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 Frenche Chirurgerye THE SIXTE TRE∣ATISE OF THE OPERATI∣one of Chyrurgerye Contayninge nine Chapiters.

• Of that, vvherone vve must consider, before vve make an apertion in avayne. Chap. 1.
• Hovv vve ought to phlebotomive, or open avayne. Chap, 2.
• VVherō vve ought to cōsider, after vve have opened the vayne, & vvhē shee bleedeth. Chap: 3.
• Of the number of vaynes, & arteries, vvhich are vsed most cōmonlye to be opened. Chap. 4.
• Of the apertione, of the Arteries. Chap. 5.
• Of Anevrisma, or broken arterye, hovve vve ought to make an inscisione therin, & after vvhat manner vve ought to binde them. Chap. 6.
• Of the Cirsotomia, vvhich is, hovv vve ought to make our inscision in the Varices, or bursten vaynes. Chap. 7.
• Of horseleeches, and of ther vse, and hovv vve ought to applye them. Chap. 8.
• Of boxes, and hovve vve must applye, and vse them. Chap. 9.

❧Wheron we must consider, when as we desire to open a vayne, or phlebotomize. Chap. 1.

MYe purpose, and intent, is not in this place to discrib vnto you, vvhat sicknesses reqvire phlebotomye, in vvhat age, in vvhat time or season of the yeare, in vvhat countrye, in vvhat cōstitutiō of the body, it must be done, & of vvhat occasione, namelye & especiallye, vvhether it be for anye simple evacuation, or for anye deprivatione, or derivatione, or for any revulsione. In like sorte alsoe in vvhat vayn vve ought to make the apertione, vvhat qvantitye of bloode vve ought to detracte out of the same, in vvhat sorte, and hovv much at one time, hovve often after the other or in vvhat time of the sicknes vve must make the apertione in the vayne.

But my purpose, and meaninge is, onlye to shevve, hovv vve ought to opē a vayne: vvher¦on vve must thinck, & dilligentlye consider, before vve make the apertione therin, after vve have opened her: & vvherone vve ought to not, vvhē the blood issveth out of the same. This doinge, shall the Chyrurgiane, be noe lesse vvorthye of prayses, because he cā verye excellentlye phlebotomize, then the physiti∣one is prayse vvorthye, by his perfect knovv∣ledge, vvhether the patiēt have neede of phle∣botomy, or not: For although, that it seemeth to be a smalle sciēce, to phlebotomize aright, & very vvel, yet notvvithstandinge is it often∣times, a difficulte matter & verye daūgerouse, because the vaynes, ar situated somtimes close to the Arteryes, yea alsoe thervppen, as alsoe are the synnues, & the tēdones. If soe be ther∣fore vve chaunce, vvith the lancet to hurte a Tendone, therafter most commonlye issueth a Spasmus, or a Gangrene and mortificatione, vvherthroughe the patiēt pitifullye & rueful∣lye, and vvith great torment endeth his lyfe. If ther be then any arterye touched, & opened, shee verye difficultlye vvil be cured, vvherby the patiēt bleedeth to death: & vvhē as vve de∣scide a vayne qvite asunder, both the endes therof are immediatlye retracted, and dravvne invvardes, the one end this vvay, & the other end that vvaye, soe that vnder the fleshe both of the endes are lost, & noe bloode cā possibly issve therout: if shee be then vvith to great ti∣morousnes & feare pricked, the skinne onlye vvhervvith shee is covered is as thē inscided, & the vayn not opened: or els if shee be onlye pricked vvith the poyncte of the lancet, the bloode as thē issveth therout droppingevvyse and the subtilest bloode onlye cometh out, vvher cōseqvently therafter she exvlcerateth.

Sometimes alsoe lyeth the vayne occulted soe deepe in the fleshe, that vve can not vvith the lācet finde thē, vvithout great paynes, yea also & although vve espye them, yet throughe there perpusillitye, & rotūditye, they avoyde, & eschevve the poyncte of the lācet, hovv ac∣cute & subtile soever the same be. Soe that ther are oftētimes divers occasions, vvherfore phlebotomye is difficulte, vvhich to an other vvhich never hath done it seemeth to be very easye.

Before the Chyrurgian maketh his apertiō in the vayne, if soe be the patiēt be restringed & bovvnde in his belly, & hath in a lōge time not bīne at stool, vve must thē first of all cau∣se him to vse a Clistere, because throughe the phlebotomye, the vaynes beīge evacuated, & emptied, doe not attracte, & dravve vnto thē out of the guttes or entralles, any corrupted, & rottē humors, vvherbye anye of the vvor∣thyest partes might be offende, & hindered.

Nether is phlebotomye expediēt, vvhen as the stomacke, is burthened, ether vvith anye cruditye, of vndigested meat, or drincke, or vvith anye other viscositye vvhatsoever, as also it is vvholye dissvvaded to doe after anye

greate evacuatione, or anye other occasione, vvherby the patient might be debilitated, as is superfluous parbrakinge, a great laske, great abstinence, continualle vigilatione, and great conversation vvith vvoemen. VVhē as ther∣fore the Chyrurgiane in the absence of the Physition, hath on all these foresayed thinges dilligentlye cōsidered, he must as then deferre the phlebotomye. And if it soe chaunced, that anye persone to praevent any dissease desired to be phlebotomized, he must then cause it to be done, vvhē as he is best of courage, as bein∣ge freede from all care, of sorrovve, of ire, and besyde all this, vve must not phlebotomize anye persone, vvhich is to timorouse, & fear∣full of phlebotomye, because the afrighted∣nes, & the feare, causeth the bloode to vvith∣dravve it selfe tovvardes the internall partes of the bodye.

