The questyonary of cyrurgyens with the formulary of lytell Guydo in cyrurgie, with the spectacles of cyrurgyens newly added, with the fourth boke of the Terapentyke [sic], or methode curatyfe of Claude Galyen prynce of physyciens, with a synguler treaty of the cure of vlceres, newely enprynted at London, by me Robert wyer, and be for to sell in Poules Churcheyarde, at the sygne of Judyth. Cum priuilegio ad imprimendum solum.

¶Demaunde.

WHyther the scyence of the Natho∣mye be necessarye and nedefull to the Cyrurgyen or nat / & by howe many & what maners? Answere. Yee•• The scyence of the Nathomy is nedefull and necessarye to the Cyrurgyen / as it

appereth by two reasons. The fyrste Galyen put∣teth in the .vj. boke of his Terapentyke, and is su∣che, for the Cyrurgyens that be ygnoraunt in the Nathomy may arre in many maners in theyr in∣cysyon of synewes and theyr knyttynges, the whi∣che yf they knewe the nature of euery mēbre, their settynge and colligacion that they haue in all the body, and with euery onely membre partyculer / yf it dyd happen y^t they were hurt they shuld knowe yf the synewes were cut or nat. And by this same reason they shuld nat arre in theyr incisions. And this reason is confyrmed by an example y^t Henry de Maūdeuille putteth / sayeng that the same ma¦ner that a blynde man worketh in hewynge of a log, so doth a cyrurgyen that knoweth nat the na¦thomy. For lyke as a blynde man that heweth on a log knoweth nat howe moch he shuld hew ther¦of, nor howe, & therfore cōmonly he arreth hewyn¦ge more or lesse than he ought to do. Lykewyse so doth the Cyrurgyen that worketh in mānes body without the Nathomy. Also the sayde Henry ap∣proueth that the Cyrurgyen ought of necessyte to knowe y^e Nathomy, for euery workeman is boun¦de to knowe the subiect of his worke in whiche he worketh, or els he shulde arre in workynge. Tha•• lykewyse yf it so be that the subiecte of the Cyrur∣gyen be the body of menkynde, it must be of neces∣syte that the Cyrurgyen do knowe y^e body of man∣kynde in it selfe / and in the partyes therof, so tha•• it is necessary for a Cyrurgyen to knowe the Na∣thomy.

And this is for the fyrste parte of the que∣styon. ¶The seconde parte where is demaūded to howe many and what thynges the scyence of Na¦thomy is necessary to the Cyrurgyen. That is to wyte howe many proffytes and vtylities be of the scyence of Nathomy? The answere. The scyence of the Nathomy is necessarye and nedefull to the Cyrurgyen for .iiij. vtylyties. The fyrste and the greatest is for y^e meruayle of the great power of God the creator of men, that so hath made theym to his lykenes & forme. The seconde is for to haue the knowlege of the membres y^t may be dyseased. The thyrde for bycause to haue knowledge to tell the disposicions to come of y^e mēbres. The fourth is for to heale the dyseases y^t come to the mēbres. ¶Demaunde. What is Anathomye, and wherof is it deryuate? Answere. Anathomy is the ryght determynacyon and dyuysyon of euery partyculer membre of y^e body of mankynde. And is deryuate of Ana, that is to saye (nyght) that is to say (dyuy∣syon.) Thus Anathomy is called nyght dyuysyon of membres done for certayne knowleges. ¶De∣maunde. In howe many & whiche maners ought ••he scyence of Anathomy be taught? Answere. In ••wo maners. That is to wyte by way of doctryne as by bokes wryten therof. In seyng and redynge that which hath ben wrytē by aūcyent doctours / and by experyence / in deuysynge and Anathomy∣synge the deade corpses. As dyd Mundy and Bo∣••oyne, and as lykewyse dyd maister Bertruce, that

