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.

THE FIFTH TRE∣ATISE OF THE OPERATI∣on of Chyrurgerye, wherin is discoursede and handelede of the disseases of the nose, & of the mouth, contayninge seaven Chapiters. (Book 5)

• Of the Polipus. Chap. 1.
• Of the Haremouth. Chap. 2.
• Of the vlcerationes, & of the excrescēce of the fleshe of the gummes, called Paroulis, ende Epou∣lis, Chap. 3.
• Of the tunge tyinge, or of the shortnes, or brevitye of the tunge, vvhich the Greeckes call An∣ciloglossum, & of the vlceration Ranula, vvhich is allsoe called Batrachos. Chap. 4.
• Hovve vve ought, to cauterise, and cutt of, the Vvula, or pallaet of the mouthe. Chap. 5.
• Of the svvellinge of the almondes, & of the vlcerations of the same. Chap. 6.
• Hovve that vve ought to dravve, breake, or cutt of teethe, Chap. 7.

Of the Polipus. Chap. 1.

* 1.1SOme men there are, vvhich have a certayne excrescēce, of fleshe in the nostrells, vvhich resumeth her originalle, out of the bone, Etmoidis, or Chri∣bleus, & out of the bones of the nose. This excrescence happeneth or com∣meth to a man, by little & little at once, and at the last, she vvaxeth soe bigge, & huge in qvā∣titye, that she stoppeth the vvhole nostrells, & sometimes alsoe hangeth dovvne to the lip∣pes, by the vvhich the patient, is mervelouslye molested, as vvell in speakinge, as breathinge. Sometimes also shee grovveth in the entrāce, or conductione, through the vvhich the ayer, & the breath, are dravvne into the throte, the vvhich vve may easilye see, vvhen as the pa∣tiēt openeth his mouthe, behinde the pallaet of the mouth, & in such a greatnes somtimes, that she stoppeth the throate, vvherthroughe the patient cōmeth in the end to be chōaked, if that in time vve doe not prevent it, And be∣cause such an excrescēce of fleshe, most com∣monlye is softe, and pale, havinge divers small sproutes, not mislike vnto the feet, of the fishe Purpura, it is therfore of the Greeckes called Polipus, & allso in our langvage Polipus.

There are noe sortes of Polipus vvhich being venoumous,* 1.2 have neede of the operatione of Chyrurgerye, because vve may not touch thē, in like sorte vve may not touch those vvhich are infected vvith the Cancer, because ther na∣ture

is thervvith polluted, & they ther through spoyled. The yōge Chyrurgiane, may knovve them by there sensiblenes,* 1.3 because they are verye dolorous, & full, of payne, & extreame hard, beinge allmost purple coloured, vvith a very stinckīg odoure, or smelle, on the vvhich the Chyrurgiane shall doe nothinge, but must be handled as if it vveare the Cancker, to vvitt, throughe koolinge, dryinge, & throughe mol¦lifyinge medicamentes, throughe the vvhich her excrescence may be praevented.

* 1.4That Polipus, vvhich is insensible, or vvhere there is little, or noe payne, vvhich is vveake, loose, tractable, vvithout beīge irritated, pale, or vvhich is of a reddishe coloure, those vve may throughe the operation of Chyrurgerye take in handes.

* 1.5To the effectuatinge of vvhich, the aunciē∣te Chyrurgiās, & those vvhich have follovved there doctrine, have effected this operatione cruellye enoughe: for some there are vvhich vvith an instrument cutt rovvnde, or circkle vvyse this Polipum, vvhich to that end & purpo¦se, therto they have caused to be made, and is called in greeke Polyticon Pathion, vvithout tou∣chinge of the cartilage, or grisle, vvhich bein∣ge effected, they dravve forthe the foresayed descided Polipus, vvith an instrument much li∣ke vnto an eare picker, or els vvith some kinde of hoocke, & then they cure & heal the vlcera∣tiō, as it reqvireth to be don. And as cōmonly there remayneth some little peece of roote, in the bones Etmoides, & of the nose, the vvhich they scrape of, alsoe from the foresayed bones turninge, & thrustīge therin, vvith an instru∣mēt, to fetche all therout, that by any meanes possible might tarrye, and remayne therein.

* 1.6Others endevour to consume, & annihilate the foresayed Polypum, vvith certayne caustic∣ke, or vstive medicamētes, as vvith Aqva for∣tis, vvith oyle of vitrioll, or vvith the liqvefac∣ted, & moulten corrosive, in the vvhich they dippe, & madefye little smalle tentes, vvhich they lay therone, vvith or throughe a little pi∣pe, because they shoulde not hurte the nose o∣ne the internalle or inner syde. Others ther a∣re, vvhich vvith an actuall cauterye, cauterize it, vvhich throughe a pipe they thrust therin. Others, after the exāple the four famous Chy∣rurgians,* 1.7 vvhich not beinge of opinion, that in noe vvyse, or in anye sorte vve vveare able to cauterize the Polipus, vnto his roote, because he is soe deepe ingraffed, they thē make an in∣scisione, one the one syde, of the cartilage of the nose, vnto the bone of the same, & havin∣ge in this sort discovered, & denudatede the Po¦lipū vnto his roote or first ofspringe, & origi∣nalle, then they there cutt, & cauterise him, & stitch together agayne the sayed inscisione, as vve are commonlye vsed to doe in the hare mouthes. The vvise, & Learned man Guido de Cauliaco, liketh & commendeth this, or such like operatione, but in noe vvise, counceleth, to stitch vp the inscision, before the foresayed Polipus, be vvholy eradicated, & rooted out, be¦cause if soe be, that anye parcell therof remay∣ne, it agayne increaseth, vvhich happening he, to be soe, all the trouble, & paynes of the pa∣tient, hath binne done for nothinge, & to noe purpose. All vvhich operations, beinge as suf∣ficiently and completlye effected as they possi¦ble may be, yet for the patiēt they are tedious & trouble some, as often times, vve have vvith our eyes behelde, vvhich to speake the very truthe indeede, they have never attayned vnto ther perfecte, and former health agayne, but rather farre vvorse, then better: vvherby vve vveare moved, to trye. & make experiment of a far more ominous, and more convenient o∣peratiō, to the curinge of this dissease, vvhich consistethe in the vvhole eradicatione of the same.* 1.8 To the vvhich end and purpose it see∣meth vnto vs convenient, that vve situate, & dispose the patient, on the most convenient māner vve may, in a seate, tovvardes the light, & the Chyrurgian, vvith his left hande openin¦ge the nostrell, vvherin the Polipus is situated, shall vvith his right hande, thrust therin the flat tōges, as deepe as possibly he may, (vvhich tonges must be sōvvhat broade, & like a Duc∣kes) bil vvhervvith he must nipe the foresayed Polipū, & gentlelye vvith both his handes tur∣ne & vvinde the same, & thervvith alsoe dra∣vve tovvardes him a little, & not at one pluc∣ke, because the roote vvhich is fast setled in the foresayed bones, might alsoe follovve, & the foresayed Polipus at one time be dravven forthe, and extirpated: vvhich I my selfe may vvith the truthe alleadge to have done, vvith verye little payne. M^r. Sourlin, a verye experte Chyrurgian, hath assured me, that he alsoe di∣vers times hath done it one the same manner, vvithout anye inconvenience.* 1.9 But the Chy∣rurgyane must consider, that he doe not advē∣ture on such an operatione, then in that Poli∣pus vvhich is tractable, and not canckerouse, & vvhich is greate enough, to be griped, & vvith out breakinge to be extirpated, vvherfore, if it be not great enoughe, vve as then let him gro∣vve, & increase. And soe farre forth as the fore¦sayed Polipus, drevve himselfe vpvvardes, avoy∣dinge the nipinge, of the little tōges, vve must thē dravve it dovvnevvardes, vvith a little hoo¦ke, because as then vve may the better, take houlde therone: the operatiō beinge finished, ther ensueth an effluxiō of bloode presētlye, therafter, vvhich vve shall permitte, & suffer to bleed, because that parte may be therof re∣leased, & vnburthened: vve must then cause the patiēt, through his nose to snufle vp redd

vvyne, & that as oftentimes a daye, vntill such time as it be internally cured, vvithout apply∣inge any pingveditye, or oyles thervnto.

