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

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

[folio 31a] Assit Principio Sancta Maria meo

[CONTENTS.]

Þe ffirste tretys of surgerie halt with inne hym generall Rulys & Canons, & hath þre techynges. þe ffurste techynge of þe furste tretys haþ þre Chapyttles. Cap. j. of þe furste techynge of the firste tretys of dyffiniciones & of partyes þat beþ suggettys to surgerye. Cap ij. is of qualite, fforme & Maners of a Surgien.

¶ Cap. iij. ys of Intencioun of a Surgien. Þe secunde techynge of þe ffyrste tretys ys O summe & on Chapitell of a notamye, þat is to sugge þe knowlechynge of þe forme, & þe complexion, & þe helpynges of alle þe synwes, veyne, grustlys, brawnys, guttys, bleddre, lyuere, Mylte, & alle oþere senglere lymes, & of þe engendrynge of þe child in þe modire wombe. The þridde techynge of þe firste tretys hath xv. Chapytells. Cap. j. on of þe þridde techynge, of þe þridde tretys, ys a comyn worde of woundes & olde woundes.

• ...

• ¶ Cap. ij. off helynge of a wounde y-makyde in flesch.
• ¶ Cap. iij. off helynge of a wonde y-makyde in þe synwe.
• ¶. Cap. iiij. of a wounde in þe bon.
• ¶. Cap. v. of a wounde y-makyd with smytinge.
• ¶. Cap vj. of a wounde to bolled & out of kynde, to hote oþere to colde
• ¶. Cap. vij. of a wounde of a wod hound, oþere a venymouse beste.
• ¶. Cap. viij. of a wounde þat is out of Ioynte & to-broken.
• ¶. Cap ix. of to myche fflux of blod of wounde.
• ¶. Cap. x. of dyotynge of men þat beþ y-woundyde.
• ¶. Cap. xj. of olde woundes
• ¶. Cap. xij. off a ffestre
• ¶. Cap. xiij. of a cancre y-woundyd
• ¶. Cap. xiiij off causes þat lettyde helynge of woundes & olde woundes
• ¶. Cap. xv. of crampe þat comyth to wounde

¶. Þe secunde tretis is of particulers woundes of alle lymes of office from þe hed to þe [folio 31b] ffot, & techynge þe Anotamye of alle lymes from þe hed to þe fote, þat happyde to be woundyde; & þou haddist

to forn þe Anotamye of veynes & synwes, & oþere smale lymes, & so whanne þis tretys is fully endyde þou hast anotamye of alle lymes of thy body. And þis tretys under summe conteynde x. Chapyttles.

• ¶. Cap. j. of þe secunde tretys is of woundys of þe hed, and hys Anotamye.
• ¶. Cap. ij. is of woundes of þe face, & anotamye of þe same vysage.
• ¶. Cap. iij. of Anotamie of þe nekke, and of þe woundes of þe same.
• ¶ Cap. iiij. of woundys of schuldre. Armys & hondys, & Anotamie of þe same.
• ¶ Cap. v. of woundes of þe brest, and lymes þat beth wiþ ynne the brest, & Anotamye of þe same.
• ¶. Cap. vj. of woundes of þe ruggebone & of whirele bonys of þe rugge, & Anotamye of þe same.
• ¶. Cap. vij. of woundes off the wesand þat goth to the stomak, & of þe stomak, & þe guttes, & þe wombe, & Anotamie of the same.
• ¶. Cap. viij. of woundes of þe lyffere & the splene.
• ¶. Cap ix. of woundes of þe ȝerde, þat ys thyn pyntel, & Anotamie.

• ...
• ¶. Cap. x. of woundes of the hanche, thyes, ffet, and Anotamye.

¶ Þe þridde tretis is of cures of oþere seknesse, þat beþ noȝt woundes þat mowen falle to dyuers lymes from þe hed to þe fote, þat comyn to be helyde off a surgien, & haþ þre techynges: þe furste techynge of þe þridde tretys hath viij Chapyttles:

• ¶ Cap. j of the furste techynge of þe þridde tretys ys off Ornamentys of heer. p. 178
• ¶ Cap. ij ys of ffallynge off heer & of scabbe. p. 180
• ¶ Cap. iij of whelkys in þe vysage, & scalys and crustlys p. 188 [folio 32a]
• ¶ Cap. iiij of Morfu, ffrakles, 1Goute, rosed of þe vysage, & Cicatrices of woundes p. 189
• ¶ Cap. v of ȝycchynge & scabbe p. 191
• ¶ Cap. vi of drye scabbe & wete scabbe p. 193
• ¶ Cap. vii of lepre, & of knowlechynge of leprys Man p. 196
• ¶ Cap. viii of fastnynge a lene lyme, & to lenen a fat lyme p. 199
• ¶ þe secunde techynge of þe þridde tretys is of apostemes, & hath xvij Chapittles
• ¶ Cap. j of þe secunde techynge of þe þridde techynge, of generaciones of humour & here lyknesse p. 201
• ¶ Cap. ij of vniuersel word of enpostemes p. 204
• ¶ Cap. iij of enposteme of the hed & watire congregated in children hedys. p. 214
• ¶ Cap. iiij of emposteme undire þe rote of þe ere. p. 216
• ¶ Cap. v of aposteme of þe nekke & þe þrote. p. 217
• ¶ Cap. vj of Aposteme undire þe Arme hole. p. 222
• ¶ Cap. vii of Aposteme þat comeþ in the arme from þe schuldre to þe Elbowe. p. 223
• ¶ Cap. viij off Aposteme þat comyth on þe sydes. p. 224
• ¶ [Cap.] ix of Aposteme þat comeþ aboute þe Mouth of þe stomak. p. 226
• ¶ Cap. x of apostem that comyth in þe grynde p. 226
• ¶ Cap. xj of aposteme þat comyth in þe hanche & þe thyes. p. 227
• ¶ Cap. xij of Aposteme off þe pyntel & þe ballokes p. 228
• ¶ Cap. xiii of scrofules & glandeles, þat buþ Curnellys þat comyth in þe fflessch p. 229
• ¶ Cap. xiiij of Cancre þat is nouȝt to-broke, & is cure p. 231
• ¶ Cap. xv of bocche þat hongyth as swynes babbe undire here nekkys p. 232
• ¶ Cap. xvj of Akþe of Ioyntes p. 233

• ...
• ¶ The þridde techynge of þe þridde tretys haþ xviij Chapittles
• ¶ Cap. I of seknesse of eyȝen, & Anotamye of þe same p. 240
• ¶ Cap. ij of seknesse of þe eren p. 254
• ¶ Cap. iij of seknesse of þe nose p. 258
• ¶ Cap. iiij of seknesse of þe mouth p. 260
• ¶ Cap. v of seknesse of a wommans tetys. to grete, to fatte, 1oþere to lene. p. 265 [folio 32b]
• ¶ Cap. vi of ciphac þat is to-broke, oþere that is to lose p. 268
• ¶ Cap. vij of brokyn ballok p. 269
• ¶ Cap. viij of stone in þe bleddre p. 273
• ¶ Cap. ix of hermofrodite, þat is to seye, þat hath þe schappe of Man & womman, & oþere of wommen þat haþ scyne withynne here schape / þat sche ne may nouȝt conseywe þe seed of man
• ¶ Cap. x of water of men þat beþ in þe dropsye p. 281
• ¶ Cap. xj of fycus, þat is, a waxynge up on þe hed of þe ȝerde cancre fleynge, bocche in þe pyntel & olde wounde. p. 287
• ¶ Cap. xij of emeroydes, festre & rogadyes, þat beþ slyttes in þe Erse p. 289
• ¶ [Cap.] xiij of cancrefis & malo mortuo, þat buþ olde sores & olde scabbys on þe schyne. p. 293
• ¶ Cap. xiiij of veynes þat buþ to grete in þe legges, & of þe leggys þat buþ to grete out off kynde of flesch p. 295
• ¶ Cap. xv of wryncles, & chynes of handes, & kybis on þe ffete, & wertys, & oþer schyn lyke flessch p. 296
• ¶ Cap. xvj of helpynges þat buþ in blod letynge p. 298
• ¶ Cap. xvij of helpys þat buþ in brennynge with yren oþere with gold p. 305
• ¶ Cap. xviij of helpe þat is with brennynge of fyre, hote watyr & oyle p. 312

¶ Þe iiij tretys is of wrenchyngis of lymes, & haþ tweye techynges, oþere tweye summes.

• ¶ þe firste techynge of þe furþe tretys haþ vij Chapyttles
• ¶ Chap j of broken bonys an vniuersel word [missing]
• ¶ Cap. ij of bonys þat buþ broken of þe face p. 313
• ¶ Cap. iij of bonys þat buþ broken of þe breste p. 316
• ¶ Cap. iiij of bonys þat buþ brokyn of þe rybbes, & þe rugge bon. p. 317
• ¶ Cap. v of Armys þat buþ broken p. 318
• ¶ Cap. vi of bonys þat buþ bende withouten brekynge p. 321
• ¶ Þe 2Secunde techynge off þe ffurþe Tretys haþ v Chapytells [folio 33a]
• ¶ þe firste chapyttle of þe secunde techynge a comyn word off wrenchynges out of Ioynte [missing]
• ¶ Cap. ij of dislocacioun of þe cheke bon. p. 314
• ¶ Cap. iij of dislocacioun of þe rugge bon. p. 322
• ¶ Cap. iiij of dislocacioun of þe schuldre & about þe schuldre p. 323
• ¶ Cap. v of dislocacioun of þe þyȝe bon & withynne p. 326

• ...
• ¶ The ffyþe tretys is Antidotarie, & hath withynne hym vij chapitells
• ¶ Cap. j of castynge abache, & þe manere how þou schalt caste abacch p. 328
• ¶ Cap. ij of resolueres & manere of vndoynge & makynge nessche p. 333
• ¶ Cap. iij of Maturatiuis, þat buþ Ripers p. 336
• ¶ Cap. iiij of Mundificatiuis, þat beþ clanseres p. 339
• ¶ Cap. v of glutinatiuis & consolidatiuis, þat buþ closeres & consouderes, & þe difference of hem p. 342
• ¶ Cap. vj of hem þat maken nessche hardnesse p. 353
• ¶ Cap. vij of Cauterisinge, that is to sugge brennynge, & opnynge þe extremites p. 349

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[figure]

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

[figure]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

¶ Now begynneþ þe secunde tretys off particuler woundes of membris of office from þe hede to þe ffot, and ffirste y begynne at the Anotamye off the hed.

