The Frenche chirurgerye, or all the manualle operations of chirurgerye , vvith divers, & sundrye figures, and amongst the rest, certayne nuefovvnde instrumentes, verye necessarye to all the operationes of chirurgerye. Through Iaques Guillemeau, of Orleans ordinarye chirurgiane to the Kinge, and sworen in the citye of Paris. And novv truelye translated out of Dutch into Englishe by A.M.

Chirurgerye THE FOVRTH TRE∣ATISE OF THE OPERATI∣on of Chyrurgerye, wherin is discoursede and handelede of the openinges, and apertions of Apostemations, Contayninge five Chapters. (Book 4)

• Of the generall vvay to open any Apostemations vvhatsoever. Chap. 1.
• Of the tumefactions, vvhich vve call, Ateromata, Steatomata, & Melicerides. Chap. 2.
• Hovve vve ought to cauterize, & make any inscisione in the Apostemations of the brest. Ch. 3.
• Hovve vve ought to make the Paracentese, and take avvay the vvater from them vvhich have the Dropsye. Chap. 4.
• Hovve vve ought to cure the Hernias aquosas, or vvater burstinges. Chap. 5.

❧Of the generall way te open Apostemations. Chap. 1.

* 1.1WHen as vve endevoure to opē anye apostematiōs, to lett the matter rūne therout, vve must first of all before vve com to the inscisione, or apertione, consider, vvhether the matter might not in anye vvayes be resolved or con∣sumed, throughe the forces of the naturall ca∣liditye, or heate, or els vvhether needes and of necessitye be chaunged into matter. VVhen as an Apostematione, must needes be brought to suppuratione of matter & can by noe mea∣nes possible be consumed or resolved, the sig∣nes therof are these, namelye a burninge hea∣te, erectīge of the tumefactione, or svvellinge, more rednes,* 1.2 & vvhich is also harder thē befo¦re, prickinge, knockinge, or beatinge payne, ponderousnes, as if there did hange anye hea∣vye thinge at that ioynte: And if soe be this a∣postematione be situated in any principall parte, then there is a chillnes and shiveringe thervvith associated, the ague allsoe is more violent by day, then by night: sometimes al∣soe the next kernells vvhich are in the bodye situated thervnto come or chaunce to svvel, & be distempered.* 1.3 But the suppuratione, or re∣solutione to matter beīge finished, or accom∣plished, the tumefactione as thē diminished, vve thē sensiblye feele prickinge, vvith a little itching therbye, alsoe a little deafnes or num∣nes, vvherbye alsoe some times is felte a great prickinge, especiallye the matter lyinge verye deepe: For the matter lyinge close vnder the skinne, there thē demōstrateth it selfe a little heade vvhich in feelinge is softe, and vvhen as vve depresse vvith the finger it glideth a syde, vvher of the skinne, in the superior parte of the same heade openeth it selfe, & separeteth it selfe from the inferior partes of the same.

* 1.4VVhen as therfore all these signes reveale themselyes, vve may thē bouldelye & freelye, opē the Apostematione, vvith the lācet, vvith out tatryinge anye longer, that it might of it selfe breake through, because the matter may thē issve forth therat, & because that through to lōge tarryinge, vvith the openinge therof, shee doe not come to diminishe into the cir∣cumiacent partes, & make other concavityes. Althoughe Celsus sayeth,* 1.5 that verye seldome vve ought to make anye inscisione, vnder the armepittes, or in the flanckes vvhen the mat∣ter is ripened, & come to a full and good sup∣puratione, in like sorte alsoe, vvhen the Apo∣stematione is not to greate & is placed vnder the skinne, but that as thē vve make the aper∣tione vvith Cataplasmes, & let them of them∣selves breake throughe, vnlesse throughe the intollerablenes, and greate dolor or payne of the patient, the Chyrurgiane vveare compel∣led, to open the same, because sayeth he, that if vvith out inscisione or cauterisatione vve make the apertione, noe deformed cicatrice, or signe, therof, may remayne. VVhē the mat¦ter lyeth deepe vve must thē cōsider,* 1.6 vvhether the part be synnuishe, & if soe be that it is soe vve must as then open the foresayed Aposte∣matione vvith a hott Iron, vvhich is thervnto verye convenient, because that apertione, al∣thoughe vve make it somvvhat smalle, it tar∣ryeth a longe time opē to make issue vnto the matter, through the vvhich alsoe the cicatrice continueth verye little. VVe vse novve in these dayes potentialle corrosives. If soe be about the place of the apertione any synnues be situated, vve ought then to feare vvhen vve must make the apertione vvith a hott irō that then the patient might fall into Spasmo, or els the ioyncte might be criple, and tarrye lame, therfore vve ought rather to vse the lancet.

It happeneth alsoe sometimes, that although the apostematione be not yet ripe,* 1.7 & vvith∣out greate store of matter, yet notvvithstan∣ding reqvireth to be opened, especiallye, vvhē

as it is situated by, or next vnto some vvorthy parte, the foresayed matter beinge venomous or pestilētialle, vvhich if vve suffered them to continue vntil there complete ripenes & ma∣turitye, might dravve invvardes, & throughe there venomous dampes, might infecte some of the vvorthyest partes, out of the vvhich, as then follovve most fearfull accidentes. And althoughe Celsus counceleth vs, that vve must stay vntill such time as all apostemations, are come vnto an accōplished maturitye, vvhich are situated in the synuuishe partes, because the skinne beinge grovven thinner, and the matter neerer approchīg thervnto, vve might then the easyer & neerer attayne therto, not∣vvithstādinge our best practisioners councell vs, that vve shoulde open such apostema∣tions: as they alsoe councell vs, to open all a∣postemations, vvhich are situated close to the ioynctes, bones, synnues, tendones, and to the ligamentes, yea and before the time of the ac∣complished maturitye, because therin, they might not cause anye great rottennes, or cor∣ruptione of other partes.

In like sorte must the apostemations of the privityes be opened, before they be come to ther full maturitye, because there chaūce noe corruptione in that parte, as all such partes throughe there greate, moystnes, are verye much inclined vnto corruptione & rottēnes, as allso beyonde this, the matter throughe to longe beinge therine continued, causeth the Intestinum rectū, or the gutte of excremētes, to corrupte, & rotte, vvhich is farr softer, thē the externall skinne, vvherthrough the foresayed matter oftētimes internallye bursteth out, by the vvich cōmonly follovveth a Fistle, vvhich is all most incurable.