❧Of the haremouthe, or splitted and cloven lippes. Chap. 2.

* 1.10THe cleavinge, or splittinge, vvhich daylye vve see, in the lippes, in the eares, and in the nose, is of Galen called Colobo∣ma, & in Lattin Curtum, vvhen as these partes throughe anye naturall dissease, are splitted, or clovene, as if there vveare a peece cutt out.* 1.11 It is impossible, that vve should ingendre, anye other matter, & restore, the substāce, vvhich therin is vvan∣tinge, because it is the vvorke of nature & not of the Chyrurgiane: but he may bringe the se∣parated partes the one, by the other, and cause such a substāce, vvhich in that parte is deficiēt, & vvantinge shall seeme as it vveare there in ingendred, soe that verye hardlye vve shall e∣spye, & marke such an vnseemlines, & defor∣mitye, especiallye if the slitte have binne but small: for these disseases might per adventure be soe greate, that they shoulde be incurable, and vveare not conveniente for vs to lay han∣des one them, & if soe be vve endevoured to cure them, vve might chaunce to make them farre vvorse, & more vnseemlye, then before they vveare. VVherfore the Chyrurgiane ought dilligentlye to consider, that one such kindes of fissures or splittinges, he impose not his handes, and especiallye in those vvhich are to vvyde seperated the one from the other, & vvhere there is to much substāce deficient or vvantinge, betvveene them bothe, for vvhen a Chyrurgian endevoureth to cure such a dis∣sease, then must necessarylye the seiunged and separated partes, ether ioyn, & heale together agayn, or els not: if soe be they grovve, & ioyn together, the lippe thē is merveylouslye stret∣ched, & lyeth close to the teethe, & one the gū¦mes: And if soe be they cā not souder, & ioyn the on vvith the other, the fissure, or splitting, vvilbe much greater, then before it vvas, be∣cause & cōsideringe that, vvhich one both sy∣des vvas taken & cutt avvaye, through vvhich occasione, the patiente, as then can farre and much more difficulter eate, and also speaketh vvorse, because that a cōplete, & vvhole lippe, is verye cōveniēte, & necessarye, as vvell to the commestione, as to the loquution, & speeche.

* 1.12This manuale operatione, is verye daunge∣rous in aged persons, & in those vvhich are vn¦healthesame, of bodye, or in those, vvhich (as vve commonlye say) have noughtye healinge fleshe, because, that in mās bodye there is noe parte or place, vvhere in the Cācker cā sooner come, and beinge therin, vvherin he may be vvorse cured, & vvith more difficulty healed. The meanes to cure such a dissease, is on this manner: VVhe must first of all situate the pa∣tiēt tovvardes the light, & vvith our left hāde, lift vp the right syde of the cloven or splitted lippe, & as then cut vvith the crooked lancett, in the middle or vpper end of the foresayed syde of the lippe, through the skinne, & alsoe betvveene them both beginninge as highe, & as neere the nose, as possible might be done, dravvīge the foresayed lācett, vnto or tovvar∣des beneath or end of the lippe,* 1.13 because that the vvhole interiacēt skinne, might be cleane therof separated and severed: then vve must change handes, takinge in our right hāde, the other syde of the clovē lippe, vvhich is situa∣ted in the left syde, & then vve must cut vvith the left hande, even as before vve have done vvith the right, because the clovē lippe, may on all sydes be cut, & on the edges be brought to ravv fleshe, vvithout leavinge the least par∣te thereof vntouched, vvhich is not cut, or ma¦de ravv, ether in the infierior, or superior par∣tes therof, & that nothinge differinge from a greene, freshe, & bloodye vvoūde, before vve assay to stitch them the one vvith the other.* 1.14 This beinge one such a manner effected, and that parte havīge somevvhat bledde, vve must as then contracte & ioyne together both the cut partes, as close, and as smoothe as by anye meanes possible vve may, and thrust a needle throughe both the foresayed revnited partes, thrustinge deepe enoughe through the fleshe, & suffere the needle to remayne therin, one the vvhich vve must rovvnde about vvīde the threde, as the Taylers are vvonte to doe, vvhē anye vvhere one there apparrell they sticke there needle there to keepe it: As farre as the fissure or splittinge be greate, vve may as then sticke tvvo needles there in, the one vnder, & the other above. If soe be the separated partes, of the foresayed lippe, can not vvith any faci∣litye, or ease be brought together, vve must thē make tvvo inscisions, in eache syde of the lipp one, informe & likenes of a halfemoone, both the korners therof tovvardes the vvoūd,* 1.15 as heer befor in the figure vve may see, vvhich inscisiones must onlye penetrate the vpper skinne, because that the edges of the vvounde beinge dravvne together, might the better ioyne the one vvith the other, for vvith anye violence they may not be compelled, but ra∣ther, vvith gentlenes, and vvithout any force, because that, they beinge brought and ioyned the one vvith the other, be not agayne vvith∣dravvne backvvardes.

It chaunceth alsoe sometimes, that the skinne one the on syde of the fissure, can not completlye vnite her selfe vvith the other, vvhere throughe, that place of the vvounde, is

deformed & mishapē, because it is not vvho∣lye cooperte, & coverede, seinge therfore that this soe chaunceth, vve must as then cut this sayed parte halfemoone vvyse, vvithout in a∣nye sorte touchīg the other syde.* 1.16 If so be the acuitye or poyncte of the needle vvhich stic∣keth in the vvounde, or lippe, sticketh some∣vvhat lōge throughe the other syde, vve must nipe, or breake it of vvith certayne pinsers or tonges because it shoulde not pricke or hooc∣ke in anye other place, & vve must applye the∣ron, a plaster of Betonica, & in those inscisions vvhich are made in the forme of a halfemoo∣ne, vve must applye therone onlye drye linte, because the lippes, or edges therof, might not heale, & because that the fleshe vvhich therin increaseth, doe not replenishe the vvounde, & the lippe ther throughe be made broader.

The foresayed suture, is commonlye healed together the seaventh day, and soudered the one vvith the other, vvhen as therfore vve es∣pye & marke that it is soe, & that they are ioy∣ned the one vvith the other, vve must cut of the threde vvhich is vvounde rovvnde about the needle, & plucke the needle therout, & cu∣re the remanēt of the vvoūde, & alsoe the stit∣ches of the needle, as necesitye reqvireth the same to be done, and effected.

* 1.17The lippes are some times splitte, or cleft in tvvo sundrye, & divers places, but therō is not soe much consistinge, if they be not soe farre separated the one frō the other, as if there vve∣are a noteable peeces cutt therout, because o∣thervvyse it is as vvell & easilye to be cured as the single fissure. If soe be there be any excres∣sēce of fleshe, or any cartilage, fovvnde abou∣te the lippes, or in anye place, vvhich necessa∣rilye is to descided vve must alsoe cut that out, because, in all places it might be of an aequalle smoothenes.* 1.18 As cōcerninge, & touchinge the fissures, of the eares, or nostrelles, vve must therevvith proceede, on such a māner, as heer∣tofore vve have sayed of the splittinges and fi∣ssures of the lippes.

Of the vlceratione, and excrescence of the gummes, called Paroulis, and Epoulis. Chap. 3.