Al thynge breffliche y-ordeynde, aftere þe devysinge of my Symple wytt, whiche þat longith to þe firste tretys of this [folio 69a] boke whiche þat holdyth certeyne rulys & techynges off surgerye vndire general chapitelis, as we han byheyȝt. Now we wylle begynne to tretyn of certeyne cures, aftere þat þe lymes ben in mannys body. & firste y wyl begynne at þe hed & at hys anotamye, & so þe processe forþ to eueryche membre devysinge þe Anotamye of euery membre, & in ordeynynge þe cures of woundys þat beþ made in eche sengle membre, I sigge þat þe hed ys made of þre partyes: of a ffleschy party, a bony partye, and a braynie partye. Þe fflesch partye is aboue þe brayn panne, whiche þat is made of an herye skyn; & þilke skyn ys fulfylde with brawnys in euery place. Þe

herys off þe hed were for grete proffyte y-ordeynde, þat neiþere colde ne hete ne scholde noȝt sodeynliche entre þe pores of þe skyn, & neuere þe lattere þat þe fumosyte of þe hed myȝte go out be þe pores þere as þe here growyth, and þat þe hed myȝte be þe more semlykere, and þat þe coloure of þe herys myȝte schewe þe complexioun of þe hed. Þe skyn þat is abouen þe breyne panne ys lacertos & ful of þykke flesch, þat he myȝte wreyen þe breyn panne, þat he scholde noȝt fele to sodeynlyche neiþere to grete hete ne to cold. Þe whiche skyn ys made of sotyll þredys of synwes þat comeþ from þe brayn & of veynis & of arteryes sotylliche y-mad; and so þe skyn of þe hed ys sotylliche y-Ioyned with þe skyn off alle þe bodye, and also þe skyn of þe hed ys more þykkere þenne þe brayne scolle, þat it scholde be more rare & more porose þat is to sigge more ful of holys. Þe lacertes of þe skyn proceden after þat þe goynge procedyth of þe herys, þe brayn panne ys mad of manye bonys. Þe fyrste summe, whiche þat wiþholdyth þe profites þat longyth to þe brayn panne, haþ tweye helpynges; on helpynge ys, þowȝ þat an hurtynge come to on bon, neuere þe latere he scholde noȝt fallen to alle þe bonys; þe secunde helpe is þat on bon þat is to harde in on partye, ne scholde noȝt be so [folio 69b] hard in an oþere

partye. Secunde summe, whiche þat withhalt helpynges, þat beþ vnder þe brayn panne, haþ with hym iiij helpynges; þe whiche helpynges beþ ful mad be þe semys þat beþ of þe breyn panne. Ne þo helpynges ne myȝte noȝt be mad, but ȝif þat þere were manye bonys. Þe firste helpe ys, þat þe veynes myȝte go doun by the semys of [of above line.] þe brayn panne, berynge norosschynge to þe same brayn.

Secunde helpe ys þat þe synwes, þat comyth out of þe brayn, myȝte habbe wey in goynge out. Þe þridde helpe ys, þat þe fumes of þe brayn myȝte habbe wey of smokynge out. Þe ffourþe ys, þat neiþere dura mater ne pia mater, þere as þey ben y-hongyde, ne myȝte noȝt greue þe brayn. Sytthe þat þe breyne panne ys made of two smeþe lyȝte tablys, þat one ys aboue & þe oþere byneþe, & þey be sumwhat spongyouse in þe myddel & rare, þat þe smokys of þe hed myȝte þe bettyre passen out, & þey be smeþe þat þey myȝte noȝt greue þe brayn. Dyuerse men þat makyth dyuerse Anotamye devydeþ þe breyn panne dyuerslyche. Somme nowmbryth mo bonys. þenne summe oþere spekyn of; but soþenesse ys that þere ben sixe; & one whyche þat susteyneþ þo sixe. Þe ffyrste bon ys clepyde þe bon of þe [þe above line.] fforhed oþere ellys coronale, & he bygynneþ from þe browys, & lastyth vnto þe seme þat departyth þe hed

twarte offere. And þylke bon is y-clepyde coronale: þis bon hath in some manere of men a smal seme in þe ffoldynge of þe fforhed, & þere fore sum men siggeþ þat þere beþ tweye bonys. Tweye oþere bonys beþ y-Ioyned wiþ þylke bon coronale in þe myden of þe hed twarte offere, & þey ben y-bounde togedyre by one Iucture, þe whiche þat strecchiþ from tofore to byhynde, by the lengthe of þe hed, þe whiche ys y-clepyde sagyttalis by as myche as he ys schapyde lyke an arwe. And þese tweye bonys beþ y-clepyde Nerualia, by cause of þe ffigure of the seme þat ys wiþ þe coronale, [folio 70a] ys þe ffigure of a synwe oþere of a corde. And þese bonys ben in þe heyest coppe of the hed, and behynde in þe nolle þere ys a bon whyche þat is y-clepyde Alauda, & ys y-made to þe Symilitude of þis cyffre of Augrym

[figure]

, whiche þat ys Ioynede with þe bonys nerualibus tofore seyde, by þe mene of on ȝem y-mad to þe lyknesse of þe bon tofore seyde. & þese þre ȝemes whiche þat Ioyneþ togedyre þe foure bonys to fore seyde, ben y-made as yt were tweye [MS. tweye twice.] ȝawes, whos teth joyned eche of hem in oþere in thys manere /

[figure]

& þis ioyninge togedire of on bon with an oþer was y-made by-cause Iuvamentes þat y haue tolde beforn; þere nys no bon y-ioynede with an oþere as þese bonys ben. Undire þe bon þat ys

y-clepyde Alauda, þere ys a ful harde bon & y-holyde in þe myddle, þe whyche bone susteyneth alle þe bonys of þe hed. Þe whiche bon ys y-clepyde Passilus, & he ys ioynede byneþe wiþ þe fyrste bon of þe nekke. Þe schappe of þe coniuccioun of þe fife bonys of þe hed ys in þis manere

[figure]

. Bothe on þe ryȝte syde & on þe lefte syde of þe forseyde bonys whiche þat beþ y-clepyde nerualia,* whiche þat beþ in lengthe in þe heyest place of þe hed, þere ben twey bonys on eiþere syde*; þe whiche þat beþ vndiresetterys to þo bonys þat beþ y-clepyde nerualia; & þo bonys þat vndire setten, ben y-clept ossa mendosa. And þese bonys in one partye ben ful harde, þere as þe hole of þe ere passyth þorwȝ, & þey ben y-clepede [MS. petotra.] petrosa & sum men siggen þat þere ben foure bonys, two on eythere syde. & whanne þat alle bonys of þe hed be Ioynede togedire þou schalt fynde in sotfastnesse, þat þere ben but sixe bonys whanne þat þou reknyste os [MS. as.] coronale ffor on bon, & tweye bonys þat beþ y-clepyde mendose tweyne þat beþ þre, and o bon þat ys y-clepyde Alanda, & tweye bonys þat is y-clepyde nerualia—þat beþ sixe, and þe vij bon ys y-clepyde passillare, þe whiche ys nought of þe bonys of þe hed, but he susteyneth alle þe oþere bonys of þe hed. And þre maner of semys makyth coniuccioun of alle þe bonys on þis

manere

[figure]

, & with tweye semys mendose in þis manere

[figure]

. And whanne þat þe corone of þe hed ys perfyt, þe hed [folio 70b] ys mad in þis manere

[figure]

. Þis ys þe forme of an hed wel proporcionede, þat he be ronde because þat he myghte þe more withholde, & þat he myȝte þe lasse be y-hurt, and þat he be longewarped havynge tofore & behynde eminence þat is to sigge aperynge, þat þe synwes þat comyth out of þe brayn, myghte haue a porose place of goynge out. And naþelese as ypocras & galyen, whiche þat exponeþ ypocras, tellyn: it is possible to fynden þre oþere manere makynge of hedys. On manere is, ȝif eminence be noȝt in þe partye of þe hed tofore; for ȝif þat he be pleyn in þe partye tofore, by þat pleynnesse þe seme is y-lost þat is y-clepyde coronalis. Secunde ys ȝif þe hed haff non eminence behynde, but þat þe hyndore party be playn, and by þat playnnesse þe seme ys y-lost þat ys y-clepyde Alauda. [MS. Abauda.] Þe þridde ys ȝif þere be non eminence tofore ne behynde in þe hed, but alle þe hed ys rounde as a cercle. And þenne þere nys but on sem in þe myddel of þe breyn panne, ffor it is vnpossible þe hed to habben enye oþere schappe wiþouten lesyng of some party of þe brayn; & þat were contrariouse aȝeyne lyf. By þe myddele seme, whiche þat is in þe hed, þere dissendyth a veyne comynge

from þe lyffere, by þe breyn ponne, of a bon whiche þat is y-holyde. þat is y-clepyde pasillaris. And by þe same weye þere arysith an Arterye comynge fro þe herte, and þey ben Ioynde togedire, & of þe weffynge of þo tweyne þere is y-mad an hard pannycle þat is to sigge a cloth þat is vndir þe brayn panne, and he is hongyde wiþ sum smale ligamentys to þe brayn panne in some of þe semys, þe whych pannycle byndeþ þe bonys togedire, & it is clepyde dura mater. And yt is ryȝtful þat an Arterye scholde arysen vpwarde from byneþyne, for þe blod þat ys in hym þat is sotyll, & hys meffynge þat ys pulsatyff [MS. prilsatyff.] ; and he hadde discendyde from aboue dunwarde, he scholde han discendyde wiþ to gret [folio 71a] an hastynesse, but þe ascendynge temprith þulke fflux. And yt is couenable þat þe veyne discende, bycause þat þe blod þat ys in þe veynes ys more þykkore, & þe blod þat is in þe veyne geþ doun softliche. & boþe þese veynes þat buþ [buþ, above line.] pulsatyf & nouȝt pulsatyf beþ y-Ioynede wiþ dura matre. And also þowȝ þe veyne streche more lowere, & of hem ys engendryde pia mater. Afterward þey descenden doun to þe brayn. & þey bryngen lyf & dywe norysschynge & cordyal spirites, þe whiche is in þe brayn and þere is diffyede, & þere resseyueþ naturel forme of vnderstondynge. Pia mater environeþ al þe brayn, & departyth hym into þe þre celoles [MS. cololes.] þat beþ chaumbres:

