass, Wood, Marble, & other like. considering The thing which is to be beaten. The strength or force wherewith it must be performed. The time or space. The situation. The things to be added. The consistence which the thing beaten must be of. More strong. By searsing, whereby we separate the pure and finer from the more impure and gross, which is done by sives and searses, made of Wood, Parchment, Horse hair. Silk, Lawn. Wherein is to be noted, that the same consideration is to be had in searsing, as in beating; therefore such things as are to be finely powdered, must be searsed in a finer searse: such as are more gross, in a courser. More pleasant. By dissolving or mollifying. Which is nothing else but a dissolving of a simple or compound medicine, of a thick or hard consistence, either into a mean consistence, or a little more liquid or soft, which is performed Either by heat only; for by heat gums and horns are mollified: or by liquor, as by vinegar, water, wine, juice of Lemons, etc. By desiccation or hardening, which Is nothing else, but the consuming of the superfluous and hurtful moisture, and this is performed, either By the Sun, or By Fire. More wholesome. By infusion, which is nothing else but the tempering or macerating of a medicine a little beaten or cut, in some liquor appropriate and fit for our purpose, as in Milk, Vinegar, Water, Oil, and the like, so long as the nature of the medicine requires. To infusion Nutrition may be reduced, which is nothing else, but as it were a certain accression of the medicine, by being moistened, macerated, rubbed, or ground with some moisture, especially with heat. By burning, that is, by consuming the humidity which is in them. And that, either that they may be the better powdered, being otherwise too glutinous, or that they may lay aside their gross essence, and become of a subtler temper; or that they may put off, or partly lose some fiery quality, as acrimony, Gal. lib. 4. cap 9 simplicium. Or that they may acquire a new colour. Now all things are burnt, either Alone, as such things as have a fatty moisture, as hairs, sweaty wool, horns: Or else with some combustible matter, as sulphur; alum, salt, barley, etc. More fit for mixture. By boiling or elixation, which is performed by a humid heat, as burning is by a dry, & that either that we may increase the weak faculties of such medicines as are boiled, by boiling them with such as are stronger; or else to weaken such as are too strong, or else wholly to dissipate such as are contrary: Or that one faculty may arise of sundry things of different faculties being boiled together, or for the longer keeping them, or bringing them to a certain form or consistence: all which are done, either by the Fire, or Sun. By washing or cleansing, whereby the impurity of the medicine is wasted away or cleansed, and such things are either Hard, as metals, stones, parts of living creatures, condensed juices, & other like: Or soft, as Rosines, Gums, Fats, Oils. And these aught first To be finely beaten, that the water may penetrate into all their substance. Or to be dissolved, & cast into a vessel filled with water, and so stirred, & then suffered to subside, so that the fat may swim aloft: and this must be done so long that the water retain nothing thereof in colour, smell, or taste. CHAP. IX. Of repelling, or repercussive medicines. REpelling or repercussive medicines are cold, and of gross and earthy parts; by which name also astringent medicines are understood, because Astringents are understood by the name of repellers. they hinder the falling down of the humours upon the part. Repercussives are such, either of their nature and of themselves, or else by accident, being not such of their own nature. These which of themselves are such, are of two kinds; for some are waterish & moist, without any astrictive The differences of repercussives faculty, which almost wholly proceeds from an earthy essence; wherefore that faculty of repelling which they possess, they have it wholly from coldness. Of this kind are lettuce, purslane, sowthistle, duckes-meat, kidney wort, cucumbers, melons, gourds, houseleek, mandrake apples, nightshade, henbane, and the like, which cool powerfully, and unless they be taken away before the part wax blackish, they extinguish the natural heat. Other some are of an earthy essence, and therefore astrictive; but yet some of these are hot, other some cold. Such things as are cold of temper, and of an earthy consistence, are properly and truly termed repellers. Of these, some are simple, other some compound: the simples are plantain, vine leaves, leaves of roses, oaks, brambles, cypress, berberies, sumach, all unripe fruits, verjuice, vinegar, red wine, the juice of sour pomegranates, acacia, the juice of barberries, and quinces, hypocistiss, pomegranate pills; oak bark, the flowers of wild pomegranates, the meal of barley, beans, panic, oats, millet, orobus mixed with juices in form of a pultis, bowl armenick, sanguis draconis, ceruse, lethargy, terra sigillata, fullers earth, chalk, marvel, the loadstone, lead, corals, all marchisites, antimony, spodium, true pomphilix, all sorts of earth, and other things of the like nature. Now compound things are oleum rosaceum, omphacinum, mirtillorum, papaveris, cidoniorum, nenupharis, unguentum rosatum, album rhasis, camphoratum, emplastrum diacalcitheos, dissolved in vinegar and oil of roses, desiccativum rubrum, populeon, emplastrum nigrum soutetrapharmacum of Galens description, empl. contra rupturam, de cerusa, pro matrice. All such cold repercussives are more effectual if they be associated with tenuity of substance, either of themselves, or by mixture with some other Why things of subtle parts are oft times mixed with repercussives. things: for to this purpose we often mix vinegar, camphire, and the like things of subtle parts, with repercussives of gross parts, that they may serve as vehicles to carry in the repercussives faculty. Repercussives of gross parts and hot, are worm wood, centory, gentian, agrimony, savin, coriander, mint, bay leaves, cardamomes, calamus aromaticus, aloes, spikenard, saffron, nutmeg, cinnamon, amber, salt, alum, coporose, sulphur, oleum absinthinum, mastichinum, nardinum, costinum, ceratum, Gal. stomachicum, santalinum, emplastrum diacalcitheos. But such things as repel by accident, are bandages, compresses, linen clothes, and rulers of all sorts, cases, cauteries, Repellers by accident. blood-letting, cupping, painful frictions in the opposite parts, and other such like things as are properly said to make revulsion. The use of repercussives is to force When, and to what parts repercussives must be applied. back the humour which flows from any other place into the part, and thus they mitigate the heat of such inflammation as that defluxion of humours hath caused, yea oft times to assuage and help pain, the fever, abscess, malign ulcers, and mortification. Such repercussives must always be so opposed to the disease, that respect may be had to the temper, complexion, and particular nature of the part whereto they are applied; for all parts cannot equally bear the like force of repercussives, as nervous & other spermatick and cold parts. Furthermore, there are some parts whereto we may by no means apply repercussives, as the groins, armpits, and those glandules or kernels which are behind the ears and brain, lest the humour should retire back into some of the principal parts: the like reason is also of bodies, for the bodies of women, children, eunuchs, cannot endure so strong repercussives and the like excess of cold as manly and vigorous bodies may. Besides, every disease requires not repercussives, for if the body be replete with ill humours, if it be plethoric, the use of repercussives, unless after general purgation, cannot be safe; as neither if the humour which is in motion shall be venenate, gross, acrid, critical, or shall cause great pain in the part, for then on the contrary we must rather make use of attractives. But now if the disease be great, weak repercussives will avail nothing against it, as lettuce against a great inflammation; and thou shalt do ill if thou set upon a small defluxion with powerful repellers; for by that means the skin is straitened, and the passages thereof stopped, whereby the inflammation is increased, or else brought to a schirrhus. Wherefore let the Chirurgeon have a care that he temper the force of his Repercussives according to the magnitude of the disease. CHAP. X. Of attractive medicines. AN attractive medicine is contrary to the repeller; the greeks call it Helcticum, What an attractive medicine is. it is of a hot and thin substance, whereby it draweth forth into the superficies of the body that which lieth hid in the centre, although sometimes it doth it by an occult quality; other whiles also by accident, as by the acrimony. Those things which by a manifest quality do attract, are either simple or compound. The simple are Bryonia, allium, caepa, porrum, arastolochia, hermodactyli, ciclamen, Attractives by a manifest quality. lilium, sigillum beatae Mariae, arum, asarum, asphodelus, gentiana, pyrethrum, ruta, sabina, calamentum, omnes tithymalorum species, viscum, abrotanum, anagallis, urtica, ranunculus, struthium, and such like: ammoniacum, bdellium, gabbanum, sagapenum, euphorbium, asphaltum, cinis e faece vini vel aceti, calx viva, sulphur, sal ammoniacus, omnes salis species, auripigmentum, oleum vetus, adeps leonis, ursi, canis, anseris, viperae, ranarum, axungia porci vetustate acris, aut attritu rotarum. Composita vero, ut oleum de spica, philosophorum, de terebinthina, de croco, de scorpionibus, rutaceum, vulpinum, laurinum, anethinum, de vitriolo, unguentum Agrippae, aragon, seu auxiliare, martiatum, enulatum, theriaca, mithridatium, empl. de meliloto, diachylon magnum & parvum, oxycroceum, divinum. Those things which draw by a secret property in nature, as are the loadstone, By an 〈◊〉 quicksilver, pyony, amber, all antidotes and treacles that are remedies against the bitings of venomous beasts, and all purging medicines. These which draw by accident, perform it otherwise than of their own nature, By accident. they have that quality out of putrefaction and corruption, as doves dung, goat's dung, cow dung, man's dung, and all kind of dungs: also leven, old cheese, and such like. Cupping glasses, leeches, syrenges, rougher and harder frictions, sucking, pain, strait ligations, cauteries do also draw, but after a different manner from them spoken of before. Attractive medicaments must neither burn nor discuss, and being very strong and sharp●, they should be tempered and mixed with oil of roses, and other lenitives: but to weak ones should be added oil of bays, calx viva, and such like to strengthen them. The use of attractives is to draw poison toward the skin, & to hasten Their 〈◊〉. forward critical abscesses; and they make those parts which were benumbed and consumed, to have life, they restore the refrigerated parts by drawing thither the spirits; they draw forth the viscous filth of malign ulcers that lies hid in the nerves, and hollow passages of them; they also draw out scailes of bones, splinters of wood, nails, thorns, arrows, and that matter which is impact in hardened inflammations. CHAP. XI. Of resolving medicines. THat is called a resolving medicine, which by heat, and the tenuity of his substance openeth the pores, attenuates the humours, dissipates and discusseth What a resolving medicine is. The differences thereof. by evaporating the unprofitable matter. There are two sorts of these kinds of medicines; the one is called Araeoticum or ratifying; the other is termed Diaphoreticum or digesting. The Araeoticum by a mean heat, and not dry, and endued with a tenuity of substance, openeth and relaxeth the skin, and draweth forth the matter shut up under it, whereby it may ease pain, like as anodynes, because it doth not much depart from a temperate heat. But the Diaphoreticum being much hotter, whatsoever sticketh in the part being there impact, it doth by thin vapour insensibly dissipate: therefore the acrid and hot things are in this case to be made use of rather than attractives, because that cold and grossness is more difficultly to be digested, and the length and involution of the ways being to be considered. The Araeoticke, which we may call weak resolvers, are either simple or compound. The simples are these, bismalvatota, parietaria, adianthum, mercurialis, ebulus, valeriana, rosmarinus', salvia, thymus, chamaemelum, melilotum, anethum, farina hordei, tritici, seminis lini, faenugraeci, nigella, furfur, adeps gallinae, anseris, anatis, cuniculi, vituli; almost all metals unless such as are acrid. The compounds are oleum chamaemolinum, anethinum, liliaceum catellorum, lumbricorum, Keirinum, de vitellis ovorum, de tritico, amygdalarum dulcium, Unguentum de althaea, empl. diachylum, ireatum. Diaphoretickes or digestives, are also both simple and compound: the simple are Aristolochia, enula campana, iris, caepa, scylla, sigillum Salomonis, sigillum beatae Mariae, bryonia, panis porcinus, dracunculus, asphodelus, origanum, mentha, pulegium, sabina, serpillum, calamentha, hyssopus, urtica, arthemisia, lavendula, chamepytis, anisum, foeniculum, cuminum, piper, nux moschata, coriandrum, baccae lauri & juniperi, farina fabarum, lupinorum, orobi, milii, frumenti, furfur, mica panis, acetum tepidum, oxycratum, vinum vetus aut aromaticum, mell, aqua vitae, muria, adeps tauri, equi, leonis, canis, hirci, medulla cervi, cruris bovis & arietis, ammoniacum, galbanum, opopanax, sagapenum, myrrha, bdellium, thus, terebinthina, pix nigra, laudanum, styrax, calamita, benjoinum, stercus caprinum, columbinum, caninum, bubulum, & aliae stercorum species. Compound diaphoretickes are oleum amygdalarum amararum, Juniperinum, laurinum, de scorpionibus, irinum, costinum, nardinum, de terebinthina, de croco, canabinum, raphaninum, è cucumere agresti, vulpinum, rutaceum, philosophorum de lateribus, de euphorbio, de tartaro, de petroleo, de kerva, sive ricininum, unguent. Agrippae, aragon, martiatum, enulatum, empl. de Vigo, without addition, and with addition, oxycroceum, diacalcitheos, dissolved in a digesting oil to the form of a cerat. Araeotickes are profitably used in the increase and state of superficial tumors. But Diaphoretickes are not to be used in the increase of tumors, unless some astringent The use of diaphoreticks. be added, lest by their more strong digestion, they should draw and increase the defluxion: but when the tumors decline, they are then only to be used in the parts chiefly where the skin is dense and hard, and when the humour is cold and gross, and lying hid deep in the body, so that the virtue of medicaments can hardly come thereto: but consideration is to be had of the parts to which resolutives are to be applied; for you may not apply relaxers or diaphoretickes to the liver, spleen, stomach, or bowels, unless you add some astringents, of which a great part must be aromatickes. To the parts where sense is more dull, may be applied the stronger diaphoreticks, but those parts which are endued with a more exquisite sense, as the eye and the nerves, to them we must apply weaker. When the matter is gross and cold, things cutting and attenuating, and then emollients are to be used, and so by degrees come to diaphoretickes; otherwise that only is resolved which is the most subtle of the unprofitable matter, the grosser becoming concrete and hardened. But if the part be afflicted with a continual defluxion, so that there may be danger of a gangrene or sphacel, it is not lawful then to make use of resolvers, but you must in the place where the humour flows, divide the skin by scarification, as it is most learnedly noted by Hollerius in that profitable book of his left to posterity, whose title is, De materia Chirurgica. CHAP. XII. Of suppuratives. A Suppurative medicine is said to be that, which shutting the pores, and What a suppurative medicine is. preventing transpiration by his emplastic consistence, increaseth the matter of native heat, and therefore turneth the matter cast out of the vessels into pus and sanies. It is of nature hot and moist, and proportionable to the native heat of the part to which it is applied, and of an emplastic consistence, that so it may hinder the native heat from being exhaled; in which respect it differeth from emollients and malactickes, of which we shall speak hereafter. There be two kinds of suppuratives, for some do it of themselves, and by their Differences of suppuratives. proper quality; others by accident. Those things which by their own strength do bring to suppuration, are either simples or compounds. Simples are radix liliorum, caepa, allium, malvarum omnium folia & semina, buglossum, acanthus, senecio, violae, parietaria, crocus, cawls, ficus, passulae mundatae, with a decoction of these things, farina tritici, farina volatilis, farina hordei excorticati, loliis, seminis lini & foenugraeci, galbanum, ammoniacum, styrax pinguis, laudanum, viscum aucupatorum, thus, pix, cera, resina, colla, adeps suillus, vitulinus, vaccinus, caprinus, butyrum, vitellus ovi, oesipus humida, stercus suillum, columbinum, caprinum, pueri. Compounds are oleum liliorum, lumbricorum, de croco, unguent. basilicum, emplast. diachylon commune, magnum, de mucilaginibus. Those things do suppurate by accident which work it only by the means of Suppuratives by accident. an emplastic consistence: for so often times astringents, because they are of earthy and thick parts, are found to suppurate; such are unguentum de bolo nutritum, and such like. Such also are those which by their coldness keep the heat in, and shut the pores. Hence is it that the qualities of sorrel are commended to generate pus: for whilst it keepeth the heat within, it increaseth his effects, to the thickening of the suppurable matter, and the overcoming other rebellious qualities. We use things ripening in great inflammations, whose growth we cannot hinder with repellers, or increase with resolvers or discussers. CHAP. XIII. Of mollifying things. THat is defined to be a mollifying medicine, which by a stronger heat than Gal. cap. 7. lib. 5. simple. that which is proper to suppuratives, without any manifest quality of drying or moistening, again malaxeth or softeneth hardened bodies: wherefore How suppuratives and emollients differ. this differs from that which suppurates, because that may be hot in the first or second degree, according to the several temper of the body, or part to which it is applied, working rather by the quantity of heat than the quality: chose, that which mollifieth being endued with a greater heat, rather worketh by the quality of the heat, being otherwise in dryness and moisture temperate. Although as many things agree together in some respects, though of a divers nature; so many emollients are such as are hot in the first degree, and dry in the second and third, that so they may the better disperse and diffuse that which is congealed, by taking away a little of the humidity, which is contained within the part affected; but not by exhausting it wholly by the violence of heat or dryness: for hereon would follow a greater hardness. Things mollifying, are either simple or compound; and these again strong or The differences of emollients. weak. The weak are, Radix liliorum alborum, cacumeris agrestis, althaeae, folia malvae, bismalvae, liliorum, anethi summitates, viola, branca ursina, semen malvae, bismalvae, lini, foenugraeci, carici pingues, passulae mundatae, pedum, capitum, intestinorum vervecinorum decoctum, adeps exjunioribus & castratis, domesticis, foeminis animalibus, ad●ps suillus, vitulinus, hoedinus, caprinus, bubulus, vulpinus, gallinaceus, anserinus, anatinus, olorinus, efficaces. The weaker are things more gentle, as, Butyrum, lana succida, cera pinguis, vitellus ovi, medulla exossibus, cervina, ovilla, caprina. The compound are oil, wherein are boiled mollifying herbs, as, Oleum liliorum, chamaemelinum, amygdalarum dulcium. Stronger emollients are, Acetum, adeps taurinus, ursinus, cervinus, leoninus, pardalinus, apri, equisevum, pinea, picea, abietina, terebenthina, ammoniacum, bdelium, styrax, galbanum, laudanum, propolis, opopanax, ung. de althaea, emp. diachylon common & magnum, de mucilaginibus, ceroneum, oxycroceum, Joannis de vigo. We use emollients in scirrhous tumors of the muscles, or in the lips of ulcers, in Their use. any of the limbs, belly, glandules, bowels, by reason of a gross, cold, and viscous matter, either phlegmatic, or melancholic. Yet those tumors which come of melancholy, commonly turn to cancers, which are exasperated by mollifying things. On the contrary, such as proceed from a phlegmatic matter, are brought to an equality of consistence, by the use of emollients. Furthermore, there are three things observable Things observable in the use of emollients. in the use of emollients: the first is, duly to consider how much the affected part differs from his proper and natural temper and proportion, that so we may apply an equivalent remedy. The second is, that we distinguish the natures of the parts. The third is, that we artificially gather after what manner this mollifying must be performed, that is, whether we should mingle with the emollients, detersive or discussing medicines. For there are many desperate schirrhous tumors, that is, such as cannot be overcome by any emollient medicine, as those which are grown so hard, that they have lost their sense; and thereupon are become smooth and without hairs. Here you must observe, that the part sometimes becomes cold in so great an excess, that the native heat plainly appears to languish, so that it cannot actuate any medicine. That this languishing heat may be resuscitated, an iron stove shall be set near to the part, wherein a good thick piece of iron heated red hot shall be enclosed, for so the stove will keep hot a long time. The figure of an iron stove. A. The casse of the stove. B. The iron Bat to be heated. C. The lid to shut the stove. CHAP. XIV. Of Detersives, or Mundificatives. ADetersive is defined to be that which doth deterge or cleanse an ulcer, and purge forth a double kind of excrement; of the which one is thicker, which is commonly called sordes, which is drawn forth from the bottom of the ulcer, by the edificatious quality of the medicine, the other is more thin and watery, which the greeks call Ichor, the Latins Sanies, which is taken away by the dryness of the medicine; and therefore Hypocrates hath well advised, that every ulcer must be cleansed and dried. Of Detersives, some are simple, some compound, some stronger, some weaker. Detersives, The simple are either bitter, sweet, or sour: the bitter are Gentiana, Aristolochia, iris, enula, scylla, serpentaria, centaurinum minus, absinthium, marrubium, perforata, abrotonon, apium, chelidonium, ruta, hyssopus, scabiosa, arthemisia, cupatorium, aloë, fumus terrae, haedera terrestris, a lixivium made with the ashes of these things, lupini, orobus, amygdala amara, faba, terebinthina, myrrha, mastiche, sagapenum, galbanum, ammoniacum, the galls of Beasts, stercus caprinum, urina benè cocta, squamma aeris, aes ustum, aerugo, scoria aeris, antimonium, calx, chalcitis, misy, sorry, alumen. The sweet are Viola, rosa, mellilo●um, ficus pingues, dactyli, uvae passae, glycyrrhiza, aqua hordei, aqua mulsa; vinum dulce, mell, saccharum, serum lactis, manna, thus. The sharp are all kind of sour things, Capreoli vitium, acetum, and other acide things. The compound are Syrupus de absinthio, de fumaria, de marrubio, de eupatorio, de arthemisia, acetosus, lixivium, oleum de vitellis ovorum, de terebinthina, de tartaro, unguentum mundificativum de apio, apostolorum, pulvis mercurialis. We use such things as deterge, that the superfluous Their use. matter being taken away, nature may the more conveniently regenerate flesh to fill up the cavity: But in the use of them, consideration is first to be had of the whole body, whether it be healthy, plethoric, or ill disposed, there is consideration to be had of the part, which is moister and drier, endued with a more exquisite or duller sense. But oftentimes accidents befall ulcers besides nature, as a callus, a defluxion of a hot or otherwise malign humour, and the like symptoms. Lastly, consideration is to be had, whether it be a new or inveterate ulcer; for from hence, according to the indication, remedies are appointed different in quantity and quality: so that oftentimes we are constrained to appoint the bitter remedy in stead of the sweet. Neither truly with a painful and dry ulcer doth any other than a liquid detersive agree: neither to the moist any other than that of a dry consistence, as Powders. CHAP. XV. Of sarcotics. THat medicine is said to be sarcotick, which by its dryness helps nature to regenerate flesh in an ulcer hollow, & diligently cleansed from all excrements. But this is properly done by blood indifferent in quality and quantity. Wherefore, if we must speak according No medicine truly sarcotick. to the truth of the thing, there is no medicine which can properly and truly be called sarcoticke: For those which vulgarly go under that name, are only accidentally such; as those which without biting and erosion do dry up and deterge the excrements of an ulcer, which hinder the endeavour of nature in generating of flesh. For as by the law of nature, from that nourishment which flows to the nourishing of the part, there is a remain, or a certain thin excrement, flowing from some other place, called by the greeks Ichor, and by the Latins Sanies: Thus by the corruption of the part there concretes another grosser excrement, termed Rypos by the greeks, and Sordes by the Latins. That makes the ulcer more moist, this more filthy. Hence it is, that every wound which requires restitution of the lost substance, must be cured with two sorts of medicines, the one to dry up and waste the superfluous humidity thereof, the other to fetch off the filth: and by how much the wound is the deeper, by so much it requires more liquid medicines, that so they may the more easily enter into every part thereof. But diversity of things shall be appointed according to the various temper of the part. For if the affected part shall be moist by nature, such things shall be chosen as shall be less dry: if on the contrary the part be dry, than such things shall be used as be more dry; but many sorts of medicines shall be associated with the sarcotics, according to the manifold complication of the affects possessing the ulcer. Therefore nature only is to be accounted the workmaster, and the efficient cause in the regenerating of flesh, and laudable blood the material cause, and the medicine the helping or assisting cause, or rather the cause without which it cannot be: as, that by cleansing and moderately drying without any vehement heat, takes away all hindrances of incarnation and orders, and fits the blood to receive the form of flesh. This kind of medicine, according to Galen, aught to be dry only in the first degree, lest by too much dryness, it might drink up the blood and matter of the future flesh, which notwithstanding is to be understood of sarcotics, which are to be applied to a delicate and temperate body. For if the ulcer be more moist, or the body more hard than is fit, we may ascend to such things as are dry, even in the third degree. And hence it is, that such drying medicines may first be called detersives, and then presently sarcoticks. A sarcoticke medicine is either simple or compound, stronger or weaker. Simple sarcoticke medicines are, Aristolochia utraque, iris, acorus, dracunculus, asarum, symphyti omnia genera, betonica, sanicula, millefolium, lingua canis, Simple Sarcotickes. verbena, scabiosa, pinpinella, hypericon, scordium, plantago, rubia major & minor, eorumque succi. Terebinthina lota & non lota, resinapini, gummi arabicum, sarcocolla, mastiche, colophonia, manna thuris, cortex ejusdem, aloë, olibanum, myrrha, mell, vinum, sanguis draconis, lythargyros auri, spodium, pompholix, iutia, plumbum ustum lotum, scoria ferri. The compound sarcotics are, Oleum hypericonis, ol●ovorum, mastichinum, Compound Sarcotickes. & catera olea, quaebalsami nomine appellantur, unguentum aureum, emp. de betonica, vigonis, de janua, Emp. gratia Dei, Emp. nigrum. We use not sarcoticks before that the ulcer be cleansed and freed from pain, defluxion, inflammation, hardness, and distemper. In using these things we consider the temper of the body, and the affected part: For ofttimes a part otherwise less dry by nature, requires a more powerful drying medicine, and stronger sarcotick, than another part which is more dry, and this for some other reason, which ought to come into our consideration: For example, the glans would be more dried than the prepuce, although it be of a temper less dry, because it is the passage of the urine. Wherefore we must diligently observe the condition of the affected parts, and thence taking indication, make choice of more strong sarcotics. For both that which is too little, and that which is too much sarcoticke, makes a sordid ulcer: the first, because it dries not sufficiently; the latter, for that by its acrimony it causeth defluxion. Therefore diligent care must be used in the examination hereof. CHAP. XVI. Of Epuloticks, or skinning medicines. AN Epuloticke medicine is that which covereth the part with skin: it is said to be such as by dryness and astriction without biting desiccates, binds, and condensates the flesh into a certain callous substance, like to the skin, which we commonly call a cicatrise or scare: yet this, as the generating of flesh, is the work of nature. A medicine therefore is said to be Epuloticke, for that it assists nature in substituting and generating a scar, in stead of the true skin, whilst it consumes the superfluous humidities, condensates, incrassates, and binds the next adjacent flesh; therefore it ought to dry more powerfully than a sarcoticke. Epuloticke medicines are of three kinds: the first is the true epulotick, Three sorts of Epuloticks. which only dries and binds. The second is an acride and biting epuloticke, which, for that it wastes the proud flesh, is called so; and this must be sparingly used, and that only to hard and rustic bodies. The third is that which only dries without astriction. The things whereof they consist are these: Aristolochia utraque, gentiana, iris, centaurium majus, pentaphyllon, symphitum majus, chamaedries, betonica, cauda equina, eupatorium, verbenaca, plantaginis & symphyti folia, gallae, baccae myrti, glans & earum calices, balaustia, cupressi nuces, malicorium, cortex quercus, cortex tamaricis, cortex ligni aloës, acacia, colophonia, sarcocolla, sanguis draconis, laudanum, lithargyros auri, argenti, cerusa, plumbum ustum, alumen ustum, tuthia, squamma aeris & ferri, & eorum scoria, aerugo, flos aeris, as ustum & lotum, sulphur vivum, chrysocolla, corali, bolus armenus, terra sigillata, cineres buccinarum, ostreorum, silicis, ossa usta & siccata, caries lignorum, ung. diapompholygos, ung. alb. rhasis, desiccativum rubrum, emp. de cerusa, de betonica, diacalcitheos, emp. nigrum. We use Epuloticks when as the ulcer is almost filled up, and equal to the adjacent Their use. skin. In the use of these we must also have respect to the tenderness and hardness of the body; for such things as are corrosives to tender and delicate bodies, are epuloticke to hard and rustic bodies. Also we must have regard, whether the body be plethoric or replete with ill humours, for such do not easily admit cicatrisation. Also it is most worthy of your observation, to mark whether the ulcer that is to be cicatrized, be fed or nourished by the present defect of any part, as the liver, spleen, lungs, or a varix lying about it. For it cannot be cicatrized before these impediments (if any such be) be taken away. Lastly, the callous lips of an ulcer, unless they be scarified or softened, hinder cicatrisation. Therefore all such defaults must be taken away, and then such an epulotickeapplyed, as may not by the too much dryness leave the scar too hollow, or the too little, leave it too high. CHAP. XVII. Of Agglutinatives. AGlutinating or agglutinative medicine is of a middle nature, between the sarcoticke and epuloticke, more strong than the former, and weaker than the latter, for it is dry to the second degree. It by the drying and astrictive faculty, void of all detersion, conjoins parts that are distant, or rather lends helping hands to nature the principal agent in this work. Glutinatives, whether they be strongly or weakly such, do agglutinate either by their proper or accidental nature: Of this sort are Plantagin is omnes species, consolida utraque, Agglutinative medicines. buglossa, millefolium, verbena, pimpinella, pilosella, cauda equina, sempervivum, telephium, sanicula, atractilis, folia quercus & dracunculi, salix, ebulus, sambucus, pentaphyllon, veronica, cortex pini, ulmi, palmae quercus, Aqua vitis, aq. è folliculis ulmi, succus calaminthae, vinumausterum, terebinthina, myrrha, sanguis draconis, bolus armenus, terra sigillata, omnia denique acerba. Glutinatives by accident are those that hinder defluxion, and bind the part, as Glutinatives by accident. Sutures, Bandages, rest, rulers, and the like. We use glutinatives in green, and as yet bloody wounds, whence the greeks call a glutinative medicine Enaema, although sometimes they are used to inveterate, malign, fistulous and sinuous ulcers; for they hinder the defluxion from coming to the lips of ulcers. You must confider, when as you intent to apply them, whether the skin be whole or no: For ulcers knit together, or heal more difficultly, if the skin be rubbed off, or cut, or otherwise lost. Neither ought you to be unmindful of the forementioned cautions and indications drawn from the sex, the tenderness or hardness of the affected body, the continuance and magnitude of the ulcer: for hence indication must be taken, what the quantity and quality of the medicine ought to be. CHAP. XVIII. Of Pyrotickes, or caustic Medicines. THat medicine is said to be Pyroticke or caustic, which by its acrimony and biting, commonly consisting in an earthy consistence, either superficially corrodes, or more deeply eats and putrefies, or lastly, burns and consumes the skin and flesh, so that it even pierces into callous and hard bodies. Therefore there are three degrees of Pyrotickes; for some are termed cathaereticke Three degrees of Caustics. or corroding, for that they waste the proud flesh of an ulcerated or any other part, and these are judged the weaker sort of the Pyrotickes. Othersome are termed Septicke or putrefying, as those which destroy and dissolve the tender and new sprung up flesh, and raise blisters in the skin, and these are more powerful than the cathaeretickes. Lastly, there are othersome termed most powerful Escharotickes, which by their fiery and terrestrial quality cause eschars or crusts; whereupon they are also termed Ruptoria, & potential Cauteries: Now all these differences are taken from that they are more or less powerful. For it ofttimes happens, that according to the different temper and consistence of the parts, according to the longer or shorter stay, a Cathaereticke may penetrate as far as a Septicke, and on the contrary, an Escharoticke may enter no farther than a Septicke. These are judged Cathaeretickes, Spongia usta, alumen ustum & non ustum, vitriolum Cathaereticks. ustum, calx mediocriter lota, arugo, chalcanthum, squamma aeris, oleum de vitriolo, trochisci andronis, phasionis, asphodelorum, ung. Aegyptiacum, apostolorum, pulvis mercurii, arsenicum sublimatum. Septickes and Vesicatories are, Radix scillae, bryoniae, sigil. beatae Mariae, buglossa, septics and Vesicatories. radix ranunculi, panis porcini, apium, risus, lac tithymallorum, lac fici, euphorbium, anacardus, sinapi, cantharides, arsenicum sublimatum: For all these weaken the native temper and consistence of the part, and draw thereunto humours plainly contrary to nature. Escharotickes or caustics are, Calx viva, fax vini cremata, & pracipuè aceti, Escharoticks. ignis, whereto are referred all Cauteries, as well actual as potential, whereof we shall treat hereafter. We use Cathaeretickes in tender bodies and diseases not very contumacious; Their use. therefore by how much they are less acride & painful, by so much ofttimes they penetrate the deeper, for that they are less trouble some by delay; but we use Septickes, and sometimes Escharotickes in ulcers that are callons, putrid, and of inexhausted humidity, but principally in cancers, carbuncles, and excessive hemorrhages. When as we make use of these, the patient must have a convenient diet appointed, must abstain from wine: lastly, they must not be used but with great discretion; for otherwise they may cause fevers, great inflammations, intolerable pains, swoon, gangrenes, and sphacels. Cauteries heedfully used, strengthen and dry the part, amend an untameable distemper, dull the force of poison, bridle putrefaction and mortification, and bring sundry other benefits. CHAP. XIX. Of Anodynes, or such as mitigate or assuage pain. BEfore we treat of Anodyne medicines, we think it fit to speak of the nature of pain. Now pain is a sorrowful and trouble some sense, caused What pain is. by some sudden distemper, or solution of continuity. There are three things necessary to cause pain; The efficient cause, that is, a sudden departure from a natural temper or union: the sensibleness of the body receiving the dolorificke cause: lastly, the apprehension of this induced change, caused either by distemper or union; for otherwise with how exquisite soever sense the body receiving the cause is endued with, unless it apprehend and mark it, there is no pain present. Hence is that Aphorism of Hypocrates, Quicunque parte aliqua corporis dolentes dolorem omninò non sentiunt, his mens agrotat, that is, Whosoever pained in any part of their bodies do wholly feel no pain, their understanding is ill affected and depraved. Heat, cold, moisture, and dryness, induce a sudden change of temper; and heat and cold cause sharp pain, dryness moderate, but moisture scarce any at all: for moisture causeth not pain so much by its quality, as it doth by the quantity. Both the forementioned qualities, especially associated with matter, as also certain external causes too violently assailing, such as these that may cause contusion, cut, prick, or too much extend. Wherefore pain is a symptom of the touch, accompanying almost all diseases; therefore ofttimes leaving these, they turn the council of the Physician to mitigate them, which is performed either by mitigating the efficient causes of pain, or dulling the sense of the part. Hereupon they make three differences of Anodynes: For some serve to cure the disease, othersome to mitigate it, othersome stupefie, and are narcotick. We term such curative of the diseases, which resist, and are contrary to the causes of diseases. Thus pain, caused by a hot distemper, is taken away by oil of Roses, Oxycrate, and other such like things, which amend and take away the cause of pain, to wit, the excess of heat. Pain caused by a cold distemper, is amended by Olcum Laurinum, Nardinum, de Castoreo. Pain occasioned by too much dryness, is helped by Hydraeleum, a bath of fresh and warm water. Lastly, by this word Anodyne, taken in the largest sense, we understand all purging medicines, Phlebotomy, Scarification, Cauteries, Cuppings, Glisters, and other such like things as evacuate any store of the dolorificke matter. But such as are properly termed Anodynes, are of two sorts: for some are What properly termed Anodynes are. temperate, others hot and moist in the first degree, and consequently, near to those that are temperate: these preserve the native heat in the proper integrity, thus they amend all distemperatures; of this kind are accounted Salad oil, oil of sweet almonds, the yolks of eggs, and a few other such like things, these strengthen the native heat, that thus increased in substance, it may with the more facility o'ercome the cause of pain: besides also, they rarify, attenuate, digest, and consequently evacuate both gross and viscide humours, as also cloudy flatulencies hindered from passing forth: such are flores chamaemeli, meliloti, crocus, oleum chamaemelinum, anethinum, oleum lini, oleum ex semine althaeae, lumbricorum, ovorum, ex tritico, butyrum, lana succida, suillus adeps, vitulinus, gallinaceus, anserinus, humanus, ex anguilla, cunicula, & aliis. Lac muliebre, & vaccinum, mucago seminis lini, foenugraeci, althaa, malvae, velejusmodi seminum decoctum: as also Decoctum liliorum, violariae, capitis, pedum, & intestinorum arietis & hoedi. Narcotickes, or stupefying medicines, improperly termed anodynes, are cold in the fourth degree, therefore by their excess of cold, they intercept or hinder the Narcoticks improperly termed anodynes. passage of the animal spirit to the part, whence it is that they take away sense: of this sort are hyoseyamus, cicuta, solanum manicum, mandragora, papaver, opium, arctissima vincula. You may make use of the first sort of Anodynes in all diseases, which are cured by the opposition of their contraries: but of the second, to expugn pains that The use of them. are not very contumacious, that by their application we may resist defluxion, inflammation, the fever, and other symptoms. But whereas the bitterness of pain is so excessive great that it will not stoop to other medicines, then at the length must we come to the third sort of anodynes. Yet oft times the bitterness of pain is so great that very narcoticks must be applied in the first place, if we would have the part and the whole man to be in safety. Yet the too frequent use of them, especially alone without the addition of saffron, myrrh, castoreum, or some such like thing, useth to be very dangerous: for they extinguish the native heat, and cause mortification, manifested by the blackness of the part. But intolerable pains, to wit, such as are occasioned by the excess of inflammation and gangrenes, may be sooner mitigated by opening a vein, purging and scarifying the part affected, than either by properly termed anodynes or narcotickes, to wit, that pain may be the remedy of pain. By purgers we here understand not only such, as taken by the mouth, produce that effect, but also such as outwardly applied perform the same, as those whereof Actius T●trab. 1. sem. 3. cap. 35. makes mention. As, ℞. pulpa seu medul. colocynth. semin. eruc. rut. sylvest. elaterii, gr. cindii, lathyrid. expurgatar. galban, nitri, cerae, singulorum, ℥ iiii. opopan. ʒ two. terebinth. ʒvi. terendaterito, Purgatives to be externally applied. & taurino fell paulatim irrigato, donec apte imbibantur. Then apply it about the navel even to the share, for thus it will purge by stool; if on the contrary you apply it to the bottom of the stomach, it will cause vomit. Another; ℞. elaterii, ʒiii. colocynth. scammon. squammae aeris, radic. cucumber. agrest. lathyrid. an. ʒi. aut pro lathyrid. tithymal. succum terito & cribrato, ac cum oleo plurimum salis habente subigito; magnam inde pilame lana confertam hoc medicamento illitam, umbilico aut lumbis applicato. Or, ℞. fellis taurin. ʒ i. gr. cindii virid. ℥ iv. succi lupinor. virid. ℥ two. euphorb. The composition of a purging oil and ointment. ℥ i. pulp. colocynth. tantundem adip. vulpin. recent. ℥ two. adip. viper. ℥ two ss. stercor. muris, ℥ iv. succi poeon. castor. singulor. ʒ iv. ol. ligustrin. ℥ vi. ol. antiq. ℥ i. fiat unguentum vel oleum. It purgeth without trouble, and besides the other commodities it also is good against distraction or madness. Two spoonfuls is the greatest quantity to be used at one time, for in some one is sufficient: anoint with it the navel and thereabouts, and a just purgation will ensue thereupon, which if it shall fly out beyond your expectation, you may foment the belly with a sponge moistened in warm wine and pressed forth again, and it will be presently stayed. Moreover Fernelius lib. 7. methodi, makes mention of a laxative ointment. CHAP. XX. Of the composition and use of Medicines. HItherto we have spoken of the faculties of simple medicines, now we think good to say something of the compounding of them: for so by the Architect are had & known every thing apart, and then he settles the workmen to the building, the conceived form of which hath been in his mind ever since he did enterprise it. Therefore the composition of divers medicaments with their qualities and effects, is a mingling appointed by the art of the Physician. Hence therefore rheum, aloe, rosa, absintbium, although they have divers Gal. 3. simp. 4. de san●t. t●end. substances and faculties, yet are notwithstanding called simple medicines, because they have that variety from nature, not from art. But we many times call simple such things as are compounded by art, as oxym. simple. oxysacch. simplex, as compared to greater compositions. And therefore often times we use compound medicines, because always the simple medicine alone, hath not strength enough to oppugn the The necessity of compound medicines. disease. For many times the sick labour with manifold, and not simple affects, from which there being taken a various indication, we gather contrary simple medicines, to apply to every affect, in one composition. But often times the nature of the part of the patient, or of the body affected, requireth another kind of medicament which may be proper for the removing that disease; wherefore it is so made to oppugn the disease and not offend the body: and we mingle many other together, whose effects may temper one another. Moreover, the composition of medicines was necessary, that because those things which have not a good taste, colour, or smell, by art or composition might be made more grateful. Compound medicines of which we intent to speak, are Glisters, Suppositories, Noduli, Pessaries, Oils, Liniments, Ointments, Emplasters, Cerats, Pultisses, Cataplasms, Fomentations, Embrocations, Epithemaes, Vesicatories, Cauteries, Collyria, Errhina, Sneesing powders, Masticatories, Gargarisms, Dentifrices, Bags, Fumigations, Semicupiums, Baths. But first it is expedient that I say something of weights and measures, with their notes, by which medicines commonly are measured and noted by Physicians. CHAP. XXI. Of weights and measures, and the notes of both of them. EVery weight ariseth from a beginning and foundation, as it were; for as A grain the beginning of all weight. our bodies do arise of the four first simple bodies or elements, into which they are often resolved: so all weights do arise from the grain, which is as it were the beginning and end of the rest. Now hereby is What is meant by agraine. understood a barley corn or grain, and that such as is neither too dry, or overgrown with ●…uldi●…ss●…r rancide, but well conditioned, and of an indifferent bigness. Ten grains of these m●… ●…bolus; two Oboli, or twenty grains make a scruple, Obolus. A scruple. A dram. An ounce. A pound. three scruples, or sixt●… grains make a dram, eight dams make one ounce, twelve oune●…ake one pound medicinal, which is for the most part the greatest weight used●… Physicians, and which they seldom exceed; and it is resolved into ounces, dr●…mes, scruples, oboli and grains, which is the least weight. To express these weights we use certain notes, the pound is expressed by this note, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. the ounc●… this, ℥. the drammethus', ʒ. the scruple thus, ℈. the obolus with the beginning●…●…ter thus, obol. the grain with his beginning letter thus, g. But sometimes we me●…e the quantity of medicines by measures and not always by weights; and th●…fore we express a handful by this note, m. a pugil thus, p. number thus, n. and the half part of every weight and measure is expressed by this note, ss. put after every note of the aforesaid weights and measures of the same sort, as the half pound, lb ss. the half ounce, ℥ ss. and so of the rest. Moreover, in describing the same medicament we use the notes sometimes of weights, sometimes of measures; and therefore it is to be noted that herbs, green or dry, are signed with these notes, m. p. but those which are dry and be brought to powder, with these notes, ℥. ʒ. p. Roots, Barks, Seeds, Fruits, by these notes, ℥. ʒ. p. m. ℥. ʒ. ℥. ʒ. an. p. ℥. ʒ. ℈. p. m. ℥. ʒ. p. ℥. ʒ. All other medicaments either dry or liquid, are described with these notes, lb. ℥. ʒ. ℈. obol. g. Having expounded these things, let us come to the description of compound medicines, beginning with glisters first, as the remedy which is most common and familiar, and almost chiefly necessary of all others. CHAP. XXII. Of Glisters. A clyster is an injection prepared first and properly for the gross intestines and fundament; for sometimes glisters are used & made for the stomach, What a clyster is. spleen, reins, bladder, womb, mesentery, and also for the head, from whence often times by sharp glisters, the hurtful matter is brought downwards, as we see in Apoplexies. Therefore there is no part of the body which receives not some benefit by glisters, but more or less according to the vicinity they have with the belly, and the strength of the clyster: for there are divers sorts Differences of glisters. of glisters, some emollients, other evacuating, some anodynes, some astringents, some cleansing, some sarcoticke, and epuloticke, and some may be said to nourish. They are all made of the parts of plants or beasts, with compound medicines either solutive or altering, and others according to the advice of the Physician. The parts The materials of glisters. of plants which are used to this purpose, are roots, seeds, leaves, flowers, fruits, shouts, juices, mucilages. Parts of beasts are yolks of eggs and whites, honey, chickens, capons, old cocks well beaten, heads and feet of sheep, the intestines, whey, milk, sewer, axungia, and such like in decoctions, wherein we mingle and dissolve simple and compound medicines. We sometimes use without any other medicament, to make a clyster with oil alone, as oil of nuts for the Colic, of whey alone, the decoction of the head and feet of the sheep alone, and of the decoction of Cicers and barley do we prepare glisters. The quantity of a clyster is sometimes less according to the divers disposition of men and their diseases: for weak children the 〈◊〉 is less: for women with Their quantity. child, and in the colic, dysentery, lyentery, o●●…uch hardened excrement is within. But when we would abundantly move ●…ement, and there is nothing that may hinder, the dose of a clyster for the mo●…art is half a pound, one pound, or three quarters of a pound. The clyster must be injected ●…rme or hot, more or less, according to the nature or condition of the sick; for b●… cold it offends the intestines, and the neighbouring nervous parts, which are co●… of themselves. It must be given by degrees, for being injected suddenly, the w●… which is usually in the guts will beat it back again, whence comes intolerable p●… But this will be more clear by that we shall teach concerning the differences o● glisters, whereof there shall be sufficient examples. ℞. malu. violar. bismalv. acanth. an. mi● radic. alth. lilior. an. ℥ i. passul. fi●… ping. ℥ ss. fiat decoctio ad lb i in qua dissolve cass. butyr. recent. an. ℥ i. ol. viol. ℥ iii fiat An emollient clyster. clyster. Glisters, that do evacuate, are prepared by the council of the Physician, and of divers Simples, being boiled for several purposes. Therefore if the humours be cold which are to be evacuated, the clyster shall be after this manner: ℞. Salviae, A clyster to evacuate a cold phlegmatic humour. origani, abrotoni, chamaem. melilot. an. m. ss. seminum anisi, foenic. cumini, an. ʒiii. semin. carthar. ʒii. Make a decoction of them, wherein dissolve Diaphon. Hier. Simpl. an. ℥ ss. ol. aneth. chamaem. an. ℥ i. ss. Mellis Antho. sach. rub. an. ℥. i. fiat Clyster. To evacuate Choleric matter, prepare a clyster after this manner. ℞. quat. remollient. pariet. Cichor. endi. an. m. ss. Semin. quat. frigid. Major. an. ʒiii. hordei integri p. i. Make a decoction of them, and dissolve in it Cass. ℥. i Ol. viol. mellis viol. an. ℥ two. fiat Clyster. To evacuate melancholy, this clyster following will be useful. ℞. Fumitory. Centaur. minoris, Mercurialis, an. m. i Polyp. Qu. folicul. sennae, an. ʒiii. seminis agni casti, Thymi, an. ʒii. Make a decoction, and dissolve therein, Confect. Hamech. ℥ ss. Cass. recens extract. ʒiii. olei violati, lilior. an. ℥ ss. Sach. rub. mellis viol. an. ℥ iss. salis, ʒi. And those Glisters do not only evacuate the humours that offend, but also correct the distemper of the bowels and inward parts. For the Glisters described against pituitous and melancholy matter, help the cold distemper; but that which is for choler, the hot distemper. Purging medicines, which are dissolved in the decoctions of Glisters, are very strong, as, Confect. Hamech. Benedicta, Diaprun. Solutivum, Diaphaenicon, being used from ʒ. vi. to ℥ i. at most: but the weaker and more gentle are Catholicon. Cassia, Hiera simplex, from ʒvi. to ℥ two. at most. An Anodyne clyster is usually made without such things as purge or evacuate: as, ℞. Flor. Chamaem. melil. Aneth. an. p. i. rad. Bismal. ℥. i boil them in Milk, and to An Anodyne clyster. the decoction add Mucaginis seminis lini foenugraeci extractae in aqua Malvae ℥ two. sachari albi, olei anethi, chamaemeli, an. ℥ i. vitellos ovorum duos, fiat Clyster. These Glisters should be kept longer in the body, that so they may more easily mitigate pain. The example of an astringent clyster. ℞. Equiseti, plantag. poligani. an. m. i. boil them in lacte ustulato, to ℥ xii. to the An astringent Glisters. decoction strained add Boli armeni, sanguinis draconis, an. ʒii. olei rosatis, ℥ two. album. ovorum duorum, fiat Clyster. We use these kind of Glisters in Dysenteries, and in the immoderate flux of the Hemotoid veins, having first evacuated the usual excrements. Glisters, which be ●…oticke, epuloticke, and cleansers of the greater guts, and fit for the curing of ulcers, are to be prepared of such medicines as are described before in their proper Chapters. Alimentary Glisters are made of the decoction of Chickens, Capons, Cocks, Nourishing Glisters. being boiled to a jelly, and strongly pressed forth. They are also prepared of Marrow, jelly, which are not altogether so strong as those which are commonly taken by the mouth, because the faculty of concoction in the guts, is much weaker than that of the stomach. Oftentimes also the matter of these kind of Glisters are prepared in wine, where there is no pain of the head or fever, but more frequently in the decoction of Barley, and in Milk, adding the yolks of Eggs, and some small quantity of white Sugar, lest by the cleansing faculty it move the guts to excretion. And therefore Sugar of Roses is thought better, which is conceived to be somewhat binding. Here you may have examples of such Glisters. ℞. Decoctionis Capi perfectè cocti lb. i ss. sachari albi, ℥ ss. misce, fiat Clyster. ℞. Decocti Pulli & Galatinae, an. lb. ss. vini oped. ℥ iv. fiat Clyster. ℞. Decocti hordei mundati, & in cremorem redacti lb. ss. luctis boni lb. i Vitellos ovorum duos, fiat Clyster. We use these kind of Glisters to strengthen Their use. children, old and weak men, and bodies which are in a Consumption. But in the use of these there are three things to be observed: First, that the feculent excrements be taken away, either by strength of nature, or by art, as by a suppository, or an emollient clyster, lest the alimentary matter, being mingled with them, should so be infected and corrupted. The other is, that there be great quantity given, that so some may ascend to the upper guts. The third is, that the sick sleep after the taking of it; for so it is more easily converted into nourishment, and the alimentary matter is better kept: for sleep hindereth evacuations. In Glisters of this kind we must be ware of Salt, Honey, and Oil; for the two first provoke excretion by their acrimony, and the last by his humidity doth relaxate and lubricate. They, who think no kind of clyster can nourish or sustain the body, rely upon this reason: That it is necessary whatsoever nourisheth, should have a triple commutation or Their Argument that deny Glisters to nourish. Confuted first by reason. concoction in the body: first, in the stomach; secondly, in the liver: thirdly, in all the members. But this opinion is repugnant to reason and experience: to reason, for that a certain sense of such things as are defective, is implanted in all and every of the natural parts of our body. Therefore seeing nutrition is a repletion of that which is empty, without doubt the empty and hungry parts will draw from any place that nourishment which is fit and convenient for them, and in defect thereof, whatsoever they meet with, which by any familiarity may assuage and satisfy their desire. But the alimentary Glisters, by us described, consist of things which agree very well with the nature of our bodies, and such as are boiled and ordered with much art, so to supply the chylification to be performed in the stomach. Therefore they may be drawn in by the meseraicke veins of the guts, which, according to Galen, have a certain attractive faculty. And thence they may be easily carried through the gate vein, liver, and so over the whole body. And experience teacheth, Secondly, by experience. that many sick people, when they could take nothing by the mouth, have been sustained many days by the help of these kind of Glisters. What is more to be said? We have seen those who have taken a Suppository by the fundament, and vomited it at the mouth; by which it also appeareth, that something may flow without danger of the sick from the guts into the stomach. Commonly they give Glisters any hour of the day, without any respect of time, but it should not be done unless a great while after meals, otherwise the meat, being hindered from digestion, will be drawn out of the stomach by the clyster. Glisters are used to help the weaker expulsive faculty of the guts, and by consequence also of the other parts, both that such as through want of age, and old people, The common use of Glisters. and such as by reason of great imbecility by sickness cannot admit of a purging medicine, may by this means at least ease themselves of the trouble and burden of hurtful humours. Galen hath attributed to Storks the invention of Glisters, which with their bills, having drunk Sea water, which from saltness hath a purging quality, wash themselves by that part, whereby they use to bring away the excrements of their meats, and of the body. But a clyster is fitly taken after this manner: whilst the Syrenge is expressed, let the patient hold open his mouth; for by this means all the muscles of the Abdomen, which help by compression the excretion of the guts, are relaxed. Let him wear nothing that may gird in his belly, let him lie upon his right side, bending in a semicircular figure; and so the clyster will the more easily pass to the upper guts, and (as it were) by an overflowing, wet and wash all the guts and excrements. It happeneth otherwise to those who lie upon their left side; for the clyster being so injected, is conceived to abide, and (as it were) to stop in the Intestinum rectum, or Colon, because in this site these two Intestines are oppressed, and as it were shut up with the weight of the upper guts. A little while he may The sick, having received the clyster, must turn to the side grieved. lie upon his back after he have received the clyster, and presently after he may turn himself on either side. And if there be pain in any part, so long as he is able he may incline to that side. Moreover, because there are many, who cannot by any reason be persuaded to show their buttocks to him that should administer the clyster, a foolish shamefastness hindering them: therefore I thought good in this place to give the figure of an Instrument, with which one may give a clyster to himself, by putting up the pipe into the fundament, lifting the buttocks a little up. The pipe is marked with this Letter A. The body of the Syrenge, whereinto the clyster must be put, with this Letter B. The figure of a clyster pipe and Syrenge, by benefit whereof a man may give himself a clyster. CHAP. XXIII. Of Suppositories, Nodules, and Pessaries. A Suppository is a certain medicament, form like unto a tent, or gobbet of paste, such as is commonly used to fat Fowl. It is put up into the fundament, that it might excite the sphincter muscle to send forth those excrements which are kept in the guts. Anciently it had the form of an acorn, whence it is called to this day Glans. The Suppositories we now usually make have the form of a Pessary, that is, round and longish, in the form of a wax Candle. They are either weak, stronger, or sharp; the weak are The differences. made of the stalks or the roots of Beets, of Lard, boiled Honey with Salt, or of Castle-sope. The stronger of purging powders, as, Hiera with Salt and Honey. The sharp with Scammony, Euphorbium, Coloquintida, and like things powdered, and with Honey, or the juices of sharp herbs, or mingled with the galls of Beasts. It is commonly made thus: as, ℞. Mellis ℥ i. irritantisʒi. The form. ℞. Mellis cocti ℥ i. pull. Colocynthidos ℈ ss. Salis gemmae. ℈ i. fiat Suppositorium. We use The use. Suppositories, when the sick by his infirmity is unwilling, or not able to bear or away with a clyster, as in burning Fevers: or, when as one being injected, is slow, and resteth in the guts. And we use the sharper Suppositories in seporiferous affects of the head, that they might provoke the dull faculty of the guts to expulsion. As also, when the condition of the disease is such, that by the use of Glisters there is manifest hurt; as, in an Enterocele, where the gut so swells, that over and above it be filled by the clyster infused, it would the more press the Peritonaeum, so that straightways by the relaxed or broken part it might easily be devolved into the Cod. Nodules have the same use with Suppositories, and are oftentimes substituted in stead of Glisters. They are made of gentle medicines, as the yolks of Eggs with a little Salt and Butter, or of Gall and Honey tied up in a cloth in the form of a Filbert, the string of it may hang forth, whereby the Nodule in the fundament may be drawn forth. This description may be an example of Nodules: ℞. Vitellum unius The form of a Nodule. ovi, cui adde salis modicum, fellis vervecis, mellis an. ℥ ss. butyri ℥ iii misce, fiant Noduli filo appensi. A Pessary is grosser than a Suppository, and is appointed for the womb, being Pessaries. made with cotton-wool or Silk steeped in some medicament, and then put into the neck of the womb. A pessary is used either to ulcers of the neck of the womb, or for the procuring, or stopping of the Menstrua, or against sordid and hurtful humours of the womb Their use. causing hysterical passions, and therefore to be wasted away and evacuated. Therefore in the composition of pessaries are used gums, juices, seeds of herbs, roots, and many other things, according to the advice of the Physician; they are also made of a solid consistence, the bigness of a finger, that they may enter into the neck of the womb; these being tied with a string, which must hang forth to pluck it out withal when occasion serves. This following may be an example of their description. rum. myrrh. aloes, an. ʒ i. sabin. semin. nigel. arthemis. an. ʒ two. radic. ellebor. nig. ʒ i croci, ℈ i. come succo mercurial. & melle fiat pessus; let it be tied to the thigh with a thread. Or this, ℞. mastic. thurii, an. ℥ iii alum. ros. rub. nuc. cupres. an. ʒ two. ladan. hypoci. sumach, myrtil. an. ʒ iii fiant pessi cum succo arnoglos. & cotoniorum. According to this example others may be made for to mollify, to bind, to cleanse, to incarnate, to cicatrise and cover the ulcers of the womb: they are to be put up when the patient lieth in bed, and to be kept all night. Pessaries are also made of medicinable powders, not only mingled with some juice, but also with those powders alone being put into a little bag of some thin matter, being stuffed with a little cotton that it might be of a convenient stiffness, and this kind of pessaries may be used profitably in the falling of the mother. An example of one mentioned by Rondeletius in his book of inward Medicines, is as followeth. ℞. Benjoini, styracis, caryoph. an. ʒ i. gall. mosch. ℥ ss. moschi, gr. vi. fiat pulvis; this Against the suffocation of the Mother. being made up with cotton may be put up into the body. CHAP. XXIV. Of Oils. PRoperly and commonly we call oil that juice which is pressed forth of Olives; but the word is used more largely, for we call every juice of a fluxible, unctuous, and airy substance, Oil. There are three differences of these oleaginous juices: The first is of those things which yield oil by expression, as well fruits as seeds being bruised, that by beating the oily juice may be pressed forth; some are drawn without fire, as oil of sweet and bitter almonds, oil of nuts, of palma Christi. Others are made to run by the help of fire, by which means is gotten oil of bays, linseed oil, rape oil, oil of hemp, and such like: The manner of drawing oil from seeds is set down by Mesue in his third book. The second sort is of those oils which are made by the infusion of simple medicines in oil, wherein they leave their qualities: and this is done three several The making olies by infusion. ways, the first is by boiling of roots, leaves, tops of flowers, fruits, seeds, gums, whole beasts, with wine, water, or some other juice, with common, or any other oil, until the wine, water, or juice be consumed, which you may perceive to be perfectly done, if you cast a drop of the oil into the fire, and it maketh no noise but burneth. It is to be remembered that sometimes the seeds or fruits are for a certain time to be macerated before they are set to the fire; but it must be boiled in a double vessel, lest the oil partake of the fire. After this manner is made oleum costinum, rutaceum, de croco, cydoniorum, myrtillorum, mastichinum, de euphorbio, vulpinum, de scorpionibus, and many others. The second is by a certain time of maceration, some upon hot ashes, others in horse dung, that by that moderate heat the oil might draw forth the effects of the infused medicines into itself. The third is by insolation, that is, when these or these flowers, being infused in oil, are exposed to the sun, that by the heat thereof the oil may change, and draw into himself the faculty of the flowers which are infused: of this kind are oil of roses, chamomile, dill, lilies, of water lilies, violets, and others, as you may see in Mesue. The third kind is properly that of the Chemists, and is done by resolution made after divers manners, and of this sort there are divers admirable qualities of divers The manner o● oils by resolution. oleaginous juices, whether they be made by the sun or fire, or putrefaction, as we shall speak in his place hereafter. We use oils when we would have the virtue of the medicament to pierce deep, or the substance of the medicines mingled with the oil to be soft and gentle. Moreover, when we prepare oils that should be of a cooling quality, the common oil of the unripe Olive is to be used: of that should the oil of roses be made. Again, when we would prepare oils of heating qualities, such as are Oleum philosophorum, or of Tiles, sweet and ripe oil is to be chosen. CHAP. XXV. Of Liniments. ALiniment is an external medicine of a mean consistence, What a lineament is. between an oil and an ointment, for it is thicker than an oil; for besides oil it is compounded with butter, axungia, and such like, which is the reason why a lineament is more efficacious in ripening and mitigating pain, than simple oil. The varieties of liniments is drawn from their effects, some cool, others heat, some humect, some ripen, others by composition are made for divers uses. The matter whereof they are usually made, is oil, axungia, suet, butter, all those things which have an oily substance or consistence, as styrax liquida, turpentine, the mucilages of fenugreeke, marshmallows, marrow, and other like. To these are sometimes added powders of roots, seeds, flowers, rinds, metals, but sparingly, that the lineament may be of a liquid consistence. An example of a lineament that is good to attenuate, heat, and digest, is this that followeth. ℞. ol. amygd. amar. lilior. an. ℥ i. axung. anat. gallin. an. ℥ ss. butyr. sal. expert. ℥ i. mucag. sem. alth. foenugr. extract. in aq. hyssop. an. ℥ ss. pulver. croci, ireos, an. ℈ i. fiat linimentum. This may be an example of a lineament to humect and mollify. ℞. ol. amygd. dulc. ℥ two. axung. human. ℥ ss. mucag. semin. malu. extract. in aq. parietar. ℥ ss. fiat linimentum: you may add a little saffron. There be many others like these which may be made for divers affects. They are easily applied to every part of the body, because they are not so liquid as