Lanfrank's "Science of cirurgie". Edited from the Bodleian Ashmole ms. 1396 (ab. 1380 A.D.) and the British museum Additional ms. 12,056 (ab. 1420 A.D.) by Robert V. Fleischhacker, DR. PHIL. Part I--Text.

Now bigynneþ þe secunde tretis of particuler woundis of membris of office from þe heed to þe foot / and first bigynne at anotamie of þe heed /

Al þing [folio 55b] brefly ordeyned aftir my symple will diuisynge, which þat longiþ to þe firste tretis of þis book which þat holdiþ certeyn rulis & techinge of surgerie vndir general chapitlis as we han bihiȝt / now we wolen bigynne to treten of curis aftir þat þe lymes ben in mannes bodi. & first I wole bigynne at þe heed & at his anotamie, & so procede forþ to ech membre dyuysynge þe anotamie of ech membre, & in ordeynynge þe curis of woundis þat ben maad in ech sengle membre. I seie þat þe heed is maad of þre parties: of a fleischi partie, of a bony partie, & a brawni partie. Þe fleischi partie is aboue þe brayn panne, þe which þat is maad of an hery skyn; & þilke skyn is fulfillid wiþ braynes in euery partie /

Þe heeris of þe heed weren for greet profite ordeyned þat neiþer cold ne hoot, ne schulde not sodeynli entre þe poris of the skyn, & neuer-þe-lattere þat þe fumosite of þe heed myȝte go out bi þe poris þere as þe heer growiþ; & þe heed myȝte be þe more semeloker, & þat þe colouris of þe heeris of dyuers men myȝte schewen þe complecciouns of þe heedis //

Þe skyn þat is [folio 56a] aboue þe brayn panne is lacertose, & ful of þicke fleisch, þat he myȝte wrie þe brayn panne, þat he schulde not fele sodeynliche to greet heete ne to greet cold. Þe which skyn is maad of sutil þredis of senewis þat comen fro þe brayn, & of veynes & of arteries sotilliche I-maad; & so þe skyn of þe heed is sotilliche ioyned wiþ þe skyn of al þe bodi / & also þe skyn of þe heed is more þickere þan þe brain sculle, þat it schulde ben more rare & more porose, þat is to seie, more ful of hoolis / Þe lacertis of þe skyn proceden aftir þat þe goynge procediþ of þe heeris /

Þe brayn panne is maad of manye boonys / Þe firste summe, þe whiche þat holdiþ þe prouitis þat longen to þe brayn panne, haþ .ij. helpingis; oon helpinge is: þouȝ þat an hurtynge come to oon boon, neuere-þe-lattere he schulde not falle to alle þe boonys / Þe secunde help is, oon boon þat is to hard in oon partie ne schulde not be so

hard in anoþir partie. / Þe secunde summe, þe which þat wiþhalt þe helpingis þat ben vndir þe brayn panne, haþ wiþinne him. iiij. helpingis; þe whiche helpingis ben ful maad by þe [folio 56b] semis þat ben of þe brayn panne; ne þe helpingis myȝte not be maad, but if þat þer were manye boonys / Þe first help is, þat þe veynes myȝten go doun bi þe semis of þe brayn panne berynge norischinge to þe same brayn / Þe secunde help is, þat þe senewis þat comen out of þe brayn myȝte haue wey in goynge out / Þe þridde help is, þat þe fumes of þe brayn myȝten haue wey of smokyng out / Þe fourþe is, þat neiþer dura mater, ne pia mater, þat as þei ben hangid, ne myȝte not greue þe brayn.

So þat þe brayn panne is maad of ij. smeþe liȝt tablis, þat oon is aboue, þe toþir is byneþe / & þei ben sumwhat spongious in þe myddis, & rare þat þe smoke of þe heete myȝte bettere passe out & þei ben smeþe þat þei myȝten not greue þe brayn / Dyuers men þat maken dyuers anotamie dyuyden þe brayn panne diuerslych / summen noumbren mo boonys þan summe oþir speken of / but soþenes is, þat þer ben .vj. & oon which þat susteyneþ þe sixte. Þe firste boon is clepid þe boon of þe forheed or ellis coronale, & he bigynneþ from þe browis & lastiþ to þe seem þat departiþ þe heed quarter.

[folio 57a] & þilke is clepid coronale / Þis boon haþ in sum maner of men a smal seem in foldynge of þe forheed, & þerfore sum men seyn þat þer ben .ij. boonis. ij oþir boonys ben ioyned with þilke boon coronable in þe myddis of þe heed ouerþwert ouer; þat þei ben bounde togidere bi oon ioynture, þe which þat strecchiþ from bifore to bihynde to þe lenkþe of þe heed, þe which is clepid sagittales, by as myche as he is schape lijk an arowe / & þese .ij. boonys ben clepid nerualia bi-cause þat þe figure of þe seem þat is with þe coronable is þe figure of a senewe eiþer of a corde / Þese boonys ben in þe hiȝeste coppe of þe heed & byhynde in þe nolle þer is a boon þe which is clepid alauda. & it is maad in þe symilitude of þis:

[figure]

: which þat is ioyned wiþ þe boones nerualibus tofore seid bi þe mene of oon þan I-made to þe lijknes of þe boon tofore seid. & þese þre semes whiche þat ioynen togidere þe .iiij. boonys tofore seid, ben maad as it were two sawis, þe whiche teeþ ben ioyned, ech of hem in oþir in þis maner

[figure]

/ & þis ioynynge togidere of oon boon wiþ anoþir was maad bi-cause of iuvamentis þat I haue told toforn; [folio 57b] þer is no boon ioyned with anoþer as þese boonys ben.

Vndir þe boon þat is clepid alauda, þer is a ful hard boon & holid in þe myddil, þe which boon susteyneþ alle þe boonys of þe heed. Þe which boon is clepid passillus, & he is ioyned byneþe wiþ þe firste boon of þe nake. Þe schap of þe coniunccioun of þe .v. boonis of þe heed is in þis maner

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. Boþe on þe riȝtside & on þe lift side of þe forseid boonys, whiche þat ben clepid nerualia *[whiche þat beþ in lengthe in þe heyest place of þe hed, þere ben twey bonys on eiþere syde.] & þo boonys þat vndir setten ben clepid ossa mendosa. & þese boonys in oon partie ben ful hard þere as þe hole of þe eere passiþ þoruȝ, & þei ben clepid petrosa; & summen seien þat þer ben .iiij. boonys ij. on eiþir side / & whanne þat alle þe boonys of þe heed ben ioyned togidere, þou schalt fynde in soþfastnes þat þer ben but vj. boonys, whanne þat þou rekenest os coronale for oon boon, & .ij. boonys þat ben clepid mendose, ij. & oon þat ben iij, & o boon þat is clepid alauda. & ij. boonys þat ben clepid nerualia þat ben .vj.; & þe .vij. boon is clepid passillare, þe which is not of þe boones of þe heed, but he susteyneþ alle þe oþere boonys of þe heed. & iij. maner of semes [folio 58a] makiþ coniunccioun of alle þe boonys in þis maner

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& wiþ .ij. semes mendose in þis maner

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. & whanne þat þe crounne of þe heed is perfiȝt, þe heed is maad in þis maner

[figure]

/ Þis is þe foorme of an heed weel propossiound, round

[figure]

þat he myȝte more wiþholde, & þat he myȝte lasse be hurt, & þat he be longe warpid, hauynge tofore & bihynde eminence: þat is to seie apeirynge, þat þe senewis þat comen out of þe brayn myȝten haue a porose place of goynge out. & neþeles as ypocras & galion, whiche þat expowneþ ypocras, telliþ, it is possible to fynde oþir in maner of makyng of heedis. Oon maner is, if eminence be not in partie of þe heed tofore, for if þat he be pleyn in partie tofore, bi þat pleynes þe seem is lost, þat is clepid coronalis / Þe secunde is, if þat þe heed haue noon eminence bihynde, but þat þe hyndere partie be pleyn, & bi þat pleynes þe seeme is lost þat is clepid alauda / Þe þridde is, if þat þer be noon eminence bifore ne bihinde in þe heed, but al þe heed is round as a sercle, & þanne þer is but oon seem in þe myddil of þe brayn panne: for it is vnpossible þe heed to haue ony oþer [folio 58b] schap wiþoute lesynge of sum partie of þe brayn, & were contrarious aȝens þe lijf / Bi þe myddil seem which þat is in þe heed, þere discendiþ a ueyne comynge fro þe lyuere bi þe

brayn panne of a boon which þat is holid þat is clepid passillarus. & bi þe same weye þer risiþ an arterie comynge from þe herte, & þei ben ioyned togidere, & of þe weuingge of þe tweyne þer is maad an hard pannicle þat is to seie a clooþ þat is vndir þe brayn panne; & he is hangid with summe smale ligamentis to þe brayn panne in summe of þe semes. Þe whieh pannicle byndiþ þe boonys togidere, & it is clepid dura mater. & it is riȝtful þat an arterie schulde arise vpward from byneþe, for þe blood þat is in him is sutil, & his meuynge is pulsatif; & he hadde discendid from aboue dounward, he schulde haue discendid wiþ to greet an hastynes, but þilke ascendynge temperiþ þilke flux. & it is couenable þat þe veyne discende bicause þat þe blood þat is in þe veynes is more þickere, & þe blood þat is in þe veynes goiþ doun sotilli. & boþe þese veynes þat ben pulsatif & not pulsatif ben ioyned wiþ dura mater / Also þe [folio 59a] veyne strecchiþ more lower, & of hem is engendrid pia mater / Aftir þei discenden doun to þe brayn, & þei bryngen lijf & dewe norischinge & cordialle spiritis, þe which is in þe brayn & þere is defied, & þere resseyueþ naturel foorme of vndirstondynge. Pia mater enuyrounneþ al þe brayn, & departiþ him into iij. celoles þat

ben chaumbris: þe firste, þe myddile, & þe laste. & þouȝ þat alle þese ben dyuydid syngulerly bi hem-siluen, it semeþ þat þe celole þat is tofore in þe brayn is departid in two parties; & bi þat cause summen seien þat þer ben .iiij. ventriclis of þe brayn. Þe forþere partie of þe brayn is greet & brood, bicause þat he schulde resceyue manye spiritis þat ben sent to him; for þat place is propre instrument of ymagynacioun þe which resceyueþ þingis þat comprehendiþ of fantasie; & þo þingis kunnen vndirstonde resceyueþ bi propre instrumentis þat longiþ. & þouȝ þat al þe brayn, in comparisoun of þe herte & of alle oþere membris of þe body, be deemed cold & moist, þis celule hauynge comparisoun to oþere celules is deemed hoot & drie. & þe myddil part of þe brayn is lasse [folio 59b] þan ony oþere of þe oþere two parties, & her foorme is punat brood twoward þe forþere side of þe heed, & scharpere twoward þe hyndere syde, þat he myȝte be þe more able to resceyue ymagynatif þingis, & þo þingis to ȝeue to þe ynnere partie, & þo þingis þat ben ȝeue to wiþholde / Þis ventricle is sett bitwene two addiamentis of þe brayn; þe whiche addiamentis ben lijk to tweie buttokkis of a man þat ben ioyned togidere, & þei ben [to]* þis ventricle as it were a sittynge

place eiþir a couche vpon þe which he is drawen abrood, whanne þat he resseyueþ ymagynatif þingis; aftirward he is drawe togidere as a worm, whanne þat he resseyueþ ymagynatijf þingis; & whanne þat þe sentence of þilke ymagynacioun is brouȝt forþ, þanne þilke ventricle is drawe along, & also þe smallere eende of þe ventricle entriþ into þe ventricle þat is bihynde in þe heed. & þis ventricle is myche lasse þan þe oþere tweyne, bicause þat no senewis proceden not out of him, & þat manye þingis myȝte be comprehendid [in litel]* place þat vertu of witt myȝte þe sunnere be gaderid togidere to take his [folio 60a] counseil; & þis ventricle to comparisoun of oþere ventriclis is deemed hoot & drie. & aftir þat þe hyndere ventricle, þe which is grettere & hardere þan þis; þe which [in]* comparisoun to þe oþere tweyne is demed cold & drie, þe which is brood twoward þe fore partie of þe heed & scharp bakward, þe which resceyueþ sentence þat ben schewid & kepiþ hem priuyliche as a cheste kepiþ tresour. & out of him goiþ out nucha þoruȝ þe hole of þe boon, þat is clepid passillaris, & þilke nucha is cloþid wiþ two pannicles þat goon ont of þe brayn.

& al þe brayn is deemed cold & moist, bicause þat he schulde

atempren spiritual fumosite þat comen of þe herte, & þat he schulde not ben dried for to myche meuynge þat he haþ in worchinge of vertues; & þe brayn is whijt, bicause þat he schulde þe bettere resseyue resoun & vnderstondynge / For if peyntouris whanne þey schulen peynte a table, first þei maken it whiȝt, for þer wole no colour lasten but þoruȝ him; & it is neische þat þe meuynge of vertues myȝte þe bettere han place; & þe brayn is towȝ þat þe senewis þat goon out of hym [folio 60b] myȝte be þe more towȝ, & þe more þei ben enlongid from her bigynnynge & þe more hardere þei schulen be, & also þat þei schulden be bowable ynowȝ & nouȝt aȝenstondynge her hardnesse. & it is nessessarie þat þe brayn be cloþid wiþ .ij. panniclis: þat is to seie .ij. cloþis, þat in his meuynge, [as]* I haue seid tofore, þat it schulde not be hurt of þe brayn panne. Al þe brayn is departid into .iij. colules with addiamentis of þe panniclis of pie matris, þat þe spiritis myȝten þe lengere dwelle in þe ventricle to resseyuen bi ordure of digestioun, foorme & perfeccioun more þan þei hadden first of þe herte; & þat euery vertu myȝte fulfille his accidens in his ventricle, or þan þe vois þat is comprehendid

myȝte passe to þe ventricle þat is sewingge. Not aȝenstondynge þese propirtees þe brayn haþ sum substaunce of marie þe which fulfilliþ þe voidenes of þe forseid panniclis. & þilke mary enuyrounneþ þe forseid panniolis, of þe which mary þer may sum partie in hurtynge of þe heed be lost; & not aȝenstondynge þe goynge out of sum partie of þilke mary, a man schal nouȝt die. For þis mary [folio 61a] is not of þe substaunce of þe ventriclis of þe brayn of þe which mynde is maad; for þei ben of so greet nobilite, þouȝ þat þer be neuere so litil infeccioun, or ellis þat þer falle neuere so litil a lesyng of hem þei ben depriued of her heelþe, in so myche þat oon colule may not be lost & a man be saued, as manye idiotis supposen contrarie / Anotamie of yȝen, eeris, nose, chekelappis, mouþ, tunge & teeþ, we deferren to ordeyne in þe þridde tretis, in þe whiche if god wole we þenken to treten, & of oþere siknessis, & of oþere lymes out-cept woundis.

& þo hurtyngis þat ben maad in þe heed eiþir þat ben maad wiþoute wounde or wiþ wounde. & wheþer þat þei ben wiþoute wounde or wiþ wounde, eiþir þei ben wiþ brekynge of þe brayn

panne or wiþoute brekynge of þe brayn panne / Or wheþer þat it be maad wiþ breche of þe brayn panne, or wiþoute breche of þe brayn panne, summe ben wiþ hurtynge of þe brayn, & summe ben wiþoute hurtynge of þe brayn / & riȝt as þilke hurtis haue difference in tokenes, so þei han difference in perels & pronosticaciouns & maners with þe whiche þei musten ben holpen /

[folio 61b] & if þat ony hurt be in þe heed wiþoute ony wounde as wiþ fallynge or wiþ smytynge of a stoon or of a staf or wiþ sum oþir þing þat brusiþ, & if þat it be wiþoute breche of þe brayn panne & wiþ hirtynge of þe brayn panne, it nediþ not but schauynge of þe heed & anoyntynge with hote oilis of rosis & [abofen þe vncture]* to strawen on þe poudre of mirtillis seed, & streyne þe place wiþ a boond til al þe place be fastned & þe swellynge be vanyschid awey / In þis maner þou fastne al þe place þat no þing schal be corrumpid, or ellis þer schal dwelle a litil corrupcioun, & if þat ony þing of corrumpcioun abide, þe place schal be opened wiþ an instrument, & so schal þe quyttur be excludid, & he schal be curid riȝt as oþere empostymes þat ben woundid.