þe firste, þe myddle, & þe laste. And þowȝ þat alle þese ben diffyede senglerlyche by hem selffyn, yt semeþ þat þe celele þat is tofore in þe brayn ys departyde in two parties, & by þat cause sum men siggen, þat þere ben foure ventricles of þe brayn. Þe furþere part of þe brayn ys gret & brod, by cause þat he scholde resseyue manye spirites þat ben y-sende to hym for þat place is propre instrement of y-maginacion, þe whiche resceyueþ þynges þat buþ comprehendide of fantasie; and þo þynges comen vndirstondynge resceyueþ by propre Instrementys þat longyth to hym, and þawȝ þat al þe brayn, in comparson of þe herte & of alle oþere membres of þe body, be y-demyde colde & moist, þis celule hauynge comparson to oþere celules ys y-demyde hot & dryȝe. Þe myddel part of þe brayn ys lasse þen eny of þe oþere two partyes, & here forme ys pyneat, brod towarde þe furþere syde of þe hed and scharpere towarde þe hyndor syde, þat he myȝte be þe more able to resceyue y-maginatyf þynges & þo þynges to ȝefe to þe ynnere partye & þo þynges þat beþ y-ȝefe to with holde. Þis ventricle ys y-sette bytwene tweyne additamentes of þe brayn, þe whiche additamentes ben y-liche þe two buttokkes of a man þat beþ y-Ioynede togedre, and þey beþ to *þis ventricle as yt were a syttynge place

oþere a couche, vpon . þe whyche he ys drawyne abrode, whenne þat he resseyueþ [folio 71b] y-maginatyff þynges. And afterwarde he ys y-drawe togedire as a worme, whenne þat he resceyueth y-maginatyff þynges; and whenne þat þe sentence of þilke y-magynacioun ys y-brought forth, þenne þilke ventricle ys y-drawe alonge. And also þe smallere ende of þis ventricle entrith into þe ventricle þat ys behynde in þe hed, and þis ventricle ys myche lasse þenne þe oþere tweyne bycause þat non synwes procedent not out of hym, and þat manye þynges myghte be endyde in litel* place, þat vertue of wytt myghte þe sonnere be y-gedryde togedre to taken hys counseyll. And thys ventrycle to comparson of oþere ventricles ys y-demyde hot & drye. After þat ys þe hyndere ventricle, whiche ys grattere & hardere þenne thys; þe whiche in *comparson of þe oþere tweyne ys y-demyde colde & drye, þe whiche is brod towarde þe fore partye of þe hed & scharpe bachwarde, þe whyche resseyuyth sentense þat beþ schewyde & kepyth hem priuyliche as a chest kepyth tresore. And out of hym goth out [in þe a, struck through after goth out.] nucha [nucha on margin.] þrowe þe hole of þe bon þat ys y-clepyde passilarys. And þilke nucha ys y-clothyde [MS. ys y-clothyde twice.] wiþ tweye pannycles þat goth out of þe brayn. And alle þe brayn ys y-demyde colde & moyst. bycause þat he scholde

atempren spirituel ffumosites þat comyth of þe herte, and þat he scholde noȝte ben y-dreyȝede fforto myche meffynge þat he haþ in worchynge of vertues. And þe brayn is whit bycause þat scholde resceyue þe bettere resoun & vnderstondynge. Ffor þese peyntores, whenne þey schulle peynten a table, firste þey maken yt whyte, for þere nylle none coloure lasten but yt be leyde vpon whyt; & it is þenne oþere rare, because þat vndirstondynge myȝte þe sonnere passe þorwe hym; & yt is nessche þat þe meffynges off vertues myghte þe betyre habbe place; & þe brayn ys towȝ, þat þe synwes þat goth out of hym, myȝte be þe [folio 72a] more towȝere, and þe more þat þey ben enlongyde from here bygynninge, þe more hardere þey scholde be; and also that þey scholde be bowable y-nowȝ nought aȝeynestondynge here hardnesse. And yt is necessarye þat þe brayn scholde be cloþed with tweye clothys, þat in hys meffynge as *y haue seyde tofore he scholde nought ben y-hurt of þe brayn panne.

Also þe brayn ys departyde into þre celules with þe additamentes of þe pannycles of pie [MS. pie, twice.] matris, þat þe spirites myȝt þe lengore dwellen in þe ventricles, to reseyfen by ordre, digestioun, forme & perfeccion, more þanne þey hadden fyrst of þe hert, and þat euery vertue myghte fulfylle hys accioun in hys ventrycle, ere

þanne þe foys þat ys comprehendyde myghte passe to þe ventricle þat ys sywynge. Nowȝt aȝeynestondynge þese propretes, þe brayn haþ sum substaunce of marie whiche fulfilleþ þe voydenesses of þe forseyde pannycleres. And þilke marye envyrownyth þe foreseyde pannycles, of þe whyche marye þere may sum partye in þe hurtynge of þe hed ben y-lost; and noȝt ageynestondynge þe goynge out of sum partye of þilke marye, a man schal noȝt deye. Ffor þis marye is nought of þe substaunce of þe ventricles of þe brayn, of whiche mynde ys y-mad; ffor þey ben of so grete noblete, ȝif þere be neuere so litel infectioun oþere ellys þat þere falle neuere so lytel a lesynge of hem, þey ben depreffyde of alle here helthe, in so myche þat on celele may noȝt ben y-lost, and a man ben saffyde, as manye ydyotes supposen. Anothomye of eynen, neose, erne, chekelappes, mouþ, tonge & teþ, we deferren to ordeynen in þe þridde tretys, in þe distyncioun whiche ȝif god wol, we þynkeþ forto treten of oþere syknesse of þe lymes, outsepte woundes. And þo hurtynges þat beþ y-mad in þe hed, oþere þey ben mad withouten wounde, oþere with wounde. & wheþere þat it be wyth wounde oþere wiþouten wounde, oþere þey ben with brekynge of þe brayn panne, oþere

without brekynge of þe breyn panne. And wheþer [folio 72b] þat yt be mad wiþ þe breche of þe brayn panne oþere withouten breche of þe breyn panne, some ben with hurtynge of þe brayn, some without hurtynge of þe brayn. And ryȝte as þilke hurtynges habben dyfference in toknes, so þey hauen differens in pereles & pronosticaciouns & maners, with þe whiche þey most ben y-holpen. And ȝif an hurt be in þe hed withouten wounde, as with fallynge, oþere with smytinge of a ston, oþere a staff, oþere with sum oþere thynge þat brusyth, and ȝif þat yt be withouten breche of þe brayn panne, & with outen hurtynge of þe brayn panne, it nedyth nouȝt but schaffynge of þe hed, & anoyntynge wiþ hote oyle of roses, and abofen þe vncture* to strawyn on þe poudre of þe seed of myrtylles, & streyne þe place with a band tyl al þe place be y-fastnyde & þe swellynge be y-vanschyd aweye. In þis manere þou schalt fastne al þe place, þat noþyng schal be corumped, oþere ellys þere schall dwelle a lytel corupcioun. And ȝif enye þynge of corumpcion abyde, þe place schal ben y-opnyde with an Instrument, & so alle þe quyter schal be excludyd, & he schal ben y-curyd ryȝt as oþere empostemys þat beþ y-woundyde. And ȝif þat þe brayn panne were y-broke withoute enye wounde of þe hed, þe whiche may ben y-knowe by dysposicioun of þe cause & eke of þe syke man, in byholdynge ȝif þat þat smyt

were stronge, oþere ellys þat þe syke haue y-fallen from hye place, oþere ellys þat he was y-smyte with stronge smytynge; and also ȝif þat he fel & myght nought hastlye aryse, and ȝif þat he hadde scotomye: þat ys to sugge a manere seknesse, whenne þat þere semyth as flyeȝes, oþere smale blake gnattys vleyȝen tofore hys eyȝen, oþere ellys he spyweþ hys mete, oþere he felyth to grete akþe in hys hed, and ȝif þat he may nought breken a knotte of a strawȝ with hys teth, and ȝif þe hed be smyten with a lyȝt dreyȝe staff, as of salwe oþere ellys pyne, and þenne leye þyn [folio 73a] ere to hys hed; & ȝif þat þe bon be hol. þou schalt heren an hol soun after þe comparsoun of þe soun of an hol belle & a bloke belle; also ȝif þat þou makyste þe syke man to holde bytwene hys teþ a þrede y-twyned & y-waxed, & þenne begynne to harpen with þy naylles vpon þe þrede faste be þe seke mannes mouth, & so harpe with þyne naylles vpon þe þred alle wey streyned, in makynge soun to þe ende of þe þred, & þilke þred schal ben of lengþe from þe mouth be þe space of a Kubyte; and þou schalt harpe so ofte tymes, & ȝif þat þe pacient mowe susteyne þe soun, he haþ noȝt hys brayn panne y-broke; ffor ȝif hys breyn panne were broke, þe seke man myghte nought susteyne þe soun of þe þred. Alle þese signes oþere ellis manye of hem betokne þat þe breyn panne is broken. And to þe

laste signes beþ more serteyne þenne enye of þe oþere. And vnderstonde þat þe breyn panne may ofte tymes ben to-broke, & naþeles þe brayn felyth nought in þe bygynninge none hurtynge. But afterwardys ofte tyme of hurtynge of þe brayn panne þe brayn ys y-hurt, Galien wytnessynge; the brekynge of þe bonys of þe hed ys dyuers in perelys from brekyng of oþer bonys of þe body, for þe accidentes whiche þat fallyth ofte tymes to þe breche of þe brayn panne. Ne þere nys no man, ne neuere ne was, þat myȝte euyre more helpen to alle accidentes whenne þat þe brayn was meffyde in þe bygynninge, þat nouȝt ageynestondynge his helpe, be he neuere so gode a leche, þat þe syke ne moste deye. Euyle accidentes whiche þat *comyth to þe accidentes of þe brayn & of hys pannycle, ben alwey dwellynge: as constipacioun of þe wombe, oþere ellys flux of þe wombe, oþere ellys crokydnesse, oþere ellys lokynge a-squynte of þe eyȝen, oþere ellys wepynge of þat on eyȝe, oþere ellys an hard scotomye, oþere ellys ffebylnesse of alle þe vertues & chaungynge. And noȝt only anymal vertues, þat beþ vertewys of þe brayn, beþ noȝt y-chaungyde, but also naturell vertewys, & lyfy vertewys sensyble & motifes; sensible, for þat þey seen noȝt

also [folio 73b] priuye vertues ben y-trublyde as ymagenatyff, ffor þey beleffe þat þey seen, *þat þey seen nouȝt; also resonable vertue, for þey speken in deveyn, & þey answeren whanne þey beþ nouȝt y-askyde; also memoryal, þat þey þynke nouȝt on here owne name; also meffable vertue ys so myche y-greuyde, þat vnneþe þey mowe nouȝt mefen hem namlyche aboute þe nekke. Þey syken greuouslye, and a scharpe ffeuere fallyth, þe whiche a rigoor goth tofore. A rigoor nys nothynge ellys but as yt were a prikynge of nedlys oþere of nettlys in þe flesch, and ȝif þis rigoor come with a ffeuyre oþere ellys with outen ffeuyre, yt is worst signe, and ȝif the crampe folwen, yt ys dedlye. Also þese beþ yuele accidentes: blaknesse of þe tonge, bleynesse [bleynesse, leady colour. See N. E. Dict. s. v. bley; mistake for bleynes, blains.] aboute þe chyn oþere þe chekenesse, oþere in enye oþere partye of þe hed þenne in* þe wounde, ys an yuele signe, and sum tyme blod comyth out at þe erys & noseþrylles. And ȝif þe more partye of þese toknys, oþere ellys alle comen, þe syke man moste nedys deyȝen, namlye & þo Accidentes contynewen, and specialy ȝif þat þe syke man haue y-be tofore manye daies in gode disposicioun, & after þilke disposicioun þese yuele accidentes fallen;