And the patiēt as yet beinge lustye, & strōg, vve must then cause him to sit in a stoole, but if soe he be feeble & debile, & is subiected vn∣to fayntnes & sovvndīge, as those are, vvhich are of a hott nature, vve must in the first let him suppe in a soft dressed egge, or a morsell of breade sopped in vvyne, & then cause him to lye one the bedde, halfe sittinge vpright, & stuff him vnder vvith cushēs as if he sate. And above all vve must dilligentlye note, that the light of the ayre, or shining of the candle, doe rightlye shine one the vayne, because that through the shaddovv therofe, the knovvledg of the vayne, & of the place vvhere she must be pearced, be not vanished out of your sight: then must the Chyrurgiane, vvith his right hande, take the right hand of the patient, or vvith his left hande, the left hāde of the patiēt, out of the vvhich he meaneth to dravve the blood out depressinge the arme sōvvat dovvn vvardes, and then vvith his left hand, or vvith a vvarmed table naptkinne, rubbe the insyde of the arme vvher he intendeth to ma∣ke the apertione: And then binde the arme dubble a little above the elbovve, vvith a little narrovve liste of vvollen clothe, not to stiffe nor to loose, because to looselye bovvnde, or to stifflye tyed doe both of them hinder the bleedinge: thē must the patiēt, shutt his hand close, vvherby as vvell throughe the binding, as throughe the closinge of the hāde, the vay∣nes lye fast & stedfastlye in the fleshe, and not move this vvay or that vvay vvhē vve should pearce them, vvherthroughe also they rayse themselves, and svvell the more, throughe the bloode, that by this meanes is dravvē thether vvardes, by the vvhich alsoe vve may the ea∣syer see, and feele them.

❧How we ought convenientlye, to make an aper∣tione in the vayne. Chap. 2.

HAvinge dilligētlye considered all these thinges if the Chyrur¦giane, determine to phleboto∣mise in the right arm, he must then take houlde one the fo∣resayed arme vvith his left hande, by the ben∣dinge of the arm, or about that place, vvherin vve purpose tO make the apertione, & lay his thumbe one the vayne, a little belovve the place, vvher vve vvil pricke, because that soe he may hovvlde the vayn stedefaste, vvithout glidinge this vvay or that vvay because some∣times the vayne beinge, spanned like a little cord, might chaunce to rovvle, & glide vnder the lancet. And because the foresayed vayne is oftentimes implete vvith vvinde, & vētosi∣tyes, shee therefore yeeldeth, & slideth avvay vnder the lancet, vvherthroughe vve can not fullye pearce her, & by this meanes the aper∣tione falleth to small: all this beinge in this sorte noted, vve must vvith the first finger of the right hand feele vvhere vvith most conve∣nience vve might make the apertione, setting an impression on the skinne above the vayne vvhere vve purpose to pricke, vvith the nayle of your finger, & then immediatlye, take the lancet in the right hande, vvhich betvveene our lippes vve must have in a readines, vvith the vvhich vve finelye must make our aperti∣one, in the vayne, causinge the poyncte, and a∣cuitye of the same, gentlye to enter into the concavitye of the vayne, & not abruptly, and rudely, vvith a hastye thrust. And to make this apertione vvith more certayntye, & vvithout tremblinge of the handes, the Chyrurgiane must take the lancet in the middle, vvith his thumbe & his first finger, sufferinge his hande vvith three of his fingers to rest on the arme, & so lay his thumbe and his first finger vvhich hould the lācet one the thumbe vvhich houl∣deth fast the vayne, on this sort to hould fast his hande, & vvith out anye tremefactione to vse the same. Some there are vvhich annoynt the place vvherin they intende to phleboto∣mise, vvith a little oyle, or vvith freshe butter, thervvith somvvhat to mollifye, & soften the skinne, & soe vvith more ease and vvith lesse payne, to pearce ther throughe. Others an∣noynte the acuitye of ther lancet vvith oyle because shee might the easyer perforate the same, & cause lesse payne, the perforatione, or vvounde might better contayne it selfe apert & the blood if soe be it vvear grosse, might the subtiler, & vvith more ease have his passage.

If soe be then that the apertiō be made vvith one thruste, it is thē good, but if not, vve must immediatly give an other pricke, ether a little belovve the same, or els a little above the sam, if the vayne sufficiētly demōstrateth her selfe. If therfore the apertiō be to small, & the blood

issue out of the same to subtilelye, soe that vve feare that vve shall not dravve sufficiēt blood enough therout, then immediatlye vve must thrust into the same hole, or apertione agayn, & a little dilate the same: because that oftenti∣mes throughe to small an apertion, the grosse bloode congealeth before the apertione, and ther conseqventlye exvlceratethe.

Havinge convenientlye brought to passe this apertione, vve must then give the patiēt, in the hande of that arme vvherin he is phle∣botomized, a roūd staffe, partlye therō to rest his arme, as alsoe to turne rovvnde the fore∣sayed staffe in his hande, because by this mea∣nes the bloode might the better shoote out: the vvhich if it doe not rightlye issue out, vve must thē marke, if the ligature be not the cau∣se therof, as if it vveare to harde tyede, vvhich as then vve must a little districte and make it loose, vvithout vvholye looseninge of the same.