whan he had a deade body by beheadyng or other wyse / he layde hym on a benche in makynge .iiij. partycyons. In the fyrste he deuyded the nutratyf mēbres, for they be dysposed to putrefaccyon. And in the seconde the spyrytuall membres. And in the thyrde the anymall mēbres. And in the fourth the extremyties. And vpon euery mēbre ought to be sought .ix. thynges. That is to wyt the posycyon / the complexyon, the substaunce, the quantyte, the nombre, the fygure, the operacyon, the vtilite, and what dyseases may come therunto. ¶Demaūde. What is the body humayne? Answere. It is one hole togyther decorate with reason / composed of many and dyuers membres. ¶Demaunde. what is membre? Answere. Dyuers auctours haue gy∣uen dyuers diffinicions. G. in the fyrste boke of the vtylyte of the partycles sayeth it is a body that is nat holly seperate, nor holly conioynt to another. And also in the fyrst boke of his canon he defyneth it in plurell, and sayth thus, that mēbres ben bo∣dyes that are engendred of the fyrste cōmyction of humours. ¶Demaunde. Howe many maners of membres are founde? Answere. Two. That is to wyt, symple membres called consēblables, and mē¦bres compost. The simple membres ben they that may nat be deuided into another kynde, but what partie thou takest of them it bereth alway y^e name and the dyffynycyon of his hole. As the bone / for what parte thou takest of the bone be it more or lesse euer it beareth y^e name and diffinicion of the

bone, for euery parte of a bone in bone / and euery parte of a synew in synew. The compost membres contraryly be they that maye be deuyded in other kyndes, for no parte of them seperated bereth nat away the name of all. As the hande, the legge, the heade. ¶Demaunde. Howe many symple mēbres ben there? Answere. There be .xi. That is to wyte the bones, grystles, or cartilages, the synewes, the vaynes, the anteres, the pannicules, the s••rynges. The cordes, the skynne, the flesshe, the grece or fat, the heare, and the nayles. The whiche althoughe that verytably they be nat membres / neuertheles in asmoche as they haue vtylyte in y^e body of man kynde, & haue regeneracyon as the membres, they be called membres, thoughe it be vnproprely.

¶Demaunde. Yf all the mēbres may regenerate after theyr perdicion, & knytte agayne after theyr dislocaciō•• Answere. For to declare that behoueth two thynges to be noted. Fyrste y^t the symple mem¦bres be of two maners. Some be sanguyne mem¦bres of whom the generacion is of sanguyne ma∣ter, as the flesshe and the grece. And the other mē¦bres be spermatyke membres so named / bycause they haue theyr breding and begynnynge of spar∣matyke mater. Secondly it is to be noted y^t there be two maners of regeneracyon. One is very re∣generacion, whiche is very reformacion of the mē¦bre in the same selfe substaūce, forme, qualyte, and quantite, and other such accidentes proprely as it was afore the corrupcion and alteracion. And the

other is regeneracyon nat very / but lyke therto as nyghe as may be. And lykewyse there is .ij. ma¦ners of consolydacyon / one is trewe, that is when both the partes of the thynge that is dyssolued by seperatynge / and reassembled and knyt without any maner of apperynge of the dyssolucyon afore / and without any meanes. And y^e other is vntrue consolydacyon / and lyke to the other as nyghe as can be done, by meanes of the poore that the Phy¦sycyons call Porus sarcoydes. These thynges ••••¦derstande & noted / I saye fyrste that all sanguyne membres may regenerate and knyt by very rege∣neracion and consolidacion, for contynually there engendreth blode ynoughe within the body for to regenerate the substaunce of the sanguyne mem∣bre lost, & for to reconsolidate and knyt it agayne. I say secondly that no membres sparmatyf after the losse of theyr substaunce maye nat regenerate bicause that their mater is attribuate to them at the very begynnynge of theyr creacyon, and after that neuer engendre agayne. And also for theyr so lidite, & bicause they are weke of here & moysture. And for these causes and reasons they do nat re∣consolydate with trewe reconsolydacyon after the desolucion of their seperatyng, but nature streng∣thynge alwayes possyble thyng{is} the best that she may / wyl nat leue them thus dyssolute, reioyneth and knytteth them the best that she may / and en∣gendreth a flesshe (for to holde y^e dissolued parties) that is called porus sarcoydes. ¶Demaunde. Be