ryȝtfullyche, for boþe herynge & oþere comyn wyttes ben y-trublyde; but sumtyme in þe bygynninge euyle accidentes comyth, afterwarde, by good gouernayle & by gode helpe of the leche, þese euyle accidentes ben departyde & good comyth, & þenne yt is a good* signe, for it betoknyth strengþe off kynde, hauynge non drede of þe syknesse & konyngnesse of þe leche. O holy gost, al thynge fulfyllynge, al þinge sanctifyinge, lytnynge & gouernynge, opyne þe eyȝen of hem þat redyn in thys booke, þat þey mowen vndirstonde þat þynge þat is wel seyde, & þat þey mowe demen þorwe þy clernesse þat þat [MS. at.] ys euyle seyde, specyaliche in pas where þat only nouȝte y þat am vnwys & vnkunnynge, but also grettere maistryes & more kunnynge han y-writen dotousliche. & haþ y-sett in þis cas [folio 74a] dyuerse vnderstondynges. Ne þey ne y ne fonde non wey in þis [Heading of the page: Cure of symple Wounde off þe hed.] werke þat myȝte maken vs sykere, specialiche in grefynges of þe breyne panne, in whose cure dyuerse men han wrought dyuerslye; y wyll begynne at a symple wounde of þe flesch & of þe hed, in þe whiche þat þere ys non hurtynge of þe brayn ne of þe brayn panne. Byholde whar þilke wounde be mad with a swerde oþere enye þynge semblable to hit, & þan sowen þylke wounde, & caste abofen þe

poudre of lym tofore seyd, and do alle þynge be ordre as yt is conteynede aboue in þe chapitell off wounde of þe flesch; and ȝif þat a wounde be mad in þe hed with a brusynge, as with a mace oþere a staf, oþer with enye þynge þat brusyth, þanne it is necessarie to leggen abofe þe brusynge a maturatyf, y-mad of foure partyes of water, & on partye of comyn oyle & floure of whete, þat suffiseþ to maken yt þikke, tyl þat þe matere þat is brusyde be matured; þe whiche maturatyff schal be do abrode on a cloþ & y-leyde to þe wonde, & þou schalt fulfille þe wounde with oyle of roses & þe ȝolke of an neyȝe, [neyȝe at the beginning of a line.] & lenet of an olde lynne clout y-medlyde to gedre, tyl þat þe wounde ȝif quyter & þe akþe be aswagede. & afterwarde leye in þe wounde dreye lynet of lynne cloth, & fille þe wounde full of þe same lynet, & leye aboue þe mundificatyff of mel rosat & barlye mele, tyl þat he be perfitlye clansyde, & leye aboute þe wounde fro þe begynnynge, tyl þat þe wonde be perfitlie clansyde, a defensyf of bol armonyak, þe whiche y haue tolde of ofte tymes; afterward incarne hit—þat is to sigge, brynge ouere flesch, & afterwarde consoude yt; and ȝif þat þis wounde touchith þe pannycle þat bynde þe bonys togedre, þowȝ þat þe bon be nouȝt to-broken,

charge yt noȝt litel but take þere of gode hede, & do in þe wounde hot oyle of roses don to þe pannycle, tyl þat þere be non akþe in þe wounde. & kepe þilke wounde, as þou woldiste kepen oþer wondys of þe brayn panne & of þe brayn, fro colde & from hete; ffor colde ys most greuest to bonys & to pannycles þat beþ woundyde. [folio 74b] Þere ben some manere of men þat leggen withouten forth on alle manere wondys of þe hed, wheþere it be wiþ wounde of þe brayn panne oþere without wounde of þe brayn panne, in what manere þat þe hed ben y-hurt, a lynnen cloth y-wett in þe oignement y-made in þis manere: ℞ whit resine [pound]. [one half]., oyle of roses [dram] v., whyt wex [dram] iij., þey melten all togedres in an erthyne panne, & þey maken þere of on body, & þey boyllen yt afterward in gode wyn by þe space of an Oure; & þey leten afterwarde nyȝh colden, & þey weten þere ynne a pece of lynnen cloth, & þey schapen þilke pece with a schere aftere þe wounde ys, & þey baþen þylke pece in gode wyn, & þey leggen þilke pece on þe wounde,* and anon afterwarde þey leggen on þilke pece on eiþere syde of þe wounde a plumacyole, y-wet in good hote wyn, & þey leggen on a drye pylwe of herdes vpon þo tweye wete pylwes, þe whiche dreye pylwe schall comprehende þe tweye wete & bynden hem faste; and þey ȝeuen some men to drynken gode

wyn, & to eten gode fflessch of capouns & of hennys; & þey comaunden to drynken a drope watere; and þey gouernen on þis manere alle men þat ben woundyde in þe hed differentlyche, & þey sigge þat mo [MS. no.] men ben y-helyde by þis manere cure þen dyȝen. But by as myche as alle auttorys beþ aȝeyns þis cure, namlyche in dyetynge, y ne was neuere hardye to preuen þis manere of cure; ffor in mannys bodye a medycine schal nouȝt ben preuyde, whiche þat is noȝt acordynge to resoun; ffor alle auctores acorden, þat þere ys noþynge þat so sone greuyth þe brayn & þe synwes as wyn doþ, and vsynge of flesch ys cause of bryngynge in an hot Emposteme. Neuere þe latere ȝif a man þat vsith of custome swyche a manere dyetynge haffe a stronge hed, & in hys hele he dredyth non wyn, & þe vertue of hym þat ys seek [folio 75a] be stronge, in some manere of folk with þis manere of gouernaylle vertue ys more y-streynþed, & sunnere þey ben y-helyde. But y ne procede nouȝt wiþ swyche a manere dyetynge, by cause of drede leste an hote empostome scholde come to þe sore; but y procede in dyetynge & worche aboute þe wounde, as y haue seyde toforn. Oþere men loken* in brekynges of þe brayn panne, wheþer þat þe brekynge of þe breyne panne be with a gret wounde oþere a smal wounde, oþere without wounde; and ȝif

þat þere ben a gret wounde þey loken wheþere þey mowe seen ȝif enye pece of þe brayn panne ben to-broken, & þey don yt awey. And afterwarde þey putten bytwene þe brayn panne & duram matrem a þenne clout y-wett in þe whyte of an eyȝe, & sumwhat þe whyte compressyde out, & þey fulfyllen alle þe wounde of þe brayn panne with swiche a manere cloth. & þey leggen in þe ofere wounde whiche þat ys in þe flesch, lenyt y-wett in þe whyte of an eyȝe, tyl þat þe blode be staunchyde; & þey leggen aboue a plumacyole y-wet in an eyȝe. And whanne þat þe blode ys y-staunchyde, þey leggen a dreye cloth vndire þe brayn panne in þe wounde, and þey leggen aboue þe wounde a potage, the whiche engendryth quytere; & whenne þat þe quyter ys engendryde, þey leggen in þe wounde carp oþere lyneth of a clout; and þey anoynt [At the end of the line.] aboute þe wounde with oygnement fusco; and at þe laste ende þey leggen aboue Apostolicon. And þey assayen in þis manere: ȝif þat þe brekynge of þe brayn panne be with a rimele, þat ys to seye a chyne, oþere a creueys; & ȝif þat þilke creveys perse to wiþynne, makynge þe syke man to streynen hys mouþ & hys nese, & þey

maken hym þenne to blowen, & þey loken ȝif enye þynge exale out by þilke rymele. *& ȝif þat enye þynge exale out by þylke rymele, as blod ore enye oþere matere, þey drede noȝt to perce þilke rymele; and þenne some sigge þat þilke rymele scholde be to-broke oþere y-perced. from þat one ende to þat oþere with Rynspyndles, persynge þe braynscolle. [folio 75b] A rynspyndell ys an Instrument þat Cutlers poudren wiþ here hefftes, whose ffigure schal be schappyde [MS. scharpyde. rp for pp, like lk for kk. See p. 120.] in þe same chapitle ffolwynge. And þe worste þynge þat a man may do, ys to perce þe rymele on boþe sydes. But oþere men don bettyre whiche þat percen þe rymele at þat one ende, whyche is moste hongynge; and þey maken as many holys on bysyde an oþere, as beþ necessarie to maken an hole in þe brayn panne, be þe whiche hole ȝif enye þynge beþ [þ above line.] fallen vpon þe duram matrem myȝte ben y-clansyde; & þese in as myche as towchynge trepanacioun worchith best. And whenne þat þey haue made manye holys, þey kutten from on hole to an oþere with an spatymyne, [Lat.: cum spatumine.] þat ys an Instrument, þat þey mowe drawyne out þe bon, þat ys betwene þe ordre of holys þat was y-made & þe rymele, & þey casten hym aweye, afterwarde

þey proceden forth in oþere manere thynges, as yt is seyde tofore. And whenne þat þou desiriste þe wey of trepanynge, *þis manere trepanynge suffiseþ to þe in þe rimeles of þe brayn panne. Þis schal ben þe forme of a trepane, *with þe whiche þe brayn scolle schal be trepaned wiþ

[figure]

. And þis is þe forme off a spatimene, with þe whiche a man schal kutte with from on hole to an oþere hole

[figure]

. And þou schalt smyten with a Mal oþere an hamere vpon þe gret ende; and whenne þou haste remefed of þe bon þat schal be remeffyde, euene þe brynkes wiþ schauynge, þat þere mowe noȝt lefe non manere scharpnesse in þe brynkes. Þis ys þe manere of þy schafe

[figure]