VVhen 〈◊〉〈◊〉 therfore vve see that ther is anye matter in the Apostemation, vvhich hath noe issue, & by her selfe can make or effect anye e∣ther consideringe her crasitude, her crudetye & viscositye, as therby not beinge possible for her to attayn vnto complete maturitye, or els because the skinne is harde, or that the foresa∣yed matter lyeth to deep, through the vvhich there remayneth a great thicknes betvveē the skinne & the matter, or els consideringe cer∣tayne inconveniences, vve may not delaye soe longe, vntill it be fully mature, and ripe, as are the Apostemations, vvhich are situated next vnto some vvorthye parte, as by anye greate vaynes, or synuishe partes, vvhich are incli∣ned to great corruptione. The Chyrurgiane must vvithout any lōger delay, make the aper∣tione vvith his lācet, rather thē to expecte any of these daūngers above rehearsed. The fittest time therfore first of all to doe an operatione, is in the morninge by time, cōsidering that in such a time, the persone is farre better qvieted & better animated and incouraged, except the greate daunger reqvired othervvyse the cōtra∣rye Secondly vve must note, that the apertion be made in a conveniēt place, vvhich cōveniēt place, is knovven by the tumefactione,* 1.8 of the parte, in the vvhich there revealeth it selfe a little heade, & ther is greate vveakenes & sof∣tenes founde therin, vvhich glideth vnder the feelinge of the finger, & vvhere the skinne is thinneste: it is right true that such an apertiō might bedone in the inferior partes of the tu∣mefactione a foresayed, because the matter might the easyer issue out,* 1.9 vvith out dravving of the medicametes, or through the harde de∣pressione of the same because all evacuations vvhich chaunce in the hanginge sores, cā farre better avoyde the matter, thē any medicamē∣tes, especially in such partes, of the vvhich vve cā not chaūge the situatione, as in the vvhole Chaos of the bodye: For although, in the armes, or legges, any apertione is made in the superi∣ore partes of the tumefactione, throughe the situatione, such a faulte may be remediede.

The third conditione is, that vve must con∣sider, one the rimpelinge of the skinne,* 1.10 & one the fibres of the muscles, and because the mus∣cles allmost runne throughe the length of the bodye, the apertione must thē be made in the length of the bodye, and accordinge vnto the right concurringe of the muscles. Notvvith∣standinge althoughe, the rimples, or forefrōte of the heade lye thvvarte over, yet the inscisiō must therin be made accordinge vnto the lēg∣the, follovvīge the fleshye fibers, of the broad muscle: othervvyse the skinne beinge cutt ac∣cordinge to the rūninge of the rimples, might chaunce to fall on the eyes, In the heade vve must observe the grovvinge of the hayre. Vn∣der the armepittes, & in the flanckes, vve must consider the shuttinge, or one the rimples of the same places, because the deformitye of the cicatrice, vnder the fouldinge of that part may be hiddē, & to praevēt the imbicillytye, vvhich is an occasione, of the receavinge of the cōcur¦ringe humors: Thē to praevēt, that vve doe not chāce to touche, any synnues, Tēdone, Vayne, Arterye, or any other partes of esteeme, & that the apertion, may be done vvithout ane daun∣ger, vve make novv the inscision in the length as thē overthvvarte, accordinge as every parte reqvireth: vvhich cā not rightly be done then of those vvhich have a complete knovvledge of the Anatomye: othervvyse they ignorātlye might chaunce to touch a synnue, or a vayne, or might chaunce to cut an arterye, vvher∣throughe the Spasmus, the Paralisis, or any great sheddinge of bloode, yea alsoe & at somtimes might because of his death.

The fourth conditione is,* 1.11 that vve must re∣mēber dilligentlye to make as smalle an aper∣tione

as vve may, survayinge the apertione, vvith the magnitude of the Apostematione: For if so be it be little, vve may as then make therine a meane and reasonable inscisione, vvhich alsoe must not be deepe, but the aposte¦matione beinge great, vve are thē sometimes vrged, to make tvvo inscisions, or more then tvvo, beinge therin made, that one of them all vvayes, be in the inferior cōcavitye of the fore sayed Apostematione, because the humor doe not chaūce heere or there to make any more cōcavityes, evē as the humors, allvvayes inter¦nallye, corrupte & eat through the circumia∣cent partes, and ther in diminishe.

* 1.12And if soe be that any apostematione, vvith great concavityes cam into our handes, & the skinne ther over might as yet becured agayne vvith the fleshe, vve must as then make but o∣ne apertiō or inscisione, throughe the vvhich the matter may issve: but if soe be the fleshe in¦ternally is eaten, & corrupted avvay, vve must as then cutt throughe vvith a right cutte, the vvhole concavitye, accordinge vnto the leng∣the therof, vvhich beinge done, & the edge of the vvounde in all places beinge very skinne, & bereft of all ther fleshe vve must clippe or cutt them cleane avvay: because such skinne restrayneth and keepeth backe the matter, vvhich causeth the circumiacent partes to cor¦rupte, & hindereth the applicatione of the me¦dicamentes: but vvhen as vve cutt the skinne, vve must doe it triāgle vvyse, or in forme of a mirtle lease, because the apertione soe much the sooner, might chaūce to heale, because all rotūditye in vlceratiōs is difficult to be cured.

* 1.13And touchinge all great apertions, vvhich may be made in the apostemations, must be made, accordinge to the abūdance, or the qvā∣titye of the matter, & accordīge as the subiecte partes therof require. As alsoe vve must con∣sider, on the depthe, & marke that vve thrust not the lancet to deepe therin, but reasonable deepe: for vvhē as vve thrust to deepe, it is thē great dolour, & payne to the patiēt, & causeth alsoe much bleedinge: & thrustinge not deepe enoughe, vve effecte & brīge nothīge to passe.

The fifth cōditione, must be observede, ac∣cordinge to the apertiō of all greate apostema¦tiōs, that at one time vve suffer not all the mat¦ter to rūne out, but rather by little, & little, es∣peciallye, the patient beinge debile, oulde, yonge, or any vvomā vvith child, because all suddayn evacuatiōs, doe cause great imbicilli∣ty & fayntnes because ther through the vitall spirites, evaporate & flye avvay, vvhich in the cōcavitye of the Apostemation vvith the mat∣ter vveare shutt therin, althoughe they are a∣gaynste nature.

* 1.14The apertione beinge done, vve must hādle the vvound, accordinge vnto the diversitye of those partes, vvherin the Apostematione vvas situated, & alsoe accordinge vnto the time & season of the yeare. The Chyrurgiane ought especiallye to eschevve the great tētes, vvhich Celsus prohibiteth to vse in the vlcerations of the arme pittes, & flanckes, & that because of the great vaynes, arteryes, & synnues, vvhich in those places are situated, layinge onlye ther one a sponge vvhich is madefied, & vvetted in vvyne. VVe cōmonlye lay theron a flatte plu¦maciolle or tent made of linte, and therone a plaster, levinge soe the solutione apert, becau∣se that the remayninge matter might issue & come forthe therat vvhich othervvyse throu∣ghe a great lōge thicke tente, might therin be retayned, & kept backe. This beinge done, vve must then dresse that parte, & vvinde it begin∣ninge to vvinde from the sovvnde parte, vnto the bottome of the cōcavitye if there be anye, endinge at the apertione because the matter may be pressed & crushed therout, vvithout be¦inge therin retayned, any longer, because by to longe tarryinge therine, it doe not cause a greate hollovve fistulous concavitye to come therin: then vve must lay that part in such a sort that the apertione may depend or hange, because soe the matter may the better issue out therat.