oils: the reason is, they are more agreeable to any of the parts. If they be to enter into any crooked narrow passage, such as the ear, they must be more liquid, and have more oil: if they be to stick on the part, they will admit of more axungia and suet. They are deceived who think that the difference between liniments and ointments is, that there is no wax in liniments as there is in unguents; for there be some unguents which admit not any wax to be added, as aegyptiacum, and all such as are used in gangrenes, and all sorts of putrid ulcers; because to these kinds of diseases all fatty things, as oils, fats, rosines, and wax, are enemies. Therefore we substitute in the place of them in aegyptiacum, honey and verdigreace; for of these it hath his consistence, and his quality of cleansing. CHAP. XXVI. Of Ointments. Ointments are of a more solid consistence than Liniments, and are therefore of more force. Their differences are partly taken from Ointments & their differences. their effects; for some heat, others cool, some dry, and some humect, some cleanse, some corroborate, some waste dead flesh, and others cicatrise, partly from the variety of colours, partly from the first invertors, as, Album rhasis, Desiccativum rubrum: partly from the number of the simple medicaments whereof they be made, as, Tetrapharmacum, Tripharmacum, or Nutritum: partly from that medicament which is principal in the composition, hence are they called, Unguentum de Lythargyro, de Minio, Diapompholigos, and such like. They are compounded of herbs, roots, seeds, fruits, metals, and parts of Beasts; the juices and other liquid things being consumed away by boiling, as we have said in the Chapter of compound Oils. Herbs, and the parts of them, if they be dry, must be powdered, and also metals; but being green, they are boiled and strained forth, and the juice so pressed is wasted by boiling. Gums and Rosins some are powdered, others being put to some convenient liquor are dissolved by fire: So Wax is dissolved in the Oil. In the composition of unguents this proportion is usually observed, that for one ounce of powder, two ounces of Wax, and eight of Oil is added: notwithstanding for that Wax serveth only to the consistence of the ointment, it is better to leave the quantity to the will of the Apothecary; but he may be more sparing in adding Wax to the ointments in the Summer than in Winter: for the heat of Summer, drying them, addeth to the consistence; by examples propounded, these common precepts will more plainly appear. ℞. Olei ros. ℥ iv. pil. lepor. bol. armen. terrae sigil. an. ʒi. bal. Gallar. an. ʒ ss. tritis terendis, Unguentum adstringens. & simul mixtis, addita cera quod sufficit, fiat unguentum. Here we must observe, that there be three ways of making Ointments: The first is of those which are made only by stirring or grinding in the Mortar without any fire, and so is made Unguentum nutritum. The second is, when we dissolve Wax in Oil, Fat, or some such substance with fire: and being all dissolved, we mingle the powders according to the proportion we noted before. After which manner are made Unguentum Aureum, Basilicon, Diapompholigos, Desiccativum rubrum, Enulatum. The third sort is, when we bruise herbs with a Pestle, and mingle them with Axungy, boiling them together, and then straining them, and the Ointment is that which is strained. Therefore let us proceed to explain this by examples. ℞. Lythar. auri triti & loti lb ss. olei ros. lb. i aceti ros. ℥ iv. fiat Unguentum. First, we put the Lytharge into the Mortar, pouring in a little Oil, and working it with a Unguentum nutritum. Pestle, that it may grow thick, then with the Oil we put a little Vinegar, continually working, until they mingle into one body, now and then between while adding sometimes a little Oil, sometimes a little Vinegar, until the whole be brought to the consistence of an Ointment. If of an Ointment of this kind thou wouldst make a black plaster, by degrees consume all the Vinegar, so shall the plaster shine and grow black. ℞. Cerae citr. ℥ vi. olei boni lb. two. tereb. ℥ two. resin. & coloph. an. ℥ i ss. olib. mastic. an. ℥ i. croci, ʒi. fiat Unguentum. First, dissolve the Wax with a good part of the Oil, then Vnguentum aureum. add the Rosin and Colophony broken small. These being dissolved, take the composition from the fire, and then add the Turpentine; when the whole is somewhat cooled, add the Olibanum and Mastic being finely powdered, than the Saffron, which shall be macerated in the rest of the Oil. Tetrapharmacon is so called, because it is made of four simple medicines, Vng. Tetraph●…macum, scu Basi●…m. Wax, Rosin, Pitch, Tallow, of each a like quantity, and so equally mixed. ℞ Resin. picis nigr. adip. vituli. & cerae an. ℥ two. ss. Olei veteris olivarum maturarum, lb i ss. or if you would have it harder, lb i. that ointment also is called Basilicon, the Wax being cut small and dissolved in Oil, then add the rest of the things, which being dissolved, thou shalt have the desired ointment. ℞. Olei ros. ℥ ix. cer. alb. ℥ iii succi solani hortensis, ℥ iv. Cerus. lot. ℥ i. Pompholygos, plumbi Ung. Diapompholygos. usti & loti, olib. puri, an. ℥ ss. fiat Unguentum. Dissolve the Wax in the Oil with a gentle fire, than you shall take it from the fire, and add to the rest of the ingredients, working them together in a stone Mortar, pouring on the juice by degrees, at least so much of it as will incorporate. ℞. Lap. calam. ter. sig. an. ℥ two. Litharg. auri, cerus. an. ℥ i ss. Camphor. ʒ ss. cerae, ℥ two ss. Olei Vng. desiccatvum rubrum. rosat. viol. an. ℥ iii fiat Unguentum. Dissolve the Wax in the Oil, than set it to cool, and work in the powders with a spatter, and at last add the Camphor dissolved in a little Oil of Roses, or Rosewater. ℞. Rad. ènul. campan. coct. cum aceto & contus. ut decet lb ss. Axung. porci, olei commu. Ung. Enulatum. an. ℥ i ss. argen. vivi extincti, & tereb. lot. an. ʒi. sal. commu. pulverati, ʒii. incorporate them according to art. The boiled roots must be drawn through a Sieve, which being boiled by a gentle fire with the Axungia, must be continually stirred, then put to the Salt with Oil & Wax: when you set it from the fire to cool, then add the Quick silver, being killed with a little Axungia and Turpentine. ℞. Olei rosat. ℥ ix. cerus. alb. ℥ iii cer. alb. ℥ two. make it thus: Let the Ceruse be finely Vng. album Rhasis. powdered, and put into the Oil and Wax whilst it is hot, and so work the whole together, until they shall be brought into a body. ℞. Rad. Ath. lb i semi. lini, foenugr. an. lb. ss. Scillae ℥ iii Olei come. lb. two. cer.. lb ss. terebinth. De Althaea. gum. heder. galb. an. ℥ i. coloph. & resin. ℥ iii The roots and seeds being bruised, are infused for three days in five pints of water; boil them until three ounces be consumed, and then draw forth the Mucilage, and boil it with the Oil, then add Wax cut small: these being taken from the fire, the Galbanum being dissolved with Vinegar, & mingled with the Turpentine, must be added together with the Gum Hederae, Colophony, and Rosin. ℞. Ocul. populi arb. lb i ss. fol. papaveris nigr. Mandrag. byoscyami, lactucae, sompervivi Vng. Populeu●… parvi & magni, violae nigrae, solani, umbilici veneris, seu cymbalar. bardanae, an. ℥ ss. (Cordus, Fernelius, & Nicolaus singulorum ℥ iii praescribunt) Adipis suilli recentis salis expertis, lb two. vini boni, lb i fiat Unguentum. The Poplar buds and Violet leaves must be bruised and maccrated in the Axungia for the space of two months, that is, until the rest of the herbs be ready; for they cannot be gathered before the Summer time, but the Poplar buds and Violets may be had in March. They must be bruised and mingled very well, and set in a warm place for eight days; then add one pint of strong Vinegar, and boil them till it be consumed, which may be perceived by casting a little of it into the fire, then strain it forth, and put up the Ointment. ℞. Tereb. cer. alb. res. an. ʒxiv. Opopanacis, floris, seu viridis aeris (nam hic flo● aris non Vng. Apostolorum. propriè accipitur pro granulis, quae scintillarum instar ab aere exiliunt dum à fabris ferrariis aqua tingitur: sed pro viridi aeris usurpatur, cujus contra maligna ulcera notae sunt vires, contra quae omninò id Unguentum est comparatum) an. ʒii. ammon. ℥ xiv. aristol. lon. thuris masculi an. ʒvi. myrrhae & galbani an. ʒiii. bdellii, ʒvi. Litharg. ʒix. olei, lb two. fiat Unguentum. The lethargy is to be mingled with two ounces of Oil for the space of five hours, and with a gentle fire to be boiled until it come to the consistence of Honey, and be always stirring, lest it burn: being taken from the fire and warm, the Wax and the Rosin, being dissolved, with the rest of the Oil, must be added. Then put to it, when it is cooling, the Gums dissolved in Vinegar, boiled and incorporated with the Turpentine. Then the Aristolochia, Myrrh, and Frankincense are to be mingled, and last of all the Verdigrease, being in fine powder, and sprinkled in: and so the unguent is made. ℞. Cortic. median. castan. cortic. median. querc. cortic. median. gland. myrtle. eques. cortic. Com●… fabar. acinor. uvar. sorbor. siccor. immatur. mespillor. immaturor. rad. chelidon. folior. prunor. silvest. an. ℥ iss. Aquae plantaginis, lb viii. cer. nov.. ℥ viii ss. olei myrtillor. lb iiss. Then these things which follow, being finely powdered, are to be sprinkled in. ℞. Pulveris corticis medianis castan. corticis medianis gland. cortic. median. arb. gland. id est, querc. gallar. an. ℥ i. Cineris oss. cruris bovis, myrtill. acinor. uvar. sorbor. siccor. an. ℥ ss. Trochiscorum de carabe, ℥ two. fiat Unguentum. First, make a decoction corticis mediani arboris quercus, acini uvar. rad. chelid. mespil. sorbor. equis. seminis myrtil. folior. pruni sylvestris, cort. fabar. cortic. medianis gland. cortic. castan. & gallar. in the Plantain water for the space of two hours, then strain it, and divide the liquor into nine parts, washing the Wax, dissolved with the Oil of Myrtils' seven times; the liquor being all spent, and the Wax and Oil being melted, than insperge the powders, Cruris bovis, ossium, cortic. median. querc. median. cortic. gland. castan. gallar. sorbor. mespil. seminum myrtil. acinor. uvar. and at last the Trochisces carab. after this manner shall you make this Ointment. ℞. Olei absinth. mastic. de spic. rosat. an. ℥ ss. pulver. absinth. ros. major. menth. an. ʒi. Caryoph. cinam. mastic. galang. an. ʒi. Powder those things which are to be powdered, Ung. pto stomacho. and with a sufficient quantity of Wax make a soft ointment, wherewith let the stomach be anointed one hour before meals continually. ℞. Cer. alb. lb two. cerus. litharg. auri, an. lb i. myrrh. medul. cervi, an. ℥ two. thuris, ℥ i. olei, lb ss. Boil the lethargy in the oil to a mean consistence, then add to the Wax Ung. ad morsus rubiosoes, ex li. 1. Gal. de comp. sce. genera. & Ceruse, and when it will not stick to the fingers, take it from the fire, and put in the Medulla, when it beginneth to cool, the Myrrah and Thus, being finely powdered, must be cast in by little and little, and the ointment may be put up for use. The chaps of the fundament, and remollient Pessaries are likewise made of it, and it is very good against the bitings of mad Dogs, and the punctures of nerves and tendons, keeping wounds so that they do not agglutinate. ℞. Picis pinguis, lb i Opopanacis in aceto forti, oleo liliorum, & veteri porci axungia cocti, ℥ iii fiat Unguentum. Oleum ex sinapi is good against those bitings of mad beasts 3. De comp. med. see. gen. and punctured nerves: for it doth open wounds when they are cicatrized. Ointments are used to overcome the contumacy of a stubborn evil by their firm and close sticking to, especially if there shall need no medicine to go further into the body. CHAP. XXVII. Of Cerats and Emplasters. SUch affinity there is in the composition of a Cerat and Emplaster, that What a Cerat is. oftentimes the one is taken for the other, as is usually done in Ointments and Liniments. A Cerat is a composition more solid and hard The differences. than an ointment, and softer than a plaster, having his name from Wax, which taking away the fluidness of the oil, bringeth him to his consistence. The differences of Cerats are taken some from the parts by which they are called, as Ceratum stomachicum: some from the effects, as Ceratum refrigerans Galeni: Others from the simple medicaments which are the chief in the composition, as, Ceratum Santalinum. The proper matter of Cerats is, new Wax & Oils, being appropriated to the grief of these, or those parts; so that Liniments & Ointments do scarce differ from Cerats, if they admit of Wax: for if ointment of Roses should have Wax added to it, it were no longer an ointment, but a Cerat. Cerats, which are made with Rosins, Gums, and Metals, do rather deserve the names of Emplasters than Cerats. And therefore Ceratum ad Hernias, we commonly call Emplastrum contra Rupturam. If that pain or inflammation do grieve any part, we make Cerats of plaster, dissolved with Oil, lest that the more hard and heavy consistence of the Emplaster should be troublesome to the part, and hinder perspiration: and therefore laying aside the composition of Cerats, let us speak of Emplasters. An Emplaster is a composition which is made up of all kind of medicines, especially Emplasters. of fat and dry things, agreeing in one gross, viscous, solid, and hard body sticking to the fingers. The differences of Emplasters are taken from those things, which the variety of ointments are taken from. Of those things which go into the composition of an Emplaster, some are only used for their quality and faculty, as Wine, Vinegar, Juices. Others to make the consistence, as Litharge (which, according to Galen, is the proper matter of Emplasters) Wax, Oil, and Rosin. Others be useful for both, as, Gums, Metals, parts of beasts, Rosin, as Turpentine to digest, to cleanse, and dry. Of Emplasters, some are made by boiling, some are brought into a form without boiling; those which be made without fire, do suddenly dry, nor are they viscous: they are made with meal and powder, with some juice, or with some humid matter mingled with them. But plasters of this kind may rather be called hard ointments, or cataplasms: for plasters properly so called are boiled, some of them longer, some shorter, according to the nature of those things which make to the composition of the Emplaster: Therefore it will be worth our labour to know what Emplasters do ask more, or which less boiling. For roots, woods, leaves, stalks, flowers, seeds, being dried, and brought into powder, are to be added last, when the plaster is boiled as it were, and taken from the fire, lest the virtue of these things be lost. But if green things are to be used in a composition, they are to be boiled in some liquor, and being pressed forth, that which is strained to be mingled with the rest of the composition; or if there be juice to be used, it is to be bruised and pressed forth, which is so to be boiled with the other things, that nothing but the quality is to remain with the mixture, as we use to do in Empl. de Janua, seu Betonica, & Gratia Dei. The same is to be done with Mucilages, but that by their clamminess they do more resist the fire. But there doth much of oil and honey remain in plasters when they are made. Those juices which are hardened by concretion, as, Aloes, Hypocystis, Acacia, when they are used in the composition of a plaster, and be yet new, they must be macerated and dissolved in some proper liquor, and then they are to be boiled to the consumption of that liquor. Gums, as, Opopanax, Galbanum, Sagapaenum, Ammoniacum, must be dissolved in Wine, Vinegar, or Aqua vitae, then strained and boiled to the consumption of the liquor, and then mixed with the rest of the plaster. And that they may have the exact quantity of Gums and Pitch, it is necessary that first they be dissolved, strained, and boiled, because of the sticks and sordid matter which are mingled with them. You must have respect also to the liquor you use to dissolve them in; for Vinegar of the best Wine doth more powerfully penetrate, than that which is of weak and bad Wine. Other Gums, which are drier, are to be powdered, and are to be mingled with plasters last of all. Metals, as, Aes ustum, Chalcitis, Magnes, Bolus Armenus, Sulphur, Auripigmentum, and others, which may be brought to powder, must be mingled last, unless advice be given by long boiling to dull the fierce qualities of them. The like consideration is to be had of Rosin, Pitch, and Turpentine, which must be put in after the Wax, and may not be boiled but very gently; but the fats are mingled whilst the other things are boiling. The lethargy is to be boiled with the oil to a just consistence, if we would have the plaster dry without biting. Ceruse may endure as long boiling, but then the plaster shall not be white, neither will the lethargy of filver make a plaster with so good a colour as Litharge of gold. Moreover, this order must be observed in boiling up of plasters: the lethargy must be boiled to his consistence; juices or mucilages are to be boiled away, then add the fats, than the dry Rosin, Wax, Gums, Turpentine, and after them the powders: You shall know the plaster is boiled enough by his consistence, gross, hard, glutinous, Signs of a plaster perfectly boiled. and sticking to the fingers, being cooled in the air, water, or upon a stone. Also you shall know it by his exact mixtion, if that all the things become one mass hard to be broken. The quantity of things which are to be put into a plaster can hardly be described, The quantity of things to be put into plasters. but an artificial conjecture may be given, by considering the medicaments, which make the plaster stiff, and of a consistence, and the just hardness and softness they make being boiled. Wax is not put into such plasters wherein is Labdanum; for that is in stead of Wax. For if there shall be in the composition of a plaster some emplastic medicaments, the Wax shall be the less: chose, if they shall be almost all liquid things, the Wax shall be increased so much as shall be necessary for the consistence of the plaster. The quantity of the Wax also must be altered according to the time, or the air; therefore it is fit to leave this to the art and judgement of the Apothecary. Emplasters are sometimes made of ointments by the addition of wax, or dry rosine, or some other hard or solid matter. Some would that a handful of medicaments powdered, should be mingled with one ounce, or an ounce and an half of oil, or some such liquor, but for this thing nothing can certainly be determined: Only in plasters described by the Ancients there must be great care had, wherein he must be very well versed, who will not err in the describing the dose of them; and therefore we will here give you the more common forms of plasters. ℞. ol. chamaem. aneth. de spica, liliacci, an. ℥ two. ol. de croco, ℥ i pingued. porci, lb i. Empl. de Vigo with Mercury. pingued. vitul. lb ss. euphorb. ʒv. thuris, ʒx. ol. lauri, ℥ i ss. ranas viv. nu. vi. pingued. viper. vel ejus loco human. ℥ two ss. lumbricor. lotor. in vino, ℥ iii 〈◊〉. succi ebuli, enul. ana, ℥ two. schoenanthi, staechados, matricar. an. m two. vini oderiferi, lb two. litharg. auri, lb i. terebinth. clarae, ℥ two. styracis liquid. ℥ i s8. argenti vivi extincti, so much as the present occasion shall require, and the sick shall be able to bear, and make up the plaster. To one pound of the plaster they do commonly add four ounces of quicksilver, yet for the most part they do increase the dose, as they desire the plaster should be stronger: the worms must be washed with fair water, and then with a little wine to cleanse them from their earthy filth, of which they are full, and so the frogs are to be washed and macerated in wine, and so boiled together to the consumption of a third part; then the squinanth must be bruised, the feverfew and the staechas cut small, and they being added, to be boiled to the consumption of one pint, and being boiled sufficiently, the decoction being cooled shall be strained and kept; and the Letharge is to be infused for twelve hours in the oil of chamomile, dill, lilies, saffron, and the axungies above spoken of. Then boil them all with a gentle fire, by and by taking it from the fire, and add one quart of the decoction above spoken of, than set it to the fire again that the decoction may be consumed, and then by degrees add to the rest of the decoction: the oil of spike shall be reserved unto the last, which may give the plaster a good smell. Then are added the juices of walwort and enula, which must be boiled until they be wasted away. Afterwards it being taken from the fire, to the composition is added the frankincense and euphorbium, and white wax as much as shall suffice. When the whole mass shall cool, then at last is mingled the quicksilver extinct, turpentine, oil of bitter almonds, bays, spike, of line, styrax and axungia, being continually stirred, and it shall be made up upon a stone into rolls. Unless the quicksilver be well extinguished, it will run all into one place, and unless you tarry until the composition cool, it will vapour away in fume. ℞. croci, ʒii. bdellii, mastic. ammon. styrac. liquid. an. ℥ ss. cerae alb. lb s8. tereb. ℥ vi. medul. cruris vaccae, adipis anserini, an. ℥ i. aesypi, vel si desit, axung. gallin. ℥ ix. olei Ceratum oesipiex Philagrio. nard quantum satis ad magdaleones formandos, expressionis scillae, ℥ i s8. olibani, sevi vitul. ℥ i. The oesypus, sepum, adeps, medulla, cera, are to be dissolved together; when they cool, add the ammoniacum dissolved in the decoction of faenugreeke and chamomile, half an ounce, and so much juice of squils, then put to the styrax and turpentine, stirring them continually; then add the bdellium, olibanum, mastic, aloes, brought into fine powder, and when they are perfectly incorporated into a mass, let them be made up with oleum nardinum into rolls. rum. terebinth. lb s8. resin. lb i. cer. alb. ℥ iv. mastic. ℥ i. fol. verben. betonic. pimpinel. an. m i. The herbs being green, the tops are to be cut and bruised in a stone mortar, Degratia Dei. and boiled in red wine to the consumption of one third part. To the strained liquor add wax cut into small pieces, and being dissolved by the fire; the liquor being consumed put to the rosine, when it shall cool add the Mastic powdered, working it with your hands, by which it may be incorporated with the rest of the things. ℞. succi beton. plantag. apii, an. lb i cerae, picis, resin. tereb. an. lb s8. fiat empl. the De janua seu de Betonica. juices are to be mingled with the wax being dissolved, and boiling them until three parts be consumed, add the rosine and pitch, which being dissolved and hot, must be strained, and then add the Turpentine, and make up the plaster. rum. croci, picis come. (or rather picis navalis, because this emplaster is used to discuss Emplastrum oxycroceum. and draw forth the matter which causeth the pain of the joints) coloph. cerae, an. ℥ two. tereb. galb. ammon. thuris, myrrhae, mastioh. an. ʒv ss. The cera, pix, and colophonia are by little and little to be dissolved, to which add the gums dissolved according to art, and mingled with the terebinth; and taking it from the fire add the thus, myrrha, and at last the crocus in fine powder, and then make it up into rolls with oil of worms. rum. ol. come. lb two. cerus. subtilis. lb i boil them together with a gentle fire, stirring De cerusa. them continually until they come to the body of an emplaster: if you would have the plaster whiter, take but ℥ ix. of the oil. ℞. lytharg. triti, acet. fortis. an. lb ss. ol. antiq. lb i fiat emplastrum: let the oil be Tripharmacum, seu nigrum. mingled with the lethargy for the space of twelve hours, then boil them until they come to a good consistence, putting in the vinegar by little and little; but you shall not take it from the fire until the vinegar be quite wasted away. rum. ol. vet. lb iii axung. vet. sine sale, lb two. lytharg. trit. lb iii vitriol. ℥ iv. let the Diapalma, seu diachalciteos. oil be mingled with the lytharge for the space of twelve hours, and boil them to a good consistence, then add to the axungia, stirring them continually with a spatter made of the palm tree, reed, or willow, and being sufficiently boiled, take it from the fire; and add the vitriol in fine powder. ℞. picis naval. aloes, an. ℥ iii lytharg. cerae, coloph. galban. ammoniac. an. ℥ two. visci Contrarupturam. querni, ℥ vi. gypsi ust. utriusque aristoloch. ana, ℥ iv. myrrhae, thuris, an. ℥ vi. tereb. ℥ two. pulveris vermium terrestrium, gallar. utriusq. consolid. bol. arm. an. ℥ iv. sang. humani, lb i fiat emplast. If you would have it of a very good consistence, you may add of the oil of myrtills or mastic; lb ss. you shall make it thus: Take the skin of a Ram cut in pieces, and boil it in an hundred pints of water and vinegar until it come to a glue or stiff jelly, in which you shall dissolve the visco quer. then add the pitch and wax broken into small pieces, and if you will you may add the oil with them, afterwards the galban. and ammoniac. dissolved in vinegar, being mingled with the terebinth, may be added. Then add the lethargy, gypsum, bol. aristoloch. consolida, vermiss, & sang. human. At last the myrrh, thus, colophon, and aloe, stirring them continually; and that they may be the better mingled, work the plaster with a hot pestle in a mortar. rum. mucag. sem. lini, rad. alth. foenug. median. corticis ulmi, an. ℥ iv. olei liliacei, cham. De mucaginibus. aneth. an. ℥ i ss. ammon. opopanac. sagap. ana ℥ ss. croci, ʒii. cerae nov.. lb ss. tereb. ℥ ss. fiat empl. Fernelius hath ℥ xx. of wax: the wax being cut small must be mingled with the oils and the mucilages, stirring them continually with a wooden spatter till the liquor be consumed. Then the gums dissolved and mingled with the terebinthina must be added, and last of all the saffron finely powdered. rum. ol. ros. myrtil. ung. populeon, ana, ℥ iv. pinguedinis gallin. ℥ two. sebi arietis castrati, De minio. sepi vaccini, an. ℥ vi. pingued. porci, ℥ x. lytharg. auri, argenti, an. ℥ iii cerus. ℥ iv. minii, ℥ iii tereb. ℥ iv. cerae, q. s. fiat emplastrum vel ceratum molle. The lithargiros, cerusa, and minium are to be brought into fine powder, severally being sprinkled with a little rose water, lest the finest of it should fly away; these being mingled with the oil of roses and myrtles, with a gentle fire may be boiled until they come to the consistence of honey; then add the axungias, and boil them till the whole grow black, after add the sebum, and that being dissolved take it from the fire, and then add the unguentum populeon, and some wax if there be need, and so bring it to the form of a plaster. ℞. litharg. puri pull. ℥ xii. ol. irin. chamaem. aneth. an. ℥ viii. mucag. sem. lini, foenug. Diachylon magnum. rad. alth. ficuum ping. uvar. passar. succi ireos, scillae, oesipi, icthyocollae, an. ʒxii ss. tereb. ℥ iii res. pini, cerae flavae, an. ℥ two. fiat emplastrum: The lethargy is to be mingled with the oil before it be set to the fire, then by a gentle fire it is to be boiled to a just consistence; after the mucilage by degrees must be put in, which being consumed the juices must be added and the icthyocolla, and they being wasted too, then put to the wax and rosine, then taking the whole from the fire, and the oesipus and terebinthina. We use plasters when we would have the remedy stick longer and firmer to the The use of plasters. part, and would not have the strength of the medicament to fly away or exhale too suddenly. CHAP. XXVIII. Of Cataplasms and Pultisses. Cataplasms are not much unlike to emplasters less properly so called, for they may be spread upon linen clothes and stoops like them, and The matter of cataplasms. so applied to the grieved parts. They are composed of roots, leaves, fruits, flowers, seeds, herbs, juices, oils, fats, marrows, meals, rosines. Of these some must be boiled, others crude. The boiled are made of herbs boiled tender, and so drawn through an hair searse, adding oils and axungia's thereto. The crude are made of herbs beaten, or their juices mixed with oil and flower, or other powders appropriate to the part or disease, as the Physician shall think fit. The quantity of medicines entering these compositions can scarce be defined, for that they must be varied as we would have the composition of a softer or harder body. Verily they ought to be more gross and dense when as we desire to ripen anything, but more soft and liquid when we endeavour to discuss. We use cataplasms to assuage pain, digest, discuss and resolve unnatural tumours Their use. and flatulencies. They ought to be moderately hot and of subtle parts, so to attract and draw forth; yet their use is suspected the body being not yet purged, for thus they draw down more matter into the affected part. Neither must we use these when as the matter that is to be discussed is more gross and earthy, for thus the subtler parts will be oaely discussed, and the gross remain impact in the part unless your cataplasm be made of an equal mixture of things, not only discussing, but also emollient, as it is largely handled by Galen. This shall be largely illustrated by examples. As, ℞. medul. paniss, lb ss. decoquantur Lib. 2. ad glaucubi deschirrho. in lacte pingui, add olei chamam. ℥ ss. axung. galin. ℥ i. fiat cataplasma. Or, ℞. rad. alth. ℥ iii fol. malu. senecionis, an. m i. sem. lini, faenug. an. ʒ two. ficus, ping. nu. vi. decoquantar An anodine cataplasm A ripening cataplasm. A discussing caplasme. How pultisses differ from caplasmes. in aqua, & per setaceum transmittantur, addendo olet lilior. ℥ i. far. hord.. ℥ two. axung. porcin. ℥ i ss. fi at cataplasma. Or, ℞. far. fab. & orob. an. ℥ two. pulv. chamam. & melil. an. ʒ iii ol. irin. & amygd. amar. an. ℥ i. succi rut.. ℥ ss. fiat cataplasma. Pultisses differ not from cataplasms, but that they usually consist of meals boiled in oil, water, honey, or axungia. Pultisses for the ripening of tumors are made of the flower of barley, wheat, and milk, especially in the affects of the entralles; or else to dry and bind, of the meal of rice, lentiles, or Orobus with vinegar; or to cleanse, and they are made of honey, the flower of beans and lupins, adding thereto some old oil, or any other oil of hot quality, and so make a discussing pultis. Also anodine pultisses may be made with milk; as thus for example, ℞. farin. triticeae, ℥ two. mica A ripening cataplasm. panis purissimi, ℥ iii decoquantur in lacte, & fiat pulticula. ℞. farin. hordei & fab. an. ℥ two. far. orob. ℥ iii decoquantur in hydromelete, addendo mell is quart. i. olei amyg. amar.. ℥ two. fiat pulticula. We use pultisses for the same purpose as we do cataplasms, to the affects both of the internal and external parts. We sometimes use them for the kill of worms, and such are made of the meal of lupins boiled in vinegar, with an Ox's gall, or in a decoction of Wormwood, and other such like bitter things. CHAP. XXIX. Of Fomentations. A Fotus or fomentation is an evaporation or hot lotion, chiefly used to mollify, relax and assuage pain, consisting of medicines having these faculties. A fomentation commonly useth to be moist, being usually made of the same things as embrocations, to wit, of roots, seeds, flowers, boiled in water or wine. The roots here used are commonly of mallows, marshmallows, and lilies. The seeds are of mallows, marshmallows, parsley, smallage, line, fenugreeke. Flowers are of chamomile, melilote, figs, raisins, and the like: all which are to be boiled in wine, water, or lie, to the consumption of the third part or the half: as, ℞. Rad. alth. & lilil. an. ℥ two. sem. lini, foenug▪ cumin. an. ʒiii. flo. cham. melil. & aneth. an p. i. summit. orig.. m. ss. bulliant in aequis partibus aquae & vini, aut in duabus partibus aqua, & una vini, aut in Lixivio cineris sarmentorum, ad tertiae partis consumptionem, fiat fotus. In imitation hereof you may easily describe other fomentations, as occasion and necessity shall require. We use fomentations before we apply cataplasms, ointments or plasters to the Their use. part, that so we may open the breathing places or pores of the skin, relax the parts, attenuate the humour, that thus the way may be the more open to the following medicines. The body being first purged, fomentations may be used to what parts you please. They may be applied with a female sponge, for it is gentler and softer than the male; with felt, woollen clothes, or the like dipped in the warm decoction wrung out, and often renewed; otherwise, you may fill a Swine's bladder half full (especially in pains of the sides) of the decoction, or else a stone bottle, so to keep hot the longer; yet so, that the bottle be wrapped in cotton, wool, or the like soft thing, that so it may not be the hardness and roughness offend the part, according to Hypocrates. 2. De victu i●●cutis. CHAP. XXX. Of Embrocations. AN Embroche, or Embrocation is a watering, when as from on high we What an Embrocation is. (as it were) shower down some moisture upon any part. This kind of remedy is chiefly used in the parts of the head, and it is used to the coronal suture, for that the skull is more thin in that part, so that by the spiracula or breathing places of this suture, more open than those of the other sutures, the force of the medicine may more easily penetrate unto the Meninges, or membranes of the brain. The matter of Embrocations is roots, leaves, flowers, seeds, fruits, and other things, according to the intention and will of the Physician. They are boiled in water and wine, to the half or third part. Embrocations may also be made of Lie or Brine against the cold and humid affects of the brain. Sometimes of oil and vinegar, otherwhiles of oil only. ℞. fol. plantag. & solan. an. m. i. sem. portul. & cucurb. an. ʒii. myrtil. ʒi. flor. nymph. & ros. an. p. ss. fiat decot. ad lb i cum aceti ℥ two. si altè subeundum sit, ex qua irrigetur pars inflammata. In affects of the brain, when we would repercusse, we often and with good success use oil of Roses, with a fourth part of vinegar. We use Embrocations, that together with the air drawn into the body by the Their use. Diastole of the arteries, the subtler part of the humour may penetrate, and so cool the inflamed part: for the chief use of embrocations is in hot affects. Also we use embrocations, when as for fear of an haemorrhagy, or the flying asunder of a broken or dislocated member, we dare not lose the bandages wherewith the member is bound. For than we drop down some decoction or oil from high upon the bandages, that by these the force of the medicine may enter into the affected member. CHAP. XXXI. Of Epithemes. EPithema, or an Epitheme, is a composition used in the diseases of the parts of the lower and middle belly, like to a fomentation, and not much What an Epitheme is. unlike an embrocation. They are made of waters, juices, and powders, by means whereof they are used to the heart, chest, liver, and other parts. Wine is added to them for the more or less penetration, as the condition of the hot or cold affect shall seem to require; for if you desire to heat, more wine must be added, as in swooning by the clotting of blood, by the corruption of seed, by drinking some cold poison: the contrary is to be done in a fainting by dissipation of the spirits by feverish heats, also vinegar may be added. The matter of medicines proper to the entrailes is formerly described, yet we commonly use the species of electuaries, In the sixth Chapter. as the species elect. triasantali the liver being affected, and Diamargariton in affects of the heart. The proportion of the juices or liquors to the powders, uses to be this, to every pint of them ℥ i. or ℥ i ss. of these, of wine or else of vinegar ℥ i. You may gather this by the following example. ℞. aqu. ros. bugl. borag. an. ℥ iii succi scabios. ℥ two. pull. elect. diamarg. frigid. ʒii. cort. citri A cordial Epitheme. sicciʒi. coral. ras. ebor. an. ʒss. sem. citri & card. ben. an. ʒiiss. croci & moschi an. gra. 5. addendo vini albi ℥ two. fiat Epithema pro cord. Epithemes are profitably applied in hectic and burning fevers to the liver, Their use. heart, and chest, if so be that they be rather applied to the region of the lungs; than of the heart; for the heat of the lungs being by this means tempered, the drawn in air becomes less hot in pestilent and drying fevers. They are prepared of humecting, refrigerating, and cordial things, so to temper the heat, and recreate the vital faculty. Sometimes also we use Epithemes to strengthen the heart, and drive there-hence venenate exhalations, lifted or raised up from any part which is gangrenate or sphacelate. Some cotton, or the like, steeped or moistened with such liquor, and powders warmed, is now and then to be applied to the affected entrail; this kind of remedy, as also all other topic and particular medicines, ought not to be used, unless you have first premised general things. CHAP. XXXII. Of potential Cauteries. THat kind of Pyroticke, which is termed a Potential Cautery, burns, and causeth an eschar. The use of these kinds of Cauteries is to make evacuation, derivation, revulsion, or attraction of The use of potential cauteries. the humours by those parts whereto they are applied. Wherefore they are often and with good success used in the punctures and bites of venomous beasts, in a venenous, as also in a pestilent Bubo and Carbuncle, unless the inflammation be great: for the fire doth not only open the part, but also retunds the force of the poison, calls forth and plentifully evacuates the conjunct matter. Also they are good in phlegmatic and contumacious tumors; for by their heat they take away the force and endeavours of our weak heat. Also they are profitably applied to staunch bleeding, to eat or waste the superfluous flesh of ulcers and wens, to bring down the callous lips of ulcers, and other things too long here to insist upon. The materials of these Cauteries are Oak ashes, Pot ashes, the ashes of Tartar, of The matter of them. Tithymals or spurges, the Figtree, the stalks of Coleworts and Beans, cuttings of Vines, as also sal ammoniacum, alkali, axungia vitri, sal nitrum, Roman Vitriol, and the like; for of these things there is made a salt, which by its heat is caustic and escharoticke, like to an hot iron and burning coal: Therefore it violently loses the continuity by eating into the skin, together with the flesh there-under. I have thought good here to give you divers forms of them. Take of unquenched Lime extinguished in a bowl of Barbers Lie three pounds: The forms of them. When the Lie is settled, let it be strained, and into the straining put of Axungia vitri, or Sandiver, calcined Argol, of each two pounds, of Sal nitrum & ammoniacum, of each four ounces, these things must be beaten into a gross powder, then must they be boiled over the fire, and after the boiling let them remain in the Lie for four and twenty hours' space, being often stirred about, and then strained through a thick and double linen cloth, lest any of the earthy dross get thorough together with the liquor. This strained liquor, which is as clear as water, they call Capitellum, and they put it in a brazen Basin, such as Barber's use, and so set it upon the fire, and as soon as it boyles, they keep it with continual stirring, lest the salt should adhere to the Basin; the Capitellum being half boiled away, they put in two ounces of powdered vitriol, so to hasten the falling of the eschar, and so they keep the basin over the fire until all the liquor be almost wasted away. Then they cut into pieces the salt or that earthy matter, which remains after the boiling away of the Capitellum, & with a knife or hot iron spatula form them into cauteries of such figure and magnitude as they think fitting, and so they lay them up, or keep them for use in a viol or glass closely stopped, that the air get not in: Or, Take a bundle or sufficient quantity of Beane stalks or husks, of Colewort stalks two little bundles, of cuttings of Vines four bundles, burn them all to ashes, which put into a vessel of river water, so let them infuse for a day's space, being stirred ever now and then; to this add two pounds of unquenched lime, of Axungia vitri half a pound, of calcined Tartar two pounds, of Sal niter four ounces, infuse all these, being made into powder, in the foresaid Lie for two or three days space, often stirring it, then strain the Capitellum or liquor through a thick cloth until it become clear. Put it into a basin, and set it over the fire, and when as the moisture is almost wholly spent, let two or three ounces of vitriol be added, when the moisture is sufficiently evaporated, make cauteries of that which remains, after the formerly mentioned manner. Take of the ashes of sound, knotty, old Oak as much as you please, make thereof a Lie; pour this Lie again upon other fresh ashes of the same wood, let this be done three or four times, then quench some lime in this Lie, & of these two make a Capitellum, whereof you may make most approved cauteries. For such ashes are hot in the fourth degree; and in like sort the stones, whereof the lime by burning becomes fiery and hot to the fourth degree: Verily, I have made cauteries of Oak ashes only, which have wrought quickly and powerfully. The Capitellum or Lye is The sign of good Capitellum. thought sufficiently strong, if that an Egg will swim therein without sinking. Or, Take of the ashes of Bean stalks three pounds, of unquenched lime, Argoll, of the ashes of Oak wood, being all well burnt, of each two pounds. Let them for two days space be infused in a vessel full of Lie made of the ashes of Oak wood, and be often stirred up and down. Let this Lie then be put into another vessel, having many holes in the bottom thereof, covered with strums or straw pipes, that the Capitellum flowing through these straight passages may become more clear. Let it be put twice or thrice upon the ashes, that so it may the better extract the heat and caustic quality of the ashes. Then putting it into a Barber's basin, set it over the fire, and when it shall begin to grow thick, the fire must be increased, and cauteries made of this concreating matter. The following cauteries are the best that ever I made trial of, as those that applied to the arm in the bigness of a Pease, in the space of half an hour without The faculty of the silken Cautery. pain, especially if the part of itself be painless and free from inflammation, eat into the skin and flesh even to the bone, and make an ulcer of the bigness of ones finger's end, and they leave an eschar so moist and humid, that within four or five days space it will fall away of itself without any scarification. I have thought good to call these cauteries Silken or Velvet ones, not only for that they are like The cause of the name. Silk, gentle and without pain, but chiefly because I obtained the description of them of a certain Chemist, who kept it as a great secret, for some Velvet and much entreaty: Their description is this. Take of the ashes of Beane stalks, of the ashes of Oak wood well burnt, of Their description. each three pounds, let them be infused in a pretty quantity of river water, and be often stirred up and down, then add thereto of unqueneht lime four pounds, which being quenched, stir it now and then together for two day's space, that the Capitellum may become the stronger, then strain it through a thick & strong linen cloth, & thus strained, put it three or four times upon the ashes, that so it may draw more of the caustic faculties from them, then boil it in a Barber's basin, or else an earthen one well leaded, upon a good Charcoal fire, until it become thick. But a great part of the secret or art consists in the manner and limit of this boiling; for this Capitellum becoming thick and concreating into salt, must not be kept so long upon the fire, until all the moisture shall be vanished and spent by the heat thereof: for thus also the force of the foresaid medicines, which also consists in a spirituous substance, will be much dissipated and weakened; therefore before it be come to extreme dryness, it shall be taken off from the fire, to wit, when as yet there shall some thick moisture remain, which may not hinder the cauteries from being made up into a form. The made up cauteries shall be put up into a glass most closely luted up or stopped, that the air may not dissolve them, and so they shall be laid up and kept in a dry place. Now, because the powder of Mercury is near to cauteries in the effects and faculty thereof, which therefore is termed Pulvis Angelicus for the excellency; therefore I have thought good to give you the description thereof, which is thus: ℞. Auripigmenti citrini, floris aeris, an. ℥ two. salis nitri, lb iss. alumin. rochae, lb two. vitrioli The description of Mercury, or Angelical powder. rom. lb iii Let them all be powdered, and put into a Retort, having a large receiver well luted put thereto. Then set the Retort over a Furnace, and let the distillation be made first with a gentle fire, then increased by little and little, so that the receiver may wax a little radish. ℞. Argenti vivi, lb ss. aquae fortis, lb i ponantur in phiala, & fiat pulvis, ut sequitur. Take a large earthen pot, whereinto put the viol or bolt head wherein the Argentum vivum and Aqua fortis are contained, setting it in ashes up to the neck thereof, then set the pot over a furnace, or upon hot coals, so that it may boil and evapourate away the Aqua fortis: neither in the interim will the glass be in any danger of breaking, when all the water is vanished away, which you may know is done when as it leaves smoking; suffer it to become cold, then take it forth of the ashes, and you shall find calcined Mercury in the bottom, of the colour of red Lead, separated from the white, yellow or black excrement; for the white that concretes in the top is called Sublimate, which if it should remain with the calcined Mercury, would make it more painful in the operation. Wherefore separating this calcined Mercury, you shall make it into powder, and put it in a brass vessel upon some coals, stirring or turning it with a spatula for the space of an hour or two: for thus it will lose a great part of the acrimony and biting, whence it will become less painful in the operation. CHAP. XXXIII. Of Vesicatories. Vesicatory and rubrifying ointments, cataplasms, or plasters are made of What vesicatory and rubrif●ing medicines are. acride medicines, which have power to draw forth to the superficies of the body such humours as lie deep, by exulcerating the skin and causing blisters. Their matter is the same with septicke medicines, as sinapi, anacardus, cantharides, euphorb. radices scillae, bryon. and the like, which with honey, turpentine, leaven, gum, or rosine, may be made into cataplasms, ointments, or plasters; therefore the composure of vesicatories, or rather their consistence differs not from that of hard or soft unguents. Therefore I will give you one example or description of them, which is thus. ℞. cantharid. euphorbii, sinapi, an. ʒss. mellis anacardini, ʒi. modico aceti, & fermenti The description of a vesicatory. quod sit satis excipiantur, & fiat vesicatorium. Some of the ancients think it better to make up these medicines with water rather than with vinegar, because experience teacheth that vinegar abates the strength of mustard. We use this kind of Their use. medicine in long diseases, when as we cannot any thing prevail with other remedies; especially in the head-ache, megrime, epilepsy, sciatica, gout, the bites and punctures of venomous creatures, pestilent carbuncles, and other inveterate and contumacious diseases. Also we use them when as we would restore life and strength to a dead or decayed part, for thus they are drawn back together with the hear; for which purpose we must make choice of more gentle vesicatories, as such which only rubrifie, so that the part may only become red, and not be burnt: the part must first be strongly rubbed, that the decayed and dull heat may be roused and stirred up, the pores of the skin more opened, that the force of the medicine may enter the deeper into the body. CHAP. XXXIV. of Collyria. A Collyrium is a medicine proper for the eyes, made of powder finely What a collyrium is. levigated and ground into the form of Alcohol, as the Arabians and our Alchemists term it: yet the word in a more general acception is used for any liquid medicine, made with liquors and powders, and applied or used to any part. Wherefore collyria The difference▪ of them. are of three kinds, some are moist or liquid, which are properly called collyria; others dry, which are of the same consistence with Trochisces; others have the consistence of honey, or a lineament. The liquid serve for Their use, the greater and lesser corners of the eyes; those of the consistence of honey are meet for the apple of the eye; but the dry are to be made into powder, and so blown into the eyes: also sometimes they are to be dissolved in some juice, or other convenient liquor, that so they may be made into moist collyria. Therefore collyria have divers uses, and are applied to several parts according to the intention and counsel of the Physician: for liquid collyria put into the corners of the eyes do more readily mitigate the heat of their inflammation, by reason they enter more easily by the tenuity of their substance, such things as have a more firm consistence adhere more tenaciously, and work more certainly. Moist collyria are made of juices, mucilages, waters of herbs, flowers, seeds, metalline bodies, Their matter, galls, and other such like medicines, which are repercussives, resolvers, detergents, anodynes, and the like, according to the nature of the present disease. Sometimes they are made of juices and distilled waters only, otherwhiles powders, or dry collyria made into powder, are mixed with them, together with the white of an egg. Powders are prescribed to ʒii. and liquors to ℥ iv. or ℥ v. in medicines for the eyes; but for other parts, as when it is to be injected into the urenary passage, they may be prescribed to the quantity of a pint. Dry Collyria are made of powders exceeding finely beaten or ground, and incorporated with some juice, whence it is that they differ little from Trochisces. Wherefore the collyrium album Rhasis is now usually termed a Trochisce, and kept with them. Cathaereticke powders are not applied in the form of a moist collyrium, but in the form of a lineament, that is, incorporated with fat or oil. All these things shall be made more plain by the following examples, ℞. aq. plant. & rosar. an. ℥ two. album. ovi unum, bene agitatum, misce, fiat collyrium. A repercussive collyrium. An anodine. A detergent. ℞. aq. rosar. & viol. an. ℥ iii trochis. alb. Rhas'. cum opio, ʒii. fiat collyrium. Or, ℞. decoct. foenug. ℥ iii mucag. sem. lini, ℥ two. sacchar. cand.. ʒi. croci, ℈ i. fiat collyr. ℞. thuris, myrrh. an. ℈ two. tut. prepar. & antimon. let. an. ʒii. cum succo chelidon. fiat collyrium in umbra siccand. ℞. fellis perdic. aut lepor. ʒss. succi foenicul. ʒi. sacchar. cand.. ʒii. syrup. ros. excipiantur, fiat collyrium. We use collyria in wounds, ulcers, fistulas, suffusions, inflammations, and other diseases of the eyes. CHAP. XXXV. Of Errhines and Sternutatories. ERrhines are medicines appointed to be put into the nose to purge the brain of its excrementitious humours by the nostrils, or to deterge What an errhine is. such excrements as are therein, by reason of an ozana, polypus, or the like disease. Errhines are either liquid or dry, or else hard, and of the Their differences. consistence of an emplaster. Liquid errhines, which usually are to purge the head, are made of the juices of herbs, as beets, coleworts, marjoram, pimpernel, hyssop or balm, or of their decoctions taken alone, or mixed with wine, or syrup, as oxymel scilliticum, syrup of hyssop, roses, or mell anthosatum: sometimes powders are mixed with these liquors, as of pepper, euphorbium, pellitory of Spain, horehound, nigella romana, castoreum, myrrh, white ellebore, showbread, and other like, in a small quantity, to wit, to ʒi. little more or less according to the vehemency of the disease. We will make this more plain by examples. ℞. succi betae, majoran, brassic. an. ℥ i. depurentur, & modice bulliant cum vini albi, The form of one. ℥ two. oxymelit. scillit. ℥ ss. fiat errhinum. When as you desire to attract more powerfully from the brain, you may dissolve in errhines some purging medicines, as agaric, diaph oenicon, senna, carthamus, and the like: hence doth arise the distinction of errhines into such as are meet to purge phlegm, choler, and melancholy. This following example is set down by Rondeletius. ℞. rad. pyreth. irid. an. ʒi. puleg. calam. origon. an. mi. agar. trochisc. ʒiii. flor. anthos & staechad. an. pi. fiat decoctjoin An errhine purging phlegm. colatur. lb i. dissolve mellis anthosatis & scillit. an. ʒiii. fiat caputpurgium. But it is better to this purpose to make use of purging simples, as agaric, turbeth, coloquintida, and the like, than of compositions, as diaphaenicon, for these make the decoction more thick, and less fit to enter the passages of the nostrils, and the sievelike bones, but apt rather there to cause obstruction, and intercept the freedom of respiration. ℞. succi betae, ʒi. aq. salv. & beton. an. ʒiiss. pull. castor. ℈ ss. piper. & pyreth. an. An errhine with powders. ℈ i. fiat caputpurgium. Dry errhines that are termed sternutatories, for that they cause sneesing, are made of powders only, to which purpose the last mentioned things are used; as also aromatic things in a small quantity, as to ʒii. at the most: as, ℞. major. nigel. caryoph. zinzib. an. ℈ i. acor. pyreth. & panis porcin. an. ℈ ss. euphorb. A Rernutatory. ℈ i. terantur diligenter, & in nares mittantur, aut insufflentur. Errhines of the consistence of emplasters, by the Latins vulgarly called Nasalia, are made of the described powders or gums dissolved in the juice of some of the forementioned herbs, incorporated with turpentine and wax, that so they may the better be made into a pyramidal form to be put into the nostrils. As, ℞. majoran. salv. nigel. ℈ two. pip. The matter of solid errhines. alb. caryoph. galang. an. ℈ i. pyreth. euphorb. an. ℈ ss. panis porcin. ellebor. alb. an. ℈ i. terantur, & in pulverem redigantur. And then with turpentine and wax as much as shall be sufficient, make them up into Nasalia of a pyramidal or taper fashion. We Their use. use errhines in inveterate diseases of the brain, as the epilepsy, fear of blindnsse, an apoplexy, lethargy, convulsion, the lost sense of smelling: yet we first use general remedies and evacuations, lest by sneesing and the like concussion of the brain for the exclusion of that which is offensive thereto, there should be made a greater attraction of impurity from the subjacent parts. Liquid things must be drawn The manner of using them. up into the nostrils warm out of the palm of the hand, to the quantity of ℥ ss. the mouth being in the interim filled with water, lest the attracted liquor should fall upon the palate, and so upon the lungs: dry errhines are to be blown into the nose with a pipe or quill: solid ones must be fastened to a thread, that they may be drawn forth as need requires, when as they are put up into the nostrils. The morning (the belly being empty) is the fittest time for the use of errhines. If by their use the nose shall be troubled with an itching, the pain thereof must be mitigated with woman's milk, or oil of violets. The use of attractive errhines is hurtful to such as are troubled To whom they are hurtful. with diseases of the eyes, or ulcers in the nose, as it oft times falls out in the Lues venerea: wherefore in this case it will be best to use Apophlegmatismes, which may divert the matter from the nose. CHAP. XXXVI. Of Apophlegmatismes, or Masticatories. APophlegmatismoi in Greek, and Masticatoria in Latin, are medicines What an apophlegmatism is. which kept or held in the mouth and somewhat chawed, do draw by the mouth forth of the brain excrementitious humours, especially phlegm: now they are chiefly made four manner of ways; the first is The differences when as the medicines are received in honey or wax, and form into pills, and so given to chaw upon. The second is when as the same things are bound up in a fine linen cloth, so to be held in the mouth. The third is when as a decoction of acride medicines is kept in the mouth for a pretty space. The fourth is when as some acride medicine, or otherwise drawing phlegm, as pellitory of Spain, mastic, and the like, is taken of itself to the quantity of a hazel nut, and so chawed in the mouth for some space. The matter of masticatories is of the kind of acrid medicines, as of pepper, mustard, hyssop, ginger, pellitory of Spain, and the like; amongst which you must make choice chiefly of such as are not trouble some by any ingrate taste, that so they may be the longer kept in the mouth with the less offence & loathing. Yet masticatories are sometimes made of harsh or acerbe medicines, as of berberies, the stones of prunes or cherries, which held for some space in the mouth, draw no less store of phlegm than acrid things; for the very motion and rolling them up and down the mouth attracts, because it heats, compresses, & expresses: the quantity of the medicine ought to be from ℥ ss. to ℥ iss.: as, ℞. pyreth. staphisag. an. ʒiss. mastic. ʒss. pulverentur & involventur nodulis in masticatoria. Or, ℞. zinzib. sinap. an. ʒi. euphorb. ℈ two. piper. ʒss. excipiantur melle, & fiant pastilli pro masticatoriis. ℞. byssop. thym. origan. salv. an. pi. bolie them in water to wash the mouth withal. Or, ℞. zinzib. caryoph. an. ʒi. pyreth. pip. an. ʒss. staphisagr. ʒii. mastiches, ℥ ss. excipiantur, fiant pastilli pro masticatoriis. We use masticatories in old The use of masticatories. diseases of the brain, dimness of the sight, deafness, pustles of the head and face, and sometimes to divert the excrements which run to the nose being ulcerated. Masticatories are very hurtful to such as have their mouths or throats ulcerated, To whom hurtful. as also to them whose lungs are subject to inflammations, destillations and ulcers; for than errhines are more profitable to derive the matter of the disease by the nostrils. For though the humour drawn from the brain into the mouth by the means of the masticatory, may be thence cast forth by coughing and spitting, yet in the interim nature will be so enured to that passage for the humour, so that it will run that way when as we sleep, and fall down upon the parts thereunder, weak either by nature or by accident. The time fittest for the use of Apophlegmatismes is the morning, the body being first purged: if any ingrateful taste remain in the mouth, or adhere to the tongue by using of masticatories, you shall take it away by washing the mouth with warm water, or a decoction of liquorice and barley. CHAP. XXXVII. Of Gargarisms. A Gargoyle or gargarism is a liquid composition fit for to wash the mouth and all the parts thereof, to hinder defluxion and inflammation, What a gargoyle is. to heal the ulcers which are in those parts, to assuage pain. Their composition is twofold, the first is of a decoction of roots, leaves, flowers, fruits, and seeds fit for the disease; now The differences thereof. the decoction is to be made either in fair water alone, or with the admixture of white or red wine, or in the decoction of liquorice and barley, or of pectoral things, as the intention of the Physician is to repel, cool, or hinder inflammation, as in the toothache caused by matter which is yet in motion; to discuss, as in the toothache already at the height; or to cleanse, as in the ulcers of the mouth; or to dry and bind, as when it is fit to heal the ulcers already cleansed. The other way of making of gargarisms is without decoction, which is, when as we make them either of distilled waters only, or by mixing them with syrupes, Their matter. mucilages, milk, the whey of Goat's milk carefully strained. There are mixed sometimes with a decoction, distilled waters and mucilages, melrosatum, oxymel simplex, diamoron, dianucum, hire a picra, oxysacchara, syrup. de rosis siccis, syrupus acetosus, and other things, as the present case shall seem to require, as alum, balaustia, myrrh, olibanum, ginger, pepper, cinnamon, dry roses, and many such things, even so that oft times there enter into gargles such medicines as have force to draw from the brain, as pellitory of Spain, carthamus, turbith, and such things as have no bitterness, which is the cause that neither agrick nor coloquintida ought to enter into gargarisms. The quantity of liquor for a gargarism is commonly from lb ss. to lb i. mix therewith some ℥ two. of syrupes, but put in powders sparingly, as some ʒ three Alum may sometimes be put in to ʒ vi. let mucilages be extracted out of ʒ two. of seeds: let these serve for some examples. ℞. plant. polygon. oxalidis, an. m i. rosar. rub. p ss. hordei, p i. fiat decoctio ad ℥ viii. An astringent gargoyle. An anodine gargoyle. in qua dissolve syrupi myrtillorum, ʒ vi. dianucum, ℥ ss. fiat gargarisma. Or, ℞. cham. melil. aneth. an. p i. ros. rub. p ss. passul. mund. & ficuum, an. p iii decoquantur in aequis partibus vini & aquae, ad ℥ vi. addendo mucag. sem. lini, & foenugr. an. ℥ two. fiat gargarisma. Or else, ℞. aq. plantag. ligust. absinth. an ℥ two. mellis rosati colati, ʒ vi. syrupi rosar. siccar. & de absinth. an. ʒ vi. fiat gargarisma. A detersive. We use gargles in the morning fasting after general purgations; they are sometimes taken or used cold, when as a malign, acride, and thin humour falls down, sometimes warm, but let these things be done according as the Physician shall advise. CHAP. XXXVIII. Of Dentifrices. DEntifrices are medicines prepared and serving divers ways for to cleanse, whiten, and fasten the teeth; for from their use they take What a dentifrice is. their name. Of these some are dry, othersome moist: of the dry The differences some have the form of opiates, others of powders grossly beaten, but the moist are commonly made by distillation: the matter of dry The matter whereof they consist. dentifrices is taken from detergent and drying things, such as are coral white and red, harts-horne, scuttle bones, alum, crystal, pumice, sal nitre, myrrh, frankincense, balaustia, acorns, all sorts of shells of fishes: all these are to be made into powder either by burning, or without it, for scuttle bones burned cast forth a stinking and unpleasant smell. To these for smell sake are added certain aromatic things, as cinnamon, cloves, nutmegs, and the like: such powders if mixed with some syrup, as oxymel scilliticum, or with mucilage of gum arabic and tragacanth, will become opiates, to be made into a pyramidal form of some finger's length, round or square, and sharp pointed, that dried they may serve for dentifrices. Sometimes emollient roots are boiled with salt or alum, that dried again they may be used for dentrifices: moist ones are made of drying herbs, distilled together with drying and astringent things. All the differences shall appear by the following examples. ℞. lapidis spong. pumicis, A powder for a Dentifricc. & cornu cervi ust. an. ʒ two. coral. rub. & crystal. an. ʒ i. alum. & sal. ust. an. ʒ i ss. cinnamon. & caryoph. rosar. rub. pulver. an. ℈ two. fiat pulvis pro dentifricio. Or, rum. ossis saepia, ʒ ss. masticbes, coralli rubri usti, an. ʒ two. cornu cervi usti, ʒ i ss. aluminis, carbonis, rorismarini, an. ʒ i cinamomis, ʒ two. fiat pulvis pro dentifricio. Or, rum. ossis saepiae, alum. & salis usti, an. ʒ i crystalli, glandium, myrrhae, thuris, an. ℈ two. corticis granatorum, macis, cinamomi, an. ℈ i. fiat pulvis qui excipiatur mucagine gummi tragacanth. & formentur pyramides longae, siccand. pro dentifricio. Or, ℞. rad. malvae junioris, & bismalvae, an. ℥ two. coquantur in aqua salsa aut aluminosa, deinde siccentur in furno pro dentifricio. ℞. salis, ℥ vi. alumin. ℥ iii thuris, mastiches, sang. dracon. an. ℥ ss. aquae ros. ℥ vi. distillentur in alembico vitreo pro dentifricio. Dentrifices are not only good to polish, cleanse, and strengthen the teeth; but Their us●… we also oft times use them for the toothache, the diseases of the mouth, and ulccrs of the gums. You may use them in the morning, before and after meat. The ancients, of lentisk wood made themselves toothpicks, and such devices to strengthen their loose teeth, which also at this day is in use with those of Languedock, with whom this wood is plentiful, so that it may be brought thence for the use of Noblemen and Gentlemen; myrrh may also serve for this same use, and any other astringent wood. Our people commonly use the stalks of fennel, yet have they no faculty to fasten the teeth, but their smell is grateful. CHAP. XXXIX. Of Bags or Quilts. Physicians term a bag or sacculus, the composition or mixture of Whata bag or quilt is. dry and powdered medicines put in a bag, therefore it is as it were a dry fomentation. Their differences are not drawn from any other Their differences. thing than from the variety of the parts whereto they are applied: such as are for the head must be made into the fashion of a cap, those which be for the whole ventricle must be made into the form of a cithern; those for the spleen, like to an ox's tongue: lastly, such as are for the liver, heart and other parts must be made according to the figure of those parts. Their matter is usually taken from whole seeds fried in a frying-pan, or made into powder; there are sometimes added roots, flowers, fruits, rinds, cordial powders, and other dry medicines, which may be easily brought into powder, and conduce to the grieved parts; the quantity is different according to the magnitude of the affected parts; In the books of practisers it is commonly found prescribed from ℥ iii to ℥ viss. sometimes flowers, and dry herbs are prescribed by handfuls and pugils: and here there is need of an artificial conjecture to conceive and appoint a fit quantity of powders: but let us give you some examples. rum. rosar. rub. p i. mastic. ℥ ss. coralli rub. ʒ iii sem. anisi, & faenic. an. ʒ two. nucis moschat. ʒ i summitat. absinth. & menth. an. m i. tritis omnibus, fiat sacculus consutus A quilt for the stomach. & compunctus pro ventriculo. ℞. furfuris macri, p i. milii, ℥ i. salis, ʒ two. rosar. rub. flor. rorismarini, staechados, caryoph. A cap for a cold head. an. m two. fol. beton. & salv. an. ʒ iii tritis omnibus fiat cucupha, intersuta & calefacta fumo thuris, & sandarachae exustorum, capiti apponatur. rum. flor. borag. buglos. & violar. an. p two. cortic. citri sicci, macis, ligni aloes, rasurae eboris, A quilt for the heart. an. ʒ i ossis de cord cervi, croci, an. ℈ two. fol. melis. m ss. pulveris diambrae, ʒ ss. contritis omnibus fiat sacculus è serico pro cord, irror andus aquascabiosae. We use bags for the strengthening of the noble parts, as the brain, heart, liver, Their use. as also for those less noble, as the stomach, spleen, breast; lastly for discussing flatulen eyes in what part soever, as in the colic, and in a bastard pleurisy proceeding from flatulencies. The powders must be strawed upon carded bombast, that they run not together, and then they must be sewed up or quilted in a bag of linen or taffeta. We often times moisten these bags in wine or distilled water, and sometimes not with the substance thereof, but by the vapour only of such liquors put into a hot dish: thus oft times the bags are heated by the vapour only, and oft times at the fire in a dish by often turning them. These, if intended for the heart, aught to be of crimson or scarlet silk, because the scarlet berry, called by the Arabians Kermes, is said to refresh and recreate the heart. Certainly they must always be made of some fine thing, whether it be linen or silk. CHAP. XL. Of Fumigations. A Suffitus or fumigation is an evaporation of medicines having some viscous and fatty moisture: of fumigations some What a fumigation is. are dry, othersome moist, the dry have the form of trochisces or pills: their matter ought to be fatty and viscous, so that it Their differences and matter. may send forth a smoke by being burnt: such are laudanum, myrrh, mastic, pitch, wax, rosine, turpentine, castoreum, styrax, frankincense, olibanum, and other gums, which may be mixed with convenient powders: for they yield them a body and firm consistence; the fumigations that are made of powders only, yield neither so strong nor long a fume. The quantity of the powders must be from ℥ ss. to ℥ i ss. but the gums to ℥ two. as, ℞. sandarachae, mastiches, rosar. an. ʒ i benjoini, galang. an. ʒ iii terebinthina excipiantur, A cephalic sum. & fiant trochisci, quibus incensis suffumigentur tegumenta capitis. rum. marcasitae, ℥ two. bdellii, myrrhae, styracis, an. ℥ i ss. cerae flavae, & terebinth. quod sufficit, fiant formulae pro suffumigio. rum. cinnabaris, ℥ two. styracis & benzolni, an. ℥ two. cumterebinth. fiant trochisci pro suffumigio