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 Cirsotomia, that is, of the manner, howe we ought to cutt of the vari∣ces. Chap. 7.

* 1.1VArices, or burstene vaynes, are troublesome, because of ther greatnes, their extracting, thicknes, and their gibbositye above ther nature, & property. VVherfor, ether because they cause payne, and hinder the actione of that parte, or els because they soacke in some cer∣tayne vlceratione, vvith some humiditye, (vvherby she can not be cured) vve are vrged to open them, and cut themof,* 1.2 or els vvith so∣me actuall cauterye, to cauterize them, & soe consume, and bringe them to nought. To vvhich purpose, the auncient professors,* 1.3 have ordayned, that vve should cut out, and cleane take avvay, those vvhich lye croockedlye and dubbelye foulded, in divers rovvnde revolu∣tions, or els lye intangled the one vvith the o∣ther. But before vve proceede to such an o∣peratione, it is necessarye, that first of all, vve bath that part vvith hott vvater, to cause the grosse bloode somvvhat to separate, and vvexe or grovve subtile, and the vaynes to svvel and exalt themselves.

But the most gentlelest remedye, is that vvhich daylye vve vse vvhich is the simple a∣pertione, and inscisione of the foresayed Va∣rices, at one, tvvo, or thre places, as if vve in∣tended to phlebotomize, makinge the aper∣tion somvvhat greater and larger therin be∣cause of the grosse, melancholicke bloode, vvhich vve desire to let therout: Throughe vvhich foresayed apertione, vve extracte as much bloode, as vve suppose to be goode, and sufficient, or els as much as the patient cā abi∣de, one vvhich foresayed apertione, vve must lay compresses, vvhich therone vve must bin∣de, as vve are commonlye vsed to doe one the vaynes, vvhē as vve have phlebotomised, pro∣hibitinge the patient, not to stirre, or goe, vvhich sayed Varices, if so be they chaunced to svvell agayn vve must as before a little distan∣ce ther after make therin an other apertione.

But if soe be vve intende vvholy to disci∣de, and cutt them out, vve must first of all,* 1.4 de∣notate the same vvith incke, one the skinne, vvhich is placed one the Varice or burstē vay∣ne, the skinne beīge annotated, vve must vvith tvvo fingers of both the handes, lift vp the sa∣me, the one this vvay and the other that vvay, vvhen vve have fast houlde therone, then vve must make an inscision, in the middest of the elevated skinn, on the selfe same place, vvhich before vve had denotated vvith incke, of such a magnitude, and greatnes, as is reqvired & ne∣cessarye: the inscisiō beinge effected, vve must suffer the skinne agayne to descende, through vvhich inscisione, the Varice, or bursten vayne vvhich is therūder situated, shalbe discovered, an denudatede of the skinne: VVhervnder, as then vve must thrust, a crooked needle: becau∣se therafter vve may vvith both the endes of the foresayed threde,* 1.5 dravve the one vpvvar∣des, and the other dovvnvvardes. This be∣inge effected, vve must make an apertione in the varice, accordinge the length, of the same

betvvixt both the thredes, vvhich must be se∣parate & aparte the one from the other a thū∣bcs bredthe, throughe vvhich apertione, vve may dravve as much bloode, as vve please: and thē dravve & binde together verye fast the fo∣resayed thredes, & thē alsoe cut, the foresayed varice, or bursten vayne, cleane avvay, vvhich is situated betvveen both the thredes, if soe be it seeme expedient vnto you, sufferinge the thredes, by continuance of time, putrifye and rott out of themselves, vvithout vvith violēce to dravve them out, because that nature, may have some respite, & time, to close, and reple∣nishe the cutt, and ligated vaynes.

* 1.6That bursten vayne, vvhich runneth right, althoughe she lye overthvvarte, if she be sim∣ple, & smalle, vve vveare better tye her then to cauterize her: But first of all vve must purge the patient, & phlebotomize him ether in the arme, or in the varice, or els in both places at once. Our praediscesors & auncient Chyrur∣gians, make mētione of the actuall Cauterye, but before they applyed the same, they first in scyded the skinne, vvhervvith the varice is cooperted, & covered, in such māner, & form, as vve doe vvhē vve binde the same: the varice therefore beinge bared, they then imposed theron, a smalle stamped Cauterye, vvhich vvas vvell glovvinge, & redd hott, vvhich rea∣sonable stifflye they impressed theron, but yet not soe violently that the advstione penetra∣ted any deeper, thē throughe the vayne, vvith out touchinge the lippes, or edges, in cauteri∣zinge, of the foresayed inscisione, vvherfore they vvith vvett, & madefyed cloutes or vvith some certayn playsters, recincted, & defended them.* 1.7 This operatione beinge after this sorte finished they applyed therone, some certayn remedyes, to the qvallifyinge of the payne & doloure, and profitable for the combustione. And because it is incident vnto all mē, to feare the hott iron, and alsoe the inscisione of the skinne, vvhich first of all must be done. Our vse therfore novv a dayes is, that vve (vvithout makinge any inscisione in the skinne) applye on the selfe same place of the varice, a great, & stronge potētiall Cauterye, because it should not only combure qvite throughe the skinn, but alsoe throughe the vvhole varice, or bur∣sten vayne: but vve may not in any sorte tou∣che the Escara, but gentlelye of her selfe suffer het to separate, vsinge at this season those re∣medyes, vvhich for that vse expresslye amon∣gest the cauteryes, vve have discribed. The vvhich I have seene to be vsed, of M^r. le Ieune the kings Chyrurgiane, and of the Duke of Gvyse, vvhich vvas a verye experte man, in all operations of Chyrurgerye.

Notes

• * 1.1

  Discrip∣tione of a Varice.
• * 1.2

  Curation of a Vari∣ce.
• * 1.3

  Councell of the auncient professors for the cu¦ringe of the Vari∣ces.
• * 1.4

  Hovv vve ought to cut avvay a bursten vayne.
• * 1.5

  The pla∣ce vvhere vve may cut the varice, or burst ••n vayne.
• * 1.6

  The aun∣ciēte Chy¦rurgians have cau∣terized the Vari∣ces,
• * 1.7

  Vse and practise in these times,