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.

❧Wheron we ought to marke, after the thruste, & apertione of the vayne, and when the bloode issueth therout. Chap. 3.

* 1.1WE may knovve, that the vayne most commōlye is vvell ope∣ned, as easily vve may percea∣ve by the bloode, vvhen as in the firste, it rousheth and as it vveare leapeth out in great haste, but immediatly altereth vnto droppin∣ge, vvhich throughe the afrightinge of the pa∣tient is caused, for vvhich reason the bloode is dravven invvardes. VVhich vvhen it chaun∣ceth vnto vs, vve must vvith patiēce abyde, & and vnbinde it somvvhat, and incourage the patient, causinge him to move his fingers, & turne,* 1.2 and crush the same in his hande. The apertione in the vayne is sometimes ample enoughe, but because the bloode is grosse, it can not issue out therat, to the vvhich end vve must put a little oyle therine, vvhich to that purpose is verye profitable.

If soe be therfore the Chyrurgyane, in ab∣sence of the physitione, findeth the patiēt ve∣rye feeble, and yet notvvithstandinge, follo∣vvinge the rule, & ordinance of the physitio∣ne, is verye necessarye to be vvell phlebo∣tomized, vve must them doe it provident∣lye, that althoughe, at the first vve have not dravvne soe much blood as the sicknes or dis∣sease reqvireth, vve must then, some certayne hovvres therafter agayn renue the phleboto∣mye for the seconde time, and if it be needfull yet once agayne, for the thirde time, vvithout over charginge of the patient vvith to great phlebotomye at one time.

It might alsoe chaūce, that before vve could detracte such a qvantitye of the patiēt as vvas ordayned, and reqvired, the patient might chaunce to be debilitated, and in daunger to fall in great fayntnes, & sovvndinge, vvheron the Chyrurgiane must dilligentlye consider: as he may easyly perceave it, vvhen the patiēt vvaxeth pale, and oppressed at his harte, his puls diminishinge, & vvhen the bloode run∣neth dovvne by his arme.* 1.3 VVhich vvhen it chaunceth, the Chyrurgian must then imme∣diatlye sease the bleedinge, layinge his thum∣be, one the apertione of the vayne, & lay the patiente on his backe, vvith his heade one a cushen, sprincklinge could vvater in his face, and give him a little vvyne in his mouth, and cause him to smell at some vineger, and then have a little patience, vntill that agayne he re∣viveth, & comme to himselfe: for as soone as he shalbe come to his former strength agay∣ne, vve may as thē finishe the phlebotomye.

* 1.4Some ther are vvhich in anye sorte can not indure phlebotomye, hovv lovve soever they sitt, althoughe it vveare on the bed, or althou∣ghe vve cōtinually helde vineger before ther nose, or gave them vvyne to drincke, yet not∣vvithstandinge they lyinge prostrate on the bedd, vvith ther heade reasonable highe, they can as thē verye vvell suffer and abyde the fo∣resayed phlebotomye, althoughe vve dravve a goode qvantitye of blood from them: As of late I my selfe have knovvne to happen, in an honorable, and coragious gentleman.

After that vve have detractede a reasonable qvantitye of blood out, vve must then dissol∣ve and make loose the ligature, and crush out the bloode of the vayne, least that the bloode chaunce to congeale therine, and coagulate, and soe exulcerate: and if soe be ther appeere∣de anye little parcell of pingvedity, or fat, vve must thē gentlye thrust it in agayne vvith the heade of a pinne, and not cutt it of, and then vvipe of the blood vvhich cleaveth & is dryed or exciccated to the arme, lay a little cōpresse, one the apertion, vvhich is madefyed in coul∣de vvater, and vvinde the ligature, tvvice or thrice aboute the elbovve, like a borgondian crosse, vvithout tyinge both the endes fast, be¦fore you have caused the patient to bende his arme, to laye the ligature therafter.* 1.5 This liga∣tione may not be to stiflye bovvnde, because the cicatrice by this meanes, may qvicklye be sitvatede on the apertione of the vayne. The arme beinge thus fouldede together if so be the patiente be able to vvalke he must vveare his arme before on his breste in a scarfe & if so be he lye on his bedde, he must gently lay the same besyde him, vvith out much mo∣vinge of the foresayed arme, nether must he lye therone: for ther have binne some, vvhich in ther sleepe have hadde ther armes vio∣lentlye to bleede, vvith great daunger of ther lives.* 1.6 The bloode issueth sometimes vvith such violence out of some partes of our bo∣dye, that vvith noe cōpresses or ligatures vve can restraygne the same: vvhich happeninge, vve are thē constrayned to lay above one the toppe of the apertione, the one halfe of a gre∣ate beane, and the compresse therone, and in this sort bind it together,

Ther remayneth somtimes a nigreditye or blacknes,* 1.7 & viriditye or greenes about the a∣pertione, but therof ensueth noe evell, vnles anye other accident chaunced thervnto.

VVhen as therfore vve desire to renue the phlebotomy,* 1.8 vve must then lay one the insci∣sione saulted oyle, because that hindereth the curinge of the vvounde, and the sault keepeth the blood from coagulation, vvherthroughe the apertione of the vvounde is stopped, And if soe be the vvounde vveare soe stopped, that the bloode vvould difficultlye issue therout, vve must not then rigerously stretch out the arme, vvhich the patient hath carried on his brest dubbed, nether depresse the vayn vvith to great violence, to get the bloode therout: Because such violēce might cause great payn,

and inflammatione,* 1.9 but vve must rather vvith a small privett or searching iron, remove that blood vvhich therin is exciccated & dryed, or rather once agayne make an inscisione, after that vve have bovvnde the arm somvvhat hi∣gher, then the elbovve, as before vve have sa∣yed.

* 1.10VVhen as vve desire to make an apertione in the vaynes or arteryes of the temples of the head, of the foreheade or vnder the tunge, vve must then cause the patient gentlye to vvring about his neck a table naptkīne, or a tovvell, therby to cause the bloode to ascēde, on high, & the vaynes to svvel, vvhich vve intend to o∣pen.* 1.11 And vvhen as vve desire to open the vay∣nes of the handes or feete vve must bath them in vvarme vvater, because throughe caliditye & vvarmethe of the vvater, the foresayed vay∣nes might erect themselves, & the bloode, the vayne beinge opened, might the better issue out therof.

Notes

• * 1.1

  Although the vayne be vvel opened, yet shee droppeth throughe the afrigh¦tednes of the patiēt
• * 1.2

  Grosse bloode doth no∣thinge but drop∣pe.
• * 1.3

  What vve ought to doe vvhē vve per∣ceave the fayntinge to ap∣proch the patient.
• * 1.4

  The pa∣tiēt lying fiat on his backe cā verye vvel suffer phle¦botomye.
• * 1.5

  The Liga¦tione of the elbo∣vve after phleboto¦mye.
• * 1.6

  Hovv vve may stopp & restray¦gne blood
• * 1.7

  Daunger that hap∣peneth to phleboto¦mye.
• * 1.8

  To renue the phle∣botomye.
• * 1.9

  To renue the phle∣botomye.
• * 1.10

  Hovv vve ought to open the vaynes or arteryes of the tē∣ples of the head.
• * 1.11

  Hovv vve ought to open the vay∣nes of the handes & feete.