, and þis schafe schal kutten on þe syde þat feldyth inwarde, & schal be blunt on þe syde þat ys outwarde. And þenne fulfyllen þe wounde þat is in þe flesch, wiþoutforþ as y haue seyde tofore, with cloþ expressyde of þe whyte of an eyȝe, & lynet to þat þe wounde be ful, and also tyl þat þe kynde haue regeneryd a repeyrement, þe whiche schal fulfylle þe place where þat þe bon was don awey. [folio 76a] Afterwarde þey cure þe wounde aftere comyn cure of wondys. Alle oþere manere of trepanacioun ys comprehendyde vndire on Somme, þowȝ þat sum men ordeynen partyklerliche aftere here devyse, dyuerse maners. But be as myche as y haue noȝt seyne in þis place no wey þat myȝte remefe

me fro doute, by as myche as y haue assayede longe tyme boþe by sum auctores experyment, & also by myn experyment, & þat wey is noȝt certeyn, þerefore here þey Galien, whiche þat seith: ȝif we mowe romywe quyter without doynge awey bonys þat scholde be do awey, hyt is good. And Auisene & Serapio acorden to þe same sentense of cure of hed-akþe, þat comyth off smytinge oþere ellys of fallynge, where þat he techith þe worchynge of hurtynges of þe brayn panne & of þe brayn, noȝt by trepanacioun, but by emplastres & by medycines. And also y toke gode hede þat manye mo men ben y-helyde by manere medycines & emplastres, þenne ben y-helyde by trepanes þat beþ persynge oþere þryllynge. Ffor y ne vse noȝt Instrumentes to remywe þe bon, but in tweye cases—þat on cas ys ȝif þat þe breyn panne be so myche y-scleud, þat þe part þat ys y-broke entre vndire þe partye þat ys hol, þe secunde cas ys ȝif þat enye pece be departyde from þe brayn panne, whyche þat pryketh duram matrem. In þe firste cas dura mater ys compressede. In þe secunde cas dura mater ys y-prikyde, þe whiche ys cause of akþe, & akynge ys cause of drawynge of humoures, the whiche engendrith a posteme vpon þe same pannycle, the whiche is cause of a [a, above line.] crampe, & of oþere accidentes tofore seyde, & at þe laste þey bryngen deþ

to þe pacient. In þese tweye causes y am constreynde to remefe a bon with handly Instrumentes. In alle oþere manere of breches oþere of crefeys, in what manere þat þey happen, þowȝ þat y be noȝt sykere of þe paciente, naþeles y procede in þis manere with more trest, by sechynge alweye help of god, þe whyche þat haþ y-helyde mo men [MS. m, en cut away.] be myn handys, þat am hys Instrument, þenne han be ded, nouȝt aȝeynestondynge al my cauteles & [folio 76b] helpynge. Ffor sytthe þat y haf beholde sotelyche þe resouns & þe processes of oþere auctorys, y holde þis wey lesse dredful þenne enye oþere. Ffor y folwe þe sentence of galien, which þat seiþ: ȝif þat a man hath but o wey to hys hele, hyt ys gode þat he holde þilke weye, þowȝ þat þilke wey be euell. And whenne þat y come to a Man þat is woundyde in the hed, & knowe þat hys breyn panne ys to-broke, by þe tokenys tofore seyde, ffirste y considere þe vertu of hym þat ys pacient, & also hys age & alle oþer [oþer, above line.] partyclere thynge, & namly vertue. And gladliche y leue þe cure, ȝif þat y se enye dedlye signes; but ȝif þat so be þat y be preyde wiþ the grettere Instaunce of þe frendes of þe seke man. And noȝt aȝeynestondynge here preyere, y telle hys frendys þat by resoun þe pacient scholde

deyȝe, & þenne y wirche aboute hym, as y worche in a Man in whom yuel accidentes apere. And ȝif þat þe signes be nought dedlyche, & þe breche of þe breyn panne be with a gret wounde of þe hed, & þat a grete partye of þe breyn panne be don aweye alle togedre, so þat y mowe han a gode wey to legge medycynes vpon duram matrem. ffirste y do schaffe hys hed, afterwarde y legge an olde lynnen clout & a þenne, y-wett in two partyes of oyle of rosys swote smellynge, & on partye of mel rosat colat bytwene þe duram matrem and þe brayn panne, slyȝlye & softlye, þat dura mater be noȝt compressyde with þe cloth þat ys y-wett tofore seyde, & y fulfille þe wounde of þe fflesch with lynt of olde lynnen cloþ wet in þe ȝolke of an eyȝe & oyle of roses, of boþe y-lyche myche; & y anoynte aboute þe wounde with deffensyfe of bol armonyak ofte tymes seyde, & y legge abouen þe wounde a plumacyole whiche þat schal keuere alle þe wounde, and þenne [folio 77a] abouen alle togedre y legge a grete plumacyole in-wet in gode hot wyn. And afterewarde y bynde þe wounde with a bande, in byndynge ofte tymes aboute þe hed, þat þe lynet & þe cloþ whyche þat is in þe wounde & aboute þe wounde myȝte noȝt slyde to non partye, and y bynde þe wounde in þat manere þat dura mater be no weye be compressyde. Þe

herys of þe hed schul be remywede awey on þis manere: clippe hem firste with scherys, afterwarde take two partyes of colde water & on partye of oyle of roses in somere, & make hot þe same watyr & þe oyle in wyntere & wassche þe hed softliche, takynge hede þat non watere ne oyle entre into þe wounde, & þenne schaffe yt with a rasoure. & whenne þat y haue seruyde þe pacient on þis manere, y lete hym resten tyl on þe morwe; and afterwarde y serfe þe wounde on þe same manere tyl þat þe wounde be hol. Naþeles y consydere ȝif þat þe pacient be replet of blod, & hys vertue be stronge; & ȝif þat he be ȝonge, & lytel blod haue nouȝt go out of hys wounde, & whanne alle þese þynges acorde, y make hym to by leten blod on þe coral veyne of þe arme; & but ȝif he mowe schiten, y helpe hym onys a day, oþere wiþ suppositorye oþere wiþ clisterye; and y procede in dyetynge as y haue seyde in þe chapytell of dyetynge. And whenne makyth sufesentlyche quyter, y legge in þe wounde of þe brayn panne & vpon þe brayn panne as y haue don toforn, & above þe wounde y legge a mundyficatyff of mel rosat colat & barlye mele, tyl þat þe wounde ben y-clansyde, & þat þe dura mater be y-soudyde wiþ þe breyn panne; & þenne y caste in þe wounde of þe hed, poudre y-mad on þis manere: ℞ ffrank Ensence, ciperi, þe

note of cypresse, sede of mirtylles, mirre ana. ȝ. i., oreby. ȝ. j., mak poudre & leye þis poudre in þe wounde, & aboue þe poudre leye þe þredys of lynne cloþ oþere ellys lynet; and aboffe al togedire y-legge an entrete [folio 77b] y-made of two partyes of whyte resyn & on party of wex y-molten togedre, & vpon stronge Vynegre, & y-colyd þorwe a þenne streynoure vpon [MS. o pound.] colde water; & whenne þat þyne hondys ben anoyntede with oyle of roses, & malaxe yt longe tyme togedyre. In somere take euene porcioun of whyt resyn & of wex; in wyntere take foure partyes of —* & þe ffifte partye of wex, & y-drawe abrode þilke tret on a cloþ & legge yt.on þe wounde, tyl þat he be perffitliche cycatrysede. And ȝif þat þere were anye —* of a bon. whiche þat prekyde duram matrem, þenne y aforce me to remeffe þilke partye þat prykeþ with pynsones ȝif y may. And ȝif þilke partye þat prikeþ ys y-ioynede so faste to þe hol bon þat he nyl nouȝt be remeffyd awey, þenne y remeffe hym aweye wiþ rugenynge. from þe partye þat halt, in makynge an hole, oþere two, oþere mo, after þe quantyte of þe bon þat scholde be don awey,* þat halt with þe hole bon; & afterwarde y kutte with a spatymene from on hole

to anoþere tyl al þe bon be remeffyde aweye.* And whenne þe bon ys remefyde awey, y procede in þe cure, as yt is seyde in þis same chapytell. But whanne þat y remeffe a bon with Instrumentes of þe brayn panne, þenne y stoppe þe syke mannys eres, þat he mowe noȝt here þe sonn of þe eyren þat trepanyth. And y remeffe þe same manere, þe partye þat is broke, whiche þat goþ vndire þe partye þat ys hol, & compressyth þe dura mater; and ȝif þat a gobbet oþere a pece of a bon helde sumwhat in þe wounde, & myȝte noȝt lyȝtlye be remeffyde awey, and he prikyde nouȝt ne compressyde nouȝt duram matrem, þenne at þe bygynninge y do on þe bon hot oyle of rosys, and y fulfylle þe wounde with oyle of roses & þe ȝolke of an eyȝe y-medled togedire, tyl þat þe bon be y-nesschyde, and mowe lyȝtlyche be remywede aweye; þenne y remeffe þe bon, & y procede in worchynge bytwene þe bon & duram matrem, as it is seyde tofore. & ȝif þat þe breche of þe breyn panne [folio 78a] were as a cerfes, oþere ellys y-sclend, & neiþere party of þe bon were lowere þenne oþere, þen y consydere ȝif þilke sclendynge parten alle þe breyn panne, & þat þou schalt y-knowe by þe toknys tofore seyde, oþere ellys þou schalt y-knowe by þis signe þat neuere faileþ: make a plastre of þe poudre of mastyk & þe

whyte of an eyȝe, y-medlyde togedyre as þykke as hony, & distende it on a cloþ, & leye it on þe place þat ys hurt from morwe tyl euene, oþere ellys from euene tyl þe morwe. And whenne þat þe plastre ys remefyd awey, ȝif þat þe crefeys persith þorwe þe breyn panne, þou schalt se þe plastre more drye anonde [Over an erasure.] þe crefeys þen in enye oþer place, for þe gret hete þat comyth from þe brayn;* & ȝif þe breyn panne* be noȝt y-sclend þorwe, þe plastre schal be namore rye abouen þe creffeys þenne on an oþere place. And ȝif þe crefeysd perse nouȝt þe brayn scolle, þe cure is as yt is seyde in þe bygynnynge of þis chapytell, þere as y tolde of þe cure of wounde of hed, where þat þe breyn panne oþere þe brayn ys noȝt y-hurt. Ffor ȝif þat þilke ryemele persyth þe breyn panne, þere ys a gret doute in þe cas, ffor some seyne þat yt ys vnpossible swyche a wounde to ben y-helyde, but ȝif þe rymele be y-trepanyd & þat a quantyte of þe bon be y-don awey, þat þe superfluyte þat ys y-caste vpon duram matrem mowe be done awey, ellys þe dura mater scholde putrefien & be corupt, & by þat skylle þe pacient scholde deye, whiche þat myȝte be helyde by remywynge of þe bon. Naþeles y þat haue y-seye in trepanynge grete peryle, namlyche whanne þat

þe crefeys ys bysyde þe semys, where þat trepanynge ys dedlyche, and y haue seye manye þat wiþouten trepanynge almyȝtie god haþ delyuerede be myn handys, without touchynge enye brayn scolle with trepane oþere with eyren; but y helde into þe crefeys hote oyle of roses, and y legge aboue cloþes y-wett in mel rosat colat, & oyle rosat colat y-medlyde togedyre aftere þe doctryne tofore seyd, ffulfyllinge all þe [folio 78b] wounde wiþ swyche manere clothys, & afterwarde y legge aboue þe ȝolke of an eyȝe & oyle of roses y-medlyde togedres, and aboue þe wounde a defensiff of bol armonyac tofore seyd, tyl þat þe quyter be engendryd. & afterwarde y contynwe mel roses & oyle rosarum in þe wounde, & aboffe a mundificatyf of mel rosarum & barly mele, tyl þat þe ligament be fulliche engendrede on þe breyn panne, & þat þou schalt y-knowe whenne þat þou seste þe bonys Ioynyde togedre, as yt were tweye bordys Ioynede to gedre wiþ colle oþere wiþ glewȝ; & þenne y fulfylle þe wounde with drye þredys of lynnen cloþ, and abouen a mundificatyf tyl þat þe bon be keffride aboue. & þenne y strawe on aboue þe capytale poudre tofore seyde, & y legge on þe schaffynge oþere ellys þe rasure of lynnen cloþ, and abouen al þis y legge on a Tret of resyne; & y do alle þynges þat y haue seyde tofore tyl þe wounde be consouded.

