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 manner howe we ought to applye these Cau∣teryes. Chap. 4.

NOvv therefore condecentlye to applye all cauteryes as vvell ac∣tuall,* 1.1 as Potentiall, vvithout ex∣pectinge therin anye reproche, vve must first of all cōsider, one those, vvhich are able to tolle∣rate them: In vvhat places they may be best sett, and applyed: & one vvhat manner vve may ap∣plye them: for commonlye, the vvithered, & le∣ane personnes, can not tollerate them, vnles it vveare one the heade, because their bodyes, are nothing els then Membranes, Vaynes, & Syn∣nues, vvherthrough sōtimes greate payn might be caused, or anye vayn, or Artery might chaū∣ce to be through corroded, one al vvhich thin∣ges vve must note, vvhen as vve must applye a∣nye Cauteryes: vve must also consider, one the nature of the Patient:* 1.2 for a strong grosse bodye as a Labourers, or countrye clovvne, may farre more easyer tollerate, & suffer a Cauterye, then a tender delicate bodye, or of a vvoman: nether can anye obdurate parte, as is the skinne of the heade, soe easylye be corroded through, as anye other soft or tender parte, vvherfore vve must houlde the Cauterye longer one the one place, then one the other. A little actuall Cautery, or a little parcell of a potētiall Cautery, vvil vvor∣ke as forciblye, one a tender, & softe bodye, as a great cauterye vvould doe, one a strong grosse, and obdurate bodye.

If soe be, it be a replete, & corpulēt bodye, or an vnhealthsame bodye, vve must then first of al Phlebotomize, or purge the same, because in the cauterized partes ther chaūce not to come, anye concursione of humors. VVhen vve desi∣re to applye anye Cauteryes, or make any Fon∣tanelles, vve must consider that vve apply them not one any synnuishe parte, nether on the en∣des, or beginninges, of any muscles, nether any greate Vayne, Arterye, or Synnue.

* 1.3VVe applye them most commonlye on the Heade, one the Armes, and one the legges, & be¦tvvixte all corners of the heade, for the curinge of divers disseases, vvhich heere before vve ha∣ve recited, the aunciente Chyrurgiās have ma∣de theire choyse of that place, vvhere the Sagit∣talle suture, ioyneth and vniteth her selfe vvith the Coronalle, vvhich place is like vnto a thre∣fould vvay of the heade: the vvhich plase becau∣se vve should not misse of the same, is shevved vnto vs, of Albucasis: To vvitt, that vve cause the Patient, to put forth the one of his handes,* 1.4 and lay the end therof, (vvhich is the vvriste, or bē∣dinge of the hande) one the originall, & begin∣ninge of his Nose, betvveene both his Eyes, and thē stretch forth his middlemost, or longest fin∣ger, tovvardes the crovvne, or superior parte of his heade, & one that place vvhere as the fore∣sayed finger shall have his endīg, ther vve must apply the Cautery, because that ther is the pla∣ce vvhere the sagitall suture vniteth her selfe vvith the Coronall suture: & if so be throughe the applicatiō of this cauterye, vve desire to doe anye vtilitye, & profite, vve must thē suffer the same to penetrate vnto the bone: for by this me¦anes the bone being denudated, it vvill exfoli∣ate, & peele, through the vvhich, the apertione continueth the longer open.

VVherfore, divers, after they have applyed the potēciall cautery, & the next day follovvin∣ge have cutt of the Escara, doe applye theron an actuall cautery, vvithout any daunger, as often∣times I have seene to be done of M^r. Paré.

VVe may applye alsoe cauteryes, of corrosi∣ves, in the posterior partes of the Heade, in the end of the suture lambdoide, behind vnder the Eare, therthroughe to avoyde the muscle Crota∣phite: To the surer findinge of the vvhich place therfore, vve must cause the patiente to opē, & shut his mouth, and soe to feele the motion of the sayed muscle. Mons^r. Martel chosen, & ordi∣narye Chyrurgian to the kinge, vvhich vvas an experte man, he applyed cauteryes behinde the Eares, in the cōcavity vvhich is situated behin∣de the little flappe of the Eare, called Fibra,* 1.5 and that agaynst all inveterate disseases of the Eyes, vvherof he certifyed me, to have allvvayes had ominouse and happye successe, vve allsoe so∣metimes applye the Cauteryes in the Necke, in the hollovvnes, or concavousnes therof, but vve must consider that they doe not penetrate to deep least that vve chaunce to adust, or cor∣rode, the eight small musckles, of the Heade, vvhich are in this place situated, vvhich might cause daungerouse accidentes, as I oftentimes have knovvne to chaunce.

