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 EIGHT TRE∣ATISE OF THE OPERATI∣one of Chyrurgerye, wherin is discoursede and handelede of the Cauteryes, and of the Setonne Contayninge five Chapiters.

• VVhat a Cauterye is, the Species, and differences therof. Chap. 1.
• Of the inventione & vse of the Cauteryes, & in vvhat disseases, and one vvhat places vve may ap∣plye them. Chap. 2.
• Of the Potentialle Cauteryes, and hovv vve should make them. Chap. 3.
• On vvhat manner vve ought to applye the Potentialle Cauteryes. Chap. 4.
• Of the Seton, & hovv vve ought to applye it. Chap. 5.

❧What a Cauterye is, & of the Kindes, & differen∣ces therof. Chap. 1.

HAvinge vvith my selfe resolved & purposed, to vvrite sōvvhat, of the Cauteryes, it is first expe∣dient and necessarye that vve knovve, vvhat a Cauterye is, & hovve manye kindes, and Spe∣cies therbe therof: vvhat theire vse is, on vvhat bodyes, on vvhat disseases vve ought to applye them, and the manner hovve vve shall applye the same. Therfore to vnderstande theire na¦ture, vve must first knovve, vvhat vve by the name Cauterium vnderstande: For it may be vn∣derstoode one tvvo sortes or vvayes, Simplely, and not Simplelye: Symplely, consideringe the instrument, & the Causticke matter, vvhich a∣dureth in anye parte, as Galen, in his sixt of the simples in his 27 Chap. describeth: Not because of the signe vvhich remayneth in the Cauteri∣zed parte, that is because of the little Vlceratio∣ne, vvhich remayneth, therin, vvhen as the Es∣cara is fallen therout: Soe that this vvorde Caute∣rium, in properlye being vnderstoode, can noe othervvise be vnderstoode, then a little Vlcera∣tione, in anye externall parte of the bodye, vvhich throughe the art of the Chyrurgiane, is made therin, throughe some comburent, & ad∣ustive medicamentes, to give issve, & passage to some certayne matter, of some dissease.

VVherfor the differēces, of these Cauteryes, or Vlcerationes, are as it vveare dravvne, from their place, & being, vvheron they are applyed, & also from theire efficient cause. The essence, & beinge of these Cauteryes, cōsisteth in theire forme, & figure, vvherfor some ther are vvhich be rovvnde, some contradictorye, others right, great, smalle, deepe, or not deed: All the vvhich have but one onlye apertiō, or sometimes also tvvo, & is thē called a transforatione, or Seton: And also of all other places, vvheron they may be possiblelye applyed, as on the Heade, in the Necke, Armes, Legges, & finally in all partes of the bodye, vvherone they might be applyed, vvhē onlye the agilitye, or actione of the parte can not ther through be hindered, or hurte: Of their efficiēt cause, vvhich is takē out of the di∣versitye of the matter, vvhich is applyed one a∣nye parte of the bodye, or ingendred in the sa∣me. The matter vvhich continuallye is applyed on the bodye, actuallye combureth, or poten∣tiallye, vvherfore they are called actuall, or po∣tentialle Cauteryes: That vvhich in our body is ingendred, can come through any sharpe, cor∣rodent, or bitinge humors, vvherthroughe the skinne is corroded, bitten throughe, & exulce∣rated, of vvhich vlceratione, may be effected &

made a Cautery, or fontanelle, vvhich may be called actuall Cauterye.

Heere of vve may coniecture and suppose, that the Cauteryes, & fontanelles, vveare in∣vented, follovving nature therin, ther throu∣ghe to give passage, to that vvhich is contrary, & opposite vnto her, & vvherof she is pertur∣bated, & molested, it be ether in quallity, or in qvantitye, as heerafter vve vvill farther speake of. And as touchīg the Cauteryes, vvhich vve call instrumentes, their principalle, & especi∣all difference, is taken, of theire substance, for∣me, & figure, & of theire tarditye & slovvnes, or festinatione, of adustion, of theire depth, & shallovvnes, & of the manner of theire appli∣catione: touching theire matter, or substance, because they actually, & in deede doe combu∣re, & burne, or potenciallye, they are therfore called actuall, or potencialle Cauteryes.