& if þat þe brayn panne were broke wiþoute wounde of þe heed þe which may be knowe bi disposicioun of þe cause & also of þe sike man, in biholdynge, if þat þat smytiþ were strong, or ellis

þat þe sike haue falle from his place, or ellis þat he was smyte with strong smyting, & also if þat he fel & myȝte not hastili arise. [folio 62a] & if þat he hadde scotomie, þat is to seie a maner sijknes, whanne þat þer semeþ as flien or oþere smale gnattis fleen tofore his yȝen / or ellis he spewiþ his mete, or he feliþ to gret akþe in þe heed, & if þat he may not breke a knotte of a straw wiþ hise teeþ, & if þe heed be smyte wiþ a liȝt drie staf as of salow or ellis of pinee—& þanne leie þin eere to his heed, & if þat þe boon be hool þou schalt here an hool soun aftir þe comparisoun of þe soun of an hool belle, also if þou makist þe sike man to holde bitwene his teeþ a þred twyned & I-wexid, & þanne bigynne to harpe with þi nailis vpon þe þred faste bi þe sike mannes mouþ, & so harpe wiþ þi naylis vpon þe þred alwey streyned & makynge soun to þe eende of þe þred, & þilke þred schal ben on lenkþe fro þe mouþ of a cubite, & so þou schalt harpe ofte tymes, & if þat þe pacient mowe susteyne þe soun, he haþ not his brayn panne broke, for if his brayn panne were broke, þe sike man myȝte not susteyne þe soun of þe þred. Alle þese signys, or ellis manye of hem bitokenen þat þe brayn panne is broken / & tweyne [folio 62b] of þe laste signys ben

more certeyn þan ony of þe oþere. & vndirstonde þat þe brayn panne mai ofte tymes be to-broken, & neþeles þe brayn feliþ noon harm in þe bigynnynge. But aftirward ofte tymes of hirtynge of þe brayn panne, þe brayn is hirt / Galion witnessynge, þe brekynge of boonys in þe heed is dyuers in perels fro brekynge of oþere boonys in þe bodi, for þe accidens þe which þat falliþ ofte tymes to þe breche of þe brayn panne. Neiþir is no man ne neuere was þat myȝte euermore helpe to alle accidentis, whanne þat þe brayn was meued in þe bigynnynge þat not aȝenstondynge his help, be he neuere so good a leche, þat þe sike ne muste die /

Euel accidentis þe whiche þat [comyth to þe accidentes of þe brayn & of hys]* pannicle ben alwey dwellynge as constipacioun of þe wombe, or ellis þe flix of þe wombe, or ellis crokidnes, or ellis lokynge asquynt of þe iȝen, or ellis wepinge of þe oon yȝe, or ellis an hard scotomie, or ellis febilnes of alle þe vertues & chaungynge. Not oonly animal vertues, þat ben vertues of þe brayn, ben I-chaungid, also naturel vertues & liui vertues—sensibles & [folio 63a] motifes;

sencible, for þei ben not riȝtfulliche; for boþe her heerynge & oþere comoun wittis ben troublid; also priuy vertues þat ben troublid as ymaginatif, for þei bileuen þei seen, [þat þey seen nouȝt];* also resonable vertues, for þei speken in deuyn & answeren whanne þei ben nouȝt I-askide / also memorial þat þei þenke nouȝt on her owne name / also meuable vertues is so myche greued þat vnneþe þei moun nouȝt meue hem nameliche aboute þe necke. Þei syke greuousleche, & a scharp feuere falliþ, þe which arrigor, þat is to seie a cold schurgynge goiþ tofore / Arrigor is no þing ellis, but as it were a prickynge of nedelis, or ellis of netlis in þe fleisch, & if þis rigor come wiþ a feuere, or ellis without feuere, it is þe worste signe tokene of deeþ, & if þe crampe folowe it is deedly / Also þese ben yuel accidentis: blaknes of þe tunge, bleynis aboute þe skyn or þe chekis, or in ony partie of þe heed þanne [in]* þe wounde, is an yuel signe. & sumtyme blood comeþ out at þe eeris & noseþrillis. & if þe more partie of þese tokenese or ellis alle comen, þe sike man muste nedis die, namely, & þe accidentis conteynen; [folio 63b] & specialy if þe sike man haue be her-to-fore manye daies in good disposicioun, & after þilke

good disposicioun þilke yuel accidentis fallen; but sumtyme in þe bigynnynge þese yuel accidentis fallen wickid, & aftirward bi good gouernaile & good help of þe leche þilke yuel accidentis ben departid & good comeþ, and þanne it is a [good]* signe, for it bitokeneþ strenkþe of kynde, hauynge no drede of þe sijknes, & kunnynge of þe leche / O holi goost, al þing fulfillynge, alle þingis sanctifiynge, & alle þingis liȝtnynge, & alle þingis gouernynge, opene þe yȝen of hem þat loken & reden on þis book, þat þei moun vndirstonde þat þing þat is weel seid, & þat þei moun demene þoruȝ þi cleernes þat, þat is yuel seid, & specialy in þis caas where þat oonly not I þat am vnwijs & vnkunnynge, but also greete maistris & more kunnynge han writen sotilliche, & han sett in þis caas dyuers vndirstondynge. Ne þei ne I ne foond no wey in þis werk þat myȝte us make sikir, specialiche in scryuyngis of þe brayn panne, in þe whiche cure dyvers men haue I-wrouȝt dyuersliche.

[folio 64a] I wole bigynne at a symple wounde of þe fleisch of þe heed, in þe which þat þer is noon hurtynge of þe brayn ne brayn panne. // Biholde wheþir þilke wounde be maad wiþ a swerd or ony þing sembla[b]le to it, & þanne sowe þilke wounde, & caste aboue þe

wounde þe poudre of lym tofore seid, & do al þing bi ordre, as it is conteyned aboue in þe chapitle of woundis of fleisch /

& if þat a wounde be maad in þe heed wiþ brusynge, as wiþ a mace, or wiþ a staf, or ony þing þat brusiþ, þanne it is nessessarie to leie aboue þe brusynge a maturatif maad of .iiij. parties of watir, & oon partie of comoun oile & flour of wheete, þat suffisiþ to make it þikke, til þat þe mater þat is brusid be maturid; þe which maturatif schal be do abrood vpon a lynnen clooþ & leid to þe wounde, & þou schalt fulfille þe wounde wiþ oile of rosis & ȝelke of an ey, & lynt of an oold lynnen clooþ medlid togidere, til þat þe wounde ȝeue quytture & þe akþe be aswagid. & aftirward leye in þe wounde drie lynt of old clooþ, & fille þe wounde of þe same lynet, & leie aboue þe mundificatif of mel roset & barly mele, [folio 64b] til þat it be perfiȝtly clensid; & leie aboute þe wounde, from þe bigynnynge til þat þe wounde be parfiȝtly clensid, a defensif of bole armonyak, þe which I haue told ofte tyme; aftirward incarne it, þat is to seie brynge ouer fleisch, & aftirward consowde.

& if þat þis wounde towche þe pannicle þat byndiþ boonys togidere, þouȝ þat þe boon be not to-broken, charge it not litil, but

take þerof good hede, & do þerynne in þe wounde hoot oile of rosis doun to þe pannicle þat byndiþ boonys togidere, til þat þer be noon akynge in þe wounde. & kepe þilke wounde as þou woldist kepe oþere woundis of þe brayn panne; & kepe þe brayn fro cold & fro heete, for cold is moost greuous to boonys & to panniclis þat ben woundid. Þer ben summe maner men þat leien wiþout forþ on alle maner woundis of þe heed, wheþer it be wiþ wounde of þe brayn panne or wiþoute þe wounde of þe brayn panne, in what maner þat þe heed be hurt, a lynnen clooþ wet in þe oynement þat is maad on þis maner / Take white rosis libram [one half], oile of rosis [ounce] v, whiȝt wex [ounce] iij, þei melten alle togidere in an yren panne, & þei maken [folio 65a] þerof .j. bodi, & boile it aftirward in good wyn bi þe space of an hour; & þei leten it aftirward nyȝ colden, & þei weten þerinne a pece of a lynnen clout, & þei schapen þilke pece wiþ a schere aftir þat þe wounde is, & þanne þei baþe þilke pece in good wiyn, & þanne leie þilke pece [on þe wounde]*, & anoon aftir þei leien vpon þilke pece on eiþir side of þe wounde a plumaciol I-wet in good hoot wiyn; & þei leien on a drie pelowe of herdis vpon þo two wete pelowis, þe which drie pelewe of herdis schal comprehende þe tweie wete, & bynde hem faste; & þei ȝeuen to summen to drynke

riȝt good wyn, & to ete good fleisch of hennes & of capouns; & þei comaunden to drynke a drope of water; & þei gouernen on þis maner alle men þat ben woundid in þe heed differentliche, & þei seyn þat mo men ben heelid bi þis maner cure þan dien. But bi as myche as alle auctouris ben aȝens þis cure, namely in dietynge, I ne was neuere hardi to preue þis maner cure; for in mannys bodi a medicyn schal not be preued which þat is not acordynge to resoun / For alle autouris acorden þat þer is no þing [folio 65b] þat so soone greueþ þe brayn & þe senewis as wiyn doiþ, & vsynge of fleisch is cause of bryngynge yn an hoot enpostyme. Neuere-þe-latter if a man þat vsiþ of custum sich a maner dietynge haue a strong heed, in his hele him drediþ no wiyn, & þe vertu of him þat is sijk be strong—in sum manere of folk wiþ þis maner gouernaile, vertu is more strenkþid, & þe sunner þei ben heelid. But I ne procede not wiþ sich a maner dietynge bi cause of drede lest an hoot enpostyme schulde come to þe sore, but I procede in dietynge & worche aboute þe wounde as I haue seid tofore.

Oþere men loke [in brekynges of þe brayn panne, wheþer þat]* þe brekynge of þe brayn panne be with a greet wounde, or smal

wounde, or withoute wounde. & if þat þer be a greet wounde, þei loken wheþer þei moun se if ony pece of þe brayn panne be tobroken, & þei don it awey. & aftirward þei putten bitwene þe brayn panne & duram matrem a þinne clout wet in þe white of an ey, & sumwhat þe white compressid out, & þei fulfillen al þe wounde of þe brayn panne with sich a maner clooþ. & þei leyn in þe ouer wounde which þat is in þe fleisch, lynet wet in þe white of an ey, til þat þe blood be staunchid; [folio 66a] & þei leien aboue a plumaciol wet in an ey. & whanne þe blood is staunchid, þei leien a dreie clooþ vndir þe brayn panne in þe wounde, & þei leien aboue þe wounde a potage, þe which engendriþ quytture; & whanne þat þe quytture is engendrid, þei leien in þe wounde carp, eiþir lynet of a cloute; & þei anoynte aboute þe wounde wiþ vnguento fusco; & at þe laste eende þei leien aboue apostolicon.

& þei asaie in þis maner if þat þe brekynge of þe brayn panne be wiþ a rimel, þat is to seie a chene, eiþir a creueis; & if þat ilke creueis peerse to wiþinne, makynge þe sike man to streyne his

mouþ & his nose, & þei maken him þanne to blowen, & þei loken if ony þing exale out bi þilke rimele,— as blod or ony other mater, þei drede not to perse þilke rimelle. & þanne summe seien þat þilke rimele schulde be to-broke eiþir peersid from þe toon eende to þe toþir wiþ rinspindelis, perischinge þe brayn scolle / A rinspindil is an instrument þat coteleris poudren with her haftis, þe which figure schal be schapen in þis same chapitle folowynge. & þe worste þing þat a man may do is to peerse þe rimele on boþe sidis / But oþere [folio 66b] men don bettere which þat peerse þe rimele on þe oon eende which is moost hangynge; & þei maken as manye hoolis, oon biside anoþer, as it is nessessarie to make an hole in þe brayn panne, bi þe which hole if ony þing be fallen vpon, duram matrem myȝte be clensid; & þese, in as myche as touchinge trepanacioun worchiþ best / & whanne þat þei han maad manye hoolis, þei kutten from oon hole to anoþer hole wiþ an instrument, þat þei moun drawe out þe boon þat is bitwene þe ordure of holis þat was maad & þe rimele, & þei casten him awey, & aftirward þei proceden

forþ in oþere maner þingis as it is seid tofore / For whanne þou desirist way of trepaninge [þis manere trepanynge]* sufficiþ to þee in þe rimelis of þe brayn panne. Þis schal be þe foorme of a trepane [with þe whiche þe brayn scolle schal be trepaned wiþ]*

[figure]

. & þis is þe foorme of a spatinam, wiþ þe which a man schal kutte from oon hole to anoþer hole

[figure]

. & þou schalt smyte wiþ a mal eiþer an hamer on þe greet eende; & whanne þou hast remeued of þe boon þat schal be remoued, euene þe brynkis with schauynge, þat þou mowe not leue no maner scharpnes in þe brynkis. Þis is þe maner of þe schap

[figure]

, [folio 67a] & þis schaue schal kutte on þe side þat foldiþ ynward, & it schal be blunt on þe oon side þat is outward. & þei fulfillen þe wounde þat is wiþinne þe fleisch wiþoutforþ, as I haue seid, with þe clooþ expressid of þe white of an ey & lynet, til þat þe wounde be ful, & also til þat þe kynde haue regendrid a repeirement, þe which schal fulfille þe place þere as þe boon was don awey. Aftirward þei curen þe wounde aftir comoun cure of woundis / Alle oþere maner of trepanacioun is comprehendid vndir o summe, þouȝ þat summen ordeyne particuler aftir her dyuyse, diuers maners.

But bi as myche as I haue not seen in þis caas no way þat

myȝte remeue me from doute, bi as myche as I haue saied bi longe tyme, boþe bi summe auctouris experimentis, & also bi myn experiment, & þat wei is not certeyn / þerfore here þei Galien, þat seiþ: if we mowe remeue quytture wiþoute doynge awei of boonys þat schulde be do awey, it is good / And auicen & serapie acorden to þe same sentence of cure of heed akþe þat comeþ of smytynge or ellis of fallynge, where þat he towchiþ þe worchinge of hurtis of þe brayn [folio 67b] panne, not bi trepanacioun, but bi emplastris & medicyns / & also I took good hede þat manye mo men ben heelid bi maner of medicyns & emplastris, þan ben heelid bi trapanes, þat ben peersynge or þrillynge / For I ne vse not instrumentis to remeue the boon but in two causis / Þe oon cause is if þat þe brayn panne be so myche I-slend þat þe part þat is broke, entre vndir þe partie þat is hool / Þe secunde caas is, if ony pece be departid from þe brayn panne, þe which þat prickiþ duram matrem / In þe firste caas dura mater is compressid. In þe secunde caas dura mater is prickid, which is cause of akþe, & akynge is cause of drawynge humouris, þere engendriþ an empostyme vpon þe same pannicle, þe which is cause of a crampe, & of oþere accidentis tofore seid; &

at þe laste þei bryngen deeþ to þe pacient / In þese .ij. causis I leeue hem constreyned to remeue a boon wiþ handely instrumentis. In alle oþere maners of brechis eiþer in creueis, in what maner þat þei happen, þouȝ þat I be not siker of þe pacientis lijf, neþeles I procede in þis maner with more trist, bisekynge alwey help of god, þe which þat [folio 68a] haþ heelid mo men bi myn hondis, þat am his instrument, þan haue ben deed, nouȝt aȝenstondynge alle my cautels & helpinge. For soþe þat I haue biholde soþliche resonis & þe proces of oþere auctouris, I holde þis wey lasse dredeful þan ony oþere / for I folowe þe sentence of Galien, which þat seiþ: if þat a man haue but o wei to his hele, it is good þat he holde þilke wey, þouȝ þat it be yuel.

& whanne þat I come to a man þat is woundid in þe heed, & I knowe þat þe brayn panne be broke, bi tokenes tofore seid, first I considere þe vertu of him þat is pacient, & also his age & alle oþere particuler þing, & nameli vertu, & gladliche I leue þe cure, if þat I se ony deedly tokenes, but if it so be þat I be preied wiþ þe grettere instaunce of þe freendis of þe sike man. & not aȝenstondynge her preier I telle hise freendis þat bi wey of resoun þe

pacient schulde die, & þanne I worche aboute him as in a man in whom yuele accidentis appere. & if þat þe signys ben not deedliche, & þe breche of þe brayn panne be with a greet wounde of þe heed, & þat a greet partie of þe brayn panne be do awey al togidere, so þat I mowe [folio 68b] haue a good wey to leie medicyns vpon duram matrem / First I do schaue his heed, afterward I leie on an eeld lynnen clout & a þenne, wett in .ij. parties of oile of rosis swete smellynge, & oon partie of mel roset colat, bitwene þe duram matrem & þe brayn panne sliȝly & softli, þat dura mater be not compressid wiþ þe clooþ þat is wet tofore seid; & I fulfille þe wounde of þe fleisch wiþ lint of oold lynnen clooþ wett in þe ȝelke of an ey, & oile of rosis, boþe liche myche; & anoynte aboute þe wounde wiþ a defensif of bole armoniak ofte tymes I-seid, & leie aboue þe wounde a plumaciol, þe which þat schal keuere al þe wounde; & þanne aboue al-togidere I leie a greet plumaciol, wett in good hoot wiyn. & aftirward I bynde þe wounde wiþ a boond, byndynge ofte tymes aboute þe heed wiþ þe lynet & þe clooþ, þe which þat is in þe wounde & aboute þe wounde myȝte not slide to no partie, & bynde þe wounde in þat maner þat dura mater bi no

wey be compressid. Þe heeris of þe heed schulen be remeued awey on þis maner: clippe hem first with scheris, afterward take .ij. parties of water cold, & oon partie of oile [folio 69a] of rosis in somer, & make hoot þe same water & oile in wyntir, & waische þe heed softliche, takynge hede þat no water ne oile entre into þe wounde, & þanne schaue it wiþ a rasour / & whanne þat I haue serued þe pacient on þis maner, I lete him reste til on þe morowe, & aftirward I serue þe wounde on þe same maner til þat þe wounde be hool / Neþeles I considere if þat þe pacient be ful of blood, & his vertu be strong, & if he be ȝong, & litil blood bled at his wounde, & whanne alle þese þingis acorden, I make him to be leten blood on þe coral veyne of þe arme / & but if he mowe go to priuy, I helpe him oonys aday, or wiþ suppositories or wiþ clisterie; & I procede in dietynge, as I haue seid in þe chapitle of dietynge / & whanne þat þe wounde makiþ sufficiently quytture, I leie in þe wounde of þe brayn panne, & vpon þe brayn panne, as I haue don tofore; & aboue þe wounde I leie a mundificatif of mel roset, colat, & barly mele, til þat þe wounde be clensid, & þat þe dura mater be sowdid with þe brayn panne / & þanne I caste in þe wounde of þe heed a poudre maad on þis maner / Take frank encense & ciperi, þat is þe

note of a cipres, [folio 69b] seed of mirtilles, mirre, ana. orobi, [ounce] j; make poudre, & leie þis poudre in þe wounde, & aboue þe poudre leie þredis of lynnen clooþ, or ellis lynet; & aboue al-togidere leie an entreet maad of .ij. parties of whiȝt rosyn, & oon partie of wex moltun togidere vpon strong vynegre, & colid þoruȝ a þinne streynour vpon cold water / & whanne þin hondis ben anoyntid wiþ oile of rosis, malaxe it longe tyme togidere. In somer take euene porcioun of whiȝt rosyn & of wex; in wyntir / take .iiij. partis of rosyn,* & þe .v part of wex, & drawe abrood þat treet on a clooþ, & leie it on þe wounde til þat he be perfiȝtliche cicatrisid. & if þat þer were ony partie of þe boon þat prickide duram matrem, þanne I aforce me to remeue þilke partie þat prickiþ wiþ pynsouns, if þat I may; & if þilke partie þat prickiþ be ioyned so faste to þe hool boon þat he wolde not be remeued awey, þanne I remeue him awey wiþ rugement from þe partie þat halt, in makynge oon hole or two, or mo, aftir þe quantite of þe

boon þat schulde be don awey [þat halt with þe hole bon & afterwarde y kutte with a spatymene from on hole to anoþere tyl al þe bon be remeffyde aweye.]* / & whanne þat þe boon is remeued awei, I procede in þe cure as it is [folio 70a] seid in þis chapitle / But whanne I remeue a boon wiþ instrumentis of þe brayn panne, þanne I stoppe þe sijk mannes eeris, þat he mowe not heere þe soun of þe yren þat trepaniþ. & I remeue þe same maner þe partie þat is broke, þe which þat goiþ vndir þe partie þat is hool, & compressiþ þe dura mater. & if þat a gobet eiþir a pece of a boon holde sumwhat in þe wounde, & myȝte not liȝtliche be remeued away, & he prickiþ not dura mater ne compressiþ not dura mater, þanne at þe bigynnynge I do on þe boon hoot oile of rosis, & I fulfille þe wounde wiþ oile of rosis & þe ȝelke of an ey medlid togidere, til þat þe boon be neischid & may liȝtliche be remoued awey; þanne I remeue þe boon softliche, & I procede in þe worchinge bitwene þe boon & duram matrem, as it is seid tofore /