per embotum. For the hardness of the sinews. We use fumigations in great obstructions of the brain, ulcers of the lungs, the asthma, an old cough, pains of the sides, womb, and the diseases of some other parts; sometimes the whole body is fumigated, as in the cure of the Lues venerea to For the relics of the Lues venerea. procure sweat; sometimes only some one part whereto some relics of the Lues adheres; such fumigations are made of cinnabaris, wherein there is much hydrargyrum. The manner of using them. The fume must be received by a funnel, that so it may not be dispersed, but may all be carried unto the part affected, as is usually done in the affects of the womb and ears. In fumigations for the brain and chest, the vapour would be received with open mouth; which thence may pass by the weazon into the chest, by the palate and nostrils into the brain: but in the interim let the head be vailed, that none of the vapour may fly away. Moist fumigations are made somewhiles of the decoction of herbs, otherwhiles of some one simple medicine boiled in oil, sometimes a hot firestone is quenched in vinegar, wine, aqua vitae, or the like liquor, so to raise a humid vapour. We oft times use this kind of fumigation in overcoming scirrhous affects, when as we would cut, discuss, penetrate deep, and dry: take this as an example thereof. ℞. laterem unum satis crassum, aut marchasitam ponderis lb i heat it red hot, and then The manner of a moist fumigation. let it be quenched in sharp vinegar, pouring thereon in the mean while a little aqua vitae, make a fumigation for the grieved part. Fumes of the decoction of herbs do very little differ from fomentations properly so called; for they differ not in the manner of their composure, but only in the application to the affected parts: therefore let this be an example of a humid fumigation. ℞. absinth. salv. rut. origan. an. pi. rad. bryon. & asar. an. ℥ ss. sem. sinap. & cumin. A moist fume for the ears. an. ʒ two. decoquantur in duabus partibus aquae, & una vini pro suffitu auris cum emboto: and oft times such fumigations are made for the whole body, whereof we shall treat hereafter. CHAP. XLI. Of a particular, or halfe-Bath. ASemicupium or halfe-bath is a bath for the one half of the body, What an ins●… is. that is, for the parts from the belly downwards; it is called also an insessiv, because the patient sitteth to bathe in the decoction of herbs: in which form and respect a semicupium differs from a fomentation; for it is composed of the same matter, to wit, a decoction The matter. of herbs, roots, seeds, fruits, but in this the quantity of the decoction is the greater, as we shall teach by the following example. ℞. malu. bismalv. cum toto, an. mi ss. beton. saxifrag. pariet. an. m i. sem. melon. milii A half bath for the stone in the kidneys. solis, alkekengi, an. ʒiii. citer. rub. p two. rad. apii, graminis, foeniculi, eryngii, an. ʒi. decoquantur insufficienti quantitate aquae pro insessu. We use these halfe-baths in affects of the kidneys, bladder, womb, fundament, The use. and lower belly, or otherwise when as the patient by reason of weakness and fear of dissipating the spirits, cannot suffer or away with a whole bath. The manner of The manner of using it. using it is thus; fill some bags with the boiled herbs, or other parts of plants, and cause the patient to sit upon them; yet in the interim keep the vapours from the head, lest they should offend it, by casting over it a linen cloth, or else let him not enter thereinto until the vapour be exhaled. CHAP. XLII. Of Baths. Baths are nothing else than as it were a fomentation of the whole body, both for preserving health, and the cure of diseases: this is a very commodious form of medicine, and among other external medicines much celebrated by the Greek, Arabian, and Latin Physicians. For a bath, besides that it digests the acrid humours, and sooty excrements lying under The faculties of Baths. the skin, mitigates pains and weariness, and corrects all excess of distemper: moreover, in the cure of fevers, and many other contumacious and inveterate diseases it is the chief and last remedy, and as it were the refuge of health, stored with pleasing delight. Baths are of two sorts, some natural, others artificial: natural, are those which of their own accord, without the operation or help of art, prevail Their differences. Natural Baths. or excel in any medicinal quality. For the water which of itself is devoide of all quality that is perceivable by the taste, if it chance to be strained through the veins of metals, it furnishes and impregnates itself with their qualities and effects: hence it is that all such water excels in a drying faculty, sometimes with cooling and astriction, and otherwhiles with heat and a discussing quality. The baths whose waters being hot or warm, do boil up, take their heat from the cavities of the earth and mines filled with fire; which thing is of much admiration whence this fire should arise in subterrene places, what may kindle it, what feed or nourish it for so many years, and keep it from being extinct. Some Philosophers would have it kindled by the beams of the sun, others by the force of lightnings penetrating the bowels of the earth, others by the violence of the air vehemently or violently agitated, no otherwise than fire is struck by the collision of a flint and steel. Yet it is better to refer the cause of so great an effect unto God the maker of the Universe, whose providence piercing every way into all parts of the World, enters and governs the secret parts and passages thereof. Notwithstanding they seem to have come nearest the truth, who refer the cause of heat in waters unto the store of brimstone contained in certain places of the earth, because amongst all minerals it hath most fire and matter fittest for the nourishing thereof. Therefore to it they attribute the flames of fire which the Sicilian mountain Aetna continually sends forth. Hence also it is that the most part of such waters smell of Sulphur, yet others smell of Alom, others of nitre, others of Tar, and some of Coprosse. Now you may know from the admixture of what metalline bodies the waters acquire their faculties by their taste, sent, colour, mud, which adheres to the How to know whence the Baths have their efficacy. channels through which the water runs, as also by an artificial separation of the more terrestrial parts from the more subtle. For the earthy dross which subsides or remains by the boiling of such waters, will retain the faculties and substance of Brimstone, Alum, and the like minerals: besides also, by the effects and the cure of these or these diseases you may also gather of what nature they are. Wherefore we will describe each of these kinds of waters by their effects, beginning first with the sulphureous. Sulphureous waters powerfully heat, dry, resolve, open, and draw from the centre The condition of natural sulphureous waters. unto the surface of the body; they cleanse the skin troubled with scabs & tetters; they cease the itching of ulcers, and digest & exhaust the causes of the gout, they help pains of the colic and hardened spleens. But they are not good to be drunk, not only by reason of their ungrateful smell and taste, but also by reason of the maliciousness of their substance, offensive to the inner parts of the body, but chiefly to the liver. Aluminous waters taste very astrictively, therefore they dry powerfully, they have no such manifest heat, yet drunk, they lose the belly: I believe by reason of Of aluminous waters. their heat and nitrous quality they cleanse and stay defluxions, and the courses flowing too immoderately; they also are good against the toothache, eating ulcers, and the hidden abscesses of the other parts of the mouth. Salt and nitrous waters show themselves sufficiently by their heat: they heat, dry, Of salt and nitious. bind, cleanse, discuss, attenuate, resist putrefaction, take away the blackness coming of bruises, heal scabby and malign ulcers, and help all oedematous tumours. Bituminous waters heat, digest, and by long continuance soften the hardened sinews; O● bituminous. they are different according to the various conditions of the bitumen that they wash, and partake of the qualities thereof. Brazen waters, that is, such as retain the qualities of brass, heat, dry, cleanse, Of brazen. digest, cut, bind, are good against eating ulcers, fistulas, the hardness of the eyelids, and they waste and eat away the fleshy excrescences of the nose and fundament. Iron waters cool, dry, and bind powerfully, therefore they help abscesses, Of iron. hardened milts, the weaknesses of the stomach and ventricle, the unvoluntary shedding of the urine, and the too much flowing terms, as also the hot distemper of the liver and kidneys. Some such are in the Lucan territory in Italy. Leaden waters refrigerate, dry, and perform such other operations as lead doth: Of leaden. the like may be said of those waters that flow by chalk, plaster, and other such minerals, as which all of them take and perform the qualities of the bodies by which they pass. Hot waters or baths help cold and moist diseases, as the Palsic, convulsion, the Of hot baths. stiffness and attraction of the nerves, trembling palpitations, cold distillations upon the joints, the inflation of the members by a dropsy, the jaundice by obstruction of a gross, tough, and cold humour, the pains of the sides, colic, and kidneys, barrenness in women, the suppression of their courses, the suffocation of the womb, causeless weariness, those diseases that spoil the skin, as tetters, the leprosy of both sorts, the scab, and other diseases arising from a gross, cold and obstructing humour, for they provoke sweats. Yet such must shun them as are of a choleric nature, and have a hot liver, for To whom hurtful. The faculties of cold baths. they would cause a cachexia and dropsy by overheating the liver. Cold waters or baths heal the hot distemper of the whole body & each of the parts thereof, and they are more frequently taken inwardly than applied outwardly; they help the laxnesse of the bowels, as the resolution of the retentive faculty of the stomach, entralls, kidneys, bladder, and they also add strength to them. Wherefore they both temper the heat of the liver, and also strengthen it, they stay the Diarrhaea, Dysentery, Courses, unvoluntary shedding of urine, the Gonnorrhaea, Sweats, and Bleeding. In The Spa▪ this kind are chiefly commendable the waters of the Spa in the country of Liege, which inwardly and outwardly have almost the same faculty, and bring much benefit without any inconvenience, as those that are commonly used in the drinks and broths of the inhabitants. In imitation of natural baths, there may in want of them be made artificial ones, Of artificial baths. by the infusing and mixing the powders of the formerly described minerals; as, Brimstone, Alum, Nitre, Bitumen: also you may many times quench in common or rain water, iron, brass, silver and gold heated red hot, and so give them to be drunk by the patient, for such waters do oft times retain the qualities and faculties of the metals quenched in them, as you may perceive by the happy success of such as have used them against the Dysentery. Besides these there are also other baths made by art of simple water, sometimes The faculty of a bath of warm water. without the admixture of any other thing, but otherwhiles with medicinal things mixed therewith, and boiled therein. But after what manner soever these be made, they ought to be warm, for warm water humects, relaxes, mollifies the solid parts, if at any time they be too dry, hard, and tense; by the ascititious heat it opens the pores of the skin, digests, attracts, and discusses fuliginous and acrid excrements remaining between the flesh and the skin. It is good against sun-burning and weariness, whereby the similar parts are dried more than is fit. To conclude, whether we be too hot or cold, or too dry, or be nauseous, we find manifest profit by baths made of sweet or warm water, as those that may supply the defect of frictions and exercises: for they bring the body to a mediocrity of temper, they increase and strengthen the native colour, and by procuring sweat discuss flatulencies: therefore they are very useful in hectic fevers, and in the declension of all fevers, and against raving and talking idly, for they procure sleep. But because water alone cannot long Why w● put oil into baths. adhere to the body, let oil be mixed or put in them, which may hold in the water, and keep it longer to the skin. These baths are good against the inflammations of the lungs and sides, for they mitigate pain, and help forward that which is suppurated to exclusion, when as general remedies according to art have preceded, for otherwise they will cause a greater defluxion on the afflicted parts: for a bath (in Galens' opinion) is profitably used to diseases when as the morbific matter is concocted. To this purpose is chosen rain water, than river water, so that it be not muddy, and then fountain water; the water of standing lakes and fens is not approved of, for it is fit that the water which is made choice of for a bath of sweet water, should be light and of subtle parts, for baths of waters which are more than moderately hot or cold yield no such commodity; but verily they hurt in this, that they shut up or close the pores of the body, and keep in the fuliginous excrements under the skin; other baths of sweet or fresh water consist of the same matter as fomentations do, whence it is that some of them relax, others mitigate pain, others cleanse, and othersome procure the courses, that is compounded of a decoction of ingredients or plants having such operations. To these there is sometimes added wine, other whiles oil, sometimes fresh butter or milk, as when the urine is stopped, when nephriticke pains are violent, when the nerves are contracted, when the habit of the body wastes and wrinkles with a hectic dryness, for this corrugation is amended by relaxing things, but it is watered, and as it were fatted by humecting things, which may penetrate & transfuse the oily or fatty humidity into the body thus rarified and opened by the warmness of a bath. Anodine baths are made of a decoction of medicines of a middle nature, such as are temperate and relaxing things, with which we may also sometimes mix resolving things; they are boiled in water and wine, especially in pains of the colic proceeding from vitreous phlegm, or gross and thick flatulencies contained or shut up in the belly, kidneys, or womb. In such baths it is not fit to sweat, but Why we must not continue in the bath till we sweat. only to sit in them so long until the bitterness of the pain be assuaged or mitigated, lest the powers weakened by pain, should be more resolved by the breaking forth of sweat: emollients are sometimes mixed with gentle detergents, when as the skin is rough and cold, or when the scailes or crust of scabs is more hard than usual, then in conclusion we must come to strong detersives and driers, lastly to drying and somewhat astrictive medicines, so to strengthen the skin, that it may not yield itself so easy and open to receive defluxions. By giving you one example the whole manner of prescribing a bath may appear. ℞. rad. lilior. albor. bismalv. an. lb two. malu. pariet. violar. an. m ss. sem. lini, foenug. A mollifying & anodine bath. bismalv. an. lb i. flor. cham. mclil. aneth. an. p vi. fiat decoctio in sufficienti aquae quantitate, cui permiscito olei liliorum & lini, ana, lb two. fiat balneum in quo diutius natet aeger. Baths though noble remedies approved by use and reason, yet unless they be fitly and discreetly used in time, plenty, and quality, they do much harm; for they Cautions to be observed in the use of baths. cause shake and chillness, pains, density of the skin, or too much rarefaction thereof, and oft times a resolution of all the faculties. Wherefore a man must be mindful of these cautions before he enter a bath: first, that there be no weakness of any noble and principal bowel, for the weak parts easily receive the humours which the bath hath diffused and rarified, the ways lying open which tend from the whole body to the principal parts. Neither must there be any plenty of crude humours in the first region, for so they should be attracted and diffused over all the body: therefore it is not only sit that general purgations should precede, but also particular by the belly and urine: besides, the patient should be strong that can fasting endure a bath as long as it is needful. Lastly, the bath ought to be in a warm and silent place, lest any cold air by its blowing, or the water by its cold appulse, cause a shivering or shaking of the body, whence a fever may ensue. The morning is a fit time for bathing, the stomach being fasting and empty, or six hours after meat, if it be requisite that the patient should bathe twice a day, otherwise The fittest time for bathing. the meat yet crude would be snatched by the heat of the bath out of the stomach into the veins and habit of the body. Many, of all the seasons of the year make choice of the spring and end of summer, and in these times they choose a clear day, neither troubled with stormy winds, nor too sharp an air. As long as the patient is in the bath, it is fit that he take no meat, unless peradventure to comfort him he take a little bread moistened in wine, or the juice of an orange, or some damask prunes to quench his thirst: his strength will show how long it is fit that he should stay in, for he must not stay there to the resolution of his powers, for in baths the humid and spirituous substance is much dissipated. Coming forth of the bath, How to order the patient coming forth of the bath. they must presently get them to bed, and be well covered, that by sweeting, the excrements, drawn unto the skin by the heat of the bath, may break out: the sweat cleansed, let him use gentle frictions, or walking, then let him feed upon meat of good juice and easy digestion, by reason that the stomach cannot but be weakened in some sort by the bath. That quantity of meat is judged moderate, the weight whereof shall not oppress the stomach: venery after bathing must not be used, because to the resolution of the spirits by the bath, it adds another new cause of further spending or dissipating them. Some wish those that use the bath by reason of some contraction, pain, or other affects of the nerves, presently after bathing, to daub or besmear the affected nervous parts with the clay or mud of the bathe, that by making it up as it were in this paste, the virtue of the bath may work more effectually, and may more throughly enter into the affected part. These cautions being diligently observed, there is no doubt but the profit by baths will be great & wonderful: the same things are to be observed in the use of Stoves or Hothouses, for the use and effect of baths and hothouses is almost the same, which the ancients therefore used by turn, so that coming forth of the bath they entered a stove, and called it also by the name of a bath, as you may gather from sundry places of Galen in his Methodus med. wherefore I think it fit in the next to speak of them. CHAP. XLIII. Of Stoves or Hothouses. SToves are either dry or moist: Dry, by raising a hot and dry aery The differences of Stoves. exhalation, so to imprint their faculties in the body, that it thereby waxeth hot, and the pores being opened, runs down with sweat. There are sundry ways to raise such an exhalation: at Paris, and How made. wheresoever there are stoves or public hothouses, they are raised by a clear fire put under a vaulted furnace, whence it being presently diffused, heats the whole room. Yet every one may make himself such a stove as he shall judge best and fittest. Also you may put red hot cogle stones or bricks into a tub, having first laid the bottom thereof with bricks or iron plates, and so set a seat in the midst thereof; wherein the patient sitting, well covered with a canopy drawn over him, may receive the exhalation arising from the stones that are about him, & so have the benefit sweeting: but in this case we must oft look to and see the patient, for it sometimes happens that some, neglected by their keepers otherwise employed, becoming faint, and their sense failing them by the dissipation of their sptrits by the force of the hot exhalation, have sunk down with all their bodies upon the stones lying under them, and so have been carried half dead and burnt into their beds. Some also take the benefit of sweeting in a furnace or oven, as soon as bread is drawn out thereof. But I do not much approve of this kind of sweeting, because the patient cannot as he will, much less as he pleaseth, lie or turn himself therein. Humid stoves or sudatories are those wherein sweat is caused by a vapour or moist heat: this vapour must be raised from a decoction of roots, leaves, flowers, and seeds, A vaporous stove or bath. which are thought fit for this purpose; the decoction is to be made in water or wine, or both together. Therefore let them all be put into a great vessel well luted, from the top of whose cover iron or tin pipes may come into the bathing tub standing near thereto, between the two bottoms thereof, by means whereof the hot vapour may enter thereinto, and diffuse itself therein. Now it is fit the bathing tub should be furnished with a double bottom, the one below and whole, the other somewhat higher and perforated with many holes, whereupon the patient sitting may receive a sudorificke vapour over all his body: now this vapour, if at any time it become too hot, must be tempered by opening the hole, which must for the same purpose be made in the top of the pipe, that so it may be opened and shut at pleasure. In the interim the tub shall be closely covered wherein the patient sits, he putting forth only his head, that so he may draw in the cool air. In defect of such pipes, the herbs shall be boiled by themselves in a caldron or kettle, and this shall be set thus hot into the bathing tub at the patient's feet, and so by casting into it heated stones, a great and sudorificke vapour shall be raised. The delineation of a bathing Tub, having a double bottom, with a vessel near thereto, with pipes coming therefrom, and entering between the two bottoms of the Tub. CHAP. XLIV. Of Fuci, that is, washes, and such things for the smoothing and beautifying of the skin. THis following discourse is not intended for those women which addicted to filthy lust, seek to beautify their faces, as baits and allurements to filthy pleasures: but it is intended for those only, which the better to restrain the wand'ring lusts of their husbands, may endeavour by art to take away those spots and deformities which have happened to fall on their faces either by accident or age. The colour that appears in the face, either laudable or illaudible, abundantly As the colour of the skin is, such is the humour that is thereunder. shows the temper both of the body, as also of those humours that have the chief dominion therein: for every humour dies the skin of the whole body, but chiefly of the face, with the colour thereof: for choler bearing sway in the body, the face looks yellowish; phlegm ruling, it looks whitish or pale; if melancholy exceed, then blackish or swart; but if blood have the dominion, the colour is fresh and red. Yet there are other things happening externally which change the native colour of the face, as sun burning, cold, pleasure, sorrow, fear, watching, fasting, pain, old diseases, the corruption of meats and drinks: for the flourishing colour of the cheeks is not only extinguished by the too immoderate use of vinegar, but by the drinking of corrupt waters the face becomes swollen and pale. On the contrary, laudable meats and drinks make the body to be well coloured and comely, for that they yield good juice, and consequently a good habit. Therefore if the spots of the face proceed from the plenitude and ill disposition of humours, the body shall be evacuated by blood-letting: if from the infirmity of any principal bowel, that must first of all be strengthened; but the care of all these things belongs to the Physician: we here only seek after particular remedies which may smooth the face, and take away the spots, and other defects thereof, and give it a laudable colour. First the face shall be washed with the water of lily flowers, of bean flowers, water Waters wherewith to wash the face. lilies, of distilled milk, or else with the water wherein some barley or starch hath been steeped. The dried face shall be anointed with the ointments presently to be described; for such washing cleanseth and prepareth the face to receive the force of the ointments, no otherwise than an alumed lie prepares the hairs to drink up and retain the colour that we desire. Therefore the face being thus cleansed and prepared, you may use the following medicines, as those that have a faculty to beautify, extend, and smooth the skin: as, ℞. gum. tragacanth. conquass. ʒ two. distemperentur in vase vitrio cum lb two. aquae communis, Compound liquors wherewith to wash the face. Virgin's 〈◊〉 sic gummi dissolventur, inde albescet aqua. Or else, ℞. lethargy auri, ℥ two. cerus. & salis come. an. ℥ ss. aceti, aquae plantag. an. ℥ two. caphur. ʒ ss. macerentur lithargyros & cerusa in aceto seor sim per tres aut quatuor hor as, sal vero & camphora in aqua qua● instituto tuo aptam delegeris: then filter them both several, and mix them together being so filtered, when as you would use them. ℞. lactis vaccini, lb two. aranciorum & limon. an. nu. iv. sacchari albissimi, & alum. roch. an. ℥ i. distillentur omnia simul: let the lemons and oranges be cut into slices, and then be infused in milk, adding thereto the sugar and alum; then let the mall be distilled together in balneo Mariae; the water that comes thereof will make the face smooth and lovely. Therefore about bed time it will be good to cover the face with linen clothes dipped therein. A water also distilled of snails gathered in a vine-yard, juice of lemons, the flowers of white mullaine, mixed together in equal proportion, with a like quantity of the liquor contained in the bladders of elm leaves, is very good for the same purpose. Also this, ℞. mica panis albi, lb iv. flor. fabar. rosar. alb. flor. naenuph. lilior. & ireos, an. lb two. lactis vaccini, lb vi. ova. nu. viii. aceti oped. lb i distillentur omnia simul in alembico vitreo, & fiat aqua ad faciei & manuum lotionem. Or, ℞. olci de tartaro, ℥ iii mucag. sem. psilii, ℥ i. cerus. in oleo ros. dissolute. ℥ i ss. borac. sal. gem. an. ʒ i fiat lintmentum pro fancy. Or. ℞. caponem vivum, & caseum ex lacte caprino recenter confectum, limon. nu. iv. ovor. nu. vi. cerus. lot. in aq. rosar. ℥ two. boraces, ℥ i ss. camph. ʒ two. aq. flor. fabar. lb iv. fiat omnium infusio per xxiv. horas, postea distillentur in alembico vitreo. There is a most excellent fucus made of the marrow of sheep's bones, which The marrow of sheep's bones good to smooth the face. smooths the roughness of the skin, beautifies the face; now it must be thus extracted. Take the bones, severed from the flesh by boiling, beat them, and so boil them in water, when they are well boiled, take them from the fire, and when the water is cold, gather the fat that swims upon it, and therewith anoint your face when as you go to bed, and wash it in the morning with the formerly prescribed water. ℞. salis ceruse. ʒ two. ung. citrin. vel spermat. ceti, ℥ i. malaxentur simul, & fiat linimentum, How to mak● Salcerussae. addendo olci ovor. ʒ two. The Sal cerussae is thus made, grind Ceruse into very fine powder, and infuse lb i. thereof in a pottle of distilled vinegar for four or five days, than filter it, then set that you have filtered in a glazed earthen vessel over a gentle fire until it concrete into salt, just as you do the capitellum in making of Cauteries. ℞. excrementi lacert. ossis saepiae, tartari, vini albi, rasur. corn. cerv. farin. oriz. an. parts aequales, fiat pulvis, infundatur in aqua distillata amygdalarum dulcium, limacum vinealium, flor. nenuph. huic addito mellis albi par pondus: let them be all incorporated in a marble mortar, and kept in a glass or silver vessel, and at night anoint the face herewith; it wonderfully prevails against the redness of the face, if after the anointing it you shall cover the face with a linen clothe moistened in the formerly described water. ℞. sublim. ʒ i. argent. viv. saliv. extinct. ʒ two. margarit. non perforat. ʒ i. caph. ʒ i ss. incorporentur simul in mortario marmoreo, cum pistillo ligneo, per tres horas ducantur & fricentur, reducanturque in tenuissimum pulverem, confectus pulvis abluatur aqua myrti & desiccetur, serveturque ad usum, add foliorum auri & argenti, nu. x. When as you would use this powder, put into the palm of your hand a little oil of mastic, or of sweet almonds, then presently in that oil dissolve a little of the described powder, and so work it into an ointment, wherewith let the face be anointed at bedtime: but it is fit first to wash the face with the formerly described waters, and again in the morning when you rise. When the face is freed from wrinkles and spots, then may you paint the cheeks How to paint the face. with a rosy and flourishing colour; for of the commixture of white and red ariseth a native and beautiful colour: for this purpose take as much as you shall think fit of brasil, and alchunet; steep them in alum water, and there with touch the cheeks and lips, and so suffer it to dry in: there is also spanish red made for this purpose; others rub the mentioned parts with a sheep's skin died red: moreover the friction that is made by the hand only, a pleasing redness in the face, by drawing thither the blood and spirits. CHAP. XLV. Of the Gutta Rosacea, or a fiery face. THis treatise of Fuci puts me in mind to say something in this place of helping the preternatural redness which possesseth the nose and cheeks, and oft times all the face besides, one while with a tumour, other while without, sometimes with pustles and scabs, by reason of the admixtion of a nitrous and adust humour. Practitioners have termed it Gutta rosacea. This shows Why worse in winter than in summer. both more and more ugly in winter than in summer, because the cold closeth the pores of the skin, so that the matter contained thereunder is penned up for want of transpiration, whence it becomes acrid and biting, so that as it were boiling up, it lifts or raiseth the skin into pustles and scabs; it is a contumacious disease, and oft times not to be helped by medicine. For the general method of curing this disease, it is fit that the patient abstain from wine, and from all things in general that by their heat inflame the blood, and Di●●. diffuse it by their vaporous substance: he shall shun hot and very cold places, and shall procure that his belly may be soluble, either by nature or art. Let blood first be drawn out of the basilica, then from the vena front is, and lastly from the vein of the nose. Let leeches be applied to sundry places of the face, and cupping glasses with scarification to the shoulders. For particular or proper remedies, if the disease be inveterate, the hardness shall Remedies. first be softened with emollient things, then assaulted with the following ointments, which shall be used or changed by the Chirurgeon as the Physician shall think fit. ℞. succi citri, ℥ iii cerus. quantum sufficit ad eum inspissandum, argenti vivi cum saliva & sulphur vivo extincti, ʒ ss. incorporentur simul, & fiat unguentum. An approved ointment. ℞. boraces, ʒ two. farin. cicer. & fabar. an. ʒ i ss. caph. ʒ i cum melle & succo cepae fiant trochisci: when you would use them, dissolve them in rose and plantain water, and spread them upon linen clothes, and so apply them on the night time to the affected parts, and so let them be oft times renewed. ℞. unguenti citrini recenter dispensatis, ℥ two. sulphuris vivi, ℥ ss. cum modico olei scm. cucurb. & succi limonum, fiat unguentum; with this let the face be anointed when you go to bed, in the morning let it be washed away with rose water, being white by reason of bran infused therein: moreover, sharp vinegar boiled with bran and rose water, and applied as before, powerfully takes away the redness of the face. ℞. cerus. & litharg. auri, sulphur is vivi pulverisatis, an. ℥ ss. ponantur in phiala cum aceto & aquarosarum: linen clothes dipped herein shall be applied to the face on the night, and it shall be washed in the morning with the water of the infusion of bran: this kind of medicine shall be continued for a month. ℞. sanguinis tauri, lb i butyri recentis, lb ss. fiat distillatio, utatur. The liquor which is distilled for the first days is troubled and stinking, but these passed, it becometh clear and well smelling. Some boil bran in vinegar and the water of water lilies, and in this decoction they dissolve of sulphur and camphire a fit proportion to the quantity of the decoction, and they apply clothes moistened in this medicine to the face in the evening. ℞. album. ovor. nu. two. aquae ros. ℥ i ss. succi plantag. & lapath. acut. an. ℥ i ss. sublimati, To dry up the pustles. ℈ i. incorporentur in mortario marmoreo. ℞. axung. porcidecies in aceto lota, ℥ iv. argenti vivi, ℥ i. aluminis, sulphuris vivi, an. ʒ i pistentur omnia diu in mortario plumbeo, & fiat unguentum; argentum vivum non debet nisi extremo loco affundi. ℞. rad. lapath. acut. & asphodel. an. ℥ two. coquantur in aceto scillitico, postea tundantur, & setaceo trajiciantur, addendo auripigmenti, ʒ two. sulphuris vivi, ʒ x. let them be incorporated and make an ointment to be used to dry up the pustles. ℞. rad. liliorum sub cineribus coctorum, ℥ iv. pistillo tusis, & setaceo trajectis, add butyri recentis, & axung. porci, lotae in aceto, an. ℥ i. sulphuris vivi, ʒ iii camphor. ℈ iii succi limonum quantum sufficit, malaxentur simul & fiat unguentum. ℞. lactis virginalis, lb ss. aluminis, ℥ ss. sulphuris vivi, ℥ i. succi limonum, ℥ vi. salis come. ʒ ss. let them all be distilled in a glass alembicke, and the water kept for the forementioned uses. ℞. lapath. acut. plantagin. & asphodel. an. ℥ i ss. olei vitel. ovor. ℥ i. terebinth. venet. ℥ ss. succi limonum, ʒ iii aluminis combust. ʒ i argenti vivi extinct. ℥ i. olei liliorum, ℥ ss. tundantur omnia in mortario plumbeo, addendo sub finem argent. viv. ne mortario adhaerescat. The juice of onions beaten with salt, or the yolks of eggs are good for the same purpose. For staying and killing of Ringworms and Tetters, the leaves of hellebore beaten To kill tetters. with vinegar are good, the milk of the figtree is good of itself, as also that of the spurges, or mustard dissolved in strong vinegar with a little sulphur. Or, ℞. sulphuris, calcanthi, & aluminis, an. ʒ i macerentur in aceto forti, trajiciantur per linteum, apply the expressed juice. Others macerate an egg in sharp vinegar, with coporose and sulphur vivum beaten into fine powder, than they strain or press it through a linen cloth. But seeing the forementioned medicines are acride, and for the most part eating and corroding, it cannot be but that they must make the skin harsh and rough, therefore to smooth and levigate it again, you shall make use of the following ointment. ℞. tereb. ven. tam diu lotae, ut acrimoniam nullam habeat, butyri salis expertis, an. ℥ i ss. To smooth the skin. olei vitel. ovor. ℥ i. axung. porci in aqua rosarum lotae, ℥ ss. cerae parum, fiat linimentum ad usum. To the same purpose you may also make use of some of the forementioned medicines. CHAP. XLVI. To black the hair. AT first the hairs, (to take the fucus or tincture, and to retain it) must be prepared with Lie, wherein a little roche Alum is dissolved. Thus the fatty scales may be washed and taken away, which hinder, and (as it were) keep away the fucus, that it cannot adhere or penetrate into the body of the hair. Then must we come to particular or proper & fitting medicines for this purpose. These aught to be aromatic and cephalic, and somewhat styptic, that by their odoriferous and astringent power they may strengthen the animal What things are fit to die the hair. faculty: Furthermore, they must be of subtle parts, that they may enter even into the inner roots of the hairs. ℞. Sulphuris, vitrioli, gallarum, calcis vivae, lethargy, an. ʒii. scoriae ferri, ʒss. in pollinem reducantur, & cum aq. communi incorporentur, ut inde fiat massa: with this at bed time let the hairs be rubbed, and in the morning let them be smoothed with the same. ℞. calcis lotae, ℥ i. lethargy utriusque ℥ ss. cum decocto gallarum, corticum, nucum, fiat massa, addendo olei chamem. ʒ two. ℞. lytharg. auri, ℥ two. ciner. clavellat. ℥ i s8. calcis viv. ʒ i dissolve omnia cum urena hominis donec acquirant consistentiam unguenti pro unctione capillorum. ℞. calcis lotae, ℥ iv. lethargy utriusque an. ℥ two. cum decoct. salv. & cort. granat. fiat pasta ad formam pultis satis liquidae: let the hair at bed time be died herewith, and washed in the morning with wine and water. Now the manner of washing lime is thus: Infuse in ten or twelve pints of fair water one pound of lime, then pour out the water by stooping the vessel, putting How to wash Lime. more in the stead thereof; the third time in stead of common water power thereon the water of the decoction of sage and galls, let the lime lie therein for so many hours, then in like manner pour it off by stooping the vessel; and thus you shall have your lime well washed. There is also found a way how to die or black the hair by only pouring of some liquor thereon: as, ℞. argenti purissimi, ʒ two. reducantur in A water to black the hair. cumʒii. aquae separationis auri & argenti, & aquae rosar. ʒ vi. The preparing of this water is thus, put into a viol the water of separation and the silver, and set it upon hot coals so to dissolve the silver, which being done then take it from the fire, and when it is cold, add thereto the rose water. But if you would black it more deeply, add more silver thereto, if less, than a smaller quantity; to use it, you must steep the comb wherewith you comb your head in this water. ℞. plumbi usti, ℥ two. gallarum non perforat. cortic. nucum, an. ℥ iii terrae sigil. ferret. hispan. an. ℥ two. vitriol. rom. ℥ vi. salis gem. ℥ i ss. caryoph. nucis mosch. an. ℥ i. salis ammon. aloes, an. ʒ ss. fiat pulvis subtilissimus: let this powder be macerated in vinegar for three day's space, then distil it all in an alembick, the water that comes therefrom is good for the foresaid use. The following medicine is good to make the hairs of a flaxen colour. ℞. flor. genist. staechad. & cardamom. an. ℥ i. lupinor. conquassat. rasur. To make the hair of a flaxen colour. buxi, corticis citri, rad. gentian. & berber. an. ℥ i ss. cum aqua nitri fiat lenta decoctio: herewith bathe and moisten the hairs for many days. CHAP. XLVII. Of Psilothra, or Depilatories: and also of Sweet waters. MEdicines to fetch off hair, which by the Greeks are termed Psilothra, and Depilatoria in latin vulgarly, are made as you may learn by these following examples. ℞. calcis vivae, ℥ iii auripigmenti, ℥ i. let the lime be quenched in fair water, and then the orpiment added A depilatory. with some aromatic thing: have a care that the medicine lie not too long upon the part, otherwise it will burn; and this medicine must be made to the consistence of a pultis and applied warm, first fomenting the part with warm water; for then the hair will fall off by gentle rubbing or washing it with warm water: but if there happen any excoriation thereupon, you may help it by the use of unguentum rosatum, or some other of the like faculty. ℞. calcis viv. aurip. citrin. an. ℥ i. amyl. spumae argent. an. ℥ ss. terantur & incorporentur cum aq. come. & bulliant simul: you shall certainly know that it is sufficiently boiled, Another. if putting thereinto a goose's quill, the feathers come presently off: some make into powder equal parts of unquenched lime and orpiment, they tie them up in a cloth, with which being steeped in water they besmear the part, and within a while after by gently stroking the head, the hair falls away of itself. The following Sweet waters. waters are very fitting for to wash the hands, face, and whole body, as also linen, because they yield a grateful smell: the first is lavender water thus to be made. ℞, Lavender water. flor. lavend. lb iv. aq. rosar. & vini alb. an. lb two. aq. vitae, ℥ iv. misceantur omnia simul, & fiat distillatio in balneo Mariae: this same water may also be had without distillation, if you put some lavender flowers in fair water, and so set them to sun in a glass, or put them in balneo, adding a little oil of spike and musk. Clove water is thus made: ℞. caryoph. ℥ two. aq. rosar. lb two. macerentur spatio xxiv. horarum, & distillentur Clove water in balneo Mariae. Sweet water commonly so called, is made of divers odoriferous Sweet water. things put together; as thus, ℞. menthae, majoranae, hyssopi, salviae, rorismarini, lavendulae, an. m two. radicis ireos, ℥ two. caryophylorum, cinamomi, nncis moschatae, ana, ℥ ss. limonum, num. iv. macerentur omnia in aqua rosarum, spatio viginti quatuor horarum, distillentur in balneo Mariae, addendo Moschi, ℈ ss. The End of the Twenty sixth Book. OF DISTILLATIONS. THE TWENTIEIGHTH BOOK. CHAP. I. What Distillation is, and how many kinds thereof there be. HAving finished the Treatise of the faculties of medicines, it now seems requisite that we speak somewhat of Chemistry and such medicines as are extracted by fire. These arc such as consist of a certain fifth essence separated from their earthy inpurity by Distillation, in which there is a singular, and almost divine efficacy in the cure of diseases. So that of so great an abundance of the medicines there is scarce any which at this day Chemists do not distil, or otherwise make them more strong and effectual than they were before. Now Distillation is a certain art or way by which the liquor or humid part of things, by What distillation is. the virtue and force of fire or some semblable heat (as the matter shall seem to require) is extracted and drawn, being first resolved into vapour and then condensed again by cold. Some call this art Sublimation or subliming, which signifies nothing else but to separate the pure from the unpure; the parts that are more subtle and delicate, from those that are more corpulent, gross and excrementitious; as also to make those matters whose substance is more gross, to become more pure and sincere, either for that the terrestrial parts are ill united and conjoined, or otherwise confused into the whole and dispersed by the heat and so carried up, the other grosser parts remaining together in the bottom of the vessel. Or a distillation is the extraction or effusion of moisture distilling drop by drop from the nose of the Alembecke or any such like vessels. Before this effusion or falling down of the liquor there goes a certain concoction performed by the virtue of heat; which separates the substances of one kind from those of another that were confusedly mixed together in one body, and so brings them into one certain form or body, which may be good and profitable for divers diseases. Some things require the heat of a clear fire, others a flame, others the heat of the Sun, others of Ashes or sand or the filings of Iron; others horse dung, or boiling water or the oiely vapour or steam thereof. In all these kinds of fires, there are four considerable degrees of heat. The first is contained in the limits of warmth, and such is warm water, or the vapour of hot water. The second is a little hotter, but yet so as the hand may abide it without Four degrees of heat. any harm, such is the heat of Ashes. The third exceeds the vehemency of the second, wherefore the hand cannot long endure this without hurt, and such is the heat of sand. The fourth is so violent, that it burneth any thing that cometh near, and such are the filings of Iron. The first degree is most convenient to distil such things as are subtle and moist as What heat fittest for what things. flowers. The second such as are subtle and dry as those things which are odoriferous and aromatical, as Cinnamon, Ginger, Cloves. The third is fittest to distil such things are of a more dense substance and fuller of juice; such as are some Roots, and gums. The fourth is fit for metals and minerals as, Alum, Vitriol, Amber, jet, etc. In like manner you may also distil without heat; as we use to do in those things which are distilled by straining, as when the more pure is drawn and separated from that which is most unpure and earthy, as we do in Lac Virginale, and other things which are strained through an hippocras bag, or with a piece of cloth cut in the form of a tongue, or by settling, or by a vessel made of Ivy wood: sometimes also somethings may be distilled, by coldness and humidity, and so we make the oil of Tartar, Myrrh and Vitriolls, by laying them upon a marble in a cold and moist place. CHAP. II. Of the matter and form of Fornaces. THe matter and form of Fornaces uses to be divers. For some Fornaces The matter the best for Fornaces. use to be made of bricks and clay, othersome of clay only, which are the better and more lasting, if so be the clay be fat and well tempered with whites of Eggs and hair. Yet in sudden occasions when there is present necessity of distillation, fornaces may be made of bricks, so laid together that the joints may not agree, but be unequal, for so the structure will be the stronger. The best and fittest form of a Furnace for distillation A round form the best for Fornaces. is round; for so the heat of the fire carried up equally diffuses itself every way, which happens not in a Furnace of another figure, as square or triangular, for the corners disperse and separate the force of the fire. Their magnitude must be such as shall be fit for the receiving of the vessel. For their thickness, so great as necessity shall seem to require. They must be made with two bottoms, distinguished as it were into two forges, one below which may receive the ashes of the coals or the like other fuel, the other above to contain the burning coals or fire. The bottom of this upper must either be an iron grate, or else it must be perforated with many holes, that so the ashes may the more easily fall down into the bottom, which otherwise would extinguish the fire; yet some Fornaces have three partitions, as the Furnace for reverberation. In the first and lowest the ashes are received, in the second the coals are put, & in the third the matter which is calcined or else distilled. The third ought to have a semicircular cover, that so the heat or flame may be reflected upon the contained matter. The lower partition shall have one or more doors, by which the fallen down ashes may be taken forth. But the upper must have but one, whereby the coals or wood may be put in. But in the top or upper part of the Furnace where it shall seem most fit, there shall be two or three holes made, that by them you may blow the fire and that the smoke may more freely pass out. But these forementioned doors must have their shutters, just like an ovens mouth. But in defect of a furnace or fit matter to build one withal, we may use a kettle, set upon a trefoote after the manner that we shall presently declare when we come to speak of that distillation which is to be made by Balneum Mariae. CHAP. III. Of vessels fit for Distillation. Vessels for Distillation consist of different matter and form, for they are either of Lead, Tin or Brass, or else earthen vessels and these are sometimes leaded, sometimes not: or else they are of Gold, silver or glass. Now for leaden vessels they are worse than the rest, and utterly Leaden vessels ill. to be refused, especially when as the liquors which are drawn by them are to be taken into the body by the mouth, by reason of the malign qualities which are said to be in Lead; by which occasion; Galen condemns those waters which run, and are contained in Leaden pipes, which by reason of their saltishness and acrimony which savours of quick silver, they cause dysenteries. Therefore you may perceive such waters as are distilled through a leaden head to be endued with a more acrid and violent piercing vapour, by reason the portion of that saltishness dissolved in them, & as it were shaved from the top of the Alembecke or head, defiles the distilled liquors, and whitens and turns them into a milky substance but copper or brass Brass worse. heads are more hurtful than Led, for they make the waters that come through them to savour or participate of brass. Those that are of gold and silver are less The best vessels for distillation. hurtful; but the greatness of the cost hinders us from making heads of such metals; therefore we must have a care that our vessels for distillation be either of potter's mettle leaded, or else of brass, or of that jugge mettle which is commonly called terra belovacensis, and these rather than of Lead, or any other mettle. Verily glasses are thought the best; and next to them, earthen vessels leaded, then of jugge mettle, and lastly these of tin. There is great variety of vessels for distillation in form and figure; for some are of an oval or cilindricall figure, that is, of a round and longish; others are twined and crooked, others of other shapes, as you may see in the beaks of the Chimicks. Of this almost infinite variety of figures I will in fit place give you the delineation and use of such as shall seem to be most necessary. CHAP. four What things are to be cousidered in distillation. FIrst make choice of a fit place in your house for the furnace, so that it may neither hinder any thing, nor be in danger of the falling of any thing that shall lie over it. When you shall distil any thing of a malign or venenate quality, ye shall stand by it as little as you may, lest the vapour should do you any harm: when you provide glass vessels for distillation, make choice of such, as are exquisitely baked, without flaws or cracks, and such as are every where smooth. Let not the fire at first be very violent, not only for fear of breaking the vessels, but also for that the first fire in distillation must be gentle, and so increased by little and little. The things to be distilled, ought not to be put in too great quantity into the body of the still, lest they should rise up or fly over. Hot things, that they may be more effectual must be twice or Hot things must be often distilled. thrice distilled, by pouring upon them their own distilled water or other fresh materials, or else by distilling them severally and by themselves: of this kind are gums, wax, fats, or oils. But in each other repeated distillations you must something lessen the force of the fire, for the matter attenuated by the former distillation cannot afterward endure so great heat: but aromatic things, as Cloves, Cinnamon, etc. as also the chemical oils of Sage, Rosemary, Time, etc. ought not to be distilled or rectified over again, for that we must presently after the first distillation have a diligent care to separate them from the phlegm, that is, the more watery substance of the whole liquor; to whic purpose we must have regard to that which is distilled, for there are some things which first send over their phlegm as Vinegar, others, wherein it comes last, as * By Aquavita in this and most other places is meant nothing but the spirit of 〈◊〉▪ aquavita. If you would give to things to be distilled another taste or smell than that which they have naturally, you may mix with them some odoriferous thing, as Cinnamon, Camphire, or Musk, or the like, as you please, and so distil them together. The distilled liquors which are drawn by the heat of ashes or sand, savour of and retain a certain empyreuma; or smatch of the fire; for the helping of which, you shall put them into glasses very close stopped, and so expose them to the sun, and now and then open the glasses that this fiery impression may exhale, and the phlegmon be consumed, if that there shall be any. But though in all distillation, three are many things to be observed, yet are there two things, chiefly worthy of note: The first is, the matter that is to be distilled and wrought upon, that is, of what kind it is, and what the nature thereof may do and suffer. The other is the Furnace, which ought to be provided of a convenient matter and figure for that which is to be distilled: for you cannot draw any thing of any matter, neither of every mixture being distilled can you rightly expect oil or water. For mixed bodies do not consist of an equal portion of the four Elements, but some are more airy, others more fiery, some participate more of the water, others more of the earth, and that presently from their ●…st original. Therefore as watery things, yield more water, so airy and fiery things yield more oil when they are distilled; neither are all instruments fit for the extracting of every liquor. Moreover you must note, that the watery liquor sometimes comes forth in the first place, and presently after by the help of a stronger fire follows the oilely, which we find happens as often as the plant or parts of the plants which are distilled, are of a cold temperament; for in hot things it happens otherwise, for the first liquor which comes forth is oilely, and the following waterish. CHAP. V. Of what fashion the vessels for the distilling of waters ought to be. FOr the distilling of any kind of waters, two kind of vessels are necessary, which are comprehended under this one general name of an Alembecke. They call one of them the body, or containing vessel, the other The parts of an Alembecke. the head, that is, the cap or top wherein the ascending vapours are condensated or turned into water. It is called the head, because it stands over the body, like as an head; from the head there comes out a pipe or nose whereby the distilled liquor flows drop by drop into the receiver, as you may see by the following figure. The Furnace for a Bolneum Mariae with the Alembeck, and their receivers. A. Shows a brass kettle full of water. B. The cover of the kettle perforated in two places, to give passage forth to the Vessels. C. A pipe or Chimney added to the kettle, wherein the fire is contained to heat the water. D. The Alembecke consisting of his body and head. E. The receiver whereinto the distilled liquor runs. The effigics of another balneum Mariae, not so easy to be removed as the former. A. Shows the vessel or Copper that contains the water. B. The Alembecke set in water. But least the bottom of the Alembicke being half full, should float up and down in the water, and so stick against the sides of the Kettle; I have thought good to show you the way and means to prevent that danger. A. Shows the Vessel or glass Alembecke. B. A plate of Lead whereon it stands. C. Strings that bind the Alembecke to the plate. D. Kings through which the strings are put, to fasten the Alembecke. You may also distil the liquors of things by the vapour or steam of boiling water, if so be that you be provided of Vessels and forms made after this following manner. A Furnace with his vessels to distil liquors with the esteem of boiling water. A. Shows the head of the Alembecke. B The body thereof, placed in a brass vessel made for that purpose. C. A brass vessel perforated in many places to receive the vapour of the water. This vessel shall contain th'alembic compassed about with sawdust, not only that it may the better and longer retain the heat of the vapour, but also lest it should be broken by the hard touch of the brazen vessel. D. Shows the brass vessel containing the water as it is placed in the Furnace. E. The Furnace containing the vessel. F. A Funnel by which you may now and then pour in water, in stead of that which is vanished and dissipated by the heat of the fire. G. The Receiver. Now for the faculties of distilled waters it is certain, that those which are drawn in balne Mariae or a double vessel, are far better and efficacious, because, they do not only retain the smell of the things which are distilled, but also the taste, as acidity, harshness, sweetness, bitterness, and other qualities, so that they will neither Why those things that are distilled in Balneo retain more of the strength of things. savour of smoke nor burning; for the mild and gentle heat of a bath contains by his humidity, the more subtle parts of the plants that are distilled, that they be not dissipated and exhaled, contrary to which it usually happens in things which are distilled by the burning heat of wood or coals. For these have a certain nitrous and acrid taste, savouring of the smoke of fire. Besides, they acquire a malign quality from the vessels out of which they are distilled, especially if they be of Lead, whence they contract qualities hurtful to the principal, vital, and natural parts. Therefore the plants which are thus distilled, if they be bitter by nature, presently become insipid, as you may perceive by wormwood water thus distilled. Those things which are distilled in Balneo Mariae are contained in a glass vessel, from which they can borrow no malign quality. Therefore the waters so drawn are more effectual and pleasing in taste, smell, and sight. You may draw waters not only from one kind of plant, but also from many compounded and mixed together: Of these some are alimentary, others medicinal, yea and purging; others acquired for smell, others for washing or smoothing of women's faces, as we shall show hereafter. CHAP. VI How the materials must be prepared before Distillation. THings before they be put into the Alembecke must undergo a preparation, that is, they must be cut small, beaten and macerated, that is, steeped in some liquor, that so they may be the more easily distilled and yield the more water, and retain their native smell and faculties; yet such preparation is not convenient for all things; for there be some things, which need no infusion or maceration, but must rather be dried before they be distilled, as What things need not to be macerated before they be dissolved. Sage, Time, Rosemary, and the like, by reason of their too much humidity; it will be sufficient to sprinkle other things with some liquor only. In this preparation there are two things observable, to wit, the time of the infusion and condition of the liquor wherein these things ought to be infused. The time of the infusion is different according to the variety of the matter to be macerated; for things that are hard, solid, dry or whole, must be longer macerated, than such as are tender, freshly gathered or beaten: whence it is that roots and seeds require a longer time of infusion; flowers and leaves a shorter, and the like of other things. The liquors wherein infusion must be made, aught to be agreeable to the things infused. For hot ingredients require hot liquors, and cold such as are cold wherein they may be infused. Such things as have not much juice, as betony, wormwood and the like, or which are very odoriferous, as all aromatic things, would be infused in wine, so to preserve their smell, which otherwise by the force of the fire, by reason of the tenuity of the substance, easily vanishes. But if we desire that the distilled liquor should more exactly retain and have the faculty of the things whereof it is distilled, then must you infuse it in the juice thereof, or some such appropriate The maceration of plants in their own juice. liquor, that it may swim in it whilst it is distilled, or at least let it be sprinkled therewith. CHAP. VII. Of the art of distilling of waters. BEfore I describe the manner how to distil waters, I think it not amiss briefly to reckon up how many sorts of distilled waters there be, and what The varieties of stilled waters. the faculties of them are. Therefore of distilled waters some are medicinal, as the waters of Roses, Plantain, Sorrell, Sage, and the like: others are alimentary, as those waters that we call Restauratives; othersome are composed of both, such as are these restaurative waters which are also mixed with medicinal things; others are purging, as the distilled water of green and fresh Rhubarb; othersome serve for smoothing the skin, and others for smell; of which sort are those that are destilled of aromatic things. To distil Risen water, it will be good to macerate the Roses before you distil Rose water. them for the space of two or three days, in some formerly distilled Rose-water, or their pressed out juice, luting the vessel close; then put them into an Alembecke closely luted to his head and his receiver, and so put into a Balneum Mariae, as we have formerly described. The distilled Alimentary liquors are nothing else than those that we vulgarly call Restauratives. Restauratives; this is the manner and art of preparing them. Take of Veal, Mutton, Kid, Capon, Pullet, Cock, Partridge, Pheasant, as much as shall seem fit for your purpose: cut it small, and lest it should acquire heat, or empyreuma from the fire, mix therewith a handful of French Barley, and of red Rose leaves dry and fresh, but first steeped in the juice of Pomegranates, or citrons and Rose-water with a little Cinnamon, as much. But if you desire that this restaurative should not only be alimentary but also medicinal, you shall add thereto such things as shall resist the disease, such as are Cordial powders as of El. Diamargarit. frigid. De Gemmis, Aromaticum Rosat. Conserve of bugloss, borage, roots, herbs, seeds and other things of that kind. But if it be in a pestiferous season, Treacle, Mithridate and other Antidotes shall be added; each of these shall be laid in ranks or orders one over another, which is vulgarly termed stratum super stratum, in a glass Alembeck, and distilled in balneo Mariae with the heat of Ashes, or else of warm sand, as the following figure shows. The delineation of a Balneum Mariae, which may also serve for to distil with Ashes. A. Shows the Furnace with the hole to take forth the Ashes. B. Shows another Furnace, as it were set in the other: now it is of Brass, and runs through the midst of the kettle made also of brass, that so the contained water or ashes may be the more easily heated. C. The kettle wherein the water, ashes, or sand are contained. D. The Alembecke set in the water, ashes, or sand, with the mouths of the receivers. E. The bottom of the second brass Furnace, whose top is marked with B. which contains the fire. There may be made other restrauratives in shorter time with less labour and cost. To this purpose the flesh must be beaten and cut thin, and so thrust through with a Another way of making restorative Liquors. double thread, so that the pieces thereof may touch each other; then put them into a Glass, and let the thread hang out; so stop up the glass close with a linen cloth, Cotton, or Tow, and lute it up with paste made of meal and the whites of eggs; then set it up to the neck in a kettle of water, but so that it touch not the bottom, but let it be kept upright by the formerly described means; then make a gentle fire thereunder, until the contained flesh by long boiling shall be dissolved into juice, and that will commonly be in some four hours' space. This being done, let the fire be taken from under the kettle, but take not forth the glass before the water be cold, lest it being hot should be broken by the sudden appulse of the cold air. Wherefore when as it is cold, let it be opened, and the thread with the pieces of flesh be drawn forth, so that only the juice may be left remaining; then strain it through a bag, and aromatize it with Sugar and Cinnamon, adding a little juice of Citron, Verjuice or Vinegar, as it shall best like the patient's palate. After this manner you may quickly, easily and without great cost have and prepare all sorts of restauratives aswell medicated as simple. But the force and faculty of purging medicines is extracted after a clean contrary manner than the oils and waters are drawn of Aromatic things, as Sage, Rosemary, Time, Aniseedes, Fennell, Cloves, Cinnamon, Nutmegs, and the like. For the strength of these, as that which is subtle and eyrie, flies upwards in distillation; but the strength of purging things, as Turbith, Agaricke, Rhubarb and the like, subside in the bottom. For the purgative faculty of these purgers inseparably adheres to the bodies and substances. Now for sweet waters and such as serve to smooth the skin of the face, they may be distilled in Balneo Mariae like as Risen water. CHAP. VIII. How to distil Aqua vitae, or the spirit of wine. TAke of good White or Claret wine or Sack which is not sour nor musty, nor otherwise corrupt, or of the Lees that quantity which may serve to fill the vessel wherein you make the distillation to a third part; then put on your head furnished with the nose or pipe, and so make your distillation in Balneo Mariae. The oftener it is distilled, or (as they term it) rectified, the more noble and effectual it becomes. Therefore some distil it seven times Spirit of wine seven times rectified. over. At the first distillation it may suffice to draw a fourth or third part of the whole; to wit, of 24. pints of Wine or Lees, draw 6. or 8. pints of distilled liquor. At the second time the half part of that is 3. or 4. pints. At the third distillation the half part again, that is, two pints; so that the oftener you distil it over, the less liquor you have, but it will be a great deal the more efficacious. I do well like that the first distillation be made in Ashes; the second in Balneum Mariae. To conclude, that aqua vitae is to be approved of, neither is it any oftener to be distilled, which put into a spoon or saucer, and there set on fire, burns wholly away and leaves no liquor, or moisture in the bottom of the vessel; if you drop a drop of oil into this same water, it incontinently falls to the bottom; or if you drop a drop thereof into the palm of your hand, it will quickly vanish away, which are two other notes of probation of this liquor. The faculties and effects of aqua vitae are innumerable, it is good against the epilepsy and all cold diseases, it assuages the pains of the teeth, it is good for punctures The faculties of the spirit of wine. and wounds of the Nerves, faintings, sownings, gangreenes and mortification, both of its flesh, as also put to other medicines for a vehicle. There is this difference between the distilling of wine and Vinegar, wine being of an eyrie and vaporous substance, that which is the best and most effectual in it, to wit, the airy and fiery liquor, comes from it presently at the first distillation. Therefore the residue that remains in the bottom of the vessel, is of a cold, dry and acrid nature; on the contrary, the water that comes first from Vinegar being distilled, is insipid and phlegmatic. For Vinegar is made by the corruption of wine, and the segregation of the fiery and airy parts; wherefore the wine becoming sour, there remains nothing almost of the former substance but phlegm; wherefore seeing phlegm is chiefly predominant in Vinegar, it first rises in distillation. Wherefore he that hopes to distil the spirit of Vinegar, he must cast away the phlegmatic substance that first rises, and when by his taste he shall perceive the spirit of the Vinegar, he shall keep the fire there under, until the flowing liquor shall become as thick as honey; then must the fire be taken away, otherwise the burning of it will cause a great stinch. The vessels fit to distil aqua vitae and Vinegar are divers, as an Alembicke or The distilling of Wine and Vinegar is different. Retort set in sand or Ashes; a Coppar or brass bottom of a still, with a head thereto, having a pipe coming forth thereof which runs into a worm, or pipe fastened in a barrel or vessel filled with cold water, and having the lower end coming forth thereof, whose figure we shall give you when as we come to speak of the drawing of oils out of vegetables. CHAP. IX. Of the manner of rectifying, that is, how to increase the strength of waters, that have been once distilled. TO rectify the waters that have been distilled in Balneo Mariae, you must set them in the Sun in glasses well stopped and half filled, being set in The first way. sand to the third part of their height, that the water waxing hot by the heat of the Sun may separate itself from the phlegm mixed therewith, which will be performed in 12. or 15. days. There is another better way to The second. do this, which is to distil them again in Balneo with a gentle fire, or if you will put them into a retort furnished with his receiver, and set them upon crystal or iron bowls, or in an iron mortar directly opposite to the beams of the Sun, as you may learn by these ensuing signs. A Retort with his receiver standing upon Crystal bowls, just opposite to the Sun beams. A. Shows the Retort. B. The receiver. C. The Crystal bowls. Another Retort with his receiver standing in a Marble or Iron mortar, directly opposite to the Sun. A. Shows the Retort. B. The Marble, or Iron mortar. C. The receiver. CHAP. X. Of distillation by filtering. YOu shall set three basons or vessels of convenient matter in that site and order that each may