AFter the inflammation, or ins∣censione of the gummes, com¦mōlye succede the & follovve the an excrescence of fleshe, vvhich of the aunciēte profes∣sors vvas called Epoulis, & that especiallye about the checke, or hindermost teethe. Such a humor, & excrescēce encreseth by little, & little, till at last it increaseth as big∣ge as a hennes egge, soe that sometimes the teeth there throughe fall out, and the patient not able to open his mouthe.* 1.19 If soe be these excrescences be blacke, and Canckerouse, vve must not applye there one any sharpe, or cor∣rodent medicamentes, nether vvith byndinge separate, & roote them oute: but must entrea∣te, & handle them, in such sorte, as before vve have spoken of the Cancker, and like all palli∣ative cures.

If soe be this excrescence be tender, soft,* 1.20 & tractable, vve must vvhilest it is smalle, descy∣de & cut it avvay, if soe be it be great, vve must thē bynde it of, vvith a stronge threde, vvhich vve must alligate, and tye vnder at the roote therof, and by degrees knitt it closer, till that in thus doinge, the roote by the threde be cutt throughe, and the excrescence fall out of the mouthe.* 1.21 Such a ligature or byndinge is farre surer, thē the discidinge or cuttinge of, the sa∣me, because that therthroughe, vve neede fea∣re noe superfluous bleedinge, & the roote bet∣ter one this manner be taken out, & allsoe the patient have lesse payne, and feare to expecte, then of the inscisione, or cuttinge, and cauteri¦satione, vvhich after the inscisione cōseqvēt∣lye follovvethe.

VVhen as therfore througe byndinge,* 1.22 vve have discided this carnositye, or excrescens, & that she reverteth & cometh agayne, as often times chaunceth, vve muste as then religate & binde agayne the same, or cut it, and cauterize the roote therof, it be ether vvith a little actu∣all Cauterium, or vvith a little oyle of Vitroll, vvith Aqvafortis, or vvith anye other liqvefac∣ted corrosive, vvhich vve finde thervnto most convenient. A parte of the aunciente profes∣sors, vveare vvōte to applye therone, some or other corrosive poulder, on the same, vvhere of the excrescence might clean be corroded a∣vvaye, vvhich in mye opinione is verye incō∣veniente, especiallye in these partes.

There is as yet an other kinde of vlceration,* 1.23 or tumefactione incident vnto the gummes, vvhich of our praedicessors vvas called Paroulis: vvhich perseavīge it to be come to his full ma∣turation, & ripnes, vve must immediatlye ma∣ke therin an apertione, & inscisione, vvith the crooked lancett, vvhich must be of an indiffe∣ferent latitude, because it might not agayne chaunce, to cause a revlceratiō or svvellinge, & soe chaunce to chaunge it selfe into a fistle: be∣inge aperte, and open the patient must vvas∣he his mouth vvith some grosse redde vvyne, vvhich must be sōvvhat vvarme, to exsiccate, & drye, to confort, to repelle, & drive backe & if neede soe reqvire to stoppe, and restayne bloode: the next day follovvīge he must vvas∣he his mouth vvithhonye vvater, to the pur∣ginge, and purifyinge of the dissease.

This vlceration, must immediatlye be ope∣nede, because the matter, chaūce to make noe more concavitye, and the cheecke bone ther∣throughe

chaūce to be polluted. If soe be ther chaunce any corruptinge, and rottenes in the gummes, vve must then annoynte them vvith a littie Aqvafortis,* 1.24 but vvith due considerati∣one, and discretione. And because that often∣times immediatlye after the disseases Paroulis, or Epoulis, there commonlye engendreth, and commeth a fistle in the gummes, vvhich pene¦trateth, & pearceth vnto the cheeckebon, vve must note, if the root of the tooth be not rot∣ten, & corrupt or altered, for if so be it vveare soe, (as oftētimes it happeneth) vve must dra∣vve forth the toothe, and correcte the place, vvherin the tooth hath stoode ether vvith a cauterye, or vvith oyle of Vitriolle, and if soe be ther be any parte of the cheecke bone cor∣rupt, by this meanes, nature vvill expell and drive from her the corrupted peece of bone, vvithout vvith violence to dravve forth the same.

❧Of the retentione of the tūge, which of the Greec∣kes was called, Anciloglossum, and we nowe call it tungetyed: And of the vlceration vnder the tunge, which of the Greeckes is cal∣led Batrachos, & of our moderne Physicions Ranula. Chap. 4.

* 1.25THe tunge in some persons, or children, is shorter then shee ought to be, vvhervvith they are borne, and by the vvhich occasiō, they must vvith diffi∣culty vtter the vvordes vvhich they vvoulde speake, the tunge beinge inter∣cepted, and hindred, by a certayne ligament, vvhich vve call the spāned vayn, vvherthrou∣ghe the tōge, is restrayned, & as it vveare, see∣meth to be brydeled, or throughe any mem∣brane thervnder situated, vvheron the tunge resteth, & because shee can not soe move her selfe, and turne, as it vveare convenient, shee shoulde. The children are verye longe time before they beginne to speake, & vvhē as they beginne, they as thē speake verye festivouslye & hastilye, & vvithout any hinderance, excep∣te in vtteringe of those vvordes, vvhich are difficulte to pronounce, as are those, in the vvhich manye R. R, R. and L. L. L. come.

This dissease, is alsoe sometimes accidētalle vnto a man,* 1.26 vvhen as after anye vlceratione vnder the tunge, there remayneth a harde cal∣lousnes, & anguste cicatrice, vvherof the tūge sometimes, inspeaking must dubble & redub∣ble her selfe, & they vvhich are troubled vvith this imperfection, doe speake vvith great pay∣nes & difficultye, vvherfore the auncient pro∣fessors of foretimes, have called thē Mogilaous. The fore sayed dissease must be cured onlye throughe the manualle operatiō. To vvhich ende & purpose, vve must situate & place the patiente as the matter is reqviringe,* 1.27 the servāt of the Chyrurgiane havinge both his fingers vvounde vvith fine linnē (to vvitt, the thum∣be, & the first finger) vvherevvith he must ta∣ke the foresayde tūge by the end, & lift her vp, tovvardes the roofe of the mouth: vvhich be∣inge done, if soe be the membranes vvherone the tunge is fastenede, be cause, of the difficul∣tye of speech, thē must the Chyrurgian vvitth a smalle hooke, as is before describede, houlde the same thervvith fast, vvith his left hande, & vvhen indiffierentlye he shall have stretched out the same, he must as then ether vvith the poyncte of his scissors, or els vvith his croo∣ked lancet, cutt, and discide it of. If soe be the shortnes be caused because the liga∣ment of the tunge, is to shorte, & stretcheth it selfe more then is needefull tovvarde, the middle of the tunge, or els because of anye ci∣catrice: vve must then alsoe in like sorte take houlde on all that vvith the hooke, & plucke or dravve it, & cut it of, vvhich is obdurated & harde, alsoe all that vvhich vvith the naturall fleshe of the tunge is not moved, or stirred. This operatione then beinge effected, the pa∣tiēt must vvas he his mouthe, vvith a little vva¦ter & vineger, & dilligentlye stirre the tunge, & often times thruste her forth of his mouth, & rubbe or vvipe his finger thervnder, & oftē times vvith his teethe crushe her vp tovvardes the roofe of the mouth, because that the fore∣sayed ligament, or mēbrane, doe not chaunce to ioyne & grovve fast agayne therō:* 1.28 for as the stirringe, & removinge vp & dovvne, are a hin¦derāce, vnto the healinge of the same, soe is all so qvietnes, & stillnes, an occassion of the vni∣tinge, & cōbinatione of the same: yea he must alsoe in the night seasō lay a compresse vnder his tunge, there by to hinder, & delay the cu∣ringe of the vvounde, vvhich easilye sleepinge might chaūce & come to passe, & that because the tunge, nether by eatinge, nor by speakinge is in anye sorte stirred or moved.