The forme of those vvhich actuallye burne is almost innumerable, vvhich are made hott, & glovvinge. The antique & auncient Chy∣rurgians, have commonlye made theire Cau∣teryes of mettles, as of gould, of siver, of Iron, & of copper. Archigenes hath cauterised the la∣chrimall fistles vvith liquefacted leade, vvhich through a little pipe he dropped therin. They vveare of opinion, that the cauteryes of gould caused lesse payne, & vveare farre more easyer to be suffered, that alsoe the Cauterized place, shoulde not avoyde soe much matter, and the adustiō is not soe daungerouse, because gould amongest all other mettles is the moste tem∣perate, vvherfore it burneth not so violently, as Iron, because it is not soe cōdensated of sub¦stance: vvherfore in like sorte alsoe the Caute∣ryes vvhich are made of Copper, doe not soe closely burne, or cauterize, as those vvhich a∣re made of Iron, because the copper, is not so solide of matter, vvherfore vve desiring strō∣gelye, & violentlye to cauterize vve must take such cauteryes, vvhich are made of the condē∣sest, & most firmest matter, & substance. Som∣times have also the aunciēte professors as Hip∣pocrates,, recited, to have cauterized, vvith ten∣tes, vvhich they dipped in ebullient, & seethī∣ge oyle, or vvith drye incended puffes as vve call them or vvith the root Aristolochiae, being madefyed in seething oyle, or vvith the rootes of Strutium, as Caelius Aurelianus, Dioscorides, and Attilus, vvhich have cauterized vvith incended Goates dunge. Aetius hath cauterised the cor∣rupted gummes, vvith ebullient oyle, vvhich he applyed theron vvith vvolle beinge therin madefyed. Albucasis in like sorte, hath cauteri∣zed the hollovve, and concavouse teeth vvith seethinge butter. Guido hath cauterised the bo∣nes, vvith liquefacted Brimstone, to vvitt of the Caries. Soe that out of all these vve may sufficientlye vnderstande, that vve may make as manye sortes of cauteryes, as there are sub∣stances, vvhich may be incended.

The foresayed cauteryes, & especiallye tho∣se, vvhich are made, & composed of any met∣tle, are also differinge in their figures the one from the other: For everye cauterye must be proportioned, accordinge to the dissease, and that vvheron vve vvill apply the same: so that some are like heades of great nayles, & trian∣gled, others rovvnde, like vnto a buttō, others cutting, some not dislike vnto a halfe moone, and others circlevvyse: As vve may behoul∣de, and see, the circles of Albucasis, other in forme of a rapersblade, as Celsus discribeth, ther vvith to cauterize the fissures in the lip∣pes.

They are alsoe differinge the one from the other in theire depthe, or shallovvnes: for vve neede somtimes to cauterize the skinn only, as Hippocrates vvilleth vs to doe, in the paynes of the shoulders: VVe must alsoe sometimes cauterize the fleshe, as in the Sciatica: Some ti∣mes also to the bone, and crushe the same rea∣sonable close thervnto as vve must doe, vvhen as vve must cauterise above on the heade, vve must sometimes cauterize, into the concavity of the bodye, as vvhen vve must cauterise in∣to the brest, to let ther out any matter, & som∣times vve doe but only scorche or singe abo∣ve one the place.

And because that amongest the cauteryes, (considering the matter vvherof they are com¦posed) ther be some vvhich are quicly heated) and some vvhich continue longer hott, then others even soe ther are some, vvhich consi∣deringe theire pōderousnes, or levitye, tardi∣tye, or festinatiō, ether in violence, or payn of theire operation, are differinge the one from the other.

The Cauteryes are alsoe differing, in theire numbre, for at somtimes vve applye but one, somtimes tvvo, thre, four, yea alsoe fifteen at one time, as Aetius cōmandeth vs, to the curing of the vlcerations of the Brest.

They differ alsoe in theire manner of appli∣catione, for some are applyed alone, others in little pipes, vvhich at one ende are aperte, and opē, or have any appertiōs, or vvindovves in the sydes therof.

Of the Invention, and of the vse of the Cauteryes, and to what disseases, and one what places, they must be applyed. Chap. 2.