Of the tumefactions, or swellinges called, Ateromata, Steatomata, and Melicerides. Chap. 2.

THe auncient professors,* 1.15 have allvvayes noted, onlye the spe¦cies & formes of vlcerations, that they onlye differed the o∣ne from the other, in the mat∣ter, vvhich is founde therine. For in the vlceration Ateroma,* 1.16 is a kinde of matter like vnto thinne pappe: the vlceration Steatoma, a kinde of fatte matter, like suet. In Melicerides, is a matter like vnto honnye: Soe that by the forme of coniecture vve may say, vvhat matter therin lyeth inclosed, but for a certayntye vve can not say it, before such time as vve have fetched some of the matter ther∣out: and one this manner they are allvvayes knovvne the one frō the other. vvhen as vve chaūce to touch the vlceratiō Ateroma, it spre∣adeth abroade, in that place vvherō vve chaū∣ce to depresse it, & doth not so suddaynly, ioy∣ne it selfe together. The vlceration Meliceres, differeth frō the Ateroma, in his forme, & sub∣stāce of his humors for his figure is much roū¦der, and the substance of the humor vvhich is therin, farre subtiler. soe that it spreadeth mo∣re abroade, then the Ateroma, vvhen vvith the finger vve depresse it, it separateth it selfe far∣re soener, & alsoe ioyneth much sooner, vvhē vve take the fingers therof. The vlceratione

Steatoma, is much harder, then both the other, & in the touchinge of it, it stirreth not, but re∣sisteth the depressinge of the fingers, & com∣mōlye in the bottome is it somvvhat broade, and verye seldome or never may vve se any vvhich are vnder narrovve & broade above.

* 1.17These foresayed vlcerations, are in ther be∣ginninge allvvay little, but in continuance of time, they grovv to be greater, some are verye harde, & vve finde sometimes therin vvond∣rous matter, as if it vveare little stones, bones, rovvled hayre, mixed vvith any matter vvhich is thicke.

* 1.18Philexomus sayeth, he sometimes hath fovvn¦de, in the matter vvhich therin lay inclosed, lit¦tle creatures, as if it had bīne gnattes, vve must note that al those foresayed humors, & al the∣se vvonderfull thinges, are inclosed as it vvea∣re in little blathers.

But as much as concernethe the apertione of the same, it hindereth nothinge vvhether the matter be like pappe, or like honnye, or li∣ke suet, or vvhat matter soever it might be: for vve have but one onlye intentione, to vvitt that vve extracte & dravve out the blather, or little bagge, vvherin the matter is inclosed, for the manner hovve to open it is this.

* 1.19VVe must first of all lift vp the skinne frō the bottome, & then cutt it of, makinge insci∣sione accordinge to the greatenes of the vlce∣ratione, dilligētlye markinge least vve cut the blather or purse vvherin the the humor is in∣closed, because the matter doe not chaunce to issue out: For the matter beinge issued, the vvhole remanēt operatiō is perturbed, & an∣nihilated, because alsoe there by the operatiō falleth flatte dovvne: soe that as then vve may or can verye difficultlye flea, peele or separate the foresayed membrane of the matter, from the fleshe, vvherthroughe the vvhole curati∣one, consisteth vvithout reciduitye.

VVhen as in this sorte, vve shall have cutt the skinne, thē the little bagge demonstrateth it selfe vvhyte, and outstretched, vvhich vvith greate dilligence, vve must endevoure to sepa∣rate thereof, vvith a Spatula, to vvitt, from the skinne, & out of the fleshe, or vvith any other instrument, vvhich is thereto serviceable, vvher vvith vve must take it out, vvith all that vvhich is therin, vvithout sufferinge anye iott therof to remayne in the bottome, because it chaunce not to increase agayne: And is it soe happened that there chaunced to tarrye anye thinge therof in the vvounde, vve must not as thē heale together the apertione verye soone, but vvith puryfyinge medicamentes, purifye that therout vvhich as yet remayneth therin.

* 1.20VVe must alsoe heer note, that some of the∣se vlcerations, are rotede betvveene anye vay∣nes, arteryes, synnues, & tēdones, vvhich era∣dication, reqvireth a greate & longe cōtinued & convenient manuall, operation, because, thinckinge qvite and cleane to take avvay the little bagge or purse from thence, vve might chaunce to burst anye vayne, arterye, synnue or Tēdone, therfore if so be therebe anye par∣te therone fastened it is then bētter to desiste from our operation. VVhē this operatione is thus finished, in anye smalle svvellinges, ther is as thē noe more daunger, vvherfore there resteth no thinge for vs to doe, then vvith any curinge medicamentes, to heale op the insci∣sione, layinge therone a Compresse, madefied in some defensive or other, because that in the dressinge, all inflāmations may be praevented, & the separated partes the on agayne conioy∣ned vvith the other. But if soe be the vvounde vveare great, & coulde not be cured, one this manner, it vvill not then seeme discommodi∣ous, that vve stitch it vp, layinge the stitches somvvhat vvyde the one from the other, to let anye medicamemt or other droppe betvveen them, & to give passage to the matter vvhich engendreth therin: & then vve must vvholye cure these vlceratiōs as all other vlcerations.

Touchinge the curing of Queēs evil vvhich is alsoe done through manuall operatione, is alsoe one this māner effected, takinge the fo∣resayed Queens evill vvholye therout, if soe be it be possible dilligentlye markinge, that vve chaūce not to hurte anye vaynes situated ther about, & especiallye of those vvhich are divi∣ded amongst the muscles, vvhich are servicea∣ble to the speach, or voyce, as are the recurren¦tes, or retrogradinge muscles, & those vvhich are situated, abute the Laringa as vvell the prin¦cipalls as commō: For it hath oftē times hap∣pened that some have had this dissease of the Qveenes evill cut out about ther throt, vvhich all there life time therafter have remayned ho¦arce & vvithout speeche.

❧The manner how to cauterize, & make an insci∣sione in the vleerations of the brest, called Empiema. Chap. 3.

BEtvveene the ribbes,* 1.21 and be∣tvveene the intercostalle mus¦cles & betvveene the mēbra∣ne Pleura, concurrethe & ga∣thereth sometimes certayne bloode together, vvhich chaū∣geth it selfe into matter, although the Physiti∣on, as vvel throughe Phlebotomye, throughe purgations, through fomētations, or through any other appliclations, hath done his best,* 1.22 to resolve & cōsume that. This foresayed matter, sometimes externallye demostrateth her sel∣fe causinge a tumefactione vnder the skinne of the brest. Then the foresayed membrane

Pleura,* 1.23 allvvayes most commōlye breaketh, & and bursteth a sunder, to give passage vnto the matter, vvhich therafter sincketh into the cō∣cavitye of the breste, & is sometimes voyded throughe the vrine, or throughe the mouth, the longes dravvinge the same vnto them, and then throughe the throte is coughed vp.