all the membres consemblables of one cōplexyon. Answere? No / for some be hote & moyste / and the other colde & moyst / and other colde & dry. And of the hote & drye there is none / for amōge all mem∣bres cōsēblables, ther is none more hote & dry thā the skynne that is temperate. And it is nat onely temperate amonge the membres of mankynde / but also amonge all the substaūces of thyng{is} that may engendre and corrupte / as Galyen sayeth in his fyrste boke of cōplexyons / & the last Chapytre. The membres hote & moyste be the mēbres that are sanguyne / as the flesshe / the spyrytes / and the naturall humydities / as wylleth Auerroys in the ••••. of collyges. The membres colde and moyste are the flewme, fat / or the grece, and the maroughes. The membres colde and drye are all the other mē¦bres after theyr degrees / as the bones / the carty∣lages / the strynges or cordes / the lygumentes, the ••••newes / the vaynes / arteres / & pannycules. And here is the mayne see / where as it behoueth ney∣••her Physycyen nor Cyrurgyen to sayle, for a phy¦••••eyen and Cyrurgyen ought for to knowe y^e com¦••••••xion of the mēbres / as natural Phylosophers. ¶Demaūde. Which are the mēbres compostes / and wherfore are they called organykes & instru∣mentalles? Answere. The membres compostes be mēores that are composed of the symple and con∣semblable membres. And therfore they be called therogenes / that is to say of dyuers natures / and may be deuyded in dyuers kyndes / that is to wyte

in to membres consemblables / and theyr partyes bereth nat away the dyffinycion and reason of the hole. As to the seconde questyon that asketh why they be called organykes & ins••rumentalles? The answere is, bycause they are ins••rumentes of the soule / as by the handes / the fete / the lyuer / y^e face, and the semblables. ¶Demaunde. Howe be the organyke membres ordeyned and composed. An∣swere. Some of these membres be pryncypalles / and the other nat pryncypalles. ¶Demaunde. Howe many vnpryncypal membres be there? and howe many vnpryncypal. Answe••e. There be .ii••••. pryncypalles / that is to wyte the herte / the lyuer / the brayne / & the genytalles / all the other be cal∣led vnpryncypalles. ¶Demaunde. Of what com∣plexyon is the herte? Answere. The herte is hote bycause it is lyke the very brēnynge hote ouen of all the body / fro whens cōmeth the heat to all the body. And albeit that Philosopher haue wylled to say that it is tēperate bycause it is pryncyple / and that it gyueth begynnynge of lyfe. Neuerthelesse the herte is drye in his complexyon bycause of his composycyon / for it is composed of strynges & pan¦nycles / and of harde and styf flesshe. ¶Demaūde. Of what complexyon is the lyuer? Answere. It is hote and moyste. For the mos••e parte of the thyn¦ges that it is composed is flesshely / blody / & ther∣with ben transmysed dyuers pypes or arteres.

¶Demaūde. Of what complexyon is the brayne? Answere. It is colde and moyste, bycause it hath a

marowy substaunce. Neuerthelesse it differeth fro the maroughe / bycause the brayne is a sparma∣tyke membre / & the marough is a sanguyne mem¦bre. And therby it is colde in comparyson of other membres / and that nat symply / for all membres be naturally hote. ¶Demaunde. Of what com∣plexyon are the kydneys and the mylt? Answere. The kydneys be hote & moyste / howebeit the kyd∣neys be nat so hote as y^e mylt, bicause of the grosse blode that is in the mylt, lyke as the mylt is nat so hote as the lyuer. ¶Demaunde. Of what com∣plexyon is the longes? Answere. Hote and moyste. It is hote bycause that heat is sent to it from the herte as Galyen sayeth in y^e fourth boke of y^e vty∣lite of the particles / & is moyste / but nat so moyste as the greas / for it melteth nat at the fyre as the greas doth.

¶Demaundes vpon the Anathomy of the skynne or the lether.

DEmaunde. What is the skynne. Answere. It is a couerynge of the body of mankynde / ••at is composed & context and wonen with thre∣••s and vaynes / with synewes and arteres / for to ••••••••nde the body & gyue it felynge. ¶Demaūde. 〈◊〉〈◊〉 many maners of skyn̄es or lether are there? ••••swere. Two, one is extrynsyke or outforth, and ••••at is proprely called lether. The other is intryn ••••ke / and that is proprely called pannycle rym or skynne as be those of the heade y^t couer the brayne and the skull / & they y^t couer y^e bowelles of y^e body.