IT may rightvvell be sayed that nature hath shevved vnto vs, the inventione, of the Caute∣ryes, & fōtanelles: For as sōti∣mes the partes being overladē vvith to manye humors ether

theire tartnes, or venoumousnes are troubled, they in the end, discharge, & vnburthen them∣selves, in some parte of the body, of that vvhich molesteth thē, as in one of the Armes, or leg∣ges, causinge ther to ther solace, and ease, some excoriatione, or apertione. So that the Physiti∣ones, & Chyrurgianes, to helpe heerin the na∣ture, have there throughe fovvnde out the vse of the Cauteryes, & Fontanelles, effectinge by their arte, that vvhich nature oftentimes, thro∣ughe her ovvne commotione thervnto ende∣voreth to doe, vvherfore vve alsoe vse the Cau∣teryes, as oftentimes as vve desire to make any derivatione, revulsione, interceptione, or eva∣cuatione, of anye matter, the vvhich ether con∣sideringe her qvantitye, or qvallitye, or vvith both of them together, might in anye sorte be occasione of any harme. VVe alsoe vse them, not onlye vvhen as vve desire, to transpire, and cause to evaporate any venoumouse vapours, but also, vvhen vve vvould cause anye concur∣rent matter to exsiccate, & consume, endevo∣ringe to dravve the same from vvithine exter∣nally, as vvell through the extractione, vvhich it heer maketh, as through the vlceratiō, vvhich therafter remayneth, as throughe certayn little open fistles, or small rūninge issues vvhervvith vve dravv the matter from invvardes, outvvar∣des, ther to evacuate the same, and cause to di∣gresse from the one place to the other.

Cauteryes are profitable sayeth Galen, & Hip∣pocrates, in all corrosive, & ambulative vlcera∣tiones, agaynst fluxions of the eyes, in the tu∣mor Aegylops, vvhen as the fore arme, is suncke and discended vnder the Armepittes: In the Sciatica, & payne of the hippes, for they retracte & dravve backe the humors, vvhich trouble & in that place hinder those partes: In the Gangrae∣na: in the extirpatione of the mēbres, to stench, & stoppe the bloode, & soe forth in all fluxions of blood, & in all other internal disseases vvhat soever, as in the Consumptione, in vlcerations of the Breste, and in the Dropsye. Abucasis avou∣cheth the Cauteryes generallye, to be profita∣ble, in all disseases, and sicknesses, vvhich take their originall, of any matter, or vvithout mat∣ter. They are also profitable, and commodiou∣se, for all bitinges, & stinginges of anye venou∣mouse creature, in the Carbuncles and Venus botches, becaus through theire heat, they con∣sume the venoumousnes of the humors, & an∣nihilate them and out of the depth dravve thē vpvvardes. They are alsoe verye profitable, in al criticke Apostemations, vvhich are could, & vvaterye, and vvhich are verye slovve in matu∣ratione because that throughe theire caliditye, they opitulate, and helpe to ripen, the could, & toughe humors, vvhich are in that parte. They are alsoe goode, agaynst all corruptione of bo∣nes, because they exsiccate the venoumous∣nes of the same, and consume it, and cause the corrupted bones to separate from the sovvnde.

VVe may applye thē on all partes of our bo∣dye, and especiallye, beinge needfulle, to make anye apertione, to give issue and passage, to a∣ny matter, or vapoure, vvhich therine is assem∣bled.

Ther are some vvhich have applyed the cau∣teryes one the vpper part of the head, about the sagittal suture, vvher she ioyneth her self vvith the Coronalle suture: VVhich vvith great and good successe I have seē to be done of M^r. Pare, agaynst the Hemicraniam, or payn of the one sy∣de of the heade, and agaynst manye other sortes of inveterated paynes of the heade, because that through such an apeatione, manye and divers humours, & vapours, vvhich are congregated in the heade, by this meanes are exhalated: allso agaynst the fallinge sicknes, to give transpirati∣one to some venoumouse humor, & vapoure, vvhich are often times the occasion of this dis∣sease: Agaynst shortnes of breath, and difficul∣tye of breathinge, vvhich have takē their origi∣nall, of the superfluitye of humors, and descen∣de out of the heade dovvnevvardes to the brest & ther hinder & molest the partes of the brest, and bringe vvith them the shortnes of breath, and oftentimes allsoe are cause of vlceratiōs in the brest through corruptiō, and putrifyinge of some pituitous humours: & also in the Ophthal∣mia, or inflammation of the eyes, vvhich is ther throughe caused, through any fluxiō, vvhich is sēt through the vaynes, vvhich lye scattered in the Pericranio, & soe runne to the externall tu∣nickle of the Eye: Agaynst reddnes of the face: Agaynst payne in the teeth, of the Eyes, in the Sqvinancie, & in manye other disseases, vvhich come in the mouth, and in the throte.

