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.

Ashmole MS. 1396.

SCIENCE OF CIRURGIE.

[folio 2b] Now þese chapitles of þis book ben y-ordeyned, I wole fulfille my purpos pursuynge ech chapitle bi ordre, & confermynge my wordis aftir þe auctorite of myn auctouris and wiþ experiment þat I haue longe tyme vsed wiþ þe help of god. // // //

Al þing þat we wolde knowe, bi oon of .iij. maners þat we moun knowe, eiþir bi his name, or by his worchinge, or bi his verri beynge schewynge propirte of him-silf / In þis þre maner we moun knowe surgerie bi expownynge of his name; for siurge comeþ of siros, þat is a word of gru, & in englisch siros is an hand, & gyros gru, þat is worchinge in englisch / For þe ende & þe profite of syurgie is * [of hand-wyrchynge. Of þe Name of a thynge Galyen seyth: he þat wyl knowe] soþfastnes of a þing, bisie him nouȝt to knowe þe name of a þing, but þe worchinge & þe effete of þe same þing / Therfore he þat wole knowe what siurgie is, he moot vndirstonde, þat it is a medicinal science, which techiþ us to worche wiþ handis in mannes bodi, wiþ kuttynge or openynge þe

parties þat ben hole & in helynge þo þat ben broken, or kutt, as þei were toforn, [folio 3a] or ellis as nyȝ as a man may, & also in doynge awey þat is to myche skyn: as wertis or wennys, or þe fleisch to hiȝe //

¶ Þe secunde chapitle of Þe firste tretis is of Þe qualitees, maners, and kunnynge of a surgian //

Nedeful it is þat a surgian be of a complexcioun weel proporciound, and þat his complexcioun be temperat / Races seiþ, who-so is nouȝt semelich, is ympossible to haue good maners *[& Auicenne: euyle maners] but folowen þe lijknes of an yuele complexioun/ A surgian muste haue handis weel schape, longe smale fyngris, and his body not quakynge, & al must ben of sutil witt, for al þing þat longiþ to siurgie may not wiþ lettris ben writen. He muste studie in alle þe parties of philofie & in logik, þat he mowe vndirstonde scripturis; in gramer, þat he speke congruliche; in [Lat.: quod docet dialectica] arte, þat techiþ him to proue his proporciouns wiþ good resoun; in retorik þat techiþ him to speke semelich. Be he no glotoun, ne noon enuyous, ne a negard; be he trewe, vnbeliche, [humbilly in margin, in smaller hand.] & plesyngliche bere he him-silf to hise pacientis; speke he noon ribawdrie in þe sike mannis [folio 3b] hous /

ȝeue he no counseil, but if he be axid; ne speke he wiþ no womman in folie in þe sik mannes hous; ne chide not wiþ þe sike man ne wiþ noon of hise meyne, but curteisli speke to þe sijk man, and in almaner sijknes bihote him heele, þouȝ þou be of him dispeirid; but neuer þe lattere seie to hise freendis þe caas as it stant / Loue he noon harde curis, & entermete he nouȝt of þo þat ben in dispeir. Pore men helpe he bi his myȝt, and of þe riche men axe he good reward / Preise he nouȝt him-silf wiþ his owne mouþ, ne blame he nouȝt scharpliche oþere lechis; loue he alle lechis & clerkis, & bi his myȝt [myȝt in margin.] make he no leche his enemye. So cloþe he him wiþ vertues, þat of him mai arise good fame & name; & þis techiþ etik. So lerne he fisik, þat he mowe wiþ good rulis his surgerie defende & þat techiþ fisik / Neþeles it is nessessarie a surgian to knowe alle þe parties and ech sengle partie of a medicyn. For if a surgian ne knewe nouȝt þe science of elementis, whiche þat ben firstmoost force of natural þingis & of dyuers lymes, he mai not [folio 3*a] knowe science of coniouncions, þat is to seie, medlyngis & complexiouns þat ben nessessarie to his craft / A surgian muste knowe þat alle bodies þat ben medlid vndir þe sercle of þe moone, ben engendrid of foure

symple bodies, her lijknes ech in oþere medlynge; þat is to seie: fier & watir, erþe & eir: þese [ben above line.] elementis for þe vttirmeste eende, & þe vttermeste contrariouste of here qualitees were fer drawen from bodilich lijf; but whanne her qualitees, þat is to seie, maner of beynge, comen into medlynge, so þat þe leeste partie of þat oon entre into þe leeste partie of þat oþer partie, medlynge brekiþ her contrariouste; & þerof comen a newe foorme, & a newe complexcioun of þe medlynge of her substaunce / Also þe medlynge of qualitees & þe quantitees is fer drawen from þe contrariouste of þe same elementis, & so complexioun is nyȝ brouȝt to a mele; & so þat þat is medlid is more able to resceiue þe noble foorme of lijf, þe which nobilite aboue alle bodies I-medlid is founden in mannes spirit. But for þat þe qualitees þat wiþ þo bodies of elementis [folio 3*b] comen into medlynge, & it is vnpossible to departe þo qualitees from bodies þat ben foure: hoot, coold, moist & drie, & complexiouns ben bi hem, it is nessessarie to fynde in bodies þat ben medlid foure complexiouns / Complexioun is no þing ellis but a maner qualite medlid in worchinge & suffrynge of contrarious qualitees þat ben founden in elementis, so þat þe leeste partie of ech element entre into þe leeste partie of þe oþere. & for þat ilke

.iiij. complexiouns, hoot, moist, coold & drie, sumtyme ben y-componed, þat is to seie, medlid, þer comen in hem .viij. as: hoot & drie, hoot & moist, & coold & drie, and coold & moist / Foure of þese ben symple, and foure componed; & for þilke .viij. sumtyme ben wiþ mater, & sumtyme wiþoute mater / þer ben .xvj.; & for þilke xvj. aftir sum consideracioun moun be naturel to summan, & summan vnnaturel / þer moun be .xxxij. Neuereþelatter among alle þe complexiouns þat man mai fynde, þat is componed of dyuers qualitees, þere ne is noon so temperat, as is mannes complexioun; & hauynge reward to mannes complexioun, alle oþere þingis *[ys] I-clepid, hoot, coold, moist, [folio 4a] eiþer drie. / Whanne [A mistranslation from the Latin: Illam namque rem ... dicimus esse temperatam, quæ cum passa fuerit a calore naturali, qui est in nobis, non calefit, etc.] þat a mete or a medicyn haþ suffrid kyndely heete þat is in man, þat heetiþ him nouȝt, ne drieþ him nouȝt, ne moistiþ hym nouȝt, so þat mannes complexioun may not conseyue wheþer it coldiþ him, heetiþ or drieþ or moistiþ him: it is clepid temperat / & þilke þing þat we seie is hoot in þe firste degree, þat is I-heet of kyndely heete þat is in oure bodies, & heetiþ oure bodies wiþouten greuauncis / & þilke we seien to be hoot in þe secunde degree, which þat is het of oure kyndely heete, so heetiþ oure bodi þat he ne myȝte heete us no more wiþoute greuaunce /

þilke we seie to be hoot in þe þridde degree, which þat is het of [vn above line.] kyndely heete bryngiþ to oure bodi sensible greuaunce. & þilke is in þe fourþe degree, þat is hot of [vn in different hand.] vnkyndely heete, distroieþ þe bodi openliche / & in þis same maner ȝe moun knowe degrees þat ben colde / I mai preue in þis maner, þat it is nessessarie a surgian to knowe complexiouns of bodies, lymes, & of medicyns. Take .ij. men þat ben of oon age, & lete hem ben I-woundid wiþ a swerd or a knyf [ouer above line.] þwert ouer þe arm in oon hour & in oon place; oon of þe men is of an [folio 4b] hoot complexioun & a moist, þat oþer of a cold complexioun & a drie. Þe comoun seiynge of lewid men is þat þei schulden boþe ben helid on o maner; but resonable surgerie I-preued techiþ us, þat þei ne schulde not boþe be helid aftir oon maner / For he þat haþ an hoot complexioun, & a moist, may liȝtly haue an hoot enpostym—þat is an hoot swellynge—& þat may be cause of an hoot feuere. What schalt þou þanne do? þou must loke, wheþer he haþ bled myche blood at his wounde, and þanne it is weel; ellis lete him blood of þe contrarious arme, or ellis*—of þe oon same side, if strenkþe & age acorde; or ventose [Lat. ventosare. Kersey, Dict. Ventose, a Cupping Glass.] him on þe two buttokkis, if þat he be feble. & if he may not schite [Lat. ascellare. Add. MS. translates accurately: go to sege. See below. Compare: a Sege of a Privay; gumfus. Cathol. Angl., p. 328. Compare the French: aller à la selle.] oones a day, helpe him

þerto, or with clisterie, or wiþ suppositorie. & brynge þou þe parties of þe wounde togidere þoruȝ sowynge, or wiþ plumaciols—þat ben smale pelewis—or wiþ byndynge, if þat sewynge be nouȝt nessessarie, & þanne worche aboute þe wounde, as it is told aftir in þe book. But aboute þe wounde leie a medicyn defensif, of bole armonyac [Bole Armoniack. See N. E. Dict.] , oile of rosis, & a litil vynegre; so þat [folio 5a] þe medicyn touche þe brynkis of þe wounde, þat humouris moun not haue her cours to renne to þe wounde; & we forbeden him wiyn, mylk & eiren & fisch þat engendriþ myche blood / But he schal ete for his mete growel maad of otemele, eiþir of barli mele wiþ almaundis; & generaliche he schal vse a streit dietynge, til þat he be sikir þat he schal haue noon hote enpostym. & if þat we kunne fende him fro a feuere & apostym, þe science of his complexioun techiþ us, þat he may of his sijknes soone be hool / þe oþere of þe cold complexioun schal not be leten blood ne ventusid, for blood schulde be kept in him, as for tresour / Forbede hem neiþir wiyn ne fleisch, for þe stomak þat is so feble ne myȝte nouȝt engendre nessessarie mater of blood þat longiþ to þe wounde / Ne we drede nouȝt in him þe feuere, for his complexioun is nouȝt able to resceyue þe feuere / We moun

fynde a medicyn maad in oon maner þat worchiþ dyuers effectis, & he be I-leid to dyuers complexiouns / Grene vitriol, & he be do to a man of a drie complexioun engendrith fleisch [fleisch in margin.] ; & if þou leie [folio 5b] him on moist compleccioun, he greueþ nouȝt oonliche, but corrodith it; and neþeles vitriol haþ but oon maner worchinge, þouȝ þat he worche dyuersliche in dyuers complexiouns / Riȝt as þe worchinge of þe sunne is dyuers, nouȝt for þe sunne, but for þe worchinge of dyuers bodies into whom he worchiþ / Vitriol drieþ wondirfulliche myche: in drie bodies he defendiþ [defendiþ, mistake for fyndiþ; see below.] þe smale lymes myȝt [myȝt for myȝty; see below.] to aȝenstonde his miȝt, wherfore he may nouȝt but drie þe superfluytees þat he fyndiþ in þe wounde; & whanne þo ben y-dried, kynde engendriþ fleisch. In moiste bodies, for þat þe smale lymes ben feble & moun not wiþstonde þe strenkþe of þe vitriol, þe fleisch meltiþ vndir it, & so bi vitriol þe fleisch rotiþ. & þat is seid of dyuers complexiouns, is y-seid of dyuers lymes / Galioun seiþ: If þat tweye woundis ben euene I-quytturid, & þe oon be a drie lyme, & þe oþer a moist lyme, þat þat is þe drie lyme nediþ þe moister medicyn / And if þat .ij. lymes leeue [leeue for leche?] ben I-woundid þat ben lich

in complexioun, & þe oon haþ myche quytture & þe toþer litil, he þat haþ þe myche quytture, nediþ to han þe drier medicyn /

[folio 6a] Iohannes damascenus seiþ, Medicyns & enplastris schulden ben acordynge to þe lymes þat þei ben leid on / Galienus: a kyndly þing schal be kept wiþ a þing þat is kyndly þerto / And þat is aȝen kynde schal be doon awei with þing þat is contrarie þerto / If þat a surgian knew not complexiouns of lymes & of bodies, he schal nouȝt conne to schewynge hise medicyns aftir þat kynde askiþ. A surgian must knowe generacioun of humouris, if he wolde knowe þe science & þe helynge of apostymes, as it schal be declarid in þe tretis of apostymes. He muste knowe þe dyuersitees & þe profitis & þe officis of lymes, þat he mowe knowe, what lymes han a greet worchinge in mannes body, & whiche ben of greet felynge, & whiche moun bere a strong medicyn / & þe vertues of lymes þou must knowe, þat he se, whanne þe worchinge of ony vartu failiþ in ony lyme, þat he mowe helpe þe vertu & þe same lyme failynge. & if he haue þe science of knowynge of vertues, þe science of spiritis schal nouȝt be hid fro him. Alle þese þingis bifore seid ben but natureles, & þei [folio 6b] ben but techinge of medicyns speculatijf /

Also he muste haue knoulechinge of þingis þat ben not naturels, þat he kunne chese good eir to him þat is woundid or ellis haþ

a boch [boch, Latin apostema; M. E. botch. See N. E. Dict.] / Woundis moun not be [heelid cancelled.] dried in a moist eir & a vapouris, but þei þat ben woundid musten ben chaungid fro þat moist eir to a swete cleer eyr & a drie / In wyntir he muste kepe him fro cold; for no þing greueþ so myche boones & senewis as cold [as cold misplaced; see below.] þat ben I-woundid / & in somer he muste haue temperable eir. It is nessessarie þat he kunne dietyn his pacient, as I schal telle in þe same chapitle of dietinge / also he muste ordeyne meuynge & reste, [to cancelled after reste.] as it nediþ to þe same sijk man / for if þat he be woundid in þe heed eiþer haue ony puncture of ony senewe, it is nessessarie þat he reste & dwelle in stillenes & haue an esy bed & a soft; lest he suffre ony traueile of his lymes / But if þat olde woundis wiþout akynge weren in his armes, it were good to him, þat is sijk, to walke on his feet, & lete his arme be bounde to his necke; & if þat þe wounde be in hise schynes & in hise feet, it were good þat he lay & traueilide wiþ hise hondis / Also a [folio 7a] surgian, in al þat he myȝte, he muste tempere a sijk mannes slepinge; for to myche slepinge engenderiþ superfluyte & febliþ his vertewes, & coldiþ & lesiþ al his bodi / To myche wakinge dissolueþ & confoormeþ [confoormeþ, erroneously for consumeþ, as below. Lat. Orig.: dissolvunt et consumunt.] hise spiritis &

makiþ scharpe hise humouris; it bryngiþ vnkindly drowþe to woundis, & is cause of akynge / Also he muste kunne evacuener him þat is ful of yuel humouris & fulfille him þat is waastid, þat he brynge sike men to good temperaunce; ellis a wounde mai not be heelid / Entempre he þe herte of him þat is sijk, for to greet wraþþe. makiþ þe spiritis renne to myche to þe wounde & þat is caus of swellynge; to greet drede, ouþir vttereste [uttereste, only known as an adj.: extremus, erroneously for untryste. See below.] of heelþe of his wounde, holdiþ þe spiritis wiþinne his bodi, þat mater mai not come to heele his wounde / Þese .vj. þingis ben clepid vnnaturel, [Lat. quæ sunt secundum membrum theoricæ medicinæ.] which techiþ a man speculatijf of leche craft.

He muste knowe þe sijknes: as olde wounde, festre, cankre & alle oþere soris, þat he traueile not in veyn & brynge þe sike man to his deeþ / For ech dyuers soor nediþ dyuers helpingis. He muste knowe þe cause of þe wounde / ffor a wounde, þat is [folio 7b] maad wiþ a swerd eiþer a knyf, must oþerwise be heelid, þan he þat is maad wiþ stoon eiþer fallinge / And a wounde þat is biten wiþ an hound schal oþerwise be heelid, þan he þat is biten with a wood hound; as þou schalt fynde soone told in þe book herafter / & he muste knowe þe accidentis þat ben aboute a wounde / for þe wounde schal neuere heele, til þe accidentis be remeued awey / accidentis is

a þing þat falliþ to a wounde out of kynde as hoot, cold, drie, eiþer to myche moistnes, crampe & oþere þinges aȝens kynde / A surgian muste ordeyne dietynge in dyuers maner, as it is told in þe chapitle of dietynge; & whanne it is nedeful, he muste ȝeue dyuers drinkis / Galien: Laxatiues & vometis ben nedeful to hem, þat han olde rotid woundis & stynkynge / For whanne þe bodi is purgid fro wickide humouris, þe wickidnes of þe mater renneþ fro þe wounde & so þe wounde is sunner helid / He þat biholdiþ alle þe parties of a medicyn, he may weel se þat it is nessessarie a surgian to knowe phisik, & oþer dyuers science, as I haue told tofore in þe book.

¶ þe .iij c^o. of þe firste techinge is of intencioun of a surgian /

[folio 8a] Al þe entencioun of a surgian, how diuers þat it be, it is on* [of] þre maners / þe first is vndoynge of þat, þat is hool / þe secunde to hele þat, þat is broke / þe .iij. is remeuynge of þat, þat is to myche; so þat it be don with hand craft / ffor al entencioun of a surgian is vndir þese .iij. entenciouns, or ellis vnder oon of hem A surgian vndoiþ þat þat is hool, whanne he letiþ blood, eiþer garsiþ, [garsiþ] Lat. scarificat; Fr. gerçer; med. Lat. gersa, garsa. See Cathol. Angl., p. 150.] eiþer brenneþ, eiþer settiþ on watirlechis, for þis is a

surgiens craft; þouȝ we for oure pride haue left it to barbouris & to wymmen / for Galion & Rasis diden it with her hondis, as her bookis tellen. And we vndoon þat, þat is hool, whanne þat we kutten þe veynes, þat ben in þe templis & þe forheed & maken cauterizaciouns for þe sijknes of þe yȝen / And whanne þat we maken cauteries in þe heed & in dyuers placis of þe bodi, as I schal telle in þe chapitle of cauterisynge / Þe secunde entencioun is to hele þat, þat is broken as woundis, olde woundis, festris, cankris & in bringyng to her placis ioyntis þat ben oute & in helynge boones þat ben to broken / Þe .iij. intencioun is to remeue þat, þat is to myche, as [folio 8b] scrofulus of þe heed & þe necke & oþere parties of þe bodie / cataractis [cataract, sebel and ungula. See Notes.] —is a watir þat comeþ bitwene þe white of þe iȝen & þe appil; sebel—þat ben veynes þat ben in þe whiȝt of þe iȝen & beþ ful of blood / vngula—is a þing, þat bigynneþ bi þe nose & goiþ ouer þe iȝe til he keuere al þe iȝe—& knottis, þat ben in þe iȝe & oþer siknes of þe iȝe; & in doynge awey polippis, þat is fleisch þat growiþ wiþinne þe nose; wertis & wennys; ficus, þat is superfluyte þat growen vpon þe skyn of þe pintils hede wiþoute, emerawdis [The Latin text has: superfluitatem hermaphroditis.] & a skyn þat enclosiþ a wommans priuy membre, þe

sixte fingre of þe hond & manye superfluytees þat beþ nouȝt semelich to a mannys body

¶ þe firste chapitle of þe secunde tretis is an vniuersal word of smale lymes & her helpingis, & of generacioun of embrioun, þat is þe child, in þe modir wombe // / / [See Vicary, ed. Furnivall, p. 78.]

