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.

[SCIENCE OF CIRURGIE.] Addit. MS. Brit. Mus. 12,056.

Now the Chapitelles of þis bok buþ y-ordeynde, y wyl fulfylle my purpos, pursuynge every chapytell by ordere, & confermynge my wordys after þe Autorite of myn Autores, & wiþ experyment þat y haue longe tyme y-vsyde with help of god.

Al thynge þat we wolde knowe, by on of þre maneres we mowe knowe, oþere by hys name ore by hys worchynge, oþere by hys verrey beynge schewynge propirte of hym selff. In þis þre manere we mowe knowe surgerie by expownynge of hys name; ffor syrugie cometh of syros, þat ys a word of grewȝ, & in englyssche syros ys an hand, & gyros grewȝ, þat ys worchynge an Englyssche; for þe ende & þe prophyte of surgerye ys* of hand wyrchynge. Of þe Name of a thynge Galyen seyth: he þat wyl knowe* soþfastnesse of a thynge, besye hym noȝt to knowe þe name [folio 33b] of a thynge, bute þe worchynge & þe Effecte of þe same thynge; where fore he þat wyl knowe surgerie ys, he mote vndirstonde, þat yt is a medycineal sciense, whyche techiþ vs to worche with handes in Mannes body, in

kuttynge ore opnynge þo partyes þat ben hol, & in helynge þo that ben tobroken oþere kutte, as þey were to fore, oþere ellys as nyȝ as a Man may, and al so in doynge aweye þat ys to myche above þe schyn: as wertys, oþere wennys, oþer flesch to hyȝh.

¶ The secunde Chapitell of þe ffurste Tretys is of þe qualites, maners and cunnynge of a surgien.

Nedfful ys þat a surgien be of a Complexioun wel proporcyonede, & þat is complexioun be temperat. Rasys seiþ, whose face ys nouȝt semlye, ys inpossible to hauen gode maners; *& Auicenne: euyle maners* beþ folwynge þe lyknesse of an yuele complexioun. A surgien moste han handys wel schape, longe smale ffyngres, and hys body nought quakynge, & alle hys lymes able to fulfyllen gode werkynges of hys soule. He most ben of sotyl wytt, ffor alle þynge þat longyth to surgerye may nought wiþ lettres ben wryten. He moste stodyen in alle þe partyes of naturell ffylosophye & in logyk, þat he mowe vndirstonde scriptures; in gramere, þat he speke congrulyche; in art, þat techyth hym to preven ys proposiciones with gode resoun; in retoryk, þat techith hym to speke semlyche; be he non glotoun, non spowsbrekere, ne Envyous, ne no nygarde; be he trewe, vmbelyche [folio 34a] & plesynglyche bere he hym-self to hys pacientis; speke he non Rybaudye in þe seke mannys house, ne in þe seke

Mannes house gif non counseyle bote he be y-askyde, ne speke he with non womman in no [no above the line.] folye in þe seke Mannes howse, ne chyde nought with þe seke Man ne with none of hys meyne; but curteslye speke to þe syke man, & in alle manere syknesse behote hym hele, þowȝ þou be of hym dyspeyred; but neuere þe lattere seye to hys frendys, þe cas as yt stant. Loue he non harde curys, & entyremete he nought of þo þat beþ in dyspeyre. Pore men helpe he be hys myght, & of ryche men aske he gode rewarde. Preyse he nought hymselff with hys owne mouth, ne blame he nought scharplye oþere lechys; loue he alle lechys & Clerkys, & by hys myght make he non leche hys enmye. So cloþe he hym with vertues, þat of hym mowe a-rysen gode fame & name, & þis techyth Etyk. So lerne he ffysik, þat he mowe with gode rulys hys Surgerye deffende, & þat techith ffysik. Naþeles yt ys necessarye a surgien to knowe alle þe partyes in eche sengle partye of a medycine, ffor ȝif a surgien knowe noȝt þe sciens of Elementis, whiche þat buþ furst Meverys of naturel þynges & of dyuerse lymes, he may noȝt knowe sciense of coniunctiounes, þat ys to seye, medlynges & complexiouns þat beþ necessarye to hys crafte. A surgien most knowe þat alle bodyes þat ben medlyde, þat ben vndire þe cercle of þe Mone, ben engendryd

of foure symple bodyes, here lyknesse eche in oþere medlyng; þat ys to sugge, fyr & eyre, erþe & water. Þese elementys, ffor þe outemast ende & outemast contraryousite of here qualites, weren fer drawen from bodily lyffe; but whanne here [folio 34b] qualytes, þat is to sugge manere of beyinge, comyn in to medlynge, so þat þe leste partye of þat on entre in to þe leste partye of þat oþere partye, medlynge brekyth here contrariosite, & þere of comme a newe forme & a newe complexioun of þe medlynge of here substaunce. Al so þe medlynge of þe qualitees & þe quantites ys fer drawyn from þe contraryousite of þe same elementes, & so complexioun is nyȝh brought to a mene, & so þat þat ys medlyde ys more able to resseyuen þe noble forme of lyff, þe whiche noblete aboffe alle bodyes y-medlyde ys y-founden in Mannys spiryt. But for þat þe qualites, þat with þo bodyes of Elementes comyth in to Medlynge—& yt ys vnpossible to departe þo qualites from bodyes—ben foure: hot, colde, moyst, & drye, & complexiouns ben by ham, yt ys necessarie to fynden in bodyes þat ben medlyde, foure complexiouns; Complexioun ys noþynge ellys but a manere qualite medlyde in worchynge, & suffrynge of contrariose qualites þat buþ founden in Elementis, so þat þe leste partye of eche elemente entre in to þe leste partye of þe oþere partye. And for þat þilke foure complexiouns: hot, colde,

moiste & drye, sumtyme ben y-componyd, þat ys to sugge medlyde, þere comen of hem VIII, as hote & drye, hote & moist, colde & drye, colde & moiste; ffoure of þese ben symple, & foure ben componyd. And for þilke VIII sumtyme ben with mater, sumtyme withoute mater, þere ben XVI; & for þilke XVI, after sum consideracioun mowe ben naturell to sum Man, [folio 35a] & to sum man vn naturell, þere mowe ben XXXII. Nevere þe lattere amonge alle þe complexiouns þat man may fynden, þat is componyd of dyuerse qualites, þere nys non so temperat as ys mannes complexioun; havynge rewarde to mannes complexioun, alle oþere þynge ys* clepyde colde, hote, moyste, oþere drye. Whanne þat a mete, oþere a medycine, hath y-suffryde kendlye hete þat ys in Man, & hetyth hym noȝt & colyth hym nauȝt, ne dryeþ hym noȝt, ne moysted hym noȝt, so þat mannes complexioun may noȝt conseyven wheþer yt colde hym, ore hete, dryȝe, oþere moyste, yt is clepyde temperat; & þilke thynge we sigge is hot in þe firste degre, þat ys y-hatte of kendlye hete, þat ys in oure bodyes & hetyth oure bodyes withouten grevaunce, & þilke we siggen be hote in þe secunde degre, whiche þat ys y-hette of oure kendlye hete, so hetyth oure body, þat he ne myȝte hete vs namore withouten greuaunce; hot in þe þridde degre:

þilke we sigge to be hot in þe þridde degre, whiche þat ys y-hatte of kendlye hete, bryngeþ to oure bodye sencyble greuaunce; hot in þe fourþ degre: and þilke in þe fourþ gre þat is y-hat of kendly hete, dystroyeþ þe body opynlyche; & in þis same manere ȝe may knowe degrees þat ben colde, & y may preve in þis manere þat yt is necessarye a surgyne to knowe complexiouns of bodyes, lymes, & of medycynes. ¶ Take two men þat ben off one age, & lete hem ben y-woundyde with a swerd oþere a knyffe twarte offere þe arme, in one oure & in [folio 35b] one place. One of þo men ys of an hote complexioun & a moyste, þe oþere of a colde & a drye; þe comyne siggynge of lewyde men ys, þat þey scholde boþe by helyde aftere o manere. But resonable surgye wel y-proved, techith vs þat þey ne schulle noȝt boþe ben y-helyde aftere on manere; for he þat haþ an hot complexioun & a moyst, may lyȝtliche haue an hote enposteme, þat ys an hote swellynge, & þat may be cause of an [an above the line.] hote ffevyre. What schaltou þanne do? Þou moste loke wheþer he haue y-bled myche blod at hys wounde, & þenne it ys wel, ellys lete hym blod of þe contraryose arme, oþere ellys* on þe fot on þe same syde; ȝif strengþe & age acorde, oþere ventuse hym on þe tweye buttokkys; gif þat he be feble, ȝif he may noȝt go to sege onys a day, helpe hym þereto

oþere wit clysterye, oþere with suppositorye; & brynge þou þe partyes of þe wounde to-gedire, oþere with sowynge, oþere wiþ plumaciolus—þat beþ smale pelewys—oþere with byndynge, ȝif þat sowynge be noȝt necessarie. And þenne worche aboute þe wounde, as it ys tolde aftere in þe boke; but aboue þe wounde leye a Medycine defensiue, of bol Armonyac, oyle of rosys, & a litel vynegre, so þat þe medycine touche þe sydes of þe woundes, þat humours mowe noȝt hauen here cours to renne to þe wounde. And we forbyde hym wyn, Milke, & eyren, & fysch, þat engendrith myche blod; but he schal ete for his Mete gruell y-made of ote Mele, oþere barly mele with Almaundes, & generaliche he schal vsen a streyt [folio 36a] doynge, tyl þou be sykere þat he schal haue non enposteme. And ȝif þat we cunne dyffenden hym from a ffevyre & aposteme, þe science of hys complexioun techyth vs þat he may of hys seknesse sone be hol. ¶ Þe oþere of þe colde complexioun ne schal noȝt be leten blod ne ventusyde, ffor blod scholde be kepte in hem as for tresoure; forbyde hym neiþere wyn ne flesch; for þe stomak þat ys so feble, ne myȝte nouȝt engendre necessarie mater of blod þat longyth to þe wounde; ne we dredyth noȝt in hym þe ffevyre, for his complexioun ys noȝt able to resceyuen þe ffevyre. We mowe

fynden a Medycine made in o manere þat wirchith dyuerse effectis, & he be y-leyde to dyuerse complexiouns. Grene vytreole, & he be done to a Man of dryȝe complexioun, engendrith flessch; & ȝif þou leggen hym on a moyste complexioun, he greuyth noȝt onlyche, but coroduþ yt. And naþeles vitreole haþ but one manere wyrchinge, þouȝ he wirche dyuerslyche in dyuerse complexiouns, ryȝte as þe wirchynge of þe sonne ys dyuerse—noȝt for þe sonne, but for þe wyrchynge of dyuerse bodyes in whom he wyrchyth. Vitreole dryeþ wonderlyche muche, & in dryȝe bodyes he fyndeþ þe smale lymes myghty to ageyne stonden hys strengþe. Wherefore he may nought but drye þe superffluites þat he fynte in þe [wound, cancelled because blotted after in þe and re-written.] wounde; & whenne þo ben y-dreyede, kynde engendryth fflesch. In moyste bodyes, ffor þat þe smale lymes beþ feble, & mowe noȝt withstande þe strengthe off þe vytreole, þe flesch meltyth vndire yt, & so be þe vitreole þe flesch rotyth; & þat þat ys seyde of dyuerse complexiouns, ys y-seyde of dyverse lymes. Galyen: ȝif þat tweye woundes [folio 36b] ben evyne i quyter, & þe on be in a dryȝe lyme, & þe oþere in a moyste lyme, þat þat is in þe dryore lyme nediþ þe dryore medycine. And ȝif þat two lymes ben y-wounded þat ben lyche in

complexioun, & þat on haþ myche quyter and þe oþere lyte, he þat haþ myche quyter nedyth to haven þe dryere medycine. Iohannes damacenus: Medycines & enplastres scholde ben acordynge to þe lymes þat þey ben y-leyde on. Galienus: a kendlye thynge schal be kepte with þynge þat ys kendlye þere to; and þat þat is aȝeyne kynde schal be done away with þynge þat is contrarye þere to. Ȝif þat a surgien knowith noȝt complexiouns of lymes & of bodyes, he schal noȝt kunne to chaungen hys medycines aftere þat kynde askeþ. A surgien moste knowe generacioun of humours, ȝif he wolde knowen þe sciense & þe helynge of Apostemys, as yt schal ben declared in þe tretys of apostemes; he moste knowyn þe dyuersite, & þe profytes, & þe offices of lymes, þat he mowe knowen what lymes han grete wyrchynge in mannys body, & whiche ben of grete felynge, & whiche mowe bere a stronge Medycine; & þe vertues of lymes he moste knowe, þat he se whanne þat þe worchynge of enye vertue fayleþ in enye lyme, þat he mowe helpe þe vertue in þe same lyme faylinge. And ȝif he haue þe science of knowynge of vertues, þe sciense of spiritus ne schull noȝt ben y-hud from hym. Alle þese þynges before seyde beþ natureles, & þey beþ techynge of medycine speculatyff. Also he moste han knowynge of thynges þat beþ noȝt natureles, þat he kunne chesen gode eyre to hym þat is y-woundyde,

oþere ellys haþ a bocche. Woundes mowe noȝt ben y-dryȝed in a [folio 37a] moyste eyre & a vaporose, but þey þat ben y-woundyde most bene y-chaungyde from þat moyste eyre to a swote cler eyre & a dryȝe. In wyntere he moste kepe hym from colde, ffor noþinge grevyth so myche bonys & synwes þat buþ y-woundyde as colde. And in somere he moste han a temperable eyre; hit ys necessarye þat he kunne dyoten hys pacient, as y schal tellen in þe same Chapytell of dyotynge. Also he moste ordeyne moffynge & reste, as yt nedeþ to þe same syke man; ffor ȝif þat he be woundyde in þe hed, oþere haue eny puncture off enye synwe, it ys necessarye þat he reste: dwelle he in styllenesse, & haue an euene bed & a softe, leste he suffren enye trauaylle of hys lemys; but ȝif þat olde woundes, wiþouten akynge, weren in hys Armes, hit were gode to hym þat ys seke to walken on hys fete, & bere hys arme y-bounden to hys nekke; & ȝif þat þe wounde be in hys schynys & in hys ffete, hit were gode þat he leyȝe & trauellyde with hys handes. Also a surgien, in alle þat he myghte, he moste atempre a syke Mannes slepynge, ffor to myche slepynge engendreþ superffluyte, & feblyth his vertues, & coldyth & losyth alle hys bodye; to myche wakynge dyssolfiþ & consumeþ hys spirites, & makyth scharpe hys humores,

& hit bryngeþ vnkyndly drowþe to woundes, & ys cause of akynge; also he moste kunne evacuen hym þat ys ful of euele humores, & fulfylle hym þat ys wastyde, þat he brynge seke men to gode temperaunce; ellys a wounde may noȝt ben helyd; entempre he þe hert of hym þat ys seke, ffor to gret wratthe makyþ þe spirites renne to myche to þe wounde, & þat ys cause of swellynge; [folio 37b] to grete drede, oþere vntryst of helpe of hys wounde holdiþ spyrites withynne hys body, þat mater may nouȝt come to hele þe wounde. Þese sixe thynges ben y-clepyde vnnaturell, whiche techith a Man speculatyff of leche craft. He mot knowen þe seknesse, as olde wounde, festre, cancre, & alle oþere sores, þat he traveylle noȝt in deveyne, & brynge þe seke man to hys deþ: ffor eche dyverse sore nedith dyverse helpynges. He mote knowe þe cause of þe wounde; ffor a wounde þat is mad with a swerd oþere a knyff mote oþere weys ben helyde þen he þat is y-makyde with ston, oþere with fallynge, & a wounde þat is byten with an hounde schal oþere weys ben helyde þen he þat ys y-byten with a wod hound, as þou schalt fynde tolde in þe boke hereaftere. And he mot knowe þe Accidentes þat buþ aboute a wounde, ffor the wounde schal nevere hele tyl þe Accidentes ben remevyde awey. Accidentis ys a þynge þat falliþ to þe wounde out

of kynde, as hete, colde, drowþe oþere to gret moistnesse, crampe, & oþere þynges aȝeyne kynde. A surgien mot ordeyne dyetynge in dyverse manere, as it is tolde in þe Chapitell of dyetynge. Whenne þat it is nedful, he mote ȝyve dyverse drynkes. Galien: laxativis & vomytes buþ necessarie to hem þat han olde, rotyde, stynkynde woundes; ffor whanne þat þe body is purgyde from evyle humours, þe wykkednesse of þe matere renneþ from þe wounde, & so þe wounde is sonnere y-helyde. He þat byholdeþ alle þe partyes of a medycine, he may wel se [folio 38a] that it is necessarie a surgyne to knowen ffysyk and oþere dyverse science, as hit is tolde tofore in þis boke.

¶ The þridde Chapitele of þe furste techynge is of Intencioun off a Surgyne.