Some of our aunciēt professors,* 1.29 to prevent the daūger, of bleedinge in such an operation, thruste through the membranous ligamēt, or through the cicatrice, vvherby the tūge is kept boūde & tyed, a needle vvith a threde, vvhich by degrees they dravve & plucke together vn∣till such time the membrane heervvith be cut a sunder.

VVhen as vve vvould cut the tunge tyednes in yonge childrē, vvhich are nuely borne,* 1.30 vve must first of al vvith the finger lift vp the tūge, & vvith the poyncte of the scissors, descide, and cutt of the membrane vvhich is situated vnder the tunge, & thē vvith the finger vvipe a little sault therin & rubbe it, vvithout doinge anye thinge els there to, commaundinge the nour∣se, to doe the same once, or tvvice more.

* 1.31It may alsoe chaunce that the speech is im∣pedited & hindered, by reason of some vlcera∣tione, vvhich commeth vnder the tūge, called Batrachos, or Ranula, in vvhich vlceratione, ther lyeth a vvaterishe humiditye therin inclosed, vvhich often times is not dislikinge vnto the vvhyte of an egge, as vvell consideringe the consistence therof, as concerning the colour, allvvayes commonlye beinge included in a little membrane, like vnto the vlceratione A∣teroma, & manye other coulde vlcerations or svvellinges. In have seene such manner of svvellinge, & tumefactions soe greate and soe often times (after they have binne thruste through to lett out the matter) returne agayn, that the patiēt, by reasō of the greatnes coulde not speake, yea allsoe in davvnger ther throu∣ghe of styfelinge, or smotheringe, soe that I have knovvne them to have binne opened foure times in one daye, and at everye season a hādefull of matter to issue therout, like vnto slime, and the vvhyte of an egge. The vvhich hath binn soe difficult to be cured, that in the end vve have binne compelled, to applye ther one an actualle Cauterium, in vvhich large and vvyde apertione, vve have imposed & layed in linte, being madefyed and made vvett in oyle of vitriolle, by the vvhich at the last the patiēt is sovvndlye, and completlye cured.

Novv to cure this dissease, vve must first of all make an apertione, vvith the crooked lan∣cet, accordinge to the length of that parte and not thvvart or crosseover, to give issue & pas∣sage to the humiditye & matter to runne out, vvhich is the occasione of this tumefactione, or vlceratione: and if soe be this svvelling re∣turne, the surest remedye, as thē is the actuall cauterye.

* 1.32To vvhich intent, vve must vvel, and con∣veniētly situate the patiēte, & cause his heade to be stayed, & helde by his servant, vvith the one hande one his heade, and the other vnder his chinne, there aboute vvhere the foresayed vlceration is situated, because partlye there throughe it may be elevated and lifted vp, for the Chyrurgiane vvith more ease & facilitye to attayne to his purpose, vvhen as vvith the lācet or vvith the cauterie vve vvill make ther in an apertione: For those partes beinge ten∣der, & softe, hovv little soever they be crushed yet notvvitstādinge yeeld thēselves invvardes vvher throughe the apertion might be hinde∣red & fayled, and all our laboure be lost, & be∣stovved in vayne. The patient therfore in this sorte beinge settled and disposed, and beinge by some servāt helde faste, must opē his mou∣the, then shall the Chyrurgiane vvith his left hande lay a peece of lattinne or a silver plate vnder the tunge of the patient, vvhich hath a hole in the middest therof right on the place, vvhere vve desire to make the apertione, then must the Chyrurgiane take in his right hande a glovvinge or redde hotte Cauterium, vvhich he must sittuate right one the hole of the fore¦sayed peece of Lattinne & thrust the same in∣to the concavitye of the foresayed vlceration: in soe doinge are the circumiacent partes de∣fended from all combustione or burninge, & the vlceratione verye convenientlye opened. This apertion beinge on such a manner effec∣ted, & brought to passe, vve must cause the pa∣tient to vvash his mouthe, vvith a mouth-vvater, or gargrise, vvhich must be made of barley-vvater, of Plantine, and of honie-vva∣ter.

❧Howe we ought to cauterize, cutt of, or bynde, and tye, the pallate, or Vvula of the mouth. Chap. 5.

NAture hath in the posteriore partes of the mouth created, a spongiouse, & carnall or fles∣hye dugge, as thick, & rovvnd. as is the end of a shaft, or qvill as easilye vve may see, vvhen as vve open the mouth. This reservinge his naturall proportione, the Greeckes as thē call it Gargareon, the Latinistes, Gurgulio,* 1.33 & vve the pallate of the mouthe: but the same beinge amplifyed, and grovven greater, then natural∣lye it is, through the discendinge of any super∣fluous humors, beinge of one crassitude abo∣ve, & beneath, it is as then of the Greeckes cal∣led Chiou, in Lattin Columella,* 1.34 as if vve vvoulde say, a little pillaer: but if soe be it be belovve rovvnder it is as then of the aunciente profes∣sors called Staphila, of the Lattines, Vva,* 1.35 and of vs, the sincking or fallinge of the pallate. It hath sometimes such a longitude, depending one the tunge, that the patient allvvayes sup∣poseth, to have somvvhat in the throt, vvhich verye vvillingly he vvoulde svvallovve.

That vvhich is blacke,* 1.36 vve must not in a∣nye vvyse meddle vvith, or take in handes, in like sorte alsoe the same being vvholye infla∣med, because as then vvith out daunger vve can by noe meanes possible, descide and cutt it of, because of the superfluous bleedinge vvhich conseqventlye follovveth, vvherfore as then vve ought rather to vse all such medi∣camentes as still, and assvvage payne, vvhich moysten and madefye, and gentlye fortifye & strenghthen the patiēt. But if soe be that there be noe inflammatione, & the pallate be tho∣roughe soaked vvith humors, & is vvaxed ve∣rye longe, vvhyte, pale, and sharpe,* 1.37 vve must as then cutt it of: as vve must alsoe doe vvhen it is above thinne, and belovve thicke.

This dissease may be cured, by takinge avvay

that, vvhich in the pallate is oppugnant vnto nature, ether throughe dissectione, or throu∣ghe cauterizinge, or els throughe bindinge of the same. If soe be vve feare anye superfluous bleedinge, it is then the surest, shortest, & ea∣siest vvaye, to discide it, because the patiēt ther throughe might be freede from manye more miseries, calamityes, & mischaūces, vvherine othervvyse he might in time chaunce to fall as is the cough, through the cōtinuallirritatiō of the forefayed longe hangīge pallate, omis∣sione, & losse, of sleepe, & somtimes alsoe the choackinge, soe that vve notinge & observin∣ge all these thinges, are of tē times compelled, for the succoure of the patient, to effect our extreame,* 1.38 and laste remedye, to preserve and keepe him from greater daunger ensvinge.