& if þat þe breche of þe brayn panne were as a creueis or ellis I-slend, & neiþer part of þe boon were lowere þan oþer, þanne I considere if þat ilke slendynge perce al þe brayn panne; & þat þou schalt knowe bi þe tokenes tofore seid, or ellis þou schalt knowe bi þis signe, þat neuere failiþ / Make [folio 70b] a plastre of poudre of

mastik & þe white of an ey, medlid togidere as þikke as hony, & distende it vpon a clooþ, & leie it on þe place þat is hurt fro morowe til euen, or ellis from þe euene til þe morowe / & whanne þat þe plastre is remoued awey, if þat þe creueis peerse þoruȝ þe brayn panne, þou schalt se þe plastre more drie aȝens þe creueis þan in ony oþer place, for þe greet heete þat comeþ fro þe brayn [& ȝif þe breyn panne]* be nouȝt I-slend þoruȝ, þe plastre schal be nomore drie aboue þe creueis þan on anoþer place / & if þe creueis perse not þe brayn scolle, þe cure is as it is seid in þe bigynnynge of þis chapitle, þere as I tolde of cure of wounde of þe heed, where þat þe brayn panne eiþer þe brain is not hurt. For if þat ilke remile peerse þe brayn panne, þer is a greet doute in þe caas, for summen seien þat it is impossible sich a wounde to heele; but if þe remele be trepaned, & a quantite of þe boon be doon awey, þat þe superfluyte þat is cast vpon duram matrem may be doon awey, or ellis þe dura mater schulde putrifien & be corrupt, & bi þat skil þe pacient schulde die, þe which þat myȝte [folio 71a] be heelid bi þe remeuynge of þe boon / Neþeles I þat haue seen in trepaninge greet perel, namely whanne

þat þe creueis is bisidis þe semys, where þat þe trepaninge is deedlich / & I haue seen manye þat wiþoute trepanyng almyȝty god haþ delyuerid bi myn hondis, wiþoute touchinge of ony brayn scolle wiþ ony trepan or wiþ iren; but I helde in to þe creueis hoot oile of rosis colat, & mel roset colat, medlid togidere aftir þe doctrine tofore seid, fulfillynge al þe wounde with sich maner cloþis; & aftirward leie aboue þe ȝelke of an ey & oile of rosis medlid togidere, & aboute a defensif of bole armoniak tofore seid, til þat þe quytture be engendrid. & aftirward I contynue mel roset & oile of rosis in þe wounde, & aboue a mundificatif of mel roset & barly mele til þat þe ligament be fully engendrid on þe brayn panne, & þat þou schalt knowe whanne þat þou seest þe boonys ben ioyned togidere, as it were two bordis weren ioyned togidere with cole or with glu; & þanne I fulfille þe wounde wiþ drie þredis of clene lynnen clooþ, & aboue [folio 71b] a mundificatif, til þat þe boon be keuerid. Þanne I strowe on aboue þe capitale poudre tofore seid, & I leie on þe schauynge or ellis þe rasure of lynnen clooþ, & aboue al þis I leie on a treet of whiȝt rosyn; & I do alle þese þingis þat I haue seid tofore til þat þe wounde be consowdid /

& if ȝe make an obieccioun how þat it myȝte, wiþoute arerynge of þe boon, þe blood & þe quytture be dried, þe which þat fil doun bi þilke slendynge vpon duram matrem / I answere: riȝt as þe mater of þe frenesie & þe mater of þe litarge þat is more doutes, bi emplastris wiþoutforþ I-leie is dissolued, & þer is no slendynge of þe brayn panne, ne no wounde in þe skyn, myche more liȝtloker & more bettere þe blood, þat is liȝt & able to be resolued, þe which þat wente doun bi þe forseid slending, may bi þe forseid slendynge þe bettere be exaled. Ne þilke blood is not viscat in þe substaunce of dure matris, as þe mater is in empostymes, wherfore he is more obeisschaunt* — — to þe attraccioun of medicyns /

& if þe brayn panne be hurt wiþoute wounde [folio 72a] of þe skyn, þe which þou shalt knowe bi þe tokenes tofore seid / þanne summen kutte aboue þe hurtynge in þe maner of a crose, & þei areren þe .iiij. quarters, & þei kutten & fleen þe pannicle þat keueriþ þe boonis. & aftirward þei vsen trapanes & her oþere comoun curis, as it is schewid tofore / But I kutte not þe skyn in þe maner of a crose, but in þe maner of a scheeld or ellis of a þing þat is triangle in þis maner

[figure]

, & I make but oon quarter, & I vnwrie þe boon þat þe oile of þe rosis may peerse yn, & þat þe vertu of þe medicyn,

þat is maad of hony of rosis & oile of rosis, may drawe fro byneþe þe brayn-panne / & I do in þis caas al þing as it is declarid next aboue. & if ȝe make obieccioun aȝens me bi costantyne or ellis bi oþere, þat seien þat bi al oure myȝt we eschewen þat neiþer oile ne noon oyntuose þing falliþ not wiþinne þe brayn-panne / I answere wiþ auicen, þat seiþ: þat he worchiþ riȝtfulliche þat vsiþ teped oilis, & þe same tellen galion & serapion; & also I seie þat oile of rosis, þe which þat schal [folio 72b] be maad of grapis of olyue trees þat ben not ripe, is not oyntuose, but it is drie, & is clepid oile enfancinum; & namely whanne þat rosis ben medlid wiþ þilke oile, þilke oile haþ gete to him a swete smellynge & a drie þing of comfortynge animal spiritis; & also þat oile haþ a vertu expressif, as galion telliþ in þe book of symple medicyns, bi þe whiche þe brayn is comfortid & akþis ben swagid / & if þer be maad ony greet blood, it is maad sutil with þat oile; & whanne alle þese þingis ben congaderid & leid aboue duram matrem, it is clensid /

¶ Sumtyme þe brayn is meued of sum greet hurt eiþer of sum fallynge or of sum smytynge wiþoute ony wounde or wiþoute ony

breche of ony boon, þanne do þou as I dide to a chanoun of þe ordre of seynt austyn. Whanne þat he wolde haue lept vpon an hiȝ hors & haue seten in þe satel, þe hors areride vpon hise two hyndere feet, & þilke chanoun fel doun bacward vpon þe erþe vpon his heed; & al his bodi was brusid & namely aboute þe heed, þat anoon he loste þe meuynge and þe felynge of al his body / Þanne a lewid leche [folio 73a] þat was frend to þilke chanoun was clepid, & he cowde not helpen him, for he hadde neuere seen þe same caas, ne he cowde not no lettrure / & at þe laste I was clepid, & I foond him neiþer heerynge, ne spekynge, ne no þing meuynge, & I deemede him for deed / & neþeless I seide, & he were my broþer, I nolde not for an .C. mark, but I asaiede in him goodnes of þe helpinge of medicyns / for ofte tyme kynde wiþ good werkis helpiþ priuyliche þat semeþ vnpossible to a leche. & þei þanne preieden me with greet instaunce / & I made þe heeris of his heed to be schauen & þanne I anoyntide al þe heed wiþ. iij. parties of oile of rosis, & oon partie of vynegre hoot medlid togidere, & I castide aboue poudre of mirtillis, & leide aboue a sotil lynnen cloþ þinne, wett in þe same

oile & vynegre, & aboue þat towȝ smal tosid, & I boond al þe heed wiþ a boond, & aboue I leide a lambis skyn. & so I chaungide it þries ech day in anoyntynge þe nolle & þe necke into þe myddil of þe rigge-boon bihynde wiþ hoot oile of camomille / In þe ij. day he openede a litil hise yȝen, & he bigan to loke aboute [folio 73b] him as it hadde be a deef man þat were in a wondring / & þanne summe wolden haue asaied if þat he myȝte haue ete / & I wolde not suffre him to ete / & I seide þouȝ þat he wolde ete þat he schulde not / In þe iij. day I spak to him / he answeride me babelynge as a child þat bigynneþ to speke, but he myȝte forþ wiþ no word / In þe iiij. dai he spak boistousliche / & þanne I ȝaf him to drynke hoot ypocras þat is maad of sugre & of watir / In þe v. day he took þikke tiȝanne / In þe vj. dai I ȝaf him broþ of a chiken; and þanne he bigan to strenkþe litil & litil, & litil & litil to meuen / & neuer-þe-lattere he myȝte not walke not manye daies aftir. & whanne þat he myȝte take sufficiently mete, I comaundide

him to take pilulas chochias for to resolue bi euaciacioun þe matere þat I-gaderide togidere in þe heed bi þilke fallinge / & I comaundide him to ete ofte þe braynes of briddis heedis, & of hennys & of smale briddis & kedis / & in þis maner he was hool; neþeles he was neuere so sotil of witt as he was tofore /

In þis ben yuel signes as þe face to be to crokid, & þe yȝen to loke asquynt [folio 74a] eiþer crokidliche, apoplexie, crampe, to schite wiþoute felynge, & vnmouablete of alle þe membris outcept þe lacertis of þe brest þat moun be saaf / He þat rediþ þis book may chese aftir his owne wil oon of iij. weies þe whiche þat ben now vsid / Þe toon is þe wey þe whiche þat is seid in þe bigynnynge of þis chapitle, þe which wey manye vsen, & a leche of Ianewe þat is clepid anselme vsiþ þis wey, & þerbi he gate myche money / neþeles I wiste weel þat manye men dieden in hise handis bi þis wey / Þe secunde maner is in almaner hurtynge of þe heed to vsen terabracioun eiþer remeuynge of þe boon wiþ handliche instrumentis / þe iij. is my wey þe

which þat I haue told openliche in almaner caas / & I bileue, if þat he take hede to alle þese weyes & þat he wole wisely discussen alle þe opynyons of auctouris, þat he schal seen fewere die bi my .iij. wey þan bi ony of þe oþere .ij. weyes // Almyȝti god lede þe redere of þis werk in þe best wey, þoruȝ whos myȝtis, wordis takis sentencis & also vndirstondinge.

Þouȝ þat we han bihoten to tretyn of anotamie [folio 74b] of membris þat ben compound, in þe bigynnynge of eueri chapitle of þis secunde tretis, neþeles we leeuen it for þe bettere for to treten of anotamie of þe visage, to þe þridde tretise, where we schulden treten of sijknes þat comen to þese membris, þe whiche syknessis ben non woundis // // //

The secunde chapitle of woundis of þe face & anotamie of þe same.

Woundis þat ben maad in þe face, or þei be maad wiþ a swerd or wiþ sum dinge ellis þat woundiþ, or þei ben maad wiþ pricknyge of a knyf, arowe, eiþer spere. It is necessarie þat a surgian haue more diligence in þe woundis of þe face, for it is a place þat is myche seen, & it is wel to do make a sotil cicatrice / A wounde

þat is maad wiþ a swerd or wiþ sumþing semblable þat is alwei in lenkþe, a man muste sotilliche sowen & gaderen þe parties of þe wounde togidere / & for þat manye men liȝen of þe wounde of þe nose, þei seien þat oon bar his nose kutt of in his hond, þe which nose was afterward sett aȝen in his owne kynde; þe which is an open lesynge / For þe spirit of lijf of felynge & [folio 75a] meuynge passiþ, whanne a membre is depertid from þe bodi / I wole bigynne at a wounde of þe nose þat is kutt in lenkþe, þe which cure is liȝt to hele / Brynge þe parties togidere of þe wounde & sowe hem, & worche aboute þe wounde as I haue seid tofore in þe chapitle of woundis / & if þat þe nose were kutt ouerþwert doun to þe ouer lippe, & neþeles þat þe ouer lippe & þe nose were kutt al awey, but þat it held faste at boþe þe eendis of þe eendis of þe wounde, þanne sette aȝen þe nose in his propre place, þe noseþrillis ech aȝen oþir as þei weren toforn, & make two smale tentis of wex & putte on eiþir noseþrille aboue þe wounde, if þat þou maist, & þanne make a poynt bi þe space of a litil fyngre from þe oon eende of þe wounde, & anoþer poynt at þe oþere eende of þe wounde, & anoþir poynt in þe myddil of þe nose aȝen þe forheed; and aftirward a poynt on eiþer side of þe nose, aftirward make [a poynt]* bitwene eueri poynt, so þat þou haue in noumbre of alle þe poyntis

whanne þei ben ful maad, .ix. Caste þe poudre þat is tofore seid vpon þe wounde, þat is maad of [folio 75b] lime, frank encense, & sandragoun / & take þe white of an ey & oile of rosis, & bete hem togidere, & wete þerinne a lynnen clooþ & leie aboue þe wounde / Aftirward bynde* þerto þre plumaciols, oon vndirneþe, anoþer on þe oon side, anoþir on þe toþir side / & þanne bynde þe nose wiþ two bandis / Þe toon schal holde vp þe nose þat he may not discende dounward / þe toþir schal be leid aboue þat he mowe kepe þe plumaciols, poudre, & þe sowynge / & þilke boond þat is vnder þe nose þat halt þe nose vpward, schal be knytt aboue vpon þe heed, & aftirward he schal be turned ouertwert ouer þe forheed, þat he mowe holde þe boond, þat þe nose decline to neiþir side. & þe boond þat is leid aboue þe nose, schal be bounden bihynde in þe nolle / & aftirward he schal turne aȝen aboue þe nose, holdynge þe plumaciols þat þei moun not wagge to neiþir side aboute þe sowynge; & aboute þe forheed, þou schalt leie þe defensif of bole, & aftirward þou schalt worche on þe wounde of þe nose, as I haue seid in a wounde of fleisch in þe fourþe tretis /

Þe woundis þat ben maad in oþere parties of þe face [folio 76a] as wiþ a swerd or ony þing semblable, brynge hem togidere & sowe hem & cure hem, as it is conteyned in general chapitlis of woundis, takynge

hede herto þat þe sowynge þat is maad in þe face schal be more sotil & fairer þan in ony oþere partie of þe body / & þou maist make a sowynge in þe face, if þat þe wounde be not to myche, on þis maner / Take mastik, sandragoun & poudre hem & tempre hem togidere wiþ þe white of an ey to þe þickenesse of hony, & wete þerinne two pecis of lynnen clooþ as longe as þe wounde / & leie þe toon on þe oon side of þe wounde, & þe oþer on þe toþir side & lete hem drien / & aftirward make þe wounde sumwhat to blede, & þanne brynge þe parties of þe wounde togidere; & sowe þilke .ij. pecis togidere, & caste aboue poudre of lyme, frankencense, sandragoun tofore seid, & wete a cloþ in þe white of an ey & oile of rosis, & leie aboue al togidere, & kepe þe partiee wiþ ligature & prosede forþ in alle þingis as I haue tofore seid /

& if þat þe wounde be maad wiþ a dart or wiþ an arewe & þe arowe be drawe out & þe wounde be myche sene, þanne þe cure is [folio 76b] þe same þat was seid in þe same chapitle or elles in þe firste tretis, wheþer þat þer be a senewe prickid eiþir noon. But if þe arowe heed were entriged in ony priuy place of þe face, so þat it myȝte not be seen, þanne euery man bisie him to knowe bi his witt how þat þe sike man stood, whanne þat he was smyte, & whens þat þe arowe cam, & to what partie þe wounde strecchiþ, þat he mowe loke

if þat he mowe fynde ony maner wey how he may drawe out þilke arowe-heed; & þanne drawe him out þe best maner wey þat he may / & if he may not, heelde he in þe wounde oile of rosis & þe ȝelke of an ey togidere medlid; & wiþ þis medicyn worche in þe wounde, til þat kynde schewe sum maner wey / Manye men han born an arowe-heed in þe parties of her face bi longe tyme; & after longe tyme kynde haþ cast out þe arowe heed, or ellis he haþ schewid sum wey bi þe which wey þilke arowe-heed myȝte be taken out. & þou must take hede bi al þi miȝt þat, whanne þat þou sowist þe woundis of þe face, þat þe mouþ be not crokid, but make so sliȝly þi sowynge þat þilke accident may [folio 77a] not fallen; & þat þou maist do weel, if þat þou cowdist ordeyne weel þi sowynge / & if þat þou canst, kepe weel þi sowynge wiþ plumaciols and wiþ byndyngis // // //

The þridde chapitle of þe secunde tretis is of woundis of þe necke & anotamie of the same.