Galienus seiþ, þat it is nessessarie a surgian to knowe anotamie; ne leeue we nouȝt þat ech brood ligament is a skyn, & ech round ligament to be a senewe, so bi his opinyoun he myȝte falle into errour / Þerfore I þenke to ordeyne a chapitle of þe kynde & of the [folio 9a] foorme & helpinge of alle smale lymes / Auicen seiþ / knoulechinge of a þing, þat haþ cause, mai nouȝt be knowen, but bi his cause. Þerfore we moten knowe þe cause, membriorum consimilium, þat is to seie, smale lymes. & I wole telle þe generacioun of embrioun: þat is to seie, how a child is I-gete in þe modir wombe / Galion & auicen tellen, þat of boþe þe spermes of man & of womman, worchinge & suffrynge togideris, so þat ech of hem worche in oþir & suffre in oþir, embrioun is bigete / But the worchinge of mannes kynde is more myȝtiere, & wommans kynde

more febler / For riȝt as þe roundeles [roundeles, rundelis. Add. MS. rendelys, coagulum. See Prompt. Parv., p. 429, renlys, or rendlys. Comp. O. Du. rinsel, runsel.] of chese haþ bi him-silf wei of worchinge & þe mylk bi wey of suffrynge, so to þe generacioun of embrion mannes sperme haþ him [mannes sperme haþ him, Lat. ita sperma viri se habet.] bi wei of worchinge & wommans sperme bi wey of suffrynge / & riȝt as þe rundelis [roundeles, rundelis. Add. MS. rendelys, coagulum. See Prompt. Parv., p. 429, renlys, or rendlys. Comp. O. Du. rinsel, runsel.] & þe mylk maken a chese, so boþe þe spermes of man & womman maken generacioun of embrioun. Þouȝ þat alle þe smale lymes of a child ben I-geten of boþe two spermes, neþeles, to cloþe hem with fleisch & wiþ fatnes, comeþ to hem menstrue [folio 9b] blood / Þe maris [maris, matrix.] of womman haþ an able complexcioun to conseiuen; & of hir kynde he castiþ þe spermes to þe deppest place of hir; & of hir nature he closiþ hir mouþ, þat þer myȝte not entre the poynt of a nedle / & þanne þe foormal vertu which almyȝty god haþ ȝeue to þe maris ordeyneþ & diuidid euery partie of þese spermes in her kynde, til þat þe child be born / Vndirstonde þat þe fleisch & þe fatnes is mad of menstrue blood, þe boones & gristlis, ligamentis & senewis, cordis, arteries, veynes, panniclis—þat ben smale cloþis—& þe skyn beþ engendrid of boþe þe spermes, as auicen & oþere auctouris tellen / If þat ony of þe lymes þat ben engendrid of þe spermes ben doon awey *[he] moun neuere veriliche be restorid, for þe mater of hem is þe sperme of þe

fadir & of þe modir; but þe fleisch the which mater is blood, þat is aldai engendrid in us, may weel & verriliche be restorid / Þese smale lymes han dyuers foormes, complexciouns & helpingis aftir þe dyuersitees of þe proporciouns of þe mater, which þat þei ben maad of / for þouȝ þat alle þe lymes ben maad of oon mater I-medlid, neþeles in ech of þe smale lymes [folio 10a] þer is a dyuers proporcioun of mater, for þe which mater þei taken dyuers foormes & dyuers helpingis. Almyȝti god ȝeueþ to ech þing of his foorme after þat his mater is* proporciound disserueþ /

Þe boon is þe first of þe consimile membris—þat is oon of þe smale lymes; þe which ben [ben for is, see below.] cold & drie & he haþ dyuers foormes in mannes bodi: for he helpiþ dyuerslich / þe cause whi þer ben manye dyuers boones in mannes bodi is, for sumtyme it is nede to meeue oon lyme withouten anoþir & þat were impossible, if þat al þe bodi were but oon boon / Anoþer cause whi þer ben manye boones: for summe defenden þe principal lymes from harm, as þe brayn scolle from [from, erroneously inserted.] þe brayn of þe heed / summe ben foundementis, as þe boones of þe rigge & of þe schenes & of þe armes / summe ben as additamentis þat ben in þe side of þe rigge boon, & summe to fulfille the holownes of summe ioyntis, as þe handis & þe feet;

& summe þer ben þat þe roundnes of þe boon myȝte entre into þe holownes of þat oþer boon / & non les schulde not lacke his meuynge as þe schuldre boones & þe hipe boones. Þou maist fynde how manye boones þer ben in þe .ij. tretis, [folio 10b] where schal be told pleynlier þe anotamie of consimile membris of al þe bodi from þe heed to þe foot.

A gristil is cold & drie, & is neischere þan a boon, & hardere þan þe fleisch, and in þe fleisch he haþ sixe helpingis / þe firste, þat þat schulde be a meene bitwene þe vttir ende of þe hard boon & þe neische fleisch / þe .ij. þat þe harde schulde not hirte þe neische, nameli in þe tyme of compressioun, & in þe tyme of smytinge / þe .iij. þat þe eende of þe boones whiche þat ben in þe ioyntis schulden haue a softere confutacioun [confutacioun, erroneously for confricacioun. See below.] in her ioyntis / þe fourþe, þat he schulde fulfille þe office of þe boon to susteyne a brawne, meuynge a membre þat haþ noon boon, as þe ouer lid of þe iȝe / þe fifþe: for it is nessessarie a gristil to ben in place, þat is nouȝt ful hard as þe þrote bolle; for þe eende of þe þrote bolle is gristeli / þe .vj.: for it is nessessarie summe lymes to han a sustentacioun, and applicacioun, [applicacioun. Read a plicacioun.] þat is foldynge, to be streyned & drawen abrod as þe noseþrillis & þe gristile of þe eere.

Lygament is cold & drie, and goþ out of þe boones & haþ þe foorme of a senewe. & he may be bowid, but he feliþ nouȝt; & he [folio 11a] haþ foure helpingis / þe firste is, þat he knyttiþ oon boon wiþ anoþer / it is nessessarie, þat oon boon be knytt wiþ anoþer, þat many boonys myȝten make oon bodi as oon boon, & neuereþelatter ech membre myȝte meue bi him-silf, & þerfore þe ligament is as bowable & incensible / for if þat it hadde be censible, þei myȝten nouȝt han I-susteyned þe traueile & þe meuynge of þe ioyntis / & if þat he hadde be inflexible as a boon, of whom he comeþ of, oon lyme myȝte not han meued wiþouten anoþer / þe secunde help is, þat he is ioyned wiþ senewis to make cordis & brawnes / þe þridde help is þat he schulde be a restynge place to summe senewis / þe fourþe þat bi him þe membris, þat ben wiþinne þe bodies, schulden ben y-teied, þe whiche þat neden hangynge.

A corde [There is a constant confusion in all the mediæval medical books between nerves and sinews. See further Notes.] is cold & drie, & he comeþ from þe brayne, eiþer from þe mucha [mucha, an error for nucha; med. Lat. nucha. Dufr.: postera pars colli. Fr. nuque. Littré gives references from the 14th cent. for the signification, marrow. See Notes.] ; þat is þe marie of þe rigge boones // From þe brayn comen .vij. peire cordes. & þei ben clepid sensible senewis / ffrom þe nucha þer comen xxx peire cordis & oon bi him silf & þei ben mouable / And alle þe cordis þat comen of þe [folio 11b] brayn & nucha, haþ

boþe felynge & meuynge. & þe cordis ben white, bowable, strong & towȝ. & of her kynde þei bryngen meuynge & felynge to lymes. & for þat it is long & dyuydiþ [& dyuydiþ] a mistake for to dyvyde. Latin: De divisione vero membrorum multum longa est doctrina.] alle þe parties of þe senewis *[in þe secunde tretys y schal ordeyne Anotamye of ȝenewes & here place] as þei ligge; in þe whiche placis þou must be war whanne þou schalt kutte eiþer brenne / whanne þat we schulen ordeyne anotamie of official membris & of her woundis / Official membris is to seie: a fyngir, a ioynt, an hand, eiþer a foot *[ore] oþere lymes of office /

Arteries ben hoote nouȝt of her owne kynde, but for þe hoot blood & lijf þat goiþ in hem from þe herte. Of her kynde þei ben colde & drie & þei han two cloþis, outcept oon þat goiþ to þe lungis; þe ynnere corde is stronger & grettere, þat he mowe wiþholde a meuable mater & an hoot. & her bigynnynge is in þe lift side of þe herte. & þere bigynnen two arteries; oon goiþ to þe lunge & haþ but oon coote and sprat in þe same lunge, & þere endiþ & bringiþ blood to þe lunge, bi whom he is norischid, & spirit of lijf, and þat he myȝte brynge from þe lunge eir to þe herte for to entempre þe fumosite of hete of þe herte. & þis arterie [Arteria venalis, Pulmonary vein. It was taken to be an artery, as it carries arterial blood. See Vicary's Anatomie, ed. Furnivall, p. 58, note 1.] is [folio 12a] y-clepid venales. & it

is a maner veyne, for as myche as he ne haþ but oon coote, and þerfore he is þe more obedient to be drawe abrood þoruȝ out alle þe lungis; & also þat þe blood þat norischiþ þe lungis myȝte liȝtly swete out of þis arterie / Þe toþer arterie þat comeþ out of þe lift-side of þe herte haþ two cootis, bi cause þat oon myȝt not aȝenstonde þe strenkþe of þe spiritis; & also þat, þat is wiþinne þe arterie, is ful derworþe & nediþ greet kepinge / Þer ben þre helpingis of þe arteries: oon is þat cold eir myȝte bi hem be drawe & I-brouȝt to þe herte whanne þe arterie is drawe abrod. Þe secunde is, þat þe fumosite myȝte be cast out whanne he is constreyned / þe þridde is, þat þe spirit of lijf myȝte be brouȝt bi hem to al þe bodi / þese arteries ben deuydid many weies; whos dyuysiouns man mai nouȝt conseyue bi his witt, ne þei ben nouȝt dredful to [a erased.] surgiens craft, but whanne þou schalt drede þe arteries I schal telle þee in her placis /

Veynes bi cause of her bodies ben deemed cold & drie; for þe blood þat is withynne hem þei ben deemed hoot; & alle þe veynes han her bigynnynge [folio 12b] at þe lyuere, in þe which lyuere .ij. veynes han pryncipal bigynnynge / oon veyne bigynneþ of þe holowȝ side of þe lyuere. & is clepid porta [Vena Porta. See Vicary, p. 22, note 1.] —þat is a ȝate / & her office is to drawe *[Chilum]

fro þe stomak & þe guttis bi mene of þe veynes miseraices [Veynis miserak. See Vicary, p. 66, note 7.] ; & þilke chilum sprediþ þoruȝ al þe lyuere bi mene of veynes capillares / Chilum [Chilum. See Vicary, p. 68, note 2.] is þe licour of þe mete, whanne it goiþ out of þe stomak & þe guttes / Veynis miserak [Veynis miserak. See Vicary, p. 66, note 7.] ben smale veynes þat comen out of þe veyne þat is clepid porta & cleueþ on þe stomak & þe guttis / Venes capillares, þat ben veynes as it were heers of a mannes heed /

After hem comeþ panniclis—þat is to seie smal clooþ, þat is maad of sutil þredis of senewis, veynes & arteries / wherfore þei ben colde & drie & censible / & þei han þre helpingis / þe firste is: þat þei moun bynde manye þingis in oon foorme, as þe panicle of þe heed byndiþ seuene boones / þe secunde Iuuament is: þat þei hangen & bynden summe membris wiþ oþere as þe reynes to þe rigge & þe maris [MS. þe maris to þe maris to þe rigge. The second maris is cancelled.] to þe rigge / þe þridde helpinge is: þat þe membris [folio 13a] þat ben incensible bi her kynde, bi þe panniclis þat wrieþ hem velen bi accident: as þe lungis, þe lyuere, & þe splene, & þe reynes. Þes lymes bi her kynde han no felynge, but what þei felen it is bi accidens of þe pannicle þat wrieþ hem.

Þe [Latin: Caro vero calida est et humida.] fleisch is not hoot, but it is moist & haþ þre maner lijknes: oon is a symple fleisch, & his helpinge is to fulfille þe voide placis

of smale lymes to brynge hem to a good schap, & þat ech hard lyme schulde nouȝt hirte oþer wiþ confucacioun [confucacioun. Addit. confricacioun. See page 23, note 2.] togidere / Anoþer maner fleisch þer is þat is glandelose, þat is as it were accornis, [accornis, glandes.] & his Iuuament is þat he turne [Latin: eius juvamentum est, ut convertat humiditates ad eius colorem. The English translator read: calorem.] humedites, þat is to seie moistnes to her heete; as þe glandelose fleisch of wommans brestis þe which þat turneþ þe blood þat is drawen from þe maris into mylk; & þe glandelose fleisch of þe ballockis, þat turneþ þe blood into sperme / & þe glandelose fleisch of þe chekis þat engendriþ spotil / þe þridde maner fleisch is a fleisch þat is in brawnys, þat is clepid a brawn fleisch, for he is medlid wiþ sutil þredis of cordis, as I schal telle after þe whiche helpingis schal be told in þe [folio 13b] anotamie of þe brawn.

At þe laste is þe skyn þat is temperat in al her qualitees; & it is maad of smale þredis of veynes, senewis, & arteries, þat makiþ him censible, & ȝeueþ him liȝf & worchinge, þat ben gouernouris of al þe bodi. & þe skyn is maad temperat, for he schulde knowe hoot, coold, moist, & drie, soft, hard, scharp, & smoþe / & if þat þe skyn were as sencible as a senewe, þanne a man myȝte not dwelle in erþe ne in hoot eir; ne þe skyn of þe fyngris endis þe whiche þat is more temperat þan ony oþir skyn of þe bodi ne schulde nouȝt be a

good demere in knowynge hoot, cold, hard, scharp, soft, eiþer neische.

Brawnes þouȝ þat þei be maad of mater medlid, neþeles þei ben rekened among membris consimiles, for þei comen to þe making of membris officials / Brawn is maad of fleisch, senewe, & ligamentis, & þei ben instrument voluntarie meuynge. Þe senewe þat comeþ fro þe brayn & þe nucha, & goiþ forþ to meue þe lymes, is medlid wiþ a ligament / & whanne þe senewe & þe ligament ben medlid togidere, it is clepid a corda / & þe corde is maad for þre skilis. þe firste [þe firste in margin.] for a symple sinewe is to censible [folio 14a] ; þe senewe bi him-silf myȝt not suffre gret traueile & meuynge, but þe felowschipe of þe ligament þat is incensible lettiþ þe felynge of þe senewe, & bringiþ him to a profitable temperaunce / Þe senewe haþ .ij. oþere defautis: neischenesse and liȝtnesse. But þo .ij. defautis þe medlynge of þe ligament fulfilliþ [fulfilliþ, supplet. See Cath. Angl., p. 145, to Fulfylle, supplere vicem Alterius.] ; for þe neischenes is temperid & strenkþid, & þe litilnes is maad more. Þe neischnes comeþ of þe brayn for it is myche, & þe litilnes comeþ of þe nucha, for it is litil. Þat þat is maad of þis nerf & þis ligament is clepid a corde; þe which þat meueþ þe lymes to þe wille of þe soule, whanne þat it is schortid

ouþer drawen after þat þe lyme bouwiþ. To þis [Lat.: Huic autem chordæ—associatur caro simplex. Comp. Add. MS.] corde, þer is asocied a symple *[fflesch] for to make a brawn for þre profitis / þe firste profiȝt þat is in drawynge & wiþdrawynge of þe corde, þe fleisch schulde be as a pelewe vpon þe which he myȝt reste / þe secunde, þat þe fleisch þat is neische & moist schulde kepe þe corde, þat he drie nouȝt in her meuynge / þe þridde, þat þe makynge of lymes were þe more schaploker./ Þe brawn is maad bowynge as a bowe þat is bent; & for þe kynde wolde kepe þis complexioun, he cloþide [folio 14b] þe brawn wiþ a pannicle / þe corde whanne he entriþ into þe brawn is departid into many smale þredis, & þei ben clepid villes [villes. Lat. villi.] —þat is to seie wrappingis. & þese villes ben of .iij. maner: in lenkþe bi þe which vertu, þat drawiþ haþ myȝt, in brede, bi þe which vertu þat castide out haþ myȝt / in þwert ouer bi þe which vertu *[þat] with halt haþ myȝt / & at þe eendis of þe brawn þilke þredis ben gaderid togidere to make a corde, aftir þat it is nessessarie / many cordis eiþer brawnes to ben engendrid. & official membris ben maad of þese consimile membris, þe whiche þat ben instrumentes to resonable soule. And in þe ij. tretis I wole telle þe anotamie of lymes of office.