Alle þe entencioun of surgerye, how dyverse þat it be, yt is on *of þre maneres: þe ffurste ys undoynge þat þat is hol; secunde ys helpynge of þat þat is tobroke; þe þridde ys remevynge of þat þat is to myche, so þat it be do with hande crafte; ffor alle þe entencioun of a surgien ys vndire one of þis þre entensiouns, oþere ellys vndire one of hem. A surgyne vndoþ þat þat ys hol, whanne he letyth blod ore garsyth oþere brenneþ, oþere setteþ on waterlechys,

ffor þis ys a surgyns craft, þawȝ we for oure pride have y-lefte yt to laborers & to wommen, for Galien & Rasys dyden it wiþ here handes as here bokys tellyþ. And we vndoþ þat þat is hol, whenne þat we kutteþ þe veynes þat ben in þe templys & þe forhed, & makyth cauterisaciones from þe seknesse of þe eyȝen, & whenne þat we maken Cauteries in þe hed & in dyverse places of þe body as y schal telle in þe chapitell of Cauterysynge. Þe secunde entencioun ys to hele þat þat is tobroke as: woundes, olde woundes, ffestres, Cancres, and in bringynge to here place Ioyntes þat bene oute, & in helynge bonys þat ben tobroken. Þe þridde entencioun is to remevyn þat þat ys to myche as scurffyls of þe hed & þe nekke, & oþere partyes of þe body, & Cataractis þat ys a water þat comyth bytwene þe whyte of þe eyȝe & þe Appul. Sebel þat beþ veynes þat buþ in þe whyte of þe eyȝe, & beþ ful of blod. Vngula, [folio 38b] þat ys a thynge þat bygynneþ by þe nese & goth overe þe eyȝe, tyl he keffere alle þe eyȝe & knottes þat ben in þe eyȝe, & oþere seknesse of þe eyȝe, & in doynge awey polippes þat is flesch þat growiþ with ynne þe nese, wertys & wennys, fficus þat is a superffluyte þat growiþ vp on þe skyn off þe pyntellys hed withouten, emeraudes & a schyn

þat enclosyth a wommans prive membre, þe sixte fynger of þe hand, and manye superfluytes þat beth nought semlye to mannys body.

¶ The ffurste Chapitell of þe secunde tretys ys an universel word off smale lymes, & here helpynges of generacioun of enbrion þat is child in þe moder wombe.

Galien seith þat it ys necessarie a Surgien to knowe Anotomye, ne leffe henoȝt þat iche brode ligament þat ys a schyn, & iche rounde ligament to ben a synwe, & so be hys opynioun he myȝte fallen in erroure. Þerefore i þynke to ordeyne a Chapitell of þe kynde & of þe fforme & þe helpynge of alle smale lymes. Avycene seith, knowlechynge of a þynge þat haþ cause may noȝt be knowe but by hys cause, þerefore we mote knowe þe cause membrorum consimilium: þat ys to sigge smale lymes. Y wyl telle þe generacioun of embrion, þat ys to sigge, how a childe ys bygete in þe modire wombe. Galien and Avycene tellen þat of boþe þe spermes of Man & womman—wirchynge & sofferynge togedires, so þat iche of hem wirche in oþere & suffren in oþere—embrion ys bygete. But þe worchynge of Mannes kynde is more myȝtyere, & wommans [folio 39a] kynde

ys more ffeblere. Ffor ryȝt as þe rendelys of chese haþ hym by weye of worchynge, & þe Mylk be weye off suffrynge, so to þe generacioun of embrion, Mannes sperme [MS. spernes.] hath hym be weye of worchynge, & wommans sperme [MS. spernes.] be weye of suffrynge, & ryȝt as þe rendles & þe mylk makyth a [Above line.] chese, so boþe þe spermes [MS. spernes.] of man & womman makyþ þe generacioun of embrion. Þowȝ þat alle þe smale lymes of a childe be y-geten of boþe two spermes, [MS. spernes.] naþeles to cloþe hem with fflesch & with fatnesse comeþ to hem menstrewe blod. Þe marys of a womman haþ an able complexioun to conseyven, & of here kynde sche castyth þe spermes to þe deppeste place off here, and of here nature sche closyth hire mouth þat þere myȝte nouȝt entre þe poynt of an nedle. And þenne þe formal virtue whiche þat almyghty god haþ ȝeuen to the marys, ordeyneþ & deff[e]ndeþ every party of þese spermes in here kynde, tyl þat þe childe ben ybore. Understande þat þe flesch & þe fatnesse ys y-mad of menstrewe blod, the bonys & þe grustlys, ligamentes, synwes, cordes, Arteries, veynes, pannycles, þat buþ smale cloþes & þe schyn buþ engendred of boþe þe spermes, as Avicene & oþere Autores tellyn. Ȝif þat enye of þe lymes þat buþ engendrede off the spermes be don away, *he may nevere verrelyche ben restoride, ffor þe matere of

hym ys þe sperme of þe fadire & þe modere. But þe flesch whose matere ys blod þat is al day engendred in vs may wel & verreliche be restoryde. Þese smale lymes han dyverse formes, complexioun, & helpynges after the dyversite of þe proportiouns of þe mater whiche þat þey ben [folio 39b] mad of; ffor þowȝ þat alle the lymes be mad of on matere y-medlyde, naþeles in eche of þe smale lymes þere is a dyverse proposicioun [read "proporcioun."] of matere, for the whiche matere þey taken dyverse forme & dyverse helpe. Almyghty god gevyth to effrye þynge of hys forme after þat hys matere *proporcioned deservyt.

Þe bon is furst of consimile membris þat is on off smale lymes, þe whiche ys colde & drye, & he haþ dyverse formes in mannes bodye, for he helpiþ dyversliche; þe cause why þere ben many dyverse bonys in mannys body is, [is above line.] ffor sum tyme it ys nede to meffyn o lyme without an oþere, & þat were inpossible, ȝif in alle þe body were but on hol bon. An oþere cause is why þere ys many bonys; for sum diffenden þe principal lymes from harme, as þe brayn scolle þe brayn of þe hed; somme ben ffundamentys, as þe bonys of þe rugge, & of þe schynes, & of þe Armes. Some ben as armure, as additamentys, þat ben in þe syde of þe rugge bon, & somme fulfylle þe holwenesse of somme Iunttes, as þe handys & þe

fete, & somme þere ben þat þe roundnesse of on bon myȝte entre in to þe holwenesse of þe oþere bon & naþeles scholde noȝt lakken hys meffynge, as þe schulder bonys, & the hepe bonys. Þou maiste fynde hou many bonys þere ben in þe secunde tretys where schal be tolde plenerliche—þe Anotamye of consimile membrys of alle [folio 40a] þe body, from þe hed to þe fot. A grustyll ys cold & drye, & is nesschere þenne a bon, & hardere þanne þe flesch, & in þe flesch hath vi helpynges. ¶ Helpynge þe grustel. The ffurste þat þere scholde be a Mene, bytwene þe vtter ende of þe hard bon, & þe nessch flesch. ¶ Þe secunde, þat þe harde scholde noȝt hurt þe nessche, namlyche, in þe tyme of comprission, & in þe tyme of smytynge. ¶ The þridde, þat þe ende of þe bonys, whiche þat ben in þe Iunttes scholde han a softere confricatioun in here Iunttes. ¶ Þe iiij, þat he scholde fulfille þe office of þe bon, to susteyne a brawne meffynge, a membre þat haþ non bon, as þe overe lyd of þe eyȝe. ¶ Þe v. for his necessarie a grustyll to be [noȝt above line.] in a place þat ys noȝt ful hard, as þe þrote bolle; ffor þe ende of þe þrote bolle ys grustlye. ¶ Þe vi. for it is necessarie some lymes to han a sustentacioun & a plicacioun, þat is a foldynge, to be streynde & drawen abrod, as þe nese þrylles & þe grustle of þe ere.

Ligamente is colde & drye, & goþ out of þe bonys, & haþ þe forme of a ȝenewe, & he may be bowyde, but he feliþ noȝt, & he haþ iiij helpynges. Þe fyrste ys þat he knytte on bon with an oþere. It is necessarie þat o bon be knytte with an oþere, þat manye bonys myȝte make on body as on bon, & nevere þe later eche membre myȝte meffyn by hym-selfe, & þere fore þe ligamente was bowable & insensible; for ȝif þat yt had y-be sensible, þey myȝte nouȝt have susteynde the travaylle & þe meffynge of þe Iunttys; and ȝif þat he hadde be inflexible as a bon, of whom þat he comyþ of, [folio 40b] on lyme myȝte noȝt han meffyde withouten an oþere. Þe secunde help ys, þat he ys joynede with ȝenewys to make cordys & brawne. Þe þridde helpynge ys, þat he scholde ben a restynge place to summe senewys. Þe fourþe, þat be hym þe membris þat ben withynne þe body scholde ben tyede, whiche þat nedyþ hongynge.

A corde ys colde & drye, & he comyth from þe brayn oþere fro þe nuca, þat ys þe marye of þe rugge bonys. ¶ From þe brayn comeþ vij peire cordys, & þey buþ y-clepyde sensible ȝenewys, from þe nuca þere comyth xxx peire cordys, and on by hym selffen & þey buþ mevable; & alle þe cordys þat comyth of þe brayn, & þe nuca

habbeþ boþe felynge & meffynge. & þe cordys ben whyte, bowable, stronge, & towȝ; & of here kynde þey brynge meffynge & felynge to lymes. & for þat hit is longe to devydeþ alle þe partyes of ȝenewes; *in þe secunde tretys y schal ordeyne Anotamye of ȝenewes & here place,* as þey ligge; in þe whiche place þou moste be ware, whenne þou schalt kutte oþere brenne, whenne þat we schulle ordeyne Anotamye of official membris & of here woundes. Official membre ys to sigge: a ffynger, a Ioynt, an hand, oþere a fote *ore oþire lymes of ofyce.

Arteries beþ hote, noȝt for here owne kynde, but for þe hote blod & lyf þat goþ in ham from þe herte. Of here kynde þey ben colde & drye, & þey han tweye cloþes, outsepte on þat goth to þe longes. Þe innore cote [folio 41a] is grettere & strengere, þat he mowe withholde a Mevable matere & an hote. & here bygynnynge is of þe lyfte syde of þe herte. & þere bygynneþ tweye Arteries, on goþ to þe longe & haþ bot on cote & sprat in þe same longe, & þere endyth & bryngeþ blod to þe longe, by whom he ys y-norysschyde, & spirit of lyf, & þat he myȝte brynge from þe longe eire [MS. eiþere.] to þe herte, for to entempren þe fumose hete of þe same herte. & þis Arterie ys clepyde

venalis, & yt is a manere veyne, ffor as myche as he may haue but o cote, & þerefore he is þe more obedient to be drawen abrod þorwe out alle þe longes & also þat þe blod þat norysschith þe longe myȝte liȝtlokere swete out of þis arterie. Þe oþere Artery, þat comyth out of þe lefte syde of þe herte, haþ two cotys, because þat on myȝt noȝt ageyne stonde þe strengþe of þe spirites, and also þat þat is wiþynne þe Arterye is ful derwarde & nediþ gret kepynge. Þere ben þre helpynges of þe Arteries: on is þat colde eyre by hem myȝte be drawe & y-brouȝt to þe herte, whenne þe arterye is drawe abrod; þe secunde ys pat þe fumosite myȝt be caste out, whenne sche is constreynyde; þe þridde ys þat þe spirite of lyf myȝte be broȝt by hem to alle þe body. Þese Arteries beþ devydyde many weyes, whose divisiones Man may noȝt conseyve by hys wyt, ne þey ne beþ noȝt dredful to surgiens crafte; but whenne þou schalt drede þe arterye i schal tellen þe in here places.

Veynes by cause of here bodyes beþ y-demyde colde & drye; but for þe blod þat is withynne hem þey beþ y-demyde hote, & alle þe veynes han here [folio 41b] bygynnynge of þe lyffere, in þe whiche lyffere two veynes han pryncipal begynnynge. On veyne bygynneþ of þe holwe syde of þe lyvere, & ys y-clepyde Porta, þat ys a ȝatte, & here ofyce is to drawe chilum from þe stomake & þe guttes by mene of þe

veynes miscraykus; þilke chylum spredeþ þorwe al þe lyffere by mene of veynes Capillares. Chilum ys þe licoure of mete & of þe drynke, whenne yt goþ out of þe stomake & þe guttes. Veynes miserayke beþ smale veynes, þat comyth out of þe veyne þat is y-clepyde porta, & clevyth on þe stomake & þe gottys. Veynes capillarys þat beþ veynes, as yt were herys of a Mannes hed.

¶ After hem comyth pannyceles, þat ys to sigge, a smal cloth, þat ys mad of sotyll þredys of synwis veynes & arteries, where fore þey ben colde & dryȝe & sensible, & þey han þre helpynges. Þe firste is þat they mowe bynden manye þynges in on forme, as þe pannicle of þe hed bynde vii bonys; þe secunde Iuvament is þat þey hongen & bynden somme membrys with oþere, as þe reyns to þe rugge & þe marys to þe rugge bon; þe þrydde helpynge ys þat some membrys þat beþ insensible by here kynde, by þe pannycles þat wreyeþ hem ffeliþ by accydent, as þe longes, þe lyffere, & þe splene, & þe reynes; þese lymes by here kynde haþ non felynge, but what þat þey felyn it ys by Accident of þe pannycle þat wreyeþ hem.

Þe flesch is noȝt hot, but yt is moist, & haþ þre manere lyknesse; on ys symple flesch, & hys helpynge ys to fulfylle þe voyde placys

of smale lymes, to bryngen hem to a gode schappe, & þat iche harde lyme [folio 42a] ne scholde nouȝt hurten oþere with confricacioun togedire. An oþere manere flesch ys þat is glandelose, þat ys as hyt were achcharnes, & hys Iuvamente is þat he turnyth vmydites to here hete: as þe glandelose flesch of wommans brestys, whyche þat turnyth þe blod þat ys drawe from þe marys into þe mylk, þe glandelose flesch of þe ballokes, þat turnyth þe blod into sperme, & þe glandelose flesch off the chekys þat engendreþ spotel. Þe þridde manere of flesch ys a flesch þat is in brawnys, þat ys y-clepede a brawny flesch, ffor he ys medlyde wiþ sotyl þredys of cordys, as y schal tellyn aftere, whose helpynge schal be tolde in þe Anotamye of þe brawne.

At þe laste is þe schyn, þat is temperat in al here qualite, & is y-mad of smale þredys of veynes, synwes, & Arteries, þat makeþ hym sensible, and geveþ hym lyf and norisschynge, þat he be governoure of alle þe body. & þe skyn ys y-mad temperat, for he scholde knowe hot, colde, moyste & drye, softe & hard, scharpe & smeþe; & ȝif þe skyn were as sensible as a ȝenewe, a man myȝte noȝt dwellen in colde eyre, ne in hote eyre; ne þe skyn of þe fyngres endys, whiche þat ys more temperat þenne eny oþere skyn of þe body, ne scholde

noȝt ben a gode demere in knowynge hot, cold, hard oþere scharpe, softe oþere nessche.

¶ Brawnys þowȝ þey ben mad of matere y-medlyde, nevere þe latere þey beþ y-reknyde amonge membrys consimiles, for þey comen to þe makynge off Membrys-officiales. Brawne ys y-mad of fflesch, [folio 42b] ȝenewe, & ligamente, & þey ben Instrument off voluntarie mevynge. Þe ȝenewe þat comyth from þe brayn & þe nuca, & goþ forþ to meve the lymes, ys y-medlyde with a ligamente, & whenne þe ȝenewe & þe ligamente beþ medlyde togedyre, yt ys clepyde a corde, & the corde ys y-made for þre skylles: þe ffurste for a symple senewe ys to sensible, & þe ȝenewe by hym-self ne myȝte noȝt suffren to grete travaylle & mevynge, but þe felawschipe of þe ligamente, þat ys insensible, lutliþ þe felynge of þe synwe, and bryngeþ hym to a profitable temperaunce. Þe ȝenewe hadde tweyne oþere defautes: nesschenesse & litylnesse, but þo tweyne defautes, þe medlynge of þe ligament ffulfilleþ; for the neschenesse ys entempred & y-strengthyde, and þe lytelnesse ys y-made more. The nesschenesse comyth of þe brayn, ffor it ys nessche; and þe lytelnesse comeþ of þe Nuca, for it ys lytel. Þat þat is mad of þis nerff & þis ligamente ys clepyde a corde, whiche þat meviþ þe lymes to wyl of þe soule,

whenne þat it is schortid oþere y-drawe, aftere þat þe lyme bowyth to þis corde. ffor þere ys Asosyed a symple *fflesch forto maken a brawne for þre proffytes: þe furste profyt, þat boþe in drawynge & wiþdrawynge of þe corde, the flesch scholde be as a pylwe, vp on whom he myȝte reste; þe secunde cause, þat þe flesch þat is nessche & moyst schulde kepen þe corde, þat [folio 43a] sche dreyȝede noȝt in here mevynge; þe þridde, þat þe makynge of lymes were þe more schap-lokore. Þe brawne is made bowynge, as a bowe þat ys y-bent; & for þat kynde wolde kepe þys compositioun, he clothyde þe brawne wyþ a pannycle. Þe corde whenne he entrith in to þat brawne, ys departyde in to many smale þredys, & þey ben clepyde vylles, þat ys to sugge, wrabbynges. & þese villes bene of þre maners, in lengþe—by whom vertue þat draweþ haþ myȝt, in brede—by whom vertu þat castyth out haþ myȝt, in twart ofere—by whom vertu *þat wiþhalt haþ myȝt; & at þe ende of þe brawne þilke þredys beþ gadride to gedre to maken a corde, after þat it is necessarie, many cordys oþere brawnys to ben engendride. & official membrys ben y-mad of þese consimile membrys, whiche þat beþ instrument to resonable sowle. And in þe secunde tretys y wyl tellen þe anotamye of lymes of ofice.

The ffurste Chapitle of þe þridde techynge is of difference of woundes & olde woundes & off generall cures.