The signes, if any matter be retayned in the brest, are these, to vvit, difficultnes in brea∣thinge, stinckinge breath, heavines in the sy∣de,* 1.24 a drye cough, vvith great prickinge in the brest, a cōtinualle ague, vvhich agaynst night redoubleth her forces, svvetinge in the ende of the digestione, little sleepe, & noe appetyte at all. Somtimes in the place of matter, there is vvater gathered in the brest, vvhich vve espy vvhen as the patient through great thirst, hath druncke great store of vvater: vvhen he con∣tinuallye cougheth, vvithout spittinge, vvith Shortnes of breth, vvith svvellinge in the fee∣te, & vvhen vve stirre the brest one the one sy∣de, vvherin the vvater contayneth it selfe, vve heare a shogging, as vve ar vvōte to heare in a pott half full of vvater: & this dissease may be called, the Dropsye of the lōges & of the brest.

* 1.25VVhen anye of these disseases have conti∣nued any time, & noe remedyes have helped, & noe hope left, that the vvater, or the matter might by anye meanes be expelled out by the mouth, or els be purged throughe the vrine, 40. dayes beinge passed, vve must as then co∣me to the manualle operatione, & endevoure to opē the brest, & make a passage for the mat∣ter to issue forth, because the longes doe not in anye sorte chaunce to corrupte, or rotte. VVhich may bedone through the inscisione, or throughe a potentiall, or actuall Cauterium. VVe must first of all cōsider, vvhether in anye partes of the brest,* 1.26 vve espye noe svvellinge or tumefactione: vvhich havīge espyed, vve must then make the apertione, vvith the lancet, or vvith the Cauterio, & that in the fittest & con∣venientest place vve can finde. But our com∣mon vse is, to applye the potentiall Cauterium, because the apertiō, vvhich vve made therine, through the Cauteriū, may the longer be kept opē and apert, vvithout troublinge of the pa∣tient, vvith the impositione or puttinge in of greate tentes, to keepe open the inscisione. And if soe be vve perceave noe tumefactione, or svvellinge, externally in the brest, vve must then betvveene the thirde and the fourth true ribbe, beginninge to account from vnder, a∣bout the midest of the one syde,* 1.27 sixe, or sea∣ven fingers bredthe from backebone, make an apertione vvith the crooked lancet, into the concavitye of the brest, not all at once, but by little and little, or by degrees, beginninge from vpvvardes, dovvnevvardes, thrustinge, the poyncte of the foresayed lancet, frō vnder the fourth ribbe, the cuttīge syde of the same, reachīge, to the vpper end of the thirde ribbe, least that vve should cut in anye vayne, arte∣rye, or synnue, vvhich lyeth occult and burie∣de vnder the inferior concavitye of the ribbe. VVe may in the same place sett a Ruptorium, vvherof the Escara beinge made, vve must cut it throughe, into the concavitye of the brest, settinge agayne the foresayed Ruptoriū, or cor∣rosive therō, if soe be at the first tim it had not made his operatione sufficient deepe enou∣ghe. This apertione may alsoe be made vvithe the actuall Cauterium, heer before discribed, vvhich vve may crus he as deepe therine, as is necessarye, to pearce the matter.

VVhen as therfore the apertione is in this sort effected,* 1.28 vve must not as then suffer the matter all at once to decurre out, because that to many of the vitall spirites, doe not chaunce to flye avvay, vvhich therin lye included, or in¦closed: soe that vvhen as one parte of the fore¦sayed matter is runne therout, vve must then put therin a tente, and lay therone a plaster of Gratia Dei, or of Betonica, Hippocrates coūceleth, that vve should make the apertione,* 1.29 one the thirde ribbe, vvhen as vve have discovered, & bared the ribb, of her skinne, & membrane, vvhervvith externallye shee is clothed, settin∣ge ther one, a Forret, or Trepane, vvhervvith vve must bore her cleane throughe the vvater vvhich is inclosed in the brest: the vvhich easy lye may be done, in those, vvhich have an vlce¦ratione vnder the ribbes, the foresayed rib∣bes, beinge broade enoughe, to set a trepane therone, betvveene the Mediastinū, vnder the brestbone, may also gather vvater,* 1.30 vvhich Co∣lumbus vvitnesseth, that vve trepaning throu∣ghe the selfe same bone, let forth the vvater therat. But vve must note, that there are some auncient professors, vvhich houlde this aper∣tione to be verye suspicious, because they pe∣arcinge into the cōcavitye of the brest, might chaunce to cutt alsoe the membrane ther vn∣der situated: fearinge least the patiēt, immedi∣atlye after the suddayne apertione, throughe the evacuatione of the animale and vitall spi∣rites, might chaunce to dye, vvhich vvith the matter flye avvay, or alsoe consideringe the in curable fistles, vvhich might therof ensue: but novv a dayes vve finde the cōtrarye because there throughe are cured, vvhithout havinge retayned anye fistle therof. In steade of such an apertione, they place in the brest certayne actuall Cauteries, or potentialle,* 1.31 to the num∣ber of 7. or 8. yea alsoe sometimes cauterizin∣ge onlye the skinne 14. times vvithout pear∣cinge anye deeper, making the Escara reasona¦ble brood but not deep, vvherof they kept the vlceratione soe long opē vntill al the coughe and all other impedimentes are, cleane gone.

Howe that we must make the Paracentese, to drawe awaye the water out of the bellyes of those which are troubled with the dropsye. Chap. 4.

