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 prognostication or iudgement of woundes Chap. 2.

IT is certayne that the praedicti∣one, or iudgemēt of vvoūdes, yea alsoe the generalle knovv∣ledge of all disseases, is a thinge most necessarye and expedient for a good Chyrurgiane: ther∣fore Hippocrates alsoe estemed it verye conve∣niente, & profitable, that a Chyrurgiane must excelle in the fore knovvledge of thinges, and be apt & redye to give iudgement and his opi∣nione of all disseases, because by that he may attayne, and at chiue vnto greate credite, and fidelitye by all men, and havinge on this man∣ner set forth, and published his knovvledge shalbe irrepraehendable, and of all men admi∣red, & soe much the safer, &, vvith more pro∣vidence finishe his vvorcke, & the boulder il∣lustraete the operatione of his arte, and give iudgement ther of vvithout anye scoffe, or checke, and be able to give a true reporte, vvhen that by the aucthoritye of some learne∣de chyrurgiane, or by the aucthorytye of so∣me Potentate, he shalbe therin imployede, & ordayned to reporte his opinione, ether of the vvounded persons life, ordeath, haultnes or criplenes. Even as alsoe the foresayed Hippo∣crates

sayeth in his Porrhet that the Chirurgi∣ane must ende voure him selfe to have a vvise & grave gesture, because that if it soe chaunce as he adiudged it shoulde, he might reape ho∣noure, & goodvvil, not onlye of the patient, but alsoo of all the circumstants, and behoul∣ders: Contrarilye if that othervvyse it happe∣ned or chaunced then he sayed, and iudged it shoulde, and that his iudgemente fayle him, he shal not onlye of all mē be hated but alsoe be esteemed as an ignorant, & sottishe fello∣vve. Beyonde all this Galenus sayeth, and testi∣fyeth vnto vs, that by our vpright, and sincere iudgement, by the frendes & Kindrede of the patiēte, althoughe he come to dye, vve shalbe liberated, & freede from all badde reportes & sclaunders, because that throughe the death vvhich consequentlye follovved, nothinge shalbe alleagede agaynst vs.

And for the givinge of such a perfect, and complete iudgement, it is necessarye for the chyrurgiane not to be ignorāt, vvhich partes of the bodye beinge vvounded, easylye, or dif¦ficultlye may be cured, vvhich of thē are prae∣sent death, and in fine, the tokens hovv to knovve vvhat partes are vvounded or hurte, because that out of ther natures, quallityes, & dispositiōs, vve may certaynlye hope, or mis∣truste of theire health, and safetye.

Such iudgemente therfore ought to be ta∣ken, out of the verye beinge, and substance, or essence of the vvoūded parte, alsoe of the vse, the actione, and situatione of the same, there must alsoe be noted, the proportione, and fi∣gure of the same vvounde, and the accidentes or other chaunces, vvhich are incident vnto her, consideringe alsoe the complexione and temperature of the bodye, the sexe, the age, on his handelinge, and trafiqve, māner of livin∣ge, the contrye, the constitutione of the time then praesent, and one the time and season of the yeare.

To conclude, all men that have receaved a greate vvoūde, are ether in daunger of death or in daunger of beinge mutilate. VVe eeste∣me and accounte the vvounde to be large, for thre occasions: The firste vvherof is, because that through her latitude, or vvidnesse, & cir∣cumiacente places, shee hath a threefoulde survayinge and measuringe to vvit, in length, brédthe, and debthe, as some there are vvhich be deepe & broadlye carvede: or right overth∣vvarte or crosse vvyse vvholye percīge throu∣ghe the principalle muscles of anye parte, by the vvhich alsoe somtimes the bones are he∣vved & cutte quite through, & broken, vvher¦fore some times they must be stitchte, bound and ligated together: or because that the vay∣nes, the arteryes, or the sinneus themselves, come to be squised and plettered. The secō∣de, cōcerninge the vvorthynes of the vvoun∣ded parte, for although the vvounde be but little, in her meatinge yet notvvithstandinge vve esteeme her to be greate, because that the strengthe and actione, of the vvounded parte or member, is verye necessarye for the vvhole bodye 'and for the vvhole lyfe of man, vvhich parte havinge lefte his naturall vse and actio∣ne, it consequentlye follovveth that the per∣sonne, must immediatly discease & dye, as vve may by experience see that daylye chaunceth in the vvoundes of the Braynes, of the Harte, and in the vvoundes of the Liver.