And ȝif me maken an obiectioun how þat yt myȝte withouten arerynge of þe bon, þe blod & þe quyter be dreyede whiche þat fel doun by þilke sclendynge vpon þe duram matrem, I answere: ryȝte as þe matere of þe frenesie & þe matere of þe litargie þat is more doutes, by emplastres withouten forth leyd is desolfed, and þere nys none sclyndynge of þe breyn panne ne no wounde in þe skyn, myche more lyȝtlokere & more bettere þe blod þat is lyȝt & able to ben reselfyde, whiche þat wende done be þe forseyde sclendynge, may be þe forseyde sclendynge beter ben exaled. Ne þilke blod ys noȝt inviscat in þe substaunce of dure matris as þe matere ys in apostemys, wherfore he ys more obeyssaunt to* þe expulcioun of kynde, & also ys more obeyssaunt to the attractioun of medycine. And ȝif þe brayn panne be hurte wiþout wounde of þe skyn, þe whiche þou schalt y-knowen by þe toknys tofore seyde, þenne sum men kutten aboue þe hurtyng in þe manere of a cros, & þey areryn þe foure quarters, & þey kytten & flen þe pannycle þat keferith þe bonys, & afterwardes þey vsen trepanys & here oþere comyn cures, as [folio 79a] yt ys schewyde tofore. But y kytte noȝt þe skyn in manere of a cros, but in þe manere of a Schelde oþere ellys of a thynge þat ys tryangle in þis manere

[figure]

, & y make but on quartere & y vnwreye þe bon, þat þe oyle of roses may persen yn,

and þat þe vertue of þe medycine, þat ys y-mad of honye of roses & oyle of roses, may drawe fro byneþe þe brayn-panne; and y do in þis cas al þynge, as yt declarith nexte aboffe. And ȝif men make obiectioun aȝeyns me by constantine oþere ellys by hym, þat seyth þat by alle oure myght we enchewyn þat neþere oyle ne non vncomys [Corrupt, probably for vnctouys.] þynge falle noȝt withynne þe brayn-panne, I answere with Avecene, þat seyth: þat he wircheþ ryȝtfulliche þat vsith certeyne oyles, & þe same telliþ galien & serapion, and also y seye þat oyle of roses, whiche þat be mad of grapes of Olyue tres þat beþ noȝt ripe, is noȝt vnctuose, but is dreyȝe; & it is clepyde oyle Omfacinum, & namlye whanne þat roses ben y-medlyde with þat oyle, þilke oyle hath y-gete to hym a swete smellynge & a dreyȝinge, cumffortynge animal spirites; and also þilke oyle hath a vertue expressif, as galien tellyth in the bok of symple medycines, by þe whyche þe brayn ys conffortyde & akþes ben aswagede, & ȝif þere be mad enye gret blod, yt is y-made Sotyll; & whenne alle þese þynges ben y-gadryde togedyre & leyde abouen, dura mater ys clansed. Sumtyme þe brayn ys meffyde of sum gret hurt oþere of sum fallynge, oþere of sum smytynge withouten eny wounde ore enye

breche of eny bon, þan do þou as dyde y to a Chanoun of þe ordre of seint Austyn. Whanne þat he wolde haue lopyn vpon an hye hors and haue seten in þe sadyll, þe hors areryde vpon hys two [folio 79b] hyndere fete, & þilke chanoun fel doun bakwarde vpon þe erthe on hys hed; & alle hys bodye was y-brusyde, and namlye aboute þe hed þat anon he lost þe ffelynge & þe meffynge of alle his bodye. Þanne a lewyde leche þat was frende to þilke Chanoun was y-clepyde, & he couþe helpe hym noȝt, for he had neuere seyne þe same cas, ne he ne couþe noȝt on lettre. And at þe laste y was clepte, & y fonde hym noȝt herynge ne spekynge ne nothynge mevynge, I demyde hym for ded, and naþeles sauyde, ȝif þat he were my broþere y nolde nouȝt for an hundrede mark, but y sayede in hym þe godnesse & þe helpynge of medycines; ffor ofte tymes kynde with gode werkys helpith preueliche þat semyth vnpossible to a leche. And þenne þey preyede me with gret Instaunce, and y made the herys of hys hed to be schaffen and þenne y anoynt all þe hed with þre partye of oyle of roses, & on partye of vyneger hot y-medlyde togedyre, & y caste abouen þe poudre of mirtylles, and y leyde abouen a sotyll þenne cloth y-wet in þe same oyle & vynegre,

& aboue þat towȝ smale y-tosyde, & y bonde alle þe hed with a band, & abouen y leyde a lambys skyn, & so y chaungede yt twyes euerye day; in anoyntynge þe nolle & þe nekke into þe myddell of þe rygge-bon byhynde wiþ hote oyle of Camamylle. In þe secunde day he opnyde a lyte his eyȝen, & he bygan to loken aboute hym as it hadde be a deff man, oþere ellys a man þat were in a wondrynge; and þenne some wolden haue assayede ȝif þat he wolde eten, & y wolde nouȝt [folio 80a] Suffren hym to eten, & y seyde þowȝ þat he wolde eten he scholde noȝt. In þe þridde day y spak to hym, & he answerde me bablynge as a childe þat begynneþ to speke, but he myȝte formen non worde. [Lat.: verbum non potuit formare.] In þe fourþe day he spak bostynglyche, and þenne y gaf hym to drynke hot ydrosacre, þat ys y-mad of Sugre & of watyre. In þe ffyfte day he toke þikke [MS. þilke.] tysan. In þe sixe day y gaf hym þe broth off a chykne, & þenne he gan to strengþe litel & lytel & lytel, & lytel to meffen, & neuere þe latere he myȝte noȝt walkyn by manye dayes. And whanne þat he myȝte take Suffisauntlye mete, y comaundyde hym to take Pylulas Cochias, for to

resolfe by evacuacioun þe matere þat was y-gadrede togedire in þe hed by þilke fallynge. And y comaundyde hym to eten ofte þe braynes of briddys hedys, as of hennys & of smale bryddes, & also of kyddes; and in þis manere he was hol; naþeles he was neuyre so sotyl of wyt as he was tofore. In þis cas buþ yuele signes: as þe face to be crokyde, & þat on eyȝe to loken asquynt oþer crokydlyche, apoplexie, crampe, to schyte wiþout felynge, & vnmevablete of alle þe membris outsepte þe lacertes of þe brest þat mowe be saff. He þat redith þis bok may chesen after hys owne wyl, one of þre weyes whiche þat beþ now y-vsyde, þat on ys þe wey whiche þat ys seyde in þe bygynninge of þis chapitell, þe whiche weye many vsen, and a leche o Ianewe þat is y-clepyde Anselme vsith þis weye, & þereby he gat myche moneye, naþeles y wyste wel þat manye men dyȝeden in his handys by þis wey. Þe [folio 80b] secunde weye is in alle manere hurtynges of hed to vsen terebracioun, oþere ellys remeffynge of þe bon with handlyche Instrumentes; þe þridde ys my weye whiche þat y haue tolde opynlye in

alle manere of cas; and y beleue ȝif þat he wyl take hede to alle þese weyes, & þat he wyll wyslye dyscussen þe opyniouns of Auctores, þat he schal se fewere dyȝe be my þridde weye þenne by enye oþere. Almyȝtie god lede þe redere of þis werk in þe beste wey, þorwe whose myȝte, wordes takyth sentence & echyn vnderstondynge. Þowȝ þat we han behoten to treten of Anotamye of membres þat ben componed, in þe bygynninge of euery chapytell of this secunde tretys, naþeles we leuen yt for þe bettire for to treten of þe Anotamye of þe vysage, to þe þridde tretys, where we schulle tretyn of seknesse þat comyth to þis membres, whyche seknesse beþ non woundes.

¶ Cap. off woundes of þe face & Anotamye of þe same.

Woundes þat ben made in þe face, oþere þey beþ mad with a swerde, ore wiþ sum thynge ellys þat woundeþ, oþere þey ben mad wiþ prikynge of a knyf, arwe, oþere spere. Yt is necessarye, þat a surgyne haue more diligence in þe woundes of þe face, for it is a place þat is myche y-seyne, & yt ys wel y-do to make a sotyll cicatryce. A wounde þat ys mad with a swerde oþere with sum þynge

semblable þat is alweye in lengthe, a man moste sotylliche sowyn & gedre þe parties of þe wounde. And for þat many men lyȝen [folio 81a] of þe wounde of þe nese, þey seyȝen þat on bare hys nose y-kytte of in hys hande, þe whiche nose was afterwarde y-sette aȝeyne in hys owne kynde; þe whiche ys an opyn lesynge, for þe spiryt of lyf of felynge & of meffynge passith aweye, whanne a membre is departyde from þe body. I wylle begynne at þe wounde at þe nese þat is y-kutte in lengthe, wose cure ys lyȝt to hele; brynge þe parties togedre of þe wounde & sowe hem, & wirche aboute the wounde as y haue seyde tofore in þe chapitle of wondes. And ȝif þat þe nese were y-kutte twarte offere doun to þe ouere lippe, & naþeles þat þe ouyre lippe & þe nose were noȝt kutte al awey, but þat it helde faste at boþe þe endys of þe wounde, þanne sette aȝeyne þe nose in his propre place, þe noseþrellys yche aȝeyns oþere as þey were tofore, & make two smale tentys of wex, & putte in boþe þe noseþrellys aboue þe wounde, ȝif þat þou maist, & þenne make a poynt by þe space of a litel fyngere from þat on ende of þe wounde, & an oþere poynt at þe oþere ende of þe wounde, and an oþere poynt in þe myddel of þe nose anentys þe forhede; & afterwarde a poynt on eiþere syde of þe nose, afterwarde make a poynt* betwene evyry poynt, so þat þou haue in noumbre of alle þe poyntes,