The most commonest novve in vse,* 1.6 is to ap∣ply the Cauteryes, one the armes, vvhere most curiouslye, & vvith greate care vve must make electione of the place: the most fittest place is in the middest of the arm, tovvardes the inner sy∣de therof, right betvveē the brachialle musckle, & the musckle Biceps close to the syde of the he∣ade vayne. And convenientlye to make choyse

of this place, vve must lay the first finger one that place, stiffelye crushinge the same, & vvith the other hande, foulde & shutt the elbovve, & agayne strech him out, & allso lift vp the Arme, because through this motione of the Arme vve might perceave, vvhether there be noe synnue or Tendone situated thervnder, to vvitt vnder your finger, & vvhether you finde in that place noe concavity, or interstitiū of muscles, vvhich is verye fitt, for a Pease or little pellet to be the∣rine, to keepe open, & apert the foresayed Cau∣terye: havinge novv vvith your finger fovvnde out the most fittest place vve must there applye the Cauterye.* 1.7 And touchinge the same vvhich vve desire to apply one the legges, the most cō∣veniētest place ther vnto is tvvo, or thre fingers breadth belovve the knees, vvhere vve are vsed to tye our garters, vvhether it be internallye, or externallye one the legge: But those that are much vsed to ride on horsebacke, & also to cau∣se better abscessione of humors, vvherthrough the Sciatica is caused, for thē it is better to apply them in the externall partes of the legges, in li∣ke sorte alsoe for vvoemen.

* 1.8 Havinge therfore vvell, & dilligentlye consi∣dered on the fittest places, and those vvhich are also the surest, you must thē first race avvay the hayre, if at the least ther be any. VVhich being finished, vve must then situate the Patient on a convenient place, beinge helde of some other persone, if soe be it be needfull, & thē you shall take your Cautery, vvhich must be proportio∣ned, & fashoned according alsoe vnto that par∣te vvhich you intende to cauterise, and must be glovvinge, & redd hott, or at the least as hott as is required, because your operatione may at one time be finished, if it by anye meanes be possible, vvhich accordinge as shalbe required, you must imprint the same deepe, or shallo∣vve in that parte, consideringe, & taking heede, that in noe sorte you chaunce to hurte the cir∣cumiacent, or finitimate parte thervnto, to the praeventing vvherof, ther are invented, & foun∣de out divers defensions for the foresayed Cau∣tery, as certayn pipes, & little cases being com∣posed, and made of Iron, least that vve shoulde chaūce to combure, the finitimate, & approxi∣mate partes, vvhether it vveare throughe the faulte of the patient, or els throughe temerous∣nes, & timorousnes of the Chyrurgian, as in o∣ther places vve more at large have spokē of, & alsoe therby have placed the discriptione of the foresayed Cauteryes.

* 1.9Beinge therfore necessary, oftentimes to rei∣terate the Cauterye, as in any great Gangraena, or in any Carie of legges, vve must then cover, the approximate places thervnto vvher vve intend to Cauterize, vvith Compresses, beinge made∣fyed in Plantine-vvater, or anye other humidi∣tye, yea & also vestite the edges of the vlceratio∣nes, vvith plasters of Infrigidans Galeni, or els vvith some linnen cloutes, beinge madefyed, and dipped in anye distilled Aquosityes, or vva∣ters.

Novv beinge sufficientlye Cauterized, vve must then by all meanes indevoure to qualifye & ease the payne, and doloure therof, & to cau∣se the Escara to separate:* 1.10 vvhich must be effected throughe anye vvarme, and moyst remedyes, vvhich is aequallye proportioned vvith our hu∣miditye, & calidity, because through the humi∣ditye, or moyster therof it may soacke through the Escara, and also the finitimate partes therof, vvhich are obdurated, & drye, & because throu∣ghe the caliditye therof, it might suscitate, and dravve vnto him, the naturalle caliditye, out of the internall partes of the body into the exter∣nall partes of the same, & by this meanes expel that frō him vvhich is mortifyed & combured. Amongst all remedyes there is none better, thē that vvhich is made of Oyle of Egges, of insul∣sed, and freshe Butter, & of Venetiane Terebe∣bentine, addīg in the end thervnto a little poul∣der of Ireas, Aristolochiae, and a little Beanemeale, vvherthroughe alsoe all the purulente matter, vvhich hangeth therone as lime, and an Escara is purifyed. Some vse a Digestive made of yolc∣kes of Egges, of oyle of Roses, & of Terebītine: But that is not soe necessary, as the formest, be∣cause it doth not soe califye, coagulating as the yolcke of an Egge is vvonted to doe, and alsoe immediatlye vvaxeth drye, and exsiccated.