be higher than other; that which stands in the highest place, shall contain the liquor to be distilled, and that which stands lowest shall receive the distilled liquor. Out of the first and second vessel shall hang shreds or pieces of cloth or cotton, with their broader ends in the liquor or upper vessel, and the other sharper ends hanging down, whereby the more subtle and defaecate liquor may fall down by drops into the vessel that stands under it, but the grosser and more feculent part may subside in the first and second vessel. You by this means may at the same time distil the same liquor divers times, if you place many vessels one under another after the forementioned manner, and so put shreds into each of them, so that the lowest vessel may receivethe purified liquor. In stead of this distillation Apothecaries oft times use bags. This manner of distillation was invented to make more clear and pure waters, and all juices and compositions, which are of such a liquid consistence. You may take an example of this from Lac Virgins, or Virgin's milk, of which this is the description. Lac Virgins. ℞. litharg. auri diligenter pulveris. ℥ iij. macerentur in aceti boni ℥ vi. trium horarum spa●●o, seorsim etiam in aqua plantaginis, solani, rosarum, aut communi sal infundatur; then distil them both by shreads, then mix the distilled liquors, and you shall have that which for the milky whiteness is termed Virgin's milk, being good against the redness and pimples in the face, as we have noted in our Antidotary. Ch. 44. of suci. The description of vessels to perform the distillation or filtration by shreds. A, Shows the vessel: B, The Clothes or shreds: CHAP. XI. What and how many ways they are to make Oils. YOu may by three means especially draw or extract the oils that you desire. The first is by expression, and so are made the oils of Olives, nuts, seeds, fruits and the like. Under this is thought to be contained Oils by expression. elixation, when as the beaten materials are boiled in water, that so the oil may swim aloft, and by this means are made the oils of the seeds of the berries of Elder and Danewort, and of bay-berries. Another is by infusion, as that which is by infusing the parts of plants and other things in oils. The third is by distillation, such is that which is drawn by the heat of the fire, whether By infusion. by ascent or by descent, or by concourse; The first way is known by all; now it is By distillation. thus, take almonds in their husks, beat them, work them into a mass, than put them into a bag made of hair, or else of strong cloth first steeped in water or in white Wine, than put them into press and so extract their oil. You may do the same in pine apple kernels, Hazel nuts, Coco nuts, nutmegs, peach kernels, the seeds of gourds & cucumbers, pisticke nuts, and all such oiely things. Oil of bays may be made of ripe bay-berries newly gathered, let them be beaten in a mortar and Oil of Bay-berries. so boiled in a double vessel, and then forthwith put into press, so to extract oil as you do from Almonds, unless you had rather get it by boiling as we have formerly noted. Oil of Eggs is made of the yoalkes of Eggs boiled very hard; when Of Eggs. they are so, rub them to pieces with your fingers, then fry them in a pan over a gentle fire, continually stirring them with a spoon until they become red, and the oil be resolved and flow from them; then put them into a hair cloth, and so press forth the oil. The oils prepared by infusion are thus made, make choice of good oil wherein let plants, or creatures, or the parts of them be macerated for some convenient time, that is, until they may seem to have transfused their faculties into the oil, then let them be boiled, so strained or pressed out. But if any aquosity remain, let it be evaporated by boiling. Some in compounding of oils add gums to them, of which though we have formerly spoken in our Antidotary, yet have I thought good to give you this one example. ℞. flor. hyper. lb ss. immittantur in phialam Oil of S. john's wort. cum flo. cent. & gum. elemi, an. ℥ ij. olei come. lb. ij. Let them be exposed all the heat of Summer to the Sun. If any will add aqua vitae wherein some Benzoin is dissolved, he shall have a most excellent oil in this kind. Oil of Mastic is made Of Mastic. Ex olei rosatis ℥ xij. mastic. ℥ iij. vini optimi ℥ viij. Let them all be boiled together to the consumption of the wine, then strain the Oil and reserve it in a vessel. CHAP. XII. Of extracting Oils of vegetables by Distillation. ALmost all herbs that carry their flowers and seeds in an umbell, have seeeds of a hot, subtle and airy substanc, and consequently oily. Now because the oily substance that is contained in simple bodies is of two kinds, therefore the manner also of extracting is twofold. For some is gross, earthy, viscous, and wholly confused and mixed with the bodies out of which they ought to be drawn, as that which we have said is usually extracted by expression; What oils are to be drawn by expression. this because it most tenaciously adheres to the grosser substance, and part of the body, therefore it cannot by reason of this natural grossness, be lifted up, or ascend. Othersome are of a slender, and airy substance, which is easily severed from their body, wherefore being put to distillation it easily rises: such is the oily substance of aromatic things, as of juniper, Aniseeds, Cloves, Nutmegs, Cinnamon, Pepper, Ginger, and the like odoriferous and spicy things. This is the manner of The first manner of drawing oils by distillation. extracting oils out of them; let your matter be well beaten and infused in water to that proportion, that for every pound of the material, there may be ten pints of water; infuse it in a copper bottom, having a head thereto either tinned or silvered over, and furnished with a colour filled with cold water. Set your vessel upon a furnace having a fire in it, or else in sand, or ashes. When as the water contained in the head shall wax hot, you must draw it forth, and put in cold, that so the spirits may the better be condensed, and may not fly away: you shall put a long necked receiver to the nose of the Alembecke, and you shall increase the fire, until the things contained in the Alembecke boil. There is also another manner of performing this distillation, the matter preserved Another way, and infused as we have formerly declared, shall be put in a brass or copper bottom covered with his head, to which shall be fitted, and well luted, a worm of Tin, this worm shall run through a barrel filled with cold water, that the liquor which flows forth with the oil, may be cooled in the passage forth; at the lower end of this worm you shall set your receiver. The fire gentle at the first, shall be increased by little and little, until the contained matter, as we formerly said, do boil; but take heed that you make not too quick or vehement a fire, for so the matter swelling up by boiling may exceed the bounds of the containing vessel, and so violently fly over. Observing these things, you shall presently at the very first see an oiely moisture flowing forth together with the waterish. When the oil hath done owing which you may know by the colour of the distilled liquor, as also by the consistence and taste, than put out the ●●re; and you may separate the oil from the water by a little vessel made like a Thimble and tied to the end of a stick; [or, which is better, with a glass funnel, or instrument made of glass for the same purpose.] Here you must also note that there be some oils that swim upon the top of the water, as oil of aniseedes; othersome on the contrary, which fall to the bottom, as oil of What oils fall to the bottom. Cinnamon, Mace, and Cloves. Moreover you must note, that the waterish moisture, or water that is distilled with oil of aniseed and Cinnamon, is whitish, and in success of time, will in some small proportion turn into oil. Also these waters must be kept several, for they are far more excellent than those that are distilled by Balneum Mariae, especially those that first come forth together with the oil. Oils are of the same faculties with the bodies from whence they are extracted, but much more effectual; for the force which formerly was diffused in many pounds of this, or that medicine, is after distillation contracted in a few drams. For example, the faculty that was dispersed over i. pound of Cloves, will be contracted into two ounces of oil at the most; and that which was in a pound of Cinnamon will be drawn into ʒiss. or ʒij. at the most of oil. But to draw the greater quantity with the lesser charge, and without fear of breaking the vessels, whereto glasses are subject, I like that you distil them in copper vessels, for you need not fear that the oil which is distilled by them will contract an ill quality from the copper, for the waterish moisture that flows forth together therewith will hinder it, especially if the copper shall betinned or silvered over. I have thought good to describe and set before your eyes, the whole manner of this operation. A Furnace with set vessels to extract the Chemical oils, or spirits of Sage, Rosemary, Time, Lavender, Aniseeds, Fennel seeds, Cloves, Nutmegs, Cinnamon, Pepper, Ginger, and the like; as also to distil the spirit of wine, of Vinegar and aqua vitae. In stead of the barrel and worm, you may use a head with a bucket or rowler about it. A. Shows the bottom, which ought to be of Copper and tinned on the inside. B. The head. C. The Barrel filled with cold water to refrigerate and condensate the water and oil that run through the pipe or worm that is put through it. D. Apipe of brass or latin, or rather a worm of Tin running through the Barrel. E. The Alembecke set in the furnace with the fire under it. Now because we have made mention of Cinnamon, Pepper, and other spices, which grew, not here with us, I have thought good to describe these out of Thevets' Cosmography, he having seen them growing. Pepper grows on shrubs in India, these shrubs send forth little branches whereon hang clusters of berries, like to Ivy berries, The description of Pepper. or bunches of small black grapes, or currance. The leaves are like those of the Citron tree, but sharpish and pricking. The Indians gather those berries with great diligence, and stow them up in large cellars, as soon as they come to perfect maturity. Wherefore it oft times happens, that there are more than 200. ships upon the coast of the lesser java an Island of that country, to carry thence Pepper and other spices. Pepper is used in Antidotes The uses thereof. against poisons, it provokes urine, digests, attracts, resolves, and cures the bites of Serpents. It is properly applied and taken inwardly against a cold stomach; in sauces it helps concotion and procures appetite; you must make choice of such as is black, heavy, and not flaccide. The trees which bear white, and those that bear black pepper, are so like each other, that the natives themselves know not which, is which, unless when they have their fruit hanging upon them, as the like happens upon our Vines which bear white and black grapes. The tree that yields Cinnamon grows in the mountains of India and hath leaves The Cinnamon tree. very like to bay leaves; branches and shoots at certain times of the year are cut from this tree, by the appointment of the King of that province, the bark of which is that we term Cinnamon. This is sold to no stranger unless at the King's pleasure and he setting the price thereof, it is not lawful for others to cut any thereof. Galen writes that Cinnamon is of very subtle parts, hot in the third degree, and partaking of some astriction; therefore it cuts and dissolves the excrements of the body, 7. simp. strengthens the parts, provokes the courses when as they stop by reason of the admixture of gross humours; it sweetens the breath, and yields a fine taste and smell to medicines, hippocras, and sauces. Of Cinnamon there is made an excellent water against all cold diseases, and also against swound, the plague and poisons. The composition thereof is this. Take of the choicest and best Cinnamon one pound, beat it grossly, and put thereto of Rose water 4 pints, of white wine half a pint, being An excellent Cinnamon tree. thus mixed, put them into a glass and so let them stand in infusion 24 hours, often stirring of them. Then distil them in Balneo Mariae, closely luting the receiver and vessels lest the spirit should fly away. CHAP. XIII. Another manner how to draw the essence and spirits of herbs, flowers, seeds, and spices; as also of Rhubarb, Agaricke, Turbith, Hermodactiles, and other Purgers. YOu may extract the essences and spirits of the things mentioned in the title of this chapter, as thus. Take Sugar, Rhubarb, Cinnamon, or any other material you please; cut it small, or else beat it, than put it into a glass with a long neck, and pour thereupon as much aqua vitae as shall be sufficient to cover the materials or ingredients, & to overtop them some finger's breadth, then stop up the glass very close that no air enter thereinto; Thus suffer it to infuse for 8 days in balneo with a very gentle heat; for thus the aqua vitae will extract the faculties of the ingredients, which you shall know that it hath done, when as you shall see it perfectly tinctured with the colour of the ingredients. The eight days A sign that the spirit of wine hath fetched out the strength of the ingredients. ended, you shall put this same aqua vitae into another vessel filled with the like quantity of the same materials prepared after the same manner, that it may also take forth the tincture thereof, and do thus three or four times, until the aqua vitae be deeply tinctured with the colour of the infused Ingredients. But if the materials from whence you desire to extract this spirit or essence, be of great price, as Lignum Aloes, Rhubarb, etc. You must not think it sufficient to infuse it once only, but you must go over it twice, or thrice, until all the efficacy be extracted out thereof; you may know that it is all wholly insipid. These things thus done, as is fitting, put all the liquor tinctured and furnished A sign that the ingredients have lo●● their strength. with the colour and strength of the ingredients, into an Alembecke, fitted and closely luted to its head, and so put into Balneum Mariae, that so you may extract or draw off the aqua vitae, to keep for the like purpose, and so you shall have the spirit, and essence remaining in the bottom. Now if you desire to bring this extract to the height of honey, set it in an earthen pot well leaded, upon hot ashes, so that the thin part thereof may be evaporated, for thus at length, you shall have a most noble and effectual essence of that thing which you have distilled, whereof one scruple will be more powerful in purging, than two or three dams of the thing its self. CHAP. XIIII. How to extract oil out of Gums, condensed juices, and rosines, as also out of some woods. ALL oils that are drawn out of Gums, oyely woods and metals, are extracted by that vessel which we vulgarly term a Retort. It must be made of glass, or jugges mettle well Leaded, and of such bigness as What a Retort is. shall be convenient for the operation you intent, though commonly it should be made to hold some gallon and an half of water; the neck thereof must be a foot and an half, or at least a foot long. The receiver is commonly a vial whereinto the neck of the Retort is fitted and inserted. Then the Retort shall be set in an earthen pan filled with ashes, or sand, and so set into a furnace, as you may see by the following figure. Of gums some are liquid, some solid; and of the solid, some are more solid than othersome; those that are solid are more troublesome to distil than the liquid, The differences of Gums. for they are not so easily dissolved or melted, neither do they yield so well to the fire, so that oft times they are burnt before they be dissolved; whence it is that some for every pound of solid gum, add two or three pounds of most clear and liquid oil of Turpentine. Besides, liquid things are also hard to be distilled, because when as they come to be throughly hot at the fire, they swell up so much, that Cautions in distilling of gums. they exceed, or run out of the Retort, and so fall into the receiver, as they were put into the Retort, especially if so be that the fire be too hot at the first. Many to shun this inconvenience, add to the things put into the Retort, some sand, as it were, to ballast it withal. The figure of a furnace, with his earthen pan and receiver: A. Shows the furnace. B. The earthen pan, or vessel to set the Retort in. C. The Retort or Cucurbite. D. The receiver. Oil of Rosin and Turpentine is thus made; take two or three pounds of Turpentine, and put it into a Retort of such largeness, that three parts thereof might remain How to make oil of Turpentin●… empty, and for every pound of Turpentine add three or four ounces of sand; then place the Retort in an earthen pan, filled with sifted ashes, and set it upon the furnace as is fit, and to the neck thereof fit and closely lute a receiver. Lastly, kindle thereunder a soft fire at the first, lest the contained materials should run over; increase this fire by little, and little, and take heed that the things become not too hot on a sudden. At the first a clear and acide liquor will drop out, wherein a certain sediment uses to concreat; then will flow forth a most clear oil, somewhat resembling the watery and phlegmatic liquor; then must the fire be some what increased, that the third oily, clear, thin and very golden coloured liquor may rife and distil; but then also a clearer and more violent fire must be raised, that so you may extract an oil that will be red like a carbuncle, and of a consistence indifferently thick. Thus therefore you may extract, four kinds of liquors out of Turpentine, and receive them being different in several receivers; yet I judge it better to receive them all in one, that so by distilling them again afterwards you may separate your desired oil; now there will ten or twelve ounces of oil, flow from an ounce of Turpentine. This kind of oil is effectual against the Palsy, Convulsions, punctures of the nerves, and wounds of all the nervous parts. But you shall thus extract oil out of wax; take one pound of wax, melt it, and How to make oil of wax. put it into a glass Retort set in sand, or ashes, as we mentioned a little before in drawing of oil of Turpentine, than distil it, by increasing the fire by degrees. There distils nothing forth of wax, besides an oily substance and a little Phlegma, yet portion of this oily substance, presently concreats into a certain butter-like matter, which therefore would be distilled over again; you may draw ℥ uj, or viij. of oil, from one pound of wax. This oil is effectual against Contusions, and also very good against cold affects. The faculties thereof. CHAP. XV. Of extracting of oils out of the harder sorts of Gums, as myrrh, mastic, frankincense and the like. SOme there be who extract these kinds of oils with the Retort set in ashes or sand, as we mentioned in the former Chapter of oils of more liquid gums, adding for every pound of gum two pints of Aqua vitae, and two or three ounces of oil of Turpentine, then let them infuse for eight or ten days in Balneo Mariae, or else in horse dung; then they set it to distil in a Retort. Now this is the true manner of making of oils of Myrrh; Take Myrrh made into fine How to make oil of myrrh. powder, and therewith fill hard Eggs in stead of their yoalkes being taken out; then place the Eggs upon a gridiron, or such like grate in some moist place as a cellar, and set under them a Leaden earthen pan; the Myrrh will dissolve into an oilely water, which being presently put into a glass and well stopped, with an equal quantity of rectified aqua vitae, and so set for three or four months in hot horse dung, which past the vessel shall be taken forth, and so stopped that the contained liquor may be poured into an Alembecke, for there will certain gross settling by this means remain in the bottom, then set your Alembecke in Balneo and so How to give it a pleasing colour and smell. draw off the aqua vitae & phlegmatic liquor, and there will remain in the bottom a pure & clear oil, whereto you may give a curious colour by mixing therewith some Alkanet, and a smell by drooping thereinto a little oil of Sage, Cinnamon or cloves Now let us show the composition and manner of making of balsams by giving you one or two examples; the first of which is taken out of Vesalius his Chirurgery; and is this. ℞. terebinth. oped. lb. i. ol. laurini ℥ iiij. galbani, ℥ iij. gum. elem. ℥ iiij ss. thuris, Myrrhae, Vesalius hi● balsam. gum. hederae, centaur. majoris, ligni aloës, an. ℥ iij. galangae, caryophyll. consolidae majoris, Cinamoni, nucis moschat. zedoaniaes, zinzib. dictamni albi, an. ℥ i. olei vermium terrestrium, ℥ ij. aq. vitae lb. vi. The manner of making it is this, let all these things be beaten and made small, and so infused for three days space in aqua vitae, then distilled in a Retort just as we said, you must distil oil of Turpentine and wax. There will flow hence three sorts of liquors, the first waterish and clear, the other thin, and of pure golden colour; the third of the colour of a Carbuncle, which is the true Balsam. The first liquor is effectual against the weakness of the stomach coming of a cold cause, for that it cuts phlegm and discusses ●●atulencies; the second helps fresh and hot bleeeing wounds, as also the palsy. The third is chiefly effectual against these same effects. The composition of the following Balsamum is out of Fallopius; and is this. ℞. terebinth. clarae, lb. ij. olei de semine lini lb. i. resinae pini, ℥ uj, thuris, myrrhae, aloes, mastiches, sarcocollae, an. ℥ iij. maces, ligni Aloes, an. ℥ ij. Fallopius hi● balsam. croci, ℥ ss. Let them all be put in a glass Retort, set in ashes and so distilled. First there will come forth a clear water, then presently after, a reddish oil, most pro●●table for wounds. Now you must know that by this means, we may easily distil all Axungias, fats, parts of creatures, woods, all kinds of barks and seeds, if so be that they be first macerated as they ought to be, yet so that there will come forth more watery than oily humidity. Now for that we have formerly frequently mentioned Thus or frankincense, I have here thought good out of Thevets' Cosmography to give you the description of the tree from which it flows. The frankincense tree (saith he) grows naturally in Arabia, resembles a pine, yielding a moisture that is presently What frankincense is. hardened, and it concreates into whitish clear grains, fatty within, which cast into the fire, take flame. Now frankincense is adulte rated with pine-rosin and Gum, which is the cause that you shall seldom find that with us, as it is here described; you may find out the deceit as thus, for that neither Rosin nor any other gum takes flame, for R●sin goes away in smoke, but frankincese presently burns. The smell also bewrays the counterfeit, for it yields no grateful smell as frankincense doth. The Arabians wound the tree that so the liquor may the more readily flow forth, whereof they make great gain. It fills up hollow Ulcers and cicatrizes them; wherefore it enters as a chief ingredient into artificial balsam; fr●n●… alone The faculties thereof. made into powder and applied, stanches the blood that flows out or wounds. Mathiolus faith, that it being mixed with Fuller's earth, and oil of Roses, is a singular remedy against the inflammation of the breasts of women, lately delivered of child. CHAP. XVI. The making of oil of Vitrial. TAke ten pounds of Vitriol, which being made into powder, put it into an earthen pot, and set it upon hot coals, until it be calcined, which is when as it becomes reddish; after some five, or six hours, when as it shall be throughly cold, break the pot, and let the vitriol be again made into powder, that so it may be calcined again, and you shall do thus so often and long The sign of perfectly calcined vitriol. until it shall be perfectly calcined, which is when as it shall be exactly red; then let it be made into powder, and put into an earthen Retort, like that wherein aqua fortis is usually drawn, adding for every pound of your calcined vitriol of tile shreds, or powdered brick 1 quarter; then put the Retort furnished with its receiver into a furnace of Reverberation, always keeping a strong fire, and that for the space of 48 hours, more or less according to the manner and plenty of the distilling liquor. You shall know the distillation is finished when as the receiver shall begin to recover his native perspicuity, being not now filled with vaporouse spirits, wherewith as long as the humour distils it is replenished and looks white. Now for the receiver there are 2 things to be observed. The first is, that it be great and very capacious, that it may not be distended and broken by the abundant flowing of vaporous spirits, as it doth oft times happen; another thing is, that you set it in a vessel filled with cold water, lest it should be broken by being over hot; you may easily perceive all this by the ensuing figure. A Furnace or Reverberation furnished with his Retort and Receiver. A. Shows the Furnace. B. The Retort. C. The Receiver. D. The vessel filled with cold water. CHAP. XVII. A table or Catalogue of medicines and instruments serving for the cure of Diseases. MEdicines and medicinallmeates fit for the cure of diseases, are taken from living Creatures, plants and minerals. From living creatures are taken, Horns. Hooves. Hairs. Feathers. Shells. Skulls. Scailes. Sweats. Skins. Fats. Flesh. Blood. Entrails. Urine. Smells whether they be stinking or sweet, as also poisons: whole creatures themselves, as, Foxes. Whelps. Hedgehogs. Frogs. Worms. Crabs. Cray-fish. Scorpions. Horseleeches. Swallows. Dungs. Bones. Extreme parts. Hearts. Liver. Lungs. Brain. Womb. Secundine. Testicles. Pizle. Bladder. sperm. Taile. Coats of the Ventricle. Expirations. Bristles. Silk. Webs. Tears. spital. Honey. Wax. Eggs. Milk. Butter. Cheese. Marrow. Rennet. From Plants, that is, Trees, shrubs, and herbs are taken, Roots. Moss. Pith. Si●ns. Buds. Stalks. Leaves. Flowers. Cups. Fibers', or hairy threads. Ears. Seeds. Bark. wood. Meal. juices. Tears. Oils. Gums. Rosins. Rottennesses Mass or spissament. Manna, which falling down like dew upon plants, presently concreates. Whole plants, as Mallows. Onions, etc. Metals, or minerals, are taken either from the water, or earth, and are either kinds of earth, stones, or metals, etc. The kinds of earth are, Bowl Armenicke. Terra sigillata. Fuller's earth. Chaulke. Okar. Plaster. Lime. Now the kinds of stone are, Flints. Lapis judaicus. Lapis Lyncis. The Pumice. Lap. Haematites. Amiantus. Galactites. Sponge stones. Diamonds. Saphire. Chrysolite. Topas. Loadstone. The Pyrites or firestone. Alabaster. Marble. Crystal, and many other precious stones. The kinds of Salts as well natural as artficiare, Common salt. Sal nitrum. Sal Alkali. Sal Ammoniacum. Salt of Urine. Salt of tartar and generally all salts that may be made of any kind of plants. Those that are commonly called minerals are, Marchasite. Antimony. Muscovy Glass. Tutty. Arsenic, Orpiment, Lazure, or blue, Rose agar. Brimstone: Quick silver, White Coprose, Chalcitis, Psory. Roman Vitriol Colcothar, vitriol, or green Coprose. Alumen scissile, Common Alum, Alumen rotundum. Round Alum. Alumen liquidum. Alumen plumosum. Boraxe, or Burrace, Bitumen, Naphtha. Cinnabaris, or vermilion. Litharge of Gold. Litharge of Silver Chrysocolla. Scandaracha. Red Lead. White Lead, and divers other Now the Metals themselves are, Gold, Silver, Iron, Led, Tin, Brass, Copper, Steel. Latin and such as arise from these, as the scailes, verdegreace, rust, etc. Now from the waters, as the Sea, Rivers, Lakes and Fountains, and the mud of these waters, are taken divers medicines, as white and red Coral, Pearls and infinite other things which nature the handmaid of the great Architect of this world, hath produced for the cure of diseases; so that into what part soever you turn your eyes, whether to the surface of the earth, or the bowels thereof, a great multitude of remedies present themselves to your view. The choice of all which is taken from their substance, or quantity, quality, action, place, season, smell, taste, site, figure, and weight, other circumstances, as Silvius hath abundantly showed in his book written upon this subject. Of these simples are made divers compositions; as, Collyria. Caputpurgia. Eclegmata. Dentifrices. Dentiscalpia. Apophlegmatismi. Gargarisms. Pills. Boles. Potions. Emplasters. Unguents. Cerates. Liniments. Embrocations. Fomentations. Epithemes. Attractives: resolver's. Suppuratives: Emollients. Mundificatives: Incarnatives. Cicatrisers. Putrifiers. Corrosives. Agglutinatives. Anodynes. Apozems. juleps. Syrupes. Powders. Tablets. Opiates. Conserves. Preserves. Confections. Rowles. Vomits. Sternutatoryes. Sudorifickes. Glisters. Pessaries. Suppositoryes: Fumigations. Trochisces. Frontalls'. Cappes. Stomichers. Bags. Baths. Halfe-bathes. Virgins-milke. Fuci. Pications. Depilatoryes. Vesicatoryes. Potential canteri●s. Nosegays. Fans. Cannopyes, or extended clothes to make wind. Artificial fountains, to distil or drop down liquors. Now these that are thought to be nourishing medicines are, Restauratives Culliss Expressions Jellies Ptisans Barly-creames Pomadoes Almond-milkes Marchpanes Wafers Hydro sacchar Hydromel and such other drinks. Mucilages Oxymel Oxycrate Rose Vinegar Hydraelium Metheglin Cider Drink of Servisses Ale Beer Vinegar Verjuice Oil Steeled water Water brewed with bread crumbs Hippocras Perry, and such like. Waters and distilled oils, and divers other Chemical extractions. As the waters and oils of hot, dry and aromatic things, drawn in a copper Alembecke, with a cooler, with ten times as much water in weight as of herbs; now the herbs must be dry, that the distillation may the better succeed. Waters are extracted cut of flowers put in a Retort, by the heat of the Sun, or of dung, or of an heap of pressed out Grapes, or by Balneo, if there be a receiver put and closely lured thereto. All kinds of salt of things calcined, dissolved in water, and twice or thrice filtered, that so they may become more pure and fit to yield oil. Other distillations are made either in Cellars by the coldness or moisture of the place, the things being laid either upon a marble, or else hanged up in a bag; and thus is made oil of Tartar, and of salts, and other things of An aluminous nature. Bones must be distilled by descent, or by the joining together of vessels. All woods, roots, barks, shells of fishes, and seeds, or grains, as of corn, broom, beans, and other things whose juice cannot be got out by expression, must be distilled by descent, or by the joining together of vessels in a Reverberatory furnace. Metals calcined and having acquired the nature of salt, aught to be dissolved and filtted, and then evaporated till they be dry; then let them be dissolved in distilled vinegar, and then evaporated and dried again; for so they will easily distil in a Cellar upon a Marble, or in a bag. Or else by putting them into a glassy retort, and setting it in sand, and so giving fire thereto by degrees until all the watery humidity be distilled; then change the receiver, and lute another close to the Retort, then increase the fire above and below, and thus there will flow forth an oil very red coloured; Thus are all metalline things distilled, as Alomes', salts, etc. Gums axungiae, and generally all rosins are distilled by retort set in an earthen vessel filled with Ashes upon a furnace; now the fire must be increased by little and little according to the different condition of the distilled matters. The vessels and Instruments serving for distillations are commonly these. Bottoms of Alembeckes. The heads of them, from whence the liquors drop. Refrigeratories. Vessels for sublimation. For Reverberation. For distilling by descent. Crucibiles' and other such. Vessels for Calcination. Hair strainers. Bags. Earthen platters. Vessels for circulation, as Pelicans. Earthen Basins for filtering: Fornaces. The secret fornaces of Philosophers: The Philosopher's egg: Cucurbites Retorts Bolt heads Urinals Receivers Vessels so fitted together that the lowermost receives the mouth of the uppermost, whence they may be termed conjoined Vessels: They are used in distilling per descensum, Marbes exquisitely smooth for distillations to be made in Cellars. Pots to dissolve calcined m●…in. A CATALOGVE OF THE Surgeon's Instruments mentioned in this whole work. RIngs wherein little Lancets lie hid, to open Impostumes. Trunks or hellow Instruments going with springs. A vent, or cooler for the womb made like a pessary. Hollow tents. Sundry Cauteries, as flat round, sharp pointed, cutting, etc. Constrictory rings to twitch or bind the Columella. Speculum Oris. Ocul. Ani. Vteri. A trunk or pipe with an actual Cautery in it. Crooked Knives. A pipe in form of a quill. Divers trusses with one, or more bolsters. A shoulder-band to be put about the neck, to hold up a truss. A needle to draw through a golden wire, etc. Pipes with fenestells, and needles fit for sutures. Cutting mullets. Mullets only to hold and not to cut. Mullets to take forth splinters of bones. Mullets to draw teeth. An incision knife. Scrapers to plain or smooth the bones, or else to cut them. Cutting or hollow Scrapers. A Leaden mallet to drive the scrapers or Chissels into the scull. A Gimlet in shape and use resembling that which Cooper's use to lift up the sunk staves of their cask withal. Levatories, of which kind is the three footed one. Other Levatories, which taken by their handles, and their tongues put under the depressed bones, lift them up. Saws. A desquamatory Trepan. Plyers to take forth splinters of bones. A Gimlet to perforate the scull. A Trepan fit to divide the scull, with the screw, peirnt or procer, brace, and cover or cap that keeps it from running in too far. A plate to set one foot of the compass upon. A cutting pair of Compasses both open and shut. A fit instrument to depress the Dura Mater without hurting thereof. A syringe to make injection withal. A pair of Pincers with holes through them to take up the skin for making a Seton. Seton's as well dry, as moistened with ointments. Crows, Parrots, Swans, Ducks, Beakes, and these either strait, crooked, toothed, or smooth. Lizards, Cranes, Catch-bullets, and Plyers to draw forth pieces of mail, and splinters of bones that lie deep in. Hollow and smooth Dilaters, diversely made for the different wounds of the parts. Probes fit for to put flamulaes into wounds; and these either strait, or crooked, perforated, or unperforated. Screwed mullets to draw forth barbed heads of Arrows and the like. Lancets to let blood, and scarify as well strait, as crooked. A Pyulc●s, or Matter-drawer. Ligatures, bands, swaths, thongs of Leather, woollen, linen, round, slit, sown together; again some are upper binder's, others under binder's. Again these are either expressing, or else containing, and that either the applied medicines, or the lips of wounds, or members put in a fit posture, which therefore they call a sarcoticke Ligature. Thread. Bottoms, or clewes of thread, or yarn. Pledgets, compresses, bolsters, doubled clothes. Ferulae, or Splints. Casses. Boxes. junckes. Glossocomies'. Ambi, a kind of Glossocomie. A pulley, with its wheels, and wooden and Iron pins, whereon the wheels may run: Ropes aswell to draw and extend, as hold up the member, &c, Screw pins. A hand-vice. Hooks. Buttons or stays to fasten to the skin to hold together the lips of the wounds. lint. Cushions, pillows, linen clothes. Files. Dentiscalpia, Dentifricia, Dentispicia. Catheters, guiders of the work. A bathing chair or seat, bathing tubs, half tubs, caldrons, funnells, with all other circumstances belonging to a bath. Stoves, or hot houses to sweat in. Cock's to turn and let out water. A Gimlet to break the stone. Hooks. Hollow probes slit on their upper sides. Winged Instruments to draw forth stones. An instrument to cleanse the bladder. Spathulues strait and crooked. Cupping-glasses. Horns. Pipes or catheters to wear Caruncles. Artificial members, as eyes of gold enameled, etc. An Urinal, or case to save the water in. An artificial yard. Crutches. Nipples, or leaden covers for sore breasts. Griffins talents to draw forth a Mola, out of the womb. A sucking glass to draw a breast withal. Pessaries, both long and oval. Syring to give glisters, as also to make injection into the ears, and womb. THE EFFIGIES OF HIPPOCRATES OF COOS, THE PRINCE OF PHYSITIONS. INVICTUM (Hypocrates quòd te potuere superbae Eoi nunquam flectere Regis opes, Cecropidae fronti ex auro fulgente coronam Promeriti memores imposuere tuae. Gratia sed levis est, Actaeis tantus Athenis Nec fuit hinc uni quam tibi partus honos. Nam quòd quae recreent languentia corpora morbo Paeonias fueris promere largus opes. Sed tua tam fundit, quam magni machina mundi Gratia, & insignis tam tua fama volat. BON. GRA. PARIS. MEDIC. SELECT APHORISMS CONCERNING CHIRVRGErie, collected out of the Aphorisms of the great Hypocrates. Aph. 27. sect. 6. Whosoever being suppurate or hydropical, are burnt, or cut therefore, if all the matter, or water flow forth at once, they certainly dye. 31. 6. The drinking of wine, or a bath, fomentation, blood-letting, or purging, help the pains of the eyes. 38. 6. Such as have hidden, or not ulcerated Cancers, had better not to cure them. For healed they quickly dye, not cured they live the longer. 55. 6. Gouty pains usually stir in the Spring and Fall. 28. 6. eunuchs are not troubled with the Gout, neither do they become bald. 49. 6. Whosoever are troubled with the Gout, have ease in forty days, the inflammation ceasing. 66. 5. In great and dangerous wounds if no swelling appear, it is ill. 67. 5. Soft tumours are good, but crude ones ill. 25. 6. For an Erysipelas, or inflammation to return from without inwards, it is not good; but to come from within outwards, is very good. 19 7. An Erysipelas coming upon the bearing of a bone, is evil. 20. 7. Putrefaction, or suppuration coming upon an Erisipelas, is ill. 21. 6. If Varices or Haemorrhoides happen to such as are mad, their madness ceases. 21. 7. A flux of blood ensuing upon a great pulsation in Ulcers is ill. 26. 2. It is better that a fever happen upon a convulsion, than a convulsion upon a fever. 4. 6. Those Ulcers that have the skin smooth or shining about them, are evil. 18. 6. The wound is deadly whereby the bladder, brain, heart, midriff, any of the small Guts, stomach or Liver are hurt. 45. 6. Whatsoever Ulcers are of a years continuance or more, the bone must necessarily scaile, and the scars become hollow. 2. 7. The bone being affected, if the flesh be livide, it is ill. 14. 7. Stupidity and lack of reason, upon a blow of the head, is evil. 24. 7. A Delirium happens if a bone (to wit, the scull) be cut even to the hollowness thereof. Whilst 〈◊〉, or matter is in generating, pains and fevers happen rather than when it is already made. 18. 5. Cold things are hurtful to the bones, teeth, nerves, brain, spinal marrow, but hot things are good. 46. 2. Two pains infesting together, but not the same place, the more vehement obscures the other. 74. 7. A corruption and abscess of the bone is caused by the corruption of the flesh. 506. Coacar praen●s. A livid or dry Ulcer, or yellowish, is deadly. 19 6. When as a bone, or gristle, or nerve, or small portion of the cheek, or the prepuce is cut as●●der, it neither increases, nor grows together. 24. 6. Aph. & 513. Coacar. If any of the small guts be cut, it knits not again. 50. 7. Those that have the brain sphacelate, that is, corrupt, they die within three days; if they escape these, they recover. 9 7. Bleeding at a wound causing a Convulsion, is the foreteller of death. 20. 5. Cold is biting to Ulcers, hardens the skin, causes pain, not easily coming to suppuration; blackness, aguish shake, convulsions, erampes. 508. Coac. Those who have the temples cut, have a Convulsion upon the parts contrary to the section. 44. 7. Whosoever being suppurate are burnt or cut, if pure and white quitture shall flow forth they escape; out if that which is bloody, feculent, and stinking, than they die. Galen. comment. ad Aphor. 29. 2. It is not ●it to take in hand to cure such as are in a desperate case, but to leave them, only foretelling the end of the disease. Celsus, Cap. 10. Lib. 2. It is better to try a doubtful remedy than none at all. FINIS. THE EFFIGIES OF GALEN THE PRINCE OF PHYSITIONS NEXT TO HIPPOCRATES. AEQWM erat Hippocratem divino è semine Diuûm, Orbem muneribus conciliare sibi: Scripta sed involuit tam multo aenigmate, verum Vt quamuis solers nullus habere queat; Pergamei auxilio nisi sint monimenta Galeni, Qui docta ambages sustulit arte senis. Ergo macte esto virtute, arcana resolvens, Quae nulli fuer ant nota (Galene) prius; Obstringensqúe orbem aeterno tibi munere totum, Aeternis sacras te quoque temporibus. BON. GRA. PARIS. MEDIC. RULES' OF SURGERY BY THE AUTHOR. 1 Practice is an operation agreeable to the rules and laws of the Theory. 2 Health is not received by words, but by remedies fitly used. 3 Remedies known and approved by use and reason, are to be preferred before such as are unknown, or but lately found out. 4 Science without experience gets the Physician no great credit with the patient. 5 He that would perform any great and notable work, must diligently apply himself to the knowledge of his subject. 6 It is the part of a good Physician to heal the disease, or certainly to bring it to a better pass, as nature shall give leave. 7 The Chirurgeon must be active, industrious, and well handed, and not trust too much to books. 8 He that hath not been versed in the operations of the Art, nor a frequent auditor of the Lectures of such as are learned therein, and sets forth himself for a brave Chirurgeon for that he hath read much, he is either much deceived or impudent. 9 He shall never do any thing praiseworthy, that hath got his mastery in Chirurgery by gold, not by use. 10 You shall comfort the patient with hope of recovery, even when as there is danger of death. 11 To change Physicians and Surgeons is troublesome, but not good for the Patient. 12 Though the disease prove long, yet it is not fit that the Physician give over the patient. 13 Great wounds of large vessels, are to be judged deadly. 14 Every contusion must be brought to suppuration. 15 As the nature or kind of the disease must be known, so also must the remedy. 16 An Abscess of the bone of the palate, is in danger to cause a stinking breath. 17 Bleeding caused by heat must be repressed by cold. 18 Wounds of nervous parts require medicines which by the subtlety of the parts may enter in and draw from far. 19 It is not fit for such as have Ulcers in their Legs, neither to walk, stand nor sit, but to rest themselves in bed. 20 All biting and acrid medicines are offensive to clean Ulcers. 21 For restoring of dislocations you must hold them fast, stretch them out, and force them in. 22 A great Gangrene admits no cure, but cutting. 23 A monster is a thing dissenting from the laws of nature. 24 Wounds of the Chest presently become sanious and purulent. 25 The wounds made by all venomous creatures are dangerous. 26 The south wind blowing, wounded members easily become mortified. 27 Such as are wounded, and desire to be quickly whole, must keep a spare diet. 28 Untemperate bodies do not easily recover of diseases. 29 Round Ulcers unless they be drawn into another figure, do not easily heal up. 30 An Erysipelatous Ulcer requires purgation by stool. 31 Crying is good for an infant, for it serves in stead of exercise and evacuation. 32 Grief is good for none but such as are very fat. 33 Idleness wealens and extinguisheth the native heat. 34 An ill natured Ulcer yields not unless to a powerful remedy. 35 A bath resolves and discusses humours, and gently procures sweat. 36 Cold diseases are troublesome to old people, and hard to be helped; but in young bodies they are neither so troublesome, nor contumacious. 37 Exercised bodies are less subject to diseases. 38 Moist bodies though they need small nourishment, yet stand they in need of large evacuation. 39 Sick people dye sooner of an hot distemper than of a cold, by reason of the quick and active operation of fire. 40 The quitture that flows from an Ulcer is laudable, which is white, smooth and equal. The end of the twentiseaventh Book. HOW TO MAKE REPORTS, AND TO EMBALM THE DEAD. THE TWENTIEIGHTH BOOK. NOw it only remains that we instruct the Chirurgeon Why a Chirurgeon must be careful in making of Reports. in making or framing his report, or opinion, either of the death of any person, or of the weakness, or deprivation of any member in the function or execution of its proper office and duty. Herein it is meet that he be very considerate, that is to say, ingenious or wise in making his report, because the events of diseases are oftentimes doubtful and uncertain, neither can any man foretell them certainly, whether they will be for life or death, by reason of the manifold nature of the subject of which we speak, and also the uncertain condition of the humours both in their kind and Why judgement is difficult. motion. Which was the cause why Hypocrates even in the first of his Aphorisms pronounceth, that judgement is difficult. But first of all, it is very expedient that a Chirurgeon be of an honest mind, that he may always have before his eyes a careful regard of true piety, that is to say, the fear of God and faith in Christ, and love toward his neighbours with hope of life everlasting, lest that he being carried away by favour, or corrupted with money or rewards, should affirm or testify these wounds to be small that are great, and these great that are small; for the report of the wound is received of the Chirurgeon according to the civil Law. It is recorded in the works of ancient Physicians that wounds may be called great for three respects. Wounds te●med great for three respects. The first is by reason of the greatness of the dissolved unity or resolution of Continuity, and such are these wounds which made by a violent stroke with a backsword, have cut off the arm, or leg, or overthwart the breast. The second is by reason of the dignity or worthiness of the part; now this dignity dependeth on the excellency of the action; therefore thus any little wound made with a bodkin, knife, in any part whose substance is noble, as in the Brain, Heart, Liver or any other part whose action and function is necessary to preserve life, as in the Weasant, Lungs or Bladder, is judged great. The third is, by reason of the greatness and ill habit, or the abundance of ill humours or debility of all the wounded body; so those wounds that are made in nervous parts, and old decayed people, are said to be great. But in searching of wounds let the Chirurgeon take heed that he be not deceived by his probe. For many times it cannot go into the bottom of the wound but stoppeth, and sticketh in the way, either because he hath not placed the patient, in the same posture, wherein he was when he received his hurt; or else for that the stroke being made down right, slipped aside to the right or left hand, or else from below upwards, or from above downwards, and therefore he may expect that the wound is but little and will be cured in a short time, when it is like to be long in curing, or else mortal. Therefore from the first day it behooveth him to How long a Chirurgeon must suspend his judgement in some cases. suspend his judgement of the wound until the ninth, for in that time the accidents will show themselves manifestly, whether they be small or great, according to the condition of the wound, or wounded bodies, and the state of the air according to his primitive qualities, or venomous corruption. But generally the signs, whereby we may judge of diseases, whether they be General signs whereby we judge of diseases. great or small, of long or short continuance, mortal or not mortal, are four. For they are drawn either from the nature, and essence of the disease, or from the cause or effects thereof, or else from the similitude, proportion and comparison, of those diseases with the season or present constitution of the times. Therefore if we are called to the cure of a green wound, whose nature and danger, is no other but a simple solution of Continuity in the musculous flesh, we may presently pronounce that wound to be of no danger, and that it will soon be cured. But if it have an Ulcer annexed unto it, that is, if it be sanious, than we may say it will be more difficult and long in the curing; and so we may pronounce of all diseases, taking a sign of their essence and nature. But of the signs that are taken of the causes, let this be an example. A wound that is made with a sharp pointed and heavy weapon, as with an halbeard being stricken with great violence, must be accounted great, yea and also mortal if the accidents be correspondent. But if the patient fall to the ground through the violence of the stroke, if a choleric vomiting follow thereon, if his sight fail him, together with a giddiness, if blood come forth at his eyes and nostrils, if distraction follow with loss of memory and sense of feeling, we may say; that all the hope of life, remaineth in one small sign which is to be deduced from the effects of the wound. But by the comparing it unto the season that then is, and diseases that then assault man's body, we Wounds deadly by the fault of the air. may say, that all those that are wounded with gunshot are in danger of death, as it happened in the schirmishes at the siege of Rouen, and at the battle of Saint Denis. For at that time, whether it were by reason of the fault of the heavens, or air, through the evil humours of man's body, and the disturbance of them; all wounds that were made by gunshot, were for the most part mortal. So likewise at certain seasons of the year, we see the small pocks and measles break forth in children, as it were by a certain pestilent contagion to the destruction of children only, inferring a most cruel vomit and laske, and in such a season the judgement of those diseases is not difficult. But you by the following signs may know what parts are wounded. Singnes of a fractured scull. If the patient fall down with the stroke, if he lie senseless, as it were asleep, if he void his excrements unwittingly, if he be taken with giddiness, if blood come out at his ears, mouth, and nose, and if he vomit choler, you may understand that the scull is fractured, or pierced through, by the defect in his understanding and discourse. You also may know when the scull is fractured, by the judgement of your external senses, as if by feeling it with your finger you find it elevated or depressed beyond the natural limits, if by striking it with the end of a probe, when the Pericranium or nervous film that investeth the scull is cut cross wise; and so divided there from it, yield a base and unperfect sound like unto a pot sheard that is broken, or rather like unto an earthen pitcher that hath a cleft, or rend therein. But we may say, that death is at hand if his reason and understanding fail him, if Signs of death by a wound on the head. he be speechless, if his sight forsake him, if he would tumble headlong out of his bed, being not at all able to move the other parts of his body; if he have a continual fever, if his tongue be black with dryness, if the edges of the wound be black or dry, and cast forth no sanious matter, if they resemble the colour of salted flesh, if he have an apoplexy, frenzy, convulsion or palsy with an involuntary excretion, or absolute suppression of the Urine and excrements. You may know that a man hath his throat, that is, his weasand and wind pipe cut. First by the sight of his Signs that the throat is cut. wound, and next by the abolishment of the function or office thereof both ways, for the patient can neither speak nor swallow any meat or drink; and the parts that are cut asunder, divide themselves by retraction upwards or downwards one from another, whereof cometh sudden or present death. You may know that a Signs that a wound hath pierced in the capacity of the chest. wound hath pierced into the breast or concavity, of the body, if the air come forth at the wound, making a certain whizzing noise, if the patient breath with great difficulty, if he feel a great heaviness or weight, on or about the midriff, whereby it may be gathered that a great quantity of blood, lieth on the place or midriff, and so causeth him to feel a weight or heaviness, which by little and little, will be cast up by vomiting. But a little after a fever cometh, and the breath is unsavoury, and stinking, by reason that the putrefying blood is turned into sanies: the patient cannot lie but on his back, and he hath an often desire to vomit, but if he escape death, his wound will degenerate into a Fistula, and at length will consume him by little and little. We may know that the Lungs are wounded, by the foaming and spumous blood, Signs that the Lungs are wounded. coming out both at the wound and cast up by vomiting; he is vexed with a grievous shortness of breath and with a pain in his sides. We may perceive the Heart to be wounded by the abundance of blood that cometh out at the wound, by the trembling of all the whole body, by the faint and small pulse, paleness of the face, That the heart is wounded. cold sweat, with often swooning, coldness of the extreme parts, and sudden death. When the midriff (which the Latins call Diaphragma) is wounded, the patient The midriff. feeleth a great weight in that place, he raveth and talketh idly, he is troubled with shortness of wind, a cough, and fit of grievous pain, and drawing of the entralls upwards. Wherefore when all these accidents appear, we may certainly pronounce that death is at hand. Death appeareth suddenly, by a wound of the hollow Vein, or the great Artery, The V●…●a and great Artery. by reason of the great and violent evacuation of blood and spirits, whereby the functions of the Heart and Lungs are stopped and hindered. The marrow of the backbone being pierced, the patient is assaulted with a Palsy The spinal marrow. or convulsion very suddenly, and sense and motion faileth in the parts beneath it, the excrements of the bladder, are either evacuated against the patients will, or else are altogether stopped. When the Liver is wounded, much blood cometh out at the wound, and pricking pain disperseth itself even unto the sword-like gristle, which hath its situation The Liver. at the Lower end of the breast bone called Sternon: the blood that falleth from thence down into the intestines doth oftentimes infer most malign accidents, yea and sometimes death. When the stomach is wounded, the meat and drink come out at the wound, there The stomach followeth a vomiting of pure choler, then cometh sweeting and coldness, of the extreme parts, and therefore we ought to prognosticate death to follow such a wound. When the milt or spleen is wounded, black and gross blood cometh out at the The spleen wound, the patient will be very thirsty, with pain on the left side, and the blood breaks forth into the belly, and there putrifying causeth most malign and grievous accidents and often times death to follow. When the guts are wounded, the whole body is gripped and pained, the excrements The guts. come out at the wound, whereat also often times the guts break forth with great violence. When the reins or Kidneys are wounded, the patient will have great pain in making his Urine, and the blood cometh out together therewith, the pain cometh The kidneys. down even unto the groin, yard, and testicles. When the bladder and ureters are wounded, the pain goeth even unto the entralls; The bladder. the parts all about, and belonging to the groin are distended, the Urine is bloody that is made, and the same also cometh often times out at the wound. When the womb is wounded, the blood cometh out at the privities, and all other accidents appear, like as when the bladder is wounded. The womb. When the sinews are pricked or cut half asunder, there is great pain in the affected The Nerves. place, and there followeth a sudden inflammation, flux, abscess, fever, convulsion, and oftentimes a gangrene or mortification of the part, whereof cometh death, unless it be speedily prevented. Having declared the signs and tokens of wounded parts, it now remaineth that we set down other signs of certain kinds of death that are not common, or natural, whereabout when there is great strife and contention made, it oftentimes is determined and ended by the judgement of the discreet Physician or Chirurgeon. Therefore if it chance that a nurse either through drunkenness, or negligence, Signs that an infant is smothered, or overlaid. lies upon her infant lying in bed with her, and so stifles or smothers it to death: If your judgement be required, whether the infant died through the default, or negligence of the nurse? or through some violent or sudden diseases that lay hidden and lurking in the body thereof? You shall find out the truth of the matter by these signs following. For if the infant were in good health before, if he were not froward or crying, if his mouth and nosethrills now being dead, be moistened or bedewed with a certain foam, if his face be not pale but of a Violet or purple colour; if when the body is opened the Lungs be found swollen and puffed up, as it were with a certain vaporous foam and all the other entralls found, it is a token that the infant was stifled, smothered or strangled by some outward violence. If the body or dead corpses of a man be found lying in a field, or house alone, and you be called by a magistrate to deliver your opinion, whether the man were slain by lightning or some other violent death? you may by the following signs find out the certainty hereof. For every body that is blasted, or stricken with lightning, doth cast forth or breathe Signs of such as are slain by Lightning. out an unwholesome, stinking or sulphureous smell, so that the birds or fowls of the air, nor dogs will not once touch it, much less prey or feed on it: the part that was stricken often times sound, and without any wound, but if you search it well, you shall find the bones under the skin to be bruised, broken or shivered in pieces. But if the lightning hath pierced into the body, which making a wound therein (according to the judgement of Pliny) the wounded part is far colder than all the rest of the body. For lightning driveth the most thin and fiery air before it, and Lib. 2. cap. 54. striketh it into the body with great violence, by the force whereof the heat that was in the part is soon dispersed, wasted and consumed. Lightning doth always leave some impression or sign of some fire either by ustion or blackness: for no lightning is without fire. Moreover whereas all other living creatures when they are stricken with lightning fall on the contrary side, only man falleth on the affected side, if he be not turned with violence toward the coast or region from whence the lightning came. If a man be stricken with lightning while he is asleep, he will be found with eyes open; contrariwise, if he be stricken while he is awake, his eyes will be closed (as Pliny writeth:) Philip Commines writeth that those bodies that are stricken with lightning are not subject to corruption as others are. Therefore in ancient time it was their custom neither to burn, nor bury them, for the brimstone which the lightning bringeth with it, was unto them in stead of salt, for that by the dryness and fiery heat thereof it did preserve them from putrefaction. Also it may be enquired in judgement, Whether any that is dead and wounded, received these wounds alive or dead. Truly the wounds that are made on a living Signs of wounds given to a living and dead man. man, if he die of them, after his death will appear red and bloody, with the sides or edges swollne, or pale round about: contrary wise, those that are made in a dead man, will be neither red, bloody, swollne, nor puffed up. For all the faculties and functions of life in the body do cease and fall together by death; so that thenceforth no spirits nor blood can be sent, or flow unto the wounded place. Therefore by these signs which shall appear, it may be declared that he was wounded dead or alive. The like question may come in judgement when a man is found hanged, whether Signs whether on be hanged alive or dead. he were dead, or alive. Therefore if he were hanged alive, the impression or print of the rope will appear red, pale, or black, and the skin round about it will be contracted or wrinkled, by reason of the compression which the cord hath made; also often times the head of the aspera arteria is rend and torn, and the second spondile, and the neck luxated or moved out of his place. Also the arms and legs will be pale, by reason of the violent and sudden suffocation of the spirits: moreover there will be a foam about his mouth, and a foamy and filthy matter hanging out at his nosethrills, being sent thither both by reason that the Lungs are suddenly heated and suffocated, as also by the convulsive concussion of the brain like as it were in the falling sickness. chose, if he be hanged dead, none of these signs appear: for neither the print of the rope appears red or pale, but of the same colour as the other parts of the body are, because in dead men the blood and spirits do not flow to the grieved parts. Whosoever is found dead in the waters, you shall know whether they were Whether one found dead in the water came therein a live or dead thrown into the water alive or dead. For all the belly of him that was thrown in alive, will be swollen, and puffed up by reason of the water that is contained therein; certain clammy excrements come out at his mouth and nosethrills, the ends of his fingers will be worn and excoriated, because that he died striving and digging or scraping in the sand or bottom of the river, seeking somewhat whereon he might take hold to save himself from drowning. chose if he be thrown into the waters being dead before, his belly will not be swollne, because that in a dead man all the passages and conduits of the body do fall together, and are stopped and closed, and for that a dead man breathes not, there appeareth no foam nor filthy matter about his mouth and nose, and much less can the tops of his fingers be worn and excoriated, for when a man is already dead, he cannot strive against death. But as concerning the bodies of those that are drowned, those that swim on the upper part of the water being swollne or puffed up, they are not so by reason of the water that is contained in the belly, but by reason of a certain vapour, into which a great portion of the humours of the body are converted by the efficacy of the putryfying heat. Therefore this swelling appeareth not in all men which do perish, or else are cast out dead into the waters, but only in them which are corrupted with the filthiness or muddiness of the water, long time after they were drowned; and are cast on the shore. But now I will declare the accidents that come to those that are suffocated and 〈◊〉 such as are smothered by Charcoal. stifled or smothered with the vapour of kindled or burning charcoals, and how you may foretell the causes thereof by the history following. In the year of our Lord God 1575. the tenth day of May, I with Robert Greauline Doctor of Physic, was sent for by Master hamel an advocate of the Court of Parliament of Paris, to see and show my opinion on two of his servants, of whom the one was his Clerk, and the other his Horsekeeper. All his family supposed them dead, because they could not perceive or feel their Arteries to beat, all the extreme parts of their bodies were cold, they could neither speak nor move, their faces were pale and won, neither could they be raised up with any violent beating or plucking by the hair. Therefore all men accounted them dead, and the question was only of what kind of death they died, for their master suspected that some body had strangled them, others thought that each of them had stopped one another's wind with their hands: and others judged that they were taken with a sudden apoplexy. But I presently enquired whether there had been any fire made with Coals in the house lately, whereunto their master giving care, sought about all the corners of the chamber (for the chamber was very little and close) and at last found an earthen pan with charcoal half burned; which when we once saw, we all affirmed with one voice, that it was the cause of all this misfortune, and that it was the malign fume and venomous vapour, which had smothered them, as it were by stopping the passages of their breath. Therefore I put my hand to the regions of their hearts, where I might perceive that there was some life remaining by the heat and pulsation that I felt though it were very little, wherefore we thought it convenient to augment and increase it. Therefore first of all, artificially opened their mouths, which were very fast closed, and sticking obstinately together; and thereinto both with a spoon and also with a silver pipe, we put aqua vitae often distilled with dissolved hiera and treacle; when we had injected these medicines often into their mouths, they began to move and to stretch themselves, and to cast up and expel many viscous excremental and filthy humours at their mouth and nostrils, and their Lungs seemed to be hot, as it were in their throats. Therefore than we gave them vomitories of a great quantity of Oxymel, and beat them often violently on the last spondyl of the back, and first of the loins, both with the hand and knee (for unto this place the orifice of the stomach is turned) that by the power of the vomitory medicine, and concussion of the stomach, they might be constrained to vomit. Neither did our purpose fail us, for presently they voided clammy, yellow and spumous phlegm and blood. But we not being content with all this, blowed up into their nostrils out of a Goose quill, the powder of Euphorbium, that the expulsive faculty of the brain might be stirred up to the expulsion of that which oppressed it; therefore presently the brain being shaken, or moved with sneesing and instimulated thereunto by rubbing the chemical oil of mints on the palate and on the cheeks, they expelled much viscous and clammy matter at their nostrils. Then we used frictions of their arms, legs, and backe-bones; and ministered sharp glisters, by whose efficacy the belly being abundantly loosened, they began presently to speak and to take things that were ministered unto them of their own accord, and so came to themselves again. In the doing of all these things, james Guillemeau Chirurgeon unto the King, and of Paris, and john of Saint Germans the Apothecary, did much help and further us. In the afternoon that the matter being well begun might have good success, john Haughty, and Lewis Thibaut, both most learned Physicians, were sent for unto us, with whom we might consult on other things that were to be done. They highly commending all things that we had done already, thought it very convenient that cordials should be ministered unto them, which by engendering of laudable humours, might not only generate new spirits, but also attenuate and purify those that were gross and cloudy in their bodies. The rest of our consultation was spent in the enquiry of the cause of so dire a mischance. For they said that it was no new or strange thing, that men may be smothered with the fume and cloudy vapour of burning coals. For we read in the works of Fulgosius, Volateranus and Egnatius, that as the Emperor Lib. 9 cap. 12. lib. 23. A history. jovinian, traveled in winter time toward Rome, he being weary in his journey, rested at a Village called Didastanes, which divideth Bythinia from Galatia, where he lay in a chamber that was newly made, and plastered with lime, wherein they burned many coals, for to dry the work or plastering, that was but as yet green on the walls or roof of the chamber. Now he died the very same night being smothered or strangled with the deadly and poisonous vapour of the burned charcoal, in the midst of the night; this happened to him in the eighth month of his reign, the thirtyeth year of his age, and on the twentyeth day of August. But what need we to exemplify this matter by the ancient histories, seeing that not many years since three servants died in the house of john Big●ne goldsmith, who dwelleth at the turning of the bridge of the Change, by reason of a fire made of coals in a close chamber, without a chimney where they lay. And as concerning the causes, these were alleged. Many were of opinion that it happened by the default of the vapour proceeding from the burned coals, which being in a place void of all air or wind, infers such like accidents as the vapour of must or new wine doth, that is to say, pain, and giddiness of the head. For