VVe Cauterize alsoe the Eyeliddes, vvhich a∣re relaxated, in like sorte also the Cilia vvhich sticke in the Eyes, and allso in those vvhich in number are to manye: Alsoe in the Arteryes of the temples of the Heade: The tumefactiō Aegy∣lops, the Polipus, and Ozena, the cleaved lippes, the Ranula, the Teeth, and the pallate of the mouth vvhen it hangeth to lōge, & also the Almōdes: The Thorax, or Brest, on divers places, somtimes shallovvly, & sōtimes to the cōcavity of the fo∣res. yed Brest: the inferior parte of the Belly: the Scrotum, or genitalles, & especiallye the hippe a∣gaynst the Sciatica: & the bone, vnder the knees, on the insyde of the legge.

Some ther are vvhich sett five cauteryes one the heade of those vvhich vve suppose to be in∣fected vvith the lazarye. VVherof vve must set the first cautery, one the Coniunctiō, of the sa∣gitalle suture vvith the Coronalle: The secōde above the forheade, vvheare the hayre ceaseth: The third in the Necke: The other tvvo the Os∣sa Petrosa above the eares, somvvhate aftervvar∣de,

tovvarde the end of the Lamdoidalle Suture, to avoyde the end of the temporalle muscle: to vvitt one, one the right syde; & an other, on the left syde: All vvhich Cauteryes are applyed, to separate those humors, vvhich cause the nose to exulcerate, and the internalle part of the mouth, in those vvhich have the lazarye, and vvhich externallye have theire face corroded, & deformed, & fearfull to behoulde. These Cauteryes are applyed one some, because vve shoulde not see that they have binne cauteri∣yed, onlye behinde in the necke, and one both the Armes.

❧Of the Potentialle Cauteryes, & how we ought to make them. Chap. 3.

THe potētiall Cauteryes are tho∣se, vvhich through theire intol¦lerable, & extream heate, being vvith their forces set to vvorke together vvith the benefites of our naturall caliditye, burne as it vveare a fyer in that parte, vvherone they are applyed, leavinge behinde them an Escara, or crust: Of the vvhich the matter of the Corrosi∣ve is in great number, and hot, vnto the fourth degree: Amōgst the vvhich ther ar som, vvhich are extreame hott, & a little gentler, accordinge as their operatione is tardive. Amongst them are numbred, the Cantharides, the Tartre, the common Vitrioll, or the calcined, the vnslissed lims, the Auripigment, the Arsenicvm, the su∣blimate, the Aqvafortis, the Oyle of Vitriolle vvith more others) the vvhich vve novvadayes, doe seldome vse, in such sorte as they are, vvith out praeparinge, or mixinge of them, to make any Fontanelles, because that experience, hath taught vs some, vvhich are farre more conve∣nient, & lesse daungerouse.

The actuall Cauterye, is much conveniēter▪ then the Potentiall, vvhether it be vve consider on the nature & substāce, on the healthfullnes festinatione, and certayntye, in operatione: for the fyer, is a simple element, havinge noe other forces then by the heate therof, & exsiccation, vvithout havīge associated vnto it anye venou∣mousnes, vvherfore the operatione therof is festivous, certayne, & healthfull, pearcing dee∣per therine vvhen vve please, vvithout causing anye accidentes in the circumiacent partes, al∣thoughe, that thervvith vve chaunce to touch them, & that because of the subtilenes therof, and consideringe the virtues of his substance. It is an enimye vnto all corruption, vvherfor, it freethe alsoe from all covruptione, & putre∣factione, yea it consumeth all venoumouse matter, & qvallityes, vvhich in that parte might lye occulted, and hidden, consumeth also all su∣perfluouse humidityes, and correcteth alsoe all vntemperate coulde, and moysture.