The potentiall Cauterye,* 1.11 vvhich maketh an Escara, or scabbe, being as it vveare a Vicarius, of the actvall, is in this manner follovvinge ap∣plyed. VVe must first of all make a playster, of Diacalcitheos, or some such like, as greate as a lar∣ge peece of tvvelve pence, in the middest vvher of vve must cut a little hole, as great as the nay∣le of ones little finger, or a little greater, accor∣dinge to the bignes as vve desire to have the a∣pertione: and if you desire to have the apertion somvvhat longe you must then alsoe make the hole in the plaster somvvhat longe, & then lay the same on that place vvhich vve desire to o∣pen: And in the hole of the foresayed plaster, vvherthroughe vve perceave the skinn denu∣dated, lay your potenciall Cauterye, or Corro∣sive, vvhether it be greate, or smalle accordinge as you desire to make the apertion great, or lit∣tle deepe, or shallovv: VVhich being done, vve must lay therō, a smalle dubbled clovte, vvhich must be sōvvhat greater thē the Cautery,* 1.12 ther∣vvith to cover the same, and theron as yet an o∣ther playster, vvhich must be a little broader then the firste, and one this plaster an other cō∣presse, vvhich must be of tvvo fingers breadthe and agayn theron an other vvhich must be yet greather, and then tyinge the same vvith a liga∣ture, acordīg as the parte shal thē be requiring.

The Cauterye therfore having done his ope∣ratiō, vvhich most commonlye in the space of tvvo hovvres is finished, if so be the sayed cau∣terye be stronge, & violent enoughe, vve must as then take it of: and presently to cause the Es∣cara to separate, vve must make a crossevvise in scisione therin: Other suffer her, of her selfe to separate, vvithout inscisioue: Some inscide her rovvnde, and then lift her vp, & so cut her loose from vnder. But vve desiringe through the ap∣plication of a Cauterye, to make an apertiō, for the evacuating of any matter, vve must not on∣lye thē inscide the foresayed Escara, but also pe∣arce somvvhat deeper therin, vntil such time as vve have sovvnded the matter, to give her pas∣sage.

* 1.13If soe be the Cauterye be applyed to make a fōtanelle, vve must then cause the Escara throu∣ghe the sayed remedves to separate, and keep o∣pen the hole, or the foresayed vlceratiō, as grea∣te as the rotunditye of a bullet: to the effectua∣tinge of vvhich, some vse a great Pease, vvhich throughe the great humiditye vvhervvith shee is soacked svvelleth as thick & as bigge agayn, as she vvas before, by the vvhich meanes vve may keep open the apertione, as longe as plea∣seth vs: others make little pellets of elder pithe, of Rhabarber, of Agarico, of the blacke neesinge roote, of a Gallenut, of Gētian, & some of goul∣de, or of sylver beinge hollovve, & concavoyse, but the most convenient, & fittest vvhich I ha∣ve experimēted, are made of vvhyte vvaxe, am∣ongst the vvhich is mixed, verdegriece, Cantha∣rides, hermodactilles, & a little auripigment, ad∣ding thervnto a little pirosin. This kinde of lit∣tle Balles, vveare invented of Mons^r. Hubert, Chyrurgiane to the kinge, one of the most ex∣pert Chyrurgians of our times.

* 1.14Touchinge the time, of keepinge open these Fōtanelles: Celsus teacheth vs, in his fourth bo∣ocke and 22. Chap. that it is oftentimes necessa∣rye for the Chyrurgiane, to exvlcerate the par∣tes of the bodye, vvith a glovvinge Cautery be∣inge, as it vveare, an aeternall prohibitione, that vve should not suffer such vlceratiōs so quick∣lye to close agayn, as of themselves they vvoul∣de, but that vve must sustayn and keepe them a∣pert & opē, till such time as the dissease, vvhich throughe this apertione vve intend to cure, be vvholye finished, and cured.

Notes

• * 1.1

  VVheron vve ought to consi∣der in the appli∣cation of the Cau∣teryes.
• * 1.2

  Divers conside∣rations.
• * 1.3

  Places vvheron vve apply the Cau∣teryes.
• * 1.4

  Hovv vve shall fin∣de in the heade the place vvheron vve must applye the Cau∣terye.
• * 1.5

  Cauterye in the Fi∣bra.
• * 1.6

  Meanes hovv fit∣tlye to ap∣plye the Cauterye on the Arme.
• * 1.7

  Meanes hovv to apply the cauteryes conveni∣entlye on the legge.
• * 1.8

  Admoni∣tione in the apply¦cation of the actu∣all Caute∣ryes.
• * 1.9

  For the reitera∣ted Cau∣teryes.
• * 1.10

  To ease the payn, and Sepa∣rate the Escara.
• * 1.11

  Hovv vve must ap∣plye the potential Cauterye
• * 1.12

  The cau∣terye ma∣keth a farre gre∣ater Esca∣ra then the hole of the Plaster.
• * 1.13

  Divers meanes to keepe, open a Fontanel, vvhich throughe a poten∣tiall cau∣terye is made.
• * 1.14

  What cō∣tinuance vve may keepe opē the vlce∣ration.