* 1.32THe Dropsye, is a tumefactio∣ne, or inflatione, agaynst natu∣re, or Phlegma is engendred, or also of some certayne vvindes and ventosityes. This svellin∣ge sometimes alsoe, spreadeth herselfe throughe out the vvhole bodye: som∣times allsoe onlye in the inferior parte of the bellye. The first kinde is engēdred, of a phleg∣maticke humor, & the secōde kinde of Drop∣sye,* 1.33 is engēdred of vvater & vvinde tohether: vvherfore the aūciēt professors have thought that there have binne thre sortes of Dropsye. VVherof the first is called,* 1.34 Anasarca, Hiposarci∣dios, Leucophlegmatias, vvhen as the vniversall bodye is through soaked vvith vvater, through the vvhich, everye parte of the bodye seemeth to be tender, or vveake softe, pale, & vnseem∣lye to the sight, soe that crushinge therone, the printes of your fingers for a little continu∣ance tarrye therin:* 1.35 The seconde, is called Tym∣panitas, and of Hippocrates the drye Dropsye. vvhen as the inferior parte of the bellye is full of inflation, or vvindes, and stiflye stretched out and spanned, soe that smitinge therone, it giveth from him a sovvnde like vnto a Drom∣me, it is right true that sometimes ther are al∣soe a fevve humors mixed theramongst, be∣cause by continuance of time the vvindes co∣me to condence them selves, and chaunge in∣to some vvaterye substance.* 1.36 The thirde kin∣de of Dropsye is called, Asites, vvhich is an in∣flation, and strectchinge out of the bellye, be∣cause of the aquositye vvhervvith it is replete, havinge vnparted her name of Ascos, vvhich is to saye, a lether vessell, vvherin in former and auncient times, they vsed to keepe anye moy∣sture in, as vve doe in the hydes, & in the buc∣kes skinnes: vvhen this dissease increaseth, & grovveth,* 1.37 sometimes the hippes, and the Scro∣tum beginne to sveelle, vvhich is a signe of Leu∣cophlegmatica, as differinge, from the selfe same beinge or essence of Ascites: as in the contrarye it is not soe, vvhē as anye aqvosytye ascendeth vp to the breste.* 1.38

Amongst all these three species, and kindes, ther is but one of them subiect vnto our ma∣nuall operatione, to dravve forth therof all that vvater vvhich lyeth enclosed in the con∣cavitye of the bellye:* 1.39 but before vve come to the apertione heerof, vve must first knovve, vvhich of thē are curable or incurable, becau∣se in vayne, & to the hinderance of the patiēt vve take it not in hande, in those vvhich throu¦ghe age are grovvē debile, and feeble, or in tho¦se, vvhich are corrupt & not sovvnde of bo∣dye, the intestines or entralls, beinge verye ill disposed and ill at ease, vvithout anye hope of amendment, & in those, vvhich vvholye are grovven impotent, or in those vvhich are ther vvithe borne, vve must not in anye vvyse through this operatione lay hādes one them. But in those vvhich as yet are yonge, stronge, & are of a goode constitutione, nether have a∣nye agues, havinge all there entralles sovvn∣de, and tempered, & in these, in the vvhich the vvater as yet hath made noe cōcavityes, vvher¦by the liver, the milte, and the guttes, might chaunce to be altered, in those remayneth as yet some hope, ominouslye to effect and brin∣ge to passe this operatione: & in this manner vve must vvith the same procede. Namelye,* 1.40 and especiallye, if the Dropsye, resume his ori∣ginall from the liver, the patient lyinge one his bedde, vve must gentelye lay him one his right syde because vve may make the inscisio∣ne one his le•••• syde: & is soe be this fore sayed Dropsye proceede, throughe anye dissease of the milte, vve must then turne him, one his left syde, to make the inscisione, in his right syde, soe that the inscisione, must allvvayes, be done one the contrarye syde, of that parte, from vvhence the Dropsye taketh her origi∣nall, & that because the patiente must lye one that syde, frō vvhence the originall of the dis∣sease commeth, for if soe be he lay othervvyse then soe then the obdurated parte, throughe the ponderousnes therof, might chaunce to sincke and descend dovvnevvardes, & makin∣ge internallye any solutione, migt ther throu∣ghe be the occasione of great payne and do∣loure.

And the patiēt lyinge one the obdurate li∣ver or milte, might throughe the vvarmeth of the bedde, be eased and stengthened. And if soe be, the patient chaunce to lye one the opē syde, the vvoūde vvould then be a great trou∣ble & hinderance vnto him, & the vvhich he mervaylouslye might be debilitated,* 1.41 & in fee∣bled. Morover it vveare inconveniēt that the debilest syde of the obdurated liver, or milte, throughe inscisione, as yet shoulde be more vexed.

The patiēt beinge in this manner situated, vve must note, in vvhat place the inscisione might easyest & vvith most conveniēce be do ne, to vvitt thre fingers bredth vnder the na∣vell, dravvinge ether tovvardes the left syde, or tovvarde the right, but not lineallye right forth, betvveene the navell, & the privityes, be cause vve must eschevv, and avoyde, the vvhyt lyne vvhich in this place is situated, & the en∣des, of the muscle Epigastri, & alsoe the synnuis he tēdonousnes, of the right muscle:* 1.42 because these vvoūded or hurt, might suscitate, & cau∣se great payne, vvith manye other daūgerous

accidētes, vvherfor they difficultlye vvilbe cu¦red, vvhen as fayne vve vvould heale vp the vvounde. Havinge noted all this, the Chirur∣giane must vvith his left hande, & his servant, vvhich assisteth him, nype in the length, the one, on the one syde, and the other, one the o∣ther syde, first of all the skinne, & the incarna∣te or fleshye pānickle, of this syde, to lift it vp, & cut it clean through overthvvarte, vnto the muscles, vvhich beinge effected, they must lett the foresayed elevated skīne, & pannickle fall agayne: And to finnish the rest of our opera∣tione convenientlye & fitlye, after this first in scisione, (because the fore sayed skinne may fall agayne, one the inscisione, vvhich inscisi∣one must alsoe bedone, in the muscles, and in the Peritoneo, to stoppe them, & to prevent the runninge forth of the vvater, then vve shall lift vp the foresayed skinne) vve must agayne lift vp vvith the hande the skinne, & the fles∣hye pannickle, and then as high as is possi∣ble follovve the fibers of the muscles, vve must easylye thruste in the crooked lancet, & cut throughe the muscles, and Peritoneum, as broade as vve are vvonte to make the apertio∣ne in bloode lettinge, or phlebotomye, dilli∣gentlye notinge, that vve nether touch anye vaynes, noe guttes, or any other parte vvhich is situated in the cōcavitye of the bellye. Novv therfore to effect this, vve may vvith great cō∣veniēce, & dexteritye, in steade of the crooked lancet, vse our punctuall instrumēt, heere be∣fore discribed & defigured, the inscision novv beinge done, vve must thrust cleane through the inscidede skinne, the fleshye pannickle, the muscles, and throughe the throughe cut Peritoneum, in to the concavitye of the bellye a goulden,* 1.43 or silver, pipe, as thicke as a qville or shaft, vvhich must have a broade end, that nothinge chaūce to slippe betvveene into the concavitye of the bellye, and therone a little string, or threde tyed, by the vvhich foresayed pipe, the vvater must be tapped as it vveare, & dravvn out, but not all at once, but by degrees & not to superfluos at one time, but on divers dayes, to vvitt, so longe till nature, beinge re∣leased, & lighted of her pack or butthē, vvhich mitigatinge this evacuatione, & governinge of the forces accordīge to the fortitude of the patient: vvhich vve may knovve, by feelinge of the Puls. Because there are some, vvhich ha¦vinge made to great an evacuatione at one ti∣me, have alsoe evacuated the vitall and livin∣ge spirites, vvhich vveare therin inclosed, and finally have caused the patiēt his death. VVhē as therfore vve shall have dravven vvater e∣noughe of at one time, vve must then stoppe the pipe, vvith a tente of linnē, or vvith a tent of sponge, to retayne the rest of the vvater, & lay theron a great plaster of Diacalcitheos: some there are vvhich dravve out the pipe, and let the vvounde vvhich is in the muscles and in the Peritoneo, the skinne, and the lippe of the vvoūde, vvhich before the inscisione vvas ni∣ped, and lifted vp, because that the foresayed vvounde, might thervv•• be stopped, and co∣vered.