both these kinds of vapour besides that they are crude, like unto those things whereof they come, can also very suddenly obstruct the original of the Nerves, and so cause a convulsion, by reason of the grossness of their substance. For so Hippocrat●s writing of those accidents that happen by the vapour of new Sect. 5. Aph. 5. wine, speaketh. If any man being drunken do suddenly become speechless and hath a convulsion, he dyeth unless he have a fever therewithal; or if he recover not his speech again when his drunkenness is over. Even on the same manner the vapour of the coals assaulting the brain caused them to be speechless, unmoveable and void of all sense, and had died shortly unless by ministering and applying warm medicines into the mouth and to the nosethrells, the grossness of the vapour had been attenuated, and the expulsive faculties moved or provoked to expel all those things that were noisome: and also although at the first sight the Lungs appeared to be greeved more than all the other parts, by reason that they drew the malign vapour into the body, yet when you consider them well, it will manifestly appear that they are not greeved, unless it be by the sympathy or affinity that they have with the brain when it is very greevously afflicted. The proof hereof is, because presently after, there followeth an interception or defect of the voice, sense and motion: which accidents could not be unless the beginning or original of the nerves were intercepted or letted from performing its function, being burdened by some matter contrary to nature. And even as those that have an apoplexy do not dye but for want of respiration, The occasion of the death of such as have the apoplexy. yet without any offence of the Lungs, even so these two young men's deaths were at hand, by reason that their respiration or breathing was in a manner altogether intercepted, not through any default of the Lungs, but of the brain and nerves distributing sense and motion to the whole body and especially to the instruments of respiration. Others chose contended and said, that there was no default in the brain, but conjectured the interception of the vital spirits letted or hindered from going up unto the brain from the heart, by reason that the passages of the Lungs were stopped, to be the occasion that sufficient matter could not be afforded for to perserve and feed the animal spirit. Which was the cause that those young men were in danger of death, for want of respiration, without the which there can be no life. For the heart being in such a case, cannot deliver itself from the fuliginous vapour that encompasseth it, by reason that the Lungs are obstructed by the grossness of the vapour of the coals, whereby inspiration cannot well be made, for it is made by the compass air drawn into our bodies▪ but the air that compasseth us doth that which nature endeavoureth to do by inspiration, for it moderateth the heat of the heart, and therefore it ought to be endued with four qualities. The first is, that the quantity that is drawn into the body be sufficient. The second is, that it be cold, or temperate in quantity. The third is, that it be of a thin and mean consistence. The fourth is, that it be of a gentle and benign substance. But these four conditions were wanting in the air which these two young men drew into their bodies being in a close chamber. For first, it was little in quantity, by reason that small quantity that was contained Conditions of the air good to breath in. in that little close chamber, was partly consumed by the fire of coals, no otherwise than the air that is contained in a cupping glass is consumed in a moment by the flame so soon as it is kindled. Furthermore it was neither cold nor temperate, but as it were inflamed with the burning fire of coals. Thirdly, it was more gross in consistence than it should be by reason of the admixtion of the grosser vapour of the coals: for the nature of the air is so that it may be soon altered, and will very quickly receive the forms and impressions of those substances that are about it. Lastly, it was noisome and hurtful in substance, and altogether offensive to the airy substance of our bodies. For Charcoal are made of green wood burnt in pits under ground, and then extinguished with their own fume or smoke, as all Colliers can tell. These were the opinions of most learned men although they were not altogether agreeable one unto another, yet both of them depended on their proper reasons. For this at least is manifest, that those passages which are common to the breast and brain, were then stopped with the grossness of the vapour of the coals: whereby it appeareth that both these parts were in fault, for as much as the consent and connexion of them with the other parts of the body is so great, that they cannot long abide sound and perfect without their mutual help by reason of the loving and friendly sympathy and affinity that is between all the parts of the body one with another. Wherefore the ventricles of the brain, the passages of the lungs and the sleepy Arteries being stopped, the vital spirit was prohibited from entering into the brain, and consequently the animal spirit retained and kept in, so that it could not come or disperse its self through the whole body, whence happened the defect of two of the faculties necessary for life. It many times happeneth and is a question too frequently handled concerning women's madenheads; whereof the judgement is very difficult. Yet some ancient Of the signs of virginity. women and Midwives will brag that they assuredly know it by certain and infallible signs. For (say they) in such as are virgins there is a certain membrane or parchment-like skin in the neck of the womb, which will hinder the thrusting in of the finger if it be put in any thing deep, which membraine is broken when first they have carnal copulation, as may afterwards be perceived by the free entrance of the finger. Besides, such as are deflowered have the neck of their womb more large and wide; as on the contrary, it is more contracted, straight and narrow in virgins. But how deceitful and untrue these signs and tokens are, shall appear by that which followeth; for this membraine is a thing preternatural, and which is scarce found to be in one of a thousand from the first conformation. Now the neck of the womb will be more open or straight according to the bigness and age of the party. For all the parts of the body have a certain mutual proportion and commensuration in a well made body. joubertus hath written, that at Lectoure in Gasconye, a woman was delivered of a child in the ninth year of her age, and that she is yet alive and called joan du Perié Lib. de error. popul. being wife to Videau Beche the receiver of the amercements of the King of Navare▪ which is a most evident argument, that there are some women more able to accompany with a man at nine years old, than many other at fifteen, by reason of the ample capacity of their womb and the neck thereof; Besides also, this passage is enlarged in many by some accident, as by thrusting their own fingers more strongly thereinto by reason of some itching, or by the putting up of a Nodule, or pessary of the bigness of a man's yard, for to bring down the courses. Neither to have milk in their breasts is any certain sign of lost virginity; For Hypocrates Aph. 39 sect. 5. thus writes; But if a woman which is neither with child, nor hath had one, have milk in her breasts, than her courses have failed her. Moreover, Aristotle reports that there be men who have such plenty of milk in Lib. 4. de hist. animal. cap. 20. Lib. 12. de subtilet. their breasts, that it may be sucked or milked out. Cardan writes, that he saw at Venice one Antony Bussey some 30. years old, who had milk in his breasts in such plenty, as sufficed to suckle a child, so that it did not only drop; but spring out with violence like a woman's milk. Wherefore let Magistrates beware lest thus admonished, they too rashly assent to the reports of women. Let Physicians and Surgeons have a care lest they do too impudently bring magistrates into an error, which will not redound so much to the judges disgrace, as to theirs. But if any desire to know, whether one be poisoned, let him search for the Symptoms and signs in the foregoing and particular treatise of poisons. But that this doctrine of making Reports may be the easier, I think it fit, to give precedents, in imitation whereof the young Chirurgeon may frame others. The first precedent shall be of death to ensue; a second of a doubtful judgement of life and death; the third of an impotency of a member; the fourth of the hurting of many members. I A. P. Chirurgeon of Paris, this twentieth day of May by the command of the A certificate of death. Counsel, entered into the house of john Brossey, whom I found lying in bed, wounded on his head, with a wound in his left temple, piercing the bone with a fracture and effracture, or depression of the broken bone, scailes and meninges into the substance of the brain, by means whereof, his pulse was weak, he was troubled with raving, convulsion, cold sweat, and his appetite was dejected. Whereby may be gathered that certain and speedy death is at hand. In witness whereof I have signed this Report with my own hand. By the Coroners command I have visited Peter Lucey, whom I found sick in bed, Another in a doubtful case being wounded with a Halberd on his right thigh. Now the wound is of the breadth of three fingers, and so deep that it pierces quite through his thigh with the cutting also of a vein and Artery, whence ensued much effusion of blood, which hath exceedingly weakened him, and caused him to swoon often; now all his thigh is woll●e, livide, and gives occasion to fear worse symptoms, which is the cause that the health and safety of the party is to be doubted of. By the justice's command I entered into the house of james Bertey, to visit his In the loss of a member. own brother; I found him wounded in his right harm, with a wound of some four fingers bigness, with the cutting of the tendons bending the leg, and of the Veins, Arteries, and Nerves. Wherefore I affirm that he is in danger of his life, by reason of the malign symptoms that usually happen upon such wounds, such as are great pain, a fever, inflammation, abscess, convulsion, gangrene and the like. Wherefore he stands in need of provident and careful dressing, by benefit whereof if he escape death, without doubt he will continue lame, during the remainder of his life, by reason of the impotency of the wounded part. And this I affirm under my hand. We the Surgeons of Paris, by the command of the Senate, this twentieth Another in the hurts of divers parts. day of March, have visited Master Lewis Vert●man, whom we found hurt with five wounds. The first inflicted on his head, in the middle of his forehead bone, to the bigness of three fingers, and it penetrates even to the second table, so that we were forced to pluck away three splinters of the same bone. The other was atwhart his right cheek, and reacheth from his ear, to the midst of his nose, wherefore we stitched it with four stitches. The third is on the midst of his belly, of the bigness of two fingers, but so deep that it ascends into the capacity of the belly, so that we were forced to cut away portion of the Kall, coming out thereat, to the bigness of a walnut, because having lost its natural colour, it grew black and putrified. The fourth was upon the back of his left hand, the bigness almost of four fingers, with the cutting of the Veins, Arteries Nerves and part of the bones of that part; whence it is, that he will be lame of that hand, howsoever carefully and diligently healed. Now because by hurting the spinal marrow, men become lame, sometimes of a leg; it is fit you know that the spinal marrow descends from the brain like a rivelet for the distribution of the Nerves, who might distribute sense and motion to all the parts under the head; wherefore if by hurting the spinal marrow, the patient's arms or hands are resolved or numb, or wholly without sense, it is a sign these Nerves are hurt which come forth of the fifth, sixth, seaventh vertebrae of the neck. But if the same accidents happen to the thigh, leg or foot with refrigeration, so that the excrements flow unvoluntarily, without the patient's knowledge, or else are totally suppressed, it is a sign that the sinews which proceed from the vertebrae of the loins and holybone are hurt or in fault; so that the animal faculty bestowing sense and motion upon the whole body, and the benefit of opening and shutting to the sphincter muscle of the bladder and fundament, cannot show its self in these parts, by which means sudden death happens, especially if there be difficulty of breathing therewith. Being to make report of a child killed with the mother, have a care that you make a discreet report, whether the child were perfect in all the parts and members A caution in making report of a woman with child being killed. thereof, that the judge may equally punish the author thereof. For he meriteth far greater punishment, who hath killed a child perfectly shaped and made in all the members; that is, he which hath killed a live child, than he which hath killed an Embryon, that is, a certain concretion of the spermaticke body. For Moses punisheth the former with death, as that he should give life for life, but the other with a pecuniary mulcte. But I judge it fit to ex emplifie this report by a precedent. I A. P. by the judges command visited Mistress Margaret Vlmary, whom I found sick in bed, having a strong fever upon her, with a convulsion and effluxe of blood out of her womb, by reason of a wound in her lower belly, below her navel on the right side, penetrating into the capacity of her belly, and the womb therein; whence it hath come to pass, that she was delivered before her time, of a male child, perfect in all his members but dead, being killed by the same wound piercing through his scull, into the marrow of the brain. Which in a short time will be the death of the mother also. In testimony whereof I have put my hand and seal. The manner how to Embalm the dead. I Had determined to finish this my tedious work with the precedent treatise of Reports; but a better thought came in my head, which was, to bring man whose cure I had undertaken, from his infancy, to his end, and even to his grave, so that nothing might be here defective which the Chirurgeon might by his profession, perform about man's body either alive, or dead. Verily there hath scarce ever been a nation so barbarous, which hath not only been careful for the burial, but also for the Embalming or preserving of their dead bodies. For the very Scythians, who have seemed to exceed other nations in barbarousness, and The care of the Scythians in the Embalming their dead. inhumanity, have done this; for (according to Herodotus) the Scythians bury not the corpses of their King, before that being emboweled and stuffed full of beaten Cypress, frankincense, the seeds of Persly, and anise, he be also wrapped in cearcloathes. The like care hath also possessed the minds of the Ethiopians; for having disburdened the corpses of their friends, of their entrails and flesh, they plastered The like care of the Ethiopians. them over, and then having thus rough cast them, they painted them with colours so to express● the dead to the life; they enclosed them thus adorned in a hollow pillar of glass, that thus enclosed they might be seen and yet not annoy the spectators with their smell. Then were they kept the space of a year, in the hands of their next kindred; who during this space offered and sacrificed to them. The year ended, they carried them forth of the City and placed them about the walls each in his proper vault, as Herodotus affirms. But this pious care of the dead, did far otherwise affect the Egyptians, than it did other nations. For they were so studious to preserve Lib. 3. the memory of their ancestors, that they embalmed their whole body with aromatic Of the Egyptians. ointments, and set them in translucent V●nes, or glass Colls in the more eminent and honoured part of their houses, that so they might have them daily in their sight, and might be as monuments, and inciters to stir them up to imitate their fathers and Grandsire's virtues. Besides also the bodies thus embalmed with aromatic & balsamic ointments were in steed of a most sure pawn, so that if any Egyptian had need of a great sum of money, they might easily procure it, of such as knew them & their neighbours, by pawning the body of some of their dead parents. For by this means the creditor was certain, that he which pawned it would sooner lose his life, than break his promise. But if all things so unhappily succeeded with any, so that through poverty he could not fetch home his pawn again, but was force● to forgo it, he was so infamous amongst all men, during the rest of the life, as one banished, or forlorn; and losing his freedom he shall become a servant, yea scorned and reviled of all men, he should be accounted unworthy to enjoy the light and society of men. And certainly the Egyptians understanding the life, which we here lead, to be of short continuance, comparison being made with that which we are to live after the separation of the soul from the body, they were more negligent in building their houses they dwelled in, but in raring the pyramids which should serve them in The reason of building the Egyptian Pyramids. steed of sepulchres, they were so beyond reason sumptuous and magnificent, that for the building of one of these edifices so renowned over all the world, which King Cheopes begun, a hundred thousand men were every 3 months, for twenty years' space there kept at work: it was five furlongs, and being square, each side was 800. foot long, and so much in height. Almost all the pieces of marble went to the building thereof, were thirty foot long, engraven and carved with various workmanship, as Herodotus reports. But before the bodies were committed to these magnificent Lib. 2. Sepulchers, they were carried to the Salters and Embalmers, who for that purpose had allowance out of the public stock. These besmeared them with Aromatic, and balsamicke ointments, and sowed up the incisions they made, then strewed them over with salt, and then covered them with brine, for 70. days; which being expired, they washed them, being taken thence, and all the filth being taken off, they wrapped them in Cotton clothes, glued together with a certain gum; then their kinsmen placed them thus ordered in a wooden Coffinne carved like to a man. This was the sacred and accustomed rite of embalming and burying dead bodies amongst the Egyptians which were of the richer sort. Our Countrymen the French stirred up with the like desire, embalm the bodies of their Kings and Nobles, with spices and sweet ointments. Which custom they may seem piously and christianly to have taken from the Old and New Testament, and the ancient and laudable custom of the jews; for you may read in the New Testament john 19, 39 that joseph bought a fine linen cloth, and Nicodemus brought a mixture of myrrh and Aloes about 100 pound weight, that they might embalm and bury the body of jesus Christ our Saviour, for a sign and argument of the renovation and future integrity which they hoped for by the resurrection of the dead. Which thing the jews had received by tradition from their ancestors. For joseph in the old Testament Gen 50, 2. commanded his Physicians, they should embalm the dead body of his father with spices. But the body which is to be embalmed with spices for very long continuance, must The manner of embalming for the long continuance. first of all be emboweled, keeping the heart apart, that it may be embalmed and kept as the kinsfolks shall think fit. Also the brain, the scull being divided with a saw, shall be taken out. Then shall you make deep incisions alongst the arms, thighs, legs, back, loins and buttocks, especially where the greater Veins and Arteries run, first that by this means the blood may be pressed forth, which otherwise would putrify and give occasion and beginning to putrefaction to the rest of the body; and than that there may be space to put in the aromatic powders; the whole body shall be washed over with a sponge dipped in Aqua vitae, and strong vinegar, wherein shall be boiled wormwood, aloes, coloquintida, common salt and Alum. Then these incisions, and all the passages and open places of the body, and the three bellies shall be stuffed with the following spices grossly powdered. R. pull. rosar. chamaem. melil. balsami, menthae, ane●hi, salviae, lavend. rorismar. majoran. thymi, absinthij, cyperi, calami aromat. gentianae, ireos florent. assae odoratae; caryophyll. nucis moschat. cinamoni, styracis, calamitae. benjoini, myrrhae, aloes▪ santal. omnium quod sufficit. Let the incisions be sowed up and the open spaces that nothing fall out; then forth with let the whole body be anointed with Turpentine dissolved with oil of roses and Chamomile, adding if you shall think it fit, some Chemical oils of spices, and then let it be again strewed over with the forementioned powder; then wrap it in a linen cloth, and then in ceare-cloathes. Lastly, let it be put in a Coffin of Lead, sure soudred and filled up with dry sweet How to embalm bodies when as we want spices. herbs. But if there be no plenty of the forementioned spices, as it usual happens in besieged towns, the Chirurgeon shall be contented with the powder of quenched lime, common ashes made of Oak wood. Why the bodies of our Princes, how wellsoever embalmed, corrupt in a few days. For thus the body being over and above washed in strong vinegar, or Lie, shall be kept a long time, if so be that a great and dissolving heat do not bear sway, or if it be not put in a hot and moist place. And this condition of time and place is the cause why the dead bodies of Princes and Kings, though embalmed with Art and cost, within the space of six or seven days, in which they are kept to be showed to the people after their embalming, do cast forth so grievous a scent, that none can endure it, so that they are forced to be put in a leaden Coffinne. For the air which encompasseth them groweth so hot by reason of the multitude of people flowing to the spectacle, and the burning of lights night and day, that the small portion of the native heat which remaineth being dissipated, they easily putrefy, especially when as they are not first moistened & macerated in the liquor of aromatic things, as the Egyptians anciently used to do, steeping them in brine for 70 days, as I formerly told you out of Herodotus. I put in mind hereby, use, that so the embalming may become the more durable, to steep the bodies (being emboweled, and pricked all over with sharp bodkinnes, that so the liquor hindering putrefaction may penetrate the deeper into them) in a wooden tub filled with strong vinegar of the decoction of aromatic and bitter things, as Aloes, Rue, Wormwood, and Coloquintida; and there keep them for twenty days, pouring thereinto eleven or twelve pin●s of Aqua vitae. Then taking it forth, and setting it on the feet, I keep it in a clear and dry place. I have at home the body of one that was hanged, which I begged of the sheriff, embalmed after this manner, which remains sound for more than 25 years, so that you may tell all the muscles of the right side (which I have cut up even to their heads, and plucked them from those that are next them for distinctions sake, that so I may view them with my eyes, and handle them with my hands as often as I please, that by renewing my memory I may work more certainly and surely, when as I have any more curious operation to be performed) the left side remains whole, and the Lungs, Heart, Diaphragma, stomach, spleen, kidneys, beard, hairs, yea and the nails, which being pared, I have often observed to grow again to their former bigness. And let this be the bound of this our immense labour, and by God's favour our rest; to whom Almighty, all powerful, immortal and invisible, be ascribed all honour and glory for ever, and ever, Amen. Labour improbus omnia vincit. The end of the Treatise of reports, and embalming the dead. THE APOLOGY AND TREATISE, CONTAINING THE VOYAGES MADE INTO DIVERS PLACES. BY AMBROSE PAIR of Laval in Maine, Counsellor and chief Chirurgeon to the King. THE TWENTI NINTH BOOK. Truly I had not put my hand to the pen, to write on Of what the Adversary accuseth the Author. such a thing, were it not that some have impudently injured, taxed, and more through particular hatred, disgraced me, than for zeal or love they bear to the public good; which was, concerning my manner of tying the Veins and Arteries, writing thus as followeth. Malè igitur & nimiùm arrogdnter inconsultus & temerarius The words of the Adversary. quidam, vasorum ustionem post emortui membri resectionem a veteribus omnibus plurimùm commendatam & semper probatam damnare ausus est, novum quendam deligandi vasa modum, contra veteres omnes medicos sine ratione, experientia & judicio docere cupiens, nec animadvertit majora multo pericula ex ipsa vasorum deligatione quam acu partemsanam profunde transfigendo administrari vult, imminere quam ex ipsa ustione. Nam si acu nervosam aliquam partem, vel nervum ipsum pupugerit, dum ita novo & inusitato modo venam absurde conatur constringere, nova inflammatio necessariò consequetur, a qua Convulsio & a convulsione cita mors. Quorum symptomatum metu Galenus non ante transversa vulnera suere audebat (quod tamen minus erat periculosum) quam masculorum apoucuroses denudasset. Add quòd forcipes quibus post sectionem iterum carnem dilacerat, cum retracta versus originem vasa se posse extrahere somniat, non minorem adferant dolorem quam ignita ferramenta admota. Quod si quis laniatum expertus incolumis evaserit, is Deo optimo maximo cuius Beneficentia crudelitate ista & carnificina liberatus est, maximas gratias habere & semper agere debet; which is thus: Ill then, and too arrogantly a certain indiscreet and rash person would blame and condemn the cauterizing of vessels after the amputation of a rotten and corrupted member, much praised and commended and always approved by the Ancients; desiring to show and teach us without reason, judgement, and experience, a new way to tie the vessels, against the opinion of the Ancient Physicians, taking no heed, nor being well advised, that there happens far greater perils, and accidents, through this new way of tying the vessels (which he will have to be made with a needle, piercing deeply the sound part) than by the burning and ustion of the said vessels; for if the needle shall prick any nervous part, yea the nerve itself, when he shall by this new and accustomed way absurdly constrain the vein by binding it, there must necessarily follow a new inflammation; from an inflammations convulsion, from a convulsion death: for fear of which accidents, Galen never durst stitch transversal veins, (which notwithstanding were less dangerous) before he had discovered the aponeurosis of the muscles. Moreover the pincers with which after the section, 〈…〉 is again dilacerated, while he thinks to draw the vessels out which are drwne in toward their original, bring no less pain than the cautering irons do. And if any one having experimented this new manner of cruelty have escaped danger, he ought to render thanks to almighty God forever, through whose goodness he hath been freed from such tyranny, feeling rather his executioner than his methodicall-Chirurgion. O what sweet words are here for one, who is said to be a wise and learned Doctor? he remembers not that his white beard admonisheth him, not to speak any The Author's answer. thing unworthy of his age, and that he ought to put off and drive out of him all envy and rancour conceived against his neighbour. So now I will prove by authority, reason and experience, that the said Veins and Arteries ought to be tied. Authorities. AS for Authorities, I will come to that of that worthy man Hypocrates, who wils and commands the cure of Fistula's in the fundament by ligature, as well to In the book of Fistulas of the fundament in the 3 chap. 5. book 4. leaf. 2. Treatise chap. 17. Treatise 3. doct. 1. chap. 3 consume the callosity, as to avoid hemorragie. Galen in his method, speaking of a flux of blood made by an outward cause, of whom see here the words, It is (saith he) most sure to tie the foot of the vessel, which I understand to be that which is most near to the Liver, or the heart. Avicen commands to tie the vein and the Artery, after it is discovered, towards his original. Guido of Cauliac, speaking of the wounds of the Veins and Arteries, enjoineth the Chirurgeon to make the ligature in the vessel. Master Holier speaking of a flux of blood, commands expressly, to tie the vessels. In the 3 book chap. 4. of the matter of Chirurgery. Wounds chap. 12. In the 26 chap. of the 5 book. Calmetheus in the chapter of the wounds in the Veins and Arteries, tells a most sure way to stay a flux of blood, by ligature of the vessel. Celsus from whom the said Physician hath snatched the most part of his book, chargeth expressly, to tie the vessels in a flux of blood happening to wounds; as a remedy most easy and most sure. Vesalius in his Chirurgery, willeth that the vessels be tied in a flux of blood. john de Vigo treating of a hemorragie in bleeding wounds, commands to tie the In the 4 ch. of the 3 book. In the book 〈◊〉 treatise. Vein, and the Artery. Tagaultius treating of the means to stay a flux of blood, commands to pinch the Vein or Artery with a Crow or Parrots bill, then to tie it with a very strong In the 12. chap. of the 2. book. thread. Peter of Argillata of Bullongne, discoursing of a flux of blood, and the means to stop it, giveth a fourth way expressly, which is made by ligature of the vessels. In the 4 treat. 11 chap. 1. book. john Andreas a Cruse, a Venetian, makes mention of a method, to stay a flux of In the first book 1 section 3. chap. 16. page 5 upon the ●8. ch. of the book of Paul. blood by the ligature of the vessels. D'Alechamp commands to tie the Veins, and Arteries. See then (my little good man) the authorities which command you to tie the vessels. As for the reasons, I will debate of them. The hemorragie (say you) is not so much to be feared in the section of the Call, as that of the Varices, and the incision of the temporal Arteries, as after the amputation In the book 2. ch. of Angealogie, lea●e. 76. In the book 1 ch. of stitches. of a member. Now you yourself command, that in cutting the Varixes, the flux of blood be stopped by the ligature of the vessels. You command the same, speaking of the stitch, with the amputation and section of the Call, changed by the outward air, see here your own words: After that must be considered concerning the Call: for if there be any part corrupted, putrified, withered, or blackish. First having tied, for fear of a flux of blood, you do not bid afterward to have it cauterised; but to say the truth, you have your eyes shut, and all your senses dulled, when you would speak against so sure a method, and that it is not but through anger, and an ill will. For there is nothing which hath more power to drive reason from her seat, than choler and anger. Moreover when one comes to cauterise the dismembered parts, oftentimes when the escar comes to fall off, there happens a new flux of blood: As I have seen divers times, not having yet been inspired by God, with so sure a means then, when I used the heat of fire. Which if you have not found, or understood this method in the books of the Ancients, you ought not thus to tread it under your feet, and speak unluckely of one who all his life hath preferred the profit of the Commonwealth before his own particular. Is it not more than reasonable to be founded upon the saying of Hypocrates; upon whose authority you serve yourself, which is thus? That what the medicament In the chapter of burning, 2 book lea●e 2●6. In the first book leaf the 5. cureth not, the iron doth, and what the iron doth not amend, the fire exterminateth: It is a thing which savours not of a Christian, to fall to burning at the first dash without staying for any more gentle remedies. As you yourself write, speaking of the conditions required in a Chirurgeon to cure well; which passage you borrow from some other place: for that which may be done gently without fire, is much more Galen in 4. book of the Meth. and in the book of Art of Hypocrates Apho. the 6. book 1. In the book of ●rte 〈◊〉. commended than otherwise. Is it not a thing which all schools hold as a Maxim, that we must always begin with most easy remedies, which if they be not sufficient, we must then come to extreme, following the doctrine of Hypocrates? Galen commands in the place before alleged, to treat or dress the diseased quickly, safely, and with the least of pain that is possible. Let us come now to Reason. NOw so it is, that one cannot apply hot irons but with extreme and vehement pain in a sensible part, void of a Gangrene, which would be cause of a Convulsion, Fever, yea oft times of death. Moreover, it would be a long while afterwards before the poor patients were cured, because that by the action of the fire there is made an eschar, which proceeds from the subject flesh, which being fallen, Of what the esch●r is made. nature must regenerate a new flesh in stead of that which hath been burned, as also the bone remains discovered and bare; and by this means, for the most part there remains an Ulcer incurable. Moreover there is yet another accident. It happeneth that oftentimes the crust being fallen off, the flesh not being well renewed, the blood issueth out as much as it did before. But when they shall be tied, the ligature falls not off until first the flesh have very well covered them again: which is proved by Galen, saying, that escharoticke medicines which cause a crust or eschar, whensoever they fall off, leave the part more bare than the natural habit In the 5 book of his Meth. requires. For the generation of a crust proceeds from the parts subject, and which are situate round about it, being also burned, as I may say: wherefore by how much the part is burnt, by so much it looseth the natural heat. Then tell Words of the adversary. me when it is necessary to use escharoticke medicines, or cautering irons? 'tis when the flux of blood is caused by erosion, or some Gangrene or putrefaction. Now is it thus? In fresh bleeding wounds there is neither Gangrene nor putrefaction. Therefore, the cauteries ought not to be there applied. And when the Ancients commanded to apply hot irons to the mouths of the vessels, it hath not been only to stay the flux of blood, but chiefly to correct the malignity, or gangreenous putrefaction which might spoil the neighbouring parts. And it must be here noted, that if I had known such accidents to happen, which you have declared in your book, in drawing and tying the vessels, I had never been twice deceived; nor would I ever have left by my writings to posterity, such a way of stopping a flux of blood: But I writ it after I had seen it done and did it very often, with happy success. See then what may happen through your inconsiderate counsel, without examining, or standing upon the facility of tying the said vessels. For see, here's Proposition of the Adversary. your scope and proposition, to tie the vessels after amputation is a new remedy, say you; than it must not be used, it is an ill argument for a Doctor. But as for that (say you) one must use fire after the amputation of members, to consume, and dry the putrefaction, which is a common thing in Gangreenes, and mortifications, that indeed hath no place here, because the practice is to amputate the part above that which is mortified, and corrupted; as Celsus writes and commands, In the 5, book ch. 26, and in the 7 book ch.. 33● to make the amputation upon the sound part, rather than to leave any whit of the corrupted. I would willingly ask you, if when a vein is cut transverse, and that it is very much retracted towards the original, whether you would make no conscience to burn till that you had found the orifice of the vein, or artery; and if it be not more easy only with a Crow bill to pinch and draw the vessel, and so tie it? In which you may openly show your ignorance, and that you have your mind In the ch. of cutting book the 2. seized with much rancour and choler. We daily see the ligature of the vessels practised with happy success after the amputation of a part, which I will now verify by experiences and histories, of those to whom the said ligature hath been made, and persons yet living. Experiences. THe 16. day of june 1582. in the presence of Master john Liebaud doctor in the faculty of Physic at Paris, Claud Viard sworn Chirurgeon, Master Mathurin A notable history. Huron, Chirurgeon of Monsieur de Sovuray, and I, john Charbonell master Barbes Chirurgeon of Paris, well understanding the Theoric, and Practice of Chirurgery, did with good dexterity amputate the left leg of a woman tormented the space of three years with extreme pain, by reason of a great Caries which was in the bone Astragal, Cyboides, great and little focile, and through all the nervous parts, through which she felt extreme and intolerable pains night and day: she is called Mary of Hostel, aged 28 years, or thereabouts, wife of Peter Herve, Esquire of the Kitchen to the Lady Duchess of Vzez, dwelling in the street of Verbois on the other side Saint Martin in the fields, dwelling at the sign of the Saint john's head; where the said Charbonell cut off the said leg, the breadth of four large fingers below the Knee, and after that he had incised the flesh, and sawed the bone, he gripped the The operation of Charbonell. Vein with the Crow bill, than the Artery, than tied them; from whence I protest to God (which the company that were there, can witness) that in all the operation which was suddenly done, there was not spilt one porringer of blood; and I bid the said, Charbonell to let it bleed more, following the precept of Hypocrates, that In the 7, sentence of the book of Ulcers. it is good in all wounds and also in inveterate ulcers, so let the blood run; by this means, the part is less subject to inflammation. The said Charbonell continued the dressing of her, who was cured in two months, without any flux of blood happening unto her, or other ill accident; and she went to see you at your lodging being perfectly cured. Another history of late memory, of a singing man of our Lady's Church named Another history. master Colt, who broke both the bones of his leg which were crushed in divers pieces, insomuch that there was no hope of cure: to withstand a gangrene and mortification, and by consequence death. Monsieur Helin Doctor, Regent in the faculty of Physic, a man of honour and of good knowledge, Claud Viard, and Simon Peter, sworn Surgeons of Paris, men well exercised in Chirurgery; and Balthasar of Lestre, and Leonard de Leschenal, Master Barber Surgeons, well experimented in the operations of Chirurgery, were all of opinion to withstand the accidents aforesaid, to make entire amputation of the whole leg, a little above the Operation done by Viard. broken & shivered bones & the torn nerves, veins, arteries; the operation was nimbly done, by the said Viard, and the blood staunched by the ligature of the vessels in the presence of the said Helin, and master Tonsard great Vicar of our Lady's Church, and was continually dressed by the said Lesche●al, and I went to see him other while; he was happily cured without the application of hot irons, and walketh lustily on a wooden leg. Another History. IN the year 1583. the 10. day of December, Toussaint Posso● borne at Ronieville, at this present dwelling at Beauvais near Dourdan, having his Leg all ulcered, and all the bones cariezed and rotten, prayed me for the honour of God to cut off his Leg by reason of the great pain which he could no longer endure. After his body was prepared I caused his leg to be cut off, four fingers below the rotula of the knee, by Daniel Powlet one of my servants, to teach him and to embolden him in such works; and there he readily tied the vessels to stay the bleeding, without application of hot irons, in the presence of james Guillemea● ordinary Chirurgeon to the King, and john Charbonell master Barber Chirurgeon of Paris: and during the cure was visited by Master Laffile and Master Courtin Doctors, Regent's in the faculty of Medicine at Paris. The said operation was made in the house of john Gohell Innkeeper, dwelling at the sign of the white horse in the Greve. I will not here forget to say, that the Lady Princess of Montpe●sier, knowing that he was poor, and in my hands, gave him money to pay for his chamber and diet. He was well cured, God be praised, and is returned home to his house with a wooden Leg. Another History. A Gangrene happened to half of the Leg to one named Nicholas Mesnager Gangrene happening by an antecedent cause. aged threescore and sixteen years, dwelling in S. Honours' street, at the sign of the Basket; which happened to him through an inward cause, so that we were constrained to cut off his Leg to save his life: and it was taken; off by Anthony Renaud, master Barber Chirurgeon of Paris the 16. day of December 1583. in the presence of Master Le Fort, and Master La Noüe sworn Surgeons of Paris; and the blood was staunched by the Ligature of the vessels, and he is at this present cured and in health, walking with a wooden Leg. Another History. A Waterman at the Port of Nesle, dwelling near Monsieur de Mas, Postmaster, named john Boussereau, in whose hands a Musket broke asunder▪ which broke the bones of his head, and rend and tore the other parts in such sort that it was needful and necessary to make amputation of the hand two fingers above the wrist: which was done by james Guillemeau then Chirurgeon in ordinary to the king, who Operation done Guilles meau. dwelled at that time with me. The operation likewise being readily done, and the blood staunched by the Ligature of the vessels without burning irons: he is at this present living. Another History. A Merchant Grocer dwelling in St, Denis street at the sign of the great Tournois Operation done by the Author. named the judge, who fell upon his head, where was made a wound near the temporal muscle, where he had an artery opened, from whence issued forth blood with great impetuosity, in so much that common remedies would not serve the turn; I was called thither, where I found Master Rasse, Master Cointeret, Master Viard, sworn Surgeons of Paris, to stay the blood; where presently I took a needle and thread, and tied the artery, and it bled no more after that, and was quickly cured. Master Rousselet can witness it, not long since Deacon of your Faculty, who was in the cure with us. Another History. A Sergeant of the Chastler dwelling near S. Andrew des Arts, who had a stroke Another operation. of a sword upon the throat in the Clackes meadow, which cut asunder the jugular vein extern, as soon as he was hurt he put his handkerchief upon the wound, and came to look me at my house, and when he took away his handkerchief the blood leapt out with great impetuosity: I suddenly tied the vein toward the root; he by this means was staunched and cured thanks be to God. And if one had followed your manner of staunching blood by cauteries, I leave it to be supposed whether he had been cured; I think he had been dead in the hands of the operator. If I would recite all those whose vessels were tied to stay the blood which have been cured, I should not have ended this long time; so that me thinks there are Histories enough recited to make you believe the blood of veins and arteries is surely staunched without applying any actual cauteries. DV BARTUS. He that doth strive against experience, Daignes not to talk of any learned science. NOw my little Master, seeing that you reproach me, that I have not written all the operations of Chirurgery in my works which the Ancients writ of, I should be very sorry for it: for then indeed might you justly call me Carnifex. I Book the 6. Chap. 4 and 5 book 2. chap. 4. book 3, ch. 9, section 7. have left them because they are too cruel, and am willing to follow the moderns, who have moderated such cruelty: which notwithstanding you have followed step by step, as appear by the operations here written, extracted from your book, which you have drawn here and there from certain ancient Authors, such as follow: and such as you have never practised nor seen. The first operation. TO inveterate fluxions of the eyes, & Migrimes, Paulus Aegineta as also Albucasis command to make Arteriotomie, see here the words of the same Aeginete. You In the 2. book of the chap. of Hypospatisme, book 14, ch. last, of the Meth. In the 4. chap. of the 16. book of my work. Book 6 chap. 7, Book 2, chap. 5. mark the Arteries which are behind the ears, then divide them in cutting to the very bone, and make a great incision the breadth of two fingers; which is the will also of Aetius that the incision be made tranverse, cutting or incising the length of two fingers, even till that the Artery be found, as you command to be done in your book; but I holding the opinion of Galen, who commands to dress the diseased quickly, safely and with the least pain that is possible, I teach the young Chirurgeon the means to remedy such evils in opening the Arteries behind the ears, and those of the Temples, with one only incision, as a letting blood, and not to make a great incision and cut out work for a long time. The second operation. TO fluxions which are made a long time upon the eyes, Paul Aeginete and Albucasis command to make incision which they call Periscythismos or Augiologie of the greeks; and see here the words of Paul, In this operation first the head is shaved, In the 2, book chap. of Periscythisme. then taking heed of touching the temporal muscles, a transverse incision must be made, beginning at the left Temple and finishing at the right, which you have put in your book word for word, without changing any thing: which showeth openly you are a right wound-maker; as may be s●ene in the Chapter which you call the Crown cut, which is made half round under the coronal suture from one temple to the another even to the bone. Now I do not teach such a cruel kind of remedy, In the 26. ch. of the 9 book of my works. but instruct the operator by reason, authority and notable proof of a sure and certain way to remedy such affections without butchering men in this kind. The third. IN the cure of the Empyema, Paul Aeginete, Albucasis and Celsus commanded to apply some 13. others 15. Cauterles to give issue to the matter contained in the Book 6. chap. 44. book 2, chap. 3. book 3. chap. 22. breast, as the said Celsus in the aforesaid place appointeth for Asthmatick people, which is a thing out of all reason (with respect to their honour be it spoken) that since the Surgeon's scope is to give issue to the matter therein contained, there is no other question than to make apertion, to evacuate the matter in the most inferior part, I have showed the young Chirurgeon the means to do it safely, without tormenting the patients for nothing. The fourth. IN Paps that are too great, Paul Aeginet and Albucrasis commands to make a cross Guide of Ca●liac the 2, treatise. Doct. 1. chap. 1. Book 7. chap 10. book 6. chap 46, book 2, chap. 47. incision, to take out all the fat, and then join together the wound by stitch: In brief, it is to slay a man alive, which I have never practised, nor counsel it to be done by the young Chirurgeon. The fifth. ALbucrasis and Paul Aeginet will cauterise the Liver and the Spleen with hot In the first book, chap. 29, & 30. also in book 2, chap. 32. Book 6, chap. 47, and 48. In the 〈◊〉, book chap. 1, De internes morbis. Book 1. chap. 33. book 3, sect. 2, chap. 89. book the 6, chap. 50. In the 3. book 12. chap. 6, 7. irons, which the moderns have never practised; for indeed reason is manifestly repugnant thereunto. The Sixth. IN the Paracenteses which is made in the third kind of Dropsy called Ascites, Celius Aurelianus commandeth divers apertions to be made in the belly. Albucrasis applies nine actual cauteries, that is to say, four about the Navel, one upon the Stomach, one upon the Spleen, one upon the Liver, two behind the back upon the spondyls, one of them near the breast, the last near the Stomach. Aetius is likewise of the same opinion, to open the belly with divers cauteries. Paul Aeginet commands to apply five actual cauteries to make the said Paracenteses. But abhorring such a kind of burning of which you speak much in your third book, I show another kind of practice, the which is done in making a simple incision in the said belly, as may be seen in my works, with happy success. I do not teach young men in my works the manner of burning, which the Ancients have called infibulare, that is not in practice though Celsus writeth of it. The Seaventh. IN the Sciaticke proceeding from an internal cause, and because the viscous humours In the 7. book chap. 25. book 6, chap. 76. book 2, chap, 72, upon the sentence 49. of the 〈◊〉 section of the book of Arts. displace the bones, Paul commands to burn or cauterise the said joy 〈…〉 the bone: Di●scorides commands the same, Which I do not find expedient, ●…king indication from the subjacent parts: for there where one would burn, 'tis in the place of the four twin muscles, under which passeth the great. Nerve descunding from the holy bone; which being burnt, I leave it to your censure what might happen, as Galen remarketh speaking of the ustion which must be made in the shoulder called humerus. The Eighth. IN the outward Laxation of the spondyls, Hypocrates commands to bind the man Sentence the 22, and 23, of the 3 section of the book of the joints, chap. 1●. of the 15. book. right upon a Ladder, the Arms and Legs tied and bound: then afterwards having raised the Ladder to the top of a tower, or the ridge of an house, with a great rope in a pulley, then to let the patient fall plumb down upon the hard pavement; which Hypocrates says was done in his time. But I do not show any such way of giving the strappado to men, but I show the Chirurgeon in my works, the way to reduce them surely, and without great pain. Moreover I should be sorry to follow the saying of the said Hypocrates, in the third book De morbis, who commands in the disease called Volvulus to cause the belly to be blown with a pair of Bellowes, putting the nosell of them into the intestinum rectum, and then blow there till the belly be much stretched, afterwards to give an emollient glister, and to stop the fundament with a sponge. Such practice as this is not made now a days, therefore wonder not if I have not spoken of it. And you not being contented to patch together the operations of the above said Authors, you have also taken divers in my works, as every man may know: which showeth manifestly that there is nothing of your own in your Surgeon's Guide. I leave out divers other unprofitable operations which you quote in your book, without knowing what beasts they are, in never having seen them practised; but because you have found them written in the books of the Ancients, you have put them into your book. Moreover you say that you will teach me my lesson in the operations of Chirurgery, which I think you cannot do: because I have not only learned them in my Study, and by the hearing for many years the lessons of Doctors of Physic: but as I have said before in my Epistle to the Reader, I was resident the space of three years in the Hospital of Paris, where I had the means to see and learn divers works of Chirurgery, upon divers diseases, together with the Anatomy, upon a great number of dead bodies, as oftentimes I have sufficiently made trial publicly in the Physicians school at Paris, and my good luck hath made me seen much more. For being called to the service of the Kings of France (four of which I have served) I have been in company at Battles, Skirmishes, assaults, and beseiging of Cities and Fortresses; as also I have been shut up in Cities with those that have been besieged, having charge to dress those that were hurt. Also I have dwelled many years in this great and famous City of Paris, where, thanks be to God, I have lived in very good reputation amongst all men, and have not been esteemed the least in rank of men of my profession, seeing there was not any cure, were it never so difficult and great, where my hand and my counsel have not been required, as I make it appear in this my work. Now dare you (these things being understood) say you will teach me to perform the works of Chirurgery, since you never went further than your study? The operations of the same are four in general (as we have declared heretofore) where you make but three, that is to say, join that which is separated, separate that which was conjoined, and to take away that which is superfluous, and the fourth which I make, is as much necessary as industrious invention, to add to Nature that which is wanting, as I have showed here above. Also it is your will that the Chirurgeon make but the three operations above said without meddling to ordain a simple Cataplasm, saying it is that which comes to your part belonging to the Physician: And that the Ancients (in the discourse which you have made to the Reader) have divided the practice of Physic into three kinds, that is to say, Diet, Medicine, and Chirurgery. But I would willingly demand of you, who hath made the partition, and where any thing should be done, who are those which are content with their part, without any enterprise upon the other? For Hypocrates, Galen, Aetius, Avicen, in brief, all the Physicians, as well greeks and Latins as Arabians, have never so treated of the one, that they have not treated of the other, for the great affinity and tie that there is between them two, and it should be very difficult to do otherwise. Now when you will vilify Chirurgery so much, you speak against yourself; for in your Epistle which you have dedicated to Monsieur of Martignes, you say, that Chirurgery is the most noble part of Physic, as well by reason of the original, antiquity, necessity, as certainty in her actions; for she works Luce aperta, as learnedly writeth Celsu● in the beginning of his seaventh book; therefore it is to be believed you never went out of your study, but to teach the Theoric (if you have been able to do it.) The operations of Chirurgery are learned by the eye, & by the touch. I will say that you much resemble a young Lad of Low Brittany, of plump buttocks, where was stuff A fair similitude. sufficient; who demanded leave of his father to come to Paris, to take France; being arrived the Organist of our Lady's Church, met with him as the Palace gate, who took him to blow the Organs, where he was remaining three years: he saw he could somewhat speak French, he returns to his father, and told him that he spoke good French, and moreover he knew well, to play on the Organs: his father received him very joyfully, for that he was so wise and learned in so short a time. He went to the Organist of their great Church, and prayed him to permit his son to play on the Organs, to the end he might know whether his son was become so skilful a master, as he said he was; which the Organist agreed to very willingly. Being entered to the Organs, he cast himself with a full leap to the bellowes, the master Organist bid him play, and that he would blow; then this good master answers, Let him play himself on the Organs if he would for him, he could do nothing but play on the bellowes. I think also my little master, that you know nothing else, but to prattle in a chair; but I will play upon the keys, and make the Organs sound (that is to say) I will do the operations of Chirurgery, that which you cannot in any wise do, because you have not gone from your study or the schools, as I have said before. But also, as I have said already in the Epistle to the Reader, that the labourer doth little profit by talking of the seasons, discourse of the manner of tilling the earth, to show what seeds are proper to each soil; all which is nothing if he put not his hand to the Plough, and couple the Oxen together. So likewise is it no great matter if you do not know the Practice, for a man may execute Chirurgery well, although he have no tongue at all. As Cornelius Celsus hath very well remarked in his first book when he saith, Morbos non eloquentia, sed remedijs curari: quae si quis elinguis, usu discretus bene norit, hunc aliquantia majorem medicum futurum, quam si sine usu linguam suam excoluerit; that is to say; Diseases are not to be cured by eloquence, but by remedies well and duly applied, which if any wise and discreet man though he have no tongue know well the use thereof, this man in time shall become the greater Physician, than if without practise his tongue were dipped with oratory; the which you yourself confess in your said book by a Tetrasticke which is thus: To talk's not all in Surgeon's Art, But working with the hands. Aptly to dress each grieved part, And guide, fire, knife, and bands. Aristotle in the first book of his Metaphysics the first chapter saith, Experience is almost like unto science, and by the same, Art and science have been invented. And indeed we see these which are experimented, attain sooner to that which they intent, than those which have reason and not experience, because that the said experience is a knowledge of singular and particular things, and science on the contrary is a knowledge of things universal. Now that which is particular is more healeable than that which is universal, therefore those which have experience are more wise and more esteemed, than those which want it, by reason they know what they do. Moreover I say, that science without experience, bringeth no great assurance. Alciat a Doctor of Milan, boasted one day of himself, that his glory was greater and more famous than that of Counsellors, Precedents, masters of Request: because that it was by his science, and his instructions that they became such: but he was answered by a Counsellor, that he was like unto a whetstone, which made the knife sharp and ready to cut, not being able so to do itself, and alleged the verses of Horace that: Fungebatur vice cotis, acutum Reddere quae ferrum valet, exhorts ipsa secandi. See you now (my little master) my answers to your calumniations, and pray you, if you bear a good mind (to the public good) to review and correct your book, as soon as you can, and not to hold young Chirurgeon in this error by the reading of the same, where you teach them to use hot irons after the amputation of members, to stay a flux of blood, seeing there is another means, and not so cruel and more sure and easy. Moreover if to day after an assault of a City, where divers Soldiers have had arms and legs broken, and shot off by Cannon Bullets, Cutlas or other instruments of war; to stay the flux of blood, if you should use hot irons, it would be needful to have a forge, and much coals to heat them: and also the soldiers would hold you in such horror for this cruelty, that they would kill you like a Calf, even as in times past they did to one of the chiefest Surgeons of Rome, which may be found written before in the third chapter of the Introduction of Chirurgery, the 〈◊〉 book. Now lest the Sectators of your writings should fall into such inconveniency, I pray them to follow the method aforesaid, the which I have showed to be true and certain, and approved by authority, reason and experience. The Voyage of Thurin, 1536. MOreover, I will here show to the readers the places where I have had means to learn the Art of Chirurgery, for the better instructing of the young Chirurgeon: and first in the year 1536, the great King Francis sent a great Army to Thurin, to recover the Cities and Castles, which the marquis of Guas●, Lieutenant general of the Emperor had taken: where the high Constable of France the great master, was Lieutenant general of the Army, and Monsieur de Montian Colonel general of the foot, of which I was then Chirurgeon. A great part of the Army The retiring of the enemies. arrived in the Country of Suze; we found the enemy which stopped the passage, and had made certain Forts, and trenches, insomuch that to hunt them out and make them leave the place, we were forced to fight, where there were divers hurt and slain, as well of the one side as of the other: but the enemies were coustrayned to retire, and get into the Castle, which was caused partly by one Captain Rat, who climbed with divers of the soldiers of his company upon a little Mountain; there where he shot directly upon the enemies, he received a shot upon the ankle of his right foot, wherewith presently he fell to the ground; and said then, Now is the Rat taken. I dressed him, and God healed him. We entered the throng in the City, and passed over the dead bodies, and some which were not yet dead, we heard them cry under our horses feet, which made my heart relent to hear them. And truly I repented to have forsaken Paris to see so pitiful a spectacle. Being in the City, I entered into a stable thinking to lodge my own, and my man's horse, where I found four dead soldiers, and three which were leaning against the wall, their faces wholly disfigured, and neither saw nor heard, nor spoke; and their clothes did yet flame with the gunpowder which had burnt them. Beholding History. them with pity, there happened to come an old soldier, who asked me if there were any possible means to cure them, I told him no: he presently approached to them, and gently cut their throats without choler. Seeing this great cruelty, I told him he was a wicked man, he answered me that he prayed to God, that whensoever he should be in such a case, that he might find some one that would do as much to him, to the end he might not miserably languish. And to return to our former discourse, the enemy was summoned to render, which they soon did, & went out, their lives only saved, with a white staff in their hands; the greatest part whereof went and got to the Castle of Villain, where there was about 200. Spaniards; Monsieur the Constable would not leave them behind, to the end that the way might be made free. This Castle is seated upon a little mountain, which gave great assurance to them within, that one could not plant the Ordinance to beat upon it, and were summoned to render, or that they should be cut in pieces; which they flatly refused, making answer that they were as good and faithful servants to the Emperor, as Monsieur the Constable could be to the King his master. Their answer Brave answer of the Soldiers. heard, they made by force of arm, two great Cannons to be mounted in the night with cords and ropes, by the Swissers and Lansquenets; when as the ill luck would have it, the two Cannons being seated, a Gunner by great negligence set on fire a great bag of Gunpowder; wherewith he was burned together with to● or twelve soldiers; and moreover the flame of the powder was a cause of discovering the Artillery, which made them that all night, they of the Castle did nothing but shoot at that place where they discovered the two pieces of Ordinance, wherewith they killed and hurt a great number of our people. The next day early in the morning a Battery was made, which in a few hours made a breach, which being made they demanded to parley with us; but 'twas too late for them; For in the mean time our French foot, seeing them amazed, mounted to the breach, and cut them all in pieces, except a fair young lusty maid of Piedmount, Exemplary punishment. which a great Lord would have kept and preserved for him to keep him company in the night, for fear of the greedy wolf. The Captain and Ensign were taken alive, but soon after were hanged upon the gate of the City, to the end they might give example and fear to the Imperial soldiers not to be so rash and foolish, to be willing to hold such places against so great a Army. Now all the said soldiers of the Castle, seeing our people coming with a most violent fury, did all their endeavour to defend themselves, they killed and hurt a great company of our soldiers, with Pikes, Muskets, and stones, where the Surgeons had good store of work cut out. Now at that time I was a fresh water Soldier, I had not yet seen wowds made by gunshot at the first dressing. It is true, I had read in john de Vigo, in the first book of wounds in general, the eighth chapter, that wounds made Counsel of De Vigo. by weapons of fire did participate of Venenosity, by reason of the powder, and for their cure commands to cauterise them with oil of Elders scalding hot, in which should be mingled a little Treackle; and not to fail, before I would apply of the said oil, knowing that such a thing might bring to the Patient great pain, I was willing to know first, before I applied it, how the other Surgeons did for the first dressing, which was to apply the said oil the hottest that was possible into the wounds, with tents and setons; insomuch that I took courage to do as they did. At last I wanted oil, and was constrained in steed thereof, to apply a disgestive of yolkes of eggs, oil of Roses, and Turpentine. In the night I could not sleep in quiet, fearing some default in not cauterizing, that I should find those to whom I had not used the burning oil dead empoisoned; which made me rise very early to visit Experience of a bold man happy success them, where beyond my expectation I found those to whom I had applied my digestive medicine, to feel little pain, and their wounds without inflammation or tumour, having rested reasonable well in the night: the other to whom was used the said burning oil, I found them feverish, with great pain and tumour about the edges of their wounds. And then I resolved with myself never so cruelly, to burn poor men wounded with gunshot. Being at Thurin I found a Chirurgeon, who had the ●ame above all others, for the curing of wounds of Gunshot, into whose favour I found means to insinuate myself, to have the receipt of his balm, as he called it wherewith he dressed wounds of that kind, and he held me off the space of two years, before I could possible draw the receipt from him. In the end by gifts and presents he gave it me, which was this, to boil young whelps new pupped, in Receipt of an excellent balm for wounds with Gunshot. oil of Lilies, prepared earth worms, with Turpentine of Venice. Then was I joyful and my heart made glad, that I had understood his remedy, which was like to that which I had obtained by great chance. See then how I have learned to dress wounds made with gunshot, not by books. My Lord Marshal of Montian remained Lieutenant general for the King in Piedmont, having ten or twelve thousand men in garrison through the Cities and Castles, who often combated with swords and other weapons, as also with muskets; and if there were four hurt, I had always three of them, and if there were question of cutting off an arm or a leg, or to trepan, or to reduce a fracture or dislocation, I brought it well to pass. The said Lord Martial sent me one while this way, another while that way, for to dress the appointed Soldiers which were beaten aswell in other Cities as that of Thurin, insomuch that I was always in the Country one way or other Monsieur the Marshal sent for a Physician to Milan, who had no less reputation in the medicinal Art (than the deceased Monsieur le Grand) to take him in hand for an hepatical flux, whereof at last he died. This Physician was a certain while at Thurin to deal with him, and was often called to visit the hurt people, where he always found me, and I consulted with him, and some other Surgeons, and when we had resolved to do any serious work of Chirurgery, 'twas Ambrose Pare that put his hand thereto, where I did it promptly and with dexterity, and with a great assurance, in so much that the said Physician admired me, to see me so ready in the operation of Chirurgery, seeing the small age which I had, One day discoursing with the said Lord Martial, he said to him, Signior, tu hai un Chirurgico giovane de anni, ma egli 〈◊〉 vecckio di sapere e di esperientia. Guarda l● been, perch egli ti fara servicio & honore. That is to Witness of the dexterity of the Author. say, Thou hast a young Chirurgeon of age, but he is old in knowledge and experience, preserve him well; for he will do thee service, and honour. But the old man knew not that I had dwelled three years in the Hospital of Paris, there to dress the diseased. In the end Monsieur Martial died with his hepatical flux. Being dead, the King sent Monsieur the Marshal of Annebae●t to be in this place, who did me this honour The death of Martial Montian. to pray me to dwell with him, and that he would use me as well or better, than Monsieur the marshal Mountain; which I would not do for the grief I had for the loss of my master who loved me intimately, and I him in the like manner; and so I came back to Paris. The Voyage of Marolle and of low Brritany, 1543. I Went to the Camp of Marolle, with the deceased Monsieur de Rohan, where King Francis was in person, and I was Chirurgeon of the company of the said Monsieur de Rohan. Now the King was advertized by Monsieur de Estampes, governor of Britain, that the English had hoist Sail to land in Low Britain, and prayed him that he would send Monsieur de Rohan, and Monsieur de Laval for succour, because they were the Lords of that Country, and for their sakes those of that Country would beat back the enemy and keep them from landing. Having received this advertisement, his Majesty dispatched to send the said Lords for the relief of their Country, and to each was given as much power as to the Governor; in so much that they were all three the King's Lieutenant's. They took willingly this charge upon them, and speedily went away in Post, and lead me with them to Landreneau, there where we found every one in arms, the Alarm bells sounding on every side, yea five or six leagues about the Harbours, that is to say, Breast, Conquer, Crozon, Le Fou Doulac, Laudanec, each of them well furnished with Artillery, as Cannons, Demy-cannons, Culverins, Sakers, Serpentines, Falcons, Harque buzes, in brief there was nothing wanting in Artillery, or soldiers aswell Brittanes as French, to hinder that the English made no landing, as they had resolved at their parting from England. The enemy's Army came unto the very mouth of the Cannon, and when we perceived them that they would land, they were saluted with Cannon shot, and we discovered our men of war, together with our Artillery: they fled to Sea again, where I was glad to see their vessels hoist sail again, which was in a great number The English retire. and in good order, and seemed like a Forest which marched upon the Sea. I saw a thing also whereat I marveiled much, which was that the bullets of great pieces made great rebounds, and grazed upon the water as upon the ground. Now to make the matter short, the English did us no harm, and returned whole and sound into England, and left us in peace. We stayed in that Country in garrison, till we were assured that their army was dispersed. In the mean time our horsement exercised their feats of activity, as to run at the ring, fight in duel, and others, so that there was still something to employ me withal. Monsieur de Estampes, to make sport and pleasure to the said Monsieur de Rohan, and Laval, and other gentlemen, caused divers Country wenches, to come to the feasts, to sing songs in the Low Briton tongue, where their harmony was like the croaking of Frogs, while they are in love. Moreover made them dance the Britain Triory, without moving feet or Dances of the Country Wenches. buttocks, he made them hear and see much good. Otherwhiles they caused the Wrestlers of the Cities, and Towns, to come where there was a Prize for the best, and the sport was seldom ended, but that one or other had a leg or an Wrestlers; little Briton & good wrestler. arm broken, or the shoulder or hip displaced: there was a little man of Low Brittany of a square body and well set, who held a long time the credit of the field, and by his skill, and strength, threw five or six to the ground; there came to him a great school master, who was said to be one of the best wrestlers of all Britain: he entered into the lists, having taken off his long jacket, in hose and doublet, and being near the little man, he seemed as if he had been tied to his girdle. Notwithstanding when each of them took hold of the collar, they were a long time without doing any thing, and they thought they would remain equal in force and skill▪ but the little man cast himself with an ambling leap under this great Pedant, and took him on his shoulder, and cast him on his Kidneys spread abroad like a frog, and then all the company laughed at the skill and strength of this little fellow. This great Dativo had a great spite, for being cast by so little a man: he rose again in choler, and would have his revenge. They took hold again of each others collar, and were again a good while at their hold without falling to ground: in the end this great man let himself fall upon the little, and in falling put his elbow upon the The little Briton killed. pitch of his stomach, and burst his heart, and killed him stark dead. And knowing he had given him his death's blow, took again his long cassock, and went away with his tail between his legs and hid himself, seeing that the little man came not again to himself, either for Wine, Vinegar or any other thing that was presented unto him; I drew near to him, and felt his pulse which did not beat at all, than I said he was dead; then the Brittanes who assisted the wrestling said aloud in their jabber, that is not in the sport. And some said that the said Pedagogue was accustomed to do so, and that but a year passed he had done the like in a wrestling. I would needs open the body to know the cause of this sudden death, where I The body opened by the Author. found much blood in the Thorax and in the inferior belly, and I strove to find out any apertion in the place, from whence might issue so great a quantity of blood, which I could not do for all the diligence I could make. Now I believe it was per Diapedesin or Anastomosin, that is to say by, the apertion of the mouths of the vessels, or by their porosities; the poor little wrestler was buried. I took leave of Messieurs de Rohan, de Laval, and Estamps. Monsieur de Rohan, gave me a present of fifty double ducats, and an ambling horse, and Monsieur de Laval another for my man, and Monsieur de Estamps, a Diamond of thirty Crowns, and so I returned to my house at Paris. The Voyage of Parpignan, 1543. A Little while after Monsieur de Rohan took me with him post, to the camp of Parpignan; being there, the enemy made a Sally forth, and came and enclosed three pieces of our Artillery, where they were beaten back, to the gates of the City: which was not done without hurting and killing many, and amongst the rest de Briss●c, (who was then chief master of the Artillery) received a musket shot upon the shoulder: returning to his Tent, all the others that were hurt followed him, hoping to be dressed by the Surgeons, that aught to dress them. Being come to his Tent and laid on his bed, the bullet was searched for by three or four the most expert Surgeons of the Army, who could not find it, but said it was entered into his body. In the end he called for me, to see if I were more skilful than them, because Address of the Author. he had known me before in Piedmount: by and by I made him rise from his bed, and prayed him to put his body into that posture as it was then when he received his hurt; which he did taking a javelin between his hands as he held the Pike in the skirmish. I put my hand about the wound, and found the bullet in the flesh, making a little tumour under the Omoplate: having found it I showed them the place where it was, and it was taken out by Master Nicholas Lavernaut Chirurgeon to Monsieur the Dolphin, who was the King's Lieutenant in that army, yet notwithstanding the honour remained to me for finding of it. I saw one thing of great remark, which is this: that a soldier in my presence gave to History. one of his fellows a stroke with an Halberd upon the head, penetrating even to the left ventricle of the brain, without falling to the ground. He that struck him said, he had heard that he had cheated at Dice, and that he had drawn a great sum of money, and that it was his custom to cheat; I was called to dress him, which I did as it were for the last, knowing well that he would quickly die: having dressed him he returned all alone to his lodging, which was at least two hundred paces distant: I bid one of his companions send for a Priest to dispose of the affairs of his soul; he helped him to one who stayed with him to the last gasp. The next day the patient sent for me by his/ she friend in a boy's apparel to come to dress him, which I would not do, fearing he should die under my hands; and to put it off, I said I must not take off the dressing till the third day, by reason he would die though he were never touched. The third day he came staggering, and found me in my Tent accompanied with his wench, and prayed me most affectionately to dress him: And showed me a purse wherein he had an hundred or sixscore pieces of Gold, and that he would content me to my desire; for all that, yet notwithstanding I left not off to defer the taking off his dressing, fearing lest he should die at the same instant. Certain Gentlemen desired me to go dress him, which I did at their request, but in dressing him he died under my hands in a Convulsion. Now this Priest accompanied him until death, who seized upon the purse for fear lest another should take it, saying, he would say Masses for his soul. Moreover he furnished himself with his clothes, and with all the rest of his things. I have recited this History as a monstrous thing, that the Soldier fell not to ground when he had received this great stroke, and was in good senses even till death. Soon after, the Camp was broken for divers causes; the one because we were advertized that four companies of Spaniards were entered into Parpignam; the other, that the Plague begun much in our Camp, and it was told us by the people of the country that shortly there would be a great overflowing of the Sea, which might drown us all; and the presage which they had, was a very great wind from Sea, which arose in such manner that there remained not one Tent which was not broken and overthrown, for all the strength and diligence that could be given; and the Kitchens being all uncovered, the wind raised so the dust and sand which salted and powdered our meat, in such sort that we could not eat it, so that we were constrained to boil it in pots and other vessels well covered. Now we did not uncampe ourselves in so good time, but that there were many Carts and Carters Mules, and Mule drivers drowned in the Sea, with great loss of baggage. The Camp broken, I returned to Paris. The voyage to Landresy. 