¶ We schulle vndirstonde þat wounde, olde wounde, ffestre, cancre y-wondyde, a bon out of loynt, a bon tobroken, Aposteme, alle þese ben y-clepyde vndoynge of þat þat ys hol, & alle þese seknesse & manye oþere as wel mowe fallen to consimile membrys. as to oficial membris. Vulnus is a newe wounde. Vlcus ys an olde rotyde wounde. I schall [folio 43b] tellen in here place þe dyfference of festre & cancre & apostemys. Plage comynliche ys y-taken of an olde wonde; and ofte tyme we fynden, þat an olde wounde ys y-clepyde Vulnus, as Ipocres seiþ: Vulnera Annua necesse est in eis os tabefieri & cicatrices concavas fieri. ¶ That is to sugge, it ys ned, þat þe bon in an olde wounde to be rotyd, & þe Cicatrices to be holwe. Cicatrice ys þe place of þe skyn above the wounde, whenne þat yt is hol. Some wounde buþ symple & some ben componyde. In tweye manere he ys clepyde a symple wounde. On manere, for he haþ noȝt leste of flesch; an oþere maner, for he haþ non oþere seknesse with hym, ne is noȝt distempride. A wounde componed ys y-clepyde contrarye to hym þat is symple. But boþe symple & also componyd

some tyme is in þe flesch oþere in þe synwe oþer in bon, oþere in veyne, oþere in arterie. Also þese wondes han dyverse causes. Some comen from wiþynne of þe malice, oþere of to gret multytude of humores; *forto gret multitude of humores oþere while tobrekyth þe membre, þat wiþholdiþ & woundiþ hym cold matere streyneþ, drye matere kutteþ, moistnesse withouten matere makeþ no wounde, but selden with matere, but he drawiþ þe lyme to brode. And also þe cause wiþout may be dyverse, oþerwhyle with a swerd, ore with a þynge þat kutteþ alonge, oþerwhile with a knyff, oþere a spere, oþere an arwe þat [folio 44a] prykeþ, & somme ben made wiþ a stafe, oþere with a ston, oþere with fallynge, & somme ben mad with bytinge of an hound, oþere of a wod hounde; & alle þese ben dyverse, after þe dyverste of here cause; & also þe manere of helynge ys dyverse. Alle þe entensioun of helynge of woundes, ys forto sowdyn & to helyn, & to restoren þat þat is departyde, whiche þat may noȝt overe al be don. Ffor ȝif þat membres of offyce ben kutte of, þey mowe nevere ben restoryd; ne non of þe consimile membres may be restoryde, & he be don awey: as bonys, pellicules, grustles, ligamentis & schyn. Ffor þe cause of here generacioun is þe sperme of þe ffadire & þe modere, as y tolde tofore; but in place of thynge þat is lore, kynde restoryth þat þat is most convenient to þat place; but the flesch may be restoryd, by cause þat þe blod ys engendred

al day in vs, & þe blod ys þe matere of flesch; & somme suggen þat veynes, synwes, & arteries myȝte nouȝt be restoryde as þey were tofore; but þey mowe be restoryd as bonys buþ. But Galien & Avycene, & I þat am expert here suggynge, suggen þat þey mowe be restoryde with verrey consolidacioun, whanne þat here kuttynge ys lytell, & whenne þat þe synwys þat buþ newe kutte beþ so wyde aȝeyne; but þey mowe noȝt be consouded, whanne þat here kuttynge ys gret & myche; & resoun grauntyth yt. Synwys by kynde buþ nessche and viscose; & þerefore þey mowe ben consouded. Þe veynes & þe arteries mowe be consouded by resoun of þe blod þat ys in hem. I þynke to ordeynen eche Chapitell [folio 44b] be hym selven, aftere þe dyversite of lymes & of placys, whyche þat þey buþ y-made yn; & y wyl begynne at a symple wounde y-mad in flesch.

¶ þe secunde Chapitell off þe thridde techynge off the ffurst tretis is of cure of a wounde y-mad in fflesch.

Now we willen treten of a wounde y-makyd in fflesch. We wylle begynne at a symple wounde, y-mad wiþ knyff oþere wiþ swerd ore spere, oþere with arwe, oþere with enye oþere thynge

semblable to hem. Bynde togedyre þilke wounde with a band þat close þe wounde to gedire, & kepe þe wounde from swellynge, with þe whyte of an eyȝe y-leyde aboue þe wounde, & lete þat wounde ben in reste, & þere nedyth none oþere cure, namlye, whanne þe wounde ys withouten akynge; but and þere be in wounde gret akynge, þanne þere is a tokne þat þere ys a synwe prikyde vndire þe wounde, oþere a pannicle þat ys betwene þe flesch & þe bon, & þanne þere ys al an oþere cure, as y schal telle in þe chapitell of the puncture of a synwe. And y haue helyd a man þat was *sefenty ȝere olde, þat was y-smyten wiþ a spere þorwe þe flesch of þe buttoke by þe lengþe of a fote *& more, but þilke wonde touchyde non synwe; & þat y wiste sykerliche, for he had non akynge; y helde the wounde opyn al a day, with a lyte smal tente & a schert þat y myȝte wyte, ȝif þat he scholde ake on þe morwe & I comaundyde hym to reste, and on þe morwe y fonde non inflacion ne akynge, & þenne y caste aweye þe tente & lete þe wounde closen, & so y comaundide hym to reste, & wiþynne þe þridde day he was al hol. And ȝif þat a wounde were mad wiþ a swerd, oþere wiþ eny þynge þat [folio 45a] kutteþ in lengþe, a man most loke ȝif þe wounde be so litel þat he nede non sowynge, & þenne brynge þe parties of þe wounde togedyre, þat it may wel ben y-joynede, & leye above þe wounde a poudere y-mad of on partye of ffranke-Ensence,

& of two partyes of sancdragoun & of þre parties of quykelyme, & lete noȝt þe poudre entre wiþynne þe wounde but above, for þere schal noþynge entre withynne þe wounde, & kepe þe parties of þe wounde þat buþ brouȝt togedire with a plumacyole þre corneled y-made of hurdes oþere towȝ in þis manere

[figure]

on be þe sydes of þe wounde, so þat boþe þilke plumacioles holde þe wounde þus y-closyde

[figure]

& joynde togedire, as yt was joyned ere þenne yt was ykutte; & bynde þe wounde togedire abouen þe plumacioles, with a rolle þat goth twartoffere after þis lettere XX, & take a lynnen cloth & wete hym in two parties of whyte of an eyȝe, & in on partie of oyle of roses i-bete togedire, vndire þe plumacioles abofe þe wounde, þat ys y-browȝt togedyre, forto kepe þe poudre, & do noȝt awey þe medycine tyl foure dayes ben ago, but ȝif þat þe wounde ake, oþere ellys be to-swollyn; & þenne bynde þe wonde as yt was toforne, with þe whyte of þe eyȝe, oyle, poudre, & plumacioles. But ȝif þe wounde were so myche, þat þe byndynge wolde noȝt suffice, oþere were kutte twart offere þe lyme, so þat þe partyes of þe lyme myȝt noȝt wel be browȝt togedire, þanne sowe þe wounde on þis manere: joyne þe lippes of þe wounde togedire, & ware þat non oyle *ne dust, ne noþynge ellys þat lattyd consolidacioun, falle bytwene

þe lippes of þe wounde, & haue an nedle [folio 45b] þre kornerde, whose eyȝe scholde be holyde on boþe sydes, so þat þe [þridde cancelled before þrede.] þrede þat is in þe nedle may ligge in þe holwe place, & þilke schal be twynede, & withoute knotte & ywaxide, & þe lippes of þe wounde schulle ben sowyde togedyre, & þe þrede schal be knette with two knottes in þe firste place; in þe secunde place with on knotte, & so make as manye punctis as yt is necessarie, & eche puncte schal be from oþere by þe brede of a lytel ffyngere, & streyne þe wounde wiþ knettynge, & þe sowynge of þe lippes of þe wounde togedire þat he ake sumwhat, but noȝt to myche, & ȝif þat þere nede mo punctis to be þere þen two, efire more þere schal be odde punctys, as þre, fyfe, oþere seuene; & þe on puncte schal be fyrst from þe on ende of þe wonde by þe [sp. cancelled before brede.] brede of a litel fyngire, & þe oþere puncte schal be at þe oþere ende of þe wounde, & þe þridde puncte schal be in þe myddul of þe wounde; & ȝif it be nede to haue mo punctis, þou schalt begynnen at þe myddel puncte, & make as manye punctes on boþe þe sydes, as yt ys nede, tyl þou come to boþe endys; ffor by þis manere of sowynge neiþere partye schal be crokyde, & so þe place may fairere ben restoryde. And eueremore take hede, *ȝif þe wounde be noȝt depe, þy sowynge schal be nouȝt depe. And ȝif þy wounde be depe þy sowynge schal be depe, þat alle þe parties of þe wounde mowe

be joyned togedire. Ffor ȝif þe wounde were depe, & þy sowynge were noȝt depe, nedys þere moste ben in þe depþe of þe wounde a gret holwenesse, to þe whiche holwenesse blod & quyter scholde be cast; & þilke quyter & blod scholde lette þe [folio 46a] helynge of þe wounde. And þe poudre þat ys seyde in þe same chapytell schal be leyde aboue þe same sowynge, & þou schalt kepen þe sowynge & þe parties of þe wounde, þat buþ brouȝt togedyre, with plumacioles þre cornelyd & with alle oþere þynges þat beþ in þis chapytel forseyde. And ȝif þat a wounde haue be to longe in þe eyre opyne, whiche þat ys cause of quyter þat latteþ consolidacioun, þenne we moste clense þe wounde with [MS. þat.] þis mundificatyff, þat is mad of floure, of whete & hony & watyre oþere mel rosate, & colat þat ys y-clansed from þe roses, & of barly mele. Of þese mundyficatyfes þou schalt han a ful techynge in þe laste tretys. But ȝif þe wounde be y-componed, a leche moste han as manye intensiones as þere ben accidentys to þe wonde. Y sette ensaumple: y suppose þat a wounde be componed with holwenesse & lesynge of fflesch & of skyn, & þere be myche quyter & al so þere be a posteme & þere be grete akynge, al this ys clepyde a wounde componyde. Þanne we schulle noȝt only take hede to consolidacioun of þilke wounde, þat is to sigge helynge, but firste we

schul aswagen akþe & aposteme, as yt schal be tolde in þe chapitle of aposteme & of akynge; aftirwarde we schullen clanse þe quyter, & aftere þat regenere fflesch, & at þe laste brynge ouere a Cicatrice. In alle þe werkynges of medicine, where þat akþe ys, ffirste we schulle aswagen akynge; ffor abouen alle oþere þynge stronge akynge, ouere comeþ myȝte of vertu & strengþe, & also resoun tellyth; membrys þat han akþe, þilke akþe ys cause of drawynge from oþere places to þe membre þat akeþ [MS. akþe.] þe worste þynge of þe humoures. Avicene seyth humours beþ drawen to [folio 46b] lymes þat aken for two causes: On cause, for kynde *& Spiritus and humoures rennyth þedyre; þe secunde cause, for akþe feblyth þe lyme, & humours *& spiritis renne to þe feble lymme. Þe swellynge schal ere ben y-helyde þen þe wounde. Galien & Avycene tellen þat alle þynge þat consoudeþ þe wounde, grefyþ þe wounde, ȝif þat þere be aposteme with þe wounde, & þe quyter schal ben y-clansyde, ere þenne þou legge enye generatyff to holwe woundys. Avicenne tellyth a cause, why þat yvele flesch growith in a wounde, ȝif þat a leche wolde besy hym with a medycin regeneratyff to engendre flesch in a wounde, ere þanne þe quytire were clansede. And whenne þat þe wounde ys clensyde, þenne we schulle fulfyllen þilke holwnesse with

flesch, ere þanne þat wounde ben y-helyde; leste þat þere dwellen an holwnesse vndire þe wounde whenne þat he ys helyde, in whom þat quyter scholde be engendryde, þe whiche eche day scholde augmente þilke holwnesse, & so we moste ben constreynede to opyne an oþere tyme þat, þat was helyde tofore. Þou mayste fynden aftere in þe chapytell of woundys of synwes how þou schalt aswagen akþe, and in the sixte Chapitell of þis techynge þou schalt fynde þe cure of a wounde, þat hath a swellynge, and ys out of kynde dystempryde, and þou schalt have in þe chapitle of olde woundys; how thou schalt clense, quytyre, and regendre flessch //

[folio 47a] Cap. iii. of the þridde techynge of the ffurst tretis is of helynge of a wounde y-makyde in synwe.

Almiȝtie god hath ȝife to synwe gret felynge, & ȝif þat he be hurt he suffrede grete akynge. Galien: a synwe that is more felynge þen anoþere *lyme yt is nessessarie þat he have gretter akynge. Vndirstonde þat a wounde þat is y-makyde in a synwe, may nouȝt ben wiþouten akynge. The woundes þat beþ y-makyde in synwe, oþer þey ben in lengthe oþere þey beþ in brede. Þo woundes þat beþ y-mad in lengthe of þe synwe beþ lasse perylous,

& þo þat beþ in brede of þe synwe beþ more perilous. Oþere whyle a synwe ys y-kut al atwo, & þenne þilke lyme to whom þilke synwe serfede, lesiþ þe menynge & þe felynge þat þilke synwe brouȝt to hym from þe brayn. Oþere while þulke synwe is nouȝt y-kut a two, but he is y prikyde, and þenne it is perel lest þe crampe come for to gret akþe. For akþe entrith in to þe part of þe synwe þat is y-kut oþer priked, & by þe party of þe synwe þat is hol akþe is brouȝt to þe brayn, & so crampe may comen to þe wounde by on of þre weyes, þat is to gret akþe colde oþer rotynge. Of þese þre oþere ellys of on by hym self, may come a drawynge togedre of a synwe þat is a cause of a crampe; & þat þat is seyde of wounde of a symple synwe, oft-tymes may fallyn in a wounde of a corde & a brawn, & namlyche of a corde þat is in þe bygynninge of a brawn. Þe woundes þat ben in þese þre consimel membris, þat is *to sigge, synwe, corde, & brawn, habben on drede in course of þe crampe, & also on drede of lesynge, felynge, & menynge, & þerfor be war in þe cure of a wounde i-makyde in synwe, wheþer þat þere be a prikynge, oþere þat þe synwe be y-kut twartofere, oþer ellys be y-kut only by his lengthe. Ȝif only he be y-prikyde þe wonde of þe skyn is hol, & þenne it is clepyde a blynde puncture, oþer þe wounde is opene & it is clepide an opene prikynge. In a blynde

prikyne hit is necessarie to opyn þe skyn, & afterwarde held in to þe hole, as [folio 47b] hot as he may suffren, oyle of roses swote smyllynge, þat is y-made of oyle de olyffe, þat is nouȝt rype tyl þe wounde be al ful. & aboue þe wounde leye whyte terbentyne y-drawe abrod betwene tweye cloutes, & anoynt al þe membris about þe wounde wiþ hote oyle of rosys, y-made þikke wiþ bol Armonyak, & after þat leye a lynne cloth y-hat aboue, & after þat a gode quantyte of towȝ y-tosyd, & bynde þe lyme [MS. lynne.] softlyche wiþout streyninge; & ȝif þe akþe wiþ þis medycine wolde nouȝt cese, remeffe & chaunge þis same medycine oft tymes in þe day & in þe nyȝt, & ȝif þe prikynge be in þe fot, anoynte þe grynde wiþ hote comyn oyle, & vndire þe Arme holys & in þe nekputte, ȝif þat þe prikynge be in þe hande. For þys vncture ratefieþ & efenyþ þo placys by whom akþe goth to þe brayn, & it lattiþ drawynge togedre of þe synwe, & þowȝ þat þou sest nouȝt akþe, sese in some men, as hastly as þou woldyst, nevere þe later chaunge nouȝt þy medycine, for þere may be no bettere medycine. But ȝif þat akþe dure ouere longe yt is nouȝt efel to putte a lutyl opin to þe oyle of rosys and þe bol armoniak, þat þou leydest aboute þe wounde. Þe seke man most reste, & by

no weye he scholde nouȝt be wroþ, hys bed most be made softe euene & smeþe þat he myȝte haue rest. Whanne þat þe akþe aswagyth & þe wounde gyueth sum qyter, þan þe syke man ys saf from al manere peryle, but ȝif he do enye newe error. Of þis wounde ypocras spekiþ: In vulneribus malis & fortibus sanie non aparente malum, þat is to seye: in evyle woundys & stronge woundes, ȝif no quyter apere, hit is yuele. Stronge woundes ben y-clepyde woundys þat sore aken. Iuel woundes beþ þo, to whom scharpe humores rennyth & beþ nouȝt obedyent to kyndlie hete to ben turnyde into quyter & þerefore ypocras seyde, þat whanne þat akynge sesyth & quyter aperith, yt is a tokne of hele. Þe þridde signe a man moste [folio 48a] knowe in þis place, þat lewyde men seyne akynge & swellynge in a lyme y-woundyde, leggen þereto a maner potage y-mad of erbys & swynes grese, water, & floure of whete, corupyn þe lyme, & þilke corupcioun is cause of þe crampe; for Galyen seiþ þat a synwe is mad of a moiste matere & a cold, & he rotyth of hete & moistnesse. Also sum men forto aswage þe akþe of a synwe þat is y-prikyde, putteþ þe lyme in to hote water,* oþer ellys caste it on þe lyme hot water, [hot water, insertion.] þe whiche water is most grefes to þe synwe. Galyen: hote water þowȝ it aswage akþe, to the

prikynge of a synwe ys most greuest; colde also gefyth sore þe synwes as wel in somere as in wyntere. Ypocras in þe ferthe partye of his Amphorismes: colde is bytinge and grefes to woundys; and also in þe chapitell nexte folwynge, bot it be in a crampe wiþ out wounde. Galyen seiþ in þe ende of his comente: colde is most grefest, to a synwe lyme þat is y-woundyde & ys toswolle, namly, & he haue þe crampe. Hit sewiþ þenne þat an hote medycine & a drye is most accordynge to synwes þat beþ y-woundyde; bot nouȝt to hot a medycine, leste þat he make þe lyme toswellyn; & drye nouȝt wiþ stipticite, lest he close þe pores of þe schyn. Galyen seiþ: it is yuel to close þe pores of a lyme þat is y-prikyde. Þe medicyne þenne most ben hote & drye, wiþ subtilite as terbentyne to moiste bodyes; & to drye bodyes, he most be medlyde wiþ a lytel eufforbium. Asa fetida is best medycine, ȝif þou make of hym emplaster, serapinum, & þe feces of wax, & þe fylthes of vesselis of been, alle þey ben gode to a synwe, þat is prikyde, wheþer þou put iche be hymself oþer opyn hem; & þou schalt fynden a ful techynge of þese medycines in þe Antitodarie of þis boke. Þou schalt nouȝt closen

a wounde, where þat þe prikynge of a synwe is, ere þan þe synwe be perfitlye clansyde & helyd, & ere þou be sykere þat þe place schal nouȝt swelle. Galyen tellyth of a man wiþ a poyntel in þe pawme of þe hand, to whom come one of [folio 48b] Tesilies clerkys, þe whiche toke hede to helyn alle woundis generalyche, & he leyde to þilke prikynge a consoudynge oygnement þat was more acordynge to a wounde y-makede in fflesch, & he leyde þereto a maturatyff plastre, where fore al þe hand rotyd, & he fel into a crampe, & so he dyede ere þe vii dayes were passyde; & ȝif þat þilke leche hadde y-made þilke wounde braddere, & þenne & hadde y-helde in þe wounde hote oyle of rosys, and þenne hadde abyde quyter wiþ hote medycines sotyl & dreying, & noȝt wiþ moiste medycines, þilke man ne scholde nouȝt haue ben ded. Ȝif þat a synwe hadde ben kut twart ouer al atwo þenne, þawȝ þat tedericus & summe oþere sigge þe contrarye, hit is good þat þou sewe togedre þe hedys of þe synwys þat beþ y-kutte, wiþ þe sowynge of þe skyn & abouen þilke maner of sewynge, þe first day leye oyle of roses, in þe whiche oyle