Thirdelye, because that some vvoundes are of a vvorser nature, & dispositione, as beinge venoumede, rebellious, and entermingled vvith some badde and dolorous accidentes, vvhich sometimes farre surpasse & excell the vvounde it selfe, as it is evidentlye & planlye to be seene in the vvoundes of the Ioynctes, vvhich immediatlye, may fall into a verye ex∣ceedinge badde estate, because that those par∣tes and places are circumligatede or clothed vvith verye smalle store of fleshe, beinge on∣lye decked & co verede vvith the Tendones, vvith sinnues, vvith Ligaments, & that verye tender, and sensible pellicle Perioflium, by the vvhich these partes or members are in more daunger of fallinge into a convulsione of sin∣nues, into Phrensye, payne, and inquietude, as much as a farre more greater vvounde in a∣nye other parte of the bodye.

Those vvoundes are accounted incurable vvhich doe happen in the Braynes, or in the ventricle of the same, in the Harte, entrāce of the stomacke, in the Vena Cava, the entrāce of the Liver, the backe bone, quite throughe the Lunges, in the small guttes, or entralles, the stomacke, the Kidnies, or in anye greate vay∣nes, or arteryes about the throate. But these vvoūdes vvhich vvil difficultlye be curede are they by the vvhich the Longes, the Liver, the mēbrane of the Brayns the Milte, the Matrix, or vvombe, the blather, anye of the greate guttes, or the Middelriefe, are vvoūded vvith verye small vvounde. Alsoe are those vvoū∣des daungerous, vvheras the greate vaynes, & Arteryes, vnder the Emunctoria or arme pittes, & in the Hockes or bēdinge of the knees are vvounded: and indeed all vvoundes are suspi∣tious, in all places vvheraboute anye greate Vaynes, or Arteryes are situated & placed, be∣cause that throughe theire effusione of bloe∣de, the vvounded persone is berefte af all his abilitye & forces: the vvoundes of the Secrete partes or privityes, and the vvoundes of the Testicles are alsoe by this reasone verye peril∣lous & daungerous, as alsoe are these vvhich happen and chaunce to light betvveene the fingers.

There is alsoe greate heede to be taken one the manner & forme of the vvoūde: for those vvoūdes vvhich chaunce, or come by crushin¦ge, or pletteringe, are farre vvorse, then those, vvhich are onlye hevvede, so that it is much better to be vvoūded vvith a sharpe edgede or cuttinge svvorde, thē vvith anye other blunte vveapone vvhich is not sharpe.

The rounde or circle vvoundes are vvorste & difficultest to be curede, but the certayneste & easyeste to be cured, are those vvhich passe by the lēngth of the fibres right like a linye or line.

The vvoundes of the Hippe, vvhich are re∣ceaved in the membranous muscle, are verye exceedinge daungerous, & especiallye if it be a thruste or stabbe,or else vvhē the apertione of the same is verye smalle, & hath noe issue, but it is soe much the vvorse if it soe chaunce ther be anye fracture or separatione of bones, it be vvhere it vvil in anye place of the hippe: & so farre forthe as if the vvounde be in anye internalle parte of the Hippe, about the greate vaynes, then the vvounde is passinge & excee∣dinge daungerous, for there ensuethe out of hāde some greate inflammatione there vnto, & consequētlye thereafter a Gangraena, or mor∣tificatione: he that happeneth to receave a vvounde in the foremoste parte of his arme, is alsoe subiecte vnto the same daunger of in∣flammatione, and mortificatione, and cau∣seth great payne & trouble, because that tho∣se vvoundes most commonlye are praesente deathe.

Novv as much as belongeth vnto the jud∣gemente & opinione, vvhich is to be conside∣red & noted out of the accidentes of all vvoū∣des, Hippocrates teaceth vs: in so much as in the greate & badde vvoundes, as are the vvoundes of the Sinues, of the Tēdones, of the Ioynctes, & of the bones, little or noe svvellinge or in∣flammatione at all apperareth, & illustratethe it selfe it is a verye evell and badde signe, for vvhye, it signifyethe vnto vs that those hu∣mors vvhich consideringe the payne shoulde have assembled, & packed thēselves that vvaye & have circumcinglede themselves rovvnde aboute the vvoūded parte, have retracted thē∣selves into some principalle & especiall parte of the bodye.