¶Questyons vpon the Anathomy of the greas.

DEmaunde. What is the grease? Answere. It is a thyng in the humayne body / that is as oyle that chauffeth and humecteth the body. ¶Demaunde. Howe many maners of greas be there? Answere. Two. The one is without forth nere to the skynne / & that proprely is called adeps or fatnes. And y^e other is inwarde & nyghe to the bely / & proprely is called auxunge or fat grease.

¶Questyons vpon the Anathomy of the flesshe.

DEmaūde. Howe many maners of flesshe are founde? Answere. Thre. One is very flesshe and propre / and it is founde but in a lytell quan∣tite, & one in two places of the body of mankynde. That is on the heed of the yerde / and betwene the tethe. The other is glandulouster, odenose, or crud¦dy and kyrnele, as is the flesshe of the ballockes / of the dugges and the flesshe of the emuntores. The other is flesshe musculous or lacertous y^t is harde as bawme styffe or knotty. And this is founde in great quantyte, and ouer all the body where as is any manyfest moeuynges.

¶Demaunde vpon the muscles and lacertes.

DEmaūde. Be the muscles symple membres•• Answere. yea, as touchynge the sensyble iu∣gement / Howbeit of very trouth they are mēbres composed of synewes / of lyens / strynges / thredes••

and flesshe that fulfylleth them / & of the pānycule that couereth them. ¶Demaunde. Wherin agre¦eth and differ the muscles and lacertes? Answere. It is all one thynge / which after dyuers consyde∣racyons hath ben called muscle and lacerte / for it is called muscle for his resemblaunce of a mouse / that in latyn hyght mus. And it is called lacerte ••ycause it hath thy forme of a Lyzard / for lyke as those two beestes are byg in the middle and sclen∣der towarde the tayle / so is the muscle or lacerte. ••Demaunde. What is the maner & howe do the muscles and lacertes procede in the body of man∣kynde. Answere. After that the muscles is compo∣sed as is aforesaid / from it discendeth roūde stryn∣ges and cordes that cōmeth nygh to the ioyntes / the which when they be nygh the ioyntes they do ••••••de abrode and enlarge / and reyse the ioynt all ••••out with the pānycle that couereth the bones. ••••d whan they are passed the ioynt / they do waxe ••••unde agayne / and retourne into cordes & with ••he flesshe make another muscle. And of this mus∣•••••• procedeth and ryseth another roūde corde and ••••••••ges that byndeth the ioynt all about & moe∣••••••••••••. And so ceaseth nat to {pro}cede tyll they come 〈◊〉〈◊〉 ••he extreme and ferthest partycles of the body. 〈◊〉〈◊〉 thus alway y^e muscle procedeth the ioynture. ••••d as the synewes that procede of the noddle ta¦••••th forme of muscle at the necke and at the brest, and than cōmeth to the ioynt of the shulder. And ••ecōmeth rounde strynges and spredynge flat in

comprysynge all the ioynt / and do plante them in the bone of the ioynte and moeueth it. And whan they come fro the ioynt of y^e sholdre a two or thre fyngre brede they waxe rounde in cordewyse. And with the flesshe and strynge that cōmeth from the heade to the bone of the shouldre is made muscle vpon the myddes of the bone of the ioynture / fro whiche cōmeth a corde that thre fyngre brede fro the elbow enlargeth and compriseth all the elbow and moeueth the lytell arme. And thre fyngers be ponde it waxeth roūde & retourneth in to a corde. The whiche with the strynge that cōmeth fro the necke and with the flesshe make a muscle vpō the sayde lytell arme / of the whiche muscle is made a corde / and thre fyngers fro the ioynte of the lytell hande it spredeth and compriseth all the ioynture of the sayde hande / than it twisteth roūde agayne and entreth the muscle of the myddes of y^e hande / of the which cōmeth cordes that moue y^e fyngers, by the which thynges it appereth that the woun¦des that are made about thre fyngers of the ioyn¦tes be peryllous, for the synewy cordes be made bare of the flesshe and apparentes. Of the whiche all onely pryckynge is cause of spasme or crampe / and of deth as Galyen sayth in the thyrde boke de regny, and in the seconde of his terapentyc / which is to be noted of the Cyrurgyen.