The firste chapitle //

¶ Þe .iij. techinge is of difference of woundis & of general curis / We schulen undrestonde þat wounde, & old wounde, festre & cankre woundid, & boon out of ioynte, & a boon to-broken, & apostyme, alle þese ben clepid vndoynge of þat þat is hool. & alle þese sijknessis, & many oon oþir as weel, moun falle to consimile membris as to official membris / vulnus is a newe wounde / vlcus is an old rotid wounde. [folio 15a] I schal tellen in her placis þe difference of festre & cankre & apostyme; plage comounly is taken for an oold wounde, & ofte tymes we fynde þat an old wounde is clepid vulnus, as ypocras seiþ / vulnera anua necesse est in eis os taliefieri [Read tabefieri.] & cicatrices concauas fieri: þat is to seie, it is nedful [it is nedful in margin.] þat þe boon in an oold wounde to be rotid & þe cicatrices to be holowȝ / Cicatrice is þe place of þe schynboon [schynboon, read schyn above. See below.] þe wounde, whanne þat it is hool / Summe woundis ben symple, & summe compound / in two maner he is clepid a symple wounde / oon maner, for he haþ not lost of fleisch / anoþer maner for he haþ noon oþir sijknesse wiþ him, ne is nouȝt distemperid / A wounde compound is clepid contrarie to him þat is symple / but boþe symple & compoundis sumtyme is in þe fleisch or

in þe senewe, or in þe boon, or in þe veynes, or in þe arterie / also þese woundis han dyuers cause. Summe comen fro wiþinne of þe malice, eiþer of to greet multitude of humouris. *[forto gret multitude of humores] oþirwhile tobrekiþ þe membre & wiþholdiþ & woundiþ him / Cold matere streyneþ, drie mater kuttiþ, moisture wiþoute mater makiþ no wounde, but selden with [folio 15b] mater, but he drawe þe lyme to brode. & also þe cause wiþoute [The cause wiþoute, causa exterior.] mai be dyuers oþirwhile wiþ a swerd eiþir wiþ a þing þat kuttiþ along, oþer while wiþ a knyf or wiþ a spere or an arowe þat prickiþ, & summe ben maad wiþ a staf or wiþ a stoon eiþir wiþ fallynge, & summe ben maad wiþ bitynge of an hound ouþir a wood hound; & alle þese ben diuers aftir þe dyuersite of her causis; & also þe maner of helynge is dyuers / Al þe intencioun of helynge of woundis is for to sowden or to helen & to restoren þat, þat is departid, þe which þat mai not oueral be doon / for if þat membris of office ben kutt of, þei moun neuere be restorid, ne noon of þe consimile membris mai be restorid, if he be doon awey: as boonis, pelliculis, gristlis, ligamentis & skyn / For þe cause of her generacioun is þe sperme of þe fadir & of þe modir, as I tolde tofore / but in place of þing þat is I-lore, kynde restoriþ þat, þat is moost conuenient to þe place; but fleisch mai be restorid bi cause

þat þe blood is engendrid al day in us, & þe blood is þe mater of þe fleisch / & summe seien þat veynes, arteries, & senewis myȝt not be restorid as þei weren tofore; but þei moun [folio 16a] be restorid as boonys ben / But Galion and Auicen & I þat am expert here seiynge, [I þat am expert here seiynge. Lat.: ego qui sum expertus eorum dicta.] we [we, added above line.] seie þat þei moun be restorid wiþ veri consolidacioun, whanne þat her kuttynge is litil, & whanne þat þe senewis þat ben newe kutt & [&, mistake for ben.] soude aȝen; but þei moun not be consoudid, whanne þat her kuttynge is myche & greet; & resoun grauntiþ it / Senewis bi kynde ben neische & viscouse; & þerfore þei moun [not, erroneously added above line.] ben consoudid, & þe veynes & þe arteries moun be consoudid bi resoun of þe blood þat is in hem. I þenke to ordeyne ech chapitle bi him-silf after þe dyuersite of lymes & of placis, þe whiche þat þei ben maad ynne / & I wole bigynne at a symple wounde maad in fleisch /

þe secunde chapitle of þe þridde techinge /

Now we wolen trete of a wounde maad in fleisch. We wolen bigynne at a symple wounde maad wiþ knyf or wiþ swerd, or spere or arowe, or wiþ ony oþir þing semblablele to hem.

Bynde togideris þilke wounde with a boond þat closiþ þe wounde togideris, & kepe þilke wounde from swellynge wiþ þe whiȝt of an ey leid aboue þe wounde, & lete þe wounde be in reste; & þer nediþ noon oþer cure, namely, [folio 16b] whanne þe wounde is wiþoute akynge; but, & þer be in þe wounde greet akynge, þanne it is a tokene, þat þer is a senewe prickid vndir þe wounde, eiþer a pannicle þat is bitwene þe fleisch and þe boon; & þanne þer is anoþer cure, as I schal telle in þe chapitle of puncture of a senewe. þat [þat, scribal insertion.] I haue heelid a man þat was *[sefenty ȝere olde þat was] smyte wiþ a spere þoruȝ þe fleisch of þe buttoke, bi þe lenkþe of a fote, *[& more] but þilke wounde touchide no senewe, & þat I wiste sikirliche, for he hadde noon akynge / I heeld þe wounde open aldai wiþ a litil smal tent & a schort, þat I myȝte wite, if þat he schulde aken on þe morowe, & I comaundide him to reste / & on þe morowe I foond noon inflacioun ne akynge; & þanne I took awey þe tent & lete þe wounde closen, & so comaundide I him to reste þe secunde dai / In þe þridde day he was hool. & if a wounde were maad wiþ a swerd or wiþ ony þing þat bitiþ in lenkþe, anoon þou must loke if þe wounde be so litil þat he nede no sowynge, & þanne brynge þe parties of þe wounde togideris, þat it may be weel ioyned, & leie aboue þe wounde a poundir maad oon partie

of frankencense, & of two parties [folio 17a] of sandragoun, [Sandragoun. Sanguis draconis: the gum of the Dragon-tree. Kersey. 1706. See Notes.] & of þre parties of quyk lym, & lete nouȝt þe poudre entre bitwene in þe wounde but aboue, for þer schal no þing entre in þe wounde, & kepe þe parties of þe wounde þat ben brouȝt togidere wiþ a plumaciol [Plumaceoli: Bolsters used by Surgeons. Kersey. 1706.] .iij. cornered maad of herdis or of towe in þis maner:

[figure]

oon bi þe sidis of þe wounde, so þat boþe þilke plumaciols holde þe wounde þus iclosed [iclosed, inserted in margin.] :

[figure]

& ioyned togidere as it was ioyned arst, or it were kutt / & bynde þe wounde togidere aboue þe plumaciols wiþ a rolle þat goiþ ouerþwert aftir þis lettre .X. & take a lynnen clooþ & wete him in two parties of þe white of an ey, in oon partie of oile of rosis, þei ben togidere medlid, undir þe plumaciols, leid aboue þe wounde þat is brouȝt togidere, for to kepe þe [MS. wounde, cancelled.] poudre; & do nouȝt awey þi medicyn til .iiij. daies ben goon, but if þat þe wounde ake or be to-swollen. & þanne bynde þe wounde as it was biforn wiþ þe white of an ey; oile, poudre, & plumaciols. But if þe wounde were so myche, þat byndynge wolde nouȝt suffice, or were kutt ouerþwert ouer þe lyme, so þat þe parties of þe lyme myȝt nouȝt wel be [folio 17b] brouȝt togideris, þanne sowe þe wounde on þis maner / Ioyne þe lippis of þe wounde, & be war þat noon oile *[ne dust] ne no þing ellis, þat lettiþ consolidacioun, falle bitwene þe lippis of þe

wounde, & haue a nedle þre cornerid, whos iȝe schal be holid on boþe sidis, so þat þe þred þat is in þe nedle may lie in þe holowȝ place, & þilke þred schal be twyned, & wiþoute knotte, & I-wexid, & þe lippis of þe wounde schal be sowid togideris; & þe þred schal be knytt wiþ two knottis in þe firste place, & in þe secunde place wiþ oon knotte; & so make as manye poyntis, as it is nessessarie, & ech poynt schal be from oþir bi þe brede of a litil fyngir, & streyne þe wounde with knottynge & þe sewynge of þe lippis of þe wounde togidere þat he ake sumwhat, but nouȝt to myche. & if þat þer nede mo poyntis to be þere þan two, euermore þer schal be odde poyntis. as .iij. v. or .vij. & þe oon poynt schal be first from þe oon eende of þe wounde, bi þe space of a litil fyngir, & þe toþir poynt schal be at þe oþir ende of þe wounde, & þe þridde poynt schal be in þe myddil of þe wounde / & if it be nede to haue mo poyntis, þanne schalt þou [folio 18a] bigynne at þe myddil poynt, & make as manye poyntis on boþe sidis as it is nede, til þou come to boþe eendis / For bi þis maner of sowynge neiþir partie schal be crokid, & so þe place mai faire be restorid, & euermore take kepe þat *[ȝif] þe wounde be not depe, þi sowynge schal be nouȝt deep / & if þi wounde be deep, þi sowynge schal be deep, þat alle þe parties of þe wounde moun

be ioyned / For if þe wounde were deep, & þi sowynge not deep, nede þer muste be in þe depþe of þe wounde a greet holownes, to þe which holownes blood & quyttere schulde be cast; & þilke quyttere & blood schulde lette þe helynge of þe wounde. & þe poudre þat is seid in þe same chapitle, schal be leid aboue on þe same wounde; & þou schalt kepe þe sewynge & þe parties of þe wounde þat I brouȝte togidere wiþ plumaciols þre cornerid, & wiþ alle þe oþere þingis þat ben in þis chapitle tofore seid / And if þat a wounde haþ be to longe in þe eir open, which þat is þe cause of quyttere þat lettiþ consolidacioun, þanne we musten clense þe wounde wiþ þis mundificatif þat is maad of flour of wheete & hony & water & mel roset, [folio 18b] I-colat, þat is to seie, clensid from þe rosis, and of barly mele / Of þese mundificatyues þou schalt haue a ful techinge in þe laste tretis /

But if þe wounde be compound, a leche muste haue as manye intenciouns as þer ben accidentis to þe wounde / I sette an ensaumple. I suppose þat a wounde be compound wiþ holownes & lesynge of fleisch & of skyn, & þere be myche quytter, & also þat þer be apostyme, & þer be a greet akynge; al þis is clepid a wounde compound / þanne schulen we nouȝt onliche take hede to consolidacioun of þat wounde: þat is to seie, helynge; but first we schulen aswage

akþe & apostymes, as it schal be teld in þe chapitle of an enpostyme & of akynge / Aftirward we schulen clense þe quytture, & aftir þat regenere fleisch, & at þe laste brynge ouer cicatrice. In alle þe worchingis of medicyns, where þat akþe is, first we schulen aswage akþe, for aboue al oþir þing strong akynge ouercomeþ myȝt of vertu & strenk þe / & also resoun telliþ; membris [Lat., Membra quoque dolorem habentia, dolor ipse est causa attrahendi aliunde humorum pessimitatem.] þat han akþe, þilke akþe is cause of drawynge from þe oþere placis to þe membre þat akiþ þe worste [folio 19a] þing of þe humouris / Auicen seiþ: humouris ben drawen to lymes þat aken for .ij. causis: o cause, for kynde *[& Spiritus and humoures rennyth þedyre; þe secunde cause, for akþe feblyth þe lyme, & humours] & spiritis rennen to þe feble lyme / þe swellynge schal eer be heelid þan þe wounde / Galion & Auicen tellen: þat al þing þat consowdiþ þe wounde greueþ þe wounde, if þat þer be apostyme wiþ þe wounde / & þe quytture schal be clensid or þou leie ony regeneratijf to holowȝ woundis. Auicen telliþ þe cause, whi þat yuel fleisch growiþ in a wounde / If þat a leche wolde bisie him wiþ a medicyn regeneratijf to regendre fleisch in a wounde, & er þan þe quytture were clensid / & whanne þat þe wounde is clensid, þanne we schulen fulfille þilke holownes wiþ fleisch or þat þe wounde be

heelid, lest perauenture [perauenture. See N. E. Dict., adventure, 1. b.] þat þer dwelle an holownesse vndir þe wounde, whanne þat he is helid, in whom þat quytture schulde be engendrid, þerwith [þerwiþ, scribal error for þe which.] ech dai schulde augmente þilke holownesse, & so we moten be constreyned to opene anoþir tyme þat, þat was heelid tofore / þou maist fynde in þe chapitle of woundis of senewis, how þou schalt aswage akþe, & in þe .vj. chapitle of þis techinge þou schalt fynde þe cure [folio 19b] of a wounde þat haþ a swellynge, & is out of kynde distemperid; & þou schalt haue in þe chapitle of olde woundis, how þou schalt clense quytture & regendre fleisch /

The þridde techinge of þe firste tretis is of heelynge of a wounde maad in senewe /

Almyȝti god hath ȝeue to senewe greet felyng, & if þat he be hirt, he suffriþ greet akynge / Galion seiþ: a senewe þat is more selynge þan anoþer *[lyme] it is nessessarie þat he haue grettere akþe / Vndirstonde þat a wounde þat is maad in a senewe, mai not be wiþoute akynge. Ne [no, scribal error for þe.] woundis þat ben maad in senewis, ouþer þat ben in lenkþe or in brede / Þe woundis þat ben maad in lenkþe of þe2 senewe, ben lesse perilous þan [þan erroneously inserted.] þo þat ben maad in brede of þe

senewe ben moost perilous / Oþerwhile a senewe is kutt al atwo / & þanne þilke lyme, to whom þat senewe serueþ, lesiþ his meuynge & þe felynge, þat þilke senewe brouȝte to him from þe brain. & þilke senewe oþirwhile is not kutt al atwo, but he is I-preickid, & þanne it is perilous lest þe crampe come for to greet akþe / For akþe entriþ into þe part of þe senewe þat is kutt or prickid; & bi þe [folio 20a] partie of þe senewe þat is hool, akþe is brouȝt to þe brayn. & so þe crampe mai come to þe wounde bi oon of þre weies: þat is to greet akþe, cold, or rotynge. Of þese þre or of oon bi him-silf mai come a drawinge togidere of a senewe þat is cause of a crampe / & þat þat is seid of a wounde of a symple senewe may fallen ofte-tymes in a wounde of a corde & a brawn, & nameliche of a corde þat is in bigynnynge of a brawn. Þo woundis þat ben in þese þre consimile membris, þat is *[to] seie senewe, corde, & brawn han o. drede in cours of þe crampe, & also o. drede of felynge, lesynge & meuynge / & [&, above line.] þerfore be-war in þe cure of a wounde maad in senewe, wheþer þat it be a prickynge or þat it be kutt ouerþwert, or ellis be kutt oonly bi his lenkþe. If oonly he be prickid þe wounde of þe skyn is hool, & þanne it is clepid a blynde puncture; eiþer þe wounde is open, & it is clepid an open puncture / In a blind puncture it is

nessessarie to opene þe skyn, & aftirward heelde into þe hoole as hoot as he mai suffre, hoot oile of rosis swete smellynge, þat is maad of oile de oliue þat is nouȝt ripe, til al þe wounde be ful. & aboue þe wounde leie whiȝt terebentine [folio 20b] [terebentine, from Pistacia Terebinthus, L. The Alah of the Old Testament, and the … of Theophrast.: now almost obsolete.] I-drawe abrood bitwene two clowtis, & anoynte alle þe membris aboute þe wounde wiþ hoot oile of rosis maad þicke with bool armoniak. & aftir þat leie a lynnen clooþ I-het aboue, & aftir þat a good quantite of tow I-tosid, & bynde þe lyme softliche wiþoute streynynge; & if þe akþe wiþ þis medicyn wole not ceessen, remeue & chaunge þis medicyn ofte tymes in þe dai & in þe nyȝt / & if þe prickynge be in þe foot, anoynte þe grynde [þe grynde, inguina. W. Wr., p. 589. 39, 15th cent.: inguen, the grynde.] wiþ hoot comoun oile; & vndir þe arme holis & in þe necke pitt, if þat þe prickynge be in þe hand, for þis enoynture rarefieþ & eueneþ þe placis bi whom akþe goiþ to þe brain, & it lettiþ drawynge togidere of þe senewe / & þouȝ þat þou seest nouȝt þe akþe ceesse in summen as hastiliche as þou woldist, neuer-þe-lattere chaunge not þi medicyn, for þer may be no bettere medicyn. But if þat akþe dure ouer longe, it is not yuel to putte a litil opium to þe oile of þe rosis & þe bole armoniak, þat þou leidist aboute þe wounde. Þe sike man muste reste & bi no wey he

schulde nouȝt be wroþ; his bed muste be maad soft, euene, & smoþe, & þat he [folio 21a] myȝte haue reste / Whanne þat þe akþe aswagiþ & þe wounde ȝeueþ sum quytture, þanne þe sike man is saaf from al maner perel, but if he do ony newe errour / Of þis wounde Ypocras spekiþ: in vulneribus malis & fortibus sanie non apparante—þat is to seie: in yuel woundis and strong woundis, if no quytture appere it is yuel / Strong woundis ben clepid woundis þat sore aken / Yuel woundis ben þo, to whom scharpe humouris rennen & ben nouȝt obedient to kyndeli heete, to be turned into quitture / And þerfore Ypocras seide: þat whanne akynge & quytture appereþ it is a tokene of heele / Þe þridde signe a man muste knowe in þis place, þat lewide men, seyinge akynge & swellynge in a lyme þat is woundid, leie þerto a potage in maner maad of eerbis & swynes greece & water & wheete flour, corruptyn þe lyme, & þilke corrupcioun is cause of þe crampe / For Galion seiþ: þat a senewe is maad of moist mater & a cold, & þerfore he rotiþ of heete and moistnes / Also summen, for to aswage akþe as [as, error for of; see below.] a senewe þat is prickid, puttiþ þe lyme in hoot watir *[oþer ellys caste it on þe lyme] þe which mater [mater, error for watir.] is þe moost greuaunce [folio 21b] to þe senewe / Galion seiþ / Hoot watir, þouȝ it aswage akþe to þe

prickynge of a senewe is most greuaunce / Cold also greueþ sore þe senewe as wel in somer as in wyntir / And Ypocras seiþ in þe .v. part of his auforismus: cold is bitynge & greuous to senewis & woundis, & also in þe chapitle next folowynge, but it be in a crampe wiþoute wounde / Galion seiþ in þe eende of his coment: coold is moost greuous to a senewy lyme þat is woundid & is sore swollen; namely, & he haue þe crampe. It schewiþ [schewiþ for sewiþ; see below.] þanne þat an hoot medicyne & a drie is moost acordynge to senewis þat ben woundid; but nouȝt to hoot a medicyn, lest perauntre þat he make þe lyme to swelle; & if it be drie, nouȝt wiþ stipticte, an auntre if þat he closiþ þe poris of þe skyn / Galion seiþ: þat it is yuele to close þe poris of a lyme þat is pricked. Þe medicyn þanne muste be hoot & drie with subtiliate as terebentine to moiste bodies; & to drie bodies he muste be medlid wiþ a litil enforbium, azafetida [Asa fœtida, a sort of gum pressed out of a certain plant, which grows in Persia.] is best medicyn if þou make of him enplastre, serapinum, [Serapinum = Sagapenum ... A gum resin obtained from the Ferula Persica. See Notes.] & þe fecis [fecis, Lat. fæces, dregs.] of a litil wex, & þe filþe of þe vessels of been, alle þei ben gode to a senewe þat is prickid, þouȝ þat þou putt [folio 22a] ech of hem bi him-silf or ellis compound / & þow schalt fynde a ful techinge of þese medicyns in þe antidotarie of þis book / Þou schalt nouȝt close a

wounde where þat þe prickynge of a senewe is, til þat þe senewe be perfiȝtly clensid & heelid, & til þat þou be sikir þat þe place schal not swelle / Galion telliþ of a man þat was prickid with a poyntel in þe pawme of þe hand, to whom came oon of tisilies [Lat., unus de secta Thessali. Thessalus lived in Rome at the time of Nero, and enjoys the reputation of being the first great quack.] clerkis þe which took hede to heele alle woundis generaliche; & he leide to þilke prickynge a consowdynge oynement þat was more acordynge to a wounde maad in fleisch; & he leide þerto a plastre maturatijf, wherfore al þe hand rotide & he fel into a crampe, & so he diede, or þat þe .vij. daies weren passid / & if þat ilke leche hadde maad þat wounde broddere, & þanne þat he hadde helt into þe wounde hoot oile of rosis, & þanne þat he hadde do [Lat., Si .. saniem .. subtiliter desiccantibus expectasset. Add. MS. translates literally, abyde. The use of do (= faire) is further illustrated by Mätzner. See don .6.] comen out quytture wiþ hoote medicyns sotil & driynge, & nouȝt wiþ moist medicyns, þat man schulde not haue be deed /