Maddokkys, þat beþ wormys of þe erthe, haue ben boyllede; and caste aboute þe wounde þe poudre þat kepyth þe sowynge a day oþer two afterward, & kepe þe sowynge wiþ plumacioles þre kernellyde & wiþ [wiþ above line.] byndynge, & kepe þe lyme from swellynge, ffor by swyche a manere sowynge of þe synwe þou maiste consoude þe synwe ageyn, for þe lym scholde haue lost in party oþer in al the meuynge, þat was y-browȝt to hym from þe brayn, for by þilke synwe þat lyme may rekeueren hys felynge, & so þe restorynge of þe brayn may be more schaplokere & fastere. Ne þou ne schalt noȝt drede of þe akynge þat scholde be made of þe prekynge of þe nelde, for þe akþe schal be don awey by one leggynge to oþere tweyne of þilke oyle; ne swyche manere akþe may noȝt make þe crampe, for þe synwe ys al kutte atwo. Ne no man *make an obiectioun wiþ galyens wordys, þat we scholde be ware in ioyninge þe partyes of a wounde togedre, [folio 49a] þat non here ne oyle ne scholde noȝt entre wiþynne þe lippes 4of a wounde, þat beþ y-brouȝt togedre.* To þilke obiectioun we answeren, þat þe stipticite of þe roses & þe oyle þat was nouȝt ripe, & þe glutinosyte of þe wormys of þe erthe remywen þe akþe of þe synwes, & al þe harme þat scholde comen of þilke sewynge. Ȝif þat a synwe were woundede in lengþe he may be wel & lyȝtlyche y-soudyde togedire, wiþ

ioynynge of þe lippys & wiþ sowynge & wiþ kepynge of þe lym, þat he scholde [scholde, error for swelle, or it belongs to: scalle, scalde, scalled, scab. See W. Wright, and Cathol. Angl.] noȝt. Understande here in þis place, þat þere is no þynge more worschipful to a leche ne more profytable to a seke man, þenne to kepe a lyme y-woundyde from swellynge, & naþeles it is hard to kepe synwys þat beþ woundyde from swellynge. Naþeles a leche here schal take hede aftere þe techynge þat schal be geuen to hym in hys chapytell of þe cure of a wounde, whanne þat þere ys wiþ hym a swellynge. Ȝif a wounde were chaungyd of þe eyre and mad quyter, þat þe sowynge were tobroke, & þe punctis weren vndo, þenne make a medycine mundyficatyff, & leye hym abrod on a lynne cloth, & leye it aboue þe wounde, & put a lytel smal tent in þe one ende of þe wounde þat is most declynynge; & þilke tent schal touche non synwe, ne make non akþe, vndire þat þat þilke wounde be wel dryede. A mundificatyff medycine of synwes y-woundyde ys y-made in þis manere: ℞. mel rosat colat [ounce] iii smal floure of barly [ounce], & medle hem togedre & boyle hem slyȝly þat þey brenne noȝt, & remywe hem from þe fyre & bete hem togedre longe wiþ a spator, & þenne put þere to [ounce]. of whyte terbentyne, & ȝif þou maiste fynde no whyte terbentyne

wassche it wyth colde watyre, tyl it be whyt; & whenne þat by þis medycine þe wounde is almost drye, þenne put in þe same medycine a lite smal poudre of franke ensence, mastike, & sank dragoun, & medle hem to gedre, & leye aboue þe wounde tyl it be al hol; & whanne þat it is hol manye dayes aftere, leye flax in gode stronge hot wyn, tyl yt be al hol perfitlyche. & ȝif þat þere leue enye hardnesse [folio 49b] in mevynge, aftere þat it is hol, þenne þou schalt vse the techynge þat schal be geuen to þe in þe laste tretys, þat schal be antitodarye in þe chapitle of medycine, molyficatyffes; þere þou schalt fynde þe manere how þou schalt helpyn beste lymes, þat beþ y-helyde & mowe noȝt ryȝt wel meffen.

The furþe techynge of þe firste tretys is of helynge of a wounde y-makyde in bon.

Whenne þat woundes beþ so depe þat only þe flesch is nouȝt y-woundyde, but þe bon þat is vndire þe flesch & þe synwe, þenne a man most byholde wheþere þat þe bon be kut al atwo, as ofte tymes yt may happen in þe bon of þe thyȝ & þe schynebonys, & þe bonys of þe Arme, & þenne þylke wounde is ful perylouse; and namlye, ȝif þe bon of þe thyȝ ore þe bon of þe arme, from þe schuldre to þe elbowe, be y-kutte al atwo, so þat þe marye gon out. But ofte tymes

on bon of þe schyne, oþere in bon of þe Arme, ys ykutt al atwo twartofere, & naþeles afterward may be restoryde; oþer a bon ys nouȝt ykut al atwo, but sum of his substaunce ys done aweye, and þilke substaunce oþere he ys don al aweye, oþere he hongyth to gedre. A general rule ys in cure of woundes in whom bonys ben woundyde, þat neuere by a leche flesch shal be y-sowdyd aboue þe bon, but first þe bon plenerlyche be repeyrede; ffor þe bon may neuere with verrey consolidacyoun ben consouded, for his matere was þe sperne of þe fadire & þe modire, but in somme children for þe nyȝte of tyme þat þey were sperme (sic); but þere schal be mad a manere restorynge in plas of þe bon þat was broken oþere lost. þat men clepen porrus sarcoydes oþere ellys caro poroydes, & þat manere thynge þat is restoryd is hardere þe flesch & nesschere þen þe bon; & ȝif þat þilke mater þat is restoryde by neye [MS. neþe.] as hard as yt were a bon, yt is clept porus sarcoydes; & ȝif þat þilke mater be nouȝt harde, but sumwhat [folio 50a] nessche, yt is clepyde caro poroydes; ȝif þat a nesch fflesch & a moist were noȝt regenered vpon bonys þat ben set togedre, a man scholde noȝt han his purpos to helyn & to consoude þe wounde. Loke þenne wheþere þe bon be kutte a-two

al togedre twartofere, þat þou brynge togedre, & bynde the partyes of þe wounde as yt schal be tolde in þe eyȝte chapytell folwynge, where þou schalt han hou a wonde schal ben helyde þat is out of joynt, y-kutte atwo & tobroke. & ȝif þat a bon be noȝt kutte atwo al togedre twartofere, loke ȝif enye pece of þe bon dwelle sadlyche to þe on partye of þe hole bon, & þenne ȝif þou myȝte brynge þilke pece to þe place þat he was yn tofore with þrustynge don þilke pece with sum Instrumentis acordynge þereto, & sowde þilke pece wiþ þe hole bon with þe poudre, þat y schal tellyn afterwarde; for so þe schap of the lyme may dwelle fairere & strengere. & ȝif þat þilke pece haue no fastnesse to þe hole bon, do þat pece awey, & þenne regenere in þe place of þe bon þat was lost a repairment. Ffor þowȝ þat ypocras & Galyen tellyn þat it ys necessarie aftere þe quantite of a bon þat is lost, an holwe cicatrice to be alwey, naþeles wiþ þis poudre þe generacioun of þese pores may be mendyde noȝt a lytel, but ryȝt myche. Þis is þe poudre: Take ffrank ensence, Mastyke, Mirre, dragagantum gu. arabyke ana. [ounce]. ij., flour of ffenngreke, [ounce], [one half], cast þis poudre a gode quantite vpon þe defaute of the bon þat was lost, tyl þat þou haue a plenere repeyrment *& a restauracioun. Þenne & noȝt ere brynge ouere fflesch ouere þe repeyrment with *generatyffes, mundificatyfes,

& consolidatyfes, aftere þe techynge that þou haddyst toforn. Undirstonde þat alle þynge þat ys seyde of bonys in þis chapitle, ys of alle þe bonys of þe body saff þe hed; & of þe bonys off the hed y schal make a chapytle by hym-selff.

Þe ffye Chapitle of þe þridde techynge of þe furst tretis is of woundis [folio 50b] that beth y-mad with smytinge.

The woundys þat beþ mad wiþ brosynge, as wiþ smytynge of a staf, oþere ston, oþer fallynge, oþere wiþ smytynge of an hors, oþer wiþ enye thynge semblable to hem, habbith gret differens from woundis þat beþ y-made wiþ kuttynge: as wiþ swerde, knyf, ore arwe prikynge, & in oþere manere þey schulle ben helyde. For þowȝ þat verreye consolidacioun be þe first & þe princypal Intencioun of helynge of a wounde, to þis chapitle it acordyth noȝt, ffor in smytinge, þe flesch & þe veynes, synwes & arteries ben y-brusyde; for in þe ynnere part of þe lyme þe bon aȝeyne stonde, & on þe vtter part þe þynge þat smyteth & kutteþ noȝt, wherefore it is necessarie, ȝif þat þere scholde ben a wounde, þat alle þe smale lymes þat beþ bytwene þe bon & þe þynge þat smyteth, scholde be brusyde; &

oþerwhyle þe flesch & þe oþere consimele membris beþ brusyde witout wounde, wherefore þe cures of boþe y wyl ordeyne in this chapytle. Ȝif þat a leche wolde enforce hym to Iune to gedire with consolidatyfes þe wounde þat is mad wiþ smytinge, nedys [MS. nedyth.] quyter & corupcioun by þilke consolidatyff, most be vndire þe wounde; þe whiche quyter scholde corumpe þylke lyme & brynge hym to putrefactioun, but ȝif þe kynde were so myȝtye, þat he myȝte eftesonys opyne þylke wounde, þat was consouded by a sorye leche, oþere þat a gode leche come & knewe þilke dispocisioun, & couþe helpe wiþ propre cure to rettefien þe corupcioun off þilke lyme. What schaltou þanne do? Þou most loke wheþere that þe body be ful of yuell humores, oþer be clene; ȝif þat he be ful, lete hym blod, ȝif alle partikelere þynges acorden: as vertu, Age, complexioun & consuetude; & þese þynges þou most alweye taken in þy mynde, þowȝ alweye þey ben nouȝt y-nempnyde, & namlye vertue; & he be nouȝt stronge & alle oþere þynges acorden, þou schalt nouȝt leten blod, bot þou [folio 51a] maiste ventosen, ȝif þat it be necessarie, oþer ellys lose *þe wombe ȝif þat he be costyff; & ȝif þat he be feble, & the brosure were in þe ouere party of þe body, voyde þe feces of hys

wombe by clisterye. & ȝif þou wilt lete blod, þou shalt lete blod on þe contrarye party of þe veyne, bryngynge norysschynge to þe lyme þat was hurt; & þilke veyne þou schalt y-knowe, ȝif þat þou knowist plenerlyche Anotamye, þat y haue tauȝte þe in þis same boke. & whenne þat þe body ys y-clansyde, ȝif þat þe brosure be wiþout þe wounde, anoynt þe membre þat is y-brusyde, whiche þat begynneþ to han a postum, wiþ hote oyle of roses, & cast aboue a poudre y-mad of þe sed of mirtylles & bynde it softlye, for ofte tymes it nedyth non oþer cure. For þis medycyne fastnyth þe place, & defendyth hym from putrefacioun, & þowȝ þis medycine mowe noȝt letten alle þe mater from rotynge, naþeles yt deffendyth myche of þe same matere fro rotynge; & ȝif þat al þe matere may nouȝt be defendyde fro putrefactioun, but sum partye þereof putrefieþ, opene þe place & exclude þe quyter, & clanse al þe place. & his cure schal be seyde in þe tretys of apostomes & of exitures. But ȝif þat þe brosure were wiþ a wounde, anoynte about þe wonde oþere ellys þe place þat is y-brusyde, wiþ þe forseyd oyle of roses, & caste aboue þe forseyde poudre of mirtillyes, for þis medycine fastnyth þe place, ne yt ne letteþ noȝt corupcioun to spredyn, oþere to be drawe abrod, & it castith to þe wounde þe corupt mater, þat

is in þe place þat is brusyde. Wiþynne þe wounde leye þe ȝolke of an eye with oyle of roses, with stupes oþere ellys wiþ lynte; & leye aboue þe wounde a potage y-made off foure partyes of water & o partye of oyle d'Olyve & floure off Whete þat suffyseþ to þe medycine, & leye þis medycine to þe wounde, tyl þat þe akþe be aswagyde & tyl þat þe quyter be engendryde; afterwarde clanse þe wounde, aftere þe clensynge regenere, & at þe laste cicatryce, & þou schalt haue a ful techynge in þe Antiodarie of mundificatyfes, maturatyfes, & ȝicatrisatifes. [folio 51b] But ȝif þat þe membre þat was y-brusyde ys ful of synwes, as þe honde oþer þe fot, þou schalt noȝt chaunge þy cure ȝif þat þere be no wounde; but þawȝ þat þere be a brusure in a synwy membre y-woundyde, ne leye noȝt þere þe potage forseyd, but only hote oyle of roses, & aboue þe oyle poudre of mirtilles, & aboue þe wounde leye terbentyne iwassche & drawe abrod betwene tweye cloþes lynnen. & make enplastre of pych, hony & bene flour, & leye aboute a lym ful of synwes: as þe fot oþere þe hand, & specialyche whenne þat þe flux of humours seseþ. & þawȝ þat þi cure be drawe along, ne go noȝt awey fro þis cure; & whenne þat al þe akþe ys y-sesyd, & alle þe swellynge ys aswagyde, forto clanse þe wounde, vse þe medycine of mel rosat colat with

barly mele, y-sayd in the wounde of synwes. Þis cure ys aprefyde by galyen, & y haue preffyde þis medycine ofte tymes.

¶ The sixte Chapitle of þe þridde techynge is of Woundes þat han enpostemes, & beþ dystempryde.

A wounde þat hath aposteme oþer an yuel discrasie—þat is to sigge, out of kynde distempride, oþere to hote oþere to cold, he may noȝt ben helyd, ne schal nouȝt ben heled, but first þe posteme be aswagyde, & þe yuele discrasie be amendide. & as y haue seyde, in an oþere place, yt is profitable to þe syke man, & worschipful to þe leche, ȝif þat he mowe dyffende þe lymes þat beþ woundyde fro eny postemys, & fro an euyll discrasie. For þenne a leche schal kepe þe canon of galyen, þat is on of foure canones; on is to kepyn lymes in here owne kendlye complexioun. For woundys mowe noȝt ellys ben y-helyd, but ȝif þey ben brouȝt first to here owne kynde, & þe wounde may be kepte from aposteme & an yuell discrasie, ȝif þat þe leche be kunnynge & do hys deffere, & þe syke man be obedyent to þe leche. Þe leche mot loke [folio 52a] ȝif þat þere haue go blod ynowȝ out of þe wounde; & ȝif þat the wounde haue noȝt bled blod ynowȝ, þe pacyent most ben lete blod, oþere ellys ben

ventusyde, takynge rewarde to alle partikelere þynges tofore seyde, & ordeyne hym a couenable dyotynge, as schal be tolde in þe Chapitell of dyotynge; & leye a defens aboute þe wounde: [ounce] j of bol Armonyake, distemperid wiþ oyle of rosys & a lytel vynegre, to þe þiknesse of hony; & ȝif þat þe tyme of þe ȝere were hot, put to þis medycine þe jus of sum colde erbe: as morel, nyȝtschode, penywort, virge pastoris, oþere sum oþer colde erbe; & bynde noȝt þe lyme to harde, ne lete noȝt þe lyme hongyn; but ȝif it be þe arme, honge him aboute þe nekke; & ȝif it be þe fot oþer þe schyne, lete hym ligge; & ȝif þat þe lyme akþe, aswage þe akþe wiþ anoyntynge of hote oyle of roses. Ffor as Galyen seyth: þere is noþynge more grefes, þan ys akynge & declynacioun of a lyme, for þese two makiþ sone an hote swellynge, the whiche is to þe ffeuyre as a welle, & to þe body as an Ovyn. Þe woundyde man most absteynen hym, aftere þat þe chapitell of dyetynge techith; & boþe þe syke man & þe leche, & alle þat ben aboute þe syke, mote absteynen hem from fleschlye knowlachynge of a womman, ne a womman *in tyme of menstrewe, ne loke noȝt on þe syke man; & onys in þe day þe syke man schal schyte, & ȝif he may noȝt schyte kendly onys in þe day,