The Chyrurgiane must alsoe have divers lancets, vvherof the one must be a little broa∣der then the other: The broade lancets are ve∣rye necessarye vvhen as the vaynes lye highe exalted, & vvhen vve desire to make an ample apertion. The smalle narrovve lancets are ve∣rye necessary, vvhē as the vaynes lye profoūd∣lye occulted in the fleshe, and also vvhen as in the highe exalted vayne, vve desyre to make a smalle apertion: because sometimes the sicke personne, reqvireth a great, & festivous phle∣botomy, to the vvhich end, vve must make an ample apertione, as vve must alsoe doe, if vve coniecture the bloode to be grosse, & dēce, & vvhen the patient is lustye, and stronge.

Contrarilye, if soe be vve retract, & dravve back the bloode, vvhich supernaturallye hath issued out of any parte of our bodye, as in tho∣se vvhich, spitt bloode, or those vvhich bleede much out of the nose, as then vve must make our apertion smalle, because that great evacu∣ation of blood is not necessarye for them, be∣cause through there noses they have avoyded sufficient, then onlye in such accidētes, vvher in is onlye reqvired a regressione of bloode. Besydes, it is necessarye & expediēt, that in the foresayed evacuatione, and sicknes, vve suffer the bloode to issve longe enoughe out of the apertione of the vayne, vvhich the patient shoulde not be able to suffer, if the foresayed apertione vveare ample, because ther vvould issue to much blood othervvise therout.

VVe are also in phlebotomye vrged to make a small inscisiō, in those, vvhich are troubled vvith Phrenesye, & in those vvhich are grovv∣ne madde, because that little vvounde might vvith all expedition be cured agayne, because that such raginge▪ & franticke persons vvill all vvayes make loose the ligature or dressing be∣fore vvear therof avvare, vvherof they might com in daunger of bleedinge to death, but the apertione being smalle, although they loosen the arme, yet notvvithstandinge they can not violently bleede because in such a small aper∣tione, the bloode congealeth, & occludeth, & stoppeth the vvounde. VVe ought to make in smalle vaynes, a smalle apertione, & in gre∣ate vaynes an ample apertione: for if so be vve make in a greate vavne a smalle apertion, thē shoulde necessaryly follovve, that the blood, vvhich coagulateth in the small vaynes, be a hinderāce vnto the issuinge or runninge out of the bloode.

Touchinge the forme, & figure of the insci∣sione, it is effected in three sundrye sortes, and fashons: vvherof the first is made overthvvar∣te, the secōd accordinge vnto the length of the vayne, vvherthroughe the vayne is cleft or splitted, & not pricked: the thirde is the meane betvveene them both, vvhich vve may vvell call the contradictorye apertione, because cō∣tradictorilye shee is made. VVe make the a∣pertione overthvvarte, vvhen as vve are not minded to reiterate the phlebotomy: for vvhē vve bende the ellbovve, thē both the endes of the vayne ioyne together agayne, This figure or forme is necessarye, vvhen as vve desire to make a large apertione. VVe must make the apertione sydelonge or contradictorye, vvhen vve purpose to iterate the phlebotomye: and vve makinge the apertione in this manner, ve∣rye seldome or never misse the vayne: and vvhich is more, it is better for the circumstan∣tes, and standers by, vvhen the bloode in this manner issueth therout. That inscisione, vvhich is made accordinge to the lēgth of the vayne, is verye expedient, vvhen vve intende to renue the bloode lettinge, & that not onlye the same day, but one the next day alsoe, be∣cause that vvhen vve bende the elbovve, both the labia, or lippes of the vayn, do separate & devide themselves.

But in vvhat forme soever vve make the in∣scisione, yet notvvithstādinge the vayne must be pearced in the middle, vvithout vvholye cuttinge a sunder of the same. Because her lip∣pes, might chaunce to be inverted invvardes, and the bloode could not resulte out of the a∣pertione, but runne dovvn a longe by the ar∣me, or both the endes of the vayne, are dravvē invvardes, vvithout deliverāce of anye blood from her, or at the least, in the first very little.

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

WE 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, 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. 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.

Some 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. 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. 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, & 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, 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, 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.

VVhen 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. 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.

❧Of the number of vaynes, & arteryes, which com¦monlye, vse to be opened in mans bodye. Chap. 4.

THe aunciēte professors of Chy¦rurgerye, have observed, cer∣tayne vaynes, vvhich in mans bodye must be opened, accor∣dinge as everye divers dissease shall reqvir: vvherof the Chy∣rurgiane must not onlye knovve ther situati∣one, & ther divisione or separatione, but alsoe the names of the sam, because that he doe not mistake the one from the other. They vvhich most commonlye are opened, are 41. vvher∣of ther are in the heade 17 een: the first vvher∣of is called the vayne of the foreheade, vvhich is situated in the middest of the foreheade, and is opened vvhen as vve have anye inveterated payn in the occipitialle partes of the heade to trouble, & molest vs. The seconde is called Vena Pupis, vvhich is situated right in the mid∣dest of the occipitialle, or hinder partes of the heade: this vayne is opened, agaynst the sopo∣riferousnes, & payne of the heade, vvhich is si∣tuated in the foreheade. The thirde is called the temporalle, or vayne of the tēples, vvher∣of in each syde ther is on, vvhich in divers brā∣ches ascēdeth in the temples of the heade: vve open those vaynes agaynst the superfluous la∣chrimation of the eyes, agaynst vehemēt pay∣ne in the eares, agaynst the Hemicrania, vvhich onlye commeth in on syde of the heade. The fourth is called the eare vayne, one eache syde one, & have ther place, & situatione behinde the eares: this vayne is opened agaynst surdi∣tye, payne, & vlceration of the eares. The fifth is the eye vayne, the vvhich in the greate cor∣ner of the eye, close by the nose, vve may per∣fectlye see: shee is opened, agaynst all disseases of the eyes, & eyeliddes. The sixt is, the nose∣vayne vvhich hath her place in the middest of the end of the nose, betvveene the tvvo grisles or cartilages: shee is opened, agaynst the hea∣vines of the head, & agaynst all reumes, of the eyes, & eyeliddes. The seaventh, is the lippe vayne, vvherof one each syde are, tvvo, in the internall partes of the opermost, and nether∣most lippe: vve opē them agaynst all tumors, & excrescenses of fleshe, agaynst all vlceratiōs of the mouth, & agaynst the vehement rednes of the face. The eight is called Ranularis vena, vvhich is situated vnder the tunge, one each syde on, vve make therin an apertion, agaynst the Sqvinantie, agaynst the incensione of the Almondes, of the pallate, & more other disse∣ases of the throte. The ninth is very publique, lyinge in the necke, and is called the Iugularis, vayne, & of the Arabians Gvides, on each syde of the necke one. Shee may very conveniētlye be opened, agaynst tht Sqvinantye, & agaynst all rheumes of the throte, vvhich bringe vs into greate angustnes, and trouble.