If þat a senewe hadde ben I-kutt ouerþwert ouer al atwo þanne, þouȝ þat Tederious [Theodoricus, an Italian (?) monk of the 13th century, was the author of a Surgery.] & summe oþere seien þe contrarie, it is good þat þow [folio 22b] sowe togidere þe eendis of þe senewis þat ben kutt wiþ þe sowinge of þe skyn. & aboue þilke maner of sowinge, þe firste dai leie oile of rosis, in þe which oile, maddockis [maddock, O.E. maðek, Dan. maddik. See Skeat, Etym. Dict., under maggot and mawkish.] —þat ben wormes

of þe erþe—han be boilid, & caste aboute þe wounde þe poudre þat kepiþ þe sowynge .o. day or two aftirward, & kepe þe sowynge wiþ plumaciols .iij. cornerid, & wiþ byndynge, & kepe þe lyme from swellynge, for bi sich a maner sowynge of a senewe þou maist consowde þe senewe aȝen; for þe lyme schulde han be lost in partie or in al, þe meuynge þat was brouȝt vnto him fro þe braun, for bi þat senewe þe lyme mai rekeuere his felynge, & so þe restoringe of þe braun may be fastere & schapliker. Þou schalt nouȝt drede of þe akynge þatt schulde be maad of prickynge [prickynge of þe senewe. The Latin, acus punctura, is correctly translated in Add. MS. See below.] of þe senewe, for þe akþe schal be doon awei wiþ oo leiynge to eiþer tweyne of þilke oile / Ne sich maner akþe may nouȝt make þe crampe, for þe senewe is al kutt atwo ne no man *[make an] obieccioun wiþ Galion wordis, þat we schulden be war in ioynynge parties of a wounde togidere *[þat non here ne oyle ne scholde noȝt entre wiþynne þe lippes of a wounde, þat betþ y-brought togedre] To þilke abieccioun we answeren: þat þe stipticite [folio 23a] of þe rosis & þe oile þat was nouȝt ripe, & þe glutinosite of þe wormes of þe erþe remeuen þe akþe of þe senewis & al þe harm þat schulde come of þe ilke sowynge.

If þat a senewe were woundid in lenkþe, he mai wel & liȝtliche

be sowdid togidere wiþ ioynynge of lippis, & wiþ þe sowynge & wiþ þe kepinge of þe lyme þat he swelle nouȝt / Vndirstonde here in þis place: þat þer is no þing more worschipful to a leche ne more profitable to a sijk man þan to kepe a lyme woundid fro swellynge, & neþeles it is hard to kepe senewis þat ben woundid from swellynge / Neþeles a leche here schal take heed aftir þe techinge þat schal be ȝeue him in þe chapitle of þe cure of a wounde, whanne þat þer is wiþ him a swellynge. If þat a wounde were chaungid of þe eyr and made quytture, þat þe sowynge were to-broke and þe puncture were vndir, [undir, mistake for undo. See below.] þanne make a medicyne mundificatif & leie him abrood on a lynnen clooþ & leie it aboue þe wounde, & putte a litil smal tent in þe eende of þe wounde þat is moost lynynge, [lynynge, for declynynge.] & þilke tent schal touche no senewe ne make noon akþe vndir [undir þat, donec.] þat, þat ilke wounde be [folio 23b] weel dried. A mundificatijf medicyn of senewis woundid is maad in þis maner: Take mel roset colat [ounce] .iij. smal flour of barly & medle hem togidere & boile hem slili þat þei brenne nouȝt, & remeue hem fro þe fier & bete hem longe togidere wiþ a spature; [spatur, spatula.] & þanne putte þerto [ounce] j. of whit terebentyne; & if þou mowe finde noon whiȝt terebentyne, þanne waische oþere

terebentyne with cold watir til it be whiȝt, & whane þat be þis medicyn þis wounde is almoost drie, þanne putte in þe same medicyn a litil poudre of frankencense mastik & saundragoun, medle hem togidere & leie aboue þe wounde til it be hool / & whanne þat it is hool manye daies aftir, leie flex in good strong wiyn het hoot til it be perfiȝtli al hool, & if þat þer leue ony hardnes in meuynge, after þat it is hool, þanne þou schalt vse þe techinge þat schal be ȝouen to þee in þe laste tretis þat schal be antidotarie in þe chapitle of medicyns mollificatyues; þere þou schalt fynde þe maner how þou schalt helpe best lymes þat ben heelid and moun not riȝt weel meuen /

Þe firste [firste, mistake for furþe.] techinge of þe firste tretis is of heelynge of a wounde maad in boon /

Whanne þat woundis ben so depe þat [folio 24a] oonly fleisch is not woundid but þe boon þat is vndir þe fleisch & þe senewe / þanne a man muste biholde, wher þat þe boon be kutt al atwo, as ofte-tyme it may happe in þe boon of þe thie & schene boonys & þe boonys of þe armes. And þanne þilke wounde is ful perilous; & nameli if þe boonys of þe thie ouþir þe boon of þe arme from þe schuldre to þe elbowe be kutt al atwo, so þat þe marie go out. But ofte-tymes

oon boon of þe schene or o. boon of þe armes is kutt al atwo ouertwert ouer & neþeles afterward may be restorid; ouþer a boon is not kutt al atwo but sum of his substaunce is don awey, & þilke substaunce, ouþer he is doon awey or ellis he hangiþ togidere / A general rule is in cure of woundis in whom boonys ben woundid: þat neuere bi a leche fleisch schal ben I-sowdid aboue þe boon, but first pleynerliche bi repeire [repeire, erroneously for repeired.] ; for þe boon may neuere be [be has to be cancelled.] wiþ verri consolidacion be consowdid, for his mater was þe sperme of þe fadir & of þe modir; but in summe children, for þe age [for þe age is toward ofte tyme, for, for þe nyȝte of tyme. See below.] is toward ofte tyme þat þei were sperme / but þer schal be maad a maner of restorynge in place of þe boon þat was broken eiþer lost, þat men clepen [folio 24b] poris sarcoides or ellis caro poroydes, & a [a, above line.] maner þing þat is restorid is hardere þan þe fleisch & neischere þan þe boon / & if þat ilk mater þat is restorid be nyȝ as hard as is þe boon, it is clepid porus sarcoides / & if þat ilke mater be not hard but sumwhat neische, it is clepid caro poroydes / & if þat a neische fleisch were & a moist nouȝt regenered vpon boonys þat ben sett togidere, a man schulde not haue his purpos to heele & consowde þe wounde. Loke þanne wheþer þe boon be kutt atwo altogidere ouerþwert ouer, þat

þou bryngist togidere & bindist þe parties of þe wounde, as it schal be told in þe .viij. chapitle folowynge, where þou schalt haue how a wounde schal be heelid þat is out of ioynte I-kutt atwo & to-broken / & if a wounde [wounde, erroneously for boon.] be not kutt atwo al togidere ouerþwert ouer, loke if ony pece of þe boon dwelle sadliche with þe oþere partie of þe hool boon / & þanne if þou myȝt, brynge þilke pece to þe place þat he was yn tofore wiþ þristynge doun þilke pece wiþ sum instrument acordynge þerto, & sowde þilke pece wiþ þe hool boon wiþ þe poudre þat I shal telle aftirward; for so the [folio 25a] schap of þe lyme mai dwelle [hool, cancelled after dwelle.] faire & strengere / & if þat ilke pece haue no fastnes to þe hool boon, do þat pece awey & regenere in þe place of þe boon þat þat [The second þat has to be cancelled.] was lost a repeirement / For þouȝ þat ypocras & Galion tellen þat it is nessessarie after quantite of þe boon þat is lost, an holowȝ cicatrise to be alwey, neþeles wiþ þis poudre þe generacioun of þese poris may be mendid, not a litil, but riȝt myche / Þis is þe poudre: take frank-encense, mastik, mirre, dragagantum, gumme arabik, ana. [ounce] ij. flour of fenegrek, .[ounce]. s' caste þis poudre vpon þe defaute of þe boon þat is lost, til þat þou holde a pleynere repeirement *[& a restauracioun. Þenne & noȝt ere brynge ouere fflesch ouere þe repeyrment wiþ] regeneratiuis, mundificatiuis

& consolidatiuis aftir þe techinge þat þou haddist biforn / Undirstonde þat al þing þat is seid of boonys in þis chapitle is of alle þe boonis of þe bodi saf þe heed / I schal make a chapitle by hym-silf //

The fifþe chapitle of þe þridde techinge of þe firste tretis of woundis þat ben maad wiþ smytynge of staf or stoon, or fallynge or smytynge of an hors, or wiþ ony oþir þing semblable.

To hem happen greet difference [folio 25b] fro woundis þat ben maad wiþ kuttynge, as wiþ swerd, knyf, eiþir arowe prickynge; & in oþere maner þei schulen ben I-heelid / For þouȝ þat verry consolidacioun be þe firste & principal entencioun of heelynge of a wounde, to þis chapitle it acordiþ nouȝt, for in smytynge, þe fleisch & þe veynes, & senewis, & arteries ben brusid, for in þe ynnere part of þe lyme þe boon aȝenstondiþ, & on þe ouer part [The passage is corrupt; the correct version is given by Add. MS.: þe þynge þat smyteþ & kutteþ noȝt.] of þe þing þat is smyten knyttiþ nouȝt / Wherfore it is nessessarie, if þer schulde be a wounde, þat alle þe smale lymes þat ben bitwene þe boon & þe þing

þat smytiþ, schulde be brusid, & oþerwhile þe fleisch & þe oþere consimile membris ben brusid wiþoute wounde / Wherfore þe curis of boþe I wole ordeyne in þis chapitle. If þat a leche wolde enforse him to ioyne togidere wiþ consolidatiuis þe wounde þat is maad wiþ smytynge, nedis quytture & corrupcioun bi þilke consolidatif muste be vnder þe wounde; þe which quytture schulde corrupte þilke lyme & brynge him to putrifaccioun, but if þat kynde were so myȝty, þat he myȝte eftsoone opene þilke wounde, þat was consowdid bi a sori leche [bi a sori leche, a malo medico. See Halliwell, Dict., sorry Laten.] ; or wiþ [wiþ, mistake for þat.] a good leche come & knowe þilke disposicioun [folio 26a] & knowe helpe, wiþ propre eir [eir, read cur.] to rectifien þe corrupcioun of þilke lyme / What schalt þou þanne do? Þou muste loke wheþer þat þe bodi be ful of wickide humouris, eiþer be clene; if þat he be ful late him blood, if alle particuler þingis acorden, as vertu, age, conplexioun & consuetude; & þese þingis moten alwey [be wanted after alwey.] taken in mynde, þouȝ alwey þei be not I-nempned & namely vertu; & he be not strong & alle oþere þingis acorden, þou schalt not lete blood, but þou maist ventosen, if þat it be nessessarie, or ellis [lose] *þe wombe if þat he be costif [costif, costive, subject to be bound in body.—Kersey.] ; & if þat he be feble, & þe brosure were in þe ouer parti of þe bodi, voide þe fecis of his wombe bi clisterie. &

if þou wolt lete blood, þou schalt lete blood on þe contrarie partie of þe veyne, bryngyng norischinge to þe lyme þat was hirt; & þilke veyne þou schalt knowe, if þat þou knowist pleynerliche anotamie, þat I haue tauȝt þee in þis same book / & whanne þat þe bodi is clensid, if þat þe brosour be wiþoute þe wounde, anoynte þe membre þat is brosid, which bigynneþ to haue an enpostym, with hoot oile of rosis, & caste aboue a poudre maad of þe seed of mirtilles, & bynde it softly; [folio 26b] for ofte-tymes it nediþ noon oþer eir [eir, read cur.] / For þis medicyn fastneþ þe place, & defendiþ him fro putrefaccioun. & þouȝ þat þis medicyn mowe not letten al þe mater from rotynge, neþeles it defendiþ myche of þe same mater fro rotynge / & if al þe mater mai not be defendid from putrifaccioun, but sum partie þerof putrifieþ, opene þe place & exclude þe quytture, & clense al þe place. & his cure schal be seid in þe chapitle of apostymes [Latin, de apostematibus exituris, apostems which discharge pus.] & of exitours / But if [if, above line.] þat a brusour were wiþ a wounde, anoynte aboute þe wounde or ellis þe place þat is brusid wiþ þe forseid oile of rosis, & caste aboue þe forseid poudre of mirtilles, for it fastneþ þe place, ne it lettiþ nouȝt þe corrupcioun to spreden eiþer to be drawen abrood; & it castiþ to þe wounde þe corrupt mater þat is in þe

place þat is brusid / Wiþinne þe wounde leie þe ȝelke of an ey, wiþ oile of rosis, with stupis, or ellis wiþ lint. [lint. Prompt. Parv., schauynge of lynnen clothe.] Leid [leid, mistake for leie.] aboue þe wounde a potage maad of .iiij parties of watir & oon partie of oile de olyue, & flour of wheete þat sufficiþ to þe medicyn, & leie þis medicyn to þe wounde, til þat þe akþe be aswagid, & til þat þe quytture be engendrid; aftirward clense [folio 27a] þe wounde, aftir þe clensynge regenerer, & at þe laste cicatrice. & þou schalt haue a ful techinge in þe antidotarie of mundificatiuis & cicatriȝatiuis / But if þe membre þat was brusid be ful of senewis, as þe hand ouþer þe foot, þou schalt not chaunge þi cure if þat þer be no wounde; but þouȝ þer be a brusour in senewy membre I-woundid, leie not þere þe potage tofore seid, but oonly hoot oile of rosis, & aboue þe oile poudre of mirtillis, & aboue þe wounde leie terebentine I-waischen & drawen abrood bitwene two lynnen clooþis. & make a plastre of pich & hony & bene flour, & leie aboute þe lyme þat is ful of senewis, as þe hand, þe foot, & speciali whanne þe flux of humouris ceessen not / & þouȝ þat þi cure be drawe along, ne go not awei from þis cure / & whanne þat al þe akþe is ceessid and þe swellynge is aswagid, for to clense þe wounde, vse þe medicyn of mel roset colath with barly mele, seid in þe wounde of senewis /

Þis cure is apreued bi galion, & I haue preued þis medicyn ofte tymes /

¶ Þe sixte chapitle of þe þridde techinge is of woundis þat han enpostymes & be distempered //

Off woundes Impostemede.

[folio 27b] A Wounde þat haþ enpostym or an yuel discrasiam—þat is to seie out of kynde distemperid, eiþer to cold eiþer to hoot— he mai not be heelid, ne he schal not ben heelid, but first he [The correct version is given by Add. MS.] be aswagid in þe yuel discurciour be amendid / & as I haue seid in anoþer place, it is profitable to þe sijk man, & worschipe to þe leche, if þat he mowe defende þe lymes þat ben woundid from enpostyme & from an yuel discrasie. For þanne a leche schal kepe þe canoun o [o, mistake for of.] galion, þat is oon of þe .iiij. canouns; oon is to kepe lymes in her owne kyndely complexcioun. For woundis moun not ellis be heelid, but if þei be brouȝt first into her owne kynde / & a wounde mai be kept from apostyme & an yuel discrasie if þat þe leche be kunnynge & do his deuer, & þe sike man be obedient to þe leche / Þe leche muste loke if þat þer go blood y-nowȝ out at þe wounde; & if þat þe wounde haue not bled blood y-nowȝ, þe pacient muste

be lete blood or ellis ventusid, takynge reward to alle particuler þingis tofore seid / & ordeyne him a couenable dietynge, as schal be told in þe chapitle of dietynge; & leie a defensif aboute þe wounde, [ounce] j. of bole armoniak distemperid wiþ oile of [folio 28a] rosis, & a litil vinegre: as þicke as hony tempere it / & if þat þe tyme of þe ȝeer were hoot, putte to þis medicyn þe ius of sum cold erbe: as morel, [morel, Lat. Solathrum. See Notes.] penywort, [penywort, Lat. umbilicus Veneris.] virge pastoris. Late not þe lyme hange; but if it be the arm, hange it aboute þe necke / & if it be þe foot eiþer þe schene, lete him ligge / & if þat þe lyme ake, aswage þe akþe wiþ an oynement of hoot oile of rosis / For as Galion seiþ: þer is no þing more noious to a wounde þan is akþe & declinacioun of a lyme, for þese .ij. maken soone an hoot swellynge, þe which is to þe feuere as a welle, & to þe bodi as an ouene / Þe woundid man muste absteyne him after þe chapitle of dietynge techiþ, & boþe þe sike man & þe leche, & alle þat ben aboute þe sike, moten absteyne hem fro fleischly knowynge of a womman, [ne a womman] *in tyme of menstrue, [See Notes.] ne loke not on þe sike man / & oonys in þe dai þe sike man schal go to priuy; [privy. Prompt. Parv., p. 414, Pryvy or gonge (or Kocay), Latrina, cloaca, ypodromium; p. 202, Goo to pryvy, or to shytyn, Acello. Pryvy still used in Yorkshire.] & if he mai not schite oonys kyndeli in

þe dai after þe quantite of mete þat he takiþ, make him a clisterie ouþer a suppositorie oonys ech day. & if þou myȝt not wiþ alle þese þingis defende þe lyme from apostyme, it is an yuel signe, for þe lyme is [folio 28b] feble, & þe humouris arn wickide; þanne bigynnen [bigynnen, mistake for bigynne.] to materen þe swellynge wiþ potage maad of flour, oile & watir, or ellis wiþ þis maturatif / Take malowe leues & leues of violet, & þe rote of holihocke; seþe hem weel in water, & staumpe hem, & take a pound of water, þat þei ben soden ynne, & comoun oile; [ounce] .iij.; of wheete flour [ounce] .iij.; of flour of lynseed [ounce] j.; of flour of fenegrek dj. [dimidium.] [ounce].; of erbis I-staumpid half a pound. & boile alle þese togidere in a panne ouer þe fier, & stire it weel wiþ a spature; & þis maturatif leie on a lynnen clooþ, & leie it on þe postyme til þat it be maturid / & whanne þat þe postyme is maturid, make þe quytture, if þou maist, be cast to þe wounde; & if it mai not be cast to þe wounde, opene þe place þat is moost lowist þere, as þe quytture mai best goon out; & þanne hele þe wounde, as I schal telle in þe þridde chapitle of apostymes / Take hede alwey to þis techinge; & if þe postyme were for þe prickynge of a senewe, ne leie not þerto þis potage maturatijf, but wiþ þe oynement of oile of rosis, & of oþere þingis, as it is seid in þe woundis of senewis /

Þou schalt knowe þe yuel discrasie of a wounde, [folio 29a] if þat þou seest þe skyn þat is aboue þe wounde to reed & to hoot in felynge, þanne þe wounde is discrasie in hete; namely, if þat þer come out of þe wounde [MS. erroneously inserts quytture after wounde.] a sotil quytture, reed; þilke discrasie þou schalt helpe wiþ coldynge þe lyme aboute þe wounde with oile of rosis & vnguentum album, Rasis of ceruse, which þou schalt fynde in þe antidotarie, & with þe ius of þe oþere eerbis colde.