after þe quantyte of mete þat he haþ takyn, make hym a clistry, oþer a suppositorye onys iche day. & ȝif þou maiste noȝt with alle þese þynges defendyn þe lyme from aposteme, yt is an yuele signe, for þe lyme ys feble, & þe humores ben wykkede; þen begynne to maturen þe swellynge, with potage y-made off flour, oyle & water, oþer ellys with þis maturatyff: ℞ malwe leuys, leffys of vyolett, & þe rote of holy hokke; seþe hem [folio 52b] wel in water, & þanne stampe hem, & take a pounde off þe water þat þey be sodyn yn, & of comyn oyle [ounce] iij, of whete flour [ounce] iij, of flour of lynsed .[ounce]. j, of flore vynegreke [ounce] [one half], of erbys i-stamped [pound]. [MS. lj] [one half]; & boylle alle þese togedire, in a pan ouere þe fyre, & stire yt wel wiþ a spator; & þis maturatyff leye on a lynne cloth, & leye on þe posteme, tyl þat yt be maturyd; & whanne þat þe posteme is matured, make þe quyter, ȝif þou maist, ben y-cast to þe wounde; & ȝif it may noȝt ben y-cast to þe wounde, opyne þe place þat ys most lowest þere, as þe quyter may best gone out; & þan helyn þe wounde, as y schal tellyn, in þe þridde chapytell of Apostemys. Take hede alweye to þis techynge, þat ȝif a posteme were for þe prikynge of a synwe, ne leye noȝt þereto þis potage maturatyff, but wyt þe vncture of oyle of roses & of oþer þynge, as yt is seyde in þe woundys of synwys. Þou schalt

y-knowe þe euyll dyscrasie of a wounde, ȝif þat þou sest the schyn þat is aboute þe wounde to reed, & to hot in felynge, þenne þe wounde is discrasyede in hete, namly ȝif þat þere come out of þe wounde a sotyll qyter & a red; & þilke discrasye þou schalt helpen with coldynge þe lyme aboute þe wounde, with oyle of roses, & with vnguentum album—rasis of ceruse—whyche þou schalt fynde in þe Antodarie, & wiþ ius of oþere colde erbys. & þou schalt knowe a colde discrasye by þe whitnesse oþer þe wannesse of þe place, & whanne þe place ys colde in touchynge, & whanne þat þe quyter is thykke; the whiche discrasye þou schalt remeffen, by þe vncture of hote oyles, as oyle of cost, oyle lauryne, oyle of enforbium, & so oþer hote oyles. A moiste discrasie þou schalt knowe by þe nesschenesse of þe place, & by þe Abundaunce of whit lyquyde rotnesse, þe whiche þou schalt helpyn with defficatyffes: as with wasschynge of wyn & honye togedres, in [folio 53a] þe whiche buþ y-sode balaustye, gallys, & þe ryndes off poume garnettys, oþer alle oþer some by hem-selffen. Þe drye dyscrasye þou schalt knowe by þe smalnesse of þe lyme, & þe smalnesse of þe lippes of þe woundes & litel quyter, ȝif þat the quyter be þenne; þe whiche discrasye þou

schalt helpen wiþ castynge on of hote water, tyl þat þe lyme wexe rede, & with an oyntynge of moiste grecys, as hennys, gosys & dokys, & þe marye bon of a Calff, & with plentefoste of gode mete, þat norysschyth, as þe brothys of flesch, & temperat wyn, & rere eyren, & smale fyssches, & oþere gode þynges, & with reste and with softnesse of alle þe body & of þe lyme þat is y-hurte; & alwey to þis techynge take hede, þat as sone as a membre ys y-broȝt to his kendlye dysposicioun, anon aȝeyne stonde with contraryouse medycine, & turne aȝeyne to þe pryncipal cure of þe wounde. But þynke noȝt to helyn þe wounde, as longe as þe wounde ys apostomyde, oþere ellys haþ an yuele discrasye, but first remywe þilke discrasye ere þan þou hele þe wounde. For whenne þat tweye þynges þat scholde ben y-helyde, buþ togedres, & þe on of hem mowe noȝt ben y-helyde withouten helynge of þe oþer, ffirst we schulle helyn hym, þat may noȝt be helyde withouten helynge of þe oþere, as þe posteme oþer þe dyscrasye; & þus Avycene techith in þe last chapitell of þe first bokys. Ne nevere þe latere ne forȝete noȝt þy pryncipal cure, þat whanne the accidentes ben asesyde, turne aȝeyne to þe princypale cure.

¶ The vij Chapitelle of þe þridde techynge is off a wounde y-made of a wod hounde, oþere of eny oþere venymouse bestys.

Whenne þat an hounde hath byten a man, ffirste loke ȝif þat þe hounde be wod; & ȝif þat þe hounde be noȝt wood, hele þe wounde as þou dost oþere comyn woundys; & ȝif þat þe hounde were wood, þou schalt y-knowe yt by certeyne causes, & by disposiciouns. [folio 53b] Ffor a wod hounde fleyth mete, & ffleyth watere, & oþerwhyle he dyeth whenne þat he seþ water; & he rennyth hydirwarde & þedirwarde, as a dronken man, wiþ opyn mouþ & hys taylle bytwene his leggys, hys tunge hongyth out, he wolde byte alle men, ne he ne knowyth nouȝt þo men þat ben his housholde, he berkyth noȝt; & ȝif þat he oþerewhyle berke, hys voys ys ful hors, & oþere houndys flen from hym & berkyn vpon hym. Also þou schalt y-knowe by dysposicioun of þe same wounde, for ȝif þat þou wetyst a crumme bred in þe blod of þe wounde & geuyste yt to an oþer hounde to etyn, he wyl noȝt etyn yt, & ȝif þe hounde etyþ yt he wyll deyen; oþere ellys take a note & stampe yt, & leye on þe wounde al nyȝt, & on þe morwe ȝif yt to an henne, sche wyl noȝt etyn hyt; & ȝif sche etyth yt sche wyl deyen. & anone as þou wost þe hounde ys

wod, sette a gret ventuse aboue þe wounde & drawe out myche blod out of þe wounde, & afterwarde drawe abrod þe wounde; & abouen alle oþere thynge brennynge of hote eyren to þe depþe of þe wounde ys most proffytable, & aftere leye aboue þe wounde attractyfes, to drawe out þe venym. Some of þese attractifes beþ symple, & some beþ componyd. Symple ben: þe lyffere of þe same wod hounde þat bote þe man, garlyke y-stampyde, salt fyssch, asschys of vyne, Opopanac ys wondirful, þe leuys of a Gourde, & þe rote of ffynegreke, þe gele of fyssches, & amptes y-stampyde. Þese medycynes ben componyde: vryne of a ȝonge man, with nytre oþer myntes, i-stampyde with salt & distempred with vynegre, & y-mad in emplastre. An oþere medicyne componyd: ℞ floris eris & salt ana ten parties, & þe fat of a calff twelf partyes, & make a plastre. An oþere: take schepys talwȝ & buttre, & make emplastre. Þis wounde schal ben y-holde opyne at þe leste fourty dayes; al þis schal be do about þe place. [folio 54a] In an oþere manere regimen vndirstande, þat þe man þat is y-bete ne schal nouȝt be lete blod in the bygynnynge, lest þe venym be drawe abrod by oþere lymes. Ne þou ne schalt ȝif hym non laxatyff, lest yt drawe þe venym to þe entraylles withynne; but þou schalt setten on þe place a stronge

ventuse, as yt is seyde tofore, þat he mowe drawe myche of þe blode. & whenne þat þre dayes ben passyde, yt is nouȝt yuele to leten blod, & to purge with a lyȝt purgacioun, þat purgith þe malyncolye, as with decoccioun of Epytemum, with gotys wheyȝ; & norissche hym with dyetynge, þat fattyth hym & make glad & bliþe; & wassche hys hed with decoccioun of water, þat þe fet & þe hed of a weþire ben y-sodyn yn. Ne lete hym nouȝt þrustyn, ne suffren hungyre ne trauell, & so ȝif þat god wyl, þou maiste kepen hym from peryle. & euery day to a moneþ ende, he schal taken oþere symple medycynes, oþer componed. *Symple buþ: Asa ffetida. Asa dulsis, polm, [polium, Paley.] terra sigillata, Wermot, Kockull, [Kockull, Nigella. See Prompt. Parv., p. 86.] mirre & gencyane. Medycynes componed gode: *℞ þe assches of crabbys y-brent in an Offyn .iiij partyes, of ffrankensens vij partyes, make a poudre; þe pacient schal take iche day of þis poudre [dram] .ij wiþ wyn. An oþer: ℞ þe poudre of crabbys y-brende vj partyes, of gencyane iij. parties, terre sigillate one partie, make poudre. Ȝif þat þou were noȝt at þe bygynnynge, & he bygynneth to haue yuele Accidentes, as yuele þouȝtes, schrewyde metynge in his slepe, & þat he be wroth & grucche & wot noȝt why, & ȝif men aske hym enye þynge he ȝeuyth no gode answere þere to, & ffleyþ lyȝt, & he hath alle oþere signes of malencolye, þanne ȝif to hym a medycine y-made

of cantarydes. Take olde grete kantarydes & do aweye þe hed & þe wynges ȝ. ij., lentys I-clansed ȝ. j., saferen, spikenard, clowys, canell ana ȝ. [one half].—in oþere bokys—ipone hem wel & make of hem smale ballys þat weyȝen j. penye wyȝt; & ȝif a ball at þre tymes, at iche tyme þe wyȝt of vij cornys of whete, tyl þat he pysse blod, for þenne he schal be saff. Ffor whenne þou art sykere, hele þe [folio 54b] wounde after þat fourty dayes ben passyde, in þe same maner. Ȝif þat a wounde were mad of þe bytinge of an eddre, oþere of eny oþere venymouse beste, þe leche schal take hede to drawe abrode þe wounde & setten abouen a ventuse & drawe out myche blod, & yt is myche worþ to enviroun þe place abouten þat is y-betyn wiþ brome y-stampyde. Ffor ȝif þat þe prikynge be in þe fot oþere in þe hande, ȝif þou enviroun þe arme oþere þe legge with brome, yt latteþ þe venym to gone vpwarde; & ȝif hym þe medycines y-wryten aboue, & also tryacle, & lete þe wounde be opyne, tyl al þe venym be escludyde.

The viij. Chapytelle of þe þridde techynge of the ffirste tretys is of a wounde y-made in a joynt & is dislocat.

Whenne þat a wounde is in a lyme & þe bon of þe same lyme ys tobroken atwo & is dislocat—þat is to sigge, out of joynt,

þanne it is gode þat þou putte in þe wounde, whanne þe blod is y-staunchyde, & also aboue þe wounde, þe ȝolke of an eyȝe, with oyle of roses, & anoynt alle þe lyme aboute þe wounde, wiþ two partyes of oyle of rosys, & wiþ half on party of vynegre, y-made þikke with bol Armonyake, tyl þat þe quyture be engendered, [MS. engenderes.] & þou be sykere þat none Aposteme schall come. Ne take none hede to brynge togedere þe parties of þe bon þat is tobroken oþere dislocat, tyl viij daies ben go in þe wyntire, & fyff in the somere; for þenne yt schal make quytere, & be sykere from swellynge; & þenne brynge togedire þe brekynge oþere þe dysynncture aftere þe techynge þat schal be seyde in þe Chapytell of Algebra. & ȝif þat þe brekynge oþere þe dyslocacioun nedyþ splyntes, make þat þe splyntes & þe byndynge faylen aboue þe wounde; & þat þou maiste do, ȝif þat þou kyttest þe splyntes & þe byndinge aboue þe wounde with a knyf oþere a rasoure, & in drawynge abrod þe hole of þe bonde aboue þe wounde [folio 55a] wiþ a nedle, so þat þou maiste by þilke hole euery day chaungen þe medycine of þe wounde withouten chaungynge of þe bonde, þat þou madest firste aboute þe bonys þat were broke oþere dislocat. Þe whiche bonde þou schalt nouȝt remeffen, tyl þe tyme þat schal be tolde in hys place; bote you schalt bynde aboue þilke

bonde a newe bonde, þe whyche þou schalt remeffe, as often as þou chaungiste thy wounde. & whanne þou art sykere from empostomynge & þou haue sette togedire þe bonys þat were sette togedire & dislocat, þenne leye vpon þe wonde by þe hole þat þou madyst in þe band a mundifycatyff of mel rosat colat, & of barlye mele, tyl þe wonde be clansyde; & leye on þilke mundyficatyff þredys of olde clene whyte lynne cloþ, tyl þat þe wounde be ful clansyde; afterward regenere fflesch, & aftereward consoude wiþ regeneratyfes & consolidatyfes, whiche þat schullen ben seyde in þe ende of þe boke.

The ix Chapitle of þe þridde techynge is of fflux blod off a wounde.

Þere beþ two manere causes þat makyth blod to bleden out of mannes body; þat on cause is clepyde cause conjuncte, & þat oþer cause antecedent. Þe encheson of cause conjuncte ys openynge of þe mouþes of þe veynes & þe Arteries, oþer ellys whanne þat the veynes beþ kut atwo, oþer ellys corosion of þe bodyes of þe same veynes & arteries, oþer ellys to gret feblenesse, oþere to gret losnesse. & þere beþ manye enchesouns & causes antecedente: as to myche

fulnesse of blod, oþer ellys to myche Acuyte of blod & also manye oþere causes; and þere beþ oþere causes þat beþ clepyd causes prymytiff; as smytinge þat wondiþ, to gret lepynge, cryinge, wraþþe, chydinge, & so many [MS. may.] oþer & iche of þese causes tofore seyde haþ hys manere helynge by hym-selfen in fesyke medecynal. Bot it ys noȝt þe entencyoun of þis boke, to tretyn but of blod, þat blediþ of wounde, þat is y-mad wiþ wounde, the [folio 55b] whiche may be restreynde by crafte of surgerye. In flux of blod, that comyth of a wounde, þe leche most loke þe disposicioun, þe Abytude, Age, vertu & complexioun of hym þat is y-woundyde; & ȝif þat þese acorden, & he be myȝtye in vertue, he schal blede myche blod at hys wounde, þowȝ þat þe leche be clepyde at þe bygynninge, bot ȝif it so be þat he feble ouere gretlyche. & ȝif nede constreyne þe leche to staunche þe blode, he most loke ȝif þat þe blod go out of þe Veynes capyllares, þat beþ smale veynes as herys of mannys hed; & þanne only þe whyte of an eyȝe, y-leyde aboue wiþ towȝ of flex suffiseþ, whenne þat þe parties of þe wounde beþ brouȝt togedire; & ȝif þou cast aboue þe poudre of lyme, tofore seyde in the chapytell of sowynge of woundes, yt schal be þe betyre; for þe poudre wiþstreyneþ þe blod & consoudeþ þe partyes of þe wounde, togedire.

& ȝif þe blod come from gret Veynes, he may noȝt so sumtyme be constreynde, but it nediþ a strengere medycyne & also a more cautele; & ȝif þat þe blod go out of an arterye, þou schalt y-knowe yt be constructioun & dilatacioun, of þe same arterye—þat is to sigge, þat þe blod goþ out with lepynge, & oþer whyle with wiþdrawynge, & þenne sette þy fyngere vpon þe mouþ of þe gret veyne, oþere ellys þe Artarye, & holde þy fyngere þere on by a grete oure; for þenne by hap sum grete drope of blod may be congelyde togedre, & þereby vertu may be myche y-comfortyde. Afterewarde leye plentyfullyche of þis medycine vpon þe [wounde, cancelled before veyne.] Veyne oþere þe arterye þat is kut atwo. ℞ ffrancencens, whyȝt gommous & fat ȝ. ii., Aloes ȝ. i., make poudre & distempre with þe whyȝt of an eyȝe as þykke as hony; after take herys of an hare smale & kutte, medle al þis þynge togedire, & þere ys no medycine so gode as þis medycine is, in streyninge of blod & consoudynge þe Veyne. Bot whanne þat þou comyst to chaunge þe medycine of þy wonde, do noȝt awey þe medycine wiþ strengþe, but [folio 56a] leye aboue of þe same medycine moist, to nessche þe firste medycine, þat yt myȝte fallyne awey by yt-selff. Naþeles yt is possible, þat a medycine caustyke, þat ys to sigge a medycine

þat brennyth, sennore staunchyth blod, þenne þis medicine of encense; & þou schalt haue gret plente of medycine caustyke in þe antitodarye, but we beþ nouȝt sykere þat þe blod of þe Veyne, oþere þe arterye an oþer tyme wyl gon out, whanne þat þe serche of þylke caustyke medycine ys remywed awey. But þy medycine of ensence, with þe herys of an hare, noȝt only staunchiþ þe blod, but also consoudeþ þe Veyne, & þe Arterye, as y haue preuyde yt ofte tymes. And forto ȝif Autorite, I sette an saumple, þat come sum tyme to myn handys: A childe of þre ȝere olde, hadde a lyte knyf in hys hande, & he fel on þat knyf, & þe poynt of þe knyf, in þe fore partye of þe þrote, persyde þe Veyne organys; ne þere ne couþe no man yt staunche, & þanne y was y-clepyde & y come to þe child in gret haste, & he hadde almoste loste hys syght; for hys eyȝen in hys hed were turnyde vp so doun, & þe blode come out of þe wounde, whyte as wheyȝe, ne he ne hadde no pous, & þenne y leyde my fyngere on þe hed of þe veyne, & y helde faste þat noþynge myȝte go out, & so y helde þe veyne by a grete houre, & þe vertue of hys body þat was almost lost quyknede aȝeyne, & þe pous bygan to apere ffeblyche as yt were a smal þreed. Þanne y

sente to þe spysers schoppe, þat was a grete weye from me, ne y ne remywede noȝt awey my fyngere from þe place tyl þat þe messagere come aȝeyne, & þe childe þenne bygan to opene hys eyȝen; and þanne y ordeynde þilke medycine to be mad, & plentyffuliche y leyde it abouen þe wounde, and y bonde þe wounde with plumaceoles & with stupes y-leyde in whyȝt of an eyȝe, & with a bande y bonde yt streytlye, & y comaundede hem to gyuen hym crommys of brede, y-leyde in water; and on þe morwene y come aȝeyne, & þenne y fonde þe childe y-cunffortede & neuere þe latere y wolde nouȝt vndo þe medycine; þe ffadire [folio 56b] preyde me wiþ grete instaunce to se þe wounde, but y wolde nouȝt; & so y lete yt be, tyl foure dayes were passyd, withouten remeffynge & naþeles y vysitede hym every day; in þe fourþe day y vndyde þe bande, & þe medycine was drye aboue þe wounde, so þat y myȝte noȝt haue remywede hyt withouten grete Vyolence. & þenne y leyde aboue þe whyte of an eyȝe, with a lytel oyle of roses, & so y lafte yt by on day. On þe morwen y turnyde aȝeyne, & þenne y remeffyde awey þe medycine withouten Vyolence, & þenne y fonde þe wounde & þe Veyne al hol. And of þis helynge þe fadire & alle his neyȝhboures hadden gret wondire. And ȝif þat with þis medicyne þou maiste noȝt soude þe Arterye, ne þe Veyne, ne þou ne maiste noȝt constreyne þe blod for sum oþere Impedement,