In the armes are sixe, in every arme three vvhich in the fouldinge of the armes are phle∣botomized. The first is the head vayn, vvhich is situated highest & most outvvardlye, in the arme, vvhich vve opē agaynst the payn of the heade, eyes, eares, & payne & svvellinge of the throte. The second is the nethermost in the in¦syde of the arme, & is called Basilica, being the foundatione of both the other vaynes, and is also called Hepatica, or liver vayne: VVe open this vayn, agaynst the stoppinge of the Liver, & agaynst all inflāmations of the vvhole bo∣dye, & all disseases, vvhich are situated vnder the heade. The thirde, is the Mediane, as vvell concerninge her situatione, as originall, be∣cause shee taketh her beginninge out of the Heade & Liver vaynes, as also considering her conditions, because vve open her as vvell for all disseases, vvhich are situated in the vpper, as vndermost partes of our vvhole body, and ther trouble, and molest vs.

In the handes, vve have sixe, in each hande three. The first descendeth a longest the Meta∣carpion of the hande, and passethe betvvixt the thumbe, & the first finger, vve call her allsoe the heade vayne, or the eye vayne. VVherfore shee is onelye opened agaynste payne in the heade, & eyes. The seconde is called Salvatella, or Liver vayn, betvvixt the little, & thirde fin∣ger, shee is phlebotomized, agaynst the yello∣vve gaundise, & in all disseases of the liver, on the right hande, and one the left agaynst all disseases of the milte, vvherfore of som in the left hande shee is called the miltvayne. The thirde, is alsoe called the Mediane, Blacke, and

Common vayne, & descendeth by the finger called Medicus, or thirde finger, vvhich vayne vve may open, vvhen vve can finde nether of the other tvvo.

In the belly are tvvo in each syde of the bel∣lye one, vvhich vve call Venam Illiacam, or Ti∣tillarem, & demonstratethe her selfe betvveen the hippes, & the flanckes. She vvhich is ope∣ned in the right syde, agaynst the Dropsye, and other disseases of the Liver: shee vvhich lyeth in the left syde, agaynst the disseases of the Milt.

In the fundament, or privityes of a mā, are one each syde tvvo, the one vvherof vve calle the Hemorrhoidalle vayne, & is onlye opened in melanckolye disseases.

In the legges are eight, in each legge four: vvherof the first is called Vena poplitis, situated in the hockes, or fovldinge of the knees, & is opened agaynst all disseases of the nethermost part of the bellye. The second Saphena, or mo∣ther vayne, vvhich vve opē one the insyde of the legge vnder the anckle, in all disseases of the kidnies, & of the vvombe, & to provoac∣ke in the vvoemen ther monthlye sicknes, or mestruousnes, in all runninge of the raygnes, and in Venus botches, or as vve call them in lattin Bubones. The third is the Schiaticke vayn, vvhich externallye demonstrateth her selfe, a∣bove the āckle, vvhich is only opened agynst the dissease called Sciatica, & agaynst all payne, and doloure of the hippes, and flanckes. The fourth is the mediane, or kidnyevayne, situa∣ted belovve the foote, and is phlebotomized agaynst all disseases of the kidnyes.

Amongst all the other vvhich are most cō∣monlye opened, are those three vvhich in the foulding of the arme are phlebotomized: to vvit the head vayn Basilica & the mediā. VVe must dilligētlye cōsider that vvhen vve make an inscisiō therī that vnder the Basilica or Liv∣er vayne lyeth an artery or great harte vayne: vnder the Median a synnue or tendone of the muscle Biceps or both of these together, but vnder the Cephalica is nether synnue artery or tendone sitvated, vvherfore amōgst all other vaynes, ther is none vvhich vvith lesse perril & daūger may be opened.