& þou schalt knowe a cold discrasie bi þe whiȝtnes eiþer þe wannesse of þe place / & whanne þe place is cold in towchinge, & whanne þat þe quytture is þicke; þe which discrasie þou schalt remeue bi þe enoynture of hote oiles, as oile of coste, [oile of coste, Lat. cum oleo de castoreo.] oile of laurine, oile of enforbium, & so oþere hoote oilis /

A moist discracie þou schalt knowe bi þe neischenes of þe place, & bi aboundaunce of whiȝt liquide rotenes, þe which þou schalt helpe wiþ desiccatiuis: as wiþ waischinge of wiyn & hony togidere, in þe whiche ben soden balaustie, [balaustie. Balaustium, the floure of the wylde Pomgranate. Halle. Table, p. 16.—1565. Turner, Herbal, II., fol. 49 b., calls it Balaustrum.] gallis & þe ryndis of some garnadis, or alle or summe bi hem-silf /

Þe drie discrasie þou schalt knowe bi þe smalnes of þe lyme, & þe smalnes of þe lippis of þe wounde, & litil quytture, if þat þe quytture be þinne; þe which discrasie þou schalt [folio 29b] helpe: with

castynge on of hoot water til þat þe lyme wexe reed, & wiþ an oynement þou muste [þou muste, mistake for of moiste.] grece, as hennes, goos, & dokis, þe marie boon of a calf, & wiþ plenteuousnes of good mete þat norischiþ: as þe broþis of fleisch, & temperate wiyn, & rere eyren, & smale fischis, & wiþ reste, & softnes of al þe bodi, & of þe lyme þat is hirt; & alwey to þis techinge take hede þat as soone as a membre is brouȝt to his kyndeli disposicioun, anoon aȝenstondiþ [aȝenstondiþ, mistake for aȝenstonde.] wiþ contrarious medicyns, & turne aȝen to þe principal cure of þe wounde. But þenke nouȝt to heele þe wounde as longe as it is enpostemed, or ellis haue an yuel discrasie; but first remeue þilke discrasie, or þat þou heele þe wounde / For whanne two þingis þat schulden ben heelid ben togidere, & þe oon of hem mowe not be helid wiþoute helynge of þat oþere, first we schulen heelen him, þat mai nouȝt be heelid wiþoute þat oþer helyng, as þe apostyme eiþer þe discrasie / Þus Auicenne techiþ in þe laste chapitle of þe firste book. Neuer-þe-lattere forȝete nouȝt þe principal cure, þat whanne þe accidentis ben asesid turne aȝen to þe principal cure //

¶ Þe .vij. chapitle of þe .iij. techinge is a wounde maad with a wood hound, eiþer of ony oþer venemous beest / [Heading to leaf 30, in a later hand, Off woundes betten with doges.]

[folio 30a] Bvt whanne an hound haþ biten a man, loke first if þat þe hound be wood; & if þat þe hound be not wood, heele þe wounde as þou doist oþere comoun woundis; & if þat þe hound were wood, þou schalt knowe it bi certeyn cause & disposiciouns / For a wood hound fleeþ mete & water; & he renneþ hidirward & þidirward as a drunken man, wiþ open mouþ & his tail bitwene hise leggis; his tunge hangiþ out, but he wolde biten alle men; ne he knowiþ not þo men þat ben in houshold. He berkiþ not / & if þat he oþirwhile berke, his vois is ful hors, & oþere houndis fleen fro him & berken vpon him. Also þou schalt knowe bi disposicioun of þe same wounde. For if þat þou wetist a crumme of breed in þe blood of þe wounde, & ȝeuest it to anoþer hound to ete, he wole not ete it; & if þat he ete it, he wole die / Or ellis take an ote, & staumpe it, & leie it on þe wounde al nyȝt, & on þe morowe ȝeue it to an hen; & þe hen wole not ete it / & if þe hen ete it, þe hen schal die /

And anoon as þou woost þat þe hound was wood, sette a greet ventuse aboue vpon þe wounde, & drawe out þe myche blood out of þe wounde, & aftirward drawe abrood þe wounde; & aboue al oþere þing, brennynge of hoot yren to þe ground [folio 30b] of þe wounde is moost profitable. & leie aboue þe wounde actractiuis, to drawe out þe venym / Summe of þese actractiuis ben symple, & summe compound / Symple beþ: þe lyuere of þe same wood hound þat boot þe man, garlik stampid, salt fisch, aischis of wiyn lies, appoponak þat is wondirful, þe leeues of a gourde, [gourde, cucumer. See Prompt. Parv., 203, Goord, Cucumer, cucurbita, colloquintida.] & þe rote of fenegrek, þe gile [gile, ne. gill. See Mätzner, Dict., p. 268. The Latin has, gluten, glue.] of fisch, & amptyn I-stampid / Þese medicyns ben compound: vreyne of a ȝong man wiþ nitre; ouþer mintis stampid [stampid, in margin.] wiþ salt, & distemperid wiþ vynegre, & maad an enplaster. Anoþer medicyn compound: take floris eris & salt, of ech .x. parties, & þe fatte of a calf, & of a wolf þat sufficiþ, & make a plastre / Anoþer: take schepis talow & buttere, & make a plaster / Þis wounde schal be holden open at þe leeste fourty daies, & þis schal be do aboute þe place. In anoþer maner regimen / Vndirstonde þat þe man þat is biten, schal not be lete blood in þe bigynnynge, lest þe venym be drawe abrood bi oþere lymes; ne þou schalt ȝeue him no laxatif, lest it drawe þe venym to þe entrailis wiþinne; but þou schalt sette

vpon þe place a strong ventuse, as it is seid tofore, [folio 31a] þat it mowe drawe miche of þe blood. And whanne þat .iij. daies ben passid, it is not yuele to lete blood & to purge with a litil purgacioun, þat purgiþ þe malencolie, as with decoccioun epithimum, [Epithemum. See Notes.] wiþ gotis whey; & norischiþ him with dieting, þat fattiþ & makiþ him glad & bliþe; & waische his heed with decoccioun of water, þat þe feet & þe heed of a weþer were soden ynne. Ne late him not þirsten ne hungren, suffren, ne traueilen; & so if þat god wole, þou maist him kepe from perile / & ech dai to a monþis eende he schal take oþere symple medicyns or compounned / *— — Take þe ayschis of crabbis I-brent in an ouene .iiij. parties, of frankencense vij. parties, & make hem into a poudre / Þe pacient schal take ech dai of þis poudre .ij .[ounce]. / Anoþer medicyn: take þe pouder of crabbis brent vj. parties, gencian .iij parties, terre sigillate oon partie, make poudre / If þat þou were not at þe bigynnynge, & it bigynne to haue yuel accidentis: as yuel þouȝtis, soruful metynge in his sleep, & þat he be wroþ & grucche, & woot not whi; & if men aske him ony þing, & ȝeueþ no good answere þerto, & fley lith, [fley lith, altered to fleyntlith with different ink. Read: fleyth liȝt.] & he haþ alle oþere signes of malencolie, [folio 31b] þanne ȝeue to him a

medicyn maad of cantarides / Take old grete cantarides, & do awei þe heed & þe wyngis, .ij dragmis; lentis [docsnet above lentis; meaning?] I-clensid, .[ounce] j.; safron, spikenard, clowis, canel, .ana .[ounce] s'.; bete hem weel, & make of hem smale ballis, þat ech bal weiȝe a dragme. & ȝeue o. bal at þre tymes, at ech tyme þe weiȝte of þre cornys of wheete, til þat he pisse blood; þanne he schal be saaf / For whanne þou art sikir, heele þe woundis after þat fourti daies ben passid, in þe same maner. If þat þe wounde were maad of bitinge of an eddre or of ony oþer venemous beest, þe leche schal take heede to drawe abrod þe wounde, & sette aboue a uentuse, & drawe out miche blood; & it is miche worþ to enuyrounne þe place aboute þat is biten wiþ brome I-stampid / For if þat þe prickynge be in þe foot or in þe hand, if þou enuyrounne þe arme with brome, it lettiþ þe venym to go vpward; & ȝeue him þe medicyns writen aboue, & also lete þe wounde be open, til þe venym be excludid /

The .viij chapitle of þe þridde techinge of þe firste tretis of a wounde maad in a ioynt, & is dislocate /

Whanne þat a wounde is in a lyme, & þe boon of þe same lyme is to-broke [folio 32a] [Heading to leaf 32 in a later hand: Off woundes in Jintes.] atwo & dislocate—þat is to seie out of ioynte, þanne

it is good þat þou putte in þe wounde whanne þe blood is staunchid, & also aboue þe wounde þe ȝolke of an ey wiþ oile of rosis, & anointe al þe lyme aboute þe wounde with two parties of oile of rosis, & half oon partie of vynegre maad þicke wiþ bole armoniak, til þe quytture be engendrid, & þat þou be sikir þat no postyme schal come. Ne take noon hede to brynge togidere þe parties of þe boon þat is to-broken or dislocate, til viij. daies ben goon in þe wyntir, & v. in þe somer; for þanne it schal make quytture, and be sikir from swellynge; & þanne brynge togidere þe brynkis eiþer þe disiuncture after þe techynge þat schal be seid in þe chapitle of algebra. & if þat þe prickynge eiþer þe dislocacioun nediþ splentis, make þat þe splentis & byndynge faile aboue þe wounde. Þat þou may do if þat þou kutte þe splentis & þe bindynge aboue þe wounde with a knyf or a rasour, & in drawynge abrood þe hoole of þe wounde [wounde, error for bonde.] aboue þe wounde wiþ a nedle, so þat þou maist bi þat hole ech day chaunge þi medicyn of þe wounde wiþoute choudynge [choudynge, error for chongynge.] of þe boond þat þou madist first aboute þe boonys [folio 32b] þat weren broken ouþer dislocate; þe which boond þou schalt nouȝt remeuen til tyme schal be teld in his place, but þou schalt bynde aboue þilke

boon a newe boond, which þou schalt remeue as ofte as þou chaungist þi wounde. & whanne þat þou art sikir fro þe enpostemynge, & whanne þat þou hast sett togidere þe boonys þat were sett togidere & dissolate, þanne leie vpon þe wounde bi þe hole þat þou madist in þe boond, a mundificatif of mel roset colat, & of barli mele til þe wounde be clensid; & leie on þat a [a, erroneously inserted.] mundificatif, þredis of oolde whiȝt lynnen clooþ, til þat þe wounde be ful clensid; aftirward regendre fleisch, & aftirward consowde with regeneratiuis & consolidatiuis, whiche þat schulen be seid in þe ende of þe book /

The nynþe chapitle of þe .iij. techinge of þe firste tretis is of fluxblood of a wounde /

Þer ben ij. maner of causis þat makiþ blood to blede out of a mannys body; þe oon cause is clepid—cause coniuncte; & þe toþer—cause antecedent / Þe enchesoun of cause coniuncte is compounned of þe mouþis of þe veynes and arteries, or ellis whanne þat þe veynes ben kut atwo, or ellis corrosion of þe bodies of þe [folio 33a] [Heading to leaf 33, Off fflux off blode in woundes.] same veynes & arteries, or ellis to greet febilnes or to greet losenes / And þer ben manie enchesouns of cause antecedentis: as to

myche frelenes [frelenes, mistake for fulnesse.] of blood, or ellis to myche acute of blood, & also manye oþere causis þer ben þat ben clepid cause of [of, erroneous insertion. See below.] primitif: as smytynge þat woundith, to greet lepinge, criyng; wraþe, chidynge, & so manye oþere; & ech of þese causis tofore seid haþ his maner heelynge by him-silf in fisik medicinal. But it is not þe entencioun of þis book to treten [but, omitted. Latin: Non est huius libri intentio tractare nisi de fluxu sanguinis...] of blood þat blediþ of wounde, þat is maad with wounde, þe which may be restreyned with craft of ciurgie. In flux of blood þat comeþ of a wounde, þe leche muste loke þe disposicioun, þe abitude, age, vertu, & complexioun of him þat is woundid; if þat þese acorden, & he be myȝty in vertu, he schal blede myche blood at þe wounde, þouȝ þat þe leche be clepid at þe bigynnynge, but if it be so þat he be [be, added in margin in same hand.] feble ouer greetliche. & if þat nede constreyne þe leche to staunche blood, he muste loke if þat þe blood go out at þe veynes capillares, þat ben smale veynes as heeris of a mannys heed / & þanne oonly þe whiȝt [folio 33b] of an ey leid aboue with towȝe of flex suffisiþ / whanne þat þe parties of þe wounde ben brouȝt togidere; & if þou caste aboue poudre of lym aforeseid in þe chapitle of sowynge of woundes, it schal be þe bettere; for þat poudre wiþstreyneþ þe blood & consoudiþ þerparties

of þe wounde togidere. & if þe blood come fro grete veynes he mai nouȝt so sumtyme be constreyned, but it nediþ a stronger medicyn & also a more cautele / & if þat þe blood go out of arterie, þou schalt knowe it bi construccion & dilatacion of þe same arterie—þat is to seie, þat þe blood go out wiþ lepinge & oþerwhile wiþ wiþdrawinge [Lat.: quod sanguis exit cum saltu secundum constrictionem et dilatationem ipsius arteriæ.] ; & þanne sette þi fyngir vpon þe mouþ of þe grete veyne or ellis on þe arterie, & holde þi fyngir þeron bi a greet hour; for þanne by grace sum greet drope of blood may be congelid togidere & þere-bi vertu may be myche comfortid; aftirward leie plenteuousliche of þis medicyn vpon þe veyne eiþer þe arterie þat is kutt atwo / Take frankencense, whiȝt gummis, & fatt .ij. ȝ., aloes .ȝ. j., make poudre & distempere with þe white of an ey as þicke as hony / after take heeris of an hare smal kutt, [folio 34a] medle alle þese togidere, & þer is no medicyn so good as þis medicyn is in streynynge of blood & consowdynge of þe veyne / But whanne þat þou comest to chaunge þat medicyn of þe wounde, do nouȝt þe medicyn awey wiþ strenkþe, but leie aboue of þe same medicyn [MS. medicyn, repeated.] moist, to neische þe firste medicyn, þat it myȝte falle awey bi him-silf / Neþeles it is possible þat a medicyn caustik, þat is to seie, a medicyn þat brenneþ, sunner staunchiþ

blood þan þis medicyn of frank encense; & þou schalt haue greet plente of medicyne caustik in þe antidotarie, but we ben nouȝt sikir þat þe blood of þe veyne eiþer arterie anoþir tyme wole goon out, whanne þat þe schorf of þilke caustik Medicine [medicine, added in margin.] is remeued awey / but þis medicyn of encense with þe heeris of an hare not oonliche staunchiþ þe blood, but also sowdiþ [MS. sowdynge.] þe veyne & þe arterie, as I haue preued it ofte tymes / And for to ȝeue autorite I sette a saumple þat come sumtyme to myn hondis: A child of þre ȝeer old hadde a litil knyf in his hond, & he fel on þat knyf in þe former partie of þe þrote persched þe veyne organise; þer cowde no man it staunche, & þanne I was clepid, & I cam to þe child in [folio 34b] greet haaste, & he hadde almost lost his siȝt; for hise iȝen in his heed weren turned vp so doun; [up so doun. See Mätzner, Dict., s. v. "doun." Latin: oculos habebat in capite revolutos.] & þe blood come out at þe wounde whiȝt as whey, vnneþe he hadde no pouste [unneþe he hadde no pouste. This passage is corrupt; for the correct version see below.] / & þanne I leide my fyngir on þe heed of þe veyne, & I heeld it faste þat þer myȝte no þing go out; & so I heeld þe veyne a greet hour, & þanne vertu of his bodi þat was almost lost quykenede aȝen, & þe pouse bigan to appere febiliche as it were a smal þred / Þanne I sente to þe spiceris

schoppe þat was a greet weye fro me / ne I remeuede not awey my fyngir fro þe place, til þat þe messanger cam aȝen, and þe child bigan þanne to opene hise iȝen; & þanne I ordeynede þis medicyn to be maad, & plenteuousliche I leide it aboue þe wounde, & I boond þe wounde wiþ plumaciols & with stupis ["Stupes (in Surgery), Pledgets of Tow, Cotton, etc., dipt in scalding hot Liquors and apply'd to the diseased Part."—Phillips.] I-leid in whit of an ey, & with a boond I boonde it streitly, and comaundide hem to ȝeue him crummys of breed leid in water; & on þe morowe I come aȝen, & þanne I foond þe child comfortid / & neuere þe lattere I nolde nouȝt vndo þe medicyn / þe fader preiede me wiþ greet instaunce to vndo þe medicyn, [folio 35a] but I wolde not; & so I lete it lie stille, til iiij. daies weren passid withouten remeuynge / & neþeles I visitide him ech day; & þe .iiij. day I vndide þe wounde, & þe medicyn was drie aboue þe wounde, so þat I myȝte not han remeued it wiþoute greet violence. & þanne I leide aboue þe whiȝt of an ey wiþ a litil oile of rosis, & so I lefte it lie oon day til on þe morowe I turnede aȝen; & þanne I remeuede awey þe medicyn wiþouten violence, & I foond þanne þe wounde & þe veyne al hool. & of þis heelyng his fadir & alle hise neiȝeboris hadden greet wondir / And if þat wiþ þis medicyn þou maist not sowde þe arterie ne þe veyne, ne þow maist not constreyne þe blood for sum