Novv certaynlye to retayne and keepe bac∣ke, the vvater M^r. Floris Phillippes,* 1.44 a verye re∣noumned Chyrurgiane, at Orleans, sticketh his needle qvite throughe both the lippes of the vvoūde, comprehendinge sufficient qvā∣titye of skinne, vvherin he letteth his needle sticke, as vve are vvonte to doe in the har•• mouthes, and vvindeth his threde rovvnde a∣boute the needle, vvhervvith he contayneth & houldeth the lippes close together, soe that there may not one droppe of vvater passe forth, and vvhen he desireth to dravve, or tap∣pe more vvater therout, he then vnvvyndeth his needle, & openeth the lippes of the vvoun¦de, vvithout dravving the threded needle ther out. VVhilest that these thinges are this doinge, vve must strengthen the patient, vvith good cibaries and foode, vvhich easilye may be chaunged in to bloode, & lett him soe rest vntill the next day: on vvhich day, if soe be he be stronge enoughe, vve must yet dra∣vve of some more qvantitye of vvater, ether through the dravvinge out of the tente, vvher¦vvith the pipe is stopped, vvhen as vve put the pipe therin, or vvith the elevatione of the skin¦ne, vvhervvith the apertione is covered, vvith out puttinge the pipe anye more therin, if soe be there can issue anye vvater out, allvvayes egallinge or proportioninge the qvantitye of vvater, vvith the forces and strengthe of the patient, and in this manner must vve procee∣de in the dravving, or tappinge of, the vvater.

Others there are vvhich in the opening of the belly lay ther one a carrosive,* 1.45 vvher by the skinne is bitten & corroded through, thē they make an inscisione throughe the Escara, vnto the concavitye of the bellye, makinge a verye, smalle apertione, throughe the vvhich the vvater shall droppingly distill forth, & havin∣ge dravven therout sufficiēt vvater enoughe, thē they stoppe it, vvith scraped linte, vvhich vvhen they are desirous to dravve more vva∣ter therout, they thē remove, & take it of. Yet ther are others, vvhich after the inscisione of the foresayed Escara, thrust therin a little pipe therebye to dravve the vvater out, as vve have above sayed. Others set there on divers, and sundrye, corrosives, on the place of the liver,* 1.46 and of the milt, penetratinge nothinge deeper then the skin in••tatinge therin the doctrine of the aunciēt professors, vvhich vveare vvōt sometime, to apply nine at once. Others ma∣ke small inscisions, like vnto little scarificati∣ons,

one the sydes of the bellye, or els they lift vp the skinne, & thrust there throughe a nee∣dle vvith a silke thred, vvhich threde they suf∣fer to continue therin.

* 1.47 And consideringe that oftentimes, in those vvhich are troublede vvith the dropsy, there navell heaveth vp it selfe, yea and somtimes as bigge as an egge, vvhich standeth as cleere, as if it vveare a blather vvith vvater, there throu∣ghe I have seene to be dravvne, a silke or vvot∣lē threde, by the vvhich the patient perceaved great ease, consideringe the great qvantitye of vvater, vvhich through this apertione, is drop∣pinge vvyse runne out.

Allsoe beyonde all this are the legges, the hippes, and the Scrotum often times, svvollen: for the vvhich there is noe better remedye, thē that vve scarifye them throughe the skin∣ne, once as broade, as the apertione is in phle∣botomye: Some there be vvhich doe this by the innermost anckle or foure fingers above it.* 1.48 I have sometimes my selfe very luckylye & ominouslye done the same, above the knees, and in the insyde of the hippes, in the bagge of the testicles, out of the vvhich first of all is∣sueth a little vvaterye bloode, but immediat∣lye therafter the vvater superfluovslye issueth therout vvithout any inflammatione, soe that the foresayed scarifications, can not shutt, or heale, before all the vvater therof be issued, & runne out, & the patient all moste grovven smaller, & the bellye evidentlye vvaxed thin∣ner, vvhich in short time vvilbe effected, vvith out anye troublesome accidentes, happenin∣ge thervnto, & vvithout anye inflammatione in the foresayed partes. More over vve are not to expecte anye daunger heerof as vve might vvel doe, vvhen as vve open the bellye of the Dropsy Ascites, because one this manner, the vvater vvith great qvātitye, at one time is not dravven of: and if soe be the patient, after that ther is a great qvantitye of vvater dravven of, beganne to be vveak, vve may as then restray∣ne the droppinge of the vvater, vvhē as vve co∣ver the scarifications, vvith scraped linte, or vvith a fevve burned peeces of linnen, and soe stoppe it, & binde it. Out of the vvhich scarifi∣catiōs, if soe be vve are disposed to dravve mo∣re vvater therout, vve as then vntye the fore∣sayed place, & take avvay the linte from the sa∣me cause the patiēt somvvhat to vvalke, or ri∣de in a vvaggen or koache, if it be possible, & vvith the legge hanginge out, To cause the vvater,* 1.49 verye superfluouslye to runne or issue out of the legges, Hippocrates comma••••eth vs, to rubbe the foresayed scarificatiōs vvith saul∣te, & therafter stue them, & vvith anye fervēte or hott medicamētes vve must allvvayes & cō¦tinually keep opē the same, to vvitt, vvith me∣dicamentes vvhich are sharpe & bitinge: be∣cause in such scarifications, the auncient pro∣fessors, as Aetius, Asclepiades, Leonides, Hippocra∣tes, and Archigenes, have allvvayes hadde great confidence therin.

But before vve must come to these scarifi∣cations, vve must consider one the strength, & one the age. of the patiēt: for these apertions, are to noe vse, or cōmodytye, to those, vvhich are vvholye overcome of the sicknes, nether those vvhich are very oulde, & macilēte, becau¦se that as vvell the one as the other, of these sca¦rified partes, might easylye out of hande be mortifyed, vvithout beinge able in any sorte to retayne & keepe backe the same, vvherō im¦mediatlye follovveth death, & by the vvhich oftē times, the Physicions, or the Chyrurgiās, are iniuriouslye & vvithout right blamed, and of all mē hated & had in little vvorthe, as I my selfe have knovvne it happen vnto some, for the vvhich I vvas not a little greeved.