If so be that through mischaūce in opening of the vayne Basilica vve chaūced to hurte the artery vvhich ther vnder is sitvated as I have knoovvne to have chaūced, vve must praesēt∣lye for the stoppinge and restrayninge of the bloode, and to the curing of the arterye, vvith∣out leavinge anye Aneurisma, cleave a bean in tvvo peeces, & laye the one halfe of the bea∣ne, one the apertione of the vayne, vvith a cō∣presse therone, gentlye tyed, vvithout visitin∣ge of the same in thre or foure dayes, or once offer to touch it. If so be in the apertion of the mediane, vve chaunced to pricke the subter si∣tuated synnue, or tendone, vve must then im∣mediatly phlebotomize the patient in the o∣ther arme: and vve must droppe in the vvoun∣de of the pricked synnue, a little hott oyle of Terpentin, and a little vvoolle, beinge dipped therin vppon the same, therby to keepe the apertione aperte, & then lay a playster of Dia∣calcitheos, rovvnde aboute the vvounded par∣te of the vvhole arme, vvhich hath bīne lique∣facted, vvith oyle of roses, and vineger.

Of the Arteriotomia, or apertion of the Arterys, or hartvaynes. Chap, 5.

COncerning the Arteriotomia, or apertione of the Arteryes, the praedicessors & auncient pro∣fessors vveare vvont to effect it especialle behinde the eares, & in the temples of the heade, a∣gaynst all continuall, & rebellious fluxions, & Rheumes of the eyes, in like sort alsoe, agaynst all diseases of the heade, vvhich have takē ther originall, frō hotte, dampishe, or subtile rheu∣mes: as yet novv a dayes vve doe, but not vvho lye as they vveare vvonte to doe, in openinge of the same: for soe farre forth as if the Arterye be small they then cut her cleane a sunder, & they also cut a peece therof avvay, & both the endes are dravven invvardes, vvher by shee as then bleedeth noe more.

And if the Arterye, be greate, & violentlye beateth, it is the surest vvay, that vve tye her vnder & above and then betvveen both those ligations cut her of, but the thredes vvhervvi∣th vve binde her, must be strōg & closly tyed because that through the continvall beatinge of the arterye, the thredes loosē, & the arte∣rye openeth, if so be it be not stiflye bovvnde: & because that she should not chaunce to cor¦rupt, before the inscision be replete & grovvē full of flesh: vvher through the mouth of the foresayed artery is stopped. But novv a dayes vve only make a simple inscision in the artery in such a manner as vve make an apertion in the vaynes, vvithout cutting of the same cle∣an of & having dravven as much blood ther∣out as vve desire, vve thē lay a litle playster of masticke on the apertion, & a litle compresse tyed theron rovvnd abovt the vvhole head as close as is possible. I knovve right vvell that ther are some vvhich houlde this apertione of the arteryes verye suspecte, because it cā hard∣lye be stopped agayne, and in doinge this, ther remayneth a cicatrice, in those partes vvhich are situated rovvnde about the foresayed arte∣rye, before the same is fullye cured, and ther

throughe often times an Aneurisma caused, vvhich is verye troublesome, and daungerous for the patient. But I may vvith verity affirme it to be true, that oftentimes I have seene ope∣ned the arteryes of the temples of the heade, vvithout any of the foresayed accidentes bein∣ge happened thervnto, the vvhich I coūcel the yonge Chyrurgiane to doe it onlye in this pla∣ce, because such an inscisione, is more fitter, & lesse daungerouse, thē the vvhole cuttings of, and ligature of the same.

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

THis 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, 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, 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, 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.

First 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, 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.

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

VArices, 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, or els vvith so∣me actuall cauterye, to cauterize them, & soe consume, and bringe them to nought. To vvhich purpose, the auncient professors, 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, 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, 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.

That 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. 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.

❧Of the Horseleeches of there vse, & howe we may applye them. Chap. 8.

THe Horseleeches are little, and perpucill creatures, like vvor∣mes, of the longitude of a fin∣ger, or theraboute, nether are they of anye great crassitude, or thicknes, vnles, it be vvhen they vvith suckinge of bloode are grouvven thicke. The end of ther head hath a rovvnde hole, much like vnto a litle lamprell, vvherin are to be behelde, and seene thre stinges, or a∣cuityes, proceedinge out of three corners, vvhich soe violentlye, & stronglye pricke, that thervvith they can pearce the hides & skinnes of all creatures vvhatsoever, & vvherone they depēde faste hanginge, vntill such time as they have sucked themselves rovvnde, and fall of vvith ther one accorde. They live, & are ingē∣dred in the vvater, & especiallye in all stagnes, & standinge vvaters, because they delight, and are solaced, in filthye, and muddye places. I esteeme, & suppose, that ther is noe Chyrur∣giane, but verye vvell knovveth them because of all men they are knovven, but everye one doth not knovve vvhich are the venoumous, or not venoumous, vvhich notvvithstanding, is verye necessarve to be knovvn, considering the accidentes, & mischaunces, vvhich might therof insue, and follovve, as in example, great tumors, Inflammations, & venoumous vlce∣rations, through ther venoumous momorsi∣ones & bitinges, yea also & death it selfe, as the historie of him, vvhich of a venoumous one, vvas bitten in his knee, & dyed therof, is vvit∣nessinge vnto vs.

The vonoumous, are as vvel knovvne, & discerned by ther greatnes, as ther colour, and alsoe by the place vvher they are caught. For those vvhich are thicke, and have a thicker head then the rest of ther vvhole bodye, shi∣ninge, like vnto glistninge vvormes, and are greenish, and vvhich have on ther backe, ble∣vve, or blacke strokes, or lines, and vveare caught in standinge pooles, vvher all manner of foetide, & stinckinge Carrions, vvith more other filthines is throvvne in, they are all ve∣noumous, vvherfore in anye sorte vve must not vse them.

