The Frenche chirurgerye, or all the manualle operations of chirurgerye , vvith divers, & sundrye figures, and amongst the rest, certayne nuefovvnde instrumentes, verye necessarye to all the operationes of chirurgerye. Through Iaques Guillemeau, of Orleans ordinarye chirurgiane to the Kinge, and sworen in the citye of Paris. And novv truelye translated out of Dutch into Englishe by A.M.

❧Of the kindes, & differences of the ligamentes. Chap. 2.

HIppocrates gennerally hath made tvvo sortes of Ligamēts: vvher of the firste is, that vvhich of it selfe, & by his virtues did pros∣per, & opitulate the curinge of the disseases, and vvithout the vvhich they can not be cured becaus that vvith out the same, the parte can not be contaynede in his statione, or forme, vvherin shee must be contayned, to be cured, & to be praevented that ther happen noe fluxione vnto the parte, ne∣ther the matter beinge therin congregatede, vvithout the sayede ligature coulde not be dri∣ven, & expellede therout. As vve may note on the ligamentes, vvhich in the vvoundes of the Heade vve vse, vvhich allso in all concavouse vlcerations vve vse, in Fractures, in dislocatiōs, recurvatione of Ioynctes, in the separatinge of those partes, vvhich agaynst nature lye the one above the other, in the reductione of the sepa∣ratede partes, in the apertione of the partes, vvhich are to closelye occludede, & shutte & a∣gaynste the minde of the Chyrurgiane, vvill combine themselves together.

The seconde ligament, is that vvhich is or∣daynede, not onlye because of it selfe it is com∣modiouse, & profitable, but Per accidens, & bye chaunce, & it is but onlye vsed, to contayne, & keepe the remedyes, & compresses, on the diss∣easede parte, as on a great, & dolorouse inflam∣matione, on a greate Apostematione, or on any other dolorouse parte.

And touchinge the ligature vvhich of it selfe is profitable, & commodiouse, ther of ther are tvvo kindes, vvhich of the vse, vvher vnto they are ordaynede, are taken: vvhich is ether to cō∣tayne the partes as close in their naturall being because therthroughe they may be combinede & vnitede, vvherfore this ligatione is called, the agglutinative, or incarnative ligatione: Or els to praevente, the fluxione vvhich might chaūce to come to that parte, & expell the same ther∣out, vvhich is molestiouse, & troublesom vnto him, vvherfore he is called the expulsive, or re∣pellinge ligature.

The incarnative or conglutinating ligation, is commōly vsed in this form on the vvounds. To vvitt, that vve roule vp the rovvler, or liga∣ture on both his endes, vnto the middest ther∣of, vvherof in each hāde vve must take the one end beinge rovvled vp: laying that parte of the ligamēt vvhich is not rovvled vp, on the other syde of the vvounde, reducinge both the endes of the ligatione, vvhich vve have in our hands above on the vvounde, that ther throughe, vve might adioyne, & bringe together, the separa∣ted partes, & lippes of the vvounde, crossinge the foresayed ligature, in forme of a Burgundi∣ane crosse, or in forme as in the margine is set dovvne vnto you: Then vve must reduce both the endes to the parte, bringinge one end, to∣vvardes the superiour parte of the membre, be¦cause therby the fluxione may be praevented, & the other end, on the inferior parte, that the bloode therthrough, vvhich is suncke, and dis∣cended into that parte, might be depressed, and crushed out: and the fore sayed Ligature must be of such a breadthe, that vvhen as he is rovv∣led vp, & applyed on the vvounded parte, may not onlye compraehende the vvounde but al∣soe both the endes, of the same.

If soe be the vvoūde vveare ample, & greate, and the ligature, cōsidering his latitude, coulde not be accommodated, vve must as then com∣praehende but the one halfe of the vvounde, & the other halfe therafter.

Such a Ligament therfore must be reasona∣ble closelye vvounde, but allvvayes a little stif∣fer one the vvounded parte, as Hippocrates vvil∣leth vs to doe, yea also, in the vvoundes vvith Fracture, because there throughe might be ex∣pressed, and crushed out, the bloode, vvhich in that parte is suncke, least that there shoulde happen anye inflammatione thervnto, & then an Apostematione.