Bi þe necke is conteyned al þe place þat is bitwene þe heed & þe schuldris, þe which anotamie I wole telle as I haue bihiȝt / Summen maken difference bitwene þe necke & þe wesaunt & þe

þrote-bolle, & alle þese ben comprehendid vndir þe name of þe necke. In þe necke þer ben .vij. spondelis þat is to seie whirlboonys / whirlboonys of þe rigge. Þe firste of þe boonys is bounde wiþ a boon of þe heed þat is clepid passillare with manye smale feble ligamentis; & þei were feble bi-cause þat þilke ioynt next to þe heed myȝte meue many weies. & þe cause whi þat þer were smale ligamentis multiplied in þat ioynt, þat manye smale myȝten susteyne a greet burþun as weel as a fewe greete; & if þat þer were a fewe greete, þei weren not so able to be meued / Þe firste spondile [folio 77b] is bounde to þe secunde / þe secunde to þe þridde, þe þridde to þe fourþe / þe fourþe to þe fifþe, þe fifþe to þe sixte / þe sixte to þe seuenþe / þe seuenþe is bounde loseliche to þe firste spondile of þe rigge, þat þe necke myȝte more liȝtliche meuen, which þat is clepid þe .viij. spondile / whanne þat þou rekenest [from þe hed dunwarde]* Seuene peire of senewis proceden out [by þese .vii. spondelis. Þe firste peire of synwe procedeþ out]* bitwene þe firste spondilis and þe boon of þe heed þat is clepid passillare / Þe secunde peire of senewis is bore bitwene þe firste spondile & þe secunde, & so euery peire passen out bitwene ech spondile / Þese senewis ben

dyuydid in many weies bi þe heed, þe necke and þe face, & þe brest, schuldris & þe armes; þe braunchis of þe senewis of þe heed in sum place ben conteynued & ioyned with þese senewis / & þese senewis ben clepid meuynge, riȝt as þe senewis þat comen of þe fore partie of þe brayn ben clepid felynge, & þese han also felynge. Of þese senewis þat comen of þe spondilis of þe necke þere ben maad braunnys, þe whiche ben instrumentis of meuynge of þo parties. In [folio 78a] þe necke bihynde, þere ben ordeyned open veynes comynge fro þe lyuere þe whiche þat ascenden into þe heed / & vndir þe veynes þer ben arteries priuyliche comynge fro þe herte & goynge to þe heed for notable profitis. & whanne þat þei han doon al her office in þe heed þei discenden doun bi þe place þat is bihynde þe eeris & þei bringe partie materie spermatife: þat is to seie mater of sperme, doun to þe ballokis / & þerfore it is seid if þat þo veynes weren kutt, a man schulde neuere engendre / On þe riȝtside & also on þe liftside of þe necke ben ordeined. ij. nollis whiche ben of ligamentis matire, þe whiche proceden out of þe

boonys of þe heed & of þe spondilis, & þei strecchen doun to þe eeris in lenkþe biside þe spin boon, & þei ben a couche & a restynge place to þe senewis þat comen out of þe nucha. In þe fore partie of þe necke þere is gula, þe which þat strecchiþ from þe chyn doun to þe forke of þe brest; & bitwene þe necke & gula wiþinneforþ þere is ordeyned mary, þat is to seie þe wesant; þe which þat discendiþ of a smal skyn enuerounnynge [folio 78b] al þe mouþ wiþinneforþ & so goynge doun to þe stomak, & he is hool & conteyned wiþ þe stomak, & is of substaunce of þe same stomak, & he discendiþ doun bi þe hyndere partie of þe necke cleuynge to þe spondilis til þat he come to þe fifþe spondile of þe rigge; & þere he is departid from þe spondilis, & he declineþ into þe ynnere partie til þat he peerse þoruȝ þe mydrif, & is compounned of .ij. panniclis, & in þe ynnere clooþ þere ben braunnys in lenkþe bi þe whiche drauȝtis is maad of mete & of drynk, & þe vttere clooþ þere ben brawnys in brede bi þe whiche is castynge out of superfluytees; & he haþ noon transuersarie, þat is to seie goynge ouerþwert, for wiþholdynge is not nedeful to him. & in þe fore partie of þe brest þere is sett þe canne of þe lungis, þe which is compounned of gristil ryngis bounde

togidere wiþ pannicleris ligamentis, hauynge in þe ynnere partie a ful smeþe pannicle ioynynge togidere þilke gristili ryngis. & þilke ryngis whanne þei ben ioyned wiþ merie, þei ben defautif aȝens þe merie / & þe foorme of þe canne of þe lungis is* as it were þe foorme of a cane, [folio 79a] þat is to seie a rehed, of þe which rehed þe fourþe partie were kutt awey in lenkþe, & aftirward þilke caane is wrie with a sotil clooþ þat whanne þat a greet mussel of mete passe doun bi þe merye, he schulde not haue lettinge, but þilke pannicle of merye ȝeueþ stede to þe greet mete passynge doun to þe stomak. Þe þrote-bolle is maad of iij gristlis, & is sett aboue þese two weies. & boþe on þe riȝtside & on þe lift side of þe caane of þe lungis þer ben ij. greete veynes þat ben clepid organice or ellis guydes; & vndir þe veynes þer ben greete arteries, & of þe kuttynge of þilke veynes & arteries þer comeþ ofte tyme greete perels, & sumtyme deeþ; for þe grete affenite þat þei han wiþ þe herte, and þe greet noyousnes þat þei han to þe lyuere, bi hem sonner blood is euacued, wherfore spiritus exaliþ, þe whiche þat ben

freendis boþe to þe body and also to þe soule / Þe ligament of þe þrote is clepid emanence eiþir þe heiȝþe of þe epiglote, & in þe sidis of þe þrote þere is sett gula. & þe goynge of brawnys, senewis and cordis, veynes & arteries & her braunchis bi [folio 79b] parties of þe heed proceden aftir þe ordour of eeris, & þei ben ordeyned in þe necke & in gula aftir her lenkþe. & herbi þou maist se þat it is necessarie a surgian to make hise kuttyngis & hise brennyngis bi lenkþe of þe necke & of þe þrote, & þat þe woundis þat ben maad ouerþwert ben more perlous, þan þo þat ben in lenkþe /

Now we wolen tretyn of woundis þat ben maad in þis place, wiþ a swerd or wiþ sum þing semblable to him, or wiþ an arowe or sum þing semblable to him. & if it be wiþ a swerd, eiþir it is ouerþwert eiþir in lenkþe / & if it be ouerþwert & þere be kutt greete veynes eiþer arteries, it is to dreden. Neþeles þou schalt helpe to staunche þe blood & consowde þe veyne, aftir þe techinge tofore asigned in þe chapitle of flux of blood. & if þer be a senewe kutt, þanne brynge boþe parties of þe senewe togidere & sowe þe pelliclis of þe senewe wiþ þe sowynge of þe woundis, as I haue tauȝt tofore in þe place of sowynge of senewis, & leie aboue lumbricus of þe

erþe, þat beth erþe-wormes staumpid & boilid wiþ oile of rosis, & kepe þe sowynge [folio 80a] with byndynge, & so procede forþ in al þing of þe cure, as it is told in þe chapitle tofore schewid / & if þat þe wounde were in lenkþe, it is not necessarie but for to sowe þe wounde & caste aboue þe poudre of lyme, frankencense, & sandragoun, & kepe þe poudre & þe sowynge wiþ byndynge, til þe wounde be ful consowdid / & if þe wounde were maad in þe parties wiþ an arowe or wiþ a knyf, or with a spere or sum þing semblable to hem, & if þer be an arowe, drawe him out; & if an arowe be drawe out, loke if þer folowe emorosogie, þat is to seie, a greet flux of blood, & þanne staunche it aftir þe doctryne þat is told tofore / & if þer be no flux of blood, loke if þer be akþe / & if þer be acþe, putte in þe wounde a litil tent þat may holde þe wounde open al a day, þat þou maist seen þat þe woundid man schal haue noon acþe / & if he haue noon acþe, lete þe wounde be consowdid; for sumtyme it happiþ, þat an arowe or sum þing semblable passiþ þoruȝ þe necke & þe þrote, & he touche not þe senewe, arterie, ne veyne, & þanne it nediþ not but þat þe wounde be [folio 80b] consowdid. & if þer were akþe eiþer bigynnynge of swellynge, þanne it were necessarie to fulfille þe wounde wiþ hoote oile of rosis & to putte in a tente not to

greet, wet in þe ȝelke of an ey & oile of rosis hoot, & so holde þe wounde open, til þat he ȝeue quytture, & aftir clense him & aftir consowde him / Vndirstonde þe perilis þat comen for [wondys]* þat ben maad in þis place / Þe firste perel is: if þat þe necke be kutt ouerþwert wiþ a swerd, so þat þe necke-boon & þe marie of þe necke-boon be al atwo, it is deedliche. & if þat nucha, þat is mary of þe necke boon, is not kutt al atwo but is hurt, it is perile of lesynge, felynge & meuynge, & at þe laste be deed, but if þat medicyns þat I schal telle moun helpe / & if þat ony veyne or ony greet senewe be kutt ouerþwert, I suppose þat he be heelid, þe necke schal neuere haue his free meuynge; & if þat ony of þe veynes organik, þe whiche þat ben clepid guydes, or ellis ony of þe arteries þat ben vndir hem be kutt, it is drede of sodeyn deeþ, for sodeyn exalacioun of þe spiritis & also for affinite of þe herte; & also if þat þe cane of þe lungis be kutt ouerþwert [folio 81a] al atwo, for þe more partie it is deedliche / Also it is seid, þat if þe veynes þat ben bihynde þe eeris bee kutt al atwo, he ne schal neuere engendre. And also sumtyme it is kutt eiþir prickid þe senewe þat is clepid reuersif, þat is vndir boþe sidis of þe eere, of þe whiche kuttynge or prickynge euermore is maad hosnesse / And if þat þe places

ben peersid with an arowe, & þouȝ þat trache arterie be peersid or ellis ysophage, so þat nucha be nouȝt prickid bi þe mydle, þanne ȝitt he may be heelid wiþ gode medicyns & acordynge.

Þou schalt helpe nucha þat is hurt in þis maner: þou schalt helde into þe wounde, in þe bigynnynge, oile of rosis, & aftirward do yn oile of rosis & ȝelke of an ey medlid togidere, and þou schalt be bisy in al maner to aswage akþe; & whanne þat quytture is maad, þanne leie a mundificatif wiþ medicyns comfortatiuis & incarnatiuis maad in þis maner / Take oile of rosis colate [dram] .iiij., wex, rosyn of ech two dragmis, terbentine .iij. ȝ, frankencense, mastik of ech .i. ȝ, mirre, sarcocol, mummie of ech [dram] .[one half]., barly mele [dram] [one half]., streyne it on a clooþ & [folio 81b] leie it on þe nucha þat is hurt. & þei þat hereof pronosticacioun schulde go tofore, þe which schulde schewe to yuel, neþeles bi þis medicyn þer comeþ a rectificacioun to þe nucha, & melioracioun of meuynge of lymes, þat ben byneþe þe place of þe nucha þat is hurt, more helpinge, þat semeþ possible to þe leche. For þer is no þing vnpossible to stalworþe nature; namely, whanne þat it is holpen wiþ a good leche & wiþ þingis, þat ben

helpinge & acordynge to a good intencioun / Here vndirstonde þat al maner wounde þat peersiþ to þe substaunce of þe brayn or ellis to þe nucha, so þat bi þer hurtynge of þe nucha þe meuynge & þe felynge of summe lymes ben lost, nameliche from þe whirle-boonys of þe rigge, of þe reynes vpward, & al maner wounde þat is maad in þe extremitees of þe lacertis as .iij. fyngir mele brede vndir þe schuldris, eiþer .iii. fyngir mele brede aboue þe elbowe eiþer byneþe, eiþir .iij. fyngir mele aboue þe kne or byneþe / & ech wounde þat is in a senewe place with strengest akþe & hardnes, [folio 82a] schal be deemed deedlich, for þe nobilte of þilke brayn, & for þe affinite of þe nucha wiþ þe brayn, of þe which nucha passiþ as a reuere from a welle, & for þe affinite of þilke senewe wiþ þe brayn bi mene of nucha, of þe whiche þei passen out as a flood / Wherfore þou schalt euermore in sich maner woundis pronosteken deth, & euermore fle as miche as þou myȝt from vnresonable curis, but if þou be with þe more instaunce y-preied / Neþeles sumtyme nature wiþ good helpinge worchiþ þat semeþ to þe leche vnpossible, neuer-þe-lattere loue noon sich [cures]* but if þou be greetliche preied & þanne entermete of þe cure of þe sike man //

The .iiij. chapitle of þe .ij. tretis is of woundis of þe spaude, schuldre, arm, handis, fyngris, brawnys, veynes, & her anotamie /

Þe spawde is oon of þe iiij. boonys, þe which þat makþ þe foorme of þe schuldre / & þe spawde-boon is þinne & brood twoward þe schuldris & in hise endis gristly. On þe vpper side of him he haþ an egge sumwhat greet & twoward þe arm [folio 82b] in þe place of þe schuldre he is greet & round; & þilke eende is holowe as a box, & þis boon is lich to a pele wiþ þe whiche men setten breed into þe ouene, & on þe hyndere partie of the schuldre he haþ an eminence. & in þe box of þis boon — — þe which is clepd adiutorium; þe which is oon boon sumwhat crokid, greet & holowe / Þis boon is greet for necessite of strenkþe, & of schap holowe, þat he were liȝt, þat he schulde not þoruȝ his heuynes lette þe worchinge of lacertis, & þe round extremite of þis boon entriþ into þe holownes of þe spawde. & þei ben bounden togidere wiþ a bowable ligament. Þe canel-boon of þe brest is in þis maner maad, hauynge

an additament sumwhat round in þe neþer partie, þe which entriþ a maner box, þe which is in þe ouer partie of þe ouer boon of þe .vij. boonys of þe brest. Euery extremite of þilke vij. boonys ben ioyned with þe spawde, þat þe schuldre myȝte be þe more strengere, & forto make þis place more strengere, þer ben sett .ij. smale boonys, þe whiche ben clepid rostralia to þe lijknes of þe bele [folio 83a] of a crowe, & for to fastne þe schuldre, þis boon rostral is putt in maner of a wegge / But þe boon of þe adiutori haþ in þe neþer partie twoward þe elbowe .ij. eminentis, & þe oon of þe eminence is more hiȝere þan þat oþer; & boþe þese eminence ben as þei it were holf a boket wiþ þe which men drawen watir / & þilke .ij. additamentis ben ioyned wiþ þe boonys of þe arm / Þe arm from þe elbowe dounward haþ .ij. bonys; & þe ouer boon, þe which þat arecchiþ fro þe þombe to þe boon þat is clepid adiutorium, is þe smallere boon; & þe neþir boon þat strecchiþ from þe litil fyngir to þe elbowe is þe grettere boon. & he haþ in þe ouer ende twoward þe elbowe an additament lijk twoward a bille or a pike; & þilke pike makiþ þe elbowe scharp whanne þe arm is folden, & it lettiþ þat þe arm may not be bowid [bakwarde]*.

Þese .ij. boonys ben so ioyned togidere, þat it semeþ as þouȝ it were but oo. boon. & þe neþir ende of þese boonys ben ioyned with þe boonys of þe hand, þe whiche ben clepid rasceta, þat ben .viij. boonys, .iiij. of [folio 83b] hem ben ordeyned & ioyned with summe additamentis to þe .ij. boonys of þe arm / & þe oþere .iiij. ben conteyned with þe boonys of þe hand þat ben clepid pecten / Þe firste boon of pecten is ioyned with þe first boon of rasceta, & þe oþere .iij. in þe same maner outaken þe þombe. —— þat haþ .iij. boonys as þe oþere fyngris han, conteyneþ his firste boon wiþ þe extremite of þe ouer fosile, & þe þombe euenliche aȝenstondiþ þe strenkþe of þe oþere fyngris in clicchinge. & alle þese boonys þat mencioun is maad of, þat ben in ioynturis, as þe schuldris, elbowis, raschet, & þe knottis of alle þe fyngris, ben ioyned togidere bi mene of ligamentis, as it is seid tofore / & þese boonys ben cloþid wiþ symple fleisch & brawnys after þat þe dyuersite of foorme of lymes askiþ /

& alle þe greete senewis proceden out of nucha, þe whiche senewis ben conpounned wiþ ligamentis & wiþ symple fleisch, makynge brawnys meuynge þo parties; of þe whiche brawnys summe ben open to a mannys siȝt, & summe ben hid; for þei ben departid in two [folio 84a] þe leeste parties / Þere ben .iiij. brawnys open in þe fleischy partie of þe arm, bitwene þe schuldre & þe elbowe: oon on þe ynnere half, anoþir on þe vttere half, anoþir on þe lowere half, anoþir on þe hiȝere half. Whanne þe ynnere brawn is drawe togidere þanne is þe arme foldid ynward, & þe contrarie brawn on

þe vttere half is maad long; & whanne þat þe vttere brawn of þe arm is maad schort, þanne is þe arm drawe outward & þe ynnere is maad long; & in þe same maner by oþere .ij. brawnys, þe arm is houe vp & lete falle doun / & whanne þat alle þe brawnys traueilen liche myche, þe arm stant euene riȝtliche & declyneþ to no partie / & þese brawnys, .iiij fyngir mele from þe ioynture of þe schuldre, ben nakid cordis, & þei ben þe same from þe ioynture of þe elbowe & in þe myddil of þe adiutorie, þat is þe place þat is from þe schuldre to þe elbowe; þe cordis ben multiplied dyuersliche wiþ fleisch to þe composicioun of þe same brawnys, .iij. fyngir mele aboue þe elbowe. & .iij. fyngir mele byneþe [folio 84b] þe elbowe ben nakid cordis; & þere þei maken anoþir brawn; & in þis maner ben maad nakid cordis & generacioun of brawnys, til euery lyme haue his meuynge, after þat it nediþ him.