þan þou moste oþere bynde þe Veyne, oþere drawyne here out of here place, & wynde þe hed of þe Veyne oþer Arterye, oþer þou most brenne here wiþ hote yren, & maken on here hed a grete croste & a depe. An oþere exaumple: þere was a childe of xv ȝere olde, þat smot hym-self with a smal knyff, & þilke knyff persyde on Veyn of þe Arme, & prikyde a Veyne þat lay vndire þilke synwe. & for þe prikynge of þilke synwe he hadde grete akynge, & blod ran to þe wounde & noȝt aȝeynestondynge medycines þe blod ran out at þe wounde. Kolde medycines weren profitable to bledynge of wounde, and colde medycines beþ greffes to prikynge of synwes; for þey stoppyn þat lyme & þat ys contraryus aȝeyns þe synwys; and þenne y demyde necessarye to drawe out alle þe Veyne out of here place & to bynde here & to helpen þilke synwe with oyle of roses. But þe modire of þilke childe sende for a lewyde leche, whyche þat reprevyde fouliche my doom, & he behyȝte to helyn safflyche þe childe. He dwellyde on þe cure, & y went my weye. Þe whyche leche toke hede to hym be ten dayes, þat neiþere þe akynge sesyde ne þe blod was noȝt y-staunchyde, & so þe syke man was [folio 57a] nyȝh ded. And at þe laste y was clepyde & y wolde noȝt come to þe pacient. But þenne a ffysisyen þat was frende to þe man of þe pacyent, blamyde þe modire & here frendys, þat þey hadde lefte my consaylle

for þe byhestys of þylke ydyote; & þilke ffysisyens proposyde, aftere þat he had herde my counseylle, þat þere was non oþere wey þat myȝte saue þe syke man from þe deþ, & þenne he askyde a surgyne, wheþere he couþe don as y hadde seyde byfore; & he seyde þat he couþe so don, & so he dyde. He kutte þe skyn aboue þe Veyne, & twynede þe veyne in his handys, & bonde þe ende of þe Veyne wiþ a þrede, & afterwarde he hylde on þe synwe hote oyle of rosys, & so by þis counseyle he was restoryde aȝeyne to hele. But ho so þat wolde aske how þat he myȝte so manye dayes be kepyde from þe crampe, for þat he suffryde so grete akþe, I answere & sigge: þat þe cause was, for he bledde at þe wounde eche day, so þat þe synwe ne myȝte noȝt be to myche replet oþere fulfyllede of blode. Alle þese thynges y haue tolde, þat he þat redyth hem may þe wyslocor in semblable causes wyrchen. And ȝif be þis medycyne he myȝte noȝt sykerliche be restreynede, þat fallyth ryȝte selden, þenne me moste brenne þe hed of þe Veyne oþere of þe synwe wiþ hote yren, þat þilke hote yren myȝte maken an harde croste. And be war þat þou touche noȝt þe lippes of þe wounde, ne þe synwe, ne non oþere thynge, bot only þe veyn with hote yren. And ȝif al þis crafte wolde noȝt helpyn me, men most drawen out þe Veyne, &

flene þe flesch aboue here & wynde þe Veyne sadlyche & bynde here hed with þyn handys. And sum tyme yt happyth, þat an Arterye is y-broke oþere y-kutte, & þe flesch þat is abouen ys hol & noȝt to-broke ne y-kutte, oþere ellys þe flessch þat is aboue þe Arterye ys y-helyde & noȝt þe Arterye, & vndire þilke flessch þere is a swellynge of blode [folio 57b] that is y-clepyde Aporisma oþere matere Sanguis & þere of þe pacient hath grete drede, lest þat þe skyn tobreke & þe blod gone out, þe whiche blod is hard to restreyne. Of þis manere seknesse spekyth Galyen, & seiþ þat a seruaunt of swyche a dysposisioun was y-helyde of a lewyde man, þat tauȝte hym þat he scholde legge snowȝ vpon þat seknesse, wherfore a man may vndirstande, þat to swyche empostemys colde medicynes & drye beth necessarye.

¶ The x Chapitle of þe þridde techynge of þe firste tretys is of men that beth y-woundyde.

Many men discorden of dietynge of men þat ben woundyde, for sum men ȝeuen to alle men þat ben woundyde, wheþer þat it be in þe hed oþer in enye oþere place, gode wyn & stronge flesch of capouns & of hennys; and þey affermen þat by swyche a manere weye seke woundyde men sonnere ben y-helyde, ffor þey siggen þat watyre putrefyeþ lymes, þat beþ woundyde, & engendrith Apostemys & corumpyth & feblyth complexiouns, & makyth many harmys. Sum oþere men gouernen alle manere of syke men þat beþ woundyde with brede & water & Applys y-sodyn, tyl x dayes ben passyde, & ȝif þat god wyl ende þis bok, yt schal be remeffynge awey Errores, & declarynge & opnynge Dowtous. Y sigge, þat boþe þese sectes erryn in here opyniouns, ffor þey taken hede onlyche to here experymentys, noȝt considerynge resoun of þe complexioun of hym þat is y-woundyde. The firste secte of þese *seyth þat some men, onlye etynge bred & watere, in so myche ben y-feblyde, þat blode & matere in here bodyes may noȝt be restoryde; þe whiche were suffisaunt

to hele with here woundys, bot þey ben so feble þat þey dyȝen, oþere ellys þey langoren longe tyme; ne þe lyme may noȝt resseyuen resonable vertue, as he scholde; & þese manere of men ben of a colde complexioun & a drye, & here bodyes weryn feble.—*The secunde secte seyth þat some þat dronken [folio 58a] wyn & etyn flesch hadde in þe membre þat was y-woundyde a gret enposteme & a ffeuyre— and þo beþ ȝonge men þat beþ of an hot complexioun & a moyst— wherefore þey comaundyde to alle oþere manere complexiouns, þat þey scholde noȝt drynken no wyn, ne eten non flesch. Þe vnderstandynge of boþe þese sectes nys noȝt comendable and þerefore y folwynge þe doctryne of rasys, Avence, galien, & of oþer doctoris, & also experymentis, þat y haue longe y-preuyde, sigge þat it is nedefull in þe bygynnynge þat a woundyde man Absteyne hym from wyn & namlye ȝif þat þe wounde be in þe hed, oþere in eny partye of a synwe. For þere nys noþynge þat so sone smyteþ with grevaunce þe hed oþere þe synwe as wyn; for he ys sone conuertyde of kendlye hete, and for he ys so sotyll, he persyth swiþe into þe synwes & he assendyth sone into þe hed, bryngynge with hym humores and spirites. Yt trublyth a mannys wyt, & wyn greuyff alle men that haþ a feble hed; & þere fore in alle manere woundys

of þe hed & off synwes, he schal be forebode in þe bygynnynge, & namlye to þo þat han hot complexiouns & moiste, into þe tyme þat þe cure be ful endyde; & to þo þat beþ of colde complexioun, whenne þre dayes ben passyde, þou maiste ȝeuen to drynke a smal temperat wyn, & afterewarde a lyte strengore; aftere þat þou art sykere, þat þere schal noȝt comen to þe membre non Aposteme., But his drynke schal be watyre of barlyche oþere watire þat crommes of brede ben sodyn yn, wiþ oþere colde watyr & namlye in sommere, & to þo þat beþ woundyde drynke watyre, oþere ellys wiþ tenþe partye of wyn of pome garnettys, oþere ellys wyth sixte partye of wyn agreste þat is smal broske wyn, oþere ellys þis is a perfyte drynke to wondys of þe hed & of synwys: Take a potell of watyr & of barlyche y-meynde [ounce]. iij, juiube, sebesten, ana .ȝ [one half], of drye prunes of damacynes [dram] .j., sucre of rosis [ounce] ij, sethe hem to þre partyes ben consumed, & þenne lete hym drynken yt. Sothlye þis drynke ys alteratyff: þat ys to sigge chaungynge, ne hyt ne swellyth noȝt. & yt latteþ fumosites to arysen to þe brayn. [folio 58b] Of mete

y sigge: þat to hym þat is of an hot & moiste complexioun, be non manere weye ne scholde noȝt be ȝeffen flesch, ffysch, Mylke, eyren, ne no manere conuertyble mete, bot ȝif þey weryn ouere come with to gret febylnesse; but he moste holde hym content with Iuse of barlyche, oþere ellys of otys wiþ almaunde mylke; out take wounde of þe hed, where y ne Apreue noȝt Almaundys, ne non oþere vaporose frutys, as notys oþer walnottys oþer Avelanes, for þey hauen a manere fumose proprete greuynge þe hed; he may etyn Amidun, betes, letuse & bred y-wassche wiþ succre, ȝif þat he were feble. And ȝif þat myȝte noȝt Abstynen hym from flesch, ȝif hym flesch of smale chyknes, & of smale briddys: as larkys & oþere sengle briddys, & kyddes & lambres, & kalffes I-saveryde with agresta, oþer with wyn of pom garnett; & þis dyetynge he schall vse, tyl he be sykere from swellynge, & þat þou schalt y-knowe, whenne þat Akynge, swellynge & extencioun of þe lyme ben secyde & þe wounde is almost consouded. Ȝif þat it was a wounde þat was sowyde oþere brouȝt togedyre with byndynge, in whom quyter was noȝt engendryde, and ȝif þat it was a wounde y-mad wyth smytinge—oþere ellys y-chaungyde with þe eyre, in whom yt is nedfull engendrynge of quyter, þenne yt is sykere þat yt schal nouȝt

enposteme, whenne þat he makyþ quyter plentyouuslyche; & whenne þat þe lyme ys wel dysposyde & noȝt toswolle, ne y-drawen abrode. & ys wiþouten akynge, & þanne chaunge a lytel & a lytel hys dyetynge, tyl þat þou come to hys dyetynge, þat he was wont to vse tofore. And ȝif þat þe pacient were of a colde complexioun & a drye & þat he hadde by nature oþere by costeme a feble stomak, [folio 59a] þanne yt were necessarye to ȝeuen hym at þe bygynnynge flesch a lytel y-saueryde with swote spysorye: as kanell gyngeffre & oþere semblable to hem & to ȝeuen hym in þe bygynninge Julep—þat is a syripe y-mad only of watyre & of sucre—& aftere þre dayes ben passyde, wyn, and boþe in þe on complexioun & in þe oþere complexioun. Ȝif þat a bon were y-broke, wiþ a wonde ore wiþouten a wounde, aboute þe ende of þe cure, þat is to sigge, whenne þou art sykere from a posteme & swellynge, yt is gode to ȝif norysschande mete, þat it myȝte make a gode & a stronge repayrment of þe bone þat was tobroke: as with ffurmente y-sode, & potage of floure wel y-sode, & with þe extremetes of bestys, as fette & swynes groynes & oxe wombys wel y-soden, & with swiche oþere þynges by whom a gode ligamente & a stronge may wel be engendrede. Where fore yt is necessarie to a surgyne to knowe in hys dyetynge, vertues of complexiouns, Ages, regeouns consuetudes & þe tymes of þe ȝere, þat

he mowe chaungen his dyetynge, aftere þat dyverse condycioun askyth*. Ne he ne schal noȝt aftere on manere of counseylle proceden in hys dyetynge.

¶ The xi. Chapitle of þe þridde techynge of þe firste tretys is of olde woundes.

¶ Olde woundes ben mad of kuttynge oþer of openynge of a posteme, oþere ellys of a wounde þat is noȝt helyde in his tyme, oþer ellys of sum manere fleynge oþer of brennynge, oþer of to grete hete, oþer of to grete drovþe, oþer to gret colde constreynynge, oþere of to grete Abundaunce of moist mater corumpynge. For euery olde wounde, hauynge rotenesse oþere virus þat is þenne venemy quyter, oþer eny oþer þynge þenne gode quyter nys noȝt y-clepyde wounde, but is y-clepyde vlous þat is an olde wounde. And of þis Vlcus, Rouland & Rogerine, & þe most partye of men þat ben now, clepyde it festre, oþer cancre. But it is neiþere festre ne cancre, but festre & cankre habbe dyfference from þis. [folio 59b] Vlcus, as a propre þynge hath dyfference, from a þynge, þat is comyn; for euerye festre & euerye cankere, þat is y-woundyde, ys y-clepyde Vlcus, but yt ne syweth noȝt þat euerye Vlcus, ys clepyde cankre oþere festre, as y schal

tellen opynlyche in euerye chapytell be hym-self. Auesene seyth þat þere ben sixe manere of þese Vlcus, for sum ben Venemy, sum hory, some depe, some cauernouse oþere y-hud, sum corosyff, sum rotyne, some Ambulatyff—þat is spredynge abrode, & some hard to consouden. Of þese manerys tofore seyde, some hath acordynge with festres in toknes & in fourmes: as Venemy & holwy, & sum han acordynge with cancre: as spredynge abrode & fretynge hym self. And naþeles þey habbe difference as yt is conteynede in þe chapytelles of cancre y-woundyde & of festre. & alle þese tofore seyde habbith difference from a wounde, for in a wounde þere ys whyte quyter & euene in al his partyes & hol & noȝt departyde, —& withouten stynke. Þis manere of quyter is engendrede, of godnesse of kendlye hete & is perfitlye deffyede. But vemyn, rottenesse, & croste, & alle oþere superfluyte of olde woundes ben engendred of a straunge vnkendlye hete. A venemy Vlcus is, in whom habundeþ venym sotyl & liquydy. Ȝif þat yt be red oþere ȝolwe, oþere a partye redyssche, & scharpe bytynge þe lyme, hit synifieþ lordschipe of straunge hete. An hory olde wounde ys y-clepyd, þat haþ sum grete crostes, oþere ellys sum grete awrotynge

proud flesch to hyȝe. A depe Vlcus is þat þat haþ a gret depnesse & an holwe, & peraunter crokynge. A wrotynge vlcus is þat of hys malyce wroteþ, bycause þat þe blod þat is sent to hym, is to scharpe. Galien: scharpe blod noȝt onlyche cordyth noȝt *flesch in woundes, but also hol flesch. A rotyde vlcus is stynkynge, habbynge a straunge hete in his grounde, & out of hym passith out a stynkynge smel oþere smoke, as þere doþ [folio 60a] out of flesch þat is y-rotyde. A walkynge Vlcus is þat walkeþ hyderwarde & þedirwarde & naþeles he profundeþ noȝt depe into þe grounde. An Vlcus þat is hard to helyn, is he þat for his yuele proprete, þat is sende to hym fro al þe body, latteþ hym to hele. & forto helyn euery manere of þese hulkes, þere ben manye dyverse rulys. Þe firste rule ys þat þey mowe noȝt ben helyde, but þe superfluytes þat ben in hem ben dryed. Þe secunde rule ys þat ȝif þat þe body oþere membre be out of hys naturell complexioun, ere þan þou þynke to hele þilke Vlcus, þou moste bryngen aȝeyne to hys due

complexioun distempride [At the margin.] þilke body oþer membre. Þe þridde rule ys, þat ȝif þat þe lyfere oþere splene ben y-greuyde, as yt happyth ofte tymes in olde woundes, þou most retyfien hem. The fourth rule ys: þat þe qualites & quantytes of humours scholde be tempride with blodletynge, & purgatiouns & with gode governaylle; and ȝif þat þe eyre be yuel, þe syke man schal be chaungyde into gode eire. And whanne þat þe leche haþ tofore seye alle þese þynges, þenne he may go to hys cure. & ȝif þat þe Vlcus be Virulente, þat is to sigge Venemy, loke ȝif þat þe Venym þat goþ out be redyssch oþere ȝolwe, & ȝif þat the lyme haue enye manere hete; & þenne wassche it wiþ water þat rosys & barlyche Alum & balaustia & lentilis with honye symple oþere componed ben sodyn In. And lete þis watere percen to þe depthe of þe wounde. And ȝif þe Virus be withouten hete & þe membre haue non hete, wassche it with water oþere wyþ wyn, þat Mirre, wermot, horhowne, sauge, pympirnel, honye symple oþer componed ben sodyn In. Clanse þe wounde perfitlye & engendre flesch & afterwarde consoud it with þis propre oygnement, þat in olde foule venemy woundys oþer Vlcus engendreth

flesch, clansyth & helyth as Auecene & Rases wytnessith, litargium nutritum. ℞ litarge as myche as þou wylt & stampe it & put it in a mortere & [folio 60b] putte wiþ hym gode oyle of roses & vynegre, now þe on now þe oþere, alweye steryinge, tyl it be perfitlyche augmentyd & come to þe fourme of an oygnement. & þis oygnement—litargirum nutritum—þat is to sigge litarge y-noryssched, þat is profitable in many casis. Afterwarde take of þilke litarge viij partyes, & of alym, & of balaustie oþere ellys, in þe stede of balaustye, wormys of þe erþe y-brend, brend bras, brent led, gallys, sanke dragoun, cathimie, Argenti ana as mychel as ys .xij partyes of alle þe oygnement, and medle al togedre, & make an Oygnement. Þis oygnement schal be leyde withynne þe woundes & aboue þe wounde, for yt dryeth þe wounde, & engendrith gode flesch & consoud. Take hede to þis rule, þat in helynge of alle olde woundes, aftere þat þey ben clansyde, aboue þe oygnement yt is gode of one a lynnen cloþ, forto dystende abrode on of þe mundyficatyfes of hony whiche þat schulle be tolde in þe antitodarye. And leye aboue aboute þilke vlcus, & specialiche from þe ouere partye, fro whom humores flotyn, a [MS. &.] defensif of bol Armonyake & terra