And aptlye to bringe this to passe, vve must cause the patient to sit in a verye lucent and lightsome place, and alsoe to set apert & vvide open his mouth, and depresse his tunge vvith the Speculum oris, then take houlde one the fo∣resayed pallate, vvith a litte instrument, or tō∣ges made onlye for that purpose, leavinge as much hanginge of the pallate vnder the fore∣sayed tonges, or instrumente, as is to longe, nought, & as must be cutt of, pluckinge of the same a little tovvardes him, because that vvith the poynct of the scissors, he may convenient∣lye cutt of, that vvhich hangeth vnder the fo∣resayed instrument or tonges but not that vvhich is above the foresayed instrument as easylye it may be done, for vven as this pal∣late, is tender, spongious, and covered vvith a mēbrane,* 1.39 vve as thē easylye take houlde ther∣on vvhen as vve vvoulde plucke him, vvher∣fore some Chyrurgians have oftentimes bin∣ne deceaved, supposinge him to be much lon∣ger, vvherfore they have cutt him to shorte, & allmost cleane avvay, vvhere throughe allsoe verye troublesome, and difficulte accidentes have follovved: because this beīge happened, al the pectorall partes, are haynouslye & mer∣veylouslye therthrough offended, vvith grea∣te difficultye of vvel speakinge, yea & someti∣mes allsoe vvith vvant of speech, or dumnes: vvherfore vve ought not onlye to leave the roote, vvheron that this dugge, or this pallate is fastened, but somvvhat more, and onlye cut of that, vvhich above his naturall constitutio∣ne seemeth to be toe longe. Others there are vvhich take houlde on this pallate,* 1.40 vvith an in¦strument called Staphilagres, vvhervvith they vvringe it rovvnde about, & havinge vvrunge it rovvnde, it vvaxeth crooked, & purple co∣loured, and in the sectione therof issveth little bloode therout. Beinge novv descided & cutt of, if soe be there follovved a greate effluxione of bloode, vve must as thē cause the patient to gargrise his mouth vvith vvater and vineger, and then vvith some constringent decoctione vvhich hath bī boyled vvith grosse redde vvy∣ne, or els touch the place,* 1.41 orvvype it vvith so∣me stronge cauterisinge vvater, vvhervvith the opened vaynes might be seared together.

The seconde manner, of effectinge this sa∣me, is done vvith an actuall,* 1.42 or a potēciall cau∣terye: as concerninge the actuall cauterye, vve must therevnto have in a readines and praepa∣red, a sylver, or copper pipe, vvhich in the one end therof must have a little apertione in sor∣me of a little vvindovve, to receave there in that parte of the pallate, vvhich you resolve to cauterize, then you shall put into the pipe your glovvinge actuall cauterye, vvhich vvith his end vvill abolishe and take avvay that, vvhich shall hāge there in as if it vveare vvith a little cheesell strokē of, and one this manner vve must cauterize, and cutt of the pallate evē, and smothe. Touchinge the potentiall caute∣rye, or corrosive, vve must first receave, into the apertiō or vvindovve of the foresayed pi∣pe, that parte of the pallate, vvhich vve desire to corrosive, and then vvith a privett or sear∣chīge irō thrust into the foresayed pipe, a pee∣ce of corrosive, aganst the foresayed peece of pallate of the mouth, and continue the same therone a certayne time, dilligentlye conside∣ringe, that not anye parte of the corrosive, fall one the tunge, or the throte, vvhen as throu∣ghe the humiditye of the pallate it beginneth to liqvefye.* 1.43 And vvhē vve desire to take avvay the foresayed pipe, vve must thē first of all lay the Speculum oris, one the tunge, because as thē noe parte of the foresayed corrosive, chaunce to light or fall one any of the subteriacēt par∣tes, nether touch any parte, but the pallate on∣lye because therby they might be indamma∣ged, and hurte. Thus havinge brought this to passe, vve must annoynt the pallate vvith a lit∣tle oyle of roses, vvith a little cotten or linnen there in beinge madefied, and made fatt, then shall the patient vvashe his mouth vvith a lit∣tle roosevvater.

A sorte ther are vvhich doe not vse the fore¦sayed pipe, but they dippe, & moysten, a little cotten, or linnen, vvhich is tyed to the privet, or searchinge iron, in oyle of vitriol, or Aqua∣fortis, vvith the vvhich they touche the pallate, and cauterize it, the tunge before beinge layed dovvne vvith the Speculo oris, & thē a little sea∣son follovvinge they vvashe it vvith Plātine∣vvater. Others take a little kinde of spoone,* 1.44 (vvhich of our praedecessors vvas called Staphi∣locaustō) full & implete vvith poulder, of corro∣sive, full Aquafortis, or oyle of Vitriolle, vvher∣in they cause the end of the pallate to depēde, allvvay before havinge layed dovvne the tun∣ge vvithe the Speculo oris, and by this meanes they cauterize, & consume, the pallate vvhich

before vvas to longe: it is right true, that some of this corrosive in the spoone might chaūce to fall one the tunge, vvherfore I vvoulde ra∣ther councell to vse that corrosive vvhich is thicke and of some crassitude, as that is vvhich may be pulverisated & beaken to poulder, be∣cause vvithout beinge pulverizated it can not shevve his forces one the pallate. VVhen as therfore, throughe the applicatione of anye of the fore sayed corrosives, or cauteryes, the place of the pallate beginneth to be blacke, it is then a signe that it is sufficiētlye cauterised, and if soe be the coloure therof be not, as yet chaunged, vve must then yet once agayne ap∣plye the corrosive thervnto, & then cause the patient to gargrise his mouth vvith Oxicrate or vvith vvarme redd vvyne.

* 1.45I have knovvne the suncken pallate to be lifted vp agayne, vvith a little povvnded pep∣per & saulte, by a spoone, beinge therone fas∣tened: others vse there to some astringēt poul∣ders. The thirde meanes, to cure this dissease, is effected by ligature, because of the timorous¦nes vvhich the patient conceaveth of the cut∣tinge of, or cauterizinge the same, or effluxion of bloode.* 1.46 VVhich is effected and completlye brought to passe, vvhē as vvith a stronge thre∣de vve tye the fore sayed pallate vnderneathe, in that place vvher it surpasseth his naturall lengthe: throughe vvhich ligature, the inferi∣or parte can obtayne noe nouriture, because the vaynes by the threde are suffulced & stop∣ped vp, soe that in a short time the threde cut∣tethe of, and causeth to separate that vvhich hath binne bovvnde, the superior parte bein∣ge allmost cicatrized, vvith out any feare of a∣nye superfluous bleedīge. The meanes hovve verye neatlye, and convenientlye to effect this operatione, and allsoe the instrument thervn∣to servinge, is described vnto you before amō∣ge the figures of the instrumentes.

The vse of the foresayed pallate of the mou∣the,* 1.47 shevveth vnto vs, that vve ought to obser∣ve a meane, in cuttinge of the same, vvhē as it surmountethe the naturalle longitude, or els the vse therof is brought to nought, and loste, because therthroughe, the voyce of mā is for∣med, and retayned, as the mouth or apertione of a Citerne, vvhen as vve touch the stringes therof, she as then geveth a sovvnde, even soe the breath of man, vvhich is the substance of the voyce, issuinge forth of the longes bein∣ge divided, and spreade over, and throughout the vvhole roofe of the mouth, there and in that place to receave the articulatione, and by the tunge, teethe, lippes, and nostrelles, in the vtterance therof to be formed. VVherfore those vvhich have the same surpassinge the naturalle length, or in any other sorte, troub∣leth them, have such a feeble, & imbicille voy∣ce, that verye difficultlye vve may heare them, or at the least speake throughe there noses: & if soe be it be cleane cut of, they leese ther spe∣eche, and vvaxe mute and dumme. Above all this it hath as yet a tvvofoulde vse, viz the one to prohibite, the duste, and anye other substā∣ce, to enter into the throte, by our breathe, vvhich constinuallye vve must dravve invvar¦des, and hangeth as it vveare dilated and sprea∣de abroade like vnto a tapistrye, over the thro∣te. The other, and second vse of this pallatis, that it vvarmeth, and temperethe, the coulde ayre vvhich vve dravve in throughe the nose and throughe the mouthe to the lunges, be∣cause throughe the extreame coulde therof, it might not chaūce to indammage the foresay∣ed tunge, vvherfore they vvhich have no pal¦late, finde themselves allvvayes very much al∣tered, & changed, and a great coulde allvvayes one the brest.

Of the swellinge of the Almondes, and of the vl∣cerations of the same. Chap. 6.