In boþe þe armes ben .iiij. open veynes þat comen from þe lyuere, & ben scharpeled þoruȝ þe arm. For þere is a braunchid veyne þe which wexiþ on þe vttere partie of þe lyuere, & is dyuydid in two parties: oon arisynge, anoþir discendynge; þe veyne arisynge comeþ to þe mydrif; & sum partie of hir is sparpoiled þoruȝ þe mydrif & þe lymes of þe brest / þat oþere partie of þe veyne passiþ to þe arm-hoolis, & þere he is forkid. & þat veyne passiþ byneþe the arm to þe elbowe, & þere sche may be seen; & he is clepid basilica or ellis epatica, & aftirward he strecchiþ bi þe neþir partie of þe arm to þe hond, bitwene þe litil fyngir & þe leche fiyngir, & sche is clepid saluatella or ellis epatica in þe riȝthond, & in þe lifthand splenatica. Þe toþir partie of þis veyne þat is dyuydid fro þis assellari strecchiþ to þe vttere partie of þe schuldre: & þere is

[folio 85a] dyuydid. & þe oon partie goiþ to þe heed & þe oþir partie to þe arm. & þilke is eftsoones dyuydid, & þe oon partie is spred bi þe arm manye weies wiþoute forþ, þat is clepid funis; & þe oþere partie strecchiþ euene to þe elbowe, & þere sche is schewid bi þe ouer partie of þe arm; & so sche strecchiþ to þe hand, & þere sche apperiþ bitwene þe fyngir and þe þombe, & is clepid cephalica. ij. braunchis þat ben diuided þat comen fro þe schuldre, þe toon is cephalica, þe oþere from assillari, þat is basilica, maken oon veyne þat is clepid mediana eiþer purpurea. & þere ben .iiij. veynys, as it is seid bifore, scilicet, finis brachij þat strecchiþ bi þe vttere partie of þe arm, & sephelica þe which þat strecchiþ bi þe ouer partie, & basilica þat strecchiþ bi þe lower partie & communis seu mediana seu purpurea seu fusca quod idem est is comun veyne eiþir myddil veyne, þe which þat is compouned of basilica & cephalica tofore seid, & sche apperiþ openliche in þe foldynge of þe myddil of þe arm. // ¶ Þe veynes þat comen from þe lyuere han manie departingis [folio 85b] & dyuers placis, & for to telle alle þe departyngis, it is not profitable for a sirurgian / Saue it suffisiþ for a sirurgian, for to knowe in what place þe grete veynes sitten & þe arterijs, so þat he mowe saue him-silf from perel & helpe hem, whanne þei ben kutt / Þis þou schalt wite, þat from þe lyuere þer comeþ a veyne to euery lyme bicause of nurischinge. & for to make þe lymes ful of lijf, Arterijs comen þerto also. & þerfore in euery place þere þat ben grete veynes, in þe same place ben arterijs.

¶ Bi þes þingis þat ben aforseid, þou maist wite wel þat þere comeþ greet perel of woundis, þat ben aboute þe schuldris & vndir þe arme-pittis, & in þe boon of adiutorie, & in þe arm, & in þe hondis / for whi: if woundis be maad in adiutorijs & in þe arme ouerþwert, it is greet perel lest þe braun be kutt awey, wherby þe arme schulde haue his meuynge; & it is perel of kuttynge of veynes and arterijs, lest þe blood myȝte not be staunchid. ¶ And if it be maad a wounde with a þing þat prickide, & falle vpon a

corde þat is in þe [folio 86a] ende of þe braun, & is clepid thenantos, þanne it is greet drede of þe spasme & aftirward of deeþ, for þe akynge entriþ in þe corde þat is prickid, & so þe akynge arisiþ vp to þe brayn, & þanne comeþ spasme. ¶ Also it falliþ many tyme þat a man is hurt þe brede of iij. fyngris wiþinne aboue þe elbowe, þer is þe eende of þe braun & þere ben cordis; & þanne þer wole come greet akynge, & þanne þe spasme aftir, & þese woundis ben mortal.

¶ If þat wounde be maad endlongis in þe arme & in adiutorio, þanne it is not so greet drede þerof, þerfore it is necessarie for a sirurgian to knowe þe perel of woundis þat falliþ in þis place, & wheþer þe wounde be ouerþwert or endelongis. & if þe wounde be endelongis, þanne he schal ioyne þe wounde togidere & sewe hem, & sprynge þeron þe poudre of lyme & oþere þingis, as it is aforeseid, for to kepe þe sewyngis & þe ligaturis togidere & alle þingis as it is aforeseid in þe wounde of fleisch. ¶ If þer be ony nerues, or arterijs, ouþer veynes kutt [folio 86b] ouerþwert: þanne þou schalt worche with þingis þat streyneþ blood, & þou schalt sewe þe hedis of þe nerues togidere or of þe cordis. & þe pacient schal be kept from akynge wiþ good kepinge & with reste, & he schal ligge in an euene bed. & þou schalt leie aboute þe wounde a defensif of bole & of oile of rosis þat is aforseid / And þouȝ þis defensijf be forȝete in oþere woundis, in þis wounde it may not in no maner. ¶ Þou schalt kepe þe sewyngis & þe ligaturis with poudre & lynet, as it is aforseid / Also þis þou must knowe if þou sewist sich a maner wounde of nerues & cordis, & if þe akynge go not awey, þou muste rippe þe sewynge aȝen, & þouȝ þis be contrarie to þe soudynge of þe nerues, ȝitt it is bettere to do þus, þouȝ he lese þe meuynge of sum lyme, þat þe nerue seruede þerfore, þan falle in þe spasme; for þanne it were drede of deeþ / Þerfore it is necessarie for to opene þe wounde & fille it ful of oile of rosis & of ȝelke of an ey. & vpon [folio 87a] þe wounde leie of þe same medicyn til þe wounde quytture, & þanne make þe wounde clene with mundificatiues, & þanne regendre floisch as it is aforseid // If it be so þat þere come ony hoot apostymes vpon woundis in þis place: þanne þou schalt worche as it is aforseid in a propre chapitre // If it so be, þat þou leie vpon þe wounde oile of rosis, & ȝelke of an ey for to do awei þe

akynge, & if þere falle a flux of blood, & þanne if þou leidist þerto ony constreyning þingis, þe akynge wolde be þe more, & if þou leidist þerto þe ȝelke of an ey & oile, þat wole make þe flux of blood þe more—In þis caas what is for to done? Þou schalt brenne þe hedis of þe veynes & of þe cordis with an hoot yrn, but þou schalt not touche þe lippis of þe wounde wiþ iren in no maner; & þanne þou schalt leie in the wounde þe ȝelke of an ey & oile of rosis, til al þe rynde of þe brennyng falle awei. & þanne þou schalt leie þerto mundificatiues, & þanne þou schalt regendre fleisch, and þanne þou schalt soude þe wounde /

[folio 87b] Of woundis of thoracis & of þe brest & of þe membris þat ben conteyned in it, & anothamia.

Thorax is maad of .vij. boonys & euery boon at þe eende is cartilaginosum / Þese .vij. boonys ben ioyned togidere in þis maner þat euery leeneþ vpon oþir, & wiþ þese .vij. boonys ben maad fast .vij. ribbis þat ben grete ribbis, & þo .vij. ribbis ben maad fast in þe rigge boon bihynde, & þese ribbis ben crokid / Wiþinne þese .vij. ribbis ben v. ribbis þat ben lasse, & ben clepid litil ribbis, & ben maad fast bihynde with .v. boonys of þe rigge, & in þe forside of a man þei haue no fastnynge to no boon, saue þei ben maad fast with lacertis. & bitwixe þe .viij. boon & þe .ix. boon, diafragma is maad fast, for to bigynne tellyngis of boonys aboueforþ. & þis diafragma departiþ þe spirituals from þe guttis. & in þe holownes þat is aboue liggiþ þe herte & þe lungis /

Þe herte [folio 88a] is maad of hard fleisch & strong & of lacertes þat þei miȝte be hard, þat it ne schulde take a greuaunce liȝtli. & þerfore summen seiden þat it is al braun; but it is not so, for þe braun of a man meueþ whanne he wole, & restiþ, & þe herte is alwei meuynge & not reste. & þe herte is schape aftir a pyne, & hangiþ in þe myddil of þe hiȝere holownes, & hangiþ sum-what to þe liftsideward; & þe hiȝere þerof is brood, & þat place is medlid wiþ cartilaginosis ligaturis, & is maad fast in þe lungis; & þe lungis touchiþ not þe herte, saue in þe aboue, þere it is maad fast togidere,

& þe lunge defendiþ þe herte from greuaunce. & þe herte haþ two ventriclis .i. two holowe placis wiþinne, & þat oon ventricle sittiþ in þe riȝtside of þe herte, & þat oþer in þe liftside; & þese ventriclis holdiþ & resseyueþ eir & norischiþ þe herte / In þe riȝt ventricle comeþ a greet veyne þat is clepid ramosa þat comeþ from gibbo epatis, & comfortiþ diafragma, & peersiþ þoruȝ diafragma. & þis veyne is ful of greet [folio 88b] norischinge blood & hoot, & it norischiþ lymes of greet substaunce. & þis veyne goiþ bi þe riȝtside of þe herte, & filliþ þe herte ful of norisching blood. & þanne þe blood in þe herte sutilliþ & filliþ ful þe two ventriclis of þe herte, & of þis clene blood þe spirit is engendrid; which spirit is more cleer & more schynyng & more sutil, þan ony bodi þat is maad of þe iiij. elementis. & þerfore it is turnid into heuenly bodies, & it is bitwixe a mannys bodi & his soule a louely byndynge. ¶ And of þe lift ventricle þere wexiþ out ij. [arteries] and þat oon þerof haþ a maner coote, & þerfore of summen it is clepid arteria venalis. & þis arterie beriþ sutil blood to þe lungis & norischiþ þe lungis / And þat oþere arterie haþ .ij. cootis. & of þe ilke comeþ alle þe arteries in a mannys bodi, & ben departid in euery lyme of a mannys bodi. & þese arterijs makiþ alle a mannis lymes to haue lijf & spiritis; & alle þes arterijs & alle þese spiritis þat ben aforeseid; and þese arterijs goiþ to þe brayn [folio 89a] & þei goiþ to þe lyuere & ȝeueþ him vertu ful myche & makiþ defiynge / And þese arterijs goiþ to a mannys ballokis & ȝeueþ him vertu for to engendre; & in þis place þe vertu of alle þe spiritis of a mannys bodi ben ioyned togidere.

¶ Þe lungis ben maad of .iij. substauncis: of fleisch þat is recchinge, & braunche of arterijs, & of veynis, & of cartilaginis þat ben holow, & þese goþ out of canna pulmonis as it is aforeseid. ¶ Þe profit þat þe lungis doiþ a man is þis: þe lungis drawiþ eir into þe herte, for to do awei þe fume & þe vntemprid heete of þe herte, & makiþ þe herte in tempre hete / And in tyme whanne þe herte is constreyned, þanne it is necessarie for to drawe coold eir to þe herte; & if þe lungis myȝte not drawe eir to þe herte, þe spirit of lijf schulde be stoppid, & so a man schulde be deed / & þerfore it is necessarie þat a man haue clene eir, for þe eir passiþ þoruȝ þe lungis þat ben tendre & goiþ to þe herte; & þerfore vnclene eir doiþ harm to þe lungis & also to þe herte. & þerfore þe lungis ben [folio 89b] departid into .ij. placis, & if þer falle ony harm to þe oon partie of þe lungis, þanne þat oþere partie beriþ al his charge //

¶ Woundis þat ben maad in þe brest. If þe wounde go into þe holownes, þanne it is miche to drede þerof, for þanne it miȝte falle þat sum substaunce of þe herte miȝte be harmed, & þanne þe wounde were mortal // ¶ Ouþer if þe wounde ȝede into þe lungis, þere were greet perel: for þe wounde mai not be helid but if it be soudid anoon // ¶ And if þe wounde go þoruȝ diafragma, it is mortal / And if it be so þat þe herte be hurt, þere lijþ no cure þeron, saue he schal die anoon; for þe herte takiþ no lijf of no lyme of al þe bodi, saue þe herte ȝeueþ lyues to euery lyme of þe bodi; & þe herte ordeyneþ alle lymes to vertues, & þe herte is þe welle of lijf; & þerfor þe herte mai suffre noon harm, saue ioie ouþer sorowe / Þerfore if þe herte be kutt wiþ a swerd ouþer ony greet arterie þat is nyȝ þe herte, þe wounde is mortal; for þe arterijs goiþ to þe herte [folio 89*a] & þanne al þe blood of þe herte & þe spirit passiþ out bi þe arterijs, as þou myȝt se bi ensaumple of a candel. For if a candel þat brenneþ, ouþer a weke, be putt al in oile ouþer in grese, þe fier þerof wole out; in þis same maner is þe spirit of lijf queynt, whanne þe herte is hurt, for þe greet flux of blood, þat falliþ to þe herte & stoppiþ þe spirit of lijf / Ouþer if þer be greet flux of blood comynge fro þe herte, þanne þe spirit passiþ out þerwiþ; as þou miȝt se bi ensaumple of a candel: whanne þe talow of a candel is doon, or wex, or oile, þanne þe liȝt wole passe, & in þe same maner it

fariþ bi a mannis lijf, as it is aforseid. ¶ Þe lungis wolen take no souding whanne þei ben hurt, but if þe leche be þe more kunnyng & soude þe wounde or it quytture. For if it qutture, þe lungis moun not be maad clene but wiþ cowȝyng, & þe more þat þe pacient cowȝeþ, þe more þe wounde wexiþ // ¶ Also þe lungis ben euermore meuynge; & [if] woundis schulen be soudid in lymes, þe lyme [folio 89*b] mote reste; & þerfore for þe contynuel meuynge of þe lungis, þe woundis þerof ben seid incurable // ¶ Also þouȝ a man wolde soude þe woundis of þe lungis wiþ ony medicyne þat is consolidatif, it ne mai not come þerto but bi a long wey as bi þe stomak, ouþer bi þe lyuere, ouþir bi veynes, & so þe vertu of þe medicyne ne may not come to þe lungs, but bi þe forseid weies; & þerfore men þat ben hurt in þe lungis falliþ in þe tisik / ¶ If a man be hurt in diafragma, þer is no remedie þerof; for diafragma is alwei meuynge, for þat is an instrument of wijnd to the herte, riȝt as a belowe is an instrument for a fier / For riȝt as a below, whanne he is opened, he takiþ in wijnd, & whanne he is closid, he puttiþ out wijnd & blowiþ þe fier /

¶ If þe herte be woundid, in þis maner þou schalt knowe: þe pacient schal swowne, & þe blood þat comeþ out is blak, & he schal siȝe sore, & þanne he is but deed //

¶ If þe lungis ben hurt, þou schalt [folio 90a] knowe in þis maner bi cowȝynge, & þe blood þat goiþ out of þe wounde wole be spumous & cleer / If þe wounde hereof be streit wiþoutforþ, make it largere, & þanne in þe wounde of þe lungis caste poudre of mastix. & olibani, draganti, gumme arabici, fenigreci ana; & he schal ete no mete saue þat, þat he mai soupe, & penidis medlid þeron, & loke þat he haue scielence & good reste, & þat he traueile not; & þou schalt not close þe wounde wiþoute, til þe wounde of þe lungis be sowdid, & þanne soude þe wounde wiþoutforþ //

¶ If þat a wounde be in diafragma, þes ben þe signys þerof: streit secchinge of breeþ, & greet agreuaunce for to drawe his breeþ, & greet akynge in his side, & greuous cowȝyngs; alle þese ben signys of deeþ, & principali if þese signys be greet & greuous /

If þese signys ben but litil & not strong greuous, þanne ȝeue him metis & drynkis þat mowe swage þe cowȝe, & þanne take a tent þat be not to greet, & wete it in þe ȝelke of [folio 90b] an ey & oile of rosis, & þanne cure þis wounde as þou doist oþere woundis /