whenne þey ben ful mad, .IX. Caste þe poudre þat is tofore seyde vpon þe wounde, þat is y-mad of lym, ffrank ensence, sancdragoun, & take whyte of an ey & oyle of roses and bete hem togedire, & leye þereynne a lynne cloþ & leye abouen þe wounde, aftirwarde [bynde]* þereto þre plumaciolus, one [folio 81b] vndireneþe, & on on þat o syde, an oþere on þe oþere syde; & þanne bynde þe nose wiþ tweye bandys, þat on schall holden vp þe nose þat he may nouȝt discendyn dunward, þat oþere schal be leyde aboffe þat he mowe kepyn þe plumacyolus, poudere, & þe sowynge. And þilke bande þat ys vnder þe nose þat halt þe nose vpwarde, schal be knett abouen on þe hed, and aftirwarde he schal be turnyde twarte offere þe forehed, þat he mowe holde þe bande, & þe nose declyne to neiþere syde. And þe bande þat ys leyde aboffe þe nose, schal be bounden behynden in þe nolle; and afterwarde he schal turnen aȝeyne aboffe þe nose, holdynge þe plumacyoles þat þey mowe noȝt wagge on neythere syde aboute þe sewynge; & aboute þe forhed þou schalt legge þe deffensif of bol, and aftirwarde þou schalt worche on þe wounde of þe nose as y haue seyde in a wounde of flesch in þe firste tretys. Þe woundes þat beþ y-mad in oþere partye of þe face as with a swerd ore oþire þynge semblable, brynge hem togedire, sowe hem, & cure hem, as yt ys conteyned in generall chapitle of woundys, takynge

hede hereto, þat þe sowynge þat ys y-mad in þe face, schal be more sotyl & fairere, þanne in enye oþere party of þe body. And þou maiste maken a sowyng in þe face, ȝif þat þe wounde be nouȝt to myche, on þis manere. ℞ mastyk & sangdragoun & poudre hem & tempre hem togedire wiþ þe whyte of an eyȝe to þe þyknesse of hony, & wete þereynne tweye pecys of lynnen cloþ as longe as þe wounde, & leye one on þat o syde of þe [folio 82a] wounde, & þe oþere on þat oþere & lete hem dreyȝen, and afterwarde make þe wounde sum what to blede, & þenne brynge þe partyes of þe wounde togedires; & sowe þilke two pecys togedres, & caste aboue þe poudre of lym, ffranc ensence, sancdragoun tofore seyd, & wete a cloþ in þe whyte of an eyȝe & oyle of roses, & leye abofe al togedyre, and kepe þe partyes with ligature, & procede forþ in alle þynges as y haue tofore seyd. And ȝif þat þe wounde be y-mad with a dart oþere with an arwe, & þe arwe ben y-drawe out and þe wounde be myche y-sene, þenne þe cure ys þe same þat was seyde in þe same chapytell oþere ellys in þe firste tretys, wheþere þat þere be a synwe prikyde oþere none. But ȝif þat þe arwe-hed were entrygede in enye privy place of þe face, so þat yt myȝte nouȝt ben seyȝen, þenne euerye man bysie hym be his wyt, to knowe how þe seke man stod, whanne he was y-smete, & whennys þat þe arwe come, & to what party þe wounde strecchith, þat he mowe loke ȝif þat he mowe fynden enye manere

wey, how he may drawen out þilke arwe-hed; and þenne drawe hym out þe beste manere þat he may. And ȝif he may nouȝt, helde into þe wounde oyle of roses, & medle he oyle of roses & þe ȝolke of an eyȝe togedre, & helde into þe wounde, & wiþ þis medycine worche in þe wounde, tyl þat kynde schewe sum manere wey. Manye men han born an arwe-hed in þat partyes of here face by longe tyme; and aftere kynde haþ cast out þilke arwe-hed, oþere ellys haþ schewyde sum weye by whom þilke arwe-hed myȝte be taken out. And þou moste taken hede be al þy myght þat whanne þat þou sowyste þe woundes of þe face þat þe mouþ be noȝt crokyde, but make so slylye þy sowynge þat þylke accident may noȝt [folio 82b] ffallen; & þat þou maiste do wel, ȝif þat þou couþest ordeyn wel þy sowynge & ȝif þou couþest kepen wel þy sowynge wiþ plumacyolus & wiþ byndynges.

¶ Cap. iij. tretis ij is off woundes of þe nekke & Anotomye of þe same.

¶ By the nekke is contynwede alle þe place þat is bytwene þe hed & þe schuldres, whose Anotamye y wyll tellen as y haue behyght. ¶ Some men makyth dyfference bytwene þe nekke & þe

wesant & þe þrote-bolle, and alle þese be conprehendyde vndire þe name of þe nekke. In þe nekke þere ben vij spondiles—þat is to say, whirle bonys of þe rigge. Þe furste of þe bonys ys y-bounde wiþ a bon of þe hed þat ys y-clepyde passilare wiþ manye smale feble ligamentys; & þey weren feble bycause þat þilke Iuncte nexte þe hed myȝte meffe manye weyes. And þe cause why þat þere were manye smale lygamentes multeplyede in þat Iuncte, þat manye smale myȝte susteyne a grete burthyne as wel as a fewe grete; & ȝif þat þere were a fewe grete, þey were nouȝt so able to be meffyde. The firste spondyle ys y-bounden to þe secunde, þe secunde to þe þridde, þe þridde to þe fourþe, þe iiij. to þe v., þe v. to þe vi., þe sixte to þe sevenþe, þe vij. ys y-bounden loselyche to þe fyrste spondile [MS. Whenne þat þou reknyst from þe hed, struck through, after spondile.] of þe rugge, þat þe nekke myȝte more lyȝtlyche meffen, whiche ys clepyde þe viij. spondile, whenne þat þou reknyste from þe hed dunwarde.* vij. peire off synwes growiþ out by þese .vij. spondelis. Þe firste peire of synwe procedeþ out* bytwene þe fyrste spondile [folio 83a] & þe bon of þe hed þat ys y-clepyde passilare; þe secunde peire of synwes ys y-bore bytwene þe firste spondile & þe secunde, & so euery peire passith out bytwene euery spondile.

Þese Synwys buþ devyeded manye weyes by þe hed, & þe nekke, & þe face, & þe breste, schuldres, & þe armes; þe braunches of þe synwes of the hed in some place beþ contynwede & Ioynde with þese synwes. And þese synwes buþ y-clepyde meffynge ryȝte as þe synwes þat comyth of þe fore partye of þe brayn beþ y-clepyde felynge & þese habbiþ also felynge. Of þese Synwes þat comyth of þe spondlis of þe nekke þere beþ mad brawnys, þe whiche beþ instrumentes of mevynge of þe partyes. In þe nekke behynde, þere ben y-ordeynde opyn veynes comynge from þe lyffere whiche þat ascendyn to þe hed, and vndire þo Veynes þere ben Arteryes y-hud priuelyche, comynge ffrom þe herte & goynge to þe hed for notable profetes. And whanne þat þey han do al here office in þe hed, þey descenden doun by þe place þat beþ behynde þe erys & þey bryngen materie spermatice, þat is to say mater of sperme, don to þe ballokes, & þerefore it ys y-seyde: ȝif þat þo Veynes weren y-kutt, a man scholde neuere engendre. On þe ryȝt syde & eke on þe lefte syde of þe nekke þere ben y-ordeynde tweye nolles, þe whyche beþ of lygamente mater, þe whiche procedeþ out of þe bonys

of þe hed & of þe spondiles, & þey strecchen doun to þe ers in lengþe besydes þe spyne bon, & þey ben a couche & a restynge place to þe synwes þat comyth out of þe nucha. In þe fore partye of þe nekke þere ys gula whiche þat strecchiþ from þe chyn doun to þe furcle of þe brest; and bytwene þe nekke & þe gulam wiþynneforþ þere ys [folio 83b] y-ordeyned mery—þat ys to seye þe wesand; þe whiche þat discendiþ of a smal schyn environynge alle þe mouth withynneforþ, & so goynge doun to þe Stomak, & he ys hol & conteynde wiþ þe Stomak, & ys of Substaunce of þe same stomak, & he dissendiþ doun by þe hyndere partye of þe nek clevynge to þe spondelis; tyl þat he come to þe .v. spondile of þe rugge, & þere he ys departyde from þe spondelis and declyneþ into þe Innere partye tyl þat he perce þorwe þe mydryff, & he ys componed of twey pannycles, and in þe Innore cloþ þere ben brawnys in lengthe, by þe whiche drauȝte ys made of mete & drynke, and in þe vtter cloþ þere bene brawnys in brede by whom ys made castynge out of superfluyte; and he haþ non transversarye, þat ys to seye goynge twartoffere, ffor wythholdynge ys nouȝt nedfful to hym. And in þe fore partye of þe brest þere is y-set þe canne of longes, þe whiche ys componed off grustlye

rynges y-bounde togedire wiþ panycleris ligamentes, habbynge in þe Innore partye a ful smeþe pannicle Ioynynge togedire þilke grustly rynges. And þilke rynges, whenne þat þey ben ioynede with mery, þey ben defautyf anonde þe mery. And þe forme of þe canne of þe longes [is]* as yt were þe forme of a cane—þat is to say a reed, of þe whiche reed þe fourþ part were kutt away in lengthe, & aftereward þe canne ys y-wreye wiþ a sotyl cloth, þat whanne þat a grete mossell of mete passe doun be þe mery, he scholde han non lettynge, but þilke pannicle of mery ȝeuyth stede to þe grete mete passynge doun to þe stomak. Þe þrotbolle þat is mad of þre grustlys, ys y-sette aboue þese [folio 84a] two weyȝes. And boþe on þe ryȝte syde & eke on þe lefte syde of þe cane of þese longes, þere beþ tweye grete veynes þat beþ y-clepyde organice oþere ellys guydes. & vndire þe veynes þere ben grete arteryes, and of þe kyttinge of þilke Veynes & Arteryes þere comyth ofte tymes gret peryle & sumtyme sodeyne deþ; for þe grete afynite [a, above line.] þat þey han in þe herte & þe grete noyenesse þat þey han to þe lyffer, sennore by hem blod ys evacued, wherefore spirites exaleþ whyche þat buþ frendys, boþe to þe body &

eke to þe soule. Þe ligamente of þe þrote ys y-clepyd þe [þe, above line.] eminence oþere þe hekþe of þe epiglote, & in þe sydes of þe þrote þere is y-set gula. & þe goynge of brawnys, cordys, synwes, veynes, arteryes & here braunchys by parties of þe hed proceden aftyre þe ordre of heres, & þey ben ordeynde in þe nekke & in þe gula aftire here lengþe. And hereby þou maiste ysene, how þat yt is necessarye a surgyn to maken hys kuttynges, & hys brennynges by lengþe of þe nekke & of þe þrote, and þat þe woundys þat ben y-mad twarte offere beþ more perylose, þen þo þat bene in lengthe.