oþer inpediment: þanue þou must ouþer bynde þe veyne, or drawe hir out of hir place, & bynde þe heed of þe veyne or arterie, ouþer þou must brenne hir wiþ hoot iren, & make on hir heed a greet cruste & a depe. ¶ Anoþer ensaumple: þer was a child of .xv. ȝeer oold þat smoot him-silf with a smal knyf, & þilke knyf perside o. senewe of þe arm & prickide a ueyne þat lay vnder þilke senewe. & for þe prickynge of þat senewe [folio 35b] he hadde greet akynge, & blood drewe doun to þe wounde & nouȝt aȝenstood [aȝenstood, for aȝenstondyng.] for alle þe staunchis of medicyns þat me myȝte do þerto, it wolde not staunche, þe blood ran out at þe wounde. & colde medicyns ben greuous to senewis þat is prickid, for þei stoppen þat lyme, & þat is contrarious aȝens senewis; & þanne I demede nessessarie to drawe out al þe veyne out of her place & to bynde hir & to helpe þilke senewis wiþ oile of rosis / But þe modir of þat child sente for a lewde leche which þat repreuede foule my doom, & he bihiȝte to heele safly þe child. He dwellide on þe cure, & I wente my wey / Þe which leche took hede to him .x. daies, þat neiþir þe akynge ceesside ne þe blood was not staunchid, & so þe sijk man was nyȝ deed / & at þe laste I was clepid, & I wolde not come to þe pacient / Þanne a fisician þat was frend to þe freendis of þe pacient blamede þe modir & hir freendis þat þei hadden left counseil for þilke idiotis

biheeste; & þilke fisician purposide, after þat he hadde herd my counseil, þat þer was noon oþer wey þat myȝte saue þe sike man from deeþ, & he axide of þe sirurgian wheþer he coude do as I hadde seid bifore. & [folio 36a] he seide, þat he coude so doon, & so he dide / He kutte þe skyn aboue þe veyne & twynede þe veyne in hise handis, & boond þe eende of þe veyne with a þred; & after he helde on þe senewe hoot oile of rosis, & so bi þis counseil he was restorid aȝen to heelþe / But who so wolde aske how þat he myȝte so manye daies be kept from þe crampe for þat he suffride so greet akþe / I answere & seie: þat þe cause was, for þat he bledde at þe wounde ech day, so þat þe senewe [senewe, error for wounde. Add MS. has the same mistake.] miȝt not be to myche replete eiþer ful of blood / Alle þese þingis I haue told, þat he þat rediþ hem mai þe visiloker in semblable causis worchen. & if bi þis medicyn he myȝte nouȝt sikirliche be restorid or restreyned þat falliþ riȝt seelde whane [riȝt seelde whane. Polychron, i. 133, wel silde whanne. Stratm., seldhwonne.] / þanne we moten brenne þe heed of þe veyne eiþer of senewe [senewe, error for arterie. The same mistake in Add. MS.] wiþ hoot iren, & þilke hoot iren myȝte make an hard cruste. & be war þat þou touche not þe lippis of þe wounde ne þe senewe, ne noon oþer þing but oonly þe veyne wiþ hoot iren. & if al þis craft wole not helpen, we musten drawe

out þe veyne & fle þe fleisch aboue here, & wynde þe veyne sadliche & bynde hir heed wiþ þin handis. [folio 36b] —Bi [An insertion of the scribe.] my witt I [I trowe a mene, "I believe to mean."] trowe amene þat a bodi schulde make þeron a knotte I-knytt of him-silf or ellis knytt wiþ a þred. I woot neuere wheþer he meneþ; for he seiþ in anoþer place tofore þat I schulde knytte it wiþ a þred, & þerfore I suppose bi my witt þat I schulde make a knotte þeron of his owne silf bi my witt.—& sumtyme it happiþ þat an arterie is broken ouþer kutt & þe fleisch þat is aboue is hool & nouȝt to-broke neiþir I-kutt, or ellis þe fleisch þat is aboue þe arterie is helid tofore & not þe arterie; & vndir þe fleisch þer is a swellynge of blood þat is clepid aperisma [aperisma, Lat. ophorisma seu mater sanguinis. Dufr. Gloss. med. Lat.: Aporisma—collectio sanguinis in aliquo membro extra venas non putrefacti maxime sanguinis arterialis.] ouþer mater sanguinis, & þerof þe pacient haþ greet drede, lest þat þe skyn to-breke & þe blood go out, þe which blood is hard to restreyne / for of þis maner sijknes spekiþ galion & seiþ þat a seruaunt of sich a disposicioun was helid of a lewde man þat tauȝte him þat he schulde leie snow on his siknes. Wherfore a man may vndirstonde þat to siche enpostymes colde medicyns & drie ben nessessarie. // // // // // // //

The .x. chapitle of þe þridde techinge of þe firste tretis ¹is of gouernaunce & diete¹ [^1—1 added in margin.] of men þat ben woundid [folio 37a] /

Þer ben manye men þat discorden of dietynge of men þat ben woundid, for sum men ȝeuen to alle men þat ben woundid, wheþir þat it be in þe heed or in ony oþere place, good wiyn & strong fleisch of capouns & of hennes; & þei affermen þat bi sich a maner wey sike woundid men ben sunnere heelid / for þei seien þat water putrifieth lymes þat ben woundid & engendriþ enpostymes & corrumpiþ & febliþ complexciouns & makiþ manye harmys / & summe oþere men gouernen alle maner of sike men þat ben woundid wiþ breed & watir & applis soden til ten daies ben goon / And if god wole eende þis book, it schal be remeuynge errouris & declarynge & openynge doutis / I seie þat þese boþe sectis erren in her opynyouns, for þei taken hede oonly to her experimentis not considerynge resoun of complexioun of him þat is woundid / Þe firste secte of þese two *[seyth] þat summen oonly eten breed & watir in so myche þei ben feblid þat blood & mater in her bodies may nouȝt be restorid; þe [þe cancelled in MS.] which were sufficient to hele with her woundis,

but þei ben so feble þat þei [folio 37b] dien, or ellis þei languren [languren, languent. See Prompt. Parv., p. 286, Languryn yn sekenesse langueo. And ibid. note 5.] longe tyme; ne þe lymes may not receyue resonable vertu as þei schulde; & þese maner men ben of cold complexcioun & drie & her bodies weren feble or þei weren woundid, & her stomak & her entrailis wiþinne weren feble / Þe secunde secte seiþ: þat summe þat drinken wiyn & eten fleisch hadde in þe membre þat was woundid a greet enpostyme & a febre—& þo ben ȝonge men þat ben of an hoot complexioun & a moist—wherfore þei comaundide to alle maner oþere of complexioun þat þei schulden drynke no wiyn ne ete no fleisch / Ȝe schulen vndirstonde þat boþe þese sectis ben nouȝt; & þerfore I folowynge þe doctryne of rasis, auicen, & galion & of oþere doctouris, & also experimentis þat I haue longe preued, I seie þat it is nedeful þat a woundid man in þe bigynnynge absteyne him fro wiyn, & namely if þat þe wounde be in þe heed eiþir in ony partie of a senewe. for þer is no þing þat so soone smytiþ greuaunce in þe heed or þe senewis as wiyn; for he is soone conuertid of kyndely heete & for he is so sotil, he persiþ swiþe into þe senewis, & he assendiþ soone into þe heed, bryngynge wiþ him humouris & spiritis. It [folio 38a] troubliþ a mannys witt, & wiyn greueþ alle men þat han a feble heed / & þerfore in alle maner woundis of

þe heed & of senewis he schal be forbode in þe bigynnynge namely to þo þingis [þingis, inserted.] þat han hoot complexiouns & moist into þe tyme þat þe cure be ful endid / & to þo þat ben of a cold complexioun, whanne .iij. daies ben passid, þou maist ȝeue to drynke smal temperat wiyn, & afterward a litil strengere, aftir þat þou art sikir þat þer schal nouȝt come to þe membre noon enpostyme. But þis [þis, error for his.] drinke schal be watir of barlich, eiþer water of crummes of breed bene soden in whit [whit, error for with.] wyn, [wyn, inserted.] or ellis lete þe breed lie in cold watir raþere þan þou faile þat he schal drynke / but he may tende weel to heete it, & nameliche in somer / & to þat ben woundid [woundid, error for wonid. Lat. homini assueto.] to drynke watir, or ellis with þe x. partie of wiyn of pome garnates or ellis with þe sixte partie of wiyn agrestis þat is smal brusk [brusk, Roman brusco (Lat. rusticus?), harsh. See later reference in N. E. Dict.] wiyn, or ellis þis is a perfiȝt drynke to woundis of þe heed & to senewis: / Take a potel of water & of barly clensid .iiij. [ounce]., juiube, [Jujube, a kind of prune growing in Italy. Kersey—1721.] sebesten [Sebesten, Arab. sebesten. Name for Cordia mysa vel sebastena.] ana. ȝ. [one half]., of drie prunis of damascenes [ounce] j, sugre of rosis .[ounce] ij., seþe hem [Corrupt passage. Lat.: donec consumetur tertia pars.] to .iij parties ben consumed, & þanne lete him drynke. To asaye it softly [softly, error for soþly.] / [folio 38b] Þis drynke is alteratijf: þat is to seie, chaunginge, ne it swelliþ not, & it lettiþ fumosite to arise

to þe brayn. Of mete I seie: to him þat is of a moist complexicioun & hoot / bi no maner wey schulde not be ȝouen fleisch, fisch, mylk, eiren, ne no comfortable mete, but if þei weren ouercomen wiþ to greet febilnes; but he muste holde him content wiþ ius of barli or ellis of ootis wiþ almaunde mylk; outake [outake, except. See Catholicon Angl., p. 264, Oute take, note.] wounde of þe heed, were [were, error for where.] I ne apreue nouȝt almaundis ne noon oþer vaperous fruyt: as notis eiþir walnotis eiþer avellanes; for þei han a maner fumose properte greuynge þe heed / he may eten amidoun, betis, letuse, & breed I-waische wiþ sugre if þat he were feble. & if þat he myȝte not absteyne him fro fleisch, ȝeue him fleisch of smale chikenes & of smale briddis & kidis & lambis & calues I-sauered with agresta eiþer wiþ wiyn of pome garnatis; & þilke dietynge he schal vse til he be sikir fro swellynge & þat þou schalt knowe whanne þat akynge swellynge & extencioun of þe lyme ben ceessid & þe wounde almoost consowdid. If þat it was a wounde [folio 39a] þat was sowid eiþer brouȝt togidere with byndinge, in whom quytture was nouȝt engendrid, & if þat it was a wounde maad wiþ smytynge or ellis chaungid wiþ þe eyr, in whom it is nedeful engendrynge of quytture, þanne it is siker þat it schal not enpostyme,

whanne þat he makiþ quytture plenteuousliche; & whanne þat þe lyme is weel disposid & not to swolle ne drawe abrood & is wiþoute akynge; þanne chaunge a litil & a litil his dietynge til þat þou come to his dietynge þat he was wont to vse tofore / & if þat þe pacient were of a cold complexioun & a drie & þat he hadde bi nature eiþer bi custum a feble stomak, þanne it were nessessarie to ȝeue him at þe bigynnynge fleisch a litil sauerid with swete spicerie: as canel, gynger & oþere semblable to hem, & to ȝeue him in þe bigynnynge Julep [Julep, med. Lat. julapium, Fr. julep, Pers. goulāb. See Skeat, Et. Dict.] —þat is a sirup maad oonly of water & of sugre —& aftir iij. daies ben passid, wiyn, & boþe in þe oon complexioun & in þe oþere complexioun. If þat a boon were broke wiþ a wounde or wiþoute a wounde aboute þe eende of þe cure, þat is to seye, whanne þou art siker from apostyme & swellinge, it is good to ȝeue norischaunt metis þat it [folio 39b] myȝte make a good & a strong repeirement of þe boon þat was to-broke: as furmente soden in, [in, erroneously inserted.] potage of flour weel soden & wiþ þe extremytees of beestis feet & swyne groynes & oxen wombe weel soden & bi siche oþere þingis bi whom a good ligament & a strong may weel be engendrid / Wherfore it is nessessarie to a surgian to knowe his dietynge, vertues of coplexciouns, agis, regiouns, consuetudes & þe tymes of þe ȝeer þat

he mowe chaunge his dietynge aftir þat dyuerse condicioun*... Ne he schal not aftir o maner of counseil procede in his dietynge.

The .xj. chapitle of þe þridde techinge of þe firste tretis.

is of olde woundis þat ben maad of kuttynge or of openynge of a postyme, or ellis of a wounde þat is not heelid in his tyme, or ellis of sum maner fleinge, or of brennynge, or of to greet heete, or of to greet drouthe, or of to greet cold constreynynge, or of to greet aboundaunce of mater corrumpinge / For euery olde wounde hauynge rotnes or wire [wire, Lat. virus.] þat is þinne venymous quyttir or ony oþir þing þan good quytture is not clepid a wounde, but it is clepid vlcus / Rowlond & Rogerine & þe moste [folio 40a] partie of men þat ben now, clepen it a festre [festre, fester in Mätzner Dict.; O.Fr. flestre, festre; Lat. flstula. Comp. N. E. fester vb.] or a cankre, but it is neiþir festre ne cankre, but festre & cankre han difference fro þis / Þis vlcus as a propre þing haþ difference from a þing þat is comoun / for ech festre & ech cankre þat is woundid, is clepid vlcus, but it ne schewiþ not þat ech vlcus is clepid cankre or festre

as I schal telle openliche in ech chapitle bi him-silf / Auicen seiþ, þat þer ben .vj. maner of þis vlcus: summe þat ben venemous, summe hore, summe depe, summe cauernose eiþer hid, summe corosif, summe rotin, summe ambulatif þat is spredynge abrood, & summe harde to consowde / Of þese maners tofore seid, summe [MS. summen.] han acordynge with festris in tokenes & in foormes as venemous & holowȝ & summe han acordynge with cankris as spredynge abrood & fretynge him-silf & neþeles þei han difference, as it is conteyned in þe chapitle of cankris I-woundid & of festre. & alle þese tofore seid han difference fro wounde / for in a wounde þer is whiȝt quytture & euene in alle hise parties & hole and nouȝt departid & wiþoute stenche. Þis maner of quytture is engendrid of goodnes & kyndely heete, & is perfiȝtly defied / But venym rotynes [folio 40b] & a cruste, & al oþere superfluyte of olde woundis ben engendrid of a strong vnkyndly heete.

A uenym vlcus is in whom aboundiþ venym sutil & liquid. If þat it be reed or ȝelu, or oon partie redisch and scharp bitynge þe lyme, it signifieþ lordschipe of a strong heete.

An hori elde wounde þat haþ summe greete crustis, or ellis a wroting, sum gret proud fleisch to hiȝe. [proud fleisch to hiȝe. Lat.: carnem superfluam grossam. Proud flesh, Fungosity. Dunglison.]

A deep vlcus is þat, þat haþ a greet depnes & an holowȝ & perauenture crokinge.

A wroting vlcus is þat of his malice fretiþ bi cause þat þe blood is sent to him so scharpe / Galion seiþ: þat scharp blood not oonli corrodiþ [noȝt]*—fleisch in woundis, but also hool fleisch /

A rotid vlcus is stynkynge, hauynge a strong heete in his ground, & out of him passiþ a stynkynge smel, eiþer smoke, as doiþ out of fleisch þat is rotid / þilke [This curious explanation of the word stynk is an insertion of the scribe. Read: ste her laddre. One letter half erased in lacdre. Ste, see Stratm. Dict., O.E. stîgan.] word 'stynk' I vndirstonde it bi my maner witt: sich breeþ þat comeþ out of a bodies ende, whanne a bodi breþiþ wiþ þe mouþ in frosty wedir, þat men taken a saumple, bifor to sle her lac dre / þanne whanne þou myȝt se þe breeþ of þin owne ende comynge out at þi mouþ in þe eir.

A walkynge / vlcus is þat walkiþ hidirward & þidirward, & neþeles he profoundiþ nouȝt depe [folio 41a] into þe ground.

An vlcus þat is hard to helin is he þat for his yuel propirte þat is sent to him fro þe bodi lettiþ him to heele.

& for to heelen ech maner of þese vlcus, þer ben manye dyuers rulis / Þe firste rule is þat þei moun not be heelid, but þe superfluytees þat ben in hem ben I-dried / Þe secunde rule / but if þat bodi ouþer þe membre be oute of his naturel complexioun, or þan þou þenke to heele þilke vlcus þou muste brynge aȝen to his diete

complexioun distemprid þilke bodi ouþir membre. Þe þridde rule is: þat if þe lyuere eiþir þe splene ben I-greued, as it happiþ ofte tymes in olde woundis, þou muste rectifien hem / Þe .iiij rule is: þat þe qualitees & þe quantitees of humouris schulden be temperid wiþ blood-letynge & purgaciouns & with good gouernaile / & if þat þe eir be yuel, þe sike man schal be chaungid into good eyr / & whanne þat þe leche haþ tofore seen alle þese þingis, þanne he may go to his cure /

& if þe vlcus be virulent, þat is to seie venemi, loke if þat þe venym þat goiþ out be redisch or ȝelowisch, & if þat þe lyme haue ony maner heete; þanne waische it wiþ water of rosis & barlich. alim [alim, Latin: aluminis.] & balaustia & lentiles with hony [folio 41b] symple eiþer compouuned ben soden yn, & lete þis watir peersen to þe depþe of þe wounde; & if þe virus be wiþoute heete & þe membre haue noon heete, waische it wiþ watir or with wiyn þat mirre wormode, [wormode, absinthium. O.E. wormôd, M.E. wormwood.] horhone, [horhone, Marrubium vulgare. See Britten, Dict.] sauge, [sauge, salvia.] pimpernelle [pimpernella, Pimpinella.] hony symple or compounned ben soden yn / Clense þe wounde perfiȝtliche & engendre fleisch & afterward consowde it wiþ þis propre oynement þat þi [þi, error for in.] olde foule venym woundis, eiþer

vlcus, engendriþ fleisch, clensiþ & heeliþ as auicen & rasis witnessen / recipe litargium ["Lithangyros, Litharge or Silver-glet, the frothy Dross, or Scum that arises in the purifying of Silver with Lead."—Phillips.] as myche as þou wolt & stampe it in a morter [MS. & putte it in a morter, scribal insertion.] & putte wiþ him good oile of rosis & vynegre now on & now þe oþere, alwey stiryng, til it be perfiȝtly an oynement & come into þe foorme of an oynement. & þis oynement is clepid litargirum nutritum, þat is to sai litarge nurschid, þat is profitable in manye causis / afterward take of þilke litarge norischid .vij. parties & of alim, & of balaustie or ellis in þe stide of balaustie wormes of þe erþe brent, bras brent, leed, gallis, sandragoun chathinie ["Cathima est minera de qua elicitur aurum vel argentum."—Sinonoma Barth. p. 14. Cathimia: argenti spuma, Cartelli Dict.] argenti .ana. as myche as is xij parties of al þe oynement; medle alle togidere and [folio 42a] make an oynement / Þis oynement schal be leid wiþinne þe wounde & al aboue þe wounde; for it drieþ þe wounde & engendriþ good fleisch & consowdiþ / Take hede to þis rule, þat in heelynge of alle olde woundis after þat þei ben clensyd, aboue þe oynement it is good to leie a lynnen clooþ, to distende abrood on of þe mundificatiuis of ony which þat schal be told in þe antidotarie, & leie aboue aboute þilke vlcus specialy from þe ouer partie fro whens humouris fleen, a defensif of bole armonyak & terra sigillata; þat

is maad on þis maner / take bole armoniak .[ounce] j. terra sigillata. [ounce][one half] oile of rosis & vynegre þat suffisiþ, I-nowȝ do in þe oon now in þe oþer til þe oynement be ful maad & liquide I-nouȝ / so þat of þe oile of rosis be double as myche as of vynegre / Þis defensiþ a membre fro corrupcioun & also vlcus þat he sprede nouȝt abrood /