¶Questyons vpon the Anathomy of the synewes.

DEmaunde. What is synew. Answere. It is a symple membre created to gyue felynge and mouyng to the membres deputed to nature. ¶Demaunde. For howe many distributary inten¦cyons were they created? Answere. After Galyen in the fourth boke of the vtylyte of the partycules in the last Chapytre, they were created for thre in¦tencions. One is to gyue felyng to the organykes sensytyfes. The seconde to gyue moeuynge to the motyfe or styrynge membres. And thyrdly to gyue knowlege to all the other membres of the thinges that hurte them. And it is notably sayd to the sen¦sytyfe or felyng membres. For in the cartilages or grystles, nor in bones, nor glaudylous or cruddy ••lesshe the synewes be nat penetrate but in y^e teth / as Galyen sayth in y^e boke aforesayd. ¶Demaū∣•••••• Fro whens bredeth the synewes? Answere. All the synewes of the body brede and come out of the ••••ayne by it selfe / or of the noddle that is his vy∣••••••••, betwene the which some brede of y^e foreparte 〈◊〉〈◊〉 the brayne / and they be softer and more propre •• g••ue felyng than mouyng. And the other come 〈◊〉〈◊〉 and brede of the hyndre parte of the noddle / 〈◊〉〈◊〉 descende fro the brayne / and these be har∣•••••••• more propre to gyue mouyng than felynge. ••••emaunde. Yf the felynge & moeuynge by one ••••••••ynew alone or by many? Answere. After Ga∣••••••n in the fyrste boke of the interyours / somtyme they are borne by one synewe alone, and somtyme by many. ¶Demaūde. Howe many parell or lyke

synewes be there that without meane spryng and brede of y^e brayne. And howe many pareyle or lyke synewes cōmeth fro it by meane of the noddle? An¦swere. Fro the brayne īmediatly springeth .vij. pe¦reylles. And .xxx. pareylles come fro it by meane of the nuke that brede behynde by the ende of the los∣sarn / as Haly Abas sayeth in his boke de Regaly dispositione, in y^e seconde sermon of the fore party.

¶Questyons vpon the Anathomy of the strynges ••r lyens.

DEmaunde. Of what nature ben the lyens or strynges / and wherof brede they? Answere. They be of the nature of synewes / howebeit they brede of the bones. ¶Demaūde. Howe many ma¦ners of lyens or stryng{is} be there? Answere. Two. Some bindeth the bones inwarde. And the other byndeth the ioyntes outwarde / as Galyen sayeth in the .xii. boke of the vtilite of the partycles in the fyrste Chapytre, of cowplynge of bones / that they are comprysed about w^t stronge braūched stryng{is}.

¶Questyons vpon the Anathomy of the cordes.

DEmaunde. Of what nature are the corbes? Answere. The strynges ben almoste as all of one nature / for both be of the nature of synewes / but yet the cordes more than the stryng{is}. For lyke as the strynges be meane amonge the cordes and the bones / so be the cordes meane among y^e stryn∣ges & the synewes. ¶Demaunde. Wherof brede the cordes / and whens take they felynge and mo∣uynge.

Answere. They brede of the muscles / and take felynge and mouynge of the synewes / wher¦by the membres are moued. ¶Demaūde. Wher∣fore is it that whan the cordes withoutforth are cut the membre leseth bowynge / and whan they withinforth are cut the mēbre leseth y^e stretching. Answere. Albeit the cordes be rounde whan they yssue of the muscle, yet do they sprede whan they ••ome to the ioynt / and they are lyens or strynges that are set rounde aboute the sayde ioynt / as the cordes about the mēbre / so that they withinforth ••••awe the mēbre / & they withoutforth do stretche it. And whan the one draweth y^e other loseth. And 〈◊〉〈◊〉 whan they are cutte outwarde the bowynge is 〈◊〉〈◊〉. And whan they are cutte inwarde the stret∣••••ynge is loste.

¶Questyons vpon the Anathomy vpon the vaynes and arteres.