1544. KIng Francis raised a great Army to victual Landresy: on the other side the Emperor had no less people, yea much more; that is to say, eighteen thousand Germans, ten thousand Spaniards, six thousand Walloons, ten thousand English, and a matter of thirteen or fourteen thousand Horse. I saw the two Armies near one another, within Canon shot, and it was thought they would never part without giving battle. There were some certain foolish Gentlemen who would approach the enemy's Camp; certain shot was made at them, and some died at the place, others had their Legs or Arms carried away. The King having done what he desired, which was to revictual Landresy, retired himself with his Army to Guise, which was the day after All Saints, one thousand five hundred forty four, and from thence I returned to Paris. The Voyage of Boulogne. 1545. A Little while after we went to Boulogne, where the English seeing our Army, left the Forts which they had, that is to say, Moulambers; the little Paradise, Monplaisir, the fort of Shatillon, the Portet, the Fort Dardelot. One day going through the Camp to dress my hurt people, the enemies who were in the Tower of Order, shot off a piece of Ordinance, thinking to kill two horsemen which stayed to talk one with another. It happened that the Bullet passed very near one of them, which threw him to the ground, and 'twas thought the said Bullet had touched him, which it did not at all, but only the wind of the said Bullet in the midst of his coat, which went with such a force that all the outward part of the Thigh became black and blue, and had muchadoe to stand. I dressed him, and made him divers Scarifications to evacuate the contused blood, which the wind of the said Bullet had made; and the rebounds that it made on the ground, killed four soldiers which remained dead in the place. I was not far from this stroke, so that I felt somewhat the moved air, without doing me any harm, than a little fear which made me stoop my head very low, but the Bullet was already passed far beyond me. The Soldiers mocked me to be afraid of a Bullet already gone. (My little Master) I think if you had been there, that I had not been afraid alone, and that you would have had your share of it. What shall I say more? Monsieur the Duke of Guise, Francis of Lorraine, was hurt before Bullogne with a stroke of a Lance, which The hurt of Monsieur de Guise. above the right eye, declining towards the nose, entered and passed quite through on the other side between the nucha and the ear, with so great a violence, that the head of the Lance with a great part of the wood was broken and remained within, in such sort that it could not be drawn out but with great force, yea with Smiths pincers. Notwithstanding all this violence which was not done without breaking of bones, nerves, and arteries, and other parts; my said Lord, by the help of God was cured: the said Lord went always with open face, which was the cause that the Lance went through on the other side. The voyage of Germany. 1552. I Went the voyage to Germany in the year 1552. with Monsieur De Rohan Captain of 50. horse, where I was Chirurgeon of his company, which I have said already. In this voyage Monsieur the high Constable of France was General of the Army: Monsieur de Chastillon, since Admiral, was chief Colonel of the foot, having four Regiments of Lansquenets, under the conduct of these Captains, Recrod and Ri●grave, having each of them two Regiments, each Regiment was of ten Ensigns, and each Ensign of five hundred men. And besides these, was Captain Chartel, who conducted the troops that the Protestant Princes had sent to the King. This was a very fair company on foot, accompanied with fifteen hundred Horse, with the following of each one two Archers, which might make four thousand five hundred Horse, besides two thousand Light horse, and as many Muskettieres on horseback, of whom Monsieur de Aumalle was General, besides the great number of Nobility who came for their pleasure. Moreover, the King was accompanied with two hundred Gentlemen of his house, & likewise with divers Princes; there was also for his troop that served him, the French, Scottish, and Swissers Guards, amounting to six hundred men on foot, and the companies of Monsieur the Dolphin, Messieres de Guise, de Aumalle, and of the Marshal S. Andrew, which amounted to four hundred Lances, which was a mervelous thing to see such a fair Company; and in this equipage the King entered into Thou and Mets. I will not omit to tell that it was ordained, that the Companions of Messieres de Rohan, of the Count of Sancerr, of jarnac, which was each of them of fifty horse, went by the Wings of the Camp; and God knows we had scarcity of victuals, and I protest to God that at three divers times I had thought I should have been famished, and it was not for want of money for I had enough, and we could not have victuals but by force, by reason that the Peasants withdrew it all into the Cities and Castles. One of the servants of a Captain of the company of Monsieur de Rohan, went History. with others thinking to enter into a Church where the Peasants were retired, thinking to find victuals by force or love: but amongst the rest this man was well beaten, and returned with seven wounds, with a sword in the head; the least of which penetrated the second table of the scull, and he had four other upon the arms, and upon the right shoulder, which cut more than one half of the blade-bone, or Omoplate. He was brought back to his master's lodging, who seeing of him so wounded, and that they were to depart thence the morrow after at the break of day, and not thinking ever he could be cured, made him a grave, and would have cast him therein, saying that, or else the Peasants would massacre and kill him; I moved with pity Charity of the Author. told him that he might yet be cured if he were well dressed: divers Gentlemen of the company prayed him that he would cause him to be brought along with the Baggage, seeing I had the willingness to dress him; to which he agreed, and after that I had clothed him, he was but put into a Cart upon a bed well covered and well accommodated, which one horse did draw. I did the office of a Physician, Apothecary, Chirurgeon, and Cook; I dressed him even to the end of his cure, and God cured him, in so much that all these three Companies admired at this cure. The horsemen of the company of Monsieur de Rohan, the first muster that was made, gave me each one, one Crown, and the Archers half a Crown. The voyage of Danvilliers. 1552. AT the return from the Germane Camp, King Henry besieged Danvilliers, those within would not render. They were well beaten and our powder failed us, in the mean time they shot much at our people. There was a Culverin shot passed a traverse the Tent of Monsieur de Rohan, which hit a Gentleman's Leg, which was of his train; which I was fain to finish the cutting off, the which was done without applying hot irons. The King sent for powder to Sedan, which being come they began a greater battery than before, in such sort that they made a breach. Messiers de Guise, and the Another History. high Constable being in the King's Chamber, told him they concluded the next day to make assault, & that they were assured they should enter into it, & that they should keep it secret lest the enemy were advertized. And all of them promised not to speak of it to any one. Now there was a Groom of the King's chamber who lay under the King's bed in the Camp to sleep, understood that they resolved the next day to give an assault, he presently revealed it to a certain. Captain and told him that for certain the day following assault should be given, & that he had heard it of the King, & prayed the said Captain that he would not speak a word of it to any body, which he promised, but his promise was not kept, for at the same instant, he went and declared it to a Captain, & this Captain to another Captain, and from the Captains to some of the Soldiers, saying always, say nothing. It was so well hid that the next day early in the morning there was seen the greatest part of the Soldiers with their round hose and their breeches cut at knee for the better mounting at the breach. The King was advertized of the rumour which run through the Camp, that the assault must be given, whereof he much mervailed, seeing there was but three of that advice, which had promised one to another, not to tell it to any one. The King sent for Monsieur de Guise, to know if he had not talked of this assault; he swore and affirmed to him he had not told it to any body; and Monsieur the Constable said as much; who said to the King he must expressly know who had declared this secret counsel; seeing they were but three. Inquisition was made from Captain to Captain, in the end the truth was found; for one said 'twas such a one told me, another said as much, till at length they came to the first, who declared he had learnt it of a Groom of the King's chamber, named Guyard, borne at Blois, the son of the deceased King Francis his Barber. The King sent for him into his Tent, in the presence of Monsieur de Guise, and of Monsieur the Constable, to understand from him whence he had it, and who told him that this assault was to be given. The King told him that if he did not tell the truth, that he would cause him to be hanged; then he declared, he lay down under his bed thinking to sleep, and so having heard it, he declared it to a Captain who was a friend of his, to the end he might prepare himself with his Soldiers the first for the assault. After the King knew the truth; he told him, he should never serve him again, and that he deserved to be hanged, and forbid him ever to come again to the Court. My Groom What it is to reveal the secrets of Princes. of the Chamber went away with this sad news, and lay with one of the King's Surgeons in ordinary, named Master Lewis, and in the night gave himself six wounds with a knife, and cut his throat; yet the said Chirurgeon perceived nothing till morning, till he saw the bed bloody, and the dead body by him: he much mervailed at this spectacle upon his waking, and was afraid lest they should say he was the cause of this murder; but was soon freed, knowing the cause to be from desperation, having lost the good amity which the King bore to him. The said Guyard was buried. And those of Danvilliers when they saw the breach large enough for them to enter in, and the Soldiers prepared for the assault, yielded themselves to the mercy of the King. The chief of them were prisoners, and the Soldiers sent away without arms. The Camp being broken up I returned to Paris with my Gentleman whose Leg I had cut off, I dressed him and God cured him; I sent him to his house merry with a wooden Leg, and was content, saying that he scaped good cheap, not to have been miserably burnt, as you write in your book, my little Master. The Voyage of Castle the Compt. 1552. A Little while after King Henry levied an Army of thirty thousand men, to go The King of Navarre prayed the Author to follow him. make spoil about Hedin. The King of Navarre who was then called Monsieur de Vendosme, was chief of the Army, and the King's Lieutenant. Being at S. Denis in France, staying while the companies passed by, he sent for me to Paris to come speak with him; being there, he prayed me, and his request was a command, that I would follow him this voyage; and I about to make my excuse told him him my wife was sick in her bed, he made me answer, that there were Physicians at Paris for to cure her; and that he as well left his own, who was as well descended as mine; promising me that he would use me well, and forthwith gave command that I should be lodged as one of his Train. Seeing this great affection, which he had to lead me with him, I durst not to refuse him. I went and met with him at the Castale of Compt, within 3. or 4. leagues of Hedin, there where there was the Emperor's Soldiers in garrison with a number of Peasants round about: he caused them to be summoned to render themselves; and they made answer they should never have them but by pieces, and let them do their worst, and they would do their best to defend themselves. They put confidence in their ditches full of water, and in two hours with a great number of Bavins, and certain empty Casks, way was made to pass over the foot: when they must go to the assault and were beaten with five pieces of Cannon, till a breach was made large enough to enter in, where they within received the assault very valiantly, and not without killing and hurting a great number of our people with musket shot, pikes and stones. In the end when they saw themselves constrained, they put fire to their powder and munition, which was the cause of burning many of History of desperate people. our people, and of theirs likewise, and they were all almost put to the edge of the sword. Notwithstanding some of our Soldiers had taken twenty or thirty, hoping to have ransom for them. That was known, and ordered by the Counsel that it should be proclaimed by the Trumpet through the Camp, that all Soldiers who had any Spaniards prisoners were to kill them, upon pain to be hanged and strangled, which was done upon cold blood. From thence we went and burnt diver Villages, whose barns were full of all kind of grain, to my great grief. We went along even to Tournaban, where there was a very great Tower where the Enemies retired, but there was no man found in it, all was pillaged, and The taking of Castle of Compt. the Tower was made to leap by a Mine, and then with Gunpowder turned topsy turvy. After that, the Camp was broken up, and I returned to Paris. I will not yet forget to write that the day after the Castle of Compt was taken, Monsieur de Vendosme sent a Gentleman to the King to make report to him of all which had passed, and amongst other things, told the King that I had greatly done my duty in dressing those that were wounded, and that I had showed him eighteen Bullets which I had taken or drawn out of the hurt bodies, and that there were divers more which I could neither find, nor draw out, and told more good of me than there was by half. Then the King said he would have me into his service, and commanded Monsieur de Goguier his chief Physician to write me down as entertained one of his Surgeons in ordinary, and that I should go meet with him at Rheimes within ten or twelve days; which I did, where he did me the honour to command me that I would dwell near him, and that he would do me good. Then I thanked him most humbly for the honour it pleased him to do me, in calling me to his service. The Voyage of Mets. 1552. THe Emperor having besieged Mets, and in the hardest time of winter, as each one knows of fresh memory: and that there was in the City five or six thousand men, and amongst the rest seven Princes; that is to say, Monsieur the Duke of Guise the King's Lieutenant, Messieurs d'Anguien, de Conde, de Montpensier, de La The names of the Princes who were at the siege of Meth. Roch upon Yon, Monsieur de Nemours, and divers other Gentlemen, with a number of old Captains of war, who often made sallies forth upon the enemies, (as we shall speak of hereafter) which was not done without slaying many, as well on the one side as the other. For the most part all our wounded people died, and it was thought the medicaments wherewith they were dressed were poisoned; which caused Monsieur de Guise and other Princes to send to the King for me, and that he would send me with Drogues to them, for they believed theirs were poisoned, seeing that of their hurt people few escaped. I do not believe there was any poison, but the great strokes of the Cutlasses, Musket shot, and the extremity of cold were the cause. The King caused one to write to Monsieur the Marshal of S. Andrew which was his Lieutenant at Verdun, that he found some means to make me enter into Mets. The said Lord Martial of S. Andrew and Monsieur the Marshal of old Ville, got an Italian Captain, who promised them to make me enter in, Nota. which he did, and for which he had fifteen hundred Crowns: the King having heard of the promise which the Italian Captain had made, sent for me and commanded me to take of his Apothecary named Deign such, and as many Drogues as I should think fit for the hurt who were besieged, which I did, as much as a post-horse could carry. The King gave me charge to speak to Monsieur de Guise and to the Princes, and Captains who were at Mets. Being arrived at Verdun, a few days after Monsieur the Marshal of S. Andrew, caused horses to be given to me, Commission of the Author. and my man and for the Italian, who spoke very good high Dutch, Spanish and Walon with his own natural tongu●. When we were within eight or ten Leagues of Mets, we went not but in the night, and being near the Camp, I saw a league and a half off bright fires round about the City, which seemed as if all the earth were on fire, and I thought we could never pass through those fires without being discovered, and by consequent be hanged and strangled, or cut in pieces, or pay a great ransom. To speak truth, I wished myself at Paris, for the eminent danger which I foresaw. God guided so well our affairs that we entered into the City at midnight with a certain Token, which the Captain had with another Captain of the company of Monsieur de Guise: which Lord I went to, and found him in bed, who received me with great thanks, being joyful of my coming. I did my message to him of all that the King had commanded me to say to him; I told him I had a little letter to give him, and that the next day I would not fail to deliver it him. That done he commanded me a good lodging, and that I should be well used, and bid me I should not fail to be the next day upon the Breach, where I should meet with all the Princes, and divers Captains, which I did; who received me with great joy, who did me the honour to embrace me, and tell me I was very welcome, adding withal they did not fear to dye if they should chance to be hurt. Monsieur de La Roch upon Yond was the first that feasted me, and inquired of me what they said at the Court concerning the City of Mets; I told him what I thought good. Then presently he desired me to go see one of his Gentlemen, named Monsieur de Magnane at this present Knight of the King's order, and Lieutenant of his Majesty's Guard; who had his Leg broken by a Cannon shot. I found him in his bed, his Leg bended and crooked, without any dressing upon it; because a Gentleman promised him cure, having his name, and his History. girdle, with certain words. The poor Gentleman wept, and cried with pain which he felt, not sleeping either night or day, in four days: then I mocked at this imposture and false promise. Presently I did so nimbly restore and dress his Leg, that he was without pain and slept all night, and since (thanks be to God) was cured, and is yet at this present living, doing service to the King. The said Lord of the Roch upon Yond sent me a Tun of wine to my lodging, and bid tell me, when it was drunken he would send me another. That done, Monsieur de Guise gave me a list of certain Captains and Lords, and commanded me to tell them what the King had given me in charge; which I did, which was to do his commendations and a thanksgiung for the duty they had done, and did in the keeping of the City of Mets, and that he would acknowledge it. I was more than eight days in acquitting my charge, because they were many; first to the Princes and others, as the Duke of Horace, the Count of Martigues, and his brother, Monsieur de Bauge, the Lords Montmorancy, and d'Anville, then Marshal of France, Monsieur de La Chapel, Bonnivet Caroug now Governor of Rohan, the Vidasme of Chartres, the Count of Lude, Monsieur de Byron now marshal of France, Monsieur de Randan the Rochfoucaut, Boxdaille d'Etrez, the younger, Monsieur de S. john in Dolphiny, & many others which it would be too long to recite; and chiefly to divers Captains who had very well done their duty in defence of their lives, and City. I demanded afterwards of Monsieur de Guise, what it pleased I should do with the Drogues which I had brought, he bid me impart them to the Surgeons and Apothecaries, and chiefly to the poor hurt Soldiers in the Hospital which were in great number; which I did, and can assure you, I could not do so much as go see them, but they sent for me to visit and dress them. All the besieged Lords prayed me carefully The hurt of Monsieur de Pienne, trepand and cured. to solicit above all others Monsieur de Pienne who was hurt at the breach by a stone raised by a Cannon shot in the Temple with a fracture, and depression of the bone. They told me that presently when he received the stroke, he fell to the earth as dead, and cast blood out of his mouth, nose, and ears with great vomitings, and was fourteen days without speaking one word, or having any reason; there happened to him also start somewhat like Convulsions, and had all his face swelled and livid. He was trepaned on the side of the temporll muscle upon the Os Coronale. I dressed him with other Surgeons, and God cured him, and is at this day living, God be thanked. The Emperor caused battery to be made with forty double Cannons, where they spared no powder night nor day. Presently when Monsieur de Guise saw the Artillery seated to make a breach, he made the nearest houses to be pulled down to make Ramparts, and the posts and beams were ranged, end to end, and between two clods of earth, beds and packs of wool, and then other posts and beams were put again upon them as before. Now much wood of the houses of the suburbs which had been put to the ground (for fear lest the enemy should be lodged, close covered, and that they should not help themselves with any wood) served well to repair the breach. Every one was busied to carry Princes carried the Baskets. earth to make the Ramparts night and day. Messieres the Princes, Lords and Captains, Lieutenants, Ensigns, did all carry the basket, to give example to the Soldiers, and Citizens to do the like, which they did; yea both Ladies and Gentlewomen, and those which had not baskets, helped themselves with kettles, panniers, sacks, sheets, and with what else they could to carry earth; in so much that the enemy had no sooner beaten down the wall, but he found behind a Rampart more strong. The wall being fallen our Soldiers cried to those without, the Fox, the Fox, the Fox, and spoke a thousand injuries one to another. Monsieur de Guise commanded upon pain of death that no man should speak to them without, for fear lest there should be some Traitor who would give them intelligence what was done in the City; the command made, they tied living Cats at the end of their Pikes, and put them upon the Wall and cried with the Cat's miau, miau. Truly the Emperialists were very much vexed to have been so long making a Breach. breach, and at so great expense, which was the breach of fourscore steps, to enter fifty men in front, where they found a Rampart more strong than the wall; they fell upon the poor Cats, and shot at them with their muskets as they use to do at birds. Our people did oftentimes make sallies by the command of Monsieur de Guise. The day before there was a great press, to make themselves enrowled, who must make the sally chiefly of the young Nobility, led by well experimented Captains. Insomuch that it was a great favour, to permit them to sally forth, and run upon the enemy: and they sallied forth always the number of one hundred, or sixscore armed men with Cutlasses, Muskets, Pistols, Pikes, Partisans and Halberds, which went even to their trenches to awaken them. Where they presently made an alarm throughout all their Camp, and their Drums sounded, plan, plan, ta, ti, ta, ta, ta, ti, ta, tou, touf, touf: likewise their Trumpets and Cornets, sounded, to the saddle, to the saddle, to the saddle, to horse, to horse, to horse, to the saddle, to horse. And all their soldiers cried Arm, arm, arm, to arms, to arms, to arms, arm, to arms, arm, to arms, like the cry after Wolves, and all divers tongues, according to their nations: and they were seen to go out from their tents, and little lodgings, as thick as little Bees, when their Hive is discovered; to succour their fellows, who had their throats cut like sheep. The horsemen likewise came from all parts, a great gallop, patati, patata, patati, patapa, ta, ta, patata, patata, and ●arried well that they might not be in the throng, where strokes were imparted to give and receive. And when our men saw they were forced, they returned into the City, still fight, and those who run after were beaten back with the Artillery which they had charged with flint stones, and fouresquare pieces of iron; and our soldiers who were upon the said wall made a volley of shot, and showered down their bullets upon them like hail, to send them back to their lodging, where divers remained in the place of the combat, and also our men did not all come with whole skins, and there still remained some for the Tithe, who were joyful to dye in the bed of honour. And where there was a horse hurt he was flayed, and eaten by the Soldiers in steed of beef and bacon, and it was fit I must run, to dress our hurt men. A few days after, other sallies were made, which did much anger the enemies, because they did not let them sleep but little in safety. Monsieur de Guise, made a warlike stratagem which was, he sent a Peasant who was none of the wisest with two pair of Letters toward the King, to whom he gave ten Crowns, and promised the King should give him an hundred, provided he gave him the letters. In the one he sent word that the enemy made no sign of retiring himself, and by all force made a great breach which he hoped to defend, yea to the losing of his life, and of all those that were within, and that the enemy had so well placed his Artillery in a certain place which he named, that with great difficulty was it kept that they had not entered into it, seeing it was a place the most weak of all the City: but he hoped quickly to fill it up again in such sort, that they cannot be able to enter. One of these letters was sowed in the lining of his doublet, and he was bid to take heed that he told it not to any man. And there was also another given to him; wherein the said Monsieur de Guise sent word to the King, that he & all the besieged did hope well to keep the City, and other matters, which I cease to speak of. They made the Peasant go forth in the night, and presently after, he was taken by one that stood Sentinel, and carried to the Duke of Albe, to understand what was done in the City, and they asked him if he had any letters, he said yes, and gave them one; and having seen it he was put to his oath, whether he had any other, and he swore, not; then they felt and searched him, and found that which was sowed to his doublet, and the poor messenger was hanged. The said letters were communicated to the Emperor, who caused his counsel to be called there, where it was resolved since they could do nothing at the first breach, that presently the Artillery should be drawn to the place which they thought the most weak, where they made great attempts to make another breach, and digged and undermined the wall, and endeavoured to take the Tower of Hell, yet they durst not come to the assault. The Duke of Albe declared to the Emperor that the soldiers died daily, yet, more than the number of two hundred, and that there was but little hope to enter into the City, seeing the season, and the great quantity of soldiers that there were. The Emperor demanded what people they were that died, and if that they were gentlemen of remark or quality: answer was made, that they were all poor soldiers; then said he, it makes no matter if they die, comparing them to caterpillars and grasshoppers, which eat the buds of the earth: And if they were of any fashion, they would not be in the camp for twelve shillings the month, and therefore no great harm if they died. Moreover he said he would never part from before that City, till he had taken it by force, or famine, although he should lose all his army: by reason of the great number of Princes which were therein, with the most part of the Nobility of France. From whom he hoped to draw double his expense, and that he would go once again to Paris, to visit the Parisiens', and make himself King of all the kingdom of France. Monsieur de Guise with the Princes, Captains, and Soldiers, and generally all the Citizens of the City, having understood the intention of the Emperor, which was to extirpate us all, they advised of all they had to do: And since it was not permitted to the soldiers, nor Citizens, no nor to the Princes, nor Lords themselves to eat either fresh fish, or Venison, as likewise some Partridges, Woodcocks, Larks, Plovers, for fear lest they had gathered some pestilential air which might give us any contagion; but that they should content themselves with the ammunition fare, that is to say, with Bisquite, Beef, powdered Cows, Lard, and gammons of Bacon: Likewise fish, as Greenefish, Salmon, Sturgeon, Anchovies, Pilchers and Herrings, also Pease, Beanes, Rise, Garlic, Onions, Prunes, Cheese, Butter, Oil, Salt, Pepper, Ginger, Nutmegs, and other Spiceries to put into pies, chiefly to horseflesh, which without that would have had a very ill taste; divers Citizens having gardens in the City sowed therein great Radishes, Turnippes', Carrots, and Leeks, which they kept well and full dear, against the extremity of hunger. Now all these ammunition victuals were distributed by weight, measure, and justice, according to the quality of the person, because we knew not how long the siege would last. For having understood from the mouth of the Emperor, that he would never part from before Mets, till he had taken it by force, or famine; the victuals were lessened, for that which was wont to be distributed to three, was now shared amongst four, and defence made they should not sell what remained after their dinner, but 'twas permitted to give it to the wenches that followed the Campe. And rose always from table with an appetite, for fear they should be subject to take Physic. And before we would yield ourselves to the mercy of our enemies; had resolved to eat our Asses, Mules, Horses, Dogs, Cats, and Rats, vea our boots and other skins which we could soften and frie. All the besieged did generally resolve to defend themselves with all sorts of instruments of war, that is to say, to rank, and charge the Artillery, at the entry of the breach with bullets, stones, Cart nails, bars, and chains of iron. Also all kinds and differences of artificial fire; as Boeites, Bariquadoes, Granades, Potts, Lances, torches, squibbes, burning faggots. Moreover scalding water, melted lead, powder of unquenched lime to blind their eyes. Also they were resolved to have made holes through, and through their houses, there to lodge musketeers, there to batter in the flank and hasten them to go, or else make them lie for altogether. Also there was order given to the women to unpave the streets, and to cast them out at their windows, billets, tables, tressles, forms, and stools, which would have troubled their brains: moreover there was a little further, a strong Court of Guard, filled with carts and pallisadoes, pipes and hogs heads, filled with earth, for barriquadoes to serve to interlay with falcons, faulconets, field pieces, harquibuzes, muskets, and pistols and wild fire, which would have broken legs and thighs, insomuch that they had been beaten in head, in flank, and in tail; and where they had forced this Court of Guard, there was others at the crossing of the streets, each distant an hundred paces, who have been as bad companions as the first, and would not have been without making a great many Widows, and Orphans. And if fortune would have been so much against us, as to have broken our Courts of guard, there was yet seven great Bastallions ordered in square, and triangle, to combat altogether, each one accompanied with a Prince to give them boldness, and encourage them to fight, even till the last gasp, and to dye altogether. Moreover it was resolved, that each one should carry his treasure, rings, and jewels, and their household stuff of the best, to burn them in the great place, and to put them into ashes rather than the enemy should prevail and make trophies of their spoils; likewise there was people appointed to put fire to the munition, and to beat out the heads of the Wine casks, others to put the fire in each house, to burn our enemies and us together: the Citizens had accorded it thus, rather than to see the bloody knife upon their throat, and their Wives and Daughters violated, and to be taken by force, by the cruel and inhuman Spaniards. Now we had certain prisoners which Monsieur de Guise sent away upon their faith, to whom was secretly imparted our last resolution, will and desperate minds; who being arrived in their Camp, do not defer the publishing; which bridled the great impetuosity, and will of the soldiers to enter any more into the City to cut our throats, and to enrich themselves of our pillage. The Emperor having understood this deliberation of the great warrior, the Duke of Guise, put water in his wine, and restrained his great choler and fury, saying, He could not enter into the City without making a great slaughter, and butchery, and spill much blood, aswell of the defendants, as of the assaillants, and that they should be dead together, and in the end could have nothing else but a few ashes, and that afterward it might be spoken of that, as of the destruction of jerusalem already made by Titus and Vespasian. The Emperor then having understood our last resolution, and seeing their little prevailing by their battery, and underming, and the great plague which was in his whole army, and the indisposition of the time; and the want of victuals and money, and that his soldiers forsook him, and went away in great companies; concluded in the end to retire themselves accompanied with the Cavalry of his Vanguard, with the greatest part of his Artillery, and the Battalia; The marquis of Brandeborg was the last which uncampt, maintained by certain bands of Spaniards, Bohemians, and his german companies, and there remained one day and a half after, to the great grief of Monsieur de Guise, who caused four pieces of Artillery to be brought out of the City, which he caused to be discharged at him on one side; and the other to hasten them to be gone, which he did full quickly, with all his Troops. He being a quarter of a league from Mets was taken with a fear least our Cavalry should fall upon him in the Rear, which caused him to put fire to his munition powder, and leave certain pieces of Artillery and much baggage which he could not carry because the Vanguard, and the Battalia, and great Cannons had too much broken the way. Our horsemen would by all means have gone out of the City to have fallen upon their breech. But Monsieur de Guise would never permit them, but on the contrary we should rather make plain their way, and make them bridges of gold and silver, and let them go, being like to a good shepherd, who will not lose one of his sheep. See now how our wellbeloved Imperialists went away from before the City of Mets, which was the day after Christmas day, to the great contentment of the besieged, and honour of Princes, Captains and Soldiers who had endured the travels of this siege the space of two months. Notwithstanding they did not all go, there wanted twenty thousand who were dead aswell by Artillery, by the sword, as also by the plague, cold, and hunger, and for spite they could not enter into the City to cut our throats, and have the pillage: and also a great number of their horses died, of which they had eaten a great part in steed of Beef and Bacon. They went where they had been encamped, where they found divers dead bodies not yet buried, and the earth all dihged like Saint Innocents Churchyard, in the time of the plague. They did likewise leave in their lodgings, pavilions and tents, divers sick people: also bullets, arms, Carts, Wagons, & other baggage with a great many of Munition loaves spoilt and rotten by the rain and snow, yet the soldiers had it not but by weight and measure; & likewise they left great provision of wood, of the remainders of the houses of the Villages which they had plucked down 2 or 3 miles' compass, likewise divers other houses of pleasure belonging to the Citizens accompanied with fair gardens, grass plots filled with fruit trees, for without that they had been starved with cold, and had been constrained to have raised the siege sooner. The said Monsieur de Guise caused the dead to be buried, and dress their sick people: likewise the enemies left in the Abbey of S. Arnoul divers of their hurt soldiers which they could not lead with them: the said Monsieur de Guise sent them all Victuals enough, and commanded me and other Surgeons to go dress them and give them medicines; which we willingly did, and think they would not have done the like toward others (because the Spaniard is most cruel, perfidious and inhuman, & therefore enemy to all nations) which is proved by Lopez a Spaniard & Benzo of Milan & others who have written the history of America, & the West Indies, who have been constrained to confess, that the cruelty, avarice, blasphemy, and wickedness of the Spaniards, have altogether alienated the poor Indians, from the religion which the said Spaniards are said to hold. And all write they are less worth than the Idolatrous Indians, by the cruel usage done to the said Indians. And a few days after we sent a Trumpet to Thionville toward the enemy, that they should send back for their wounded men in safety, which they did with Carts and Wagons, but not enough. Monsieur de Guise, caused them to have Carts and Carters, to help to carry them to the said Thionville. Our said Carters being returned back, brought us word that the way was paved with dead bodies, and that they never lead back the half, for they died in their Carts, and the Spaniards seeing them at the point of death, before they had cast out their last gasp, cast them out of their Carts, and buried them in the mud, and mire, saying they had no order to bring back the dead. Moreover our said Carters said, they met by the way divers Carts loaden with baggage sticking in the mire, which they durst not send for back, for fear lest those of Mets should fall upon them. I will again return to the cause of their mortality, which was principally through hunger, plague, and cold; for the snow was two foot thick upon the earth, and they were lodged in the caves of the earth, only covered with a little straw. Notwithstanding each soldier had his field bed, and a covering strewed with glittering stars, more bright than fine gold, and every day had white sheets, and lodged at the sign of the Moon, and made good cheer when they had it, and paid their host so well over night, that in the morning they went away quit, shaking their ears, and they needed no comb, to take away the down out of their hairs, either of head or beard, and found always a white table cloth, losing good meals for want of Victuals. Also the greatest part of them had neither boots, nor buskinnes, slippers, hose, or shoes, and divers had rather have none than have them, because they were always in mud, half way of the leg; and because they went bare legged, we called them the Emperor's Apostles. After the Camp was wholly broken, I distributed my patients into the hands of the Surgeons of the City, to finish their cure: then I took leave of Monsieur de Guise, and came back toward the King, who received me with a loving countenance, and demanded of me how I did enter into the City of Mets. I recounted to him, all that I had done, he caused two hundred crowns to be given me, and one hundred I had at my going out, and told me he would not leave me poor; then I thanked him most humbly of the good and the honour which he pleased to do me. The Voyage of Hedin, 1553. Charles' the Emperor caused the City of Theroünne to be besieged, where Monsieut the Duke of Savoy, was General of the whole army: it was taken by assault where there was a great number of our men slain and prisoners. The King willing to prevent that the enemy should not also come to beseige the City & Castle of Hedin, sent Messiers the Duke Boüillion, the Duke Horace, the marquis of Villars, a number of Captains, and about eight hundred soldiers, & during the siege of Theroüenne, the said Lords fortified the said Castle of Hedin, in such sort that it seemed impregnable. The King sent me to the said Lords to help them with my Art, if there were any need. Now soon after the taking of Theroüenne, we were besieged with the army: there was a quick clear fountain or Spring, within Cannon shot, where there was about fourscore whores, and wenches of the enemies, who were round about it to draw water. I was upon a Rampart beholding the Camp, and seeing so many idlers about the said fountain, I prayed Monsieur de Pont Commissary of the Artillery, to make one Cannon shot, at that roguish company, he made me much denial, answering me that such kind of people were not worth the powder they should waste. Again I prayed him to level the Cannon, telling of him, the more dead the fewer enemies; which he did through my request, and at that shot fifteen or sixteen were killed and many hurt. Our soldiers sallied forth upon the enemies, where there was many killed, and slain with musket shot and swords, as well on the one side, as of the other, and our soldiers did often make sallies forth upon the enemies before their trenches were made; where I had much work cut out, so that I had no rest night nor day for dressing the wounded. And I will tell this by the way, that we had put many of them in a great Tower, laid upon a little straw, and their pillows were stones, their coverlets were their cloaks, of those that had any. Whilst the battery was making, as many shot as the Cannons made, the patients said they felt pain in their wounds, as if one had given them blows with a staff, the one cried his head, the other his arm, and so of other parts; divers of their wounds bled afresh yea in greater quantity than first when they were wounded, and then it was I must run to stay their bleeding. My little master, if you had been there, you had been much troubled with your hot irons, you had need to have had much charcoal to make them red hot, and belee ve they would have slain you like a Calf for this cruelty. Now through this diabolical tempest of the Echo from these thundering Instruments, and by the great and vehement agitation of the collision of the air resounding and reverberating in the wounds of the hurt people, divers died, and others because they could not rest by reason of the groans and cries that they made, night and day; and also for want of good nourishment and other good usage necessary to wounded people. Now my little master, if you had been there, you would hardly have given them jelly, restauratives, culliss, pressures, panado, cleansed barley, white meat, almond milk, Prunes, Raisins, and other proper meats for sick people: your ordinance would only have been accomplished in paper, but in effect they could have had nothing but old Cow beef, which was taken about Hedin for our munition, salted and half boiled, insomuch that who would have eat it he must pull it with the force of his teeth, as birds of Prey do carrion. I will not forget their linen wherewith they were dressed, which was only rewashed every day, and dried at the fire, and therefore dry & stubborn like Parchment, I leave you to think how their wounds could heal well. There was ●oure lusty whores to whom charge was given to wash their linen, who discharged their duty under penalty of the baton, and also they wanted both soap and water. See then how the sick people died for want of nourishments, and other necessary things. One day our enemies feigned to give us a general assault, to draw our Soldiers upon the breach, to the end to know our countenance and behaviour: every one ran thither, we had made great provision of artificial fire, to defend the breach; a Priest belonging to Monsieur du Boüillon took a granado, thinking to throw it on the enemies, and set it on fire sooner than he ought to have done: it broke asunder, and the fire fell amongst our fire works, which were put into a house near the breach; which was to us a mervelous disaster, because it burned divers poor soldiers: it also took hold on the house itself, and we had been all burned had not great help been used for to quench it; there was but one Well there wherein was water in our Castle, which was almost quite dried up, and in steed of water, we took beer and quenched it: then afterwards we had great scarcity of water; and to drink the rest that remained which we must strain through napkins. Now the enemy seeing this smoke and tempest of the fire works which cast a very great flame and clashing noise, believed we had put the fire on purpose for the defence of our breach, to burn them, and that we had great store of others. That made them to be of another opinion, than to taken us by assault; they did undermine, and dig into the greatest part of our walls, so that it was the way to overthrow wholly the Castle topsy turvy, and when the mines were finished, and that their Artillery shot, the whole Castle did shake under us, like an earthquake, which did much astonish us. Moreover he had leveled five pieces of Artillery which they had seated upon a little hill, to play upon our backs when we should go to defend the breach. The Duke Horace had a Cannon shot upon one shoulder, which carried away his arm on one side, and the body on the other, without being able to speak one only word. His death was to us a great disasture for the rank which he held in this place. Likewise Monsieur de Martigues had a stroke with a Bullet which peireed through his Lungs; I dressed him, as I will declare hereafter. Then we demanded Parle, and a Trumpet was sent toward the Prince of Piedmont, to know what composition it pleased him to make us: His answer was, that all the chief, as Gentlemen, Captains, Lieutenants, and Ensigns, should be taken for ransom, and the Soldiers should go out without Arms; and if they refused this fair and honest proffer, the next day we ought to be assured they would have us by assault or otherwise. Counsel was held, where I was called to know if I would sign as divers Captains, Gentlemen and others, that the place should be rendered up. I made answer it was not possible to be held, and that I would sign it with my proper blood, for the little hope that I had, that we could resist the enemy's force, and also for the great desire which I had to be out of this torment, and hell; for I slept not either night or day, by reason of the great number of hurt people, which were about two hundred. The dead bodies yielded a great putrefaction, being heaped one upon the other like Faggots, and not being covered with earth because we had it not; and when I entered into one lodging, Soldiers attended me at the door to go dress others at another; when I went forth, there was striving who should have me, and they carried me like a holy body not touching the ground with my foot in spite one of another, nor could I satisfy so great a number of hurt people. Moreover I had not what was necessary to dress them withal; for it is not sufficient that the Chirurgeon do his duty towards the patients, but the patient must also do his, and the assistance, and all exterior things; witness Hypocrates in his first Aphorism. Now having understood the resolution of the yielding up of our place, I knew our affairs went not well; and for fear of being known I gave a velvet Coat, a Satin doublet, a very fine cloth cloak lined with velvet, to a Soldier, who gave me a scurvy old torn doublet cut and flashed with using, and a leather jerkin well examined, and an ill favoured hat, and a little cloak; I smutcht the collar of my shirt with water in which I had mingled a little soot; likewise I wore out my stockings with a stone at the knees and the heels as if they had been worn a long time, and I did as much to my shoes, in so much that they would rather take me for a Chimney sweeper, than a King's Chirurgeon. I went in this equipage towards Monsieur de Martigues, where I prayed him that he would take order that I might remain near him to dress him, which he agreed to most willingly, and had as much desire I should remain with him as I myself. Soon after, the Commissioners who had charge to elect the prisoners, entered into the Castle, the seaventeenth day of july one thousand five hundred fifty three, where they made Messieurs the Duke of Boüillon, the marquis of Villars, the Baron of Culan, Monsieur du Pont commissary of the Artillery, and Monsieur de Martigues and I to be taken through the request that he made to them; and all other Gentlemen which they could perceive were able to pay any ransom, and the most part of the Soldiers and the chief of the Companies, having such, and so many prisoners as they would. Afterward the Spanish Soldiers entered by the Breach without any resistance, for ours esteemed they would hold their faith and composition that they should have their lives saved. They entered in with a great fury to kill, pillage, and rifle all they retained: some hoping to have ransom, they tied their stones with Arquebuse cords, which was cast over a Pike which two held upon their shoulders, than pulled the said cord with a great violence and derision, as if they would ring a Bell, telling them that they must put themselves to the ransom, and tell of what houses they were; and if they saw they could have no profit, made them cruelly dye between their hands, or presently after their genital parts would have ●alne into a Gangrene, and total mortification; but they killed them all with their Daggers, and cut their throats. See now their great cruelty and perfidiousnes, let him trust to it that will. Now to return to my purpose being lead from the Castle to the City with Monsieur de Martigues, there was a Gentleman of the Duke of Savoys, who asked me if Monsieur de Martigues wound was curable, I answered, not; who presently went and told the Duke of Savoy; now I thought he would send Physicians and Surgeons to visit and dress my said Monsieur de Martigues: in the mean time I thought with myself whether I ought to make it nice and not to acknowledge myself a Chirurgeon for fear lest they should retain me to dress their wounded, and in the end they would know I was the King's Chirurgeon, and that they would make me pay a great ransom. On the other side I feared, if I should not make myself known to be a Chirurgeon, and to have carefully dressed Monsieur de Martigues, they would cut my throat, so that I took a resolution to make it appear to them he would not dye for want of good dressing and looking to. Soon after, see, their arrives divers gentlemen accompanied with the Physician and Chirurgeon to the Emperor, and those of the said Duke of Savoy, with six other Surgeons following the Army, to see the hurt of the said Lord of Martigues, and to know of me how I had dressed him, and with what medicines. The Emperor's Physician bid me declare the essence of the wound, and how I had dressed it. Now all the assistance had a very attentive ear to know if the wound were mortal or not: I began to make a discourse that Monsieur de Martigues looking over the wall to perceive them that did undermine it, received a shot from an Arquebuse quite through the body; presently I was called to dress him, I saw he cast blood out of his mouth, and his wounds. Moreover he had a great difficulty of breathing, and cast out wind by the said wounds with a whistling, in so much that it would blow out a Candle, and he said he had a most sharp pricking pain at the entrance of the Bullet. I do believe and think it might be some little pieces of bones which pricked the Lungs. When they made their Systole and Diastole, I put my finger into him; where I found the entrance of the Bullet to have broken the fourth Rib in the middle and scales of bones which the said Bullet had thrust in, and the outgoing of it had likewise broken the fifth Rib with pieces of bones which had been driven from within outward; I drew out some but not all, because they were very deep and adherent. I put in each wound a Tent, having the head very large, tied with a thread, lest by the inspiration it might be drawn into the capacity of the Thorax, which hath been known by experience to the detriment of the poor wounded; for being fallen in, it cannot be taken out, which is the cause that engenders putrefaction, a thing contrary to nature. The said Tents were anointed with a medicine composed of yolks of Eggs, Venice Turpentine, with a little oil of Roses: My intention for putting the Tents was to stay the flux of blood, and to hinder that the outward air did not enter into the breast, which might have cooled the Lungs and by consequent the heart. The said Tents were also put, to the end that issue might be given for the blood that was spilt within the Thorax. I put upon the wound great Emplasters of Diacalcitheos' in which I had relented oil of Roses and Vinigar to the avoiding of inflammation, than I put great stupes of Oxycrate, and bound him up, but not hard, to the end he might have easy respiration; that done I drew from him five porringers of blood from the Basilicke vein of the right arm, to the end to make revulsion of the blood which runs from the wounds into the Thorax, having first taken indication from the wounded part, and chiefly his forces, considering his youth and his sanguine temper; He presently after went to stool, and by his urine and siege cast great quantity of blood. And as for the pain which he said he felt at the entrance of the Bullet which was as if he had been pricked with a bodkin, that was because the Lungs by their motion beat against the splinters of the broken Rib. Now the Lungs are covered with a coat coming from the membrane called Pleura, interweaved with nerves of the sixth conjugation from the brain, which was cause of the extreme pain he felt; likewise he he had a great difficulty of breathing, which proceeded from the blood which was spilt in the capacity of the Thorax, and upon the Diaphragme, the principal instrument of respiration, and from the dilaceration of the muscles which are between each Rib, which help also to make the expiration and the inspiration; and likewise because the Lungs were torn and wounded by the Bullet, which hath caused him ever since to spit black and putrid blood in coughing. The Fever seized him soon after he was hurt, with faintings and swound. It seemed to me that the said fever proceeded from the putredinous vapours arising from the blood which is out of his proper vessels, which hath fallen down, and will yet flow down. The wound of the Lungs is grown great and will grow more great, because it is in perpetual motion, both fleeping and waking, and is dilated and compressed to let in the air to the heart, and cast fuliginous vapours out: by the unnatural heat is made inflammation, than the expulsive virtue is constrained to cast out by cough whatsoever is obnoxious unto it: for the Lungs cannot be purged but by coughing, & by coughing the wound is dilated, and grows greater, from whence the blood issues out in great abundance, which blood is drawn from the heart by the vein arterial to give them nourishment, and to the heart by the vena cava; his meat was barley broth, stewed prunes, sometimes panado; his drink was Ptisan: He could not lie but upon his back which showed he had a great quantity of blood spilt within the capacity of the Thorax, and being spread or spilt along the spondyls, doth not so much press the Lungs as it doth being laid on the sides or sitting. What shall I say more, but that the said Lord Martigues since the time he was hurt hath not reposed one hour only, and hath always cast out bloody urines and stools. These things than Messieres considered, one can make no other prognosticke but that he will dye in a few days, which is to my great grief. Having ended my discourse I dressed him as I was wont; having discovered his wounds, the Physicians and other assistants presently knew the truth of what I had said. The said Physicians having felt his pulse and known his forces to be almost spent, and abolished, concluded with me that in a few days he would dye; and at the same instant went all toward the Lord of Savoy, where they all said, that the said Lord Martigues would dye in a short time; he answered, it were possible if he were well dressed he might escape: Then they all with one voice said, he had been very well dressed, and solicited with all things necessary for the curing of his wounds, and could not be better, and that it was impossible to cure him, and that his wound was mortal of necessity. The Monsieur de Savoy showed himself to be very much discontented and wept, and asked them again if for certain they all held him deplored and remediless, they all answered, yes. Then a certain Spanish impostor offered himself, who promised on his life that he would cure him, and if he failed to cure him, they should cut him in an hundred pieces; but he would not have any Physicians, Surgeons or Apothecaries with him. And at the same instant the said Lord of Savoy told the Physicians and Surgeons they should not in any wise go any more to see the said Lord of Martigues Also he sent a Gentleman to me to forbid me upon pain of life not to touch any more the said Lord of Martigues, which I promised not to do; wherefore I was very glad, seeing he should not dye in my hands, and commanded the said impostor to dress the said Lord of Martigues. And that he should have no other Physicians nor Surgeons but him; he came presently to the said Lord of Martigues, who told him, Senor Cavallero el senor Dugue me ha' mandado que viniesse a curar vostra herida, yo os juro á Dios que antes de acho dias yo os haga subir a Cavallo con la lansa en puno contalque no ago que yo qúos togue, Comereiss y bibereiss todas comidas que fueren de vostro gusto y yo hare la dieta pro V. m. y desto os de veu aseguirar sober de mi, yo he sanado mun hos que tenian magores heridas que la Vostra. That is to say, Lord Cavalleere, Monsieur the Duke of Savoy hath commanded me to come dress thy wound; I swear to thee by God, that before eight days I will make thee mount on horseback with thy Lance in thy hand, provided, that no man may touch thee but myself; thou shalt eat and drink any thing thou hast a mind to, I will perform thy diet for thee, and of this thou mayst be assured upon my promise, I have cured divers who have had greater wounds than thine: and the Lord replied, God give you the grace to do it. He demanded of the said Lord a shirt and tore it in little rags, which he put a cross, muttering, and murmuring certain words over the wound; and having dressed him, permitted him to eat and drink what he would, telling him he would observe a diet for him, which he did, eating but six prunes and six bits of bread at a meal, and drinking but