If it so be þat a wounde be in a caua & noon of þe forseid lymes ben not hurt, þanne wete a tent in oile of rosis hoot & putte in þe wounde; & whanne þou remeuest þi medicyne ouþer leist þerto ony medicyne, be war þat þer passe out noon eir þoruȝ þe wounde, ne entre in noon eir into þe wounde, & þerfore or þou chaunge þi tent, loke þat þou haue þingis þat ben necessarie þerfore redi, þat þe wounde mowe be stoppid anoon, þat þere go no breeþ into þe wounde, ne out of þe wounde / For if þer go ony breþ out, it wole afeble þe patient, & if þer go ony breeþ þere, it wole do harme to þe spaulis. Leie vpon þe wounde oile of rosis & þe ȝelke of an ey, & herwiþ wete þi tent til þe wounde quytture. & þanne euery dai make him to turne vpon his side, & make him cowȝe & spitte out þe quytture, & avoide þe quytture bi þe wounde also. & if þere be myche quytture, & may not be avoidid bi þe wounde, þanne þou schalt make sich a maner waischinge & putte it yn wiþ [folio 91a] an instrument maad lijk a clisterie / ℞ .mel ro. [ounce] iiij., mirre, fenigreci, farine lupinorum ana [dram] [one half], boile hem to þe consumpcioun of þe .iij. part in lī j. of swete wijn, & lī j. of water, & þanne cole hem & putte in þe colature as it is aforseid. Vpon þe wounde wiþoutforþ, from þe tyme þat it quytturiþ, leie þis mundificatif planed vpon a clooþ. ℞ mel ro. lī j., farina ordei substillissimi. [ounce] iiij., mirre, fenigreci ana. [dram] j., be þei encorperat & boilid at esi fier / & whanne þei ben weel boilid, & weel medlid togidere so þat it be þicke, do hem doun of þe fier, & do þerto [dram] .iij. of terbentyne waischen & medle hem weel togidere. Þis emplastre þou schalt vse, & þe waischingis þat is aforseid, & þou schalt holde open þe wounde with a tent wet in oile, til þe quytture þat is withynne be perfitli dried / Þis þou schalt knowe bi þe vertu of þe patient & bi þe sauour of his breeþ, & whanne his cowȝynge goiþ awei, & whanne

his vnkyndely heete goiþ awei / If þou doist alle þese þingis to him þat ben aforseid, & þe quytture [folio 91b] be not wiþdrawe þerwith, & his cowȝynge & his akynge be not aswagid, & his vertu be feble, & his spirit be nouȝt, þanne do þou nomore þerto, saue he schal al turne him to goddis merci // ¶ Saue if it so be þat he haue þe cowȝe & greet quytture in þe wounde, & he be strong, & principali if þer wexe ony swellyng in his side bihinde bitwixe þe .iiij. & þe .v. rib, þan þere þou schalt make a newe kuttyng & lete out þe quytture, & bi þis place drawe out þe quytture, & holde þe wounde open, & lete þe olde wounde close togidere. & if it be nede, caste yn þe forseid waischinge bi þis wounde & leie a mundificatif wiþoute til þe quytture be al aweie, & þis cure þou schalt folowe / It falliþ ofte tyme þat a man is hurt an hiȝ aboue in þis place, & þanne þe blood & þe quytture falliþ vpon diafragma & gaderiþ togidere, þanne þou schalt kerue him bitwixe þe .iiij. & þe .v. rib as it is aforseid, for þe blood & þe quytture mai haue no cours to þe wounde aboue; & if he is kutt so byneþe, þanne þe blood & þe quytture mai be drawe awey; [folio 92a] & if þou doist not þus þe pacient schal die, & if þou doist þus þe pacient schal be delyuerid wel // Whanne woundis ben in thorase ouþer in þe brest, & þe woundis ne goon not þoruȝ, þanne þou schalt cure him as it is aforseid in oþere woundis //

Of woundis of þornis ouþer spondilium, & of þo þat ben conteyned in him & anothamie /

Bonys of þe necke, as we haue aforsed, ben .vij, & rigge boonys of þe brest ben .xij, & of þe reynes ben .v. riggeboones, & vndir þe reynes ben .iij. riggeboones, & vpon þe place þat is clepid —Þe boon of þe tail is maad of .iij. rigge boones, & þere ben .xxx. ¶ Eueri boon of þe rigge is an hole þoruȝ, & þoruȝ þe ilke hoolis nucha goiþ endelong þe rigge; & euery boon of þe rigge haþ .iiij. addiciouns to him, & summe han mo; þis is not necessarie to telle to a sirurgian, saue it is necessarie to a sirurgian for to knowe þis:

þat euery rig-boon haþ a greet hole, & nucha goiþ þer þoruȝ. & þer ben oþere smale hoolis in þe boones bi þe sidis aboutforþ, & þere þoruȝ goon nerues for to holde þe lymes faste [folio 92b] togidere. & so þese .xxx. boones ben bounden togidere wiþ stronge ligaturis, & þei ben so strongeli bounden togidere þat þei semeþ al oon boon. Þese boones bineþe þe necke is clepid þe rigge ouþer spina, & þis is þe foundement of al þe bodi //

¶ Woundis þat ben maad in þis place. If nucha be kutt þoruȝ ouerþwert, þe wounde is mortal for þe nobilte of nucha þat comeþ fro þe brayn riȝt as a ryuer comeþ of wellis. ¶ And þouȝ nucha be not kutt al þoruȝ saue hurt, it is greet perel þerof, for þe lymes bineþe schulen lese her meuynge, for þe nerues þat ben aboute þe boones of nucha ben kutt. & also þe rigge-boones ben kutt & herof cometh greet perel / And if þe braun þat sittiþ endelongis þe rigge in boþe sidis of þe rigge-boon & duriþ from þe heed adoun anoon to þe tail eende, & if ony of alle þese be kutt ouþer prickid, it is greet perel for þe spasme, for þe causis þat ben aforseid /

Þe curis herof ben lijk to þe curis þat ben aforseid of oþere woundis, saue it is necessarie for a cirurgian to knowe pronosticatiuis of þis [folio 93a] place, & also if a man be hurt in þat place, he mote haue for þe causis aforseid //

Of woundis of þe stomac / & intestinum & wombe, & anothamia /

I haue seid heretofore in what maner mery goiþ doun þoruȝ þe necke wiþinneforþ, and goiþ þoruȝ diafragma, & is maad fast with diafragma, & diafragma goiþ aboute þe mouþ of þe stomak. & þe stomak is schape in þis maner, & in oon side he is gibbous, & in þe toþer side he is more playn. & þe stomac is maad of .ij. cloþis. & þat oon clooþ sitt wiþoute & þat oþer wiþinne, & þe clooþ þat sittiþ wiþinne is villosus & neruous, & þe clooþ þat is wiþoutforþ is fleischi / ¶ In þe ynner clooþ ben longe villis wherof comeþ drawynge, & þere ben villis ouerþwert, wherof

comeþ wiþholdyng / In þe clooþ þat is wiþoutforþ, þere ben longe villis, & þat makiþ expulcioun. Þe ynner clooþ is neruous, þat it mowe fele whanne it is ful; wiþoutforþ it is fleischi for to make him hoot & moist, þat he miȝte helpe for to make digestioun. Þat skyn þat is wiþinne þe stomak is norischid with moisture of mete [folio 93b] þat is resseyued into þe stomac / The skyn þat is wiþoute þe stomac is norischid of blood, þat comeþ fro þe lyuere in smale veynes & goiþ al aboute þe stomac. ¶ Also þere comeþ arterijs from þe herte to þe stomak & makiþ him to haue lijf, & of þese .ij. þingis, þat is to seie vena & arteria, gibbus is maad þat gouerneþ þe stomac & þe guttis wiþ his fatnes, & makiþ hem hoot. ¶ In þe botme of þe stomak þere is a mouþ, and þat mouþ is more streit þan þat aboue. & þe firste gutt is maad fast to þe lower mouþ, & þis gutt is clepid duodenum. Þis is þe skille whi he is clepid so, for he is of þe lengþe of xij. ynchis; & þanne þere ben .vj. guttis bineþe him; & þanne þis firste gutt is maad of .ij. cootis, as alle þe oþere guttis ben, but þe .ij. gutt is smal & folde togidere. Þe .iij. gutt is clepid ieiunum, id est, fastynge, for he is euermore voide, & þat is for he is nyȝ þe galle & resseyueþ myche colre for to avoide him, & þere goiþ to him manye veynes, wherbi he is voidid / Aftir him þere comeþ a gutt þat is clepid orobum [folio 94a] ouþer a sak, & it haþ but oon mouþ, & he resseyueþ alle þe fecis; & þere is fulfillid þe firste digestioun of þe guttis / Aftir þis gutt þer is a gutt þat is clepid colon, & lijþ ouerþwert þe wombe & resseyueþ feces / And aftir þis gutt comeþ langaon, & is þe eende of alle; & he haþ .iiij. brawnys, & þerof he haþ vertu for to wiþholde þe fecis yn, & for to putte hem out whanne a man wole / Euery meuynge of þe guttis is kindely & eueri gutt of þese þat ben aforseid haþ diuers kynde // ¶ Þer ben manye maner causis whi þat guttis ben folde with nerues: þe firste enchesoun is þis, þat a man schulde not as soone as he hadde ete, anoon riȝt go to sege as

doiþ a beest. Þe .ij. cause is þat þe mete miȝte abide in þe stomak for to make digestion, & þat þat is not fulfillid in þe stomak is fulfillid in þe guttis. Þe .iij. cause is þis, þat it first abide in oon gutt / & þanne it is sent to anoþer & so forþ. & þanne for to holde alle þese þingis / þe stomak & þe guttis is ordeyned a skyn, þat is clepid þe siphac; & is a syngle skyn & is not [folio 94b] villous, & is engendrid bineþe as is diafragma is aboue, as it is aforeseid, & is maad fast at þe rigge bihinde, for to holde vp þe stomak & þe guttis / In þis partie bineþe þis þer ben engendrid of siphac ij. þingis þat ben clepid dindimi & goiþ adoun al aboute þe ballokis, & is clepid þat ynner skyn of þe ballokis; & þoruȝ þis dindimi goiþ arterijs & veynes to þe ballokis, & makiþ hem haue lijf & norischinge & kynde of sperme // ¶ Alle þese þingis þanne ben comprehendid in a skyn þat is fleischi & of lacertis maad, & is clepid mirac, & is clepid þe vttere wombe in whiche ben lacertis, for to helpe putte out þe fecis & wijnd & vrine /

Þerfore woundis þat ben maad in þe stomac ben perilous, & in þe guttis, for manie causis / Þe firste cause is þis, for her worchinge is necessarie to þe bodi, for þei ben þe firste instrument of digestioun, & her worchinge is so necessarie to þe bodi, þat it mai in no maner be susteyned, ne abide wiþoute hem / Þerfore if þere be ony woundis in þis place her worchinge [folio 95a] is lost, but if þe wounde be soudid anoon; & þat is ful hard & sumtyme inpossible for þei ben neruous, & þere is no fleisch on hem, & also for þei ben alwey meuynge, & principali whanne woundis ben maad in þe hindere partie of þe stomac ouþir in þe smale guttis / For if þe woundis falle in þe neþir partie of þe stomac þat is fleischi, ouþer in þe greete guttis bineþe, if þe leche be kunnynge, þe pacient mai lyue /

¶ If it bifalle þat a man be hurt in ony of þese placis þat ben aforseid in þe stomak ouþer in þe guttis, þe leche muste knowe wheþer þe substaunce of þe guttis or of þe stomak be prickid þoruȝ or no; þat þou miȝt knowe bi þe goyng out of þe fecis at þe wounde, & þanne þe wounde is iugid mortal. ¶ If a man be woundid in his stomak & þe wounde of þe wombe wiþoutforþ ne be not brood, þanne kutte it more & þanne sewe the wounde of þe stomak wiþ a nedele þat is iiij. squar & wiþ a sutil þreed, & þis þou schalt speciali, whanne þe wounde is in [folio 95b] a fleischi place of þe stomak,

for if þe wounde be aboue in a place of þe stomak þat is neruous, ne traueile þou not þere aboute þanne, for it is an idil / Whanne þou hast sewid þe wounde bineþe as it is aforseid, þanne springe þeron poudre consolidatif & soude þe wounde of þe stomak, & holde open þe wounde of þe skyn wiþoute, til þe wounde of þe stomak be hool // ¶ If it bifalle þat a man be hurt in þe greete guttis bineþe, so þat þe wounde be not to greet, þanne þou schalt sewe þe gutt, & þe eendis of þe þredis schulen hange out, & þe vtter wounde schal be holde open, til þe wounde of þe gutt be soudid ¶ If it so be þat þe wounde of his wombe wiþoutforþ be so brood þat þe guttis falle out, putte hem yn anoon while þei ben hote / If it be so þat þe guttis be colde, or þat þou come þerto, & þe wounde of þe wombe be to swolle, & þe guttis be chaungid wiþ þe eir, wherfore þe guttis wolen not in aȝen, þanne þou must sutilli make þe wounde of þe wombe a litil more, þat þe guttis [folio 96a] mowe liȝtly falle yn aȝen wiþoute greuaunce. Whanne þe guttis ben ynne, sewe mirac & siphac in þis maner togidere, so þat þei moun boþe be soudid togidere; for if mirac were soudid & not siphac, þanne aftir þe tyme þat þe wounde were soudid, þere wolde leue a crepature. Þerfore þou must sewe in þis maner / Take þat oon side of mirac & siphac togidere so þat þei be euene, & loke þat þi nedel be .iij. squar, & þanne make oon poynt þoruȝ hem ij. togidere, in þe same maner in þe toþer, & þus þou schalt make þeron as manie pointis as þou þenkist necessarie / And whanne þou hast sewid mirac & siphac togidere in a good maner, þanne knytte þe þredis togidere þat þei vnknytte not, as þou seest þat is to doing; & lete þe eendis of þe þredis hange out, & þanne springe vpon þe sewynge þe poudre consolidatif þat is aforseid, and holde open þe wounde wiþoutforþ til mirac & siphac be perfitli soudid, for in þis maner mirac & siphac moun be soudid bi þis cause: Siphac is neruous & haþ [folio 96b] no fleisch, & mirac is fleisch, & bi þe vertu of him siphac is soudid; & þanne do þe cure herof aftir as it is tofore // ¶ Summen seien þat þe smale guttis moun be sowdid in þis maner: make a pipe of eldre, & putt wiþinne þe gutt, & þanne soude þe gutt þer vpon. & I seie þat it is not sooþ, for þis þing, þe smale guttis wolen not soude, & to þe greete guttis þis queyntise is nouȝt; þerfore triste to þe maner þat is aforseid, & take kepe of þe perels þat ben forseid.

Of woundis of þe lyuere & splen & reynes & þe bladdre, and anothamia /

The firste schapinge of þe lyuere is maad of þe .ij. spermes as ben þe oþere principal lymes, saue þe greetnes of þe lyuere is principali maad of blood & is in þe hardnes of fleisch. & þe substaunce þerof is fleischi, & it is in þe maner as it were blood runne, & chilus comuneþ fro þe stomac to þe lyuere for to ȝeue him norischynge, & þe lyuere is gibbous wiþoute, & wiþinne holow þat it miȝte be þe more closynge to þe stomac. & þe heete of þe [folio 97a] lyuere makiþ þe stomac to seþe as fier makiþ a furneis to seþe. ¶ The lyuere haþ addicioun, & ben diuers; for in summe ben .iiij. & in summe ben .v. & in summe ben .iij. Of sperme þe mater of þe lyuere wiþinne is gaderid. & þerof comeþ a greet veyne & is engendrid in sima epatis, & is clepid þe ȝate of þe lyuere. & of þis veyne summen seien þat þere ben engendrid .viij. veynes, & summen seien þat þere ben mo; & þus veynes ben ȝatis riȝt as rootis of a tree. & þese veynes ben clepid miseraice / & summe of þese veynes ben maad fast wiþ þe botme of þe stomac, & wiþ a gutt þat is clepid duodeno, & summe wiþ þe smale guttis, & summe wiþ þe gutt þat is clepid ieiunum, & summe wiþ orobo ouþir wiþ þe sak //

¶ Þe lyuere is maad fast to þe riȝtside of þe stomac, & in þe liftside of þe stomac sitt þe splene, & is schape along, & is maad fast with o partie of þe stomac. & oon partie þerof is maad fast twoward þe rigge in þe liftside, & haþ .ij. poris, & þoruȝ þat oon pore he drawiþ malancolious blood of [folio 97b] þe lyuere, & clensiþ þe lyuere of malancolious superfluite, & þerof þe splene is norischid. & þere is anoþer pore þat goiþ to þe mouþ of þe stomac, & makiþ þe mouþ of þe stomac to haue appetite //

Þe reynes ben set, þat oon in þe riȝtside & sittiþ hiȝere, & þat oon in þe liftside & sit lowere, & ben maad of hard fleisch, & ben sett in two sidis of þe rigge boon. Boþe þe reynes hauen .ij. veynes ouþir .ij. neckis, & þat oon is aboue, & þat oþere is bineþe. Þoruȝ þe necke aboue of þe reynes is drawe watri blood & comeþ from vena ramosa; & þis watri blood is vryne, & from þe reynes it goiþ to þe necke of þe bladdre þoruȝ a veyne þat is clepid kylym, & in þis maner þe vryne comeþ into þe bladdre /

Þe bladdre is maad of .ij. þinne skynnes, & boþe skynnes ben neruous, & þe necke of þe bladdre is fleischi. In men þe necke is long, for it passiþ þoruȝout þe ȝerde, & in wymmen þe necke of þe bladdre is schort, & is maad fast to the cunte. / Þe necke of þe bladdre hath oon braun, & is in þe mouþ of þe bladdre [folio 98a] & þat makiþ a man holde his vryne whanne he wole, & putte cut his vryne whanne he wole, wiþ help of þe wombe þat pressiþ, & of lacertis // ¶ Of þe galle we makiþ noon anothamie, for al oure science makiþ noon mencioun of a wounde in þe galle /

¶ Woundis þat ben maad in þe lymes aforeseid ben euermore perilous / For alle þese lymes, ouþir þei ben principal lymes as is þe lyuere, ouþir þei serueþ principal lymes, wiþoute whiche lymes þe bodi ne mai not be susteyned / If þe lyuere be hurt in þe depe substaunce, þanne þe lyuere schal lese al hir worchinge, & al þe blood þerof wole be disturblid þat is matere of þe spirit, & in þis maner þe spirit of lijf is disturblid & þe foundement of alle hise vertues; saue if þe wounde of þe lyuere be but litil it may be soudid, so þat þe wounde be freisch & not oold hurt, forwhi a principal lyme mai not suffre longe sijknes // ¶ Þouȝ a man were hurt in þe splene, ȝitt he miȝte be wel curid, & þouȝ þere were a gobet þerof kutt awey, so þat it ne were not to myche and ouerþwert, [folio 98b] for þerof ofte tyme falliþ þe dropesie; ouþir if þe poris were kutt, it wolde afeble þe stomac. ¶ Woundis þat ben in þe reynes ben not curid,

for þei ben norischid wiþ watri blood, for þat is contrarious to soudinge / & for þe reynes ben alwey in meuynge, & also vryne þat alwei is bitynge goiþ þoruȝ þe reynes. ¶ Þe bladdre ne mai not be soudid if it be kutt, for it is a lyme þat is neruous & haþ no fleisch, & is alwei meuynge, & for he is alwei resceuynge vryne & also þe vryne fretiþ & þat lettiþ þe souding / For ypocras seiþ / If þe bladdre be kutt, or þe brayn, or þe herte, þe wounde is mortal. ¶ If a leche be sent aftir, for to come to a man þat is woundid in ony of þese forseid / if þe leche be a man of good loos & a kunnyng man, he schal, whanne he comeþ to þe pacient, & seeþ þe perel þerof, he schal telle þe perel of þe wounde to þe pacientis frendis, & he schal seie to þe man þat is hurt þat he schal ascape & fare weel; and first he schal make him haue hise riȝtis [folio 99a] of holy chirche, & lete him make his testament, or þat his vertu faile / þanne he schal bigynne wiþ his good worchinge, riȝt as he took no drede þerof / for ofte tyme kinde worchiþ, þat þat semeþ vnpossible to þe leche, & principali if he worche wel. Neþeles þouȝ þe leche se goode signys bi þe pacient, he schal alwei haue his owne pronosticacioun as it is aforseid, til þe man be al hool, if he schal ascape / for ofte tyme whanne þe pacient drawiþ toward þe deeþ, his passioun wole aswage; & also þe contrarie þerof is seen, þouȝ þe pacient haue greet peyne & þe signes of deeþ, ȝitt he mai ascape / & þerfore for þese perels þat ben aforseid, he mot be war of vndirtakynge & of biheest // ¶ If a leche be in straunge cuntre, he ne schal bi no maner wei take sich a cure. & also he schal forsake alle maner of curis þat ben harde to do, & also he schal forsake curis þat ben longe for to make ony perfeccioun þerof, & he mote be war þat faire biheste, ne veyn glorie, ne coueitise ne bigile him not /

[folio 99b] Of woundis of þe ȝerde & of ballokis, & of þe regioun of þe bladdre and anothamia.