An hory wounde shal be heelid, in remeuynge awey þe crust eiþere filþe þat is in him wiþ poudre of affodill, þat schal be said in þe eende of þis book, ouþer wiþ sum oþer mundificatiuis; aftir consowde it wiþ consolidaciouns /

A deep wounde is heelid [folio 42b] wiþ castynge into þe depþe of þe wounde with an instrument maad to þe lijknesse of a clisterie, ony of þe waischingis þat ben seid in þe venemy wounde aboue, aftir þat þe disposicioun of þe membre askiþ of heete or of cold. & aftir þat, he is clensid in castynge in watre ouþir wiyn þat mastik or frank encense is soden ynne & in leggyng wiþouten oon of þe mundificatiuis of hony þat schal be seid aftir. & also it is good to ordeyne þe lyme so þat þe mouþ of þe wounde hange dounward, & streyne þi ligature at þe ground of þi wounde, & bynde it losely at þe mouþ of þe wounde; also it were good, if þat it myȝte be, þat þer were maad a newe wounde in þe place þat is moost hangynge, þat þe rotynes & þe quytture myȝte þe bettere goon out; for so þilke vlcus myȝte þe sunnere be heelid /

A wroting vlcus is heelid in leggynge specialiche aboute him colde þingis whiche þat ben [ben, erroneously inserted.] obtunden or casten bach þe scharpnes of þe same vlcus; & also with amendynge, as with metis & drynkis, þe scharpnes of þe same blood, & in purgynge þe reed colere; & wiþ anoyntynge wiþ colde oynementis & consolidatiuis. & þerto [folio 43a] is miche worþ vnguentum album rasis þat schal be told in þe antidotarie /

A stynkynge wounde is heelid in remeuynge awey þe stinche & þe rotenes; & þerto is myche worþ a waischinge of ydromel: þat is hony & watir soden togidere wiþ mirre, & a mundificatif maad wiþ ius of wormod & barly mele & hony & mirre, þat is maad on þis maner / take ius of wormod. [ounce] iij. of hony. [ounce] iij. barli mele [ounce] ij. of mirre ana. [ounce] j. & compounne hem togidere & fille þe wounde wiþinneforþ with lynnet of lynnen clooþ. & if þat wormes ben engendrid in þe wounde, sle hem wiþ þe ius of calamynte ouþer wiþ þe ius of þe leeues of pechis, or ellis persicarie, [persicarie glossed colorag. See Notes.] eiþer wiþ decoccioun of elebre. & whanne þat a perfiȝt mundificatif is maad, engendre fleisch & consowde as it is seid tofore /

A walkynge vlcus is heelid wiþ fleobotomie & formacie [O.Fr. farmacie = purgation. See Littré, Dict.] þat is

laxatiuis purgynge þe colere & brent humouris, & in leggynge aboute a defensif of bole & terra sigillata þat is seid tofore in þis chapitle; & with oon of þe cold mundificatiuis, & sumtyme þou muste cauterise þe vlcus aboue with an instrument of gold. For þilke maner of brennynge rectifieþ weel þe membre /

Þe cause whi þat summe vlcus [folio 43b] is hard to consowde is, for an yuel disposicioun þat is hid in þe bodi, & þerfore it nediþ to rectifien þe membre & þe bodi as I haue seid tofore. & if þe cause be vpon, [vpon, error for open.] oon oþer manye, do awei þilke cause or ellis þe manye causis, or þat þou go to þis principal cure / Þese ben þe causis þat letten consowdynge of olde woundis: an yuel disposicioun of al þe bodi as ydropisie; or ellis an yuel disposicioun of þe lyuere as if þat he be to feble, as to hoot or to cold, to moist or to drie, wiþ mater or wiþoute mater, as wiþ to greet hardenes; or ellis þe splene is to feble to purge þe malancolient blood; or ellis to myche blood or ellis to litil blood; or ellis þe veynes ben to fulle of blood þat goon doun to þe vlcus; or elles þat glandeles þat ben kirnelis þat ben in þe ground [ground. See grynd, page 41, note 3.] þat senden doun mater to the vlcus þat is in þe þies & in þe leggis; or ellis þe lippis of þe vlcus ben to grete; or ellis myche fleisch; or ellis mys-ordynaunce of dietynge or ellis an

inconuenient medicyn to þat membre or ellis þe lyme þat is hirt haþ an yuel discrasie; or ellis þilke vlcus is in an yuel place as in þe eende of þe [folio 44a] elbowȝe; or ellis þe vlcus is al round; or ellis þe boon þat is vndir þe vlcus is corrupt / Alle þase tofore seid letten vlcus to be heelid / wherfore it nediþ þe, to take kepe to alle þese þingis tofore seid, to amende al þe bodi & namely þo lymes þat han principalte in mannes body, & kepen alle þe lymes þat ben in her naturel disposicioun with þingis þat ben acordinge to her naturel disposicioun, þo / & if þei ben discrasid, remeue þilke discrasie wiþ þat, þat is contrarie to þe discrasie / also tempre þe qualite & þe quantite of þe blood & streyne þe veyne if þat þou brynge þidir blood, or ellis if þat it be possible latt þe blood awey; vndo þe glandeles þat ben kirnels þat sendin þider mater, & remeue deed fleesch, smale þe lippis of woundis þat ben greete & kutte hem awey if þat þou myȝt do noon oþirwise; amende his dietynge; & brynge aȝen þe rondnes of þilke vlcus into a long forme aftir þe lenkþe of þe membre with a knyf hoot brennynge / but if a veyne or a senewe lette. & þou schalt remoue þe boon þat is corrupt on þis maner: in kuttynge awey al þe fleisch & þe boon þat is corrupt with an hoot [folio 44b] iren, or wiþ a medicyn þat schal be seid in þe laste eende of þis book, or ellis it is bettere to don it awey wiþ hoot

iren. & whanne þat þe boon þat is corrupt [MS. corrrupt.] is vnkeuerid, schaue it not as manye men doon, but touche harde þat boon with hoot iren; & aftirward heelde on þilke boon hoot oile of rosis, & leie on oon of þe mundificatiuis þat ben in þe antidotarie whiche þat wolen remoue þe rotid boon wiþoute violence / For vndirstonde weel þouȝ þat þou clense þe rotid boon wiþ schauynge or wiþ filynge with violence, neuere þe lattere kynde wole afterward don awey a schelle of þilke same boon, nouȝt aȝenstondynge þi schauynge & þi rasynge / wherfore in remeuynge þilke boon þou multipliest þi traueile & makist newe [newe, error for no.] mundificacion to þe fulle [to þe fulle. Lat.: ad plenum. See Polychr., iii. 443, he forgaf him the trespas at the fulle.] & þerof may come ofte tymes an yuel festre. An inconuenient medicyn is amendid in considerynge þe complexioun of al þe body & þe complexioun of þe lyme & þe gre of þe medicyn; for if þat þe membre be drie as þe eeris & al bony & gristly lymes, & þei han greet putride & rotschipe, þanne þou nedist a ful drie medicyn / & if þat þe bodi or þe lymes [folio 45a] ben mene bitwene fatnes & lenenes þat is neiþer to fatt ne to leene, þanne þou nedist a medicyn þat is in kynde mesurabiliche driynge / & if þat þe bodi or þe membre be natureliche moist, & if þat he haue a litil putrede or rotschipe, þanne þou nedist a medicyn

þat is litil driynge / & if þat .ij. membris ben in complexioun I-liche euene, & þe toon haue myche quytture, & þe toþer litil quytture, he þat haþ þe more quitture nediþ þe driere medicyn / & *he þat haþ but litil quytture, him nediþ his medicyn I-maad nouȝt fulliche so drie / Þerfore it nediþ bi mesure þat þou kepe naturel þing wiþ þing þat is acordinge to þe same naturel þing / & also remeue with mesurable contrariouste þing þat is aȝens kynde / But þe quantite of medicyns þat schulden be leid to þe soor as galion witnessiþ mai not wiþ lettris be writen / neþeles it sufficiþ þat a man diuise þe medicyn after [N. E. Dict. s. v., "after C. 2. c" gives later references for the use of after conj. = according as, without relative particle.] þe complexioun mai bere / For kynde þat is wondirful, fulfilliþ þing þat is absent, & þat. þat is to myche, castiþ awey, but if þat it be to myche aȝen kynde; & þanne kynde muste nede faile in his kyndely worchinge / A medicyn mundificatif [folio 45b] & exciccatif þat is nessessarie in ech old holowe wounde,—— [Both MSS. omit the end of the passage. Lat. "Medicina vero mundificatiua & exiccatiua — — aut est fortior, quam conuenit, aut debilior competenti." Then, as a heading to the next passage: "Significatio si medicina est magis sicca quam oportet." The þat in & þat may be knowe, refers to this omitted heading.]

& þat may be knowe bi þis maner / if þat þe medicyn make þinne quytture & blodi & make þe wounde holower, þanne he schulde be, þanne is medicyn to scharpe / & if þe quytture be þicke & towȝ, þanne is þe medicyn to liþe / & also anoþer signe þat þe

medicyn is to scharp, þat þe place aboute þe wounde is to grene, blak, reed, eiþer ȝelow; & þanne þe sike man schal fele to greet heete & brennynge, also þe venym of þe wounde multiplieþ / and whanne þe vnkunnynge leche seeþ þese accidentis tofore seid, he ordeyneþ a drie medicyn; & so ech day þe wounde apeiriþ. [apeiriþ intr. See Prompt. Parv. Appeyryn, or make wors. Pejoro, deterioro.]

& þe signe þat þe medicyn is of feble driynge is, þat þe quitture & þe rotynes þat goiþ out þerof is greet in substaunce, ponderous & vneuene, wan ouþir pale & þe membre is cold & is whiȝt ouþir wan, ouþir cleer in colour ouþer soft; & þe sike man feliþ cold in his membre / & whanne þat þou knowist þese þingis in þe firste cause make not þi medicyn so drie, & in þe secunde cause make þi medicyn more drie, & also chaunge þi worchinge as condicioun of kynde askith [folio 46a] boþe of bodi & membre as weel symple as compound medicyns / He þat knowiþ not þes canones. wel yuele schal he heele woundis / wherfore manye lechis bryngen liȝtliche woundis with her yuel worchinge into þe worste olde woundis þe whiche moun not aftir ben I-heelid bi a good leche / Þese ben liȝt medicyns whiche þat drien olde woundis þat neden a litil driynge: mastik, frank encense, barli mele. & þese medicyns ben sumwhat more driere: yrios, [yrios. Lat. Iris. See Prior, Dict., p. 123.] aristologie rotunda, orabum ["Orobus, gall. uesche, anglice thare uel mousespese."—Alphita, p. 131.] þat is wiilde tare, lupines,

þe rotynes eiþer þe drie poudre of trees; & þese medicyns ben strongere: balaustie, psidie, ["Psidia cortex est mali granati."—Synonoma Barthol., p. 35.] rose, notts of cipris et cetera / & þese ben liȝt mundificatiuis: sugre, hony, water of barlich, gotis whay, watir of þe see, watir of brimstoon þat clensiþ & heteþ, water of alym þat clensiþ & coldiþ. & þou schalt haue greet plente of enplastris, mundificatiuis, oyntmentis compounned in þe antidotarie of þis book /

The .xij. chapitle of þe iij. techinge of þe firste tretis is of festre /

Festre is a deep old wounde, & þe mouþ of him is streyt, & þe ground is brood, & he haþ [folio 46b] wiþinne him a calose [O. Fr. calus, (Godefroy). See later references in N. E. Dict.] hardnesse al aboute as it were a goos penne or ellis a kane / & a festre haþ difference from a deep vlcus & a cauernose / for a deep vlcus & cauernose of whom it is toold in þe chapitle tofore seid, þouȝ þat þei acorden togidere in depnes & in streitnesse of þe mouþ, þe vlcus haþ not wiþinne him a calose hardnes / Wherfore a festre mai not be clensid wiþ waischinge with which a cauernose vlcus mai be clensid / but it is nessessarie aftir þat þou hast waischen it to

remeue þilke calose hardnesse wiþ a cauterie eiþer with a medicyn cauterizinge þat is brennynge, þe which cauterie ouþir brennynge schulde make þe depþe of þe vlcus holowere þan he was / Wherfore it is nessessarie to a surgian to knowe þe difference of þis science, þat he mowe knowe to heele boþe þe vlcus & þe festre wiþ medicyns different þat longen to hem boþe /

& if þat a festre be in þe fleisch or ellis bitwene senewe & senewe, so þat þe substaunce of þe senewe be not corrupt ne þe boon, it is no nede to take noon oþere medicyn but egrimoyne & staumpe it with salt as þou woldist make sause, & drawe out þe ius of þilke egrymoyne, & do it into þe [folio 47a] hole of þe festre wiþ a penne & leie þe substaunce of þe same eerbe þere-vpon til he haue slayn þilke festre & clensid it; & þou schalt knowe bi reednes & sadnesse of fleisch þat is wiþinne þe festre al aboute; & aftirward haue þis sirup of hony wiþ þe whiche þou schalt waische þe festre þat is now vlcus I-compounned in þis maner / Take a pound water, vynegre half a pound, of hony dispumed [ounce] .iiij., of leeues of olyuetre bounden togidere wiþ a þred / [ounce] j., of galingale [galingale, ne. galangale, for sagitelle.] [dram] j, boile alle þese to þe perfiȝtnesse of a sirup, & lete it colden, & do awey þe

leeues of þe olyue, & kepe al þe remenaunt of þe sirup with þe leeues of sagittel & waische þe vlcus þat was festred tofore wiþ þis licour twies on þe day þat þe licour may go to þe ground, & aftirward drie it weel & fille it ful of drie leeues of sagittelle & leie a sagittel-leef aboue; & þis medicyn þou schalt contynuen til it be hool / Euery festre þat is in fleisch is heelid wiþ þis medicyn I-preued, but if þat substaunce of þe senewe & of þe boon be apeirid in þe ground, & specialiche if þat þe festre be not old, & if þat þe calosite be nouȝt to hard. In þese two causis þe medicyn of egrimoyne [folio 47b] ne suffisiþ nouȝt, but it is nessessarie to haue a cauterie of fier eiþer a medicyn caustik / & of þese medicyns þou schalt haue a ful techinge folowynge in þe book / & if þat þe boone were corrupt in þe depþe of þe festre, do it awei aftir þe techinge tauȝt in þe chapitle tofore / & herof take hede, if þat a festre perse bi þe weyes of þe vryne so þat þe vryne go out bi þilke weie, as we han seen ofte tymes, or ellis þat it go bi crokid placis & hid placis of þe face [Lat. per tortuosas aut occultas partes faciei.] persinge into depþe, it is [it is, above line.] an vnperfiȝt cure, but þou maist pale [pale, Lat. palliare. Dufr., Gloss.: 1. tegere; 2. simulare.] it, & do it awey þe stinche with hony waischinge, enplastre, & hony mundificatiuis, & with defensiuis aboute þe place

þat his malice mowe [MS. moore.] þen lasse greue. For a festre þat is in ioynturis as þe feet eiþer þe knee, eiþer þe hand, eiþir þe elbowe, is hard for to heele, & sumtyme impossible / & if þat he be in anoþer place, & he haue corrodid eiþer rotid sumwhat of þe senewe, þow þat it be greuous for to cure it, þer is noon oþer wey, but a liȝt cauterizacioun of þe senewe þat is hurt / For cauterizacioun wiþ hoot iren eiþer wiþ gold, þat is bettere, it clensiþ & drieþ þe senewe þat is corrupt & rectifieþ þe complexioun of al þe membre & [folio 48a] a medecyn caustik worchiþ þe contrarie / Brennynge medicyns, boþe þe symple & þe compound þou schalt haue to þe fulle [See page 86, note 3.] in [þe þridde tretis folowynge / & whanne þou hast maad a perfiȝt mundificacioun struck through in red. after to þe fulle in.] antidotarie of þis book, & þou schalt fynde þe maner of cauterisynge to þe fulle in þe þridde tretis folowynge. & whanne þou hast maad a perfiȝt mundificacioun of þilke colose fleisch, regendre fleisch & consowde with medicyns regeneratius & consolidatiuis þe whiche þou schalt fynde in þe antidotarie //

The xiij chapitle of þe þridde techinge of þe firste tretis is of a cankre /

Cankre I-woundid comeþ of openynge, eiþer of kuttinge, eiþer of brekynge of a cankre not I-woundid, whos techinge þou schalt

haue in þe chapitle of þe apostymes in þe þridde techinge / & he comeþ of a wounde yuel heelid, to whom comeþ a malancolient mater rotid; or for þe mater þat comeþ to þe wounde is þere corrumpid & chaungiþ þe vlcus into a cankre /

& þese ben þe tokenes of þe cankre / Þe vlcus is foul & stynkynge, þe lippis ben grete, wan, or blak, hard, & wiþinne kirnely, & ouer al aboute arerid and [folio 48b] holowe / & þis is þe difference bitwene a cankre & a foul vlcus & an hori of whom I haue maad mencioun aboue, þat if þat þou waische hem boþe wiþ liȝe, þe cankre schal be palere & foulere þan he was bifore, & þere schal falle out of him pecis gobetmele. [gobetmele, piecemeal. Polychron., iv. 103: membratim. See further, Mätzner, Dict.] & þe vlcus is clensid wiþ þilke liȝe, & þe fleisch is maad fairer þan it was tofore, ne þe vlcus stynkiþ not bi þe same stinche as þe cankre doiþ; for þe cankre haþ a propre sauour, þe which mai not be write wiþ lettre; but þilke sauour is best knowe of men whiche þat best han seiȝe cankreis. [MS. cankre is.]

