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.

❧ Of the swellinge Aneurisma, and of the mea∣nes howe to binde, and cut of the same. Chap. 6.

* 1.1THis tumefactione Aneurisma, is caused most commonlye, throughe the dilatation of an arterye, vvhich only vve must vnderstande of the smalle A∣neurismata, beinge impossible, that the arterye, shoulde so dilate, & as it vvea∣re vnshutt in the greate Aneurismata vvhich of¦tentimes vve see: vvherfor vve vvill rather say, and houlde vvith the opinione, of the aunciēt professors, that Aneurisma is then caused, vvhē as the bloode, and the vitall spirites, are repul∣sed out of the arteryes, throughe the apertion, or orificia of the same, vvhich vve call Anasto∣mosin, or els vvhen as the tunicle of the arterye is burst, it be ether throughe a vvounde, or by anye other occasione: as vve may se, vvhen as the Chyrurgiane, purposinge to opene the vayne in the elbovve by chaūce prickethe the arterye vvhich is therūder sitvated & the skīne vvhich is therō lyinge, cicatrizeth it selfe and the perforatiō of the artery, through her cōti∣nvalle reverberatiōe, tarrieth vncured, & opē & is not stopt, or vvith anye carnall substance replete, as beinge vnprofitable for anye vse & in noe sorte can be bound so close as the arte∣rye of the temples of the heade, but throughe the blood & vitalle spirites, vvhich by degrees issue therout, & are congregatede vnder the skinne, & soe conseqventlye cause the svvellīg supposinge they verye vvell did knovve, ther∣in to be matter, or any other slimye substance, or viscositye, for vvhich reason, they have ma∣de an apertione therin, vvhervppon a little ti∣me therafter death hath follovved, because of the bloode, and of the vitall spirites, vvhich in great hast have rushed therout, vvithout anye remedy hovve to restraygne them. Novv per∣fectlye to knovve such a svvellinge, and to dis∣cerne it from other tumefactiōs,* 1.2 vve must ob∣serve, that in this tumefactione ther is, a con∣tinuall reverberatiō, the foresayed tumor, be∣inge of one coloure vvith the skinne, hovve great or smalle, the inflatione be, it is alsoe tē∣der, and soft in the touchinge of the same, gli∣dinge avvay vnder the finger vvhen as vve de¦presse it, yea and almost throughe the foresay∣ed depressione vvholye vanisheth out of our sight, considering the bloode of the vitall spi∣rites, vvhich through the foresayed depressiō, are crushed in the arterye, vvherfore they al∣soe, as passinge throughe a little apertiō vvhich violence, do make a noyse, or sovvnde, vvhich havinge taken avvay, and removed the finger immediatlye shoote agayne in ther foresayed concavitye, as alsoe agayne in ther forth com∣minge, of the foresayed angust apertione, vve may heare a certayne sovvnde: vvhich cōmon¦lye chaunceth vvhen as this Aneurisma, is cau∣sed throughe an Anastomosis, and not of anye vvounde, because, the Orificium beinge apert, the vitall spirites, as being most subtile, are be∣fore the bloode driven out, soe that the vvhole tumefaction, is almost replete vvith vitall spi∣rites. But if soe be the Arterye be burste, there as then issueth much bloode therout, vvhich bringeth in the tumefaction more blood, thē vitall spirites, vvherfore alsoe it is more obdu∣rate, and harder, and the sayed bloode coagu∣lateth, and therin rotteth, and corrupteth.

As much as concerneth the curatione of this tumefactione, it consisteth onlye,* 1.3 in the bindinge of the foresayed arterye, and especi∣allye the same beīge somvvhat thicke, for they vvhich are greate, and especiallye the arteryes of the necke, the arme pittes, or of the flanc∣kes, may or can in noe sorte be tyed, because it is impossible to finde them, & make them ba∣re, and if vve allsoe make an inscisione therin ther then follovveth such a quantitye of bloo∣de, and of the vitall spirites, that most commō∣lye the patient, dieth vnder the handes of the Chyrurgiane.

That arterie, vvhich is situated in the ben∣dinge of the arme may easilye be cured,* 1.4 as out af this subsequent historye vve may note. My lorde of Maintenon, desired me to visite the sonne, of my lorde, of Belleville, vvhich throu∣ghe phlebotomy in the bendinge of his arme, had gotten a little Aneurisma, vvhich through continuance of time, is grovven as greate as a fiste, vvherin, in the ende the bloode vvhich therin vvas included, coagulated: so that in the foresayed tumefaction Aneurisma, ther came a corrupting and rottennes, vvhich he one the out syde of the foresayed skinne, of the svvel∣linge he espyede, vvhich from the vitall and livinge coloure vvas chaunged into a blacke, and purple coloure, vvherebye alsoe ther vvas an apertione caused in the skinne: To the remedyinge, and curinge of the vvhich, especiallye the superfluous effluxione of

bloede, vvhich might therof ensue, & the losse alsoe of the vitall spirites, if soe be the apertiō as yet vveare dilated: I as then councelled, the Physitions, and Chyrurgians, to praevent far∣ther evells, that vve ought to tye, & binde the Arterye, (vvhich vvas situated, and his place in the bending of the arme) somvvhat higher then the Aneurisma, to the vvhich opinion, & propositione, in the end they all consented, & agreed: The vvhich alsoe vvith happye succes∣sione of all causes vvas brought to passe, in the praesence of the vvorpshipfull master Dro∣vet, Doctour of Physicke, at Beauvais, and of the Chyrurgiane dvvellinge at Avet, vvhich vveare come thether to cure him.

* 1.5First of all, I cōsidered, on the arterye, in the vppermost, and inner parte of the fore arme, as shee from above descēdeth vnder the arm∣pittes, vnto the bēdinge of the arme, three fin∣gers bredth therabove, on the vvhich place vvhen I had seene, and fixede myne eyes the∣rone, I made an inscisione, in the skinne ac∣cording to the length therofe, vvhich lay ope∣ned right above the Arterye vvhere by tactu∣re vve might feele her, vvhich vvhen I had found, and discovered her, I thrust a crooked needle thervnder, vvherin vvas a strōg threde, vvhere vvith I tyed the foresaeyde Arterye, vvith a dubble knott: this beinge done, I took avvay, and purifyed, all the congealed, or coa∣gulated bloode, & all other impuritye out of the vvounde or svvellinge, and have vvashed the same vvith Aqvavitae,* 1.6 in the vvhich I mix∣ed a little Aegyptiacum, by this means to clean∣se it the better from all putrefactions: and the patient, is vvithin a moneth therafter ensuin∣ge, vvholye cured, and grovvne sovvnde, vvith out retayninge any lamnes in his arm: vvher∣in I my selfe have vvondered. If soe be that in anye other externall parte, there chaunced to come any Aneurisma into the Chyrurgians handes, he must then knovv, that allvvayes for certayntye, he shall finde the arterye in her vppermost parte, or discover, and bare her, & soe bynde, and tye her vvith out anye more ceremonies.

Notes

• * 1.1

  Discripti∣on of the tumefac∣tion Ane∣urisma.
• * 1.2

  Signes of this tu∣mefactiō.
• * 1.3

  Curation of Ane∣urisma.
• * 1.4

  Of an ar∣terye vvhich of the Au∣thor vvas tyed abo∣ve the A∣neurisma
• * 1.5

  On vvhat sorte the Aucthor tyed this Arterye.
• * 1.6

  Remedye agaynst the putre¦factione.