beer. Notwithstanding, two days after, the said Lord of Martigues died; and my Spaniard, seeing of him in the agony, eclipsed himself and got away without bidding, farewell to any body; and I believe if he had been taken he had been hanged for his false promises, which he had made to Monsieur the Duke of Savoy, and to divers other gentlemen. He died about ten of the clock in the morning, and after dinner, the said Lord of Savoy, sent Physicians and Surgeons and his Apothecary, with a great quantity of Drogues, to embalm him; they came accompanied with divers gentlemen and Captains of the Army. The Emperor's Chirurgeon came near to me, and prayed me kindly to open the body; which I refused, telling him I was not worthy to carry his plaster box after him: he prayed me again, which then I did for his sake, if it so liked him. I would yet again have excused myself, that seeing he was not willing to embalm him, that he would give this charge to another Chirurgeon of the company; he made me yet answer, that he would it should be I, and if I would not do it, I might hereafter repent it: knowing this his affection, for fear he should not do me any displeasure, I took the razor and presented it to all in particular, telling them I was not well practised to do such operations which they all refused. The body being placed upon a table, truly I purposed to show them that I was an Anatomist, declaring to them divers things, which should be here too long to recite. I began to tell all the company that I was sure the bullet had broken two ribs, and that it had passed through the Lungs, and that they should find the wound much enlarged, because they are in perpetual motion, sleeping or waking, and by this motion the wound was the more dilacerated. Also that there was great quantity of blood spilt in the capacity of the breast, and upon the midriff, and splinters of the broken ribs which were beaten in at the entrance of the bullet, and the issuing forth of it, had carried out. Indeed all which I had told them was found true in the dead body. One of the Physicians asked me, which way the blood might pass to be cast out by Urine, being contained in the Thorax. I answered him that there was a manifest conduit, which is the Vena A●ygos, who having nourished the ribs, the rest of the blood descends under the Diaphragme, and on the left side is conjoined to the emulgent vein, which is the way by which the matter in pleuresies and in Empiema, do manifestly empty themselves by urine and stool. As it is likewise seen, the pure milk of the breasts of women newly brought to bed, to descend by the Mammillary Veins, and to be evacuated downwards by the neck of the womb without being mixed with the blood. And such a thing is done (as it were by a miracle of nature) by her expulsive and sequesting virtue, which is seen by experience of two glass vessels called Mount-wine; let the one be filled with water, and the other with Claret wine, and let them be put the one upon the other, that is to say, that which shall be filled with water, upon that which shall be filled with wine; and you shall apparently see the wine mount up to the top of the vessel quite through the water, and the water descend atraverse the wine, and go to the bottom of the vessel without mixture of both; and if such a thing be done so exteriorly and openly to the sense of our eye, by things without life: you must believe the same in our understanding. That nature can make matter and blood to pass, having been out of their vessels yea through the bones without being mingled with the good blood. Our discourse ended, I embalmed the body, and put it into a Coffinne; after that the Emperor's Chirurgeon took me apart, and told me if I would remain with him that he would use me very well, and that he would clothe me anew, also that I should ride on horseback. I thanked him very kindly for the honour he did me, and told him that I had no desire to do service to strangers, and enemies to my Country; then he told me I was a fool, and if he were prisoner as I, he would serve the devil to get his liberty. In the end I told him flat that I would not dwell at all with him. The Emperor's Physician returned toward the said Lord of Savoy, where he declared the cause of the death of the said Lord of Martigues, and told him that it was impossible for all the men in the would to have cured him; and confirmed again, that I had done what was necessary to be done, and prayed him to win me to his service, and spoke better of me than I deserved. Having been persuaded to take me to his service, he gave charge to one of his stewards named Monfieur du Bouchet, to tell me, if I would dwell in his service that he would use me kindly: I answered him, that I thanked him most humbly, and that I had resolved not to dwell with any stranger. This my answer being heard by the Duke of Savoy, he was somewhat in choler, and said, he would send me to the Galleys. Monsieur de Vandeville, Governor of Gravelin, and Colonel of seventeen Ensigns of foot, prayed him, to give me to him, to dress him of an Ulcer which he had in his Leg this six or seven years; Monsieur de Savoy told him because I was of worth, that he was content, and if I rankled his Leg it would be ●ell done; He answered that if he perceaved any thing, that he would cause my throat to be cut. Soon after, the said Lord of Vaudeville sent for me by four german Halberdiers, which affrighted me much, not knowing whither they led me, they spoke no more French than I high Dutch; being arrived at his lodging, he told me I was welcome, and that I was his; and as soon as I should have cured him of that Ulcer in his Leg, that he would give me leave to be gone without taking any ransom of me. I told him I was not able to pay any ransom. Then he made his Physician and Surgeons in ordinary to show me his ulcerated Leg; having seen and considered it, we went apart into a Chamber where I began to tell them, that the said Ulcer was annual, not being simple but complicated: that is to say, of a round figure, and scaly, having the lips hard and callous, hollow and sordid, accompanied with a great varicous vein which did perpetually feed it; besides a great tumour, and a phlegmonous distemper very painful through the whole Leg, in a body of choleric complexion; as the hair of his face and beard demonstrated. The method to cure it (if cured it could be) was to begin with universal things, that is, with purgation and bleeding, and with this order of diet, that he should not use any wine at all, nor any salt meats, or of great nourishment, chiefly these which did heat the blood: afterward the cure must begun with making divers scarifications about the Ulcer, and totally cutting away the callous edges or lips, and giving a long or a triangular figure, for the round will very hardly cure, as the Ancients have left it in writing, which is seen by experience. That done, the filth must be mundified, as also the corrupted flesh, which should be done with Vnguentum Aegyptiacum, and upon it a bolster dipped in juice of Plantain and Nightshade and Oxycrate, and roll the Leg beginning at the foot, and finishing at the knee, not forgetting a little bolster upon the Varicous vein, to the end no superfluities should flow to the Ulcer. Moreover that he should take rest in his bed, which is commanded by Hypocrates, who saith, that those who have soar Legs should not use much standing or sitting, but lying along. And after these things done and the Ulcer well mundified, a plate of Lead rubbed with quickesilver should be applied. See then the means, by which the said Lord Vaudeville might be cured of the said Ulcer; all which they found good. Then the Physician left me with the Chirurgeon, and went to the Lord Vaudeville; to tell him that he did assure him I would cure him, and told him all that I had resolved to do, for the cure of his Ulcer: whereof he was very joyful. He made me to be called to him, and asked me if I was of the opinion that his Ulcer could be cured, and I told him, yes, provided he would be obedient to do what he ought. He made me a promise he would perform all things which I would appoint; and as soon as his Ulcer should be cured, he would give me liberty to return without paying any ransom. Then I beseeched him to come to a better composition with me, telling him that the time would be too long to be in liberty, if I stayed till he was perfectly well, and that I hoped within fifteen days the Ulcer should be diminished more than one half, and it should be without pain, and that his Physicians and Surgeons would finish the rest of the cure very easily. To which he agreed, and then I took a piece of paper, and cut it the largeness of the Ulcer, which I gave him, and kept as much myself. I prayed him to keep promise, when he should find his business done: He swore by the faith of a Gentleman he would do it; then I resolved to dress him well, according to the method of Galen, which was, that after all strange things were taken out of the Ulcer, and that there wanted nothing but filling up with flesh, I dressed him but once a day, and he found that very strange. And likewise his physician which was but a fresh man in those affairs, who would persuade me with the Patient, to dress him two or three times a day, I prayed him to let me do what I thought good; and that it was not to prolong the cure, but on the contrary to hasten it, for the great desire I had to be in liberty. And that he would look in Galen in the fourth book of the composition of medicaments secundum genera, who saith, that if a medicine do not remain long upon the part it profits not so much, as when it doth continue long, a thing which many Physicians have been ignorant of, and have thought it hath been better to change the Plaster often. And this ill custom is so inveterate and rooted, that the Patients themselves accuse oftentimes the Surgeons of negligence, because they do not oftener remove their emplasters; but they are deceived. For as you have understood and read in my works in divers places: The qualities of all bodies which mutually touch, operate one against another, and both of them suffer something, where one of them is much stronger than the other, by means whereof the said qualities are united, they familiarise with the time, although they are very much differing from the manner, that the quality of the medicament doth unite, and sometimes becomes like to that of the body, which is a very profitable thing. Therefore they say, he is to be praised much who first invented not to change the Plasters so often, because it is known by experience, this is a good invention. Moreover it is said, great fault is committed to dress Ulcers often in wiping of them hard, for one takes not away only the unprofitable excrement, which is the pu● or Sanies of the Ulcer, but the matter whereof the flesh is engendered; wherefore for the reasons aforesaid it is not needful to dress Ulcers so often. The said Lord Vaudeville, would see whether that which I alleged out of Galen were true, and commanded the said Physician to look there, for that he would know it; he caused the book to be brought upon the table, where my saying was found true, and then the Physician was ashamed, and I very joyful. So that the said Lord of Vaudeville desired not to be dressed but once a day, in so much that within fifteen days the Ulcer was almost cicatrized; the composition being made between us, I began to be merry. He made me eat and drink at his Table, when there was not men of more great rank with him. He gave me a great red sear●e, which he commanded me to wear. I may say I was as glad of it as a dog that hath a clog, for fear he should go into the vineyard and eat the grapes. The Physician and Chirurgeon led me through the Camp to visit their hurt people, where I took notice what our enemies did; I perceived they had no more pieces of Cannon, but only twenty five or thirty pieces for the field. Monsieur de Vaudeville held Monsieur de Bauge prisoner, the brother of Monsieur de Martigues who died at Hedin. The said Lord of Bauge was prisoner in the Castle of the heap of wood belonging to the Emperor, who had been taken at Ther●üenne by two Spanish Soldiers. Now the said Lord of Vaudeville having looked well upon him, conceived he must be a Gentleman of some good house, and to be the better assured, he caused him to have his stockings pulled off, & seeing his stockings and his feet clear and neat, together with his white fine sock, it confirmed him the better in his opinion, that it was a man was able to pay some good ransom. He demands of the Soldiers if they would take thirty Crowns for their prisoner, and that he would give it to them presently, to which they agreed willingly, because they had neither means to keep him, nor feed him; besides they knew not his worth, therefore they delivered their prisoner into the hands of the said Lord of Vaudeville, who presently sent him to the Castle of the heap of wood with a guard of four Soldiers with other Gentlemen prisoners of ours. The said Lord Bauge would not discover himself, who he was, and endured very much, being kept but with bread and water, and lay upon a little straw. The said Lord of Vaudeville after the taking of Hedin, sent word to the said Lord Bauge and other prisoners, that the place of Hedin was taken, and the list of those that had been slain, and amongst the rest, Monsieur de Martigues: and when the said Lord of Bauge heard the sound of the death of his brother the Lord Martigues, he began much to weep and lament; his keeper demanded of him, why he made so many & sogreat lamentations? He declared unto them that it was for Monsieur de Martigues his brother's sake. Having understood that, the Captain of the Castle dispatched a man away quickly, to tell it to Monsieur de Vaudeville that he had a good prisoner; who having received this good news rejoiced greatly, and the next day sent me with his physician and four Soldiers to the wood Castle to know if his prisoner would give him fifteen thousand Crowns for a ransom; he would send him free to his own house, and for the present he desired but the security of two Merchants of Antwerp, that he would name. The said Lord Vaudeville per vaded me that I would make his agreement with his prisoner. See then why he sent me to the wooden Castle, and commanded the Captain of the Castle to use him well, and to put him into a Chamber hung with Tap●strie, and that they should make his guard more strong, and from that time they made him good cheer at his expense. The answer of the said Lord of Bauge was, that to put himself to ransom he was not able; and that, that depended upon Monsieur d'Estamps his Uncle, and of Mistress de Bressure his Aunt, and that he had not any means to pay such a ransom. I returned with my keepers to the said Lord Vaudeville, and told him the answer of his said prisoner, who told me, Perhaps he should not out at so good a rate, which was true, for he was discovered. And forthwith the Queen of Hungary, and the Duke of Savoy sent word to the Lord Vaudeville, that this morsel was too great for him, and that he must send him to them, (which he did) and that he had enough prisoners besides him: he was put to forty thousand Crowns ransom besides other expenses. Returning toward the said Lord Vaudeville I passed by S. Omer, where I saw their great pieces of battery, whereof the greatest part was flawed and broken. I came back also by Theroüenne, where I did not see so much as stone upon stone, unless the mark of a great Church. For the Emperor gave commandment to the country people within five or six leagues about, that they should empty and carry away the stones; in so much, that now one may drive a Cart over the City, as is likewise done at Hedin, without any appearance of Castle or Fortress. See then the mischief which comes by the wars. And to return to my purpose, presently after my said Lord Vaudeville was very well of his Ulcer and little wanted of the entire cure, which was the cause he gave me my leave, and made me be conducted with a Passport by a Trumpet to Abbeville, where I took post, and went and found the King Henry my Master at Au●imon, who received me with joy, and a good countenance. He sent for the Duke of Guise the high Constable of France, and Monsieur d'Estrez, to understand by me what had passed at the taking of Hedin; and I made them a faithful report, and assured them I had seen the great pieces of Battery, which they had carried to S. Omer. Whereof the King was very joyful, because he feared least the enemy should come further into France. He gave me two hundred Crowns to retire myself to my own house, and I was very glad to be in liberty and out of this great torment and noise of Thunder from the Diabolicke artillery, and far from the Soldiers, blasphemers and deniers of God. I will not omit to tell here that after the taking of Hedin, the king was advertised that I was not slain, but that I was a prisoner, which his Majesty caused to be written to my wife by Monsieur du Goguier his chief Physician, and that she should not be in any trouble of mind for me, for that I was safe and well, and that he would pay my ransom. The Battle of S. Quintin. 1557. AFter the battle of S. Quintin, the King sent me to the Fere in Tartemis toward Monsieur the Marshal of Bourdillon, to have a Passport by the Duke of Savoy to go to dress Monsieur the Constable, who was grievously hurt with a Pistollshot in the back, whereof he was like to dye, and remained a prisoner in his enemy's hands. But the Duke of Savoy would never give consent that I should go to the said Lord Constable, saying he should not remain without a Chirurgeon, and that he doubted I was not sent only to dress him, but to give him some advertisement, and that he knew I understood something else besides Chirurgery, and that he knew me to have been his prisoner at Hedin. Monsieur the Marshal of Bourdillon advertized the King of the Duke's denial, by which means the King writ to the said Lord of Bourdillon, that if my Lady, the Lord high Constable's wife, did send any body of her house; which was an able man, that I should give him a letter, and that I should also have told him by word of mouth, what the King and Monsieur the Cardinal of Lorraine had given me in charge. Two days after there arrives a servant of the Lord Constable's Chamber, who brought him shirts, and other linen, for which the said Lord Martial gave Passport, to go to the said Lord Constable; I was very glad thereof, and gave him my letter, and gave him his lesson, of that which his Master should do, being prisoner. I had thought being discharged of my embassage to return toward the King. But the said Lord of Bourdillon prayed me to stay with him at the Fere to dress a great number of people who were hurt, and were thither retired after the battle; and that he would send word to the King, the cause of my stay; which I did. The wounds of the hurt people were greatly stinking, and full of worms with Gangrene and putrefaction; so that I was constrained to come to my knife to amputate that which was spoilt, which was not without cutting off arms and legs, as also to Trepan divers. Now there were not any medicines to be had at the F●re, because the Surgeons of our Camp had carried all with them; I found out that the Chariot of the Artillery tarried behind at the Fere, nor had it yet been touched. I prayed the said Lord Martial that he would cause some of the drogues to be delivered unto me which were in it; which he did, and there was given to me, one half only at a time▪ and five or six days after I way constrained to take therest, neither was there half enough to dress so great a number of the people, and to correct and stay the putrefaction, and to kill the worms which were entered into their wounds; I washed them with Aeyptiacum dissolved in wine and Aqua vitae, and did for them, all which I could possible, yet notwithstanding all my diligence, very many of them died. There were Gentlemen at the Fere who had charge to find out the dead body of Monsieur de Bois-Dolphin the elder, who had been slain in the battle; they prayed me to accompany them to the Camp to find him out amongst the dead, if it were possible, which indeed was impossible; seeing that the bodies were all disfavoured and overwhelmed with putrefaction. We saw more than half a league about us the earth covered with dead bodies; neither could we abide long there, for the cadaverous scents, which did arise from the dead bodies, aswell of men, as of horses. And I think we were the cause, that so great a number of flies, rose from the dead bodees, which were procreated by their humidity and the heat of the Sun, having their tails green and blue; that being up in the air made a shadow in the Sun We heard them buzz, or hum, which was much marvel to us. And I think it was enough to cause the Plague, where they alighted. (My little master) I would you had been there as I was, to distinguish the ordures and also to make report to them which were never there. Now being cloyed and annoyed in that Country, I prayed Monsieur the Lord Martial, to give me my leave to be gone, and that I was afraid I should be sick, by reason of my too great pains, and the stinks which did arise from the wounded bodies, which did almost all die, for what diligence soever was used unto them. He made other Surgeons, to come finish the dressing of the said hurt people, and I went away with his good grace and favour. He wrote a letter to the King, of the pains I had taken with the poor wounded. Then I returned to Paris, where I found yet many Gentlemen who had been hurt, and were there retired after the battle. The Voyage of the Camp of Amiens, 1558. THe King sent me to Dourlan, and made me to be conducted by Captain Govas● with fifty men in arms, for fear I should be taken by the enemies. And seeing that in the way we were always in alarms, I caused my man to alight, making him to be my master for that time, and I got upon his horse, which carried my male, and took his cloak and hat, and gave him my ambling Mare. My man being upon her back, one would have taken him for the master, and I for the servant. Those of Dourlan seeing us far off, thought we were enemies, and let fly their Cannon shot at us. Captain Govas● my conductor, made sign with his hat, that we were not enemies, so that they left shooting, and we entered into Dourlan with great joy. Those of Dourlan made a sally forth, upon the enemies five or six days before, who killed and hurt divers of our Captains, and good soldiers; and amongst the rest Captain St. Aubin valiant at the sword, whom Monsieur de Guise loved very well, and for whom chiefly the King sent me thither, who being in the fit of a quartan fever, would needs go out to command the greatest part of his company: a Spaniard seeing him that he commanded, perceived he was a Captain, and shot a musket bullet quite through his neck; my Captain Saint Aubin thought with this stroke he was dead, and with the fear (I protest to God) he lost his quartane ague, and was altogether freed from it. I dressed him with Anthony Portall Chirurgeon in ordinary to the King, and divers other Soldiers: some died, others escaped quit with the loss of a leg, or an arm, or the loss of an eye, and they said they escaped good cheap, escape that can. When the enemy had broke their Camp, I returned to Paris. here I hold my peace of my little master, who was more at ease in his house than I at the Wars. The voyage of Harbour of Grace, 1563. YEt I will not omit to speak of the voyage of the Harbour of Grace; then when they made the approaches to plant the Artillery, the English who were within it killed some of our Soldiers, & divers pioneers, who undermined, who when they were seen to be so hurt that there was no hope of curing, their fellows stripped them & put them yet alive, in the mines, which served them for so much filling earth. The English seeing they could not withstand an assault, because they were very much attainted with diseases, and chiefly with the Plague, they yielded, their lives and jewels saved. The King caused them to have ships to return to England, being glad to be out of this place infected with the Plague: the greatest part died, and carried the Plague into England, and since have not yet been exempted. Captain Sarlabous master of the Camp, was left there in garrison, with six Ensigns on foot, who had no fear of the Plague, and were very joyful to enter therein, hoping there to make good cheer. My little master had you been there you had done as they. The Voyage to Roüen, 1562. NOw for the taking of Roüen they killed divers of ours before the assault, and at the assault: the day after they entered into the City, I Trepaned eight or nine, who were hurt at the breach with the strokes of stones. There was so malignant an air, that divers died, yea of very small hurts, insomuch that some thought they had poisoned their bullets: those within said the like by us, for although they were well treated in their necessities within the City, yet they died also aswell as those without. The King of Navarre was hurt in the shoulder with a bullet some sew days before the assault; I visited and help● to dress him, with his own Chirurgeon, named Master Gilbert one of the chief of Montpelier, and others. They could not find the bullet, I searched for it very exactly, I perceived by conjecture, that it was entered by the head of the Adiutorium, and that it had run into the cavity of the said bone, which was the cause we could not find it. The most part of them said it was entered and loft within the cavity of the body. Monsieur the Prince of the Rock upon You, who intimately loved the King of Navarre, drew me to one side, and asked me if the wound was mortal. I told him yea, because all wounds made in great joints, and principally contused wounds, were mortal according to all Authors who have written of them. He enquired of the others what they thought, and chiefly of the said Gilbert, who told him that he had great hope that the King his master, would be cured, and the said Prince was very joyful. Four days after the King and the Queen mother, Monsieur the Cardinal of Bourbon his brother, Monsieur the Prince of Rock upon Yon, Monsieur de Guise, and other great personages, after we had dressed the King of Navarre, caused a consultation to be made in their presences, where there was divers Physicians and Surgeons: each man said what seemed good unto him, and there was not one of them, who had not good hope of him; saying that the King would be cured, and I persisted always on the contrary. Monsieur the Prince of the Rock upon Yond who loved me, withdrew me aside, and said I was only against the opinion of all the rest, and prayed me not to be obstinate against so many worthy men. I answered him, that when I saw any good signs of cure, I would change my advice. Divers consultations were made, where I never changed my word, and prognosticke, such as I had made at the first dressing, and always said that the arm would fall into a Gangrene, which it did, what diligence soever could be had to the contrary; and gave up his soul to God the eighteenth day of his hurt. Monsieur the Prince Upon Yon, having heard of the death of the said King, sent his Physician and Chirurgeon toward me, named Feure now in ordinary to the King, and to the Queen Mother, to tell me, that he would have the bullet taken out, and that it should be looked for in what place so ever it could be found: then I was very joyful, and told them that I was well assured to find it quickly, which I did in their presences, and divers gentlemen. It was lodged in the very midst of the cavity of the adjutory bone. My said Prince having it, showed it to the King and the Queen, who all said, my prognosticke was found true. The body was laid to rest in the Castle Galliard, and I returned to Paris, where I found divers hurt men who were hurt at the breach at Roüen, and chiefly Italians, who desired me very much to dress them, which I did willingly; there were divers that recovered; and others died. I believe (my little master) you were called to dress some of them, for the great number there was of them. The Voyage of the battle of Dreux 1562. THe day after the battle given at Dreun, the King commanded me, to go dress Monsieur the Count of Yew, who had been hurt with a Pistol shot in the right thigh, near the joint of the hip; which fractured and broke the Os femoris in divers places, from whence divers accidents did arise, and then death, which was to my great grief. The day after my arrival I would go to the field, where the battle was given, to see the dead bodies; I saw a league about, all the earth covered, where there was by estimation five and twenty thousand men, or more. All which were dispatched in the space of two hours. I would (my little master) for the love I bear you, that you had been there to recount it to your scholars and to your children. Now in the mean time while I was at Dreux I visited and dressed a great number of gentlemen and poor Soldiers, & amongst the rest many Swisser Captains, I dressed 14 in one chamber, only all hurt with Pistol shot, and other instruments of Diabolical fire, and not one of the fourteen died. Monsieur the Count of E● being dead, I made no long tarrying at Dreux: there came Surgeons from Paris who performed well their duty toward the hurt people, as Pigray, Cointeret, Hubert, and others; and I returned to Paris, where I found divers gentlemen wounded, who had retired themselves thither after the battle to be dressed of their hurts. The Voyage of the battle of Moncontor. 1569. During the battle of Moncontour King Charles was at Plessei the Towers, where he neard they had won it; a great number of hurt gentlemen and Soldiers with drew themselves into the City and suburbs of Towers, to be dressed and help●, where the King and Queen Mother commanded me to show my duty with the other Surgeons, who were then in quarter, as Pigray, du Bois, Portail, and one named Siret, a Chirurgeon of Towers, a man very skilful in Chirurgery, and at that time Chirurgeon to the King's brother; and for the multitude of the wounded we were but little in repose, nor the Physicians likewise. Count Mansfield Governer of the Duchy of Luxembourge, Knight of the King of Spain's order, was greatly hurt in the battle, in the left arm, with a Pistol shot, which broke a great part of the joint of the elbow, and had retired himself to Bourgueil near Towers; being there he sent a gentlemen to the King, affectionately to beseech him to send one of his Surgeons to help him in his hurt. Counsel was held what Chirurgeon should be sent. Monsieur the Marshal of Montmorency told the King and the Queen, that it were best to send him his chief Chirurgeon, and declared to them that the said Lord Mansfield was one part of the cause of winning the battle. The King said flat he would not that I should go, but would have me remain close to him. Then the Queen Mother said, I should but go and come, and that he must consider it was a strange Lord, who was come from the King of Spain's side, to help and succour him. And upon this he permitted me to go, provided that I should return quickly. After this resolution he sent for me, and likewise the Queen Mother, and commanded me to go find the said Lord Mansfield in the place, where I was to serve him in all I could, for the cure of his hurt; I went and found him, having with me a letter from their Majesties: having seen it, he received me with a good will, and from thenceforth discharged three other Surgeons that dressed him; which was to my great grief, because his hurt seemed to me uncureable. Now at Bourgueil there were retired divers gentlemen, who had been hurt at the said battle, knowing that Mounsieur de Guise was there, who had been also very much hurt with a Pistol shot through one leg, well assured that he would have good Surgeons to dress him, and also that he being kind and liberal, would assist them with a great part of their necessities. And for my part, I did help and aid them in my Art as much as it was possible; some died, some recovered, according to their hurts. The Count Ringrave died, who had such a shot in the shoulder, as the King of Navarro before Roüen, Monsieure de Bassompiere Colonel of twelve hundred horse, was hurt also in such a like place as Count Mansfield, whom I dressed and God cured. God so well blessed my work that within three weeks I led him back to Paris, where I must yet make some incisions in the arm of the said Lord Mansfield, to draw out the bones which were greatly broken and cariesed, he was cured by the grace of God, and gave me an honest reward, so that I was well contented with him and he with me, as he hath since made it appear: he writ a letter to the Duke of Ascot how that he was cured of his hurt, and also Monsieur de Bassompiere of his, and divers others, which I had dress'● after the battle of Montcontour, and counselled him to beseech the King of France my good master, to give me leave to go see Monsieur the marquis of Auret his brother. Voyage of Flanders. MOnsieur the Duke of Ascot did not fail to send a Gentleman to the King with a letter, humbly to beseech him to do him so much good and honour, as to permit and command his chief Chirurgeon to come see the marquis of Auret his brother; who had received a Musket shot near the knee, with fracture of the bone, about seven months since, with the Physicians and Surgeons in those parts were much troubled to cure. The King sent for me, and commanded me to go see the said Lord Auret, and to help him in all that I could for the cure of his hurt; I told him I would employ all that little knowledge which it had pleased God to give me. I went then conducted by two Gentlemen to the Castle of Auret, which is a league and a half from Mounts in Hainaut, where the said marquis was: as soon as I arrived I visited him, and told him the King had commanded me to come see him, and to dress him of his hurt; he told me he was glad of my coming, and was much bound to the King to have done him the honour, to have sent me to him. I found him in a great Fever, his eyes very much sunk, with a countenance ghastly and yellow, his tongue dry and rough, and all the body emaciated and lean, his speech low like that of a dying man: then I found his thigh much swelled, apostemated, ulcerated, and casting out a green stinking matter; I searched it with a silver probe, and by the same I found a cavity near the groin, ending in the middle of the thigh, and others about the knee, savious and cuniculous; also certain scales of bones some separated, others not. The Leg was much tumified, and soaked with a pituitous humour, cold, moist, and flatulent; in so much that the natural heat was in the way to be suffocated, and extinguished, and the said Leg crooked and retracted toward the buttocks, his rump ulcerated the breadth of the palm of an hand, and he said he felt there a great pain and smarting, and likewise in his reins, inso much that he could not take any rest night or day; neither had he any appetite to eat, but to drink enough; it was told me he fell often into faintings and swound, and sometimes as it were into an Epilepsy, and had oftentimes desire to vomit, with such a trembling that he could not carry his hands to his mouth. Seeing and considering all these great accidents, and the forces much abated; truly I was much grieved to have gone to him, because me thought there was little appearance that he could escape. Notwithstanding to give him courage and good hope, I told him, that I would quickly set him on foot by the grace of God, and the Physicians and Surgeons help. Having seen him, I went a walking into a Garden, where I prayed to God that he would give me the grace to cure him, and that he would give a blessing to our hands, and medicaments, to combat against so many complicated maladies. I bethought in my mind the ways I must keep to do it. They called me to dinner, I entered into the kitehin where I saw taken out of a great pot, half, a Mutton, a quarter of Veal, three great pieces of Beef, and two Pullet's, and a great piece of Bacon, with great store of good Herbs. Then I said to myself this broth was full of juice, and of good nourishment; After dinner all the Physicians and Surgeons assembled, we entered into conference in the presence of Monsieur the Duke of Ascot, and some Gentlemen that did accompany him; I began to tell the Surgeons that I mervailed much they had made no apertions in the Marquis' thigh; which was all apostemated, and the matter which issued out was very foul and stinking, which showed it had a long time lurked there, and that I had found with my probe a Caries in the bone, and small scales which were already separated; they made me answer, he would never give consent, and likewise it was almost two months since they could win him to put on clean sheets on his bed, neither dust one scarce touch the coverlet, he feel't so great pain. Then said I, for to cure him, we must touch other things than the coverlet of the bed. Each one said what he thought best of the Lords grief, and for conclusion held it altogether deplorable. I told them there was yet some hope, because of his youth, and that God and nature do sometime such things which seem to Physicians and Surgeons to be impossible. My consultation was, that all these accidents were come by reason of the bullet hitting near the joint of the knee, which had broken the Ligaments, tendons, and aponeurese of the muscles which tie the said joint together with the Os femoris; also nerves, veins, and arteries from whence had followed pain, inflammation, aposteme and ulcer: and that we must begin the cure by the disease, which was the cause of all the said accidents, that is to say, to make apertions to give issue to the matter retained in the interspaces of the muscles, and in the substance of them: Likewise to the bones which caused a great corruption in the whole thigh, from whence the vapours did arise and were carried to the heart, which caused the sincope, and the fever; and the fever an universal heat through the whole body; and by consequent, depravation of the whole Occonomie; Likewise that the said vapours were communicated to the brain, which caused the Epilipsie, and trembling, and to the stomach disdain and loathing, and hindered it from doing his functions, which are chiefly to concoct and digest the meat, and to convert it into Chylu●; which not being well concocted, they engender crudities and obstructions, which makes that the parts are not nourished, and by consequent the body dries, and grows lean; and because also it did not do any exercise, for every part which hath not his motion remaineth languid, and atrophiated, because the heat & spirits are not sent or drawn thither, from whence follows mortification. And to nourish and fatten the body, frictions must be made universally through the whole body, with warm linen clothes, above, below, on the right side, and left, and round about: to the end to draw the blood and spirits from within outward, and to resolve any fuliginous vapours retained between the skin, and the flesh; thereby the parts shall be nourished and restored, (as I have heretofore said in the tenth book treating of wounds of Gunshot) and we must then cease when we see heat and redness in the skin, for fear of resolving that we have already drawn, and by consequent make it become more lean. As for the Ulcer which he had upon his rump, which came through too long lying upon it without being removed, which was the cause that the spirits could not flourish or shine in it; by the means of which there should be inflammation, aposteme and then ulcer, yea with loss of substance of the subject flesh, with a very great pain; because of the nerves which are disseminated in this part. That we must likewise put him into another soft bed, and give him a clean shirt, and sheets; otherwise all that we could do would serve for nothing, because that those excrements and vapours of the matter retained so long in his bed, are drawn in by the Systole and Diastole of the Arteries which are disseminated through the skin, and cause the spirits to change and acquire an ill quality and corruption, which is seen in some that shall lie in a bed where one hath sweat for the Pox, who will get the Pox by the putrid vapours which shall remain soaked in the sheets and coverlets. Now the cause why he could in no wise sleep, and was as it were in a consumption, 'twas because he eat little, and did not do any exercise, and because he was grieved with extreme pain. For there is nothing that abateth so much the strength as pain. The cause why his tongue was dry and fowl, was through the vehemence of the heat of the fever, by the vapours which ascended through the whole body to the mouth. For as we say in a common proverb, when an Oven is well heat, the throat feels it. Having discoursed of the causes and accidents, I said they must be cured by their contraries, and first we must appease the pain, making apertions in the thigh to evacuate the matter retained, not evacuating all at a time for fear least by a sudden great evacuation there might happen a great decay of spirits, which might much weaken the patient and shorten his days. Secondly, to look unto the great swelling and cold in his Leg, fearing lest it should fall into a Gangrene; and that actual heat must be applied unto him because the potential could not reduce the intemperature, de potenti● ad actum; for this cause hot bricks must be applied round about, on which should be cast a decoction of nerval herbs boiled in wine and Vinegar, then wrapped up in some napkin, and to the feet an earthen bottle filled with the said decoction, stopped and wrapped up with some linen clothes; also that somentations much be made upon the thigh, and the whole Leg, of a decoction made of Sage, Rosemary, Time, Lavender, flowers of Camomile, melilot, and red Roses boiled in white wine, and a Lixivium made with oak ashes with a little Vinegar, and half an handful of salt. This decoction hath virtue to attenuate, incise, resolve and dry the gross viscous humour. The said fomentations must be used a long while, to the end there may be a greater resolution; for being so done a long time together, more is resolved than attracted, because the humour contained in the part is liquified, the skin and the flesh of the muscles is ratified. Thirdly, that there must be applied upon the rump a great emplaster made of the red desiccative and Vnguentum Comitissae of each equal parts incorporated together, to the end to appease his pain and dry up the Ulcer, also to make him a little down pillow which might bear his rump aloft without leaning upon it. Fourthly to refresh the heat of his kidneys one should apply the unguent called Refrigerans Galeni freshly made, and upon that the leaves of water Lilies. Then a napkin dipped in Oxycrate, wrung out and often renewed: and for the corroboration and strengthening of his heart a refreshing medicine should be applied made with oil of nenuphar, and unguent of Roses and a little saffron dissolved in Rose Vinegar, and Treacle spread upon a piece of Scarlet: For the Sincope which proceeded from the debilitation of the natural strength troubling the brain. Also he must use good nourishment full of juice, as rear eggs, Damask prunes stewed in wine and sugar, also Panado made with the broth of the great pot (of which I have already spoken) with the white fleshy parts of Capons, and Partridge wings minced small, and other rostmeate easy of digestion, as Veal, Goat, Pigeon, Partridge, and the like. The sauce should be Oranges, Verjuice, Sorrell, sharp Pomegranates; and that he should likewise eat of them boiled with good herbs; as Sorrel, Lettuce, Purslan, Succory, Boglosse, Marygolds, and other the like. At night he might use cleansed barley with juice of Nenuphar and Sorrell, of each two ounces, with five or six grains of Opium and of the four cold seeds bruised, of each half an ounce, which is a remedy nourishing and medicinal, which will provoke him to sleep: that his bread should be of Meslin, neither too new nor too stale; and for the great pain of his head, his hair must be cut, and rub his head with Oxirrhodinum luke warm, and leave a double cloth wet therein upon it; likewise should be made for him a frontal of oil of Roses, Nenuphar, Poppies, and a little opium and Rose Vinegar, and a little Camphor and to renew it sometimes. Moreover one should cause him to smell to the flowers of Henbane and Nenuphar bruised with Vinegar Rosewater, and a little campher wrapped in a handkerchief, which shall be often and a long time held to his nose to the end that the smell may be communicated to the brain, and these things to be contained till that the great inflammation and pain be past, for fear of cooling the brain too much. Besides, one may cause it to rain artificially in pouring down from some high place into a kettle, and that it make such a noise that the patient may hear it, by these means sleep shall be provoked on him. And as for the retraction of his Leg that there was hope to redress it, when evacuation was made of the matter and other humours contained in the thigh, which by their extension (made by repletion) have drawn back the Leg, which might be remedied in rubbing the whole joint of the knee with Vnguentum Dialth●a and oil of Lilies, and a little aqu● vitae, and upon it to be laid, black wool with the grease thereof. Likewise putting in the ham a feather-pillow folded in double, and by little and little to make his Leg to stretch out. All which my discourse was well approved of by the Physicians and Surgeons: the consultation ended we went to the sick patient, and I made him three apertions in his thigh, from whence issued out great quantity of matter and Sanies; and at the same time I drew out some scales of bones, nor would I let out too much abundance of the said matter for fear of too much decaying his strength: Then two or three hours after I caused a bed to be made near his own, where there were clean white sheets then a strong man lifted him into it, and rejoiced much in that he was taken out of his foul stinking bed. Soon after he demanded to sleep, which he did almost four hours, where all the people of the house began to rejoice, chiefly Monsieur the Duke of Ascot his brother. The days following I made injections into the bottom and cavities of the Ulcer, made with Aegyptiacum, dissolved sometimes in aqu● vitae, and sometimes in wine. I applied to mundify and dry the spongy and loose flesh, bolsters, at the bottom of the sinuosityes hollow tents of Lead, that the Sanies might have passage out; and upon it a great Emplaster of Diacalcitheos' dissolved in wine: likewise I did roll it with such dexterity, that he had no pain, which being appea●ed the fever began much to diminish. Then I made him drink wine moderately allayed with water, knowing that it restores and quickens the spirits: and all the things which we rested on in the consultation were accomplished, according to time, and order; and his pains and fever ceased, he began to grow better, and discharged two of his Surgeons, and one of his Physicians, so that we were but three with him. Now I remained thereabout two months, which was not without seeing divers sick people, as well rich as poor which came to me three or four leagues about. They gave meat and drink to the needy, all which he recommended to me, and prayed me also for his sake to help them. I protest I did not refuse any one, and did to them what I possibly could, whereof he was joyful. Then when I saw he began to mend, I told him he must have a consort of Violons & a jester to make him merry, which he did: in one month we so wrought, that he could hold himself up in a chair, and made himself to be carried and walk in his garden, and at the gate of his Castle to see the people pass by. The Country people of two or three leagues about, knowing they could see him, came the feast day male and female, to sing and dance pell mel, in joy of his amendment, allbeing very glad to see him, which was not done without good laughing and drinking. He caused still a barrel of beer to be given them, and they drank all merrily to his good health. And the Citizens of Mont Hainaut and other gentlemen neighbours came to see him in admiration, as a man coming from the tomb. And as soon as he began to mend, he was not without company, and as one went out another came in, to visit him: his table was always well covered. He was greatly loved of the Nobility, and of the common people, as well for his liberality as by reason of his beauty, and honesty, having a pleasant look and a gracious speech, insomuch that those that beheld his face were constrained to love him. The chief of the City of Monts came on Saturday to beseech him to permit me to go to Monts, where they had a great desire to feast, and make me good cheer for his sake. He told them he would pray me to go there, which he did. But I made them answer that they should not do me so much honour, as also that they could not give me better cheer than I had with him. And he prayed me again affectionately to go thither, and that I should do that for his sake, to which I agreed. The day after they fetched me with two Coaches, and being arrived at Monts we found the dinner ready, and the chief of the City with their wives, stayed for me with a good will. We went to the Table and they placed me at the upper end, and drank all to me, and to the health of Monsieur D'auret, saying that he was very happy, and they likewise to have obtained me to take him in hand, for that they knew that in this company, he was greatly honoured and loved. After dinner they led me back to the Castle of Auret, where Monsieur the marquis stayed for me with great expectation to recount unto him, what we had done in our banquet, I told him that all the company had drank divers times to his health in 6 weeks he began to uphold himself a little with crutches, and to grow very fat and get a lively natural colour. Now he had a desire to go to Beaumond which is the dwelling place of Monsieur the Duke of Ascot, and made himself be carried in a great chair with eight men by turns, and the Country folks where we passed along, knowing 'twas Monsieur the marquis fought and strove together who should carry him, and constrained us to drink, but it was but Beer, but I believe had it been Wine or Hippocras they would have given it us with a very good will, so much did they show themselves joyful to see the said marquis, and prayed all to God for him. Being arrived at Beaumond all the people came before us to do him reverence, and prayed God to bless him, and keep him in good health. We entered into the Castle where there was more than 50 gentlemen which the Duke of Ascot had sent for to come make good cheer with his brother, who kept his table furnished three days together. After dinner the gentlemen run at the Ring, played at Foils, and rejoiced greatly to see Monsieur Auret, because they had heard he would never come out of his bed again, or be cured of his hurt. I was always at the upper end of the table, where every one draul●●●arouses to him, & me, thinking to make me foxed, which they could not do: for I drank but according to my old custom. A few days after we returned back and took leave of Madam the Duchess of Ascot, who took a Diamond ring from her finger which she gave me, acknowledging I had very well dressed her brother; which Diamond was more worth than fifty Crowns. Monsieur Auret grew still better and better, and walked all alone round about his garden with crutches. I begged leave of him divers times, to come away to Paris, declaring that his Physician, and Chirurgeon, would well do the rest that remained, for the cure of his grief. And now to begin a little to estrange myself from him, I prayed him to give me leave to go see the City of Antwerp, which he willingly accorded to: and commanded his Steward to conduct me thither accompanied with two Pages: we passed through Malign●s and Bruxelle, where the chief of the City prayed the said Steward, that at our return they might hear of it; and that they had a great desire to feast me, as they of Monts had done. I thanked them most kindly, and told them that I was not worthy of such honour; I was two days and a half to see the City of Antwerp, where some Merchants knowing the Steward, prayed him to do them the honour, that they might bestow a dinner or supper upon us. There was striving who should have us, and were all very joyful to hear of the good health of the marquis of Auret, doing me more honour than I expected. To conclude, we came back to the marquis making good cheer, and within five or six days I asked my leave of him, which he granted with great grief, and gave me an honest Present, and of great value, and made me be conducted by the said master of his house and two Pages, even to my house at Paris. I have forgot to tell you, that the Spaniards have since ruined, and demolished his Castle of Auret, sack't, pillaged, rifled and burnt all the houses, and Villages belonging unto him, because he would not be of their side, in the slaughters and ruins of the Low Countries. The Voyage of Bourges, 1562. THe King with his Camp remained not long at Bourges, but those within yielded it up, and went out with their jewels saved. I know nothing worthy of memory, but that a Boy of the King's privy kitchen, who being near the walls of the City before the composition was made, cried with a loud voice, Huguenot, huguenot; shoot here, shoot here, having his arms lifted up, and his hand stretched out; a soldier shot his hand quite through with a bullet: having received his stroke, he came and found me out to dress him. My Lord high Constable, seeing the Boy to have his hand all bloody, and all rent and torn; demanded of him who had hurt him. Then there was a gentleman who saw the shot made, said it was well bestowed because he cried, Huguenot, shoot here, shoot here. Then the said Lord Constable said this Huguenot was a good musketiere, and bore a pitiful mind, for it was very likely if he would have shot at his head, he might have done it more easily than in the hand. I dressed the said Cook who was very sick, but at length was cured, but with lameness of his hand, and ever since his companions call him Huguenot; he is living. The battle of Saint De●is, 1567. ANd as for the battle of Saint Denis, there were divers slain aswell on one side as on the other: ours being hurt, went back to Paris to be dressed together with the Prisoners who were taken, whereof I dressed a great part. The King commanded me by the request of the Lady high Constable, to go to her house to dress my Lord, who had received a Pistol shot in the middle of the spondyls of his back, whereby he presently lost all sense and motion of thighs and legs, with retention of excrements, not being able to cast out his Urine, nor anything by the fundament, because that the spinal marrow, (from whence proceed the sinews to give sense and motion to the inferior parts,) was bruised, broken, and torn by the vehemence of the bullet. He likewise loft his reason, and understanding, and in a few days he died. The Surgeons of Paris were a long time troubled to dress the said wounded people, I believe (my little master) that you saw some of them. I beseech the great God of Victories, that we may never be employed in such evil encounters, and disasters. The voyage of Bayonne, 1564. NOw I say moreover, what I did in the voyage with the King to Bayonne, where we have been two years and more to compass all this Kingdom, where in divers Cities and Villages I have been called into consultations for divers diseases, with the deceased Monsieur Chaplain chief Physician to the King, and Monsieur Chastellan chief to the Queen Mother, a man of great honour and knowledge in Physic and Chirurgery: making this voyage I was always inquisitive of the Surgeons if they had marked any rare thing of remark in their practice, to the end to learn some new thing. Being at Bayonne there happened two things of remark for the young Surgeons. The first was, that I dressed a Spanish Gentleman, who had a grievous great imposthume in his throat: he came to have been touched by the deceased King Charles for the Evil. I made incision in his Aposteme, where there was found great quantity of creeping worms as big as the point of a spindle, having a black head; and there was great quantity of rotten flesh. Moreover there was under his tongue an imposthume called ●anula, which hindered him to utter forth his words, and to eat and swallow his meat: he prayed me with his held up hands to open it for him if it could be done without peril of his person, which I immediately did, and found under my Lancet a solid body, which was five stones like those which are drawn from the bladder. The greatest was as big as an Almond and the other like little long Beans, which were five in number; in this aposteme was contained a slimy humour of a yellow colour which was more than four spoonfuls; I left him in the hands of a Chirurgeon of the City to finish the cure. Monsieur de Fontaine Knight of the King's Order, had a great continual pestilent Fever, accompanied with divers Carboneles in divers parts of his body, who was two days without ceasing to bleed at nose, nor could it be staunched; and by that means the fever ceased with a very great sweat, and soon after the Charboncles' ripened and were by me dressed and by the grace of God cured. I have published this Apology to the end that each man may know, with what foot I have always marched, and I think there is not any man so ticklish, which taketh not in good part what I have said, seeing my discourse is true, and that the effect showeth the thing to the eye, reason being my warrant against all Calumnies. The end of the Apology and Voyages. FINIS. A GENERAL TABLE OF ALL THE CHIEF THINGS TREAted of in this Worke. A ABortions why frequent in a pestilent season. Pag. 821 their causes, etc. 921 Abductores musculi. 223, & 238 Abscesses how to be opened. 259 Aconite, the symptoms caused thereby, and their cure. 807 Actual Cauteries preferred before Potential, 749. Their forms and use, 750. 751. Their force against venomous bites. 784 Action, the definition and division thereof, 23 Voluntary Action. 24 Adders their bitings, the symptoms thereone usuing, together with the cure. 790 Adiposa vena. 116 Adductores musculi. 222 Adjuncts of things natural. 27 Ad●ata, sive Conjunctiva, one of the coats of the Eye. 182 Aegilops what, 948. the differences thereof, Ibid. the cure. 649 Aegyptiacum, the force thereof against putrefaction, 433. a cleanser and not a suppurative, 46. descriptions thereof, 456, 423. the praise thereof. 856 Afterbirth, see Secundine. 1 After-tongue. 195 Afterwrest. 518 Age what, the division thereof. 9 Ages compared to the four seasons of the year. 10 Agony what. 40 Agues, see Quotidian, quartan, Tertian. Bastard Agues how cured. 286 Agglutinative medicines, 326. their nature and use. 1046 Air an Element, the prime qualities thereof, 6 the necessity thereof for life, 29. which hurtful, 30. What understood thereby, ib. How it changes our bodies, 31. Though in Summer colder than the Brain, 357. How it becomes hurtful, 416. How to be corrected, 429. Of what force in breeding diseases, 433. What force the Star, have upon it, 434. How that which is corrupt or venomous may kill a man, 782. How it may be corrupted, 819. Penned up it is apt to putrify, 837. change thereof conduces to the cure of the Plague. 837 Alae what. 130 Allantoides tunica, there is no such, showed by three several reasons. 132 Albugineus humour, the use thereof. 184 Almonds of the throat or ears, their History, 193. their tumour with the causes and signs thereof, 293. The cure. 294 Almonds increase the pain of the head. 357 Alopecia what; the cause, which curable, and how, and which not. 637 Amnios tunica the substance and composure thereof. 132 Amphiblistroides, vel retiformis tunica. 183 Amputation of a member when to be made, 457. How to be performed, 458. To staunch bleeding ensuing thereon, 459. how to dress the part, 460. To perform the rest of the cure, 461. Sometimes made at a joint. 463 Anatomy, the necessity of the knowledge thereof, 79. A threefold method thereof, 80. The definition thereof, etc. ibid. anatomical administration of the lower Belly, 87. Of the sternon, 139. Axioms, 122 152, 183, 212, 226 Aneurisma what, 286. How cured, 287. Which incurable. ibid. Anger, the effects thereof. 39 Angina, see squinancy. Anima how many ways taken. 7. See soul. Animal parts which, 83. Their division. 84 Anodyne medicines, 1047. For the eyes, 379 in pains of the teeth. 401 Antidotes must be given in great quantities, 785, No one against all poisons, 809. To be used in the cure of the plague. 843, 844 Antipathy, see sympathy. Antipathy between some Men and a Cat, 804. Of poisons with poisons. 823 Ants. 59 Their care. 60 Apes their imitation of men's actions. 69 Apium risus, the poisonous quality thereof, with the cure. 805 Apology concerning wounds made by Gun-shot. 432. That such wounds are not poysonea, 436. Concerning binding of vessels, etc. 1133 Apophlegmatismes what, and their use. 1069 Apophyses clinoides. 172, 174 Aphorisms concerning Chirurgery selected out of Hypocrates, 1116. 1117. Of the Author. 1119 Apostumes, see impostumes. Apothecaries, choice of such as shall have care of those sick of the Plague. 830 Appendices glandulosae. 122 Aqua fortis the poisonous quality, and the cure thereof. 810 Aqua theriacalis the description & manner of making thereof, 755, 824. good against the Plague. 824 Aqua vitae how distilled. 1100 Aqueus humour. 183 Arachnoides, sive araneosa tunica. 183 Ar●oticke medicines. 1040 Archagatus a Roman Chirurgeon, slain by the people. 5 Argentum Vivum, see Hydrargyrum. l Aristomachus the Philosopher a great observer of Bees. 59 Arm or shoulderbone, the fractures thereof. 575 Arm and the bone and muscles thereof, 214. The defect thereof how to be supplied. 880, 882 Arsenic, the poisonous quality thereof, and the cure. 810 Arrows, wounds made by them, and their several forms, 438. How to be drawn forth. 440 Artery what, 97. The division of the great descendent Artery, 113, 115. Distribution of the left subclavian Artery, 153. Of the axillary, 211. Of the crural, 223. Not dangerous to be opened, 641. Rough Artery, 157. Figure of the Arteries. 154 Arteria Venosa, and the distribution thereof, 147. Carotydes, 153. Cervicalis, ibid. Intercostalis, ibid. Mammaria, ibid. musculosa, ibid. Humeraria duplex, ibid. Thoracica duplex, ibid. Aspera, 156. Muscula, 225. Arthrodia what. 243 Articulation and the kinds thereof, 242. 243, 244 Ascarides have known. 766 Ascites, see Dropsy. Asp his bite, and the symptoms that happen thereon, with their cure. 794 Asses milk how to be used in the cure of a Heotique. 395 A stragalus. 233 Atheroma what, 271. The cure thereof, 〈◊〉. Atrophia how helped. 634, 635 Attractive medicines what, 1039 Auricula cordis. 145 Auripigmentum, the poisonous quality, and the cure thereof. 810 Autumn, the condition thereof. 10 Axioms anatomical, 122. 152, 183, 212, 226. Philosophical. 184 B Backebone and the use thereof. 198 Bags, the diversity and use. 1071 Ball bellowes. 415 Balneum Mariae. 1096, 1097 Balsams fit to heal simple, not contused wounds. 434 Balsam of Vesalius his description, 1107. Of Fallopius his description, ibid. An anodyne, and sarcoticke one. 402 Bandages, their differences, 553. What cloth best for them, ibid. Indications how to fit them, 554. Three kinds necessary in fractures, 555 Common precepts for their use, 557. uses whereto they serve. 558 Barnard the Hermit. 1017 Barrenness, the cause thereof in men, 931. In women. 932 Basilisk, her description, bite and the cure thereof. 792 Battail●s where the Author was present, See Voyages. 20 Baths good in pain of the Eyes. 646 Baths their faculties and differences, 1074 How to know whence they have their efficacy, ibid. Their faculties and to whom hurtful 1075. half baths. 1073 Beautroll a beast of Florida, 1021 Bearwormes, the bites and the cure thereof. 798 Bears, their craft: 56 Beasts, inventors of some remedies, 56. Their faculty in presaging 57 Their love and cure of their young, 60. Most wild ones may be tamed, 64. They know one another's voice. 72 Bees their government, 58. Care and justice 59 Their stinging & the cure thereof, 798 Baggars their cousenages and crafty tricks. 992, 993, etc. Belly, why not bony, 85. The division of the lower belly. ibid. Bezoar and Bezoarticke medicines. 808 Biceps musculus. 218, and 231 Binding of the vessels for bleeding, 341. An apology therefore, 1133. Authorities therefore. 1134. Reason, 1135. Experience, 1136. Histories to confirm it. 1137 Birds their industry in building their nests, 58. Ravenous birds, 70. Counterfeit man's voice, 72. They have taught men to sing. ibid. Bird of Paradise. 1017 Birth, see Childbirth. Bitings of man and Beast venenate. 360▪ 1782 Bite of a Mad-dogge, Adder etc. see Dog, Adder, etc. Bitter things not fit to be injected into wounds of the Chest. 390 Bladder of the Gall. 110 Bladder of Urine, 123. The substance, figure, etc. ibid. Signs of the wounds thereof, 397. Ulcers thereof and their cure 481. 686 Bleare-eyes their differences and cure. 644 Bleeding in wounds, how helped 328. How stopped by binding the vessels, 341. Why devised by our Author. 462. In amputation of Members. 459 Blood, the temper thereof, 11. The material and efficient causes thereof, 12. Where perfected, ibid. All the four humours comprehended under that general name, ibid. compared with new wine, ibid. the nature, consistence, colour, taste and use. 13 Blood-letting whether necessary at the beginning of pestilent diseases. 845 Blood-letting, when necessary in a synochus. 261. When in an Erysipelas, 263. When in a Tertian, 267. In what wounds not necessary, 326. The two chief indications thereof, 359. Why necessary in the Fracture of the beele, 632. See Phlebotomy. Bloody Urine and the causes thereof. etc. 685 Boate-bone. 234 Body how divided, 83. 85. The forepart thereof, 86. The back part, 87. The crookedness thereof how helped. 876 Bolsters and other use. 359 Bones, how they feel, 81. Their definition, 138. Their differences, 139. How hurt by the Trepan, 365. What hastens their scailing, ibid. Their corruption, 371. How helped. 372 Bones of the scull, 162. Of the face, 178. Of the nose. 179. Of the auditory passage, 191 Of the arm, 214. Of the back, 198. Of the breast, 136. Of the cubit, 217 Of the wrist, afterwrest and fingers, 218. Seede-bones 220. Of the Thigh, 228. Of the Leg, 231. Of the foot, 233. Of the Toes, 234. A brief recital of all the Bones. 239 Bones more brittle in frosty weather, 562. sooner knit in young bodies, 563. Their general cure being broken or dislocated, 564. How to help the symptoms happening thereon, 566. Why they become rotten in the Lue venerea, and how it may be perceived, 747. How helped. ib. Bones sticking in the Throat or law, how to be got out. 556 Brachiaeus Musculus. 218 Brain and the History thereof. 165. The Ventricles thereof, 166. The mamillary proccsses. ibid. Brain, the moving or concussion thereof, 350 how cured. 376 Breasts, 137. Their magnitude, figure, etc. ibid. How they communicate with the womb. 138 Breastbone, the History thereof. 126 Breast bone, the depression or fracture thereof, bow helped. 570 Brevis musculus. 218 Bronchocele, the differences thereof and the cure. 298 Bruises, see Contusions. Bubo's, by what means the humour that causes them flows down. 224 Bubo's, venereal ones returning in again causes the Lues venerea, 724. Their efficient and material causes, 746. Their cure. ibid. Bubo's in the Plague, whence their original 817. The description, signs and cure, 853 prognostics. 857 Bubonocele what: 304 Bullets shot out of Guns do not burn, 410. They cannot be poisoned, 412. 437. remain in the body after the healing of wounds. 429 Buprestes their poison and the cure. 800 Burnes, how kept from blistering, 410. See Combustions. Byshop-fish. 1002 C. Cacochymia what. 37 Caecum intestinum. 106 Calcaneum os. 234 Caeliaca arteria. 113 Callus what, and whence it proceeds, 323 Better generated by meats of gross nourishment, 562. Made more handsome by Ligation, ibid. The material and efficient causes thereof, 588. Medicines conducing to the generation thereof, ibid. How to know it is a breeding, 589. What may hinder the generation thereof, and how to help it being ill form. 590 Camels their kinds and condition. 70 Cancer, the reason of the name, 279. Causes thereof, ibid. differences, 280. Which not to be cured, ibid. The cure if not ulcerated, ibid. Cure if ulcerated, 281. Topicke medicines to be thereto applied. 282 Cancer or Canker in a child's mouth how to be helped. 905 Cannons, see Guns. Cantharideses, their malignity and the help thereof, 799. Applied to the head they ulcerate the bladder. 800 Capons subject to the Gout. 707 Carbuncles whence their original, 817. Why so called, together with their nature, causes and signs, 857. prognostickes, ibid. cure 859 Caries ossium. 