DEmaūde. What is a vayne? Answere. It is the place of the blode of nourysshyng. ¶De∣••••••••. What is artere. Answere. It is the pla∣•••• the spyrytuall blode. ¶Demaunde. Wherin ••••ag••e and differ the vaynes fro the arteres. An∣••••••••. They do agre in that they be of consembla∣•••• dystryoucyon throughe all the body / that is in ••••rynge of blode. And they dyffer in two thynges. The fyrste appereth by theyr dyffynycyons afore∣sayd / that is y^t the vaynes bereth the nourysshyng blode / and the arteres the spyrytuall blode. The seconde dyfference betwene theym is taken of the

place of their breding. For the veynes brede of the lyuer, and the arteres of the hert as Galyen sayth in the .xvij. boke of the partycles. ¶Demaunde: Do they separe in any wyse one from the other in the body of mankynde / so that the veynes may be without the arteres, and the arteres without the veynes. Answere. In some places the veynes do separe from the arteres. And the arteres be foūde w^tout veynes. As it is manyfest both in y^e armes / and in rethe mirable, howbeit no vayne is founde without artere. ¶Demaunde. What is the ma∣ner of procedyng of the veynes & arteres through the body? Answere. Whan they go forth of the place of theyr breding, they rēne forkewyse in two partyes / the one vpwarde and the other downe∣warde / and yet of them euery partye braunchet•• and procedeth vnto the last and extreme partyes of y^e body for to nourysshe and gyue lyfe to all th•• membres thereof.

¶Questyons vpon the Anathomy of the bones.

DEmaunde. Wherfore are the bones made? Answere. Bycause they shulde be the founda¦cyon of all the body & susteynynge therof. And ther¦fore they are made harde and strong the better to here the burthen of all the other. Howebeit some of y^e bones are made for the defēce of the inwarde membres / as the bones of the heed, the brest bone, and the backe bone. ¶Demaūde. Howe many in nombre are all the bones in a body of mankynde••

Answere. Auycen sayeth that there is .CC.xlviij. saufe the bone that is called (os laude) wherto the tongue is founded. The whiche bones thou mayst consyder and se by the fygure here before wryten / and of whiche partyculer mencyon shal be made, and declared in this present treaty. ¶Demaunde Howe ben the dyuersytyes amonge the bones of the body of mankynde? Answere. They be deuersy¦fyed in dyuers maners / for some bycause of y^e ioyn¦tes are full of maroughes / & the other nat. Some are streyght / & other croked. Some are lytell / and ••ome byg. And all bones are bygger at the endes ••han in the myddes by reason of the ioyntes. And ••ome are enbossed for to entre, and other haue va∣••nytees that receyueth. And some haue both the one and y^e other. And other haue neyther one nor the other. And of them that haue enbossyng{is} and ••a••uytees, some haue them clauelares lyke keyes 〈◊〉〈◊〉 y^e teth / And other ben sacratyles or sawe wyse, as the skull of the heade. And other knotty in eche ••••de as v••na in the thyghe. Other be foueable or ••olow as the faucylles or forke bones. Other ha∣••e both sortes as the fyngers. And they that haue ••eyther one nor other ben ioyned solidatiuely, and they that haue the enbossynges and vacuacyons be they that make the ioyntes / of whom cōmeth dyfloracyon and other separacyons.

¶Questyons vpon the Anathomy of the cartylages or grystles.

Demaūde. What is cartylage? Answere. It is a substaunce as it were of the kynde of bo∣nes, but it is softer or sowpler than the bone is. ¶Demaunde. Wherfore were the cartylages made? Answere. For two reasons. One to fulfyll the lacke of the bone / as in the palpebres or eye lyddes / the nosethyrlles, and eares. The seconde to make the better coniūction of the bones with the parties next them, as in thorax and parties of the loynes / bycause that the softe substaunce, (as the flesshe and other partyes) be nat hurte by the mo∣uynge of the bones whiche are harde.

¶Questyons vpon the Anathomy of the nayles.

DEmaunde. Wherfore are the nayles made of the vtter partes of the body? Answere. The better to take holde.

¶Questyons vpon the Anathomy of the heares.

DEmaūde. Wherfore were the heares made•• Answere. For two reasons / that is to wyte / to encrease beaute and to purge.