But those, vvhich are small, rovvnd, & have a little heade, & are of coloure much like vnto a liver a rovvnde belly, & the backe stripped, stroked vvith gouldeyellovv strokes, vvhich live in cleane runninge vvaters, they are not venoumous, vve may safelye, and vvith all securitye vse them. And yet notvvithstāding, those vvhich ar soe as is before sayed, may vve as soone, as vve have caught them, applye them to the bodye, but must first of all, keepe

them tvvo, or three vveekes in a glasse of fayre vvater, because therin they may avoyd the vis∣cositye, & impurenes, refreshīge the foresayed vvater everye three dayes once, vvashinge the sayed horseleeches, vvith your handes from all ther viscositye & slimishnes. Galen councel∣leth vs, that the first day vve shoulde give them a little blood, & then, put thē in freshe vvater. VVe may praeserve, & keepe thē a vvhole yea∣re, or longer if vve please, to vse thē, vvhen the necessitye soe reqvireth.

The vse of Horseleeches, vvas invented in place, of scarifyinge: vve apply thē most com∣monlye one such places of the bodye, vvhere vve can not set any boxes at all: as in example in the privityes, one the gummes, one the lip∣pes & somtimes alsoe one ravve fleshe of anye vvounde, on the nose, above on the hande, & fingers, & vvhē the patient too much feareth the boxinge, or els vvhen as vve desire to dra∣vve & extracte anye venoume, out of a thrust, or bitt of anye venoumous creature.

Before therfore vve apply them, & because they might be hungrye, nether retayne anye thinge in ther bodyes, & because they shoulde the sooner take houlde, vve must take thē out of the vvater, & suffer thē thre or foure dayes before vve vse them to lye in a nue little vvod∣den boxe. VVhich beinge in this sorte praepa∣red, to apply one the body, vve must first vvas∣he that place vvher vve purpose to applye thē verye cleane, & if so be the place, by reason of of anye salve or plaster, vvear fattye, vve must alsoe vvashe that place & vvype it very cleane, because they are enimyes vnto all pingveditye & fatnes: this being effected, vve must thē take them the one after the other, in ther middles vvith a vvhyte cleane clothe, (for if soe be vve touch them vvith bare fingers, they as thē vvil not bite) & praesēt, or place ther heades to that place vvher vve desire to have them sucke. If so be the Horseleech vvill nōt at the first byte, & take houlde, vve must then annoynt the sayed place vvith pigeons bloode, or hennes blood, or cause the place ether vvith the poyncte of a lancet, or vvith a pinn, to bleed, vvherthrough immediatlye she vvill beginne to sucke. And soe far forth as she sucketh not stronge enou∣ghe, or if soe be vve desire to have her to sucke violentlye, before she leave, & is not vvholye full, & satisfied, vve must vyith a payre of scis∣sors clippe her a sunder, about the thirde part of her bodye: vvher by, she beginneth to sucke farre stronger & vvith more violence, and the bloode as fast as she sucketh de parteth frō her through the hindermost partes vvhich are cut avvaye. As soone as the one Horseleeche is fallē of, if vve please, vve may applye an other theron: for they being replete & satisfied, prae∣sently of themselves, fall of: & if soe be vve de∣syre to have them fall of, before they be satisfi∣ed, vve as then stravve a little saulte, or ashes of vvoode on ther heades & immediatlye they fall of. Ther as yet droppeth blood out of the bitt vvhen as they are fallen of, vvhich is a sig∣ne & token, that they have dravven & suckede the blood from farre, vvhich blood, vve must not one the suddayne restraygne, & stoppe, be¦cause that parte may the better purge, & puri∣fye it selfe, from all venoumous humors, if soe be there be any at hande: vvherfore some ther be vvhich to that end, apply some small boxes, on the bitinge of the Horseleech, or els they vvashe that parte vvith hott vvater, beīge saul∣ted, & cause it to bleed somvvhat longer, if soe be that parte require the same, & the patiēt be able to suffer the same: If soe be the blood run∣ne therout somvvhat to longe, & vvil difficult∣lye be restraygned, throughe anye compresses, vve must then apply theron a little adusted, or burned linnē, or a splitted or cloven beane, re∣tayninge the same vvith his finger soe longe therone, vntill such time as she cleaveth fast theron, vvheron therafter vve must lay a small compresse, & binde the same therone, if soe by anye meanes possible it may be done.

❧Of Boxes, and howe we may applye them. Chap. 9.

A Boxe, is an instrumēte, of Chy¦rurgery, the magnitude vvher of, must aeqvallye be proporti∣oned, accordinge to the great∣nes of that parte, vvheron vve purpose, and intende to apply them, & alsoe divers formes, & figures: for so∣me ther are vvhich are shorte, & thicke, others vvhich have a longe necke, & belovve vvyde, vvhich cōmonly dravve better thē any other. Others are of divers substance, for ther are so∣me of Copper, others of Horne, of Tinne, and of glasse, vvhich vve most commonlye vse, be∣cause throughe the glasse vve might see, vvhe∣ther they dravve much bloode or not. Ther a∣re alsoe some vvhich are made of vvoode, and some baked of earthe: yea for vvant of Boxes, vve may vse little vvooddē dishes, or little ear∣then pottes. Touchinge ther forme, they must have a vvyde mouth, and a reasonable broade bellye, thicke & rovvnde edges, because in the applyinge therof they should not chaunce to hurte.

And if soe be they are very greate, they must thē have a little hoale on the one syde, vvhich vvith vvaxe must be occluded, befor vve apply thē that vve may give thē ayr, vvhē vve vvill ta¦ke of the same, some ther are, vvhich lay a little sticke, crosse over in the mouth therof, on the vvhich they impose a little peece, or inche of a

candle, vvhich in the application therof they incende, and light.