VVher on the contrarye, the matter, vvherof the Potentiall cauteryes are made, are oftenti∣mes venoumouse: And hovv soever they be praepared, yet ther operatione, & actione, is vn∣certayne, retardate, and slovve, and sometimes alsoe daūgerouse, vvithout simplye knovvinge the vittues therofe, & hovve to limite his ope∣ratione: Because somtimes it spreadeth it selfe broader, then our meaninge is it shoulde, and causeth more detriment, and harme in corrosi∣one, then vvillinglye vve vvoulde, it shoulde, because it doth not only combure & burne the place vvhereone it is applyed: But beinge vni∣ted, vvith our naturalle caliditye, it extendeth, and pearceth alsoe deeper in the fleshe then is necessarye it shovlde, vvherthroughe that par∣te beinge by little, and little calefyed, and vvar∣med, it imprinteth not onlye one that place his venoumouse nature, but extendeth it self far∣ther, throughe the circumiacent vaynes, & Ar∣teryes, & Synnues, in the vvorthye partes, spoy∣linge, & oftentimes burninge, the good, & vvel disposed complexion of that parte, out of the vvhich commonlye follovve verye badde acci∣dentes, and vlcerations, vvhich therafter verye difficultlye vvilbe cured, yea also some times a Gangraena.

Notvvithstandinge althoughe the Chyrur∣gians novveadayes, are boulde enoughe in the application of actuall Cauteryes, novvithstan∣dinge most commōlye they vse the potentialle consideringe the feare, & affrightednes, vvhich the Patientes conceave therofe, soe that the ac∣tuall Cauteryes are allmost therthroughe re∣lapsede into oblivione: It is right true, that the Potentiall Cauteryes vvhich novve adayes vve vse are indeede of velvet, & verye excellēt, & vvhere of I never as yet knevve anye badde accident to follovve, throughe the longe vse vvherof, vve have learned the certayntye hovve to make them.

VVe must note, that in the Potentiall Caute∣ryes, or Ruptoryes, vve adde nothinge, vvhich hath any venoumouse nature or qvallitye: Be∣cause they, cōsidering their virtues, are through our naturall calliditye compelled to doe their operation, vvhich by little, & little suscitateth, the redormitinge, & soporiferouse forces ther∣of, soe that it is not possible, but that of necessi∣tye, this venoumouse nature, must imprint so∣me parcell of her venoumousnes in that parte, if soe be at the least ther be any venoumousnes mixed thervvith: vvherfore most commonlye one this sorte vve praepare it, that immediatlye it might shevve forth his operatione.

VVe make novve adayes Cauteryes in form of Trociskes, of divers kīdes of Ashes, Saultes, & limes. The ashes are made of Oackē vvood,

of Figgetreevvoode, of VineBranches, of Bea∣nestravve, of Cabbage stalkes, and of Titimallo: The saultes are Alcali, Salpeter, Armoniac, Sault of glasse, Vitrioll, Tartare, or Pottashes, vvher∣of vve, ether of anye partes of the same make lye, out of the vvhich vve extracte a Corrosive sault, vvhich may be made strong, debile, or ex∣treame stronge, and acute, accordinge vvith all that vvhich commeth in the foresayed lye.

Amōgst all Cauteryes vvhich are made that is one of the best, vvhich M^r. Paré, calleth the Cauterye of Velvet, vvhen it is only sodden, & made, as it reqvireth to be done: notvvithstan∣dinge it seemed convenient vnto me, heere to discribe certayn other Cauteryes, vvherof I my selfe have seene divers goode operations. Take sault of glasse, Potashes, vnflist lime, of each a povvnde, ashes vvhich are burned of the inve∣terate sydes of a vvynepipe, tvvo povvnde: Put all these together in a great earthen pott, & in∣fuse theron 18, or 20, povvnd of cleere vvater, and let it so stande soackinge 8. or 10 dayes, or as longe, till one your tunge you feele, the lye to be verye sharpe, and tarte, or vntill that ther may drive an egge theron, vvith a sticke daylye stirringe of the same, and then vve must lett it to clarifye, & sincke, vvherof you must defu∣se the vppermost therof, and ether straygne it throughe a thicke close cloute, or els throughe a Felt, vvithout stirringe of the bottom or foe∣ces therof, of vvhich aeqvall parte, you must ma¦ke Trociskes, as heer after vve vvill demonstra∣te.

An other Cauterye, of the disceased Mons^r. Cheval, Chyrurgiane.