God almyȝti þat alle þingis knewe tofore þe makyng of þe world ouþir of man, he knewe þat a man schulde be maad of moist substaunce, as of sperme, in which natural hete schal worche. & for to resseyue þe mater of sperme, it is necessarie þat

a man hauo ballokis / He made ballokis as it was necessarie, & ȝaf hem schap & complexioun for to engendre / & he ȝaf a man greet delite for to lie bi a womman, so þat a man schulde not haue abhominacioun þerof, saue a man schal do it with greet will & wiþ greet loue, so þat generacioun miȝte be multiplied wiþ greet delite / ¶ Also god almiȝti schop in a man a ȝerde. & in þe bigynnynge þerof ben cartilaginis & ben maad fast to þe laste boon of þe rigboon, & is maad of nerues, veynes & arterys, & is sumwhat holow, þat he miȝte be fulfillid wiþ spirit. & in þe heed þerof is fleisch þat is felynge, & a skyn þat goiþ ouer & is clepid prepucium. & þe meuynge of þat skyn [folio 100a] & of þe fleisch tofore helpiþ for to putte out þe sperme / Þe risynge of a mannes ȝerde comeþ of a mannes herte, & witt of þe brayn, wilnynge, & greet desier; & watri humour comeþ of þe lyuer. & haþ .ij. open holis; & þoruȝ þat oon hole goiþ out vryne & comeþ fro þe bladdre, & þoruȝ þat oþir hole comeþ sperme and comeþ fro þe ballokis. & þese .ij. holis ben good for to knowe / And auicen seiþ: þat þere is þe .iij. hole, & þoruȝ þat hole passiþ a maner of superfluite þat a man feliþ not, as whanne he halsiþ a womman wiþ hise hondis; saue þis þridde hole is not knowen of a cirurgian //

Þe .ij. ballokis ben maad of hard fleisch in þe maner as ben wommans brestis, & þat oon ballok of a man is grettere þan þe toþer & stronger, & to þe ballokis comeþ veynes & arterijs, & makiþ hem haue lijf & norischinge. & superfluite of good blood & clene comeþ þerto of alle þe lymes, & gaderiþ togidere in a mannes ballokis, & þere it bicomeþ whiȝt & turneþ into sperme, riȝt as blood bicomeþ [folio 100b] mylk in a wommans brestis / And þer ben maad fast wiþ þe ballokis .ij. vessels, & ben brode vpon þe ballokis, & narowe toward þe ȝerde, & ben clepid þe vessels of sperme, & ben clepid of auicenne

barbachi, & of þese vessels comeþ sperme into þe ȝerde, & þoruȝ þe ȝerde is born into þe matris of wymmen / In þese .ij. vessels sperme is fulfillid, saue þe hete þerof comeþ of þe ballokis; & to þe ballokis as it is aforseid cometh veynes & arterijs, & goiþ þoruȝ dindimous, þat ben maad fast to þe siphac as it is aforseid //

¶ Þe maris in a womman is maad neruous & is schape as it were a ȝerde þat were turned aȝenheer. & þe necke of þe maris is fleischi, & brawny, & felynge, & gendring, & in þe necke of þe maris ben veynes þat ben to-broke whanne a womman lesiþ hir maydenhode. & þe botme of þe maris is schape as it were þe case of a mannes ballokis / And þe maris haþ .ij. brode ballokis in þe necke, & wiþ þe ilke .ij. ballokis ben maad fast .ij. vessels of sperme, & ben more schort þan a mannes vessels of sperme / And of þese [folio 101a] vessels, a wommans sperme goiþ to þe botme of þe maris / And in þe tyme of conseyuynge þe wommans sperme [is] medlid wiþ a mannes / And þe maris of a womman haþ wiþinne .ij. grete concauitees / And þe maris haþ manie veynes, & þoruȝ þe ilke veynes, whanne a womman haþ conseyued, comeþ blood to þe lyuer for to norische þe child. And whanne a womman is not wiþ childe, þoruȝ þe same veynes cometh blood of þe veynes menstrue & is putt out, & in þis maner a womman is purgid of superfluite of blood; & it is maad fast bitwixe þe grete gutt & þe bladdre, & is hiȝere þan þe bladdre, & is maad fast to þe rigge wiþ ligaturis, & in tyme of child berynge þe ligaturis recchiþ, & aftir þat tyme *—— /

If þere be woundis in ony of alle þese placis, þei ben stronge perilous for her sutil complexioun, & for her nobilte of worchinge.

¶ If it so be þat a man be hurt in his ȝerde or ouerþwert in a litil quantite, þou schalt sewe þe wounde, & sprynge þeron poudre, & leie þerto defensiuis, & lete him blood, & diete him with þinne [folio 101b] mete, & cure him wiþ good diligence // ¶ If it so be þat a mannes ȝerde be kutt al off ouerþwert, þanne it is greet drede þerof / for þe veynes þat comeþ þerto & þe arterijs & manie nerues, for sumtyme þe pacient mai be deed, or þe blood mowe be staunchid / Saue

in þis cas þou schalt take hede for to do awei þe akynge wiþ oile of rosis, anoynte him aboute þe ers & þe regioun of þe ȝerde, & brenne þe ȝerde wiþ an hoot irn for to constreyne þe flux of blood; for a cauterie streyneþ blood tofore alle þingis. ¶ Woundis þat ben in þe ballokis, þei roten hem anoon, & þouȝ a man be not in perel of deeþ þoruȝ þe hurtyng of hem, ȝitt his generacioun is lore / A wounde in þis place schal be curid in þe same maner as woundis in oþere place of þe bodi, & þe cure schal not be chaungid þerof // ¶ If it so be þat a womman be hurt in her marijs wiþ a swerd, ouþir wiþ a knyf, ouþer wiþ a dart, þe wounde is mortal // ¶ If it bifalle þat colon be hurt wiþ sum scharp þing ouþir wiþ hardnes of humouris, he may wel be curid þe while þe wounde is freisch, with putting [folio 102a] of vnguentum album rasis of ceruse distemprid wiþ ius of arnoglossa. & if it so be þat þe wounde of þis place be olde, þanne it is for to make a mundificatif þerto, wiþ castynge yn of gotis whay ouþir watir of barly //

Of woundis in þe haunche and of þe coxe of þe knee, and of boonis of þe feet and of anothomia.

Bonys of haunchis ben maad fast wiþ þe lattere boon of þe rigboon / & riȝt as þe rigboon susteyneþ alle þe boones aboue, so alle þe boones bineþe ben maad fast to him / Þese boones ben cartilaginous & sutil toward þe fore partie, & bineþe þei ben more greet; & eueri of hem haþ a box þat is clepid pixis haunche & vertebrum sit þeron. & þat is þe eende of þe hipe boon. & wiþ this boon is maad fast þat boon þat goiþ ouerþwert vndir þe ars aboue þe ȝerde, & is clepid os pectinis. & as summen seien þere ben iiij. partis, saue in cirurgie it is seid al oon. & þe place of þe coniuncioun of þese boones is clepid þe scie. & sumtyme þese boones goon out of þe ioynt, as þou schalt haue a perfit teching [folio 102b] herof in þe .iiij. tretis in þe chapiter of dislocacioun / Þis hipe boon, as it is

aforseid, is maad fast aboue wiþ ligaturis & pannyclis & nerues, & it is a greet boon & miche holow wiþinne, & is ful of marow; & it is greet, for it schulde be strong; & it is holow, for it schulde be liȝt. & þis boon is maad fast in þe knee, & þere þe boon of þe hipe & þe boon of þe leg ben ioyned togidere in a box as it is aforseid. & þese boones ben bounden togidere wiþ ligaturis & senewis, & vpon þe ioynt of þese boones & for to kepe þis ioynture from harm, is ioyned þeron a round boon & is clepid rotula, & of summen it is clepid þe yȝe of þe knee, & alle þese boones ben bounden togidere wiþ strong ligaturis// ¶ Vndir þe round boon of þe knee ben ordeyned .ij. boones in þe leg, & þat oon þerof is grettere & sittiþ tofore in þe leg, & þe toþer is smaller & sittiþ bihynde in þe leg. & in þe neþer partie þei ben maad fast wiþ þe boon of calcanei þat susteyneþ alle þe boones, & with alkarad, & þat is a boon þat fulfilliþ þe ioynture & is [folio 103a] ioyned wiþ þe boon þat is clepid nauicula / ¶ Racheta of þe foot is maad of iiij. boonis, & ben bounden togidere wiþ ligaturis. & wiþ þese boonys ben maad fast þe bonys of þe toos þat ben .xiiij., for eueri boon haþ .iij. boones, saue þe boon of þe grete too, & þat haþ but .ij. boones / to alle þese boones comeþ nerues fro þe riggeboones—& wiþ þese nerues, & with þese ligaturis, & wiþ symple fleisch þese boones ben maad fast togidere —& ȝeueþ to þese lymes meuynge & felynge. & þer ben greete brawnes in a mannes leggis & in hise hipis, & ben ful of grete veynes & arterijs & senewis, & ben departid into alle þe leggis & to þe feet / & summe of þese veynes comeþ fro a veyne of þe lyuer, þat is clepid vena ramosa as it is aforseid in armys. & þerfore þese placis ben swiþe perilous, whanne þei ben woundid, for þe perels þat ben aforseid. & þese veynes ben departid in þe foot, & .ij. þerof ben in þe holow of þe foot wiþoutforþ, & þat oon veyne þerof is clepid sciatica, & þat oþere is clepid renalis, [folio 103b] & þis is þus miche to seie: þat oon veyne serueþ for þe scie, & þat oþer for þe reynes / Þanne þer ben ij. oþer veynes in þe holow of þe foot withinne, & þat oon is clepid sophena, & þat oþer is clepid vena ventris, id est a veyne of þe wombe. ¶ Þe veyne þat is clepid renalis scheweth itsilf bitwixe þe lift too & þat oþer too next, & þe blood-letyng of þis veyne is good for þus manye þingis: for cancrena þat ben in

þe hipis & for a mormal, & for varices & for vlcera þat ben in þe hipis ouþer in þe leggis.

Bi alle þese skillis þou myȝt wel se, þat woundis þat be maad in þese placis ouerþwert ben swiþe perilous for þe kutting of nerues & of cordis & braun, & of veynes & of arterijs, for alle þese þingis goiþ endelong þe leggis & þe hipis, & þerfore woundis þat ben maad ouerþwert in þis place ben swiþe perilous as it is aforseid // ¶ Woundis þat ben maad in þes placis þat ben curable, schulen be curid in þe same maner as it is aforseid in curis of armys & of hondis / Saue of o þing þou schalt take kepe, þat woundis þat ben maad iij. fyngris brede wiþinne þe knee, for þe [folio 104a] nobilte of þe place & for þe causis þat ben forseid, þe wounde is iugid mortal / Þerfor woundis þat ben in þese placis þat ben forseid & ben curable þou must do good diligence þerto, & be wel war of woundis þat ben mortal as it is aforseid //

¶ The techinge of þe .ij. tretis is fulfillid þoruȝ þe help of god, & now schal bigynne þe techinge of þe .iij. tretis & schal conteyne .xvij. chapitris /