The manner of applicatione is this. That vve first of all, perfricate, and rubbe the place Vvherone vve intend to applye thē situatinge that parte of applicatione, in the right forme therof, because the muscles, may lye in ther right situatione, and places, and not be recur∣ved this vvay, or that vvaye, because the boxes beinge theron fastened, might not vvithe the reflection of the parte, or ioyncte, fall therof, vvhen as the foresayed recurved muscles, shoulde reverte agayne to there accustomed locationes, and places. This beinge done, vve must impose therone a counter or any other peece of coine, vvith a little, flocke of flexe, or tovve incended in the middest of that place, vvherone vve desire to applye the Boxes, least that the fyer chaunce to touche the skinne, vvheron immediatlye, vve must vvhelve the Boxes, turninge the same a little rovvnde, be∣cause he shoulde the better fasten theron: the vvhich as then vve must cover, vvith a dubble vvarmed cloute. Some there are vvhich in the bottome of the Boxes applye and laye a plaster, and therone a little tovve, in place of an inche of candle, vvhich in the applicatiō, theyt set one fire, vvith a candle.

As touchinghe the hornes, they are vvyde above, and narrovve belovve, havinge a little perforatione in ther middest, and internally, a little leatherne tūge, vvhich is very thinne, vvhich stoppeth the foresayed hoales. They are applyed vvithout fyer, & sucked vvith the mouthe. To vvitt vvith a little pipe, or vvith a quille, vvhich vve impose in the foresayed perforation, vvhervvith the foresayde tunge is thruste backevvardes, vvhich stoppeth the horne, vvhen it hath dravven and sucked suf∣ficient, & dravvinge the pipe therout, the fo∣resayed tunge, internally shutteth, & cleaveth it selfe soe close to the hole, as vve may see in a kind of ballon, vvhen he is blovven vp.

Those vvhich are ignorant of this secrete, stoppe, & occlude the hole vvith a little vva∣xe, vvhich in deede is not so necessarye, and needfulle. Those little Boxes vvhich are lay∣ed in vvarme vvater, are aplyed, after that vve have putt the flame of the candle, therin and must then vvith all expeditione be theron im¦posed.

The vse of these small Boxes, is thre fould: Namely thervvith to vvithdravve, and repell, the blood, and humors, vvhich are concursed to anye place: to dravve forth any particulare thinge vvhich nature cā not expell from her: & to dravve, out or cause to consume, any oc∣cluded ventosityes, in any partes of our body: vvherfore vve applye them one divers, & sun∣drye places: they are very goode and commo∣dious to be placed behīd in the necke, agaynst all rheumes vvich are incident vnto the eyes: behinde in the middest of the necke are they necessarye to be applyed, for those vvhich are shorte of respiratione, and troubled vvith the cough: one both the shoulder blades, agaynst payne, and doloure in the heade agaynst He∣micraniam, agaynst ophthalmye, and payne in the teeth: vve apply thē alsoe in place of phle∣botomye one the right hippe, agaynst bleedī∣ge at the nose: in like sorte alsoe close to vvoe∣mens brestes, vvhen as there menstruositye, too superfluouslye flovveth from them, and vvhen there lye included anye ventosityes in the Liver: on the left syde, vvhen as ther is any vvynde retayned in the Milte: on the Navelle aganst the vvynde colicke: on the Vreteres, to cause the gravell to descēde, vvhich is con∣tayned, in the kidnyes: on the rumpe, agaynst the vlcerations, and the Hemorrhodes of the fundament: on the hippes, agaynst all vesicall disseases, and of the vvombe, and provocation the monethlye sicknes, or menstruositye.

To conclude, vve may applye them, on all partes of mans bodye, yea allsoe one the selfe same place vvhere the payn is, vvhich vve en∣devoure to cure, to retract and dravve therout all humors, vvhich are therī secluded, as vvhē vve desire to dravve any humors outvvardes, vvhich lye profoundlye & deepelye occulted, and hiddē, or els alsoe, any ventositye, vvhich in the foresayed parte lyeth inclosed, as on a∣nye bitt, or pricke, of any venoumous creatu∣re, least that the venoume might chaunce to penetrate and pearce, into some of the vvor∣thyest partes: one the Venus botches, or Bubo∣nes, one the venoumouse, & Pestilentialle Pa∣rotides. But desiringe to applye them agaynst anye superfluous efluxione of bloode, vve must then situate them on the contrarye syde consideringe the allyance, & communitye of the vaynes vvhich is betvveene them, throu∣ghe the vvhich the bloode is retracted, & dra∣vven backe. It chaunceth also somtimes, that vve nether applye the Boxes, on the disseased, or dolorouse place, nether one the contrarye syde therof, but one that parte vvhich nexte, and proximately thervnto is situated: as vvhē vve desire to suscitate and provoacke, the re∣tayned and kept backe mestruosityes, vve as then place the Boxes, one the bone Pubis in the flanckes, and allsoe one the flatnes of the hippes.