371 Carpiflexores musculi. 222 Carpitensores musculi. 221 Cartilago scutiformis, vel en●iformis. 136 Caruncles, their causes, figures and cure, 742. Other ways of cure: 744 Cases, their form and use. 560 Caspilly a strange Fish. 69 Catagmaticke powders. 363 Catalogue of Medicines and Instruments for their preparation, 1109 1110, etc. Of chirurgical Instruments, 1113, 1114 Cataplasms, their matter and use. 1062 Catarractes, where bred, 184. Their differences, causes, etc. 651. Their cure at the beginning, ibid. The couching of them. 653 Catarrh sometimes malign and kill many. 821 Cathareticke medicines. 1046 Cats, their poisonous quality, and the Antipathy between some men and them. 804 caustic medicines their nature and use. 1046, 1047 Cauteries, actual ones preferred before potential, 749. Their several forms, 749, 750, 751. Their use, 741. Their force against venomous bites, 784. Potential ones. 1064 Cephale what. 243 Cephalica vena. 210 Cephalic powders how composed. 752 Cerats what, their differences. 1508 Ceratum oesypi ex Philagrio. 1060 Ceruse, the poisonous quality thereof, and the cure. 810 Certificates in sundry cases. 1129 Chalazion an affect of the eyelid. 642 Chameleon his shape ●nd nature. 1024 Chance sometimes exceeds Art, 49. Finds out remedies. 409 Change of native temper, how it happens. 18 Chaphs, or Chaps occasicned by the Lues venerea, and the cure, 754. In divers parts by other means, and their cure. 957 Charcoal causeth suffocation. 1125 Chemosis an affect of the Eyelids. 647 Chest and the parts thereof, 136. Why partly gristly, partly bony, ibid. The division thereof, 137. The wounds thereof, 388. Their cure, 389. They easily degenerate into a Fistula. 391 Child, whether alive or dead in the womb, 913. If dead, then how to be extracted, 914, 915 Children why like their fathers, and grandfathers, 888. Born without a passage in the fundament, 898. Their site in the womb, 900 901. When and how to be weaned, 913. Their pain in breeping teeth, 959. They may have impostumes in their mother's womb. 594 Childbirth and the cause thereof, 899. The natural & unnatural time thereof, 901 women have no certain time, ibid. Signs it is at hand 902. What's to be done after it. 904 China root, the preparation and use thereof. 730 Chirurgery, see Surgery. Chirurgeon, see Surgeon. Choler, the temper thereof, 11. The nature consistence, colour, taste and use, 13. The effects thereof, 15. Not natural how bred and the kinds thereof. 16 Choleric persons, their habit of body, manners and diseases, 17. They cann●t long brook fasting. 707 Chorion what. 132 Chylus, what. 12 Cirsocele, a kind of Rupture, etc. 304. The cure. 312 Cinnamon and the water thereof. 1105 Chavicle, see Collar-bone. Cleitoris. 130 Clyster, when presently to be given after blood-letting, 262. See clyster. Coats, common coat of the Muscles, the substance, quantity, etc. thereof, 91. Of the eyes, 182. Of the womb. 132 Cockatrice, see Basilisk. Cock's are kingly and martial birds. 66 Colchicum the poisonous quality thereof, and the cure. 866 Colic, and the kinds thereof, etc. 689 Colon. 106 Collar-bones, or Clavicles, their History, 138, 139. Their fracture, 568. How to help it, ibid. Their dislocation and cure, 601 Collyria what, their differences & use, 1067 Colour is the bewrayer of the temperament, 28 Columella, see Wula. Combustions and their differences, 449. their cure. 450 Common sense what, 896 Comparison between the bigger and lesser world. 761 Complexus musculus. 201 Composition of medicines, the necessity thereof. 1099 Compresses, see Bolsters. Concoction, fault of the first concoction not mended in the after. 707 Concussion of the Brain, 350. how helped. 376 Condylomata, what they are, and their cure, 957 Conformation, the faults thereof must be speedily helped. 904 Congestion, two tauses thereof. 250 Contusions what, their causes, 442. Their general cure, ibid. How to be handled if joined with a wound 445. How without a wound, ib. how kept from gangrening, 446 Contusions of the ribs, 447. Their cure 634 Convulsion, the kinds and causes thereof, 329 the cure, 330 331. Why on the contrary part in wounds of the head. 357 Convulsive twitching in broken members and the cause thereof. 586 Coneys have taught the art of undermining 66 Cornea tunica. 183 Corone, what. 243 Coronalis vena, 112 Corroborating medicines. 270 Cotyle what. 243 Cotyledones what. 129, 891 Courses, how to provoke them, 863 948. How to stop them, 864, 951 952. The reason of their name, 945. Their causes, 946. causes of their suppression, 947. What symptoms follow thereon, 948 symptoms that follow their immoderate flowing, 951 Crabs. 69 Cramp the cause and cure thereof. 722 Cranes observe order in flying and keep watch. 67 Cremaster muscles. 120 Cridones what disease, and the cure. 319 Crocodiles may be tamed. 76 Crookedness how helped. 876 crural vein, 224. Artery. 223 Crureus musculus. 232 Crus how taken. 223 Crystallinus humour. 184 Cubit, the bones and muscles thereof. 217 Cubit-bones, the fracture of them. 555 Cuboides os. 234 Cupping glasses and their use, 694. Their use in the cure of a Bubo. 853 Cures accidental and strange, 49, 50. Deceitful. 51 Custom how forcible. 33 Cuticle, the matter, quantity, figure, etc. thereof. 88 Cuttell-fish his craft. 68 Cysticae gemellae. 112 D. Dartos. 119 Death, the inevitable cause thereof, 41. How sudden to many. 778 Definition of Chirurgery. 3 Definition how different from a description. 80 Defluxion of humour show diverted. 256 Delirium, the causes thereof, 334. The cure. 335 Deliverance in Childbirth how furthered, 903. Which difficult, 921. Which easy. ib. Deltoides musculus. 216 Dentifrices, their differences, matter, and for me. 1071 Depilatories. 1182 Derma. 89 Detersives, 259. 1043. Their use. ibid. Devils and their differences, 986. Their titles and names, 987. They are terrified and angered by divers things. 990 Devil of the Sea. 1004 Diabete what, the causes, signs and cure. 688 Diaphoretic medicines. 140 Diaphragma, see Midriff, Why called Phrenes. 142 Diaphysis what. 231 Diary fever, the causes and signs, 260. The cure. 261 Diarthrosis. 242 Die-bone. 234 Diet hath power to alter or preserve the temperament. 28 Diet convenient for such as have the Gout, 707. For such as fear the stone, 667. In prevention of the Plague, 822. In the cure thereof. 839, 840, 841 Differences of muscles. 92, 93 Digitum flexores musculi. 222, 237. 238 Digitum tensores musculi. 221, 237 Diploe what. 163 Disease the definition and division thereof, 41. Causes. ibid. Diseases strange and monstrom. 49 Diseases incident to sangnine, choleric, phlegmatic and melancholic persons 17. Wherefore some are hereditary, 886. supernatural, 989. Monstrous accidents in them. 996 Dislocations, their kinds and manner, 593. their differences, 594. Causes, ib. Signs, 595. Prognostics, 595. The general cure, 564. 597. Symptoms that may be fall a dislocated member. 634 Dislocation of the jaw, 600. The cure, ibid. & 601. Of the Collar-bone, 601. Of the spin, 602. Of the head, 603. Of the neck, 603. Of the Rump, 607. Of the Ribs, ibid. Of the shoulder, 608. Of the Elbow, 619. Of the Styliformis processus, 621. Of the wrist, 622. Of the Afterwrest, 623. Of the Fingers, ibid. Of the thigh or hip, ibid. Of the whirlebone, 630. Of the knee forwards. 631. Of the greater and less Focile, 631. 632. Of the heel, 632. Of the Pastern or Ankle, bone, 633. Of the instep and back of the foot, 633. Of the toes. 634 Dismembering, see Amputation. Distemperature and the diver sity thereof. 41 Distillation and the kinds thereof, 1093. Fornaces & the vessels therefore. 1094. What to be considered therein. 1095. How to prepare the materials therefore. 1098 How to distil waters. 1099. How aqua vita. 1100. How to rectify them. 1101. To distil in the Sun. ibid. By filtering: 1102. Of Oils. 1103. Of Spirits, 1105. Of Oils out of Gums. 1107. Of Oil of Vitriol. 1108 docility of Beasts. 69 Dogs their love to their masters, 61. Their docillitie. 69. Why they become mad sooner than other creatures, 785. How their bites may be known. 786. Prognostics. 787. The cure of such as are bitten by them. 788 Dorycnium, the poisonous quality thereof and the cure. 805 Doves free from adultery. 62 Draco marinus, the Sea Dragon his poisonous puncture, the symptoms & cure. 801 Dracunculus what, 315. The cure. 316 Dragons their craft. 68 Dreams of the sangnine, choleric, phlegmatic and malancholicke persons, 17, 18. Not to be neglected. 36 Dropsy what, 299. The differences, Symptoms and causes, ibid. Signs and prognostics, 300. The cure, 301. Following upon a Tumour of the mesentery. 930 Dugs, their substance, magnitude, etc. 137 What to be done to them to dry up milk. 918 Duodemum, the magnitude, etc. 105 Dura matter what, 164. The hurts thereof by Trepanning, and how helped, 373. Remedies for the inflammation and the Apostumation thereof, 374. Why it easily endures acride medicines. 375 E Ears, their parts and composure. 189. Their wounds and cure, 386. To supply their defects, 875. Their ulcers, 479. Their stopping and things falling into them how helped. 655 Ears of the heart. 145 Ear wax, for what use it serves. 190 Earth a cold and dry element. 6 Earthquakes, their cause. 415 Ecchymosis what and how cured. 343 Echo, the cause thereof. 190 Effects of Phlegm. 14. Of choler and melancholy. 15 ejaculatory vessels in men, 121. In women. 127 Elbow the dislocation thereof, 619. how to restore it dislocated outwardly, 619. To the inside, 621. Why most subject to anchyliosis. ibid. Elements how understood, and their principal qualities, 6. What those of generation are, 7. What these of mixed bodies are, ibid. The cause of their transmutation. 415 Elephants, their strength, piety, etc. 62, 63. Where bred, and their qualities. 1019 Embalming the dead, 1130. The manner how. 1131 Embryo, when it takes that name. 893 Embrocation what, & how performed, 1063 Emollient and resolving medicines, 275, 278 Emplasters what, their differences, 1058. Signs they are perfectly boiled, 1059. Their use, 1061. Cautions in their application. 269, 270 Emplastrum de Vigo cum Mercurio, 1060 De gratia Dei. ibid. De Betonica sive de janua. ibid. Oxycrocium, 1061. De cerusa, ibid. Tripharmacum se●●igrum. ibid. Diapalma seu Diacalcitheos', ibid. Contra Rupturam, ib. De Mucilaginibus, ibid. De minio, ibid. Diachylum magnum. ibid. Empyema what, 298. The cure thereof. 299 Emptiness. 37 Emulgens Arteria, 114. Vena, 116 Enarthrosis, a kind of articulation. 242 Enterocele a kind of Rupture. 304 Ephemera febris, 260. The causes and signs thereef, ibid. The cure. 262 Epidermis. 88 Epidydimis. 119 Epigastrium what, 87. The containing parts thereof. ibid. Epigastrica vena. 117 Epiglottis what. 195 Epiploon what. 101 Epiplois vena. 113 Epiplocele. 304 Epithemes to strengthen the principal parts, 845. Their composition and use. 1064 Epomis musculus. 216 Epulis what, the symptoms and cure. 292 Epuloticke, or skinning medicines, their kinds and use. 1045 Errhines their differences, description and use. 1068 Erysipelas what, 262. What tumours referred thereto, 253, The differences thereof, 262. Prognostics, 267. Their cure. ibid. Erythrois tunica. 119 Eschar how to hasten the falling away thereof, 856. Medicines causing it. 1047 Escharoticks, 1047. Why used to spreading Ulcers. 401 Ostrich between a bird and a beast, 1014. The sceleton of one. 1015 Evacuation and the kinds thereof, 37. What to be observed therein. 38 Eunnches assimulated to women. 27 Excrements of the first, second and third concoction what. 898 Exercise, the use and best time for it, 34. The quality thereof. 35 Exomphalos, or standing forth of the navel 303 Epostosis in Lue venerea. 746 Experience without reason, of what account. 45 Eyebrows. 181 Eyelids, 181. To stay them being too lax, 641. To open them fastened together, 643. To help their itching. 644 Eyes their site and quickness, 181. Figure, composure, &c, 182. Their muscles, coats & humours, 182, 183, 184. their wounds, 379. to hide the loss or defect of them, 669, their ulcers, 476. their cure, 477. their affects, 641, 642, etc. their inflammation. 645 F. FAce a discloser of affections and passions 40. the wounds thereof, 378. How to help the redness thereof. 1080 Faculties what, 21. their division. 22 Falling down of the Fundament the causes and cure thereof. 313 Fat, the substance, and cause, etc. thereof, 90. 91. Why not generated under the skull, 377. How to be distinguished from the Brain, ibid. the cure thereof being wounded. 398 Fauces what! 194 Falcon, her sight with the Herne. 70 Faults of conformation must be speedily helped, 904. Of the first concoction, not helped in the after. 707 Fear and the effects thereof. 39 Fever sometimes a symptom, otherwhiles a disease. Fever's accompanying Phlegmons and their cure, 260. Happening upon Erysipelous tumours, 165. Upon Oedematous tumours, 275. Upon Schirrous tumours, 284. The cure of bastard intermitting Fevers. 286 Feet and their bones, 233. Their twofold use. 236 Fierce Clare a fish. 803 Females of what seed generated. 888 Fibra auris what. 189 Fibula. 231 Figures in Anatomy, and first of the forepart of man, 86. Of the backparts, 87. Of the lower belly, and parts thereof, 100, 102, 107, 114, 122. Of the stomach, 104. Of the vessels of seed, and Urine, 118. Of the Bladder and Yard, 124. Of the womb, 127. Of some parts in women different from those of men, 131. Of the hollow vein, 149. Of the Arteries, 154. Of the rough Artery, or weazon, 157. First and and second of the brain, 164. Third of the Cerebellum, 167. Fourth and fifth of the brain, 169. The sixth of the brain 170. Seaventh showing the Nerves of the Brain, 171. The eighth of the brain, 173. Of the spinal marrow, 176. Of the Eye 185. Of the chief muscles of the face, 188. Of the lower jaw, 189. Of the ears, 190. Of the backbone, 197. Of the muscles in sundry parts of the body, 199, 200 201, 202, 203, 204, 247. Of the nerves 215. Of the bones in the hands, 220. Of the thighbone, 228. Of the bones of the feet, 235. Of the Sceleton, 239, 240, 241 Figures of Instruments used in Chirurgery, See Instruments. Figures of divers sorts of javelins and Arrow heads. 438 Figures of monsters, 962, 963, etc. Of divers beasts, etc. as of the Succarath, 61. Of the Elephant, 63. 1020. Of the Rhinoceros, 65. Of the Camel, 71. Of the Crocodile, 77, 1023. Of a Crab, 279. Of the Scorpion, etc. 762, 764. Of the Serpent Hamorrhous, 791. Of the Serpent seps, 792. Of the basilisk, 793. Of the salamander and Torpedo, 794. Of the sting-Ray, 803. Of the Sea-hare, 804. Of the Monk and Bishop-fish, 1002. Of the Sea Devil, 1004. Of the Sea Morse and Boar, 1105. 1006. Of the Fish Hoga. 1008. Of a monstrous flying fish, 1009. Of Bernard the Hermit, 1010. Of the sailing fiish, 1011. Of the Whale, 1013. Of an Ostrich, 1014. Of the birds of Paradise, 1016. Of a Giraffa, 1018. Of a Beast called Thanacth, 1021. Of the beast Haijt & a monstrous African beast, 1022 of a Chamaeleon. 1024. Figures of Furnaces and other things fit for distillation, 1096, 1093, 1099, 1101, 1102. 1104. 1106, 1109. Figure of a fractured arm with a wound in a fit posture, 576. Of a Leg fractured with a wound and bound up, 584. Of Ligatures for extension, 598. How to restore the dislocated spin, 605. Of putting the shoulder into joint, 609, 610, 611, 612, 613, 614. Of the Ambi and the use thereof, 615, 616. Of restoring the dislocated Elbow, 610. Of the thighbone dislocated inwards, 628. Outwards, 629. Of restoring a knee dislocated forwards. 631 Figure of a Semicupium. 670. Of a Barrel to be used in the cure of a Caruncle, 743. Of the Helmet flower, 807. Of the site of the child in the womb, 900. Of leaden Nipples, 912. Of a glass to suck the breasts with. 919 Figures of Artificial Eyes, 870. Of Noses, 871. Of Teeth, 872. Palates, 873. How to supply the defect of the tongue, 874. of the Ears, 875. Iron Breastplates, 876. of an Vrine-Bason and artificial Yard, 877. of an iron finger stall, 878. of an erector of the Hand, 879. of Boots for such as are crookelegged, 880. of an artificial hand, 881. of an arm and leg, 882, 883. of a Crutch. 884 Filings of Lead, their harm taken inwardly, and cure. 811. Filtration the manner and use thereof. 1102 Fingers and their parts, etc. 218. their dislocation, 623. Why easily restored, ibid. how to take away such as be superfluous, and help those that stick together, 661. How to supply their defects. 878. Fire and the qualities thereof, 6. The force thereof against the Plague. 823 Fishes their industry, 57 They may be tamed 64 Fisher, a Fish so called. 68 Flatulent Tumours, their causes, signs and cure. 269 Flatulencies about the joints counterfeiting the Gout. 718 Fistula lachrimosa, see Aegilops. Fistulas what, their differences, signs, etc. 484. Their cure, ibid. In the Fundament, 485. The cure, 486. Upon wounds of the Chest and the cure. 391 Fleshy Pannicle, the History thereof. 90 Flesh quickly putrifies in maritime parts. 416 Flexores musculi. 230. Superior. 238 Flux of blood in wounds how helped. 328 Flux of the belly how to be stopped. 865, 866 Flying fish of a monstrous shape. 1009 Focile what, 231. How to cure the separation of the greater and lesser, 631. The separation from the pastern bone. 632 Fomentations and their use, 1063. For broken bones. 591. They hurt plethoric bodies, 591. What to be observed in their use. 591, 634. Fornaces, their matter and form, 1094, 1096, 1097, etc. Fornix. 168 Foxes and their craft. 67 Fracture what and the differences thereof, 501. Their causes, 562. Signs and prognostics, ibid. Their general cure, 564. How to help the symptoms, 566. Why deadly in the joint of the shoulder, 570. why near a joint more dangerous, 581 Fractures of the scull, their differences, 337, 338. Of the causes and signs, 339, Signs manifest to sense, 346. A Fissure, the first kind of Fracture, 341. How to find it being less manifest, 342: A contusion the second kind of fracture, 343. An Effracture the third kind, 346. A Seat the fourth kind, 348. Resonitus the fifth kind, ibid. The Proguosticks, 352. general cure of them and their symptoms 356. They are hurt by venery, 359 By noise, 360. The particular cure, 362. Why Trepa●ed. 364 Fractures more particularly and first of the nose, 567. Of the lower jaw, ibid. Of the Collar-bone, 568. Of the shoulderblade, 569. Of the breast bone, 570. Of the Ribs, 571. Of the vertebrae. or Rackbones. 573. Of the Holybone, 574. Of the Rump, ibid. Of the Hip, ibid. Of the shoulder or armebone, 575. Of the Cubite or el a Wand, ibid. Of the Hand, 577. Of the Thigh, ibid. Of the Thigh near the joint, 581. Of the patella or whirle-bone, 582. Of the leg, 582. Of the bones of the feet. 591 Fractures associated with wounds, how to be bound up. 557, 584 French Pox, see Lues venerea. Frictions, their kinds and use. 34 Fuci, how made. 1078 Fumigations, their differences, matter and form. 1072, 1073 Fundament, the falling down thereof. 313, 958. The causes and cure. ibid. Fungus, an excrescence sometimes happening, in Fractures of the scull. 370, 371 G. Galens' Effigies and praise. 1118 Gall and the bladder thereof, etc. 110 Ganglion what, 272. Properly so called. 274 Gangrene what, 452. The general and particall causes, ibid. That which is occasioned by cold, upon what part it seizes, 454. Signs, 454. Prognostics, 455. The general cure. ibid. The particular cure. 456 Gargareon. 193 Gargarisms, their matter and for me, 1070. repelling, ripening and detergent ones. 297 Garlic good against the Plague. 823 Gastrica vena. 112 Gastrepiplois vena, 112 Major. 〈◊〉 113 Geese their wariness in fleeing over mount Taurus. 68 Gemelli musculi. 237 Gemini musculi. 230 Generation, what it is, 23. What necessary thereto. 889 Generation of the Navel. 891 Giddiness, see Vertigo. Ginglymos what. 243 Giraffa a strange beast. 1017, 1018 Glandula what sort of Tumour. 272 Glandula lachrimalis. 182 Glandules in general, 108. At the root of the tongue, 193. Their inflammation and cure. 293 294 Glans penis, 126. Not rightly perforated, how to be helped. 663 Glisters, their differences, materials, etc. 1050. Several descriptions of them, 1051. They may nourish. 1052 Goat's dung is good to discuss sehirr●ous tumours. 279 Golden ligature, how made. 309 Gomplosis what. 243 Gonorrhaea, how different from a virulent strangury, 738. The cure. 740 Gout, the names and kinds thereof, 697. The occult causes thereof, ibid. The manifest causes thereof, 699. out of what parts it may flow, 701. Signs that i● flows from the Brain, or Liver, ibid. How to know this or that humour accompanying the Gouty malignity, 702. Prognostickes. ibid. The general method to prevent and cure it, 704. Vomiting sometimes good, 705. other general remedies, 706. Diet convenient, 707. What wine not good, 708. How to strengthen the joints, ibid. The palliative cure thereof, 709. Local medicines in a cold Gout, 710. In a hot or sanguine Gout, 713. In a Choleric Gout, 714. What is to be done after the sit is over, 717. Tophi or knots how caused, ibid. The hipgoute or sciatica, 719. The cure thereof. 720 Gristles what, 136. of the nose, 186. of the Larinx. 194 Groins their wounds, 399. Their Tumours, see Bubo's. Guajacum, The choice faculties and parts, 728. The preparation of the decoction thereof, 729. The use. 730 Gullet and the History thereof, 157. The wounds thereof. 387 Gums overgrown with flesh, how to be helped. 293 Guns, who their inventor, 406. Their force, 407. The cause of their reports. 415 Gunpowder not poisonous, 409. 412. How made. 412 Gutta rosacea what, 1080. The cure. 1081 Guts, their substance, figure and number, 105 Their site and connexion, 106. Action, 107. How to be taken forth, 115. Signs that they are wounded, 396. Their cure, 397. Their Ulcers. 480 H. HAemorrhoides what, their differences and cure, 487. In the neck of the womb. 955 Haemorrhoidalis interna, 112. Externa. 117 Haemorrhoidalisarteria, ●ive mesente●ica inferior. 115 Haemorrhou● a Serpent his bite, the signs und cure. 791 Haijt, a strange beast. 1022 Hair what the original and use, 160. How to make it black, 1081. 1082. How to take it off. 1082 Hairy sealpe, the connexion and use. 160. The wounds thereof not to be neglected, ibid. The cure thereof being contused, 361 Hand taken generally what, 208, 209. The fracture thereof with the cure, 577. How to supply the defect thereof. 879, 881 Hares how they provide for their young. 61 Hare-lips what, 383. Their cure. 384 Harmonia what. 243 Hawks. 70 Head, the general description thereof, 159. The containing and contained parts thereof, 160. The musculous skin thereof, ibid. Why affected when any membranous part is hurt, 160. The watery Tumour thereof. 289. The wounds thereof. 337, 338, etc. The falling away of the Hair and other affects thereof, 637, 638, etc. The dislocation thereof. 603 Hearing, the Organ, object, etc. thereof, 24 Heart and the History thereof, 144, 145. The ventricles thereof, 145. Signs of the wounds thereof. 388 Heat one and the same the efficient cause of all humours at the same time, ●14. Three causes thereof. 250 Hectic fever with the differences, causes, signs and cure. 393 Hedgehogs, how they provide for their young. 61 Heel, and the parts thereof, 234. Why a fracture thereof so dangerous, ibid. The dislocation thereof, 632. symptoms following upon the contusion thereof, ibid. Why subject to inflammation. 633 Hemicrania, see Megrim. Hemlock the poisonous quality thereof, and the cure. 806 Henbane the poisonous quality, and the cure. 805 Hermaphrodites, 28, and 972. Herne, his sight, and the Falcon. 70 Hernia and the kinds thereof, 304. Humoralis. 313 Herpes and the kinds thereof, 264. The cure. 265 Hipgout, see Sciatica. Hip, the dislocation thereof, 623. prognostickes, 624. signs that it is dislocated out-wardly or inwardly, 625. dislocated forwards 626. backwards ibid. how to restore the inward dislocation, 627. the outward dislocation, 629. the forward dislocation, ibid. the backward dislocation, 630 Hypocrates his effigies, 1115 Hoga, a monstrous fish, 1008 Holes of the inner Basis of the scull, 174. of the external Basis thereof, 175. small ones sometimes remain after the cure of great wounds, 384 Holybone, his number of Vertebrae, and their use, 198. the fracture thereof, 575 Hordeolum, an affect of the Eyelids, 642 Horns used in stead of Ventoses, 696 Horseleeches, their application and use, ibid. their virulency, and the cure, 800 Hothouses, how made, 1077 Hulpalis, a monstrous beast, 1017 Humeraria arteria, 153 Vena, 210 Humours, their temperaments, 11. the knowledge of them necessary, ibid. their definition and division, 12. Serous and secundary, as Ros, Cambium, Gluten, 15. An argument of their great putrefaction, 417 Humours of the eye, 182 Aqueus, 183 Crystallinus, 184 Vitreus, ibid. Hydatis, 643 Hydrargyrum, the choice, preparation, and use thereof in the Lues venerea, 731 Hydrophalia, whether uncureable, 787 What cure must be used therein, 789 Hydrocephalos, what, 289. The causes, differences, signs, etc. ibid. The cure, 290 Hydrocele, 304. 311 Hymen, 130 Whether any or no, 937 A history thereof, 938 Hyoides os, the reason of the name, composure, site, etc. thereof, 191 Hypochondria, their site, 85 Hypochyma. 651 Hypogastricae venae, 117 Hypopyon, 650 Hypothenar, 222 I. JAundice, a medicine therefore, 303 Jaw, the bones thereof, and their productions, 178 The fracture of the lower jaw, 567 How to helpeit, 568 The dislocation thereof, 600 The cure, ibid. Ibis, abird, the inventor of glisters, 56 Ichneumon, how he arms himself to assail the Crocodile, 66 Idleness, the discommodities thereof, 35 Jejunum intestinum, 105 Ileon, 106 Iliaca arteria, 115 Vena, 117 Ilium os, 227 Ill conformation, 41 Imagination, and the force thereof, 897 Impostors, their impudence and craft, 51 372 Impostume, what, their causes and differences, 249 Signs of them in general, 250 Prognostickes, 252 What considerable in opening of them, 259 Inanition, see Emptiness. Incus, 163. 191 Indication, whence to be drawn, 5. of feeding, 33. what, 42. the kinds, 43. a table of them, 48. observable in wounds by gunshot, 426 Infant, what he must take before he suck, 907 their crying what it doth, 912. how to be preserved in the womb when the mother is dead, 923. See Child. Inflammation of the almonds of the throat, and their cure, 293. 294. of the Uuula, 294. of the eyes, 645 Inflammation hinders the reposition, or putting dislocated members into joint, 619 Insessus, what, their manner, matter, and use, 1073 Instruments used in Surgery for opening abscesses, 258. 259 A vent for the womb, 283. 955 An iron plate and actual cautery for the cure of the Ranula, 293 Constrictory rings to bind the Columella, 295 Speculum oris, ibid. & 332 A trunk with cautery to cauterise the Uuula, 296 An incision knife, 298 An actual cautery with the plate, for the cure of the Empyema, 299. of a pipe to evacuate the water in the Dropsy, 303. Wherewith to make the golden ligature, 310. to stitch up wounds, 327 A Razor or incision knife, 341. A chisel, ib. Radulae, vel Scalpri, 343. A threefooted levatory, 344. Other levatories, 345. 346. Saws to divide the skull, ib. a desquamatory Trepan, 346. Rostra psittaci, 347. Scrapers, pincers, and a leaden mallet, ib. A piercer to enter a Trepan, 365. Trepans, 366. 367. Terebellum, 367. A lentill-like Scraper, ib. cutting compasses, 368. 369. A conduit pipe. & syrenge, 370. to depress the dura Meninx, 1373. speculum oculi, 379. for making a Seton, 382. Pipes used in wounds of the chest, 392. to draw out bullets, 419. 420. etc. Dilaters, & Probes to draw through flammulas, 422. to draw forth arrow-heads, 439. 441. A scarificator, 446. A dismembering knife, & saw, 459. A dilater to open the mouth, 464. A pyoulcoes, or Matter-drawer, 479. A Glossocomium, 578. A latin Casse, 587. A pulley and hand-vice, 599. the glossocomium called Ambi, 615. little hooks, needles, and an incision knife to take away the Web, 648. files for filing the teeth, 658. for cleansing & drawing the teeth, 660. cutting mullets, to take off superfluous fingers, 662. a Cathaeter, 665. Gimlet to break the stone in the passage of the yard, 671. other instruments to take out the stone, 672. used in cutting for the stone, 673. etc. 680. 681. 〈◊〉 Lancet, & Cupping-glasses, 695. Horns to be used for ventoses, 696. Cathaeters to wear away caruncles 744. Trepans for rotten bones, 748. actual cauteries, 749. Griffins talons, 927. 929. Hooks to draw forth the child, 916. Specula matricis, 956 Instruments, when necessary in restoring broken bones, 565 Intercartalaginei musculi, 206. 2071 Intercostalis arteria, 113. 153 Intercostales musculi externi, 206. interni, 207 Interosses musculi, 223. 239. Intestinalis vena, 112 Intromoventes musculi, 230 Joy, and the effects thereof, 39 Joints, their wounds, 403. how to strengthen them, 708. how to mitigate their pains caused only by distemper, 716 Ischiadica vena, 224. Ischium o●. 227 Issues, or fontanelles, 706 Itching of the Womb, 957 Judgement, why difficult, 1131 Junks, what, 559. their use, 560. K. KAll, its substance, etc. 101. 102. what to be done when it falls out in wounds, 308 Kernels of the ears, 189. Kibes, where bred, 238 Kidneys, their substance, etc. 117. signs that they are wounded, 397 ulcers, & their cure, 481. 686. their heat how tempered, 850 Kings-evil, what, the cause, 274. the cure, 275 Knee dislocated forward, how to restore it, 631 L. LAgophthalmia, what, 378. the causes and cure, 642 Lament how helped, 884 Lamprey, their care of their young, 64 Lampron, their poysonons bite, 801 Larinx, what meant thereby, 194. its magnitude, figure, composure, etc. ib. Latissimus musculus, 208 Leeches, see Horseleeches. Leg, taken in general, what, 223. the bone thereof, 231. the wounds, 399. the fracture & cure, 582. the cure of the Author's leg being broken, 582. 585. their crookedness how helped, 879. defect supplied, 882. 883 Leprosy, & the causes thereof, 769. the signs, 770, etc. why called Morbus jeoninus, 771 the prognostics, diet, cure, 773. it sometimes follows the Lues venerea, 724 Lepus marinus, the poison, the symptoms, & cure, 803 Levator musculus, 208. Levatores Any, 107 Life, what, & its effects, 895. See Soul. Ligaments, their use, 96. why without sense, 198 their difference, 199. their wounds, 404. Ligatures for wounds are of three sorts, 325 too hard hurtful, 374. they must be neatly made, 555. for what uses they chiefly serve, 358. in use at this day for fractures, 579. how infractures joined with wounds, 584 which for extension, 598. See Bandages. Lightning, the wonderful nature, & the stinking smell thereof, 414. how it may infect the Air, 781 Lime unquenched, the hurtful quality & cure, 810 Linime●●s are not to be used in wounds of the Chest, 390. their matter, form, & use, 1055 Lion, his provident care in going, 66 Lion of the sea, 1003. Lippi●udo, 644 lethargy, its poisonous quality & cure, 810 Liver, what, 109. its substance, etc. ibid. 110. sggns of the wounds thereof, 396. why it is called parenchymas, 893 Loins, their nerves, 226 Lo●gus musculus, 205. 218. 232 Lays venerea, what, 723. the hurt it causeth, ib. the causes thereof, 724. in what humour the malignity resideth, 725. it causes more pain in the night than in the day, ib. sometimes lies long hid, ib. signs thereof, 746. prognostics, 727. how to be oppugned, 728. to whom wine may be allowed, 730. the second manner of cure, ibid. the third manner of cure, 734. the fourth manner, 736. how to cure its symptoms 737. it causes bunches on the bones, 746. rotten bones, how perceived & cured, 747. tetters and chaps occasioned thereby, and their cure, 754. how to cure children of this disease, 755. it kills by excess of moisture, 779 Lumbaris regio, sive lumbi, 85. Arteria, 114. Vena. 116. Lumbrici musculi, 222. 239 Lungs, their substance, etc. 142. 143. signs of their wounds, 388. which curable, 392. Lupiae, what, their causes and cure, 272 Luxation, 593. which uncureable, 95. Lying in bed, how it must be, 36 M Mad dog, see Dog. Magic, and the power thereof, 989 Magistrates office in time of plague, 829 Males of what seed generated, 888 Malleolus, one of the bones of the auditory passage, 163. 191 Mammillary processes, 166. their use, 169 Mammaria arteria, 153 Man, his excellency, 74. etc. the division of his body, 83. why distinguished into male and female. 885 Mandrake, its danger, and cure, 806 Marrow, why it may seem to have the sense of feeling. 589 Masseter muscle. 188 Mastoideus musculus. 204 Masticatories, their form and use, 1069 Matrix, see Womb. Medow-saffron, the poisonous quality thereof, and cure. 809 Meat, the quantity and quality thereof, 31 accustomed more grateful and nourishing 32. order to be observed in eating, 33. the time, ib. fit to generate a Callus. 589 Meazels, what, their matter, 757. why they itch not, 758. their cure. 759 Mediastinum, its substance, etc. 141 Medicines, their excellency. 1027. their definition and difference in matter and substance. 1028. in qualities, and of their first faculties, 1029. their second, third, & fourth faculties, 1033. the preparation, 1037. the composition, necessity, and use thereof. 1049 Megrim, the causes, etc. thereof. 640 Melancholy, the temper thereof, 11. the nature, consistence, etc. 13. the effects thereof, 15. of it corrupted. 16 Melancholic persons, their complexion, &c 18. why they hurt themselves. 786. Meliceris, what kind of tumour, 271 Membranosus musculus, 232 Memory, what. 897 Menstrual flux, signs of the first approach thereof, 950. See Courses. Meninges, their number, etc. 164 Mercury, sublimate, its caustick force, 809 the cure, 810 Meremaid, 1004 Mesentery, its substance, etc. 108. the tumours thereof, 929. the sink of the body, 930 Midriff, its substance, etc. 141. 142. signs of the wounds thereof. 388 Milk soon corrupts in a phlegmatic stomach 907. the choice thereof. 909. how to drive it downwards, 918. Millepes, cast forth by urine, 762 Milt, see Spleen. Mola, the reason of the name, and how bred, 925. how to be discerned from a true conception, 925. a history and description of a strange one, 926. the figure thereof, 927. what cure to be used thereto, 928. Mollifying medicines, 141. 142 Monks-hood, the poison and cure, 905 Monstrous creatures bred in man, 762, etc. Monsters what, 961 their causes, & descriptions, 962. etc. caused by defect of seed, 975. by imagination, 978. by straightness of the womb, 980. by the site of the mother, ib. by a stroke, etc. 981. by confusion of seed of divers kinds, 982. by the craft of the Devil, 985. Of the Sea, 1001. 1002. etc. Morse, Sea-calf or Elephant, 1005. 1006 Mortification, and the signs thereof, 475 Mother, see Womb. Mother's fittest to nurse their own children, 907. their milk most familiar to them, ib. Motion, which voluntary, 25. taken for all manner of exercise, 34 Mouth, and the parts thereof, 193. the ulcers and their cure, 478 how to prevent & heal them in cure of the Lues venerea, 735 Mummy, frequently used in contusions, 447. not good therein, 448 Mundificatives, 1043 Muscles, what, 92. their differences, and whence taken, 93, etc. their parts, 95. a further enquiry into the parts of them, 96. Muscles of the Epigastrium, 97. of the fundament, 106. of the testicles, 120. of the bladder, 124. of the yard, 125. the broad muscle, 180. that open and shut the eye ibid. of the eye, 182. of the nose, 186. of the face, ibid. of the lower jaw, 188. of the bone Hyoides, 191. of the tongue, 192. of the Larinx, 194. of the Epiglottis, 195. of the neck, 199. of the chest & loins, 205, 206. 207. of the shoulderblade, 207. of the arm, 214. of the cubit, 217. moving the hand, 220. of the inside of the hand, 222. moving the thigh, 229. of the leg, 232. moving the foot, 237. of the toes, 238. An epitome or brief recital of all the muscles, 244. 245. Musculous skin of the head, 160. the wounds thereof and their cure, 360. Musculosae venae, 117. Arteriae, 153. Mushrooms, their hurtful and deadly quality, and the cure, 805. Music, the power thereof, 49. Mydriasis, a disease of the eye, the cause, and cure, 650. N. Nails, why added to the fingers, 209. why grow continually, ibid. whence generated. 220. Napellus, the poisonous quality & cure, 805 Narcotickes, 257. cautions in their use, 264 improperly termed anodynes, 1048. Nata, what, 272. Nates, 168. Nature oft doth strange things in curing diseases, 385. Natural parts, and their division, 84. Natural, see Things, Faculties, Actions, Navel, what, the figure, and composure, 133. the generation thereof, 891. the relaxation thereof in children, 959. the swelling or standing forth thereof, 303. the cure, 304. Nautilus, or sayling-fish. 1011. Neck, & the parts thereof, 196. the wounds thereof, 386. the dislocation thereof, 603. Necrosis, or mortification, 457. Nerves, what, 96. their distribution to the natural parts, 115. of the sixth conjugation, and their distribution, 152. Ramus costalis, ib. recurrens, ib. stomachicus, 153. their seven conjugations, 170. Nerves of the neck, back, and arms, 212. of the loins, holybone, and thigh, 226. Nerves and nervous parts, their wounds, 399. their cure, 400. Nightshade, the deadly nightshade, his poisonous quality, and the cure, 805. Nightingales sing excellently, 72. Nipples, 138. how to help their soreness, 912 Nodus, what, 272. Nodules, their form and use, 1053. Northern people how tempered, 20. Nose and the parts thereof, 186. the wounds thereof, 384. their cure, ib. how to supply the defect thereof, 871. the ulcers thereof, 477. their cure, ib. the fracture, 567. Nurses, their error in binding and lacing of children, 606. they may infect children with the Lues venerea, and be infected by them, 724. participate their diseases to their children, 907. the choice of them, 908. 909. of their diet, and other circumstances, 910. Nutrition, what, 22. 24. Nymphae, 130. O. OBlique descendent muscles, 97. ascendent muscles, 98. Obliquator externus musculus, 221. Obturatores musculi, 230. Oedema, what, 267. which tumours referred thereto, 254. the differences thereof, 267. the causes, ib. signs, prognostics, cure, 268 Oesophagus, or Gullet, the substance, attractive force, etc. thereof, 157. the magnitude, figure, site, temper, and action, 158. Oil of whelps, the description, and use thereof, 409. 423. it helps forward the scailing of bones, 751. Oils, and the several making of them, 1054. 1055. 1102. by distillation, 1103. out of gums, 1106. 1107. Ointments, their differences, descriptions, and use, 1056. 1057. 1058. Old age, and the division thereof, 9 it is a disease, 32. Old wives medicines, 991. Olecranum, what, 217. Omentum, or the K●ll, the substance, magnitude, figure, and composure thereof, 101. the connexion, temper, and twofold use, 102. it sometimes hinders conception, ibid. Operations of Surgery, of what nature, 4. why some which are mentioned by the Ancients, are omitted by our Author, 1138. 1139. Opium, why not used in poisoning, 806. the symptoms caused by it, and their cure, ib. Order to be observed in eating our meat, etc. 33. in lying to sleep, 34. Organical parts, which, 81. What observable in each of them, ibid. Orifices of the heart, 146. Orpiment, the poisonous quality thereof, and the cure, 810. Os & ossa, occipitis, 162. Basiliare, ibid. Coronale, ib. Bregmatis, sive parietalia, ib. Petrosa, ibid. Cuneiforme, sive sphenoides, ib. Ethmoides, cribrosum, seu spongiosum, ibid. Zygoma, sive jugale. 178. Hyoides, ypsiloides, etc. 191. Sesamoidia, 220. Ilium, 227. Ischium, ibid. Pubis, 228. Innominata, 234. See Bones. Ozaena, a filthy ulcer of the nose, the cause and cure, 477. P. Pain, and the causes thereof, 250. It must be assuaged, 256. The discommodities thereof, 257. In wounds how helped, 329. palate, the nerves, holes, and coat thereof, etc. 193. How to supply the defects thereof, 873. Palmaris musculus, 222. Palsy, the differences, causes, etc. thereof, 332. The cure, 333. Follows upon wounds of the neck, 386. Pancreas, the substance, site, etc. thereof, 109. The tumors thereof, 929. Pannicle, see Fleshy. Pap, how to be made for children, 911. and the condition thereof, ibid. Paracenteses, and the reasons for and against it, 301. The place where, and manner how, 302. Parassoupi, a strange beast, 1018. Parastates, their substance, etc. 120. Paronychia, what, 314. The cure, ibid. Parotides, their site and use, 191. Their difference, prognosticke, cure, etc. 291. 292. Partridge, their care of their young, 60. Parts, similar, 81. Organical, ibid. Instrumental, 82. Things considerable in each part, ibid. Principal parts which, and why so called, ibid. Of generation, 82. 886. distinguished into three, 83. The containing parts of the lower belly, 87. Of the chest, 137. Passions of the mind, their force, 39 They help forward putrefaction, 820. Pastinaca marina, or the sting-Ray 802. Patella, what, 231. Pectoralis musculus, 208. Pedium, what, 234. Pediosus musculus, 238. Pelvis, the site and use thereof, 168. Pericardium, and the history thereof, 143. Pericranium, what, and the use thereof, 160. Perinaeum, what, 125. Periostium, 160. Peritonaeum, the substance and quantity thereof, 100 The figure, composure, site, use, etc. 101. Perone, 231. Peronaeus musculus, 237. Perturbations of the mind, see Passions. Pessaries, their form and use, 1053. 1054. Pestilence, see Plague. Pestilent fever, how bred, 837. Pharinx, what, 194. Phlebotomy, the invention thereof, 56. Necessary in a Synochus putrida, 261. The use, scope, etc. thereof, 691. How to be performed, 693. See Blood-letting. Phlegm, the temper thereof, 11. is blood half concocted, 13. Why it hath no proper receptacle, ibid. The nature, consistence, colour, taste and use, ibid. The effects thereof, 14. Not natural, how bred, and the kinds thereof, 16. How many ways it becomes so, 267. Phlegmatic persons, their manners and diseases, 17. In fasting they feed upon themselves, 707. Phlegmon, what kind of tumour, 254. What tumors may be reduced thereto, 253. How different from apblegmonous tumour, 254. How generated, ibid. The causes, and signs thereof, 255. The cure, 256. The cure when it is ulcerated. 258. Phrenica Arteria, 113. Phthisis oculi, 646. Phymosis & paraphymosis, what, 663. Physic, the subject thereof, 81. Physicians to have care of such as have the plague, how to be chosen, 830. Physocele, 304. Pia matter, the consistence, use, etc. 164. Pigeons, see Doves, Pilot fish, 67. Pine glandule, 168. Pinna auris, which 189. Pinna & Pinnoter, 1011. Pismire, see Ant, Pith of the back, 175. Plague what, 817. How it comes to kill, ib. Divine causes thereof, 818. Natural causes, ibid. Signs of the air and earth that prognosticate it, 821. Cautions in air and diet to prevent it, 822. Preservatives against it, 824. 825. 826. Other observations for prevention, 828. Such as die thereof quickly putrefy, 829. How such as undertake the cure thereof must arm themselves, 831. Signs of infection, 832. Mortal signs, 833. Signs thereof, without fault of the humours, ib. with the putrefaction of them, 834. Prognostickes therein, 835. What to be done when one finds himself infected, 837. Diet, 839. 840. 841. Antidotes, 843. 844. Epithemes to strengthen the principal parts, 845. Whether purging and bleeding be necessary at the beginning, 845. What purges fit, 847. Symptoms accompanying the disease, 849. Spots or Tokens, 851. Their cure, 852. Sores, 853. etc. See Bubo's, and Carbuncles. Sundry evacuations, 861. 862. How to cure infants and children thereof, 867. Plaster, the hurtful quality thereof, and the cure, 810. Plasters, see Emplasters. Plantaris musculus, 238. Pleura what, the original, magnitude, figure, etc. 140. Pleurisy, what, 298. Plexus choroides, 167. Pneumatocele, 312. Polypus, the reason of the name, 290. The differences, ibid. The cure, 291. Poplitaeus musculus, 233. Porus biliaris, 111. Potential Cauteries, 1064. 1065. Pox, French Pox, see Lues venerea. Small pox what, their matter, 757. What pernicious symptoms may happen upon them, 758. Prognostickes, ibid. The cure, 759. What parts to be armed against, and preserved therefrom, 760. Poisons, the cause of writing them, 775. What they are, ibid. Their differences, 776. All of them have not a peculiar Antipapathy with the heart, ibid. How in small quantities they may work great alterations by touch only, ibid. The reasons of their wondrous effects, 777. none of them kill at a set time, ibid. How they kill sooner or later, ibid. Whether things feeding on poisons, be poisonous, ibid. General signs that one is poisoned, 778. How to shun poison, 780. The general cure of poisons, ibid. Whether vapours arising from things burnt, may poison one, 781. Each poison hath its proper effects, 782. Their effects and prognostics, ibid. The cure of poisonous bites, 783. Poison of Adders, Asps, Toads, etc. see Adders, Asps, Toads, etc. Poisonous plants, and the remedies against them, 805. Poisons of Minerals, and their remedies, 809. Praeputium, 126. to help the shortness thereof, and such as have been circumcised, 662. The ulcers thereof are worse than those of the Glans, 737. Praeparation of simple medicines, and the divers kinds thereof, 1037. Preservatives against the plague, 824. 825. 826. Principal parts which, and why so called, 82. Processus mammillares, 167. Processes of the Vertebrae, right, oblique, transverse, 196. that called the tooth, ib. Acromion and Coracoides, 208. Prodigy, what, 961. divers of them, 1025. 1026. Prognostickes in Impostumes, 252. in an Erisipelas, 267. in an Oedema, 268. in a Scyrrhus, 278. in a quartain Ag●e, 285. in an Aneurisma, 287. in the Parotides, 291. in the Dropsy, 300. in a Sarcocele, 312. in wounds, 323. in fractures of the skull, 352. in wounds of the liver and guts, 397. in a Gangrene, 455. in ulcers, 468. in Fractures, 562. in Dislocations, 595. in a dislocated Jaw, 600. in the dislocated Vertebrae, 606. in a dislocated Hip, 624. in the stone, 666. in suppression of the urine, 684. in the ulcerated reins and bladder, 686. in the Gout, 702. in the Lues venerea, 727. in a virulent strangury, 739. in the small pox, 758. in the leprosy, 773. concerning poisons, 782. in the bite of a mad dog, 787. in the plague, 835. in plague sores, 857. Pronatores musculi, 222. Properties of a good Surgeon, 5. Proptosis oculi, 646. Prostates, 121. Proud flesh in ulcers, how helped, 472. Psilothra, their form and use, 1082. Pudendae venae. 117. Pulse, the triple use thereof, 22. Pulsation in a Phlegmon how caused, 255. Pulti●●es how different from Cataplasms, 1062. Punctus aureus, 309. Puncture of a nerve, why deadly, 400. Purging, whether necessary in the beginning of pestilent diseases, 845. Purple spots, or tokens in the plague, 851. Their cure, 852. Pus, or quitture, the signs thereof, 258. Now it may flow from the wounded part, and be evacuated by urine and stool, 684. Putrefaction in the plague different from common putrefaction, 819. Three causes thereof, 820. Pies may be taught to speak, 72. Pylorus, 104. Pyramidal muscles, 99 Pyrotickes, their nature, kinds, and use, 1046. Q. QUadrigemini musculi, 230. quartan ague or fever, the causes, signs, symptoms, 284. Prognostics, and cure, 285. Quicksilver, why so called, 811. Whether hot or cold, ibid. Wherefore good, 812. The kinds thereof, ibid. How to purify it, 813. See Hydrargyrum. Quotidian fever, the cause thereof, 275. The signs, symptoms, etc. 276. The cure, 277. How to be distinguished from a double Tertian, ibid. R. Rackebones, their fracture, 573. Radish root draws out venom powerfully, 860. Radius, what, 217. Ramus splenicus, 112. Mesenteriacus, 113. Ranula, why so called, the cause and cure, 293. Ratsbane, or Roseager, the poisonous quality and care, 810. Raving, see Delyrium. Reason, and the functions thereof, 897. Recti musculi, 202. 232. Rectum intestinum, 106. reins, see Kidneys. Remedies supernatural, 989. See medicines. Remora, the wondrous force thereof, 1013 Repletio ad vasa & ad vires, 37. Repercussives, 461. What dissuades their use, 253. When to be used, 256. Fit to be put into, and upon the eye, 379. Their differences, etc. 1038. Reports how to be made, 1121. Resolving medicines, and their kinds, 1040. Resolving and strengthening medicines, 264. 292. Respiration how a voluntary motion, 25. The use thereof, 143. Rest necessary for knitting of broken bones, 580. Rete mirabile, 172. Whether different from the Plexus choroides, 174. Rhinocerote, 65. His enmity with the Elephant, 1023. Rhomboides musculus, 206. 208. Ribs, their number, connexion, and consistence, 139. Their contusion, and a strange symptom sometimes happening thereon, 447. Their fracture, the danger and cure, 571. Symptoms ensuing thereon, 572. Their dislocation and cure, 607. Right muscles of the Epigastrium, 98. Rim of the belly, 100 The figure, composure, etc. thereof, 101. Ringworms, 264. Rotula genu, 231. Rough artery, 156. Rulers, see Bandages. Rules of Surgery, 1119. Rump, the fractures thereof, 575. The dislocation thereof, 607. The cure, ibid. Ruptures, 304. Their kinds, ibid. Their cure, 305. 306. 307. 311. S. SAcer musculus, 207. Sacrae venae. 117. Sacrolumbus musculus, 206. Salamander, the symptoms that ensue upon his poison, and the cure, 793. Salivation, 38. Sanguine persons, their manners and diseases, 17. Sapheia vena when and where to be opened, 224. Sarcocele, 304. The progrostickes and cure, 312. Sarcotickes, simple and compound, 1044. None truly such, ibid. Scabious, the effect thereof against a pestilent Carbuncle, 860. Scailes, how known to be severed from the bones, 586. Scailes of Brass, their poisonous quality and cure, 810. Of iron, their harm and cure, ibid. Scaldhead, the signs and cure thereof, 638. Scalenus musculus, 205. Scalp, hairy scalp, 160. Scaphoides os, 234. Scars, how to help their deformity, 861. Scarus, a fish, 67. Sceleton, 239. 240. 241. what, 242. Sciatica, the cause, etc. 719. The cure, 720. Scirrhus, what, 278. What tumors referred thereto, 254. The differences, signs, and prognostics, 278. Cure, ibid. Scorpion bred in the brain by smelling to Basill, 761. Their description, sting, and cure, 797. Scrophulae, their cause and cure, 274. Scull and the bones thereof, 162. The fractures thereof, See Fractures. Depression thereof how helped, 344. Where to be trepaned, 369. Sea feather and grape, 1007. Sea-hare, his description, poison, and the cure thereof, 803. Seasons of the year, 10. Secundine, why presently to be taken away after the birth of the child, 904. Why so called, 906. Causes of the stay, and symptoms that follow thereon, ibid. Seed- bones; 220. 236. Seed, the condition of that which is good, 885. The qualities, 888. The ebullition thereof, etc. 893. Why the greatest portion thereof goes to the generation of the head and brain, 894. Seeing, the instrument, object, etc. thereof, 24. Semicupium, the form, manner, and use thereof, 1073. Semispinatus musculus, 207. Sense, common sense, and the functions thereof, 896. Septum lucidum, 167. Septicke medicines, 1046. Serpent Haemorrous, his bite & cure, 791. Seps, his bite and cure, ibid. Basilisk, his bite and cure, 792. Asp, his bite and cure, 794. Snake, his bite and cure, 795. Serratus musculus major, 206. posterior & superior, ibid. minor, 208. Serous humour, 15. Sesamoidia ossa, 220. 236. Seton, wherefore good, 381. the manner of making thereof, ibid. Sepe, what, and the difference thereof, 27●. Histories of the change thereof, 974. Shame and shame fac'tnesse, their effects, 40 Shin- bone, 231. Shoulderblade, the fractures thereof, 569. the cure, 570. the dislocation, 608. the first manner of restoring it, 609. the second manner, 610. the third manner. 611. the fourth manner, ibid. the fifth, 612. the sixth, 614. how to restore it dislocated forwards, 617. outwards, 618. upwards, ibid. Signs of sanguine, choleric, phlegmatic, and melancholic persons, 17. 18. Signs in general whereby to judge of diseases, 1122. etc. Silkworms, their industry, 60. Similar parts, how many and which, 81. Simple medicines, their difference in qualities and effects, 1029. hot, cold, moist, dry in all degrees, 1031. 1032. their accidental qualities, 1032. their preparation, 1037. Siren, 1001. Skin twofold, the utmost or scarfe-skin. 88 the true skin, 89. the substance, magnitude, etc. thereof. ib. Sleep, what it is, 35. the fit time, the use and abuse thereof, 36. when hurtful, 277. how to procure it, 850. Smelling, the object and medium thereof, 24. Snake, his bite, and the cure, 795. Solanum manicum, the poisonous quality, and cure, 805. Soleus' musculus, 238. Solution of continuity, 42. why harder to repair in bones, 562. Sorrow, the effects thereof, 39 Soul, or life, what it performs in plants, beasts & men, 7. when it enters into man's body, etc. 895. Sounds, whence the difference, 191. Southern people how tempered, 17. South wind why pestilent, 823. Swooning what, the causes and cure. 334. Sparrows with what care they breed their young. 58. Spermatica arteria, 114, vena, 116. Spermatick vessels in men, 119. in women, 126. the cause of their foldings, 887. Sphincter muscle of the fundament, 106. of the bladder, 124. Spiders, their industry, 58. their differences and bites, 798. spinal marrow, the coats, substance, use, etc. thereof, 175. signs of the wounds thereof, 389. Spinatus musculus, 205. Spine, the dislocation thereof, 602. 603. how to restore it, 604. a further enquiry thereof, 605. prognostics, 606. Spirit what, 25. threefold, viz. Animal, Vital, and Natural, 25. 26. fixed, ib. their use, 27. Spirits, how to be extracted out of herbs and flowers, etc. 1105. Spleen, the substance, magnitude, figure, etc. thereof, 111, 112. Splenius musculus, 201. Splints and their use, 559. Spring, the temper thereof, 10. Squinancy, the differences, symptoms, etc. thereof, 296. the cure, 297. Stapes, one of the bones of the Auditory passage, 163. 191. Staphiloma,, a affect of the eyes, the causes thereof, 649. Stars, how they work upon the Air, 30. Steatoma, what, 271. Sternon, the anatomical administration thereof, 139. Sternutamentories, their description and use, 1068. Stinging of Bees, Wasps, Scorpions, etc. see Bees, Wasps, Scorpions, etc. Sting-Ray, the symptoms that follow his sting, and the cure, 802. Stink an inseparable companion of putrefaction, 318. Stomach, the substance, magnitude, etc. thereof, 103. the orifices thereof, 104. signs of the wounds thereof, 396. the ulcers thereof, 480. Stones, see Testicles. Stone, the causes thereof, 664. signs of it in the kidneys and bladder, ibid. prognostickes, 666. the prevention thereof, 667. what to be done when the stone falls into the ureter, 669. signs it is fallen out of the ureter into the bladder, 670. what to be done when it is in the neck of the bladder, or the passage of the yard, 671. how to cut for the stone in the bladder, 672. 673. 674. etc. how to cure the wound, 679. to help the ulcer when the urine flows out by it, 681. how to cut women for the stone, 682. divers strange ones mentioned, 996. 997. Storks, their piety, 61. Stoves, how to be made, 1077. Strangury, the causes, etc. thereof, 688. a virulent one, what, 738. the causes and differences thereof, ibid. prognostickes, 739. from what part the matter thereof flows, ibid. the general cure, 740. the proper cure, 741. why it succeedeth immoderate copulation, 887. Strangulation of the mother or womb, 939. signs of the approach thereof, 941. the causes and cure, 942. Strengthening medicines, see Corroborating. Strumae, see King's-evil. Sublimate, see Mercury. Subclavian, see Artery and Vein. Subclavius musculus, 206. Succarath, a beast of the west Indies, 61 Suffusio, see Cataract. Sugillations, see Contusions. Summer, the temper thereof, 10. Supinatores musculi, 221. Suppuration, the signs thereof, 251. caused by natural heat, 275. Suppuratives, 258. 275. 292. an effectual one, 433. their differences, etc. 1041. how they differ from emollients, ibid. Superfoetation what, 924. the reason, thereof, ibid. Suppositories, their difference, form and use, 1703. Suppression of urine, see Urine. Surgery, what, 3. the operations thereof, 4. Surgeons, what necessary for them, 3. their office, 4. the choice of such as shall have care of those sick of the plague, 830. they must be careful in making reports, 1121 how long in some cases they must suspend their judgements, I. 122. they must have a care lest they bring Magistrates into an error, 1128. how to report, or make certificates in divers cases, 1129 Sutures of the skull, their number, etc. 161 wanting in some, ib. why not to be trepaned, 162. 167. Sutures in wounds, their sorts and manner how to be performed, 326. 327. Sweeting sickness, 821 Sweet bread, 108. Sweet waters, 1083 Swine assist their fellows. 67 Symptoms, their denfition, and division, 42 Sympathy and Antipathy of living creatures, 73 Symphysis, a kind of articulation, 243 Synarcosis, Synarthrosis, Synchondrosis, Syneurosis, 243 Synochus putrida, its cause and cure, 261 T. TAlparia, what, 272 Tarentula's poisonous bite, & cure, 49 Tarsus, what, 181 Tastes, what, their differences, 1034. their several denominations, & natures, 1035. Tasting, what, 22. Teeth, their number, division, & use, 179 wherein they differ from other bones, ib. pain of them how helped, 401. their affects, 657. how to draw them, 659. to cleanse them, 660. how to supply their defect, 872. to help the pain in breeding them, 959 Temporal muscle, 188. what ensues the cutting, thereof, 369 Temperament, what, the division thereof, 7 ad pondus, ib. ad justitiam, 8. of a bone, ligament, gristle, tendon, vein, artery, 9 of ages, ib. of humours, 11. Temper of the four seasons of the year, 10 native temper how changed, 18 Temperatures in particular, as of the southern, northern, etc. people, 19 20 Tensores musculi, 230. Tentigo, 130 Tertian agues, or fevers, their causes, etc. 265. their cure, 266 Testicles, their substance, 119. in women 126. their wounds, 399 Testudo, what, 272 Tetters, their kinds, and causes, 264. their cure, 265. 1081. occasioned by the Lues venerea, 754. their cure, ib. Thanacth, a strange beast, 1021 Thenar musculus, 222. & 238. Thigh, the nerves thereof, 226. its proper parts, 227. and wounds thereof, 399. Thighbone, the appendices and processes thereof, 228. 229. the fracture and cure, 577. nigh to the joint, 580. its dislocation, 623. 720. see Hip. Things natural, 5. not natural, 29. why so called, ib. against nature, 41 Thorax, the chest and parts thereof, 135 Thoracica arteria, 153 Throat, how to get out bones, and such like things that stick therein, 655 Throttle, and the parts thereof, 194 Throws, and their cause, 903 Thymus, what, 156. Tibia, 231 Tibiaeus anticus musculus, 237. posticus, 238. Tinea, what, 638 Toad, his bite and cure, 796 Tongue, its quantity, etc. 192. its wounds, its cure, 385. its impediment & contraction, and the cure, 661. to supply its defects, 873. Tonsillaes, 293. their inflammations, and their cure, 293. 294 toothache, the causes, signs etc. 656. Tophi, or knots at the joints in some that have the gout, how caused, 717. in the Lues venerea how helped, 746 Torpedo, his craft & stupefying force, 794 Touching, how performed, 22 Toucha, a strange bird, 1016 Trapezius musculus, 208 Transverfarius musculus, 205 Transverse muscles of the Epigastrium, 99 Treacle, how useful in the gout, 706. how it dulls the force of simple poisons, 783 Trepan, when to be applied, 342. their description, 365. where to be applied, 369 Trepaning why used, 364. how performed, ib. a caution in performance thereof. 366 Triangulus musculus, 207 Triton, 1001. Trochanter, 229 Trusses, their form and use, 306. 307. Tumours, their differences, 249. their general causes, signs, 250. general cure, 252. which hardest to be cured, ib. the four principal, 253. flatulent & waterish, their signs and cure, 269. 270. of the gums, 292. of the almonds of the throat, 293. of the navel, 303. of the groin and cod, 304. of the knees, 314 Turtles, 62 Tympanites, s●● Dropsy. V. VAlves of the heart, their action, site, etc. 146. Varicous bodies, 120 Varices, what, their causes, signs and cure, 483. V●… breve, seu venosum. 113 Vsa ejaculatoria, 121. Vasti musculi, 232 Vein, what, 97. Gate vein, & its distribution, 112. descendent hollow vein, & its distribution, ascendent hollow vein, & its distribution, 116 they are more than arteries, 155. those of the eyes, 184. which to be opened in the inflammation of the eyes, 186. the cephalick, 210. median, ib. distribution of the subclavian vein, ib. of the axilary, 211. of the crural, 224 Venae, porta, 112. cava, 216. arteriosa, 147. phre●icae, coronales, azygoes, intercostalis, mammariae, cervicalis, musculosa, 148. axillaris, humeralis, jugularis interna & externa, 149. recta, pupis, 152. cephalica, humeraria, mediana, 210. salvatella, & plenica 211. sapheia, vel saphena, ischiadica, 224. muscula, poplitea, suralis, ischiadica major, 225 Venery, its discommodities in wounds of the head, 359 Venomous bites and stings, how to be cured, 783 Venom of a mad dog outwardly applied, causeth madness, 787 Ventoses, their form and use, 694. 695 Ventricle, see stomach. Ventricles of the brain, 166 Verdegreace, its poisonous quality and cure, 810 Vertebrae, & their processes 196. of the neck, ib. of the holy-hone, 198. how different from those of the loins, 205. Tenth of the back, how the middle of the spin, 206, their dislocation. See Spine. Vertigo, its causes & signs, 639. the cure, 640 Vessels for distillation, 1094. 1096. 1097 etc. Vesicatories why better than cauteries in cure of a pestilent bubo, 854. whereof made, 1046. their description and use, 1067. Viper, see Adder. Virginity, the signs thereof, 1128 Vital parts which, 84. their division, ibid. Vitreus humour, 184 Viver, or, as some term it, the Weaver, a fish, his poisonous prick & the cure, 801 ●cers conjoined with tumours how cured, 265. in●… at bodies not easily cured, 417. their nature, ●…uses, etc. 466. 467. signs, prognostics, 468 their general cure, 470. signs of a distempered one, & the cure, 471. a painful one & the cure. 472. with proud flesh in them, ib. putrid and breeding worms, 473. a sordid one, ibib. a malign, virulent, and eating one, 474. advertisements concerning the time of dressing ulcers, 475. how to bind them up, 476. such as run are good in time of the plague, 828. Ulcers in particular, & first of the eyes, 476. of the nose, 477. of the mouth, 478 of the ears, 479. of the windpipe, weazon, stomach & guts, 480. of the kidneys & bladder, 481. of the womb, 482. that happen upon the fracture, of the leg, rump and heel, 586 how to prevent them, 587. they must be seldom dressed when the callus is breeding, 589 umbilical vessels, how many & what, 892 Unction to be used in the Lues venerea, 731. their use, 732. cautions in their use, ib. and the inconveniences following the immoderate use, 734 Ungula, or the web on the eye, the causes, prognostickes, and cure, 647 Unguentum adstringens, 1056, nutritum, ib. aureum, ib. basilicum, sive tetrapharmacum, ib. diapompholigos, 1057. desiccativum rub. ib. enulatum, ib. Album Rhasis, ib. Altheae, ib. populeon, ib. apostolorum, ib. comitissae, ib. pro stomacho, 1058. ad morsus rabiosoes, 〈…〉 ibid. Unicorn, if any such beast what the name imports, 813. what the ordinary horns are, 814. not effectual against poison, ib. effectual only to dry, ib. in what cases good, 815 Voices, whence so various, 194 Vomits, their force, 38. their descriptions, 277 Vomiting, why it happens in the Colic, 106. the fittest time therefore, 705. to make it easy, ib. Voyages and other employments wherein the Author was present; of Thurin, 1142. of Marolle & low Brittany, 1144. of Perpignan, 1145. of Landresie, & Bologne, 1146. of Germany, 1147. of Danvilliers, 1148. of Castle of Compt, 1149. of Mets, 1150. of Hedin, 1155. Battle of S. Quintin, 1164. Voyage of Amiens, of Harbour of Grace, 1165. to Roven, ib. battle of Dreux, 1166 of Moncontour, 1167. voyage of Flanders 1168. of Burges. 1172. battle of S. Denis, 1172. voyage of Bayon, 1173 Uraclius, 134. Ureters, their substance, etc. 123 Urine s●opt by dislocation of the thighbone, 626 suppression thereof how deadly, 666. how it happens by internal causes, 683. by external, 684 prognostics, ib. things unprofitable in the whole body, purged thereby, 683. bloody, the differences and causes thereof, 685. the cure, 687. scalding thereof how helped, 740. a receptacle for such as cannot keep it, 877. Urines of such as have the plague sometimes like those that are in health, 832 Utelif. a strange fish, 69. Uvea tunica, 183 Vulnerary potions, their use, 752. the names of the simples whereof they are composed, 753. their form, and when chiefly to be used, ib. Uuula, the site & use thereof, 193. the inflammation and relaxation thereof, 294. the cure, 295. W. WAlnut tree, and the malignity thereof, 808 Warts of the neck of the womb, 955. their cure, 956. Washeses to be beautify the skin, 1079 Wasps, their stinging how helped, 789 Watching, and the discommodities thereof, 37 Water, its qualities, 6. best in time of plague, 824 Waters, how to b●●distilled, 1099. Waterish tumours, their signs and cure, 269. 270 Weapons, of the Ancients compared with those of the modern times, 407 Weazon, the substance, etc. thereof, 156. how to be opened in extreme diseases. 294. the wounds thereof, 387. the ulcers thereof, 480 Weakness, two causes thereof, 250 Web on the eye, which curable, & which not, 647 the cure, ibid. Wedge bone, 172 Weights and measures, with their notes, 1049 Wens, their causes and cure, 272. 273. how to distinguish them in the breast from a Cancer, 273 Whale, why reckoned among monsters. 1012. they bring forth young & suckle them, ib. how caught, ibid. Whale-bone, 1013 Whirle-bone, the fracture thereof and cure, 582 the dislocation thereof, 630 White lime, 100 Whites, the reason of the name, differences, etc. 952. causes, 953. their cure, 954 Whitlowes, 314 Wine, which not good in the Gout. 708 Winds, their tempers and qualities, 20. 30 Winter, and the temper thereof, 10. how it increaseth the native heat, 11 Wisdom the daughter of memory and experience, 898 Witches hurtby the Devil's assistance, 989 Wolves, their deceits and ambushes, 66 Womb, the substance, magnitude, etc. thereof, 128. 129. the coats thereof, 132. signs of the wounds thereof, 347. ulcers thereof, & their cure, 482. when it hath received the seed it is shut up, 891. the falling down thereof how caused, 906 it is not distinguished into cells, 924. a scirrhus thereof, 930. signs of the distemper thereof, 933 which meet for conception, ib. of the falling down pervertion or turning thereof, 934. the cure thereof, 935. it must be cut away when it is putrefyed, 936. the strangulation or suffocation thereof, 939. see Strangulation. Women, their nature, 27. how to know whether they have conceived, 890. their travel in childbirth, and the cause thereof, 899. what must be done to them presently after their deliverance, 917. bearing many children at a birth, 970. 971 Wonderful net, 172 Wondrous original of some creatures, 1000 nature of some marine things, ibid. Worms in the teeth, their causes, and how killed, 658. bred in the head, 762. cast forth by urine, 765. how generated, and their differences, ibid. of monstrous length, 766. signs, ib. the cure, 7●7 Wounds may be cured only with li●● & water, 52 Wounds termed great in three respects, 323, 112. Wounds poisoned how cured, ●80 Wounds of the head at Paris, and of the leg▪ at Avignon, why hard to be cured, 4●7 Wounds, what, the divers appellation and divison of them, 321. their causes & signs, 322. prognostickes, 323. small ones sometimes mortal, 324 their cure in general, ibid. to stay their bleeding, 328. to help pain, 329. why some die of small ones, and others recover of great, 351. whether better to cure in children or in old people, 352 Wounds of the head, see Fractures. Of the musculous skin thereof, 360. their cure, 361. of the face, 378. of the eyebrows, ib. of the eyes, 379 of the cheek, 382. of the nose, 384. of the tongue 385. of the ears, 386. of the neck and throat, ibid. of the weazon and Gullet, 387. of the chest, 388. of the heart, lungs and midriff, ibid. of the spin, 389. what wounds of the lungs curable, 392. of the Epigastrium or lower belly, 396. their cure, 397. of the Kall and fat, 398. of the groins, yard, and testicles, 399. of the thighs, and legs, ibid. of the nerves and nervous parts, ibid. of the joints, 403. of the ligaments, 404 Wounds contused must be brought to suppuration, 417 Wounds made by gunshot are not burnt, neither must they be cauterised, 408. they may be dressed with suppuratives, 410. why hard to cure, ibid. why they look black, 413. they have no Eschar, ibid. why so deadly, 415. in what bodies not easily cured, 417. their division, 418. signs, ibid. how to be dressed at the first, 419. 423. how the second time, 424. they all are contused, 432 Wounds made by arrows how different from those made by gunshot, 438 Wrest, and the bones thereof, 218. the dislocation thereof, and the cure, 622 Y YArd, and the parts thereof, 125. the wound thereof, 399. to help the cord thereof, 663 the malign ulcers thereof, 737. to supply the defect thereof, for making water, 877 Yew tree, his malignity, 807 Z ZIrbus, the Kall, the substance, etc. thereof, 101 FINIS.