A general rule in þe cure of a cankre is, þat a cankre mai not be heelid, but if þat he be do awey wiþ alle hise rotis / Þe secunde rule is, þat he schal not be touchid wiþ hoot iren ne with hoot medicyn caustik, þat is to seie brennynge, but he be in place

where he may al be doon awey / for þe more þat þou touchist him wiþ a violent þing eiþer medicyn, þe more his malice is encreessid / Take þanne good heede if he be in a fleischi place, where þat he may be don al wey, & þanne kutte him al awey wiþ alle hise rotis / & þanne þriste out al þe malancolient [folio 49a] blood þat is wiþinne þe veynes þat ben aboute þe cankre. & aftirward brenne al aboute in þe place þere as þe cankre was with hoot iren / aftirward leie on þis confeccioun maad of flour of wheete & hony & ius of smalache, [smallage, Halle Table, p. 12. "Smalache, Marche, or Marshe Persley." See Prior, Dict., p. 217.] til þat he be perfiȝtliche clensid. After regendre fleisch & cicatrice. To þis rule / take hede as ofte as þou wilt wiþ sirurgie heelen a cancre: first euacue þe malancolient mater, for þat is ypocras techinge; & if þat he be growen in sich a place þere as he may not be doon al awey, as in þe necke or in þe tetis, or in þe face, or in þe arshole, or in þe mareis; & also for schortere conclusioun, & he be entrid in ony place þere as ony senewis, arteries, veynes, ben—as ypocras seiþ—it is bettere nouȝt to cure þe cankre þan to cure. For & he be curid, þat is to seie kutt or I-brent, þei perischen þe sunnere; & if þei ben not curid, þei lyuen þe lengere tyme—libro vjo. afforismorum: Cancri absconditi multum tempus perfuciunt

curati vero cicius pereunt / But defende þe lyme þat is hool aboute with defensif of bole þat I haue ofte tymes seid & waische þe wounde of þe cankre wiþ gotis whey, & drie it softly, [folio 49b] & anoynte þe wounde wiþinne & wiþoute with þis oynement of rasis & [&, erroneously for of.] tutie [tutie, Matth. Sylvat. "Tuchia . . Lat. Cadimia & pomfolix." Arab. tūtīā. Fr. tutie. See Wr. Wü., p. 559, 13. "Tucia, i. tutie" (xiiith cent.). It is: Oxidum Zinci impurum.] / take ceruse, [ceruse, white lead. See N. E. Dict. s. v. Ceruse.] tutie I-waische & medle hem wiþ oile of rosis & wiþ ius of purcelane [purcelane, Lat. portulaca. Halle Table, p. 90. "Another herbe there is also called Portulaca marina, only of the likenes that the leaves therof haue with porcelaine." See "Purslane," Prior, Popular Names, p. 193.] or of sum oþere cold eerbe, putte ynne sum of þe toon, & now sum of þat oþer, til þe oynement be weel I-maad / Þis oynement is myche worþ for to defende þat þe malice of þe cancre schal not wexen, & also þat þe pacient vse a good gouernaile: as drinke good wiyn & cleer & lithe, & he muste leeue reed wiyn & troublid & þicke wiyn, & he may ete good fleisch, as motoun [moton, carnes ovine, Wr. Wü., 741, 39, xvth cent.] of a weþer, kide fleisch sowkynge, capouns, hennes, chikenes, partrichis, [partrichis, Cathol. Ang., p. 270, a Partryke, perdrix. See further Skeat, Et. Dict.] fesauntis, & smale briddis, & he muste leeue: beeues fleisch [bef, added above line, in different hand.] & gotis fleisch, hertis fleisch & haris fleisch, goos, dokis, & alle greete briddis þat lyuen in watri placis, & al salt þing & acute þing: as garleek, oynonys & vynegre et cetera [þat]*

þe sike man may lyue þe lengere vpon erþe / Neþeles if vlcus be riȝt foul & haue nouȝt so greet malice as a cankre, of þe which vlcus I haue told tofore may be curid wiþ poudre of affadillis, and aftirward weel be clensid; & for þat þis vlcus [folio 50a] þat was so foul may be heelid / Rogeryn and Rowlond & manye oþere settide in her bokis þe cure of a cankre, þouȝ þat he be in a senewey place, & þei seien þat þei han heelid him / But vndirstonde weel for certeyn, þat an olde cankre mai not be heelid bi noon oþer wey, but bi þe same wey þat I haue seid in þe bigynnynge of þis chapitle / & if þat þou dredist wheþer þat it be a symple vlcus or a cankre & a foul, for þe signes & þe tokenes tofore seid beþ doutis, bigynne to mortifie it wiþ sum maner of poudre: as wiþ poudre of affadillis, & bi my witt poudre of erbe robert [erbe robert, insertion of the scribe. Geranium Robertianum. See Prior, p. 113. Cronenburg. De Compositione Medicamentorum, a. 1555, fol. 106, A. Ruprechtskraut: Roberti herba (Geranii species).] / & loke aftirward þe prosis of þi worchinge seiþ þis boke [seiþ þis book, erroneously inserted.] / For if þat he be a uerry cankre, þou schalt se þe more þou woldist clense him, þe more his malice schal wexen / & if he be not a cankré, he schal be clensid riȝt as an vlcus / Whanne þat þou seest þe wexynge of a cankre & his malice agmenten, ceesse from þe verry cure & turne aȝen to þe forseid cure of þe oynement of tutie, þe which þat paliþ þe cankre. For & þou bisie þee to

cure þe cankre, & þou procede in þi cure, þou schortist þe pacientis lijf / & if þou palist, þou lenkþist his lijf /

[folio 50b] The .xiiij chapitle of þe þridde techinge of þe firste tretis is for to remeue causis þat letten þe cure of olde woundis /

I tolde þee aboue in þe general chapitle of olde woundis cause whiche þat letten olde woundis to be heelid / & also I tolde þe techinge plenerliche þat ben nessessarie to remeue ech sengle cause þat is nessessarie, how þat alle maner causis þat letten mai be don awey bi a good surgien & a wijs; so þat þou ioynest þis chapitle wiþ þe oþere chapitle tofore seid, þou schalt han a pleyner techinge. If þat þe bodi be ful of olde humouris eiþer in þe idropisie, loke þat he may be heelid of þilke disposicioun, & þanne heele him if þat þou canst / & [The translator, perhaps intentionally, altered his original: si non (scis), pete physicum qui curationem illius dispositionis faciat.] if þat he be not ful of olde humouris whiche þat neden no curynge of olde disposicioun. Ne traueile not in deueyn [in deueyn = in veyn.] þe sike man neiþir wiþ medicyns corosiuis, ne wiþ kuttynge, ne with puttynge into þe woundis greete tentis; but do aboue þe vlcus liȝt

mundificatiuis & swete smellynge, þat kepiþ þe membre liȝtliche clene þat it stynke not / & whanne þat he is keuerid from an yuel disposicioun, thanne turne aȝen to þe principal cure / & þis same þing [folio 51a] [Heading to this page: Causes þat lettes þe cure off old woundes.] I saye of yuel disposicioun of þe lyuere of what maner cause þat he be enfeblid; þe same I saye of þe splene / But if þese tweyne ben in her kyndely disposicioun, olde woundis moun not be heelid. If [if above line.] þat greet multitude of blood lettiþ, þat may be knowen bi ful replecioun of þe veines of al þe bodi, bi reednesse & extencioun of þe face, bi swetnes of þe mouþ, bi flating [flating, Add. MS. wlattynge. See Wright Wü. O.E. wlatung.] / Whanne þat a man is fastynge, bi heuynes of þe browis, & bi ȝong age, & his complexioun is hoot & moist, & þat he haþ vsid in his dietynge wiyn and fleisch; & make him þanne be lete blood of þe veyne þe which þat bryngiþ norischinge to þe lyme, & aftirward of þe veyne þat mai best voiden þe membre þat is hurt / & if þat þe blood trespace oonly in qualite, amende him as if þat he be to hoot, voide him a litil & diete him with colde metis & stiptik. & aftirward procede forþ in alle maner oþir causis as it is told in þe general chapitle, takynge hede þat þer ben summe maner medicyns whiche þat ben driynge & clensynge, & han a priuy [privy. See Cathol. Angl., pryvay, occultus.] propirte to consowde

olde woundis whiche þat ben difficult to be consowdid; of þe whiche medicyns summe ben symple & summe [folio 51b] ben compouuned / Symple ben: limature of iren, flour of bras brent, vitriol leed brent, & alle scharpe corosiuis if þat þei ben brent; for þat þei han vertu more to consowden, & also her corrisoun is lessid / þis is a medicyn compounned: take floris [Lat. flor. æris.] eris, limature of bras ana. [ounce] j. litarge of gold, litarge of siluir, [dram] .viij. gumme of cipresse, [dram] .iiij. sal gemme, [sal gemme. A Salt so named, from its Transparent and Crystalline Brightness.—Kersey.] [dram] .ij. aristologia I-brent smal to poudre of frankencense, ana. [dram] .v. wex & oile of mirtill þat suffisiþ // //

The .xv. chapitle of þe þridde techinge of þe firste tretis is of a crampe þat comeþ to a wounde /

Nessessarie þing is to a surgian to knowe þe causis of a crampe, þe which þat comeþ to a wounde þat schulde be heelid, & also þat he knowe þe disposicioun of him þat haþ þe crampe, & also what þing þat þe crampe is, þat he mowe resonabliche hele þe crampe / Þe crampe is a sijknes cordous eiþer neruous, in þe which sijknes cordis & þe senewis weren drawen to her bigynnynge; of þe whiche drawynge þat ben .ij. causis coniunct: þe toon is repleccioun of þe

senewe, þe oþere of þe corde, þe oþer is inanisioun. [inanisioun, Lat. inanitio. Vigo. Interpretation. "Inanition, emptyng."] He þat is of in-anisioun, [folio 52a] ofte tymes he haþ a cause goynge tofore as to myche euacuacioun of blood eiþer of sum oþer þing, as to longe affliccioun for long akþe, or ellis for þe appetite of þe sike man haþ ben longe tyme enfeblid; & þis comeþ litil & litil, & þe crampe þat comeþ of boþe þese causis may not be heelid. & he þat comeþ of replecioun haþ oon of þe .iij. causis goynge tofore / þe firste cause is to greet akþe / þe .ij. cause is cold / & þe .iij. cause is putrifaccioun eiþer rotynge / & þouȝ þat oon sengle cause sumtyme suffice to make a crampe, ofte tymes alle þese causis happen to come togiders / And þis crampe may be heelid or þat he be confermed, & aftir þat he is confermed seelden or neuere / A surgian muste þanne be bisy in al þat he myȝte, þat a crampe ne wexe not in þe wounde þat schulde be heelid, wiþ obuiacioun [obuiacioun, Lat. cum obuiatione defensiuorum.] defendinge þe lyme, þat noon of þe .iij. causis tofore seid ne come nouȝt into þe wounde: þe oon is in defendynge þe lyme from putrifaccioun / þe toþere is for kepinge þe lyme fro rotynge / þe þridde is to gouerne him from a greet akynge / for it is more sikir to defende þat a crampe [folio 52b] ne come not, þanne aftir þat he is come with medicyns þat is douteful or dredeful to

do awey / For if a feuere come to an heed or to a senewe þat is woundid, & if þe crampe folowe, euermore it is deedliche.

Take hede þanne to aswage þe akþe wiþ anoyntynge of oile of rosis, in doynge as I haue seid afore in þe chapitle of senewis þat ben woundid; for ofte tymes þe crampe comeþ fro woundis þat ben maad in þe heed or ellis in þe senewe / & if þat akþe were so greet, þat makiþ þe crampe for þe prickynge of a senewe or ellis of a corde / & if þat þou myȝtist nouȝt defende þe crampe neiþir wiþ blood letynge, neiþer wiþ ventusynge, ne wiþ clisterie, ne wiþ suppositorie, ne wiþ defensif in anoyntynge þe necke, ne þe grynde, ne þe arm hoolis, þanne it is nessessarie þat þou kutte al atwo þilke senewe or þilke corde þat is prickid, þouȝ þat þe felynge or þe meuynge of þe lyme to whom þilke senewe or þilke corde serueþ in parti or in al be lost / For it is bettere þat a man lese þe felynge & þe meuynge of a lyme, þan for to deie. But it is bettere, if þat þou cowdist, to kepe a man þer-fro with oþere [folio 53a] medicyns þan þat þe senewe or þe corde be kutt al atwo. & if [if, above line.] þat þou were not at þe bigynnynge, & þou fyndist a man hauynge þe crampe for a wounde, do þou as I dide at melain. Þer was a scoler of myn þat was a surgian þat was clepid Olyuer, which þat curide a scheþere

of a wounde þat he hadde in þe heed; & bi þilke wounde þe pannicle ouþir þe skyn þat keueriþ þe brayn panne þat is vnder þe fleisch was hurt, & neuer-þe-lattere þe brayn panne was not hurt. & þilke leche, or þanne he hadde perfiȝtlich purified þilke pannicle, sowdide þe wounde wiþoutforþ [wiþoutforþ, extrinsecus, from without.] ; & whanne þilke wounde was sowdid, þe pannicle þat was not weel heelid hadde a dedein [dedein, Lat. panniculus indignatus causa fuit spasmi. The translator misunderstood indignatus, and gives us an "indignant pannicle." indignatus, Med. Lat. damaged, hurt. See Tommas. s. v. indegnare 3.—Compare þe ludych lorde—hade dedayn of þat dede.—Allit. Poems, B. 74.] & was cause of gendrynge of a crampe in þilke wounde. & at þe laste I was clepid to þe sike man, & I foond him hauynge þe crampe, & wiþ þe crampe he hadde manye smale enpostymes aboute his face—& þat is an yuele tokene in þe woundis of þe heed—& þanne I demede him for deed / Neþeles at þe instaunce of hise freendis I wolde asaie þe worchinge of kynde vpon resoun; I made his heed to be schaue, [I made his hed to be schaue, abradi caput feci.] & I kutte aȝen þe wounde þat was [folio 53b] consowdid wiþ a rasour to þe depþe of þe same wounde, & aftirward I fulfillide þe wounde with hoot oile of rosis, & I anoyntide al þe heed with þe same oile of rosis & a litil vynegre medlid togidere, & I anoyntide þe nolle & þe necke oonly wiþ oile of rosis, & I dide on þe wounde þe ȝelke of an ey wiþ oile of rosis, and I boond al

þe heed wiþ a boond leiynge þer vndir herdis [herdis. See Wright Wü. 614. 2. "Stupa, herdes."] or towȝ smal I tosid, and I openede his mouþ & putte into his mouþ þe broþ maad of a chiken, wiþ comyn & also wiþ cleer wiyn medlid wiþ myche water; on þe morowe I turnede aȝen & I foond þe sike of bettere disposicioun, & I openede bettere his mouþ, & he spak bettere; neþeles I foond þe wounde drie, & þanne I dide ofte tymes þe same medicyn & þe same oynture. In þe þridde dai þe skyn of þe heed was maad moist, þe which was bifore as drie as þe skyn hadde be rostid at þe fier, & in so miche [þat, inserted.] þe skyn was maad þinne, þat þer was no þing bitwene þe skyn & þe brayn panne. & at þe laste þe wounde quytturide wiþ contynuaunce of þe same cure tofore seid, & in þis [folio 54a] maner þe ȝonge man was heelid boþe of þe crampe & also of þe wounde / But þilke crampe was wiþoute feuere; for I may not þenke þat I haue seen a feuere in þe woundes of þe heed, or ellis of þe senewis prickid a crampe, þat nouȝt aȝenstondynge remedie eiþer medicyns þe pacient þat hadde þe crampe diede / My beste counseil is to lete him blood in þe bigynnynge þat haþ þe crampe, namely, & he be strong & replete, & if þat he haue not bled ynouȝ at his woundis; & anoynte his nolle & his necke wiþ hoote oynementis as wiþ oile

of nardine, euforbine, oile of rue, [rue, ruta. Turner, Herbal, ii. 122 b. Ruta is named in Greke Pegamon, in English Rue or herbe grace, in French rue de gardin, in Dutch Weinraut.] lilijs et cetera / & also to make smale cauteries punctale, þat is to seie as smal as þe eende of a pricke, bitwene ech whirlebon of þe necke, so neuere-þe-lattere þat þe cauterie go not ouer depe / Aftirward bynde long wolle to his heed bihynde & to his necke & to hise schuldris, & do þeron hoot oile, & leie him in a soft bed & lete him be in reste & in pees / But þer ben summe þat setten in her bookis medicyns þat prouoken þe feueris; for þat ypocras techiþ in .iiijto afforismoris: a spasmo [Cramp and Tetanus. See Notes.] vel tetano [folio 54b] habito febre [febre superveniente, error for febris superveniens.] superueniente soluit egritudinem / þat is to seie: if þat a man haue a crampe or ellis a tetane þat is a sijknes þat halt þe membre lich streit on boþe sidis as a crampe halt þe oon side of þe membre & þe feuere come on þilke crampe eiþir þilke tetane, he distrieþ þe crampe eiþir þe sijknes; & also þei anoynte wiþ to hoot an oynement to prouoke þe feueres, þe which þing I ne apreue not in þe crampe of a wounde þouȝ þat þilke oynement myȝte be profitable in a crampe wiþoute wounde, & where þat humouris abounde, namely, if it be fleume.

Summe ben general tokenes & summe ben special of schewynge of þe crampe / General tokenes ben þese: to greet akþe, crokidnes [crokidness, Lat. obliquitas.]

of iȝen, & crokidnes of schewynge, & crokidnes of eeris, of þe nose þrillis, & of þe lippis, & whanne þat a man may not speke, & þe cheke be constreyned & difficulte of meuynge, and namely, of þe necke, & ofte constreynynge togidere, & a sodeyn schakynge togidere. Special signes maken oon of þre maner of crampis: þe toon is clepid amprostonos [Latin, Emprosthotonos.] , þe toþer empistenos [Latin, Opisthotonos.] , þe .iij. tetanus / In þis maner of crampe þat is clepid amprostonos, [folio 55a] þe senewis tofore ben drawe togidere / þe fore partie of þe heed is crokid, þe sike man may not heuen it vp, he beriþ his chyn as it lijþ on his brest, & his mouþ is streit & he may not opene it, & þe fyngris of his hand ben folden into his fist / & in empistonies þe necke is crokid, his mouþ is open, hise chekis ben open, & þe fyngris of his hand ben streyned bacward / & þe tetane halt þe boþe parties of þe body, so þat he may not turne his necke to no partie but al þe bodi is stif & streyned, as a staf were putt yn at his necke & out at his ers / Alle þese tokenes or ellis summe of hem schewiþ þe disposicioun of him þat haþ þe crampe / And whanne þat þese tokenes fallen in þe wounde of þe heed, or ellis of a senewe þei techen bettere þe leche to fle from þe sike man þan on him to abide & cure /

¶ The firste tretis is eendid wiþ þe help of almyȝty god. Now with þe help of þe same, go to þe secunde /