ONe both sydes of the pallate, and in the hīder partes therof, in the angustnes of the throte, vvhich of the Greeckes is cal∣led Isthmos, hath nature crea∣ted and formed, tvvo Almon∣des, the one right opposite agaynst the other, vvhich are therfore called Paristmia: vvhich be cause of the forme, figure, and qvantitye ther∣of, are vvholye likened to an Almonde, & are for that occasione called Almōdes: ther func∣tione, and office is, that they retayne in them, a certayne sputaminous humiditye, vvhich sincketh & descendeth out of the heade, ther∣bye not onlye to refreshe & moystē the mou∣the, & the circumiacent partes of the same but alsoe the throte, and the entrance of the sto∣macke, because the tunge in speakinge might not vvholye be exsiccated and dryed, and that the cōtinuall speech might not therby be hin∣dered, and interrupted.

These foresayed Almondes, are situated,* 1.48 in a moyste, and vvarme place, and consideringe ther spongious, nature, are subiected to all cō∣cursions of humors, and all inflammations, vvherthroughe oftētimes they vvaxe harder, and greater, thē naturally theyought to be out of the vvhich, procedethe an vlceratiō or tu∣mefactione, called of vs Antiades,* 1.49 vvherthrou∣ghe the passage of eatinge, drinckinge, & brea∣thinge is stopped, & interrupted, soe that tho∣se afflicted patientes, can not vvithout great difficultlye, svvollovve, or respire & breathe, & even as the patiētes, heere throughe are co∣me into great perill, & daunger, soe they must

immediatlye be succoured vvith excellent & good remedyes.

* 1.50The assuredest and most convenient reme∣dye is, that vve cause thē praesentlye to be phle¦botomised, after that they shall at the first ha∣ve vsed a glister: and thē in like sort cause him to be lett bloode vnder the tūge: that vve boxe thē behinde in the necke, that they vse gargri∣ses, vvhich are indifferentlye frigifyinge, and astringent.

* 1.51This tumefactione oftentimes is of such a magnitude, that it exvlcerateth: vvhich easilye vve may espye, vvhen as vve perceave it to be rumpeled, and vvhytishe, and vvhen as before ther hath binne any prickīge therin. VVhich havinge espyed to be soe, vve must vvith an in¦strument, vvhich onlye to that intent, & pur∣pose vvas made, open the foresayed vlceratiō, or els vvith a lancett, vvhich rounde about vn∣to the poyncte is vvounde vvith linnen. The apertion must be reasonablye dilated, because theris noe especiall greate vayne situated in that place, vvhich vve might hurt, except it vveare in the bottome or roote of the foresay∣ed Almondes. VVe are sometimes cōstrayned to opē this vlceratione, before it be fullye ma∣ture, and ripe, to vnburthen, and release that parte therof, because the bloode vvhich issu∣eth out of the foresayed vlceratione, diminis∣heth & intercepteth the payne, and inflamma¦tione therof, adminestreth better passage vn∣to the meate, and drincke, and finallye, prolō∣geth the breathe. It is right true, that vve all¦vvayes in the first, ought by all meanes ende∣voure to mitigate the payne, and coole the caliditye of the vlceratione as much as is pos∣sible.

If soe be these sayed Almōdes, are groovvē soe longe & harde, vvith out anye hope to re∣duce them agayne to ther former & naturall estate, & beinge, vve must as then vse the ma∣nuall of Chyrurgerye thervnto, ether by cut∣tinge of the same, or els throughe inscisione: if soe be there be nothinge to hinder or be a let heere vnto, then the ligature vveare most convenient thervnto, and especiallye, vvhē as vve feare anye superfluous bleedīge. VVhich verye conveniētlye may be done,* 1.52 vvith an in∣strument, one the same forme and fashon, as before vve have rehearsed, in the tyinge of the pallate, ever observinge, that vve cutt therof noe more, then is needfull, contentinge our selves thervvith, not to cut therof anye more, then that vvhich surpasseth his naturall mag∣nitude, & greatnes: because that throughe the largenes and romthe of the throte vvhich by this dissectione might chaūce, there be not ir∣ritated and occasioned to follovve, all such ac∣cidentes and inconveniēces, as before vve ha∣ve discribed, of the pallate vvhich is to shorte cut of, or anye daungerouse bleedinge, if soe vve descide and cutt it of vnto the naturall, & sovvnde fleshe, of the forerehearsed almon∣des, because of the greate vaynes vvhich there vnder lye dispearsed.

But before vve proceede unto this operati∣one, vve must consider,* 1.53 vvhether they be not of some canckerouse nature, because those vvhich are canckerouse may not by the ma∣nualle, operation of Chyrurgerye be cured: they are most easyest knovvne, vvhen as they are harde, of a purple coloure, rugged, full of payne, and have a great roote. But if they be pale rovvnde, tender, smoothe, and belovve thinne, vve may as then vvithout daūger tye, and cutt them of. And in as much as concer∣neth this operatione,* 1.54 the historye of Albucasis shall at this time suffice, to instructe the yon∣ger Chyrurgian, to imitate the same, vvhich affirmethe to have had a vvoman in handes, vvith such an vlceratione vvherbye her thro∣ate vvas allmost occluded and stopped, that vvith great difficultlye shee respired, & brea∣thed, nether coulde shee anye more eate, or drincke, beinge in greate perill, & daunger of death, if soe be that in that estate she had con∣tinued but one day longer, in vvhome this vl∣ceratione vvas soe extreamlye svvollen, that it had yet spreade it selfe abroade into tvvo branches more, into the nostrelles. In vvhich greate necessitye, and perplexitye, vvith al ex∣peditione he tooke, a little hooke, vvhervvith he layed houlde one the one branche therof, vvhich vvas come into the nostrelles, vvher∣vvith he drevve forth therof a reasonable qvā¦titye, and then as deepe as he coulde, he cutt it of, & havinge done the same, in the other no∣strell allsoe he hath aperted and opened her mouth & depressinge the tunge dovvnevvar∣des, hath taken houlde on the svvellinge and tumefactione, vvith a hooke, & allsoe cutt a great qvantitye therofe, vvithout anye greate store of bloode issuinge out of it: This beinge finished, the miserable & poore vvomā hath immediatlye opened her mouthe & beganne to eate, & drincke vvater. At other seasons al∣soe therafter he hath cut avvay ther frō other peeces, but yet notvvithstādinge, as oftē & as much as he descided & cut therof, is increased agayne & grovvne thervnto: vvhich vvhē he had marked, he cauterised the same, & by this meanes in the end hath praevented the excre∣scence of this tumefactione: but beinge con∣strayned to take his iourny to some other pla¦ce, coulde never heare, or by any man vnder∣stande, hovv it happened therafter vvith her: & it may right vvell be thought, that the cau∣terisinge of this dissease vnto his roote, could not in anye sorte increase agayne, as before it had done.