Take sault of glasse halfe a povvnd, Sal gem∣mae six ovvnces, Sublimate vvhich is smally per¦fricated, halfe an ovvnce, Ashes of Vinebran∣ches halfe a povvnde, 10 povvnde of common vvater, let all this stande and soacke, as is abo∣ve sayed, and therof make trociskes, addinge in the end thervnto tvvo dragmes of Opiū, vvhich is liqvefacted in Aqvavitae.

An other of Mons^r. Rasse Desneux.

Take tvvo povvnde of potashes, Saul•• ••f glass and Sal alcali, of each halfe a povvnd•• 〈◊〉〈◊〉 povvnde of common vvater, & heerof make a Lixivye, as is above rehearsed, and alsoe make therof Trociskes,

An other of M^r. Iaqves de Vile neufve, a great practisioner at Mompeliers, as I have in the same cittye seene him make.

Take Sopemakers lye tvvo pounde, Vitriol three ovvnces, Sublimate one ovvnce, make heerof Trociskes addinge in the end thervnto tvvo dragmes of Opium.

An other of Mons^r. de Iovine.

VVe may also make goode Lixivye, onlye of Oackē ashes, or of Ashes of Vinebranches, vvhē as the same is vvel soddē, vvith potashes, and of Beanestravve, addinge thervnto a little vnslissed lime, vvherof vve may make verye ex∣cellent goode Cauteryes.

An other vvhich qvicklye can be made.

VVe may in one day make verye goode Cauteries taking therto a povvnde of vnslissed lime, halfe a povvnde of Potashes, Sal alcali pulverizated very smalle, foure ovvnces, com∣mone ashes of vvoode tvvo povvnde, infuse heer in 15 povvnde of common vvater, let it stande & soacke three or foure hovvres, & then seeth it a little, if you take it to be convenient, and then let it stande & purifye, or sincke, and then let is straygne throughe a Felte, & heerof you may make goode Cauteryes.

Allthoughe that vve have all these foresayed thinges in a readines, therof to make a lye or lixivye, vnles that you ebulliate your sault, ve∣rye short, & drye, it vvill as then have noe great forces, & vvill qvicklye be liqvefacted, & agayn dissolved. Therfor to seeth a right your lye you shall infuse it in a Basen, & let her there seethe, and ebulliat, or evaporate, till such time as shee be verye thicke, like vnto honye, mixe, & stirre it vvell together, vvith an iron Spatula, and then the foresayed sault, vvill somtimes present di∣vers colours, as blevve, & by little & little, vvill grovv thicker, yet not vvithstandinge, vve must yet make greater fyer thervnder, vvith violente flames, as if it vvear a liqvefactīge fyer, because the foresayed sault might be melted and liqve∣facted, as Butter, & chaunged into vvater, of the vvhich you must take a little on your Spatula, & lay it on a stone, & if soe be it immediatly vvex harde, it is thē a signe that it is sufficientlye sod∣den: For if soe be as then you keepe it longer one the fyer it vvill as then burne, & agayne be chaunged into ashes, as beinge needfull that there be some humiditye therby to keepe it in his vvonted thicknes: vvhich beinge done, you must then remove your Basen from the fyer, & vvith the Spatula, take out the sault, or your Cau¦terye therout, vvhilest as yet it be hott, least that it cleave therone to harde, vvherof yon must then make great or little Trociskes, vvhich im∣mediatly you must put, into divers little glasses violles, least that through the ayre they chaun∣ce to be altered, and chaunged, and stoppe the

same very close, & vse thē vvhensoever it shall please you.

And to praevent, that the Escara, of the caute∣ryes, or ruptoryes, be not to harde, a certayne frende of mine for certayntye imparted vnto me, that in the end of the ebullitione of your lixivye, vvhen shee is aboute the thicknes of hony, vve infuse thervnto a little Aquavitae, or spanishe vvyne, or els anye other stronge vvy∣ne, as Malmasye. And to make them soe, that they shoulde not cause anye great payne, vve must as thē adde vnto it a little Opium, vvhich is liqvefacted in Aquavitae, but I never tryed it.

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

NOvv therefore condecentlye to applye all cauteryes as vvell ac∣tuall, 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: 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.

VVe 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, 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, 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, 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. 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.

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.

Beinge 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: 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, 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, 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.

If 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.

Touchinge 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.

Of the transforation, or seton, and of the manner how we ought to apply it. Chap. 5.