Wonde of þe nekke. ¶ Now we wyl tretyn of woundes þat beþ mad in þis place wiþ a swerd oþere with sum þynge semblable to hym, oþere wiþ an arwe, oþere with sum þynge semblable to hym. And ȝif it be wyth a swerde, oþere yt ys twarte offere ore in lengthe; and ȝif it be twart offere, and þere ben y-kutt grete Veynes oþere arteryes, hit ys gretly to dreden. Naþeles þou schalt helpe to staunche þe blod & to consoude þe veyne, aftere þe techynge tofore asygned in þe chapytle off fflux of blod. And ȝif þere be a synwe kutte, brynge þe parties of þe synwe togedyre, & sowȝ þe pellykles of þe synwe with þe sowynge of þe wounde, as y haue tauȝt tofore in þe [folio 84b] place of sowynge of synwes, and leye aboffe lumbricus of þe

erthe þat beþ erthe wormes y-stampyde & boylled wyth oylle of roses, & kepe þe sowynge with byndynge, and so procede forþ in alle þynge in þe cure, as yt is tolde in the chapitle tofore schewyde. And ȝif þat þe wonde were in lengþe, yt ys noȝt necessarie but forto sowe þe wounde & to casten aboue, þe poudre of lym, ffrank ensence & sank dragoun, & to kepe þe sewynge & þe poudre with byndynge, tyl þat þe wounde be ful consouded. And ȝif þat þe wounde were y-mad in þo parties with an arwe oþere a knyff, oþere a spere, oþere sum þynge semblable to hem, and ȝif þere be an arwe, drawe hym out, and ȝif þe arwe be drawen out, loke ȝif þere folwe emorosogie, þat ys to seye, a gret flux of blod, & þenne staunche hym aftere þe doctryne y-told tofore. & ȝif þere be non flux of blod, loke ȝif þere be akþe; & ȝif þere be akþe, put into þe wounde a lytel tente þat may holde þe wounde opyn al day, þat þou may se þat þe wounded man schal han non akþe. And ȝif he haue non akþe, lete þe wounde be consoudyde; ffor sum tyme it happith, þat an arwe, oþer sum thynge semblable passith þorwe þe nekke & þe þrote, & ȝit he touchiþ noȝt veyne, arterye, ne synwe, & þenne it nediþ noȝt but þat þe wonde be consouded. And ȝif þere were akþe oþere ellys a bygynnynge of swellynge, þan yt were necessarie to fulfylle þe wounde wiþ hot oyle of roses & to put in a tente noȝt to grete,

y-wett in þe ȝolke of an eyȝe & oyle of roses hot, & so holde þe wounde open to þat he ȝyfe quyter, & afterwarde clanse hym & afterwarde consoude hym. Nota: vndirstande þe peryles þat comeþ from wondys* þat ben mad in þis place. Þe firste [folio 85a] Perel ys: ȝif þat þe nekke be kutte twarte offere with a swerd, so þat þe nekke-bon & þe marye of þe nekke-bon be y-kut al atwo, yt is dedlyche; and ȝif þat nucha, þat ys þe marye of þe nekke-bon, is noȝt y-kut al atwo but ys y-hurt, yt is peryle of leosynge, ffelynge & meffynge, & at þe laste to be ded, but ȝif þe medycines þat y schal tellen afterwarde mowe helpen. And ȝif þat enye Veynes oþere enye gret synwe be y-kut twart offere, y suppose þat he be helyde, þe nekke schal neuere haue hys fre meffynge; and ȝif enye of the veynes organyk whiche þat beþ clepyde guydes, oþere ellys enye of þe arteries þat beþ vndire hem beþ y-kut, yt ys drede of sodeyne deþ, ffor sodeyne exalacioun of þe spirites & also for Afynyte of þe herte; & also ȝif þat þe canne off þe longes be y-kut twarte offere al atwo, for þe more partye it is dedlyche; & so it ys seyde ȝif þat þe veynes þat beþ behynde þe eres be y-kut al atwo, he schal nevire engendre. Also sum tyme ys y-kut oþere y-prekyde þe synwe þat is clepyde reuersiff, þat ys vndire boþe þe sydes of þe ere, of whose kuttynge oþere prekynge euere more ys mad horsnesse. And ȝif

þat place ben y-perced with an arwe, & þowȝ þat trachea arteria be y-percyde oþere ellys ysophage, so þat Nucha be noȝt þrillede be þe mydle, þey mowe ben y-helyde with gode medycines & acordynge. Þou schalt helpe Nucha þat ys y-hurt in þis manere: þou schalt helden into þe wounde in þe bygynninge oyle of roses & afterwarde leye aboffe oyle of roses & þe ȝelke of an eyȝe, and þou schalt be busy in alle manere to aswage akþe; & whenne þat quyter ys y-mad, þenne leye a mundificatyff wiþ medicynes confortatyff and [folio 85b] Incarnatyfes y-mad in thys manere: ℞. oyle of rosis colat .ȝ. iiij, with [wiþ for wex.] resyne ana. ȝ. ij, terbentyne ȝ. iij, frank ensence, mastyk ana. ȝ. i, mirre, sarcocolle, [MS. sarcticolle.] mumie ana .ȝ. [one half], barly mele .ȝ. [one half]; streyne it on a cloþ & leye yt on þe nucha þat is hurt. And þawȝ þat hereof euere more pronosticacion scholde go tofore whiche scholde sownen to yuele, naþeles by þis medicine þere comyth rectificacioun to þe nuca, & amelioracioun off mevynge of lymes þat beþ beneþe þe place of þe nuca þat ys y-hurt, more helpynge, þenne semyth possible to þe leche. For þere ys noþynge vnpossible to Stalworth nature; namlyche whanne þat yt is holpen wiþ a gode leche & wiþ þynges, þat beþ

helpynge & acordynge to a gode entencioun. Here vndirstande þat alle manere wounde þat persith to þe substaunce of þe brayn oþere ellys to þe nuca, so þat by þe hurtynge of þe nuca þe meffynge & þe ffelynge of some lymes ben y-lost, namlyche from þe whirlebonys of þe rugge, of þe reynes vpwarde, & alle manere wounde þat ys mad in þe extremites of þe lacertes as þre fyngremele brede in þe schuldres, oþere þre fyngre mele brede aboue þe elbowe oþere byneþen, oþere þre fyngre mele aboue þe kne oþere byneþene, & euery wounde þat ys in a synwye place with strengest akþe & hardnesse, schal be demyde dedlyche: ffor þe noblete of þilke brayn, & for þe Affynite of nuca wyth þe brayn, of þe whiche nuca passith as þe Ryuere from a welle, & for þe Afynite of þilke Synwes wiþ þe brayn, by mene of þe Nuca, of whom þey passen out as of a flod, wherefore [folio 86a] þou schalt euyre more in swiche manere woundes pronostiken deþ, and euere more fle as myche as þou mayst from vnresonable cures, but ȝif þou be wiþ þe more Instaunce y-preyȝede. Naþeles sumtyme nature with gode helpynges worchith þat semeþ to the leche vnpossible. Neuere þe latere loue non swiche cures* but ȝif þou be gretliche y-preyede, and þenne entyremete of þe cure of þe syke man.

¶ Capit. iiij. tretis .ij. is of woundes of þe spaude, schuldre, arme, handis, ffingres, brawnes, veynes, and here Anotamye.

Þe spawde ys one of þe iiij bonys whiche þat makiþ þe forme of þe schuldre, & þe spawde-bon is þenne & brode towarde þe schuldres & in hys endys grustly. On þe vppere syde of hym he haþ an egge sumwhat gret & towarde þe arme in þe place of þe schuldre he ys grete & rounde. And þilke ende ys holwe as a box, and þis bon ys lyche to a pele, þe whiche men settyth brede into þe ovyne, and on þe hyndere partye of þe schuldre he haþ an emynense. & in þe box of þis bon — —* whiche ys y-clepyde adiutorium þe whiche ys a bon sumwhat crokyde, gret & holowȝ. Þis bon ys gret for necessite of strengthe, & of schappe holwe, þat he were lyȝte, þat he scholde nouȝt þrowen his hevynesse lette þe wirchynge of lacertes, and þe rounde extremite of þis bon entreþ into þe holwenesse of the spaude. & þey beþ y-bounde togedre with a bowable ligament. Þe canel-bon of þe brest ys in this manere

y-made, habbynge an additamente sumwhat [folio 86b] rounde in þe neþere partye, þe whiche entryth a manere box, þe whiche ys in þe offere partye of þe ovyre bon of þe vij. bonys of þe brest. And euerye extremyte of þilke vij. bonys beþ y-Ioyned wiþ þe spawde, þat þe schuldre myghte be þe more strenger; and forto make þis place þe more strengere, þere beþ sette two smale bonys whiche beþ y-clepyde rostralis to þe lyknesse of þe byle of a crowe, & forto fastne þe schuldres, þis bon rostrale ys y-put in þe manere of a wegge. But þe bon of þe adiutorie haþ in þe neþere partye towarde þe elbowe tweye emynences, and þe on of þe emynence ys more herre þenne þe othire; and boþe þese emynence beþ as yt were half a bokett wiþ þe whiche men drawiþ water; and þilke tweye Additamentis beþ y-Ioyned with þe bonys of þe arme. Þe Arme from þe Elbowe dunwarde, haþ two bonys, and þe offere bon whiche þat strecchiþ from þe þowmbe þat ys clepyde adiutorium is smallere bon, and þe neþere bon þat strecchith from þe lytel fyngere to þe elbowe is þe grettere bon. & he haþ in þe offere ende towarde the elbowe an additament like to a byle oþere a pyk, and þilke pyk makyth þe elbowe scharpe, whenne þat þe arme ys y-folden, and it letteþ þat þe arme may noȝt ben y-bowyde bakwarde.* Þese tweye bonys beþ

so y-Ioynede togedire, þat it semyth as on bon. And þe neþere ende of þese bonys beþ y-Ioyned wiþ þe bonys of þe hande, whiche beþ y-clepyde rasceta þat beth viij bonys.

Here the Add. MS. ends.