It happeneth allsoe sometimes, that the Al∣mondes soe chaūce to svvelle, that ther is noe hope left, that vve shoulde perforate, or thrust them throughe, or to binde & tye thē, because somtimes it is impossible for the patient to o∣pen his mouthe, & not beīge able in any sorte to respire, must of necessitye dye: vvhich per∣ceavinge to be in such an estate, vve are then constrayned in our extreame necessitye, to ta∣ke our last refuge, vnto the makīge of an insci∣sione in the throte, or Trachea arteria, rather thē vvith our eyes behoulde the patiēt to smother & choake. VVhen as therfore vve vvoulde effect this, vve must cause the patient to lye, & leane on his backe, and hange his heade back∣vvardes, because the throte, or Trachea arteria, may evidentlye shevve it selfe, then vve must vvith our fingers, take hould on the skinn, of the third, or fourth ringle of the throat, vvher vvith the foresayed, circles, or rovvndes of the throate are covered, & lifted vp, novv this be∣inge, soe heaved vp, vve must accordinge vnto the lōgitude therof make the inscisiō, vvhiche beinge cut throughe, & agayn let fall, vve shal as then perceave the throte bared, & if soe be therone vve espyed any vayn, vve must detru∣de it one the one syde & eschevve, or avoyde the same. VVhich beinge effected, vve must vvith the poyncte of a croocked lancet, make our inscisione thvvarte over, betvveē the thir∣de or fourth rotūditye or circle, qvite through the mēbrane, vvhervvith both the foresayed cartilages, or circles are the one vvith in other vnited, & holden together, of vvhich betvveen thē both is situated, vvithout touchinge ether of both these cartilages, or rovvndes, into the concavitye of the foresayed Trachea arteria, or throate, vvhich easyly vve may perceave vvhē as the breath issueth forth of the vvounde: in the vvhich vvound, immediatlye therone, vve must impose a silvern, or gouldē pipe, because ther throughe duringe some shorte space the patient may breathe. This sayed pipe must in the one end be somvvhat broade, vvith a thre∣de theron fastened, because that through the dravvinge of breath, it doe not chaunce to be dravvne into the throate. Novve the daunger of choakinge beinge passed, vve must as then take it therout agayne, because that the vvoū∣de, vvith convēnient remedyes may be cured.

Howe we ought to drawe, thrust out, and cut, of the teeth. Chap. 7.

* 1.55THere are divers disseases insci∣dente vnto the teeth, vvhich throughe the manuall opera∣tion of Chyrurgerye must be cured: as by cauterisinge, of the same, & by dissipation of the gūmes frō the toeth, by filinge, by cuttin∣ge of, by dravvinge by settinge, by cuttinge in therofe, & by allegation & bindinge together of the teeth. Those teeth vvhich are slimye, & therō, a blacke, yellovve or vvhyte tough mat∣ter, & sōtimes like vnslissed lime, or as it vvea∣re some putaminous substāce, chaunced to be therō obdurated, & hardened, vve must vvith a little scraper, or instrument, for that purpose make thē cleane & purifye thē, vvithout hur∣tinge of the gūmes, & looseninge of the same, because that such teeth vvhich are heervvith polluted, are not most cōmonlye very fast: the aged poeple, & the rheumaticke, they vvhich are trovbled in the lūges, or vvhich have anye dissease in the stomack, vvhich in times passed have binne infected vvithe the poxe, are com∣mōly subiect vnto disseases of ther teeth: vvhē as this increscēs is not as yet obdurate or hard vve may then vvith more facilitye remove the same, & in the first vve must vvashe the gūmes as vvell of the one as the other vvith a little al∣ume vvater vvherby the increasinge of this matter is sōvvhat praevented, & retarded,* 1.56 & it fasteneth allsoe the gummes vnto the teethe, vvhē as they hāge looselye therō. Some there are vvhich esteeme this a greate secrete vvhich heertofore I my selfe have vsed, to vvitt, that vve take a little Aquafortis, and a little sticke, as thicke as a quille, the one end therof beinge dipped in this vvater, vvith vvhich end of the foresayed sticke, vve must vvel rubb the tooth thervvith, dilligētly observīge, that noe drop∣pe therof chaūce to falle one the lippes or gū∣mes, & immediatly the tooth being heervvith rubbed, vve must as then vvith a linnē cloute vvipe the toothe, the linnē clothe beinge ma∣defied in could vvater therbye to dissipate frō the tooth the tartenes therof, vvhich the Aqua¦fortis hath left behinde it, causinge the patient immediatly to spitte, & therby the toothe vvil be exceedinge vvhite as snovve.* 1.57 If ther bee any tooth corrupted, foraminous, concavous & stinkinge, & that cavseth sometimes great doloure, & payne, yet notvvithstādinge vve al¦vvayes endevoure to praeserve him, ether be∣cause he is cōmodious for chavving, or servi∣ceable for the speech, or els is for a decorū or grace vnto the mouth: to the repellīg of vvhich payne, vve must vse a little oyle of Sage, of ro∣semary, of cloves, or any other oyle, of aroma∣ticalle spices. And if soe be thervvith the pay∣ne, & the corruptione be not seased, vve must as then vvith Aquafortis cauterise the teeth, or vvith oyle of vitroll vvherein vve must dippe and moystē a little cotten, vvhich neatlye vve must thrust into the cōcavity of the toothe: & if so be all these remedyes be not sufficiēt, ther is as thē noe surer, or better remedy, thē is the vse of the actuall Cauteriū, vvhich must be pro∣portioned verye little, & accordinge vnto the concavitye of the tooth.

Other Chyrurgians ther are vvhich hovvld in greate esteem the filīge of the teethe,* 1.58 vvher

they be corrupted, vvhich I alsoe esteeme to be commodious, vvhen as convenientlye it may be effected, & vvhen the tooth is corrup∣ted but on the one syde therof: for by this me∣anes vve shall intercept, & hinder the corrup¦tione of the next toothe ioyninge thervnto, that he be not thervvithe polluted above o∣ther commodityes, vvhich therthrough vve shal effect.

* 1.59Ther grovveth oftentimes a tooth higher, then the other of the teeth, ether vpvvardes, outvvardes, or invvardes, the poyncte vvher∣of is soe accute, that in speakinge it ether hur∣teth the tunge or the lippes. Alsoe sometimes the teethe ar rugged & vnsmoth above, vvher¦fore they, one the toppes & summityes therof be filed, by this meanes to make them smoo∣the, as the other. And convenientlye to vse the file theron, & to cause that the toothe doe not chaunce to stirre in the filinge, vve must hould fast vvith our fingers the foresayed too the, layinge certayne peeces of linnen on the gummes,* 1.60 vnto the rootes of the toothe. VVe must file of all such teeth vvhich extrud them selves externally, vvill not be cōtayned in the semicircle of the other teeth, or they vvhich are brokē, & a little peece therof as yet remay∣ninge in the place, least they might chaunce to hurte the tung, or the mouthe. Conserninge the supernaturall teeth, because it vveare to great paynes & labour to file thē, it is alsoe so∣metimes daūgerous to dravve thē because cō∣mōlye they are grovven, & sticke verye fast in the cheekebone, vve cut thē of vvith our cut∣ting pellicane,* 1.61 or instrumēts vvhich onlye for that purpose are cōposed & made, & are befo∣re figured & set dovvne in ther formes: vve all soe breack thē sometimes i•• place of cuttinge of thē, vvith such instrumētes as heere before are praefigured vnto vs: but the best vvay is to cut thē of, if by any meanes possible vve cā ef∣fecte it.* 1.62 The payne of the teethe is at someti∣mes soe vehemēt & in tollerable, because that the tooth, is corrupted vnto his synnue, pear∣ced, & is hollovved, that the persone, is almost phrēsye, & cōsideringe that there is somtimes noe remedy to be hadde, for the quallifyinge of this payne, he is as then cōstrayned to cause the sayed tooth to be dravvne, vvhich as then is the certaynst vvay.

* 1.63VVhē as therfore vve vvoulde dravve forth a tooth vve must cause the patiēt to sit in such a sorte as is most cōveniēt, & thē make choyse of the corrupted & rotten tooth, because vve doe not mistake the one for the other, vvhich vve must make loose frō the gumes, & fill vp the cōcavity or hollovvnes of the tooth vvith a little peece of leade, or vvith a little lint, or cottē sticke it full, because in the Pellicane he chaūce not to breake, through the harde shut¦tinge of the same: havinge houlde theron, vve must gētly & easyly crushe the tooth dravver together, least the tooth chaūce to breake, and thē dravvinge the foresayed tooth a little a sy∣de plucke him out, because that if to rigorou∣slye vve vvaggle the tooth vp or dovvne that parte of the cheeke bone vvherin the roote stoode soe fast, might easylye be brokē, vvhe∣refore he vvill not vvith to greate violence be dravvne out, as alsoe by to violent dravvinge, vve might disioyne, and plucke out of ioyncte the nethermost cheekebon, & cause great per¦turbation in the vppermost chavve evē to the eyes. The tooth beinge dravven,* 1.64 vve must vvith both our fingers shutt, & ioyn together agayn the gummes & cause the patiēt to vvas∣he his mouth vvith a little Oxycrate, vvherin vve must also put in a little sault. If soe be ther vveare any effluxiō of bloode, vve ought not to esteeme it to be a small matter because I ha∣ve knovvne some to bleed thēselves to death.