THe transforation, or the Seton, may in tvvo sortes be vnder∣stoode, properlye, and impro∣perly, vve simplely vnderstand it, cōsidering the threde vvhich vve dravve cleane through the skinne, vvith the needle, vvhich threde in aun∣ciēt time, vvas made of, course hayre, as of hor∣sehayre, or any other such like, vvhich of the la∣tinistes is called Seta: But vve novv a dayes ma∣ke our threde of silcke, of Cotten, or of Course yarne. Improperly, vve vnderstand by the Setō, a logestretchinge vlceration, in anye externall parte of the body, vvhich is clean thrust throu∣ghe the dubble skinne, and that throughe agi∣litye, and dexteritye vvith a glovvinge Cau∣terye.

VVe apply especiallye the transforatiō, or the Seton, in thre partes of the body: to vvitt be∣hinde cleane through the Necke, although so∣me to follovv, the direct concurrence of the fi∣bers, applye the same in the length therofe: In the Navle, and in the Scrotum, vvhen as it is full of matter, & ventosity, as it oftentimes is vvon∣te to happen in the Dropsye.

This transforatione, is vsed, ether for any re∣gressione of humoures, or for an evacuation, or expulsione of the same: For vve applyinge the foresayed transforatione behinde in the necke, it then revelleth, and dravve the backe agayne those humors vvhich concurre tovvardes the Eyes vvith those allsoe vvhich runne tovvarde the Mouth, and the Brest, and retayneth allsoe those humours, vvhich descende, and sinck, be∣hinde in the Backebone, and in the Hippes: He beinge dravven through the Navle, or Scrotum, he then dravveth ther throughe all the Aquo∣sitye, and ventositye vvhich is therin contay∣ned.

It is novve adayes also applyed on tvvo man∣ner of vvayes, namelye vvith Pinsers, and vvith an actuall Cauterye, or through the Needle on∣lye. The transforation vvhich onlye is layed in the Necke, must be applyed betvvixt the secon∣de & the third Vertebram. VVhich convenient∣ly to effecte, vve must cause the patient to sit on a little stoole, and least that the transforatione should cōpraehend more one the one syde then one the other vve must denotate a line vvith Inck in the middle of his neck, or els on the sa∣me parte vvher vve vvill apply the tranforatiō, causing the patiēt to hould his heade on highe, and leene backevvardes over, because therby, the skinne might be the looser, and stretch the farther commaunding then one of the servan∣tes, or standers by, that vvith one of his handes he take hould one the skinn, close by the hay∣re, as deep as he cā, ether according the lengthe, or thvvarte over the skinn, follovving the line vvhich therī is made, liftīg the same in the mid∣dle on highe, vvhich thē the Chyrurgian, vvith his lefte hand shall take hould one in the mid∣dest of the same, and elevate it, because that he vvith his right hande, & vvith a rounde, & vvell cuttinge threded needle vvhich must be thre∣ded vvith a thicke threde, may thrust cleane

throughe the same, the foresayed thred beinge in this sorte thrust therthroughe vve must cutt him of close to the Needle. But if rather you desired, to effecte the foresayed transforatione vvith a hott Iron, the skinne beinge lift vp on both sydes, through some servant, or through the Chyrurgiane vvith his Pinsers, vvhich he must houlde fast in his left hande, dilligentlye consideringe least he take houlde thervvith of anye Muscles of the Necke, vvhich are situated vnder the foresayed skinne, as to that purpose, & intent he must cause the Patient to bende his necke, hould his heade vp, or on highe, & right by this meanes to knovve, vvhether anye of the foresayed, Muscles are compraehended of the Pinsers or not. VVhich beinge done the Chy∣rurgyane must nipe, & shut close together the foresayed pinsers theron applyed, therby to be∣numme & dissipate the senses & feelīg vvhich through the hott iron might be caused, & as thē vvith a triāgled glovving cautery thrust throu∣ghe the hole of the pinsers & soe throughe the elevated skinne alsoe: The vvhich foresayed skinne being in this sorte perforated, & imme∣diatlye agayn being dravven therout, vvithout suffering the skinn to fal, vve must thrust thro∣ughe the perforatione, a needle vvith a thicke dubble threede vvhich threde must be soacked in the remedyes above rehearsed for the Caute∣ryes, or els at the leaste being made fatt in some Digestive, & then the sayed threde being dissec∣ted, and cutt of, vve must suffer him to remayne therin, as is above rehearsed, & applye therone a Playster of Refrigerans Galeni, for the first or se∣conde daye, and then a Playster of Betonica.