sigillata þat is mad on þys manere: ℞ bol armoneake [ounce] j terre sigillate [dram] [one half]., oyle of rosis & vynegre, þat suffyseþ, now do in þe on, now þe oþer, tyl þe oygnement be ful mad & lyquyde ynowȝ; so þat of þe oyle of roses be duble as myche as of þe vynegre. Þis diffensiff defendiþ a membre fro corupcioun, & also Vlcus þat he sprede noȝt abrode. An hory wonde ys y-helyde, in remeffynge awey þe croste oþere þe fylthe þat is in hym with poudre of affodylles schal be sayde in þe ende, oþere with sum oþere mundificatyfes; afterwarde consoude yt with consolydatyfes. A depe wounde ys y-helyde in castynge in to þe [folio 61a] depþe of þe wounde with an instrument y-mad to þe lyknesse of a clisteyre, any of þe wasschynges þat beþ seyde in þe Venemy wounde aboue, after þat þe disposisioun of þe membre askeþ of hete oþer of cold. And aftere þat he is y-clansyde, in castynge in water oþere in wyn þat mastyke oþere frankensence ys y-soden yn, & in leggynge without, on of þe mundificatyfes of hony, þat schal be sayde aftere. & also it is gode to ordeyne þe lyme, so þat þe mouth of þe wounde honge dunwarde, & streyne þi ligature at þe grounde of þy wounde & bynde it looslye at þe mouþ of þe wounde. And also yt were gode, ȝif þat it myȝte be, þat þere were made a newe wounde in þe place þat is most hongynge þat þe

rotnesse & þe quytere myȝte þe betyre gone out, for so þilke Vlcus myȝte sunnere be helyde. A ffretynge vlcus ys y-helyde, in leggynge specialiche aboute hym colde þynges, whiche þat obtunden oþer castyn bach þe scharpnesse of þe same Vlcus, & also in amendynge with metys & with drynkes the scharpnesse of þe same blod, & in purgynge þe rede colore & with anoyntynge wiþ colde oygnementes & consolidatifes, & þereto is myche worþ vnguentum album Rasis, þat schal be told in þe antitodarye. A stynkynge wounde ys y-helyde in remevynge awey þe stenche & þe rottenesse, & þerto ys myche worth a wasschynge of ydromel þat is hony & water y-sode togidre wiþ mirre, & a mundyficatiff y-mad with Ius of wermot & barly mele & hony & mirre, þat is made on þis manere: take jus of wermot .[ounce]. iiij, of hony [ounce] iij, of barly mele .ȝ. ij, off mirre [ounce] .j., compone hem togedire, & fulle þe wounde, wiþynne forth wiþ lynete of lynnen cloþ. & ȝif þat wormys ben engendride in þe wounde, sle hem wiþ jus of calamynte, oþere with þe juse of þe leuys of pechys, oþere ellys persicarie, oþer with decoccion [folio 61b] of ellebre. And whanne þat a perfyte mundyficacioun is mad engendre flesch & consoude, as yt is seyde tofore. A walkynge Vlcus ys y-helyde with flebotomye & ffarmasye þat is laxatyfes purgynge þe colere &

brende humoures, & in leggynge aboute a defensif of bol & terra sigillata þat is seide tofore in þe same Chapytle, & with on of þe colde mundyficatyfes & sum tyme men most cauterise þe Vlcus aboue with an instrument of gold. for þilke manere of brennynge rectefieþ wel þe membre. Þe cause why þat sum Vlcus is hard to consoude is, for an yuel disposicion ys y-hydde in þe bodye, & þerefore it nedyth to retyfien þe membre & þe body as y haue seide to-fore. And ȝif þe cause be opene, on oþere manye, do aweye þilke causes oþer ellys þo manye causes, ere þanne þou go to þe pryncipal cure. Þese ben þe causes þat lettyn consoudynge of olde woundes, an yuele disposisioun of alle þe body: as dropsye, oþer ellys an iuele disposisioun of þe lyuere: as ȝif þat he be to feble, as to hot oþere to colde, to moiste oþere to drye, with mater ore withouten matere, as wiþ to grete hardnesse; oþere ellys þe spleen is to feble to purge þe malancolyent blod; oþere ellys to myche blod, oþere ellys to acute blod; oþere ellys þe veynes beþ to ful of blod, þat goþ doun to þe Vlcus; oþer ellys curnellys þat glandeles, þat beþ kurnellys þat beþ in þe grynde, þat sendiþ doun matere to þe Vlcus þat is in þe thyȝes & þe legges, oþer ellys þe lippes of þe Vlcus beþ to grete & hard, oþere ellys to myche flesch, oþer ellys mysordeyninge of

dyetynge, oþer ellys an vncouenable medycine to þilke membre, oþer ellis þe lyme þat ys y-hurt haþ an yuele discrasie, oþere ellys þilke Vlcus is an yuele place—as in þe ende of þe elbowe, oþere ellys þe Vlcus ys al rounde, oþere ellys þe bon þat is vndire [folio 62a] þe vlcus is corupte. Alle þese tofore seide letteþ Vlcus to by helyde, wherefore yt nediþ þe, to take kepe to alle þese thynges tofore seyde, & to amendyn alle þe body, & namlye þe lymes þat habbiþ principalte in mannes body, & kepe alle þe lymes þat beþ in here naturell disposisioun wiþ þynges þat beþ acordynge to here naturel disposisioun, & ȝif þey ben discrasyede, remywe þilke discrasye with þat, þat is contrarye to þilke discrasye. Also tempre þe qualyte & þe quantyte of þe blod, & streyne þe veynes ȝif þat þey brynge þedire blod. Oþer ellys ȝif it is possible, lete þe blod aweye. Vndo glandeles, þat beþ kurnell þat sendeþ þedire mater, & remywe ded flesch, smale lippes of þe woundes þat beþ grete, & kytte hem awey, ȝif þou maiste do non oþere weys; amende his dyetynge, & brynge aȝeyne þe roundnesse of þilke Vlcus in to a longe fourme, aftere þe lengþe of þe membre, wiþ a knyf hot brennynge, but ȝif þat a synwe oþere a Veyne latte. And þou schalt remywe þe bon, þat is corupe on þis manere: unwrey al þe bon, in kuttynge awey al þe flesch,*—þe bon þat is corupte with an yren, oþer wiþ a medicyne þat schal be seyde in þe laste ende of þis boke. Oþer ellys it is

bettere to don it awey with hot yren & whanne þat þe bon þat is corupte is vnkeueryde, schaue yt noȝt as many men don, but touche harde þilke bon with hot yren & afterewarde helde on þilke bon hot oyle of rosys, & leye on one of þe mundyficatyfes þat beþ in þe antitodarye, whiche þat wylle remywe þe rotyde bon withoute violence. Ffor vndirstond wel, þawȝ þat þou clanse þe rotyde bon with schavynge oþere wiþ vylinge with vyolence, neuere þe latere kynde wyl afterwarde don aweye a schelle of þilke same bon, noȝt aȝenstondynge þy schauynge & þy raspynge; wherefore in remefynge þilke bon, þou multiplyest þy trauell, & þou makyste no mundificatioun to þe folle; & þerof may come ofte tymes, an yuele festre. And inconuenient medycine ys amendyde, in consyderynge þe complexioun [folio 62b] of alle þe bodye, & þe complexioun of þe lyme, & þe gree of þe medycine; for ȝif þat þe membre be drye as þe erys, noseþrylles & alle bony & grestly lemes, & þey han grete putrede & roteschippe, þenne þou nedyste a ful drye medycyne; & ȝif þat þe body oþere þe membre be naturellyche moist, ȝif þat he haue a lyte putrede oþere roteschippe, þanne thou nedyste a medycine þat ys lyte dryinge. And ȝif þat the body oþere þe lymes ben mene betwene fatnesse and lenesse—þat nys neiþere to fatte ne to lene, þenne þou nedyst a medycine þat is in kynde, mesurablyche dryinge.

And ȝif þat two membrys ben in complexioun i-lyche euene, & þe on haue myche quyter & þe oþere lyte quyter, he þat haþ þe more quyter nedyth þe dreyere medycine,*——afterwarde it nediþ by mesure þat þou kepe naturel þynge, with þynge þat is acordynge to þe same nature, and also to remeffe with mesurable contraryouste þynge þat is aȝeyns kynde. But þe quantite of medicynes þat scholde [MS. þat scholde, twice.] be leyde to þe sore, as Galien witnesseþ, ne may noȝt with lettres ben wryten. Neuer þe latere it suffisith, þat a man defye þe medycine, aftere þe complexioun may bere; ffor kynde þat is wondirfull fulfylleþ þynge þat is absent & þat þat is to myche castyth aweye, but ȝif þat it be to myche aȝeyne kynde; & þanne kynde most nedys faylen in his kendlye wirchynge. A medycine mundyficatyff & exsiccatif þat is necessarie in eche olde holwe, vlcere,*—may be knowe by þis manere: ȝif þat þe medycine make þenne quyter & blody & make þe wounde holwere þan he scholde be, þenne ys þe medycine to acute; & ȝif þe quyter be þikke & towȝ, þenne ys þe medycine to lythye; and also an oþere [medycine, cancelled before signe.] signe þat

þy medycine is to scharpe, þat þe place about þe wounde ys to grene, blake, red oþere to ȝelwe & þe syke man felyþ to grete hete [folio 63a] & brennynge, & also þe Venym of þe wounde multiplyeth, and whanne þe vnkunnynge leche seþ þese Accidentes tofore seyde, he ordeyneþ a dryere medycine; & so eche day þe wounde apeirith. And þe signe þat þe medycine is of feble dreyinge is þat þe quyter & þe rotnesse, þat goþ out þere of, ys gret in substaunce, ponderose & vneuene, wan oþer pale; þe membre is colde whyte oþer wan, oþer clere in coloure, oþer softe, & þe syke man felyth colde in his membre, & whenne þat þou knowist þese þynges in þe firste cas, make noȝt þy medycine so drye. In þe secunde cas make þy medycine more drye, & so chaunge þy wirkynge, as condyciouns of kynde askyth, boþe of body & of membre, as wel symple as componede medycines. He þat knowiþ noȝt þese kanones wel*—schal helen olde woundes; wherefore manye lechys brynge lyȝte woundes wiþ here iuele wirchynge, into þe worste olde woundes, þe whiche mowe noȝt aftere be helyde by a gode leche. Þese ben lyȝte medycines, whiche þat drye olde wondys þat neden a lytel dryȝinge; mastyke, ffrankensence, barlymele. Þese medicynes beþ sumwhat dreyere: yreos. Aristologia. Orobum þat is wilde Tare, lupines, þe rotenesse

oþer þe dryȝe poudre of trees. Þese medycines ben strengere: balaustie, prosidye, rose, notys off Cipresse et. cet. And þese [MS. þese, twice.] ben lyȝte mundificatyfes in cure, [in cure, a scribal mistake from sugre.] hony, watire of barlye, gotyswheyȝ, water of þe see, water of brymston þat clansith & hetyþ, water of Alym þat clansyth & coldyth. Þou schalt haue grete plente of enplastres, mundificatyfes, and oygnementys componede in þe antitodarye of þis ilke booke.

¶ Cap. xii of þe þridde techynge of þe firste tretis is of a [of a, above line.] festre.

ffestre [MS. ffirste.] is a depe olde wounde and [in, cancelled; and, above line.] þe mouth is streyt of hym & þe grounde is brod, & he haþ wiþ ynne hym a callose hardnesse alle aboute, as yt were a gose penne oþer ellys a kane, & a ffestre haþ [folio 63b] diffence from a depe Vlcus & a cauernose; for a depe Vlcus & a Cauernose, of whom yt ys tolde in þe chapitle toforeseyde, þowȝ þat þey acorden togedire in depnesse & in streytnesse of þe mouþ, þe Vlcus haþ noȝt wiþyn hym a callose hardnesse, wherefore a festre may noȝt be clensyde with wasschynges, with þe whiche a [a, above line.] cavernose Vlcus may be clansyde, but it is necessarye, aftere þat

þou hast y-wasschyde yt, to remeffyn þilke callose hardnesse with a cauterye, oþere wiþ a medycine cauterysynge þat ys brennynge, þe whiche cauterye oþer brennynge scholde make þe depþe of þe Vlcus holwere þanne he was. Wherefore it is necessarie to a surgiene to knowe þe difference of þis scyence, þat he mowe conne hele boþe þe Vlcus & þe festre with medycines different þat longyth to hem boþe. And ȝif þat a festre be in þe flesch, oþer ellys bytwene synwe & synwe, so þat þe Substaunce of þe synwe be noȝt corupte ne þe bon, yt nys non nede to take non oþere medycine but egremoyne, & stampe hym wiþ salt, as þou woldest maken sause, & drawe out þe jus of þilke egremoyne, & do yt into þe hole of þe festre with a penne, & leye þe substaunce of þe same erbe þere-vpon, tyl he haue slaw [At the end of the line. One letter wanting.] alle þilke festre & y-clansyde yt; & þat þou schalt knowen by þe rednesse & sadnesse of flesch þat is withynne þe festre al aboute, & aftirwarde haue þis surype off honye, with þe whiche þou schalt wassche þe festre, þat ys now Vlcus componed, in þis manere: [Confection of syrup mellyne, in margin.] ℞ water [pound] .j., of vynegre [pound]. [one half], of hony despumed [ounce] iiij, off leuys of olyue-tre, y-bounde togedre with a þrede, [dram] .j., of [folio 64a] sagytelle [ounce] .j., boylle al þis to þe perfytnesse of a sirupe, & let yt

coldyn & do aweye þe leffys of þe olyfe, & kepe alle þe remnaunt of þe surype with þe leffys of sagytelle, & wassche þe Vlcus þat was festre tofore with þis licoure twyes a day, þat þe lycoure may go to þe grounde, & afterwarde dreye it wel & fyl yt ful of drye leffys of sagytelle, & leye a sagitelle leff aboue, and þis medycine þou schalt conteynen tyl þat it be hol. Every festre þat is in flesch ys helyde with þis medycine y-prefed, but ȝif þe substaunce of þe synwe & of þe bon be apeyred in þe grounde, & specialyche ȝif þe festre be nouȝt old & ȝif þat þe callosite be noȝt to hard. In þese tweye cases þe medycyne of egremoyne ne suffiseþ noȝt, but it ys necessarye a kauterye of fyre oþer a medycine caustyke; & of þese medycins þou schalt han a ful techynge, folwynge in þe boke. And ȝif þat þe bon were corupte in þe depþe of þe festre, do yt aweye after þe techynge, þat y haue tauȝte þe in þe chapitell tofore. And hereof take hede: ȝif þat a festere perse be þe weyȝes of þe vryne, so þat þe Vryne go out by þilke weye, as we haue seyne ofte tymes, oþer ellys þat he go by crokyde placys and hudel [hudel, adj. See Mätzner, Dict., hudels, sb. O.E. hȳdels, hiding-place.] places of þe face, persynge into þe depnesse of þe hed whose grounde þou maiste noȝt perseyue, hit ys bettyre noȝt for to cure with a perfyte cure, but þou maiste pale it & don awey þe stynke, with hony & wasschynges of emplastre in mundificatyfes & with defensifes aboute þe place, þat

his malyce mowe þe lasse greff. A festre þat is in juncturys as þe fote oþer þe kne, oþer þe hand, oþere þe elbowe, is hard forto hele & sumtyme vnpossible. And ȝif þat he be in an oþere place & he haue coroded oþer rotyd sumwhat of þe synwe, þowȝ þat it be greffes forto cure it, þere nys none oþere weye bote a lyȝt cauterys-acioun of þe synwe, þat is y-hurt: ffor cauterysacioun wiþ hote yren, oþer wiþ gold þat is betyre clansyth & dryeþ [folio 64b] þe synwe þat ys corupte, & rectefyeth þe complexioun of al þe membre, and a medycine caustyke worcheþ þe contrarye. Brennynge medycines, boþe symple & componed, þou schalt han to þe fulle in þe antitodarye of þis boke, & þou schalt fynde þe manere of cauterysinge to þe fulle in þe þridde tretys folwynge; & whanne þou hast made a perfyte mundyficacioun of þilke callose flesch, regenere flesch & consoude with medycines regeneratyfes & consolidatyfes, þe whyche þou schalte fynde in þe antitodarye.

¶ Cap. xiii off þe þridde techynge off þe ffirste tretys is Off a Canker.