The assuredest remedye vvhich I ever have knovvne to be vsed, is this, that divers times, vve must thrust therin som cottē, vvhich hath binne madefyed in iuyce of lēmones, vvhich allvvayes vve must put in that place, out of the vvhich the tooth vvas dravven.

And touchinge the conveniēce of the liga∣tione, or tyinge of the teeth,* 1.65 to ioyn thē toge∣ther, & to inserte & set fast those teeth, vvhich are loose, & grovvē to be moveable & may be vvaggled vp & dovvne, & alsoe to inserte anye therin vvhich by arte ar made, all this may ve∣rye conveniētlye & fitlye one this manner be effected, vvith a fyne gouldē vvyer of fine ori∣entall goulde, vvhich vve may easylye bende & bovve, betvveen the foresayed teeth vvith∣out any violence. First dubble the vvyer, laying the same vvith his duplication, betvvee¦ne tvvo sovvnde teeth & then bringe both the endes, to that tooth vvhich is loose, vvhether it be one or more, vntill such time as vve shall have dravvne vnto the seconde sounde tooth one the other syde, then vve must reduce the vvyer vnto that tooth vvhence vve tooke our originalle, gentlye dravvinge the foresayed vvyer together, close to the roote of the tooth least that he goe loose: This beinge done vve must vvith a pare of sheares cutt of both the endes of the foresayed vvyer vvhich are to lō∣ge, & vvinde the rest therof rovvnd about the sovvnd tooth, as close to the roote that the fo∣resayed gouldē vvyer, may very difficultlye be espyed, nether in anye sorte may perturbe, or hinder the tunge. The teethe not onlye bein∣ge loose but alsoe vvholye fallen out, vve may for all that inserte them in there place, & tye them, vvith a gouldē vvyer, as is before rehe∣arsed, or els vve may set other teeth in ther pla¦ces, vvhich are by art made of Ivory,* 1.66 or of any other matters, as here before vve have set dovvne the figures and discriptions therof.

Notes

• * 1.1

  Roote, & originall of the Po∣lipus.
• * 1.2

  Noe sor∣tes of Po∣lipus, can throughe Chyrur∣gery be cured.
• * 1.3

  Signes of a veno∣mous Po∣lipus.
• * 1.4

  Signes of a tractable Polipus.
• * 1.5

  Hovve vve ought to cure the Poli∣pum.
• * 1.6

  An other manner.
• * 1.7

  An other manner to cure the Poli∣pum.
• * 1.8

  The man¦ner hovve to drovve out the Polipus, more cer¦tayner, & conveni∣enter, through extirpati∣one.
• * 1.9

  Admoni∣tione for the Chy∣rurgiane.
• * 1.10

  Colobo∣ma, Cur∣tum.
• * 1.11

  To rege∣nerate a∣nye sub∣stance is a vvorke of nature and not of the Chyrurgi¦ane.
• * 1.12

  In vvhat persons this ope∣ratione is daunger∣ous.
• * 1.13

  Hovv vve ought to cure the cloven lippes, or haremou¦thes.
• * 1.14

  We must let that parte som¦vvhat bleede.
• * 1.15

  Vievve the figure before.
• * 1.16

  We must nipe of the poyn∣cte of the needle.
• * 1.17

  Lippes vvhich are cleft in tvvo places.
• * 1.18

  Cleaving of the ea∣res, and nostrelles
• * 1.19

  We may not pro∣voacke the Canc∣kerouse.
• * 1.20

  The man¦ner to cu∣re Epoulis
• * 1.21

  Such a li∣gature is more cer∣tayne thē inscisione
• * 1.22

  Hovve vve ought to handle the Epou∣lis that returneth
• * 1.23

  Paroulis, and the meanes hovv to cure it.
• * 1.24

  A reme∣dye a∣gaynst the cor∣ruptinge of the gū∣mes.
• * 1.25

  The disse¦ase of a hortened tunge.
• * 1.26

  The disse¦ase of the tunge af∣ter a cal∣louse vlce∣ratione.
• * 1.27

  Hovv vve ought to cure the tunge tyinge.
• * 1.28

  Hovve vve may hin∣der the healinge.
• * 1.29

  Membra∣nous liga∣ment or tunge tyinge.
• * 1.30

  Hovv vve ought to cutt the tunge ty∣inge of yonge children.
• * 1.31

  The vlce∣ratione Ranula, and the orginall therof.
• * 1.32

  Hovve vve ought to cure this vlce∣ratione & his return agayne.
• * 1.33

  Gurgulio
• * 1.34

  Columel¦la.
• * 1.35

  Vva.
• * 1.36

  Wen vve ought not to cutt a∣vvay the pallate.
• * 1.37

  Thre me∣anes or vvays to cure this dissease.
• * 1.38

  The first vvay to cure the sinckinge of the pal∣late.
• * 1.39

  Accidētes vvhich may insue through cuttinge to highe of the pallate.
• * 1.40

  An instru¦ment or tonge, called Sta¦philagres.
• * 1.41

  Remedye agayst the bleeding of the de∣scided pallate.
• * 1.42

  The secō∣de māner to cure the sine∣kinge of the palla∣te throug cauterisa∣tione.
• * 1.43

  This cor∣rosive is discribed before amonge the instru¦mentes.
• * 1.44

  Staplulo∣causton, a certayne kinde of spoone soe called
• * 1.45

  A tryed remedye.
• * 1.46

  The tyin∣ge, vvith the third meanes hovve to cure the pallate beinge suncke.
• * 1.47

  Vse of the pallate.
• * 1.48

  The vse, situatione & compo¦sitione, of the Al∣mondes.
• * 1.49

  A tume∣factione called Antiades.
• * 1.50

  Reme∣dyes a∣gaynst the tumefac∣tion An∣tiades.
• * 1.51

  Signes hovve to knovv vvhē the tumefac∣ted Almō¦des, exvl∣cerates and ther remedyes
• * 1.52

  Ligature, or inscisi∣on in the almōdes, vvhē they are gro∣vven to longe & harde.
• * 1.53

  The canc¦kerouse almondes may not be tyed, not cut of.
• * 1.54

  Historye of Albu∣casis.
• * 1.55

  Divers Chyrur∣gicall ope¦rations.
• * 1.56

  Practise & inven∣tione of the au∣cthore.
• * 1.57

  For rottē hollovve & stinc∣kinge teeth.
• * 1.58

  Whye vve file the teeth.
• * 1.59

  Teeth vvhich grovv forth vvith an acuitye.
• * 1.60

  Teeth vvhich stand out of ther ordre, vvhich are brokē & vvher∣in as yet remay∣neth som little peece.
• * 1.61

  Superna∣turall teeth.
• * 1.62

  For great payne & doloure in the teethe.
• * 1.63

  Hovv vve ought to dravve a tooth.
• * 1.64

  The blee¦dinge of the gum∣mes vvhē as the tooth is dravvne out, is not to be litt∣le estee∣med of.
• * 1.65

  After vvhat sor∣te vve ought to tye the teeth, shutt, & sett them fast vvhich a∣re loose, & alsoe inserte those vvhich throughe art are made.
• * 1.66

  Looke a∣fore in the figure or formes