How that we shall cure the water burst, called Her∣nia aquosa. Chap. 5.

IN the Scrotum, vvhich vve call the bagg vvher in the testicles are contayned, is cōgregate & gathered together a certayne, vvaterishe moysture, through the vvhich the fore sayed bag∣ge commeth to svvel, vvhich tume factione, or inflatione, of the Greeckes is called Hydroce∣le,* 1.50 vvhich seemeth to be a particularre kīde of Dropsye: & must heere note that this svvellin¦ge, sometimes cōmeth but in one syde onlye: if soe be that this dissease proceedeth out of a∣ny antecedent or foregoinge occasions, it ne∣cessarilye follovveth, that the bloode, vvhich into all partes of the bodye is sent as nurritu∣re, is permutated & chaunged. into some vva∣terye substāce: & if so be of any blovve, or fall, it produceth his originalle, then is conteyned in the svvellinge a blooddye kinde of moystu∣re. This aqvositye, remayneth not,* 1.51 in one cer¦tayne place onlye because sometimes she is congreated & situated betvveen the first & se∣cōde membrane of the testicles: vve may kno∣vve this, vvhen as vve depresse the svvellinge, because as then the foresayed moysture agayn by little & little runneth therin: the bagge as then is more safter, nether can vve perceave a∣nye hardenes, or tumefaction therin as the vvaterye moysture, vvhich is situated, vvithin the concavitye of the Scrotum, because the fore¦sayed aqvositye, is not drivē therin: yea also in the same syde, vvher the moystnes demonstra¦teth her selfe, there lyeth the svvellinge in for∣me of an egge, or in an ovale figure, nether as then can vve ether throughe the sight percea∣ve,

or throughe the touchinge therof feele, a∣ny parte of the testicle, because the foresayed testicle lyeth therin hidden, and vvhen vve as∣semble & liken them both together, he appe∣areth somvvhat greater, & more svvollen, and vvhen as this svvellinge or inflation of the tes∣ticles is greate, thē is the bagge of the testicles, vpvvardes somvvhat longe stretched out, and elevated, soe that the vpper end of the yarde, partlye alsoe vnder the tumefaction lyeth hid∣den, & occulte. Somtimes alsoe is this vvater∣ishe humidty secluded in a severall membra∣ne, as in a little blather, the vvhich onlye for that purpose is constituted & ordayned, as cō∣monlye chaunceth in the tumefactione Ate∣roma, and vvhen it is soe, then is the svvellinge rovvnde, & closelye compacted together, soe that it seemeth to be a thirde testicle.

There is alsoe oftentimes, a ventosytye ga∣thered together, in the bagge, or Scrotum, as if it vveare a vvaterye humiditye or moysture, vvhich rightlye to discerne & knovve the one frō the other vve must consider that the vvin∣dye Hernia,* 1.52 or burst, is partlye harde and light, and is at one time engendred, on the suddayn, & subitlye cā it leese it selfe, & departe: vvhere to the contrarye, the vvaterye Hernia, doth not vvholye departe, but vvaxeth somtimes a lit∣tle smaller, consideringe anye smalle ague, or els consideringe the greate abstinence, & that especiallye in yonge childrene. If so be therfo¦re that there be noe great qvantitye of moystu¦re, or humiditye, then is the tumefaction soft, but if that there be greate qvantitye, it causeth then such a renitatione, or stretchinge out, as a bottle vvhich is full, and closelye stopped, & is heavye in elevatinge, or liftinge vp: such a svvellinge by little & little increaseth: the vay∣nes of the bagge of the testicles svvell, vvhē as vvith the fingers, vve thrust theron: the hume¦ditye flyeth befor the finger, & spreadethe her selfe rovvnde about the finger, & that vvher∣on vve doe not crushe, beareth vp it selfe: and this vvaterishe humiditye, revealeth her selfe over thvvarte, as in a glasse, or in a blather: as easylye vve may espye, vvhen as vve houlde a cādle close thervnto, one the syde of the svvel∣linge, and looke then one the other syde: And soe farreforth as the humiditye, therin contay¦ned, and occluded, be vvaterishe, then the in∣flatione or svvellinge glistenneth, & is of such a colour, as the circumiacent partes therabout lyīge are: if soe be it be blodye, or like the vvi∣ne mother or dregges, and faeces of vvine, then is the svvellinge reddishe of coloure, or pur∣ple coloured:* 1.53 & if soe be vve finde all these si∣gnes, and tokens, in both sydes of the Scrotum, or bagge of the testicles, it is then a signe of tvvo kindes of Hernia, to vvitt, in everye syde one. All these svvelinges, of themselves, cause noe payne, vnles it vveare great spanninge, of that parte might chaunce, throughe the great tumefactions, and that especiallye, vvhereas the vvatery moysture lyeth inclosed, betvveen the membranes of the testicles. Novve to abo∣lishe such aqvositye, there is nothinge more profitable, and commodious, then to make an apertion therinne, on this manner as follovv∣eth and succedeth.

Havinge shaved avvay the hayre,* 1.54 rovnde a∣bout the privityes (if soe bo the patient be noe childe) vve must then cause him to lye one his backe, ether one a bedde, or benche, beinge vvel stored of linnē, then vve must cause a ser∣vant, or helper, to stande one the one syde of the patient, & on the other syde of thē vvher∣in vve vvill make the apertione, vvhich fore∣sayed servant, must dravve the yarde tovvarde him: then must the Chyrurgian vvith his left hande crushe, on the inferior parte of the bag¦ge, because that parte vvhich he vvill thrust throughe might shevve it selfe the more stret∣ched, and fuller of substance, and pricke vvith his right hande, vvherin he must have a stron∣ge crooked lancett, from vpvvardes,* 1.55 dovvne∣vvardes, vnto the concavitye of the bagge of the testicles, because that the aqvosity may rū∣ne out. And if soe be the foresayed humiditye, lye inclosed in the mēbranes of the testicles, vve must as then most gentlye, & artificiallye, once agayne thrust therin, dilligentlye notin∣ge, that vve chaūce not to touch, the foresayed testicles, nether anye of the spermaticke ves∣sels: and if the humiditye vveare inclosed in a blather, the Chyrurgiane must then vvith his left hande, crushe one the inferior parte of the bagge, on this manner to drive vpvvardes the svvellinge, and the svvellinge beinge there re∣tayned & kept, vve must cōtinue it in this pla∣ce, least that she sincke dovvnevvardes agay∣ne, and vvith the crooked lancet, cut in the ne∣thermost part of the foresayed Scrotum vnto the blather, or bagge, vvherin the humiditye lyeth inclosed, & let it runne therout, as mu∣che as is possible: And if soe be, it be able to be done, vve must take therout, some parte of the bagge, or blather, because it should not heale agayne, & other vvater therin be engendred: then vve must put therin a great tente made of linte, vvhich must not be to harde vvounde, thervvith to keepe open the vvoūde, and not so quicklye heal it: for if soe it come to be too soone healed, & shutt ther might then chaun∣ce to be an other collectione, and gatheringe together of vvater, soe that it might be right needfull, to be sure of the curinge of the same, that as much as vve cā, vve cause the membra∣nes, to be purified, and cleansed, of all the hu∣miditye, and moysture vvhervvith they are throughlye soaked.