¶ Cankyre y-woundyde comyth of opnynge, oþere of kuttynge, oþere of brekynge of a cancre noȝt y-woundyde, whose techynge þou

schalt habbyn in þe Chapitle of enpostemes in þe þridde techynge & he comyth of a wounde yuele y-helyde, to whom comyth a maly-colient rotyde matere, oþer for þat þe matere comeþ to þe wounde is þere coruppyd, & chaungyth þe Ulcus into a Cankere. And þese beþ þe toknys of þe cankere: þe Ulcus ys foule & stynkynge, þe lippes beþ grete, wanne, oþere blake, harde, and wiþinne kernelly, & ouere alle aboute areryde & holwy, & þis is þe dyfference bytwene cancre & a foule Ulcus & an hory, of whom y haue made mensioun aboue, þat ȝif þat þou wassche hem boþe [MS. oþere.] wiþ leyȝe, þe cancre schal ben pale & foulere þenne he was tofore, & þere schal fallen out of hym pecys, gobetmele. And þe Ulcus ys y-clansede with þilke leyȝe, & þe flesch ys made fayrere þenne yt was tofore, ne þe Ulcus stynkeþ noȝt by þe same stenche as þe cancre doþ; for þe cankre hath a propre saffoure, þe which may noȝt be wryten wiþ lettres, but þilke safoure ys best knowyn to of men, whiche þat beste han seye cankrys. A [folio 65a] generall rule in þe cure of cankre ys, þat a cankyre may noȝt ben helyde bot ȝif þat he be done awey wiþ alle hys rotys. The secunde rule ys, þat he schal noȝt ben touchyde with hot yren ne wiþ hot medycyne caustyk—þat is to sigge, brennynge

—but he be in place, þere he may al be don away; ffor þe more þat þou touchiste hym with a vyolent thynge oþer medycine, þe more hys malys is encressyde. Take þenne gode hede ȝif he be in a fleschlye place, where þat he may be don al aweye, & þenne kutte hym al aweye wiþ alle hys rotys, & þruste out þe malencolyent blod þat ys withynne þe Veynes, þat beþ aboute þe cancre, & afterwarde brenne alle aboute in þe place, þere as þe cankre was, wiþ hote yren. Afterward leye on þis confectioun y-mad of floure of whete hony, jus of smallache, tyl þat he be perfitly y-clansyde. After regenere flesch & cycatrice. To þis rule take hede as ofte as þou wylt wiþ surgerye helyn a cancre: furst evacue þe malencolyent matere, ffor þat is ypocras techynge, & ȝif he be growen in swyche a place, þere as he may noȝt be done alle aweye, as in þe nekke ore in þe tetys, oþere in þe face, ore in þe ers hole, oþer in þe marys, and also for the schortere conclusioun, & he be entrede in enye place, þere as enye Veynes, synwes, & arteryes buþ, as ypocras seith, yt ys betyre noȝt to cure þe cancre, þen to cure; ffor he be curyde, þat is to sigge, y-kutte oþere y-brent, þey perysschen sonnere; & ȝif þey be noȝt curyde þey lyuen longe tyme—libro sexto afforismorum Cancri absconditi multum tempus per ficiunt

curati vero cicius pereunt. [Regula, in margin.] ¶ But diffende þe lyme þat is hol aboute with defensiff of bol, þat y haue ofte tymes seyde, & wassche þe wounde of þe cancre with gotys wheyȝ, & drye yt softlyche & anoynt þe wounde withinne & without, with þis oygnement of rasys of tutye, ℞ ceruse, tuthye, y-wasschyn and medle hem wiþ oyle of roses & wiþ jus of poslane, [folio 65b] oþere of sum oþere colde erbe, now puttynge in sum of þe on & now sum of þe oþere, tyl þe oygnement be ful mad. Þis oygnement ys myche worth forto diffende; þat þe malys of þe cancre þat is y-woundyde schal noȝt waxen, and also þat þe pacient vse a gode gouernaylle: as drynkinge gode wyn & clere & lyȝt, & he mote leuen red wyn and troblyde & þykke wyn; & he may eten gode flesch, as motoun of a weþire, kyde fflesch sokkynge, Capouns, hennys, Chykenys, partryches, ffesauntes, & smale briddes, & he moste leuyn beffys flesch, gotys fflesch, hertys flesch, harys fflesch, goses, dokys, & alle grete briddys. þat lyuen in watrye places, & alle salt þynge & acute þynge: as garlyke, Oynouns, vynegre, &c.;, þat* þe syke men mowe lyuen þe lengere vpon

erthe. Naþeles ȝif vlcus be ryȝt foul & hath nouȝt so gret malys as a cancre, off þe whyche Vlcus y haue tolde tofore, may ben y-curyde wiþ poudre of affedylle, and afterwarde wel be clansyde, & for þat þis Vlcus þat was so foul may be helyde. Rogeryne & Rouland & manye oþere settyde in here bokys þe cure of þe cancre, þowȝ þat he be in a synwy place, & þey siggen þat þey haue helyde hym. But vndirstande wel for certeyne, þat an olde cancre may noȝt ben helyde by none oþere wey, bote by þe same wey, whiche þat y haue seyde in þe bygynnynge of þys chapytell. & ȝif þat þou dredyst, wheþere þat yt be a cancre oþere a symple Vlcus & a foul, for þe signes & þe toknys tofore seyde beþ doutes, begynne to mortefye yt wiþ sum maner poudre as wiþ poudre of affodylles, & loke after-warde þe processe of þy worchynge; ffor ȝif þat he be a verrey cancre þou schalt se, þe more þou woldyste clansen hym þe more hys malys schal waxen, and ȝif he be noȝt a cancre, he schal be clansyde ryȝt as an Vlcus. Whanne þat þou seste þe waxyng [folio 66a] of þe cancre & hys malys augmenten, sese fro þe verreye cure & turne ageyne to þe forseyde cure of þe oygnement of tuetye, whiche þat palyth þe cancre. ffor & þou bysy þe to cure þe cancre, & þou procede

in thy cure, þou schortest þe pacientes lyff. And ȝif þou palest þou lengthiste hys lyff.

¶ Cap. xiiij of þe þridde techynge of þe furste tretys, is forto remefe causes þat latten þe cure of olde woundys.

¶ I tolde þe aboue in þe general Chapytle of olde Woundes, causes whiche þat latteþ olde woundys to by helyde. And also y telde þe techynges plenerlyche þat beþ necessarye to remywe eche sengle cause, þat is necessarye to be done awey. And now y schal in þis specyal chapytle teche, how þat alle manere cause þat lettyth may be done awey by a gode surgyne & a wyse, so þat ȝif þou joynest þis chapitele with þe oþere chapytell to fore seyde, þou schalt han a plenere techynge. Ȝif þat þe body be ful of elde humores, oþere in þe dropsye; loke ȝif þat he may be helyde of þilke disposicioun, & þenne hele hym ȝif þat þou canst, and ȝif þat he be noȝt ful of elde humorys; whiche þat nedyth to curynge of olde disposicioun. Ne traueyle noȝt in deveyne þe syke man, nowþere with medycines corosifes, ne with kuttynges, ne with puttynges into þe wounde grete tentys; but do aboffe þe Vlcus lyȝte mundyficatyfes & swote

smellynge þat kepyth the membre lyȝtlyche clene, þat he stynke noȝt. And whanne þat he is curyde from an yuele disposicioun, turne aȝeyne to þe princypal cure; & þis same þynge y sugge of yuele disposicioun of þe lyfere, of what manere cause þat þe enfeblyde; þe same y sigge of the spleen, ffor but ȝif þese tweyne ben in here kendlye dysposicioun, olde woundes mowe noȝt ben helyde. Ȝif þat grete multitude off blode lette þe, þat may be knowe by ful replecioun of þe veynes of alle þe body, by rednesse & extension of þe face, be swetnesse of þe mouth, be wlattynge, whenne þat a man ys fastynge, by [folio 66b] heuynesse of þe browys, & by ȝonge age, & þat hys complexoun ys hot & moyst, and þat he hath y-vsyde in hys dyotynge wyn & fflesch, and þenne make hym be lete blode on þe veyne, whiche þat bryngeth norysschynge to þe lyme, & afterwarde of the Veyne þat may beste voyden þe membre þat ys y-hurt. And ȝif þat þe blode trepasse onlye in qualyte, amende hym as ȝif þat he be to hot, voyde hym a lytel & dyote hym wiþ colde metys & styptyke. And afterwarde procede forth in alle oþere manere cases as it ys tolde in þe generall chapytell, takynge hede þat þere ben sum manere medycines, whiche þat beþ dryȝinge & clansynge, & haue a prefe proprete to consoude olde woundys,

whiche þat beþ deffykel to be consoudyde, of þe whyche medycines some beth symple & some beþ componed. Symple beþ: lymature of bras, lymature of Iren, ffloure of bras brent; vytreol rede y-brent, and alle scharpe corosifes, ȝif þat þey ben y-brent. ffor þat þey han þe more vertue to consouden, and al so here corosion ys y-lassyde. Þis ys a medycine componyde: ℞. ffloris eris, lymature of bras ana .ȝ. j., litarge of gold, litarge of syluere ana. ȝ. viij., gumme of cypresse .ȝ. iiij, sal gemme .ȝ. ij, Aristologie I-brende, smal poudre of ffrank Ensence ana. ȝ. v., wax & oyle of myrtyne þat suffyseþ.

¶ Cap. XV. off the þridde techynge of þe ffirste tretys is off a Crawmpe, that comyth to a Wounde.

Necessarye thynge ys a surgyne, to knowe þe causys of þe crampe whiche þat comyth to a wounde þat scholde ben y-helyde, and also þat he knowe þe dysposicioun of hym þat haþ þe crampe. And also what þynge þe crampe ys, þat he mowe resonablyche hele þe crampe. The crampe ys a seknesse cordouse, oþere ellys nervose, in the whiche syknesse þe cordes & þe synwes were drawyne to here bygynnynge; of þe whiche drawynge þere beþ tweye causes

conjuncte: þe on ys repletion of þe synwe, oþere of þe corde, þe oþere is Inanysion. He þat ys in [Scribal mistake.] avision ofte tymes haþ a cause goynge to fore, [folio 67a] as to myche evacuacioun of blod, oþere of sum othire thynge; as to longe afflictioun for longe akþe, oþere ellys, for þe Apetite of the syke man hath be longe tyme enffeblyde; & þis comyth lytel & lytell, and þe crampe þat comyth of boþe þese causys may noȝt ben helyde. And he þat comyth of repletion hath on of þre causys goynge tofore: þe firste cause ys to grete akþe, þe secunde cause ys colde, þe þridde ys putrefaccioun oþer rotynge; and þowȝ þat one sengle cause sumtyme suffiseth to maken a crampe, ofte tymes alle þese causes happe to come togedres. And þis crampe may ben y-helyde ere þat he be comfermyde, & after þat he ys confermyde selden oþere neffere. A surgyne moste þenne be busye; in alle þat he myȝte, þat a crampe no wexe noȝt in þe wounde þat scholde be helyde, wiþ obuiacion dyffendynge þat none of þe þre causes tofore seyde ne come noȝte to þe wounde; þe one ys in deffendynge þe lyme from putrefaccioun, þe oþere is in kepynge þe lyme from rotenesse, þe þridde is to gouerne hym from gret akynge; ffor it is more sykere to dyffende, þat a crampe ne come noȝt, þenne aftere þat he ys come with medycine þat is doutes oþere dredful to

don aweye, Ffor ȝif þat a ffeuyre come to an hed oþere to a synwe þat ys y-woundyde, & þe crampe folwe euyre more, yt ys dedlyche. Take hede þenne to aswage þe akþe with anoyngtynge of oyle of rosys, and in doynge as y haue seyde tofore in þe chapitle of synwes þat beþ y-woundyde; ffor ofte tymes þe crampe comyth for woundys, þat beþ made in þe hed oþere ellis [ellis, above line.] in þe synwe: And ȝif þat akþe were so grete, þat makyth a crampe for þe prikynge off a synwe oþer ellys of a corde, and ȝif þou myȝtest noȝt deffende þe crampe, newhere wiþ blode letynge, ne wiþ ventosynge, ne wiþ clysterye, ne wiþ suppositorye, ne with defensif in anoyntynge þe nekke, ne þe grynde, ne þe arme holys, þenne yt is necessarie þat þou kytte alle atwo þilke synwe oþere corde þat is y-prikyde, þowȝ þat þe ffelynge oþere þe meffynge of þe lyme, to whom þilke synwe oþere corde servyde, in party oþer in al be loste. Ffor yt is bettyre [folio 67b] þat a man lese þe felynge & þe meffynge of a lyme þenne þawȝ þat he deyȝe. But yt is bettyre ȝif þat þou couþest kepen a man with oþere manere medycines, þenne þat þe synwe oþere corde be y-kutte al atwo. And ȝif þat þou were noȝt at þe bygynninge, and þou fyndest a man hauynge a crampe for a wounde, do þou as y dyde at Melan. Þere was a Scolere of myne þat was a Surgyne þat was y-clepyde Olyfere, whyche þat

curyde a schepere of a wounde þat he hadde in the hed; & by þilke wounde þe pannycle oþere þe skyn þat keueryth þe breyne panne, þat is vndire þe fflesch, was y-hurt, & nere þe latere þe breyn panne was noȝt y-hurt. & þilke leche, ere þanne he hadde perfytlyche y-puryfiede þylke pannycle, soudyde þe wounde withouten forth; & whanne þat þilke wounde was y-sowdyde, þe pannycle þat was noȝt wel helyde hadde a dedeyne, & was cause of engendrynge of a crampe in þilke wounde. And at þe laste y was clepyde to þilke syke man, & y fonde hym habbynge þe crampe, & with þe crampe he hadde manye smale enpostemes aboute hys face, & þat ys an yuele tokne in þe woundys of þe hed, and þenne y demyde hym for ded. Naþeles at þe instaunce of hys frendys y þat wolde assaye þe worchynge of kynde vpon resoun, I made hys hed ben y-schaue, and y kutte aȝeyne þe wounde, þat was consoudid, with a rasoure to þe depþe of þe same wounde, & afterewarde y fulfylde þilke wounde with hote oyle of rosys, & y anoyntede alle þe hed with þe same oyle of roses & a lytell vynegre y-medlyde togedre, & y anoyntede þe nolle & þe nekke onlye wiþ oyle of rosys, and y dyde on þe wounde þe ȝolke of an eye with oyle of rosys, and y bonde alle þe hed wiþ a

bonde leggynge þere undyre hurdys oþere towȝ smal tosyde, and y opnyde hys mouth & put into hys mouth þe broth of a chyken y-made with comyn, and also clere wyn y-medlyde with myche watyre. On þe morwe y turnyde aȝeyne & y fonde þe syke of bettyre dysposicioun, & he opnyde bettyre hys mouth, & he spak bettyre; & naþeles [folio 68a] y fonde þe wounde drye, & þenne y dede efte sonys þe same medycine & þe same vncture. In þe þridde day þe skyn of þe hed was y-mad moyst, whyche þat was to forne as drye as a skyn hadde be rostyde to þe fyre, and in so myche þe skyn was y-made þunne, þat þere was noþynge betwene þe skyn & þe breyne panne. & at þe laste þe wounde quyteryde wiþ contynewaunce of þe same cure tofore seyde, & in þis manere þe ȝonge man was helyde boþe of þe crampe & eke of þe wounde. But þilke crampe was withouten ffeuyre; ffor y ne may noȝt þynke þat y haue seyn [a wounde struck through after seyn.] a ffevyre in þe woundes of synwes, oþere ellys of þe hed precede a crampe, þat noȝt aȝeyne stondynge remedye / oþere medycynes þe pacient þat hadde þe crampe ne deyede. My beste conseyle is to letyn hym blod in the bygynninge þat haþ þe crampe, namly, & he be stronge & replete, and ȝif þat he haue nouȝt bled ynowȝ at hys wounde; and anoynte hys nolle & hys nekke wiþ hote oynementys, as with oyle of

nardyne, enforbine, Oyle rewe, lylyes &c.;, and also to make smale cauteryes punctales, þat is to sigge as smale as þe ende of a prykke, bytwene euery whirlebone of þe nekke, so neuere þe latere þat þe cauterye go nouȝt ouere depe. Afterwarde bynde longe wolle to hys hed be hynde, & to his nekke, & to his schuldres, & do þere on hote oyle, & leye hym in a softe bed, & lete hym ben in reste & in pees. But þere be summe þat setten in here bokys medycines, þat provocen þe ffeuerys; ffor þat ypocras techyth in quarto afforismorum: a spasmo vel detano habito febre superveniente soluit egritudinem þat ys to sigge; ȝif þat a man haff þe crampe, oþere ellys a tetane, þat is a syknesse þat halt the membre y-lyche streyt on boþe þe sydes, as a crampe halte þe on syde of þe membre, & þe ffeuere come on þilke crampe oþere þilke tetane, he distroyeth þe crampe oþere þe seknesse, and also þey anoynte with to hote oynement to provoke þe ffeuerys, þe whyche þynge y ne apreff nouȝt in þe crampe of a wounde, þowȝ þat þilke oynement myȝte be profitable in a crampe withouten [folio 68b] wounde, & where þat humores habounde, namlye, ȝif yt be fflewme. Somme ben general toknys, & some be speciall of schewynge of a crampe. General toknys ben þese: to

gret akþe, crokydnesse of eyȝen, & crokydnesse of erys of nose þrell & of lyppes, & whenne þat a man may noȝt speke, & þe chekys ben constreynde, & dyficulte of swolwynge, & diffyculte of mevynge, namlye of þe nekke, & ofte constreynynge togedre, & sodeyne schakynge togedire. Special signes maken one of pre manere of crampes: þe on ys y-clepyde Emprostonos, þe oþere Empistonos, þe þridde tetanus. In þese manere of crampe þat is clepyde Emprostonos þe synwes tofore be drawen togedire, þe fore party of þe hed ys crokyde, ne þe syke man ne may noȝt heffyn it vp, he berith hys chyn as yt leye on hys brest; hys mouþ is streyte, ne he ne may noȝt opyne yt, and þe ffyngres of hys hande ben foldyde into hys fust. And in Empistonos þe nekke ys crokyde, his mouþ is opyne, his chekes beþ opyne, & þe fyngres of hys handys ben streynde bakwarde, and þe tetane halt boþe þe partye of þe body, so þat he may nouȝt turne hys nekke to non partie, but alle þe body is styffe & streynde, as a staf were put in at hys hed & out at his ers. Alle þese toknys oþere ellys sum of hem schewith þe disposicioun of hym þat haþ þe crampe. And whanne þat þese toknys fallyn in þe wounde of an hed oþere ellys of [of, above line.] a synwe, þey teche bettire þe leche to fle from þe syke man, þenne on hym to abyde & cure. The firste

tretys ys y-endyde wiþ helpe of almyȝtie god, now with þe helpe of [MS. of twice.] þe same y go to þe secunde.