This foresayed threde, or Seton, vve must suf∣fer it to continue therin, as longe as it shalbe needfull, as vve have sayed of the Fontanelles.

As concerninge the transforation, vvhich in the navle, or in the Scrotū may be applyed it vvil be sufficient vvhen vve take the Scrotum, & the extreamest end of the navle, & so perforate the skinn being doubled, vvith a reasonable greate or grosse needle, vvhich must be threded vvith a vvoollen, cotten, or silcke thred, and applyinge therone, the selfe same remedyes, of the vvhich vve have in the transforatione of the necke re∣hearsed.

Notes

• The na∣me of a Cauterye may be vnder stoode in tvvo sor∣tes.
• The diffe¦rences of the Cau∣teryes not properlye taken.
• Actuall Cauterye
• Differen∣ces of the cauteryes simply taken.
• The sub∣stance of the actual cauteryes
• Archige∣nes.
• Substāce of the cau¦teryes vvhich the aun∣cient Chy¦rurgians vsed.
• A kinde of spongi¦ouse mat∣ter full of dust gro∣vvinge on the moū∣taynes vvher∣vvith vve vse to stench bloode.
• Aurelia∣nus, Dios∣corides. Attilus. Aetius. Albucasis Guido.
• Differen∣ces of the cauteryes cōcernin∣ge their figures.
• Cautery∣es to cau∣terize deepelye.
• Differen∣ces of the cauteryes taken out of theire actione.
• Differen∣ce in numbre.
• Differēce taken out of the manner of the ap∣plycation
• The invē¦tiō of the cauteryes is dimon∣strated vn¦to vs through nature.
• Vtilitye of the cauteryes
• Albucasis
• In vvhat partes the Cauterye must be applyed.
• M^r. Pare.
• Caute∣ryes for such as a∣re troub∣led vvith the lazary
• The potē¦tiall Cau∣terye, and the mat∣ter therof
• The vse of the ac∣tuall Cau∣terye.
• The vse of the po¦tentiall Cauterye the mat∣ter, & vir∣tues ther∣of, and vvherone vve ought to consi∣der.
• Velvet Caute∣ryes.
• The mat∣ter of the potentiall Cauteries vvhich novv a∣dayes are in vse.
• M^r. Pare.
• Receipte, of the Velvet Cauterye
• Of Mons^r Cheval.
• An other of Rasse desneux.
• An other of Iaqves de Ville∣neufve.
• An other vvhich vvith all expeditiō can be made.
• An obser∣vatione in seethinge of the saulte to the Cau∣terye.
• Liqvefac¦tinge fyer
• Hovv vve must prae∣serve the cauteryes
• VVheron vve ought to consi∣der in the appli∣cation of the Cau∣teryes.
• Divers conside∣rations.
• Places vvheron vve apply the Cau∣teryes.
• Hovv vve shall fin∣de in the heade the place vvheron vve must applye the Cau∣terye.
• Cauterye in the Fi∣bra.
• Meanes hovv fit∣tlye to ap∣plye the Cauterye on the Arme.
• Meanes hovv to apply the cauteryes conveni∣entlye on the legge.
• Admoni∣tione in the apply¦cation of the actu∣all Caute∣ryes.
• For the reitera∣ted Cau∣teryes.
• To ease the payn, and Sepa∣rate the Escara.
• Hovv vve must ap∣plye the potential Cauterye
• The cau∣terye ma∣keth a farre gre∣ater Esca∣ra then the hole of the Plaster.
• Divers meanes to keepe, open a Fontanel, vvhich throughe a poten∣tiall cau∣terye is made.
• What cō∣tinuance vve may keepe opē the vlce∣ration.
• Setō Pro∣perlye ta∣ken.
• Setō im∣properlee vnder∣stoode.
• In vvhat partes vve ought to apply the Seton.
• The vse of the Seton.
• Tvvo sor∣tes of ap∣plycation of the transfora∣tion.
• Hovv vve ought to apply the transfora∣tion be∣hinde throughe the nec∣ke.
• The trans¦foration vvith an actuall Cautery.
• A transfo¦ration ap∣plyed in the Scro∣tum.