The Boxes, or hornes, are sōtimes applyed vvith scarificationes, and somtimes vvithout: If soe be vve applye them vvithout scarificati∣ones, they then onlye dravve certayn dampes vnto them: but if ther be anye badde humors, in those partes, vve as then scarifye it: And the dissease proceedinge out of vvindes, and ven∣tosityes,

vve then applye them vvithout scari∣fications, but vvhen vve are minded to scarifye anye parte, vve first sett the Boxes therone, and havinge agayne removed, and taken the same of, vve thē pricke, or scarify therin, ether vvith a lancet, or vvith the poyncte of a rasor, vvhe∣ther it be deepe, or not deep, accordinge as vve suppose, and iudge the bloode, to be grosse, or subtile, but allvvayes vve must note not to sca∣rifye deeper then the skinne: touchinge the number of the foresayed scarificatiōs, if soe be vve are not intēded to dravve much blood ther out, vve may not as then make manye scarifi∣catiōs: but if vve intend to dravve much blood therout vve must then make many scarificati∣ons: vvherō vve must agayn applye the boxes, soe that vvhē vve desire to dravve much blood therout, vve must applye the foresayed boxes tvvo, or three times theron, & everye time sca∣rifye the place, & especially vvhen ther is con∣tayned in that part anye venoumouse ventosi∣tye, or grosse, and corrupt bloode. In delicate, and dayntye persons, vvhich are tender of fles∣he, and have an aperte or open skinne, in such persons vve must scarifye but once, notvvith∣standinge must apply the boxes tvvo, or three times after other theron: vvhich beinge finis∣hed, and havinge vviped, and dryed the parte, vve must then apply one the scarlficatione, the Cerotum Galeni, or els the Vnguentum Rosarum.

Notes

• Intenti∣one, & porpose of the aucthor.
• Why phle¦botomye is difficul¦te, & daū∣gerous.
• Acci∣dentes vvhich are cau∣sed, & ta∣ke ther originall of ther hurtinge of anye vayne, synnue, arterye, or tendone.
• Wheron vve ought to cōsider before phleboto¦mye.
• Hovve vve shoul¦de conve¦nientlye phleboto¦mize.
• Dubble bande in Phlebo∣tomye.
• Continv∣ance of the man∣ner right∣lye to phleboto¦ve.
• To molli∣fye the skinne.
• Why vve must give a staffe to them in ther hāde vvhich vve Phle∣botomize
• Broade, & nar∣rovv lan∣cets.
• In the Phrenesy vve ought to make but a small aper¦tione.
• Three for¦mes of in∣scisions in phleboto¦mye.
• The vay∣ne must be insci∣ded in her midd¦le.
• Although the vayne be vvel opened, yet shee droppeth throughe the afrigh¦tednes of the patiēt
• Grosse bloode doth no∣thinge but drop∣pe.
• What vve ought to doe vvhē vve per∣ceave the fayntinge to ap∣proch the patient.
• The pa∣tiēt lying fiat on his backe cā verye vvel suffer phle¦botomye.
• The Liga¦tione of the elbo∣vve after phleboto¦mye.
• Hovv vve may stopp & restray¦gne blood
• Daunger that hap∣peneth to phleboto¦mye.
• To renue the phle∣botomye.
• To renue the phle∣botomye.
• Hovv vve ought to open the vaynes or arteryes of the tē∣ples of the head.
• Hovv vve ought to open the vay∣nes of the handes & feete.
• Vayne of the fore∣heade.
• Vena Pu∣pis.
• The tem∣porall vayne.
• Eeare vayne.
• Eye vayn.
• Nosevayn
• Lippe∣vayne.
• Ranula∣ris.
• Iugularis.
• Head∣vayne. Cephali∣ca.
• Basilica,
• Hepatica or Liver vayne.
• The Me∣diane or Mediana.
• Eye vayn in the hande,
• Salvatel∣la,
• Blacke vayne,
• Blacke vayne
• Vena Illi∣aca.
• Hemor∣rhoidall vayne.
• Vena Po∣plitis.
• Saphena or Mother vayne.
• The vayn Sci••tica. The kid∣nye vayne
• Basilica, or liver vayne is daunge∣rous to be phlebo∣tomised.
• Cephali∣ca or head vayne is opened vvithout daunger.
• Remedye for a vvoū¦ded arte∣rye.
• Hovv vve vse novv adayes to to open an artery
• Aneuris∣ma is a daunge∣rous disse¦se.
• Discripti∣on of the tumefac∣tion Ane∣urisma.
• Signes of this tu∣mefactiō.
• Curation of Ane∣urisma.
• Of an ar∣terye vvhich of the Au∣thor vvas tyed abo∣ve the A∣neurisma
• On vvhat sorte the Aucthor tyed this Arterye.
• Remedye agaynst the putre¦factione.
• Discrip∣tione of a Varice.
• Curation of a Vari∣ce.
• Councell of the auncient professors for the cu¦ringe of the Vari∣ces.
• Hovv vve ought to cut avvay a bursten vayne.
• The pla∣ce vvhere vve may cut the varice, or burst ••n vayne.
• The aun∣ciēte Chy¦rurgians have cau∣terized the Vari∣ces,
• Vse and practise in these times,
• Descrip¦tione of Horselee∣ches,
• Messali∣nus dyed of the by∣tinge of a venou∣mous Her¦seleech,
• Signes of a venou∣mous Horse∣leech,
• Signes of goode Horse∣leeches.
• What vve ought to doe befo∣re vve vse the Hor∣seleeches.
• Vse of the Horselee∣ches.
• Horselee∣ches are enimyes vnto all fatnes.
• To make a Horse∣leeah vio∣lentlye to sucke.
• Hovv vve vve shall cause thē to fall of.
• Hovv vve shall re∣strayne the blood
• Differēce of Boxes▪
• Hovv vve shall ap∣plye the boxes.
• Discrip∣tione of the horne Boxes.
• The vse of small boxes.
• The Box∣es may be applyed one all partes of mans bo∣dye.