Notes

• Heading to this page: Anotemy off þe hed & woundes off the same. / Compare Vicary's Anatomie, ch. iii. p. 24.
• rare. Lat. rarus.
• Lat. Prima nanque summa ..
• MS. inserts &.
• panne after brayn cancelled.
• þat insertion.
• Latin: "Quartum os est ex parte posteriori in puppi; et conjungitur cum prædictis nervalibus mediante una commissura ad modum literæ laudæ grecæ." The word lauda is a corruption of lambda.
• MS. as.
• Add. MS. 10,440, fol. 2: "& he is vnterberynge in þe hynder partie al þe bones of þe heued, & þerfore he is clepid þe berere vp, or paxillus."
• longe warpid, Lat. oblongus. Comp. Langwyrpe bôc, Indices Monast. 12, ed. Kluge.
• telliþ, error for tellen.
• MS. inserts þe.
• MS. celose.
• Lat.: res a phantasia comprehensas.
• Read, þo þingis comyn undirstondynge resceyueþ. Lat.: quas(res) communis sensus recipit.
• punat, Lat.: pineatus.
• MS. procende.
• cellis, written above line.
• accidens for accioun.
• vois, Lat.: "antequam res comprehensa posset ad sequentem ventriculum pertransire."
• MS. swingge.
• MS. inserts &.
• of hem written on margin.
• cellul written above.
• The MS. has a marginal note: Anotemy off eyen, eres, nose, chekes, mouthe, tounge, teth.
• scotomie. Vigo Interpret. "Scotomia. They shoulde saye, Scotoma, and it is a disease, when darckenes ryseth, when al thinges seme to go rounde about."
• help in margin.
• One word "spewinge" omitted, and as erroneously inserted in both MSS. Lat.: "Mala autem accidentia .. sunt vomitus perseverans constipatio ventris," etc.
• MS. inserts nouȝt.
• liui, Lat. vitales.
• ben, error for seen. Lat.: quia non recte vident.
• See page 102, note 2.
• MS. alle.
• schurgynge, schurien, to shower.
• Lat.: vel in alia parte capitis quam in vulnere: quod est malum signum.
• conteynen for contynwen.
• demene, O.Fr. "demener," for demen.
• in þis caas. Lat.: in isto passu. See below pas.
• cure, above line.
• have, above line.
• mace, Lat. macia.
• MS. þilke.
• Lat.: & præcipiunt quod unam guttam aquæ non bibat.
• carp, Lat. carpia, 'charpie.' oile struck through after carp.
• Apostolorum Unguentum, a cleansing Ointment, so call'd, because it is made of twelve Drugs, according to the number of the Apostles.—Kersey. 1706.
• rimel, Lat.: si fractura esset rimalis. O.Fr. rimule, Lat. rimula, a small chink.
• þanne struck through after loken.
• as blod or ony oþer mater . þei drede not to perse þilke rimelle, this is as a note at the bottom of the page.
• rinspindil, see mod. Germ. Rennspindel, f., upright drill, pump drill. Trépan.—Rumpf, Technolog. Dict.
• poudren for boren, under the influence of 'pore.' Lat. porus.
• Lat.: quantum est ad trypanacionem.
• þe struck through after of.
• mal, Lat. malleus.
• Serapie, probably Ser. the Elder, an Arab physician, cc. 900.
• towchiþ for techiþ.
• islend, Add. MS. ysclend. See slent, to tear, to rend (Dorset).—Halliwell.
• hem for am; leeue is erroneously added in margin.
• handely ne. handy.
• MS. ixele.
• MS. þanne, error for a þenne. Lat.: pannum lineum vetustum et subtile. See below.
• coral veyne, vena cephalica.
• At the foot of lf. 69 is this note: R radicis erios, aristologe, thuris, mer, aloes, sanguis draconis, orobus ana, ffac puluis.
• whight rosyn, hardened Terpentine.
• malaxe, Lat. malaxo, mollify.
• treet = entreet. See p. 123, note 1.
• wiþ pynsouns, cum piccario. See Pynsone, Tenella. Prompt. Parv., p. 400.
• wiþ rugement. Lat.: cum rugine ruginando, Fr. rugine, ruginer.
• Both MSS. omit to translate the Lat. si non possum.
• slendinge, see p. 128, note 4.
• MS. þilke.
• distende, Lat. distendo.
• bi þat skil, Lat. quare. Skil = causa, synon. with 'resoun' occurs frequently in Polychron. See Gloss. The same construction in: '& by þe same skile' ea ratione, ibid., iii. 465.
• ben, above line.
• cole, Lat.: sicut si essent duo ligna cum glutino in simul incolata.
• rasure, Lat. rasura.
• litarge, Lat. lethargus. Lethargy, stupor.
• viscat, Lat. inviscatus, inclosed. See below, inviscat.
• Constantinus Africanus, c.c. 1070.
• teped, Lat. tepidus.
• enfancinum, for omfacinum…, oil made from unripe olives (Diosc. I. 29). Vigo Interpr.: "Omphax in Greke is an vnripe grape. Vigo calleth oyle of omphacyne, that oyle that is made of vnrype Olyves." Compare Tomm. Dict. s. v. onfacino.
• See below.
• Lat.: nec sciebat aliquid de scripturis. O.Fr. lettreure. See Piers the Plowman, ed. Skeat. Gloss.
• Lat.: meo tamen addens judicio quod pro centum marchis argenti non dimitterem, quin adhuc probarem in eo, si meus esset frater, juvamenta medicinæ inducens.
• of þe myddil, inserted.
• See below, note 8.
• boistisliche. Lat.: balbutiendo, stammering, seems to connect the sense of O.Fr. boistous, lame, with boisterous.
• ypocras, errour for ydrosacre. See below. "Hydrosaccharum, a Syrup made of Water and Sugar." Phillips. Hippocras, a kind of "Artificial Wine, made of Claret or White Wine, and several sorts of Spice." Ibid.
• Lat. ptisanam spissam. Matth. Sylv.: "Tisanna i. aqua ordei uel fariola."
• Cochia. An ancient name for several officinal purgative pills. Dunglison, Medic. Lex…., a pill. Alex. Trall. Compare Fr. cochée.
• be to, added in margin.
• Lat.: præterquam lacertorum pectoris qui sallire videntur. The translator evidently read salvere instead of sallire.
• Anselmus de Ianua. A. de Porte, quoted by Guy de Chauliac as Anserinus de Ianua, XIII. cent. Ianua is Genoa, see Eloys Dictionn. historique.
• "Terebration, a boring or piercing; a Term more especially used in Surgery." Phillips. "Terebra, an Awger or Wimble, a Piercer; also an Instrument to engrave on Stones; also a Surgeon's Trepan or Trepandiron." Ibid.
• Lat. relinquimus tamen propter melius.
• MS. now.
• dinge, in margin.
• Compare: þis instrument may ȝe do make wiþoute grete cost. Quinte Essence, p. 62.
• a sotil, in margin.
• Heading to this page: Off wondes off the fface & Anotumy off þe same ffrom the face to the ffote.
• MS. kutt.
• MS. þe neþir.
• fourþe for firste.
• wesaunt gula; wesande, ysophagus. Wright W., page 676, XV. cent. See Vicary, page 47, note 4.
• See Vicary. page 44, note 2.
• MS. of. Add. MS. 10,440, fol. 2: "& he is vnterberynge in þe hynder partie al þe bones of þe heued, & þerfore he is clepid þe berere vp or paxillus."
• open, Lat. manifestæ, superficial.
• Lat. arterie occulte.
• MS. ben.
• Avicenna quotes Hippocrates as authority for this curious belief: "Et Hip. quidem dixit in suis intentionibus quod plurimum materiei spermatis est ex cerebro & quod descendit ex duabus venis que sunt post ambas aures. Et propter hoc abscindit phlebotomia ambarum generationem & facit incurrere sterilitatem." Canon Lib. III, Fen XX, Tract. 1, Cap. 3, ed. Ven. 1523, fol. 5.
• nolles, Latin cervices, seem to be the transverse processes.
• whiche, struck through after nollis.
• eeris for ers.
• the forke of the brest, the clavicle.
• mary, Lat. meri siue oesophagus. Arab. marī'.
• MS. of, twice.
• mydrif, diaphragma. Wright W., Gloss., page 578, l. 23, XV. cent.
• MS. same. Lat. canna pulmonis. See Vicary, page 47, note 7.
• Read reed.
• ȝeueþ stede, Lat. cedere. See Catholicon Angl., page 155, to giffe stede, cedere, locum dare.
• þrote-bolle. See Vicary, page 48, note 1.
• guydes, Lat. guidegi, Ibid. p. 48, note 3. Compare Arab. widādsch, vena jugularis. Matth. Sylv.: "Guedegi sunt vene guides. Alguidegi in collo flobotomantur."
• noyousnesse. See noyous, Cathol. Angl., page 256. The Latin has: propinquitatem, and the translator seems to have been influenced by the preceding affenite.
• sonner, in margin.
• to, above line.
• Lat.: qui est inter corpus et animam amicabile ligamentum.
• in, inserted.
• eeris for heeris.
• Lat. emorosagia. Matth. Sylv.: "Emorogia. Emorosagia .i. sanguis fluxus vel discursus."
• Lat.: est periculum amissionis sensus et motus.
• haue, in margin.
• hosnesse. Prompt. Parv., p. 248. "hoorsnesse, Rancor."
• Sarcocolla, Gr.…, "is the Gumme or liquore of a tre growyng in Persia." Halle, Table, p. 109.
• mummie, mumia. See Halle, Table, p. 72, and Notes.
• MS. of here.
• stalworthe. See Skeat, Et. Dict., s. v. Stalwart.
• MS. as. Lat. in extremitatibus lacertorum.
• lacertis, the sinewy part of the arm. See Vicary, p. 57, note 1.
• iij fyngir mele brede. Lat. tribus digitis.
• MS. rēuere.
• spaude, spatula = scapula, shoulder-blade. See Cathol. Angl., p. 352. "spawde Armus." O.Fr. espalde.
• pele, Lat. palla. See Cathol. Angl., p. 273, note 4.
• Some words are wanting in both MSS. (entriþ þe extremite of a boon). Lat.: In hac pyside sive concavitate huius ossis, intrat extremitas ossis adiutorii.
• See N. E. Dict. This is the earliest reference for canelbone = clavicula.
• rostralia. Coracoids. "Rostriformis Processus, a Process of the Shoulder-blade, and of the lower Jawbone."—Phillips.
• Compare Vicary, p. 49, 1. 18, where the word polly is substituted for bucket.
• Rasceta, Arab = carpus. Castelli, Lexicon medic., p. 139. See Littré: "rachette," and Devic Suppl. to Littré. Dict.
• conteyned, conteyneþ for contynued, contynueþ.
• pecten, Latin, pecten manus. See Halle, Treatise of the Anatomye, p. 62 (A.D. 1562). "And after these bones Rasseta, are constitute the bones of the palmes of the hands, called Ostea metacarpis. i. Postbrachialia, Palma, vel manus pectus." The corrupt form Patinis occurs in Vicary, p. 50, 1. 9.
• MS. pasceta.
• Two words (þe þombe) are wanting. Latin: Nam pollex tria habens ossa.... He counts the metacarpal bone of the thumb as a phalanx.
• conteyned, conteyneþ for contynued, contynueþ.
• fosile, Latin: focile. See Vicary, p. 49, note 3.
• in clicchinge, Latin: (pollex) ut sit solus ex opposito comprehendens cum aliis firmius, et firmius retinens apprehensum.
• Lat. in tres partes minimas diuiduntur.
• brawn, struck through after of þe.
• MS. ben.
• ben, inserted.
• corde, cancelled, after anoþir.
• ben schorpeled, Latin: disperguntur—O.Fr. escharpiller, mettre en pièces. See Godefroy.
• is sparpoilid, Latin: dispergitur—O.Fr. esparpeiller. See Cathol. Angl., p. 351, note 6.
• Basilica. See Vicary, p. 52, note 5. There is one reference for… given in Stephanus Thes., from Synesius, De febribus, which is a translation of an Arab. treatise by Constant. Africanus.
• leche fyngir. See Prompt. Parv., p. 291, note 4. O.E. læ¯cefinger, Leechd., vol. i. p. 394. See Notes.
• Salvatella. See Vicary, p. 53, note 1. Dufresne gives one reference for Salvatella with a different meaning: "Pellicula involvens cerebrum." It occurs frequently in the Latin translations of Arab. authors, and translates Arab. sceilem or osailemon.
• funis, Castelli, Lexic. Medicum, p. 351. "Arabes venam Medianam vocasse Funem brachii, testatur Ioh. Zecchius, lect. ii. in sect. 1. Sph. Hipp. p. m. 109." On this place funis evidently means not the vena mediana, but one of the recurrent veins.
• Vena ascellaris. Matth. Sylv.: "Vena communis nigra purpurea media — — dicitur communis quoniam componitur ex assellari et humerali."
• finis for funis.
• þe arme-pittis. See Wr. W., 627. 3. xv. cent.
• thenantos, sinew. Matth. Sylv.: "Tenantos gre. est chorda que in capitibus musculorum aggregatur." It is a corrupt form of Gr.… (Suidas Gloss.).
• do above line.
• wiþinne. The Latin has infra, which the translator took for intra.
• lacertis. See Vicary, page 57, note 1.
• Avicenna, Lib. III., Fen XI., Tract. I., Cap. 1, ed. Venet, 1527, f. 204: "Cor quidem ereatum est ex carne forti ut sit longinquum a nocumento."
• lungis, a mistranslation of panniculi. The pericardium is also called panniculus cordis.
• The translator has omitted the following passage: "In medio illorum duorum ventriculorum est quedam fouca: & vocatur a quibusdam ventriculus tertius, super ventriculo dextro et sinistro. Item duo additamenta cartilaginosa fortia et flexibilia quandam habentia concauitatem, et constringuntur & dilatantur, & recipientes & retinentes nutrimentum et aerem ad nutriendum et temperandum cor."
• The translation is not correct. Lat.: "ad dextrum nanque ventriculum venit una vena ex ramosa vena." This vein is the vena cava inferior, which gets the blood from the liver by the venæ cavæ hepaticæ. "The seconde veyne is called Vena choele, or Vena concaua, and of some Vena Ramosa." Halle, Anatomie, page 78.—1565.
• gibbus. See Vicary, page 69, note 1.
• sutilliþ. Latin: subtiliatur
• MS. turid. Latin: vergit in naturam supracelestium corporum.
• arteries, wanting.
• Arteria venalis. See Vicary, page 58, note 1.
• MS. inserts, ij cootis
• The translation is corrupt. Lat.: Iste namque spiritus cordialis, qui per viam quæ dicta est a corde sumit originem, sicut omnes virtutes, quarum est instrumentum, cum ad ventriculos peruenit cerebri, aliam ibi recipit digestionem, quæ meretur formam suscipere spiritus animalis, & ita ut ad epar dirigitur, in ipso formam recipit nutritiui, et in testiculis generatiui, donec omnis spiritus, omnisque particularis virtutis perfectio cum virtutum operationibus coniungatur.
• recchinge. Latin: rara.
• braunche of arteriis & of veynes. Latin: ramis arteriæ venalis.
• MS. do. Lat.: Cor autem vulneratum curam non recipit.
• þat inserted. Lat.: et vulnerata membra indigent ut quiescant.
• "Tisica, Italis et Hispanis Phthisis."—Dufresne. "Tissick, an Ulceration of the Lungs, accompany'd with an Hectick Feaver, and causing a Consumption of the whole Body."—Phillips, 1706. tysyk, Hampole, 701. "þat man þat hath þe tisik & þe etik," Quintess, p. 17, 7.
• Olibanum. Thus masculinum. Arab. al-louban (Devic. Dict.). N.E. oliban.
• Penidium, barley sugar.
• swage. See Cathol. Angl., p. 372.
• MS. canna. Lat.: Cum autem vulnus est in cassum penetrans. Cassus, Pecten. Semibarbaris ex Arabico. Castellus, Lex. Med. Casse, Arab. Kas, cup, calice.—Devic. I would rather trace it from Lat. cassus adj. void, hollow, and cassum, i = cassa, orum sb. the hollows. The latter form cassa gave origin to Ital. cassa f. See cassa del cranio, etc.
• &. Lat.: super pannum distensum. O.Fr. planer, Lat. planare.
• encorperat. Lat. incorporatus, O.Fr. encorperer.
• MS. þorais. Lat.: De vulneribus spinæ seu spondylium & eorum anatomia. The scribe changed þornis, the translation of 'spinæ,' into þorais, for thoracis, as in the heading to Cap. V. The words: & of þo þat ben conteyned in him are taken from the same Chapter-heading.
• See Vicary's Anatomy, page 74.
• One word is here wanting. Lat.: super locum qui dicitur aboratur alahume. aboratur is perhaps a corruption for ab arabis, alahume is the Os sacrum.
• nucha, Arab. nukha', spinal marrow.
• Rases, Liber ad Almansorem, Tract. I, Cap. 1, ed. Ven. 1506, fol. 2. "Cerebrum quasi fons sensuum est et motus voluntarii, Nucha vero sicut fluuius magnus ab eo manans."
• duriþ. Lat. distenditur. As to the local sense, compare O.Fr. durer.
• mery, oesophagus. Arab. marijun, windpipe.
• In the margin is a diagram of the shape of the stomach.
• gibbus, mistake for ȝirbus. See Vicary, page 64, note 2; and page 86, note.
• duodenum. See Ibid. page 65, note 1.
• jejunum. See Vicary, page 65, note 2.
• Avicenna, Lib. III., Fen. XVI., Tract. I., Cap. 1, ed. Ven. 1527, f. 248. "et nominatur hoc intestinum ieiunum, quum ipsum inuenitur secundum plurimum inanitum et vacuum."
• colre. Lat. cholera. Choler, "Bilis."—Huloet.
• orobum. Lat. orbum. The Ileum is here meant.
• langaon. See Vicary, page 66, note 5. Lat. longanon, longao = the straight gut.
• siphac. See Vicary, page 62, note 4.
• dindimi, used elsewhere to signify the Testicles.
• crepature, hernia.
• See Vicary's Anatomy, page 68.
• "for his heate is to the stomacke as the heate of the fyre is to the Potte or Cauldron that hangeth ouer it."—Vicary, p. 69.
• sima, concavitas hepatis. Matth. Sylv., see Dufr. …, hollow, concave: …, the bottom of the liver. Poll. 2. 213, Galen. It is used opposite to …, convex, curved, in Galen ad Glauc. 2.—See Stephanus Thesaurus.

  Sloane 2463, fol. 40: "Syma of þe lyuer is as it were þe palme oþer þe holwenesse of þe hond. The vtilite, whi þat it is of suche forme oþer schappe is because þat it schulde ben aplied oþer leyen to þe stomak as þe hond lieth to an appull, whan þe appull is in þe hond."
• Lat.: venæ quæ sunt ipsi portæ sicut radices arbori.
• De propr. rer. Trevisa, Lib. V., Cap. 41, Add. 27,944, fol. 57b: "& Constantyn seiþ þat þe melte is i-set in þe lift side, & þe schap þerof is euelong, and is somwhat holouȝ toward þe stomak & bunchinge toward þe ribbis. In þese tweye places he is i-bounde with certeyn smale cloþinge, & me seiþ þat þe melte haþ tweye veynes, by þe on þerof he drawiþ blak colera of þe blod to þe lyuour, & by þe oþir he sendiþ what sufficeþ to þe stomak to comforte þe appetite þerof."
• vena ramosa, Vena Cava.
• Lat.: per venam chylim quæ a quibusdam pori uritides dicitur = Meatus Urinarii = Ureter. Kylym, from …, juice. See also Vicary, p. 72, note 3.
• 'Hec vulva, cunte." Wright, Voc., p. 677. 32, xvth cent. O.Fr. cunne, Lat. cunnus, cunte is a diminutive form like cunetta of cuna.
• Lat.: primo tamen ipsum faciat confiteri.
• Comp. Vicary's Anatomy, p. 81.
• Compare Auicenna, Lib. III., Fen. XX., 1. 1., ed. Venet. 1527, fol. 279: "Sublimis deus creauit duos testiculos," etc.
• De propr. rer., Lib. V., Cap. 48, Add. 27,944, fol. 60b: "For as Constante seiþ, to covenable getynges & gendringe of bestis god haþ ordeyned & i-made couenable membres, in þe whiche he haþ i-sette þe cause & mater of generacioun, þe whiche may not come forþ in dede wiþoute affeccioun of loue. ¶ In þe membres genytal god haþ send such an appetite inseperable, þat eueriche beest schulde be comfortid to multeplie beestis of his owne kynde, and þat is i-doo by schewinge of god, lest ȝif þe doynge of generacioun were abhominable, generacioun of best were i-lost." This passage is taken from Constantinus Afric. De morb. cog. et. cur., Lib. VI., Cap. 1, ed. Basil, 1536, p. 122.
• Avicenna l. c., "Et in virga sunt meatus tres, meatus vrinæ et meatus spermatis et meatus alguadi." Matth. Sylv.: "Alguedi est humor ille qui egreditur, cum aliquis tangit mulierem."
• barbachi, Arab. bárbah, 'conduit of water, canal of the urine.'
• Galen (ed. Kuehn, vol. IV., p. 635) has originated this curious comparison, which has been copied by the Arab. authors. Avic., Lib. III., Fen. XXI., Tract. I., Cap. 1, Ven. 1527, fol. 285b: "Matrix est quasi conversum instrumentum virorum."
• to, mistake for from. Lat.: per quas sanguis ei venit ab hepate.
• Some words are wanting. Lat.: partusque completo tempore constringatur.
• Lat. Se si collo vulnus fleri accideret. Phillips. "Collum Uteri, the Neck of the Womb."
• arnoglossum. Wr. Wü., p. 559. 27 (XIII. cent.) "Arnoglosa, i. plauntein," O.E. wegbrade, waybread.
• Sloane 2463, fol. 42b: "þei ben cleped ylia other ossa yliorum, and in þe vtter partie of þe mydward of hem ben concauytes other holewnesse, þe whiche ben clepid boystes, in þe whiche þe endes of þe bones of the þiȝcs ben receyved inne."
• scie, Med. Lat. scia, from …, it means the hip-joint. Wr. Wü, 610. 11 (XV. cent.), "Scia an^ce the whyrlebon."
• alkarad, Lat. alchaab, from Arab. al kab, a die.
• Racheta, Lat. Rasceta, from Arab. rusgh, which means the carpus or the tarsus. The Rasceta pedis is not exactly our tarsus, as it comprises only the three Cuneiform bones and the Cuboid bone.
• for a mormal, ad malum mortuum, a severe form of leprosy. See Prompt. Parv., p. 343.
• Inserted by the translator; the number of the chapters is incorrect. Lat. Add. 26,106, f. 44b: "Incipit tractatus tertius, et erit de curis morborum, qui non sunt vulnera, qui possunt accidere diuersis membris a capite usque ad pedes, que veniunt ad curam cyrurgici, qui continet tres doctrinas et est capitulum primum doctrine prime, tractatus tertii de ornatu capillorum."