Some there are vvhich applye alsoe in the superior parte of the Scrotum, a potentiall cau∣terye, the operatione vvherof beinge done, they thē make an inscisione in the Escara, vn∣to the concavitye of the Scrotum, vvherin the foresayed vvater lyeth inclosed, & then suffer the foresayed Escara of her selfe to fall out and separate. Such an apertione, vvhich is made vvith corrosive, can not soe easylye be cured, soe that in the meane season the vvater hath time enoughe to issue out therat.* 1.56 Others, dravve through the svvellinge, vvith a strong needle, a silkē threede, in steade of making an inscisione, or applyinge of the corrosive, in place of a Setō, or transforatiō vvher through the foresayed vvater by little & little leaketh out.

But the apertione vvhich is least daūgerous of these three foresayed, is, the inscisiō, vvher∣of noe, or at the least, verye small accidentes, can ensue, if soe be she be done expertlye, and one a conveniēt place. It appeareth according as vve have above tought, in the openinge of Apostemations, that the apertion of the Scro∣tum, or bagge, reqvireth to be done in the infe¦rior partes of the same:* 1.57 notvvithstandinge ex∣periēce teacheth vs, that ther happeneth farre more payne, & inflammation, vnto it, vvhen the inscisione is made belovve, thē vvhen she is done & made above, tovvardes the flāckes: for ther is lesse daūger of hurtinge of the testi∣cles above, or ther membrane, because it is si∣tuated more inferior, vvher all the fibers, of the foresayed Scrotū, doe finishe & end, vvher∣fore, they are verye sensible & paynfull. So that Celsus, & Paulus, coūcell vs, that vve should make the inscisiō close by the flanckes.* 1.58 VVhē as therfore this species, and kinde of Hernia, is double, vve must then make & doe such an o∣peration one both sydes, & especiallye vvhen vve se, that they doe not in any sort assvvage.

Notes

• * 1.1

  What vve ought to consider before vve make the apper¦tione.
• * 1.2

  Signes of suppura∣tione.
• * 1.3

  Signes vvhē the matter is fullye ri∣pened▪
• * 1.4

  When vvith the lancet vve ought to opē an Aposte∣matione.
• * 1.5

  Opinione of Celsus.
• * 1.6

  When the Aposto∣matione must be opened vvith a hott Iron.
• * 1.7

  What apo¦stematiōs vvilbe opened before there cō∣plete ri∣penes.
• * 1.8

  Secondly
• * 1.9

  Four prin¦cipalle cō¦ditions, vvhich the Chy∣rurgiane must con¦sider befo¦re he opē any svvel¦linge.
• * 1.10

  The third cōditione
• * 1.11

  The fourth cō¦ditione.
• * 1.12

  An admo¦nitione conside∣ringe all great Apo¦stematiōs
• * 1.13

  Frō vvhē∣ce vve must take our indi∣cation, of the great∣nes of the vvounde.
• * 1.14

  An other conditiō vvherone vve must consider after the apertione of the svvelling.
• * 1.15

  The diffe¦rence of these thre Vlcerati∣ones.
• * 1.16

  Signes to knovve them.
• * 1.17

  We often¦times fin∣de harde matter in these vl∣cerations.
• * 1.18

  The mat∣ter lyeth enclosed in a little blather.
• * 1.19

  The ope∣ratione to cure the vlceratiōs is nothing different.
• * 1.20

  We must in the ope¦ratione dilligent∣lye consi∣der, that vve doe not chaū∣ce to brea¦ke anye Vaynes, synnues, arteryes, or tendo∣nes.
• * 1.21

  Hippocra¦tes in pro∣gnosticis and in his thirde booke of diseases.
• * 1.22

  This tu∣me facti∣one exter¦nallye so∣metimes demōstra¦teth it selfe.
• * 1.23

  The vice-ratione of the brest, vvhich vve call Empiema often ti∣mes dē∣monstra∣teth it sel∣fe.
• * 1.24

  Signes of the mat∣ter vvhich is retay∣ned in the brest.
• * 1.25

  Dropsy of the brest and her tokēs
• * 1.26

  Hovve vve ought to make the aper∣tiō in the Empiema vvith a lancet or vvith a corrosive
• * 1.27

  The place of the a∣pertione.
• * 1.28

  Admoni∣tione of lettinge the mat∣ter or vva∣ter goe from the brest.
• * 1.29

  Opinione of Hippo∣crates.
• * 1.30

  The trep∣ninge of the brest bone through the advi∣ce of Co∣lumbus.
• * 1.31

  The man¦ner novv a dayes to make an apertione
• * 1.32

  Descrip∣tione of the Drop∣sye.
• * 1.33

  Thre sor∣tes of Dropsye.
• * 1.34

  The first kinde.
• * 1.35

  The secō∣de.
• * 1.36

  The third kinde.
• * 1.37

  Accidētes of the Dropsye.
• * 1.38

  Ascites is subiecte to Paracē∣tese.
• * 1.39

  In vvhat persons the dra∣vvinge of of vvater must be used and in vvhat persons it must be left.
• * 1.40

  Hovv vve ought to effect this openinge
• * 1.41

  The place vvhere the aper∣tione must be made.
• * 1.42

  Excellent conside∣ration.
• * 1.43

  The vse of the pi∣pe.
• * 1.44

  Practise of M^r. Flo∣ris Philip¦pes, a re∣noumned Chyrur∣gian at Orleans.
• * 1.45

  Corrosive vvith in∣scisione in the Es∣cara.
• * 1.46

  Applica∣tions of divers cor¦rosives.
• * 1.47

  The na∣vell vvhich heaveth vp it selfe may be pricked thorough
• * 1.48

  In vvhat places the scarifica∣tions may be made.
• * 1.49

  Councell of Hippo∣crates, to dravv of the vva∣ter.
• * 1.50

  Hydroce∣le.
• * 1.51

  The sig∣nes of a vvater burst.
• * 1.52

  Whereby vve may knovv the vvin∣dye Her∣nia.
• * 1.53

  To kno∣vve vvhe¦ter the Hernia be one both sy∣des.
• * 1.54

  Hovve vve ought to make the aper∣tione.
• * 1.55

  Inscisione of the Scrotum.
• * 1.56

  Apertion by the thrusting through of a silke threde.
• * 1.57

  The ape¦tione is better to be done above 〈◊〉〈◊〉 vnder.
• * 1.58

  A dubb•••• inscisione in a ••••••∣ble Her∣nia.