The expulsive, or repellinge ligamente, is ve∣rye much vsed in Fistles, & in concavouse vlce∣rations, thervvith to expell the matter, vvhich is discending to the grovvnde or bottome of the same, & vvhich throughe the longe retenti∣one, internallye corrodeth that part. This liga∣ture is allso verye commoeiouse in the Varices or bursten vaynes, & in tumefacted Legges, but vve may not vse it in Fistles, nor in any conca∣vouse vlcerationes, vnlesse first of all they be putrifyede, & their callositye taken therout, ne∣ther in inflammationes:

This ligamente is imposed, vvith the one end being revolvede, & rovvled vp, begīning vvith the sovvnde part, vvhich is sitvated close to the bottome of the Sinus, vvhere he muste be som∣vvhat more dravven together, & shutt, & then is reduced agayne tovvard the vvounded parte,

& tovvarde the mouth, or apertion of the con∣cavitye, vvith out bindinge the same to stiffe, & consideratione, of the inferiour parte.

As if the Sinus be in the legge, & the bottome of the same vnder the Knees, & is alsoe higher, & hath his issu in the crassitude of the calfe, vve must them beginne to binde, one the Knees, & finishe in the inferiore partes therof. Contra∣rilye if soe be the inferior parte of the Legge, & the issue therof be by the Knees, vve must thē beginn the ligatiō by the foote, & end the same close to the Knees. But if vve desire to vse this Ligature in greate Armes, and great Legges, vvhich are Varicouse, vve must then beginne from belovv the legge, or Arme, vpvvardes, vvhich is the most farthest, from the originall of the Vaynes and supernallye end the same, to vvitt, about the Harte, & the Liver, vvhich are the originalls of all Vaynes, & Arteryes, heerby to repell the humors vvhich are in that parte, & to praevent that there concurre noe more vnto that place.

As farre forth therfore, as if that parte be rug¦ged, and vnsmoothe, as is that Legge, vvhich is farre more thicker in the Calfe therof, then in the lovvermost partes therof, vve must thē frō palme, to Palmebreadthe, a little more thē half throughe cutt the same, and fovvlde both sydes cōtradictorilye the one to the other, & soe loos∣lye sovve the same, by vvhich meanes the sayed Ligament, is made to be recurvated, and crooc∣kedlye vvounde, like a Bovve. Having therfore stifflye rovvled op this foresayed ligature, or rovvler, vve may thervvith as smoothlye vvind & involve a Legge, vvithout makinge, therin a∣nye inaeqvalitye, or furrovves causing that syde vvhich vvas cut of, & thē agayn sovved, aeqval∣lye to agree vvith the thīnest parte: & the vvhol parte vvhich is the longest, to agree vvith the greatest parte. Above these tvvo foresayed Kin∣des, & differēces of Ligamentes, vve may as yet adde thervnto a thirde Kinde: The vvhich vve call an attractive Ligamēt, vvhich vve may vse vvhen vve desire to retracte, anye bloode, nou∣rishment, or anye other vitall Spirites into that parte, the vvhich, the parte of it selfe can not dravve, & attracte vnto it, because her attracti∣ve forces are debilitated, & very much feebled.

VVe vvill somvvhat alsoe speake of that liga∣ment, vvhich of it selfe is for noe vse profitable but accidentallye cureth, throughe his conti∣nuāce of the remedyes, vvhich are applyed vn∣to the dissease, vvherfore vve may call it the re∣tentive Ligament: vvherin vve must consider thre especiall thinges. First in vvhat disseases it is commodious: Secondly on hovve manye fashones, it may be composed, & made: Third∣ly, & lastelye, hovve vve ought to vse the same.

Touchinge the first, vve ether vse the same, consideringe the parte, or the Dissease, vvhich can tollerate noe other: Consideringe the Dis∣sease, as anye vvounde, or vlceratione, accom∣panied & associated, vvith anye great payne, or inflammatione, or vvhen vve disire an Aposte∣matione to be matured: Consideringe the par∣te, as vvhen a vvounde is in the Heade, in the Necke, in the Bellye, or in the Testicles, vvhich partes cā not indur to be stiffly tyed, or bovvnd, & therfore neede noe ligatione, but only to re∣tayne the remedyes therone, because that the other stiffe ligatures, bringe vvith them great discommoditye.

Concerninge the seconde poyncte: The re∣tentive Ligamēt, must have tvvo, three, or four endes, accordinge to the forme, & situatione of the parte vvhich vve vvoulde dresse. Touching the thirde poyncte, that must be begunne in the dissease, & ended on the other syde of the same.

Notes

• Tvvo sor¦tes of liga¦ments in generall.
• First kind of ligatu∣re.
• The se∣cōd sorte of Liga∣ment.
• Redivisiō of the first kind of Liga∣ture.
• Icarnati∣ve Liga∣ment.
• Nota.
• Hippocra¦tes.
• Expulsive Ligamēt.
• Admoni∣tione.
• Hovv vve may ma∣ke the expulsive ligament.
• An at∣tractive Ligature.
• The secō∣de kinde of Liga∣ment a¦bove re∣hearsed.
• Ligamēt for the dissease.
• Ligamēt for the parte.