Those vvoundes in the vvhich there appea¦rethe anye svvellinge, or tumefactione verye selden or never fall into any Phrensye, or into cōvulsione of Sinnues, because that the veno∣mous humors, vvhich might, ascende & dra∣vve tovvarde the Braynes or into the sinuishe partes of the boddye, have congregate and ga∣therede thēselves together aboute the vvoun∣de: but if that one the suddayne the svvellinge vvithout anye evidente reason, as in example, in the applyinge of anye remedyes, throughe purgations, or throughe phlebotomisinge or bloode lettinge, came to departe & vvith dra∣vve it selfe into some other place and that in such, as are vvounded behinde in there backe bone, that persone is troubled vvith convulsi∣one of synnues, through the vvith dravvinge of the matter, into the sinnuishe partes of the backebone:and the vvounde beinge in the fo∣remost partes of the bodye, and the matter of the svvellinge, ascēdinge vpvvardes, throughe the greate vaynes, tovvarde the Braynes, the patient strayghtvvay fallethe into a madnesse & Phrenesye: or if soe be that the matter dra∣vve tovvarde the breste, then ther ensue grea∣te & intollerable stitches, or Apostemations, because that those badde humors can not by anye meanes possible be consumed or vvaste∣de, but descende & sincke dovvne into the cō∣cavitye of the breste. And if that the svvellin∣ge novv departinge be of a verye highe & red∣de colloured, & that thervvas store of bloode therin, vvhich is descended & suncke dovvne tovvarde the guttes, then it necessarylye & cō∣sequentlye fellovveth that the patiente falleth into the Blodye flyxe, or Dysenterye.

As farre forthe therfore as there procedethe anye convulsione of synnues out of a vvoun∣de, & especiallye from anye greate inflamma∣tione, that is a signe of deathe, for therbye vve may playnlye, note, & marke that the synnuis∣he partes of the bodye, must needes be hurte, and that the Braynes are in some, or other pas∣sione.

If that into anye vvoūdes, vvhich have fier∣celye bledde anye Spasmus happen, that is a bad signe.

All thrustes of the sinnues, and Tendones, are verye daungerous, and especiallye, vvhen as the skinne and the fleshe chaunce to shutt together, for therin engenderethe a sharpe & corrodinge matter, vvhich resuscitatethe and causethe greate & intollerable payne, because she can not by anye meannes get issue, out of the vvhich procedethe & follovvethe convul∣sione of synnues, inflammatione, and a Gan∣graene, or mortificatione. In soo much as a∣nye especiall and principalle, or Organicke parte, or anye instrumentalle parte, totallye & vvholye is hevved of, and sequestred and sepa∣ratede from the bodye, it can not by anye me∣anes be restored and cured, because that the blode, and the vitalle Spirites are vvholye ex∣halated, throughe the greate vaynes, vvhich are cleane a sunder, and that by the vvhich the cure must be done, and the foregoinge health agayne restorede.

The temperature of the boddye, the time of the yeare, the age the handlinge and trafi∣que, and the manner of the patients livinge,

the knovvledge of the cōtrye are a greate hel∣pe & ayde for the prognosticatione of vvoun∣des: a childe, or a yongemā, vvhich as yet is in-his grovvth vvil better and vvith more ease be healed or curede, then an aged personne: and a stronge mā, a greate deale sooner then a fee∣ble, and debile person. A leane and sclender persone, vvilbe curedevvith more facilitye, then a thicke, and grosse lived man. And a sounde bodye farre sooner, then a sicke and corrupte bodye. That man vvhich labou∣reth, easier, then a stillsittinge and idle perso∣ne. A soberman, farre sooner, then a banc∣ketter, and one that haunte the hoores. The most conveniente time of the yeare, to cure & heale a vvoūde, is in the fore summere or Ver∣nall time of the yeare, or at the least in such a time, in the vvhich it is nether to hotte nor to coulde, because that extreame heate, or ex∣treame coulde,are the enymyes of all vvoun∣des, and especiallye the changinge of heate, & of coulde, vvherfore alsoe the fore vvinter or Autūnus, is verye vnprofitable for the same. In some regions and countryes, the vvoundes are ether easyer, or difficulter to becurede: for at Rome, the vvoundes of the heade are diffi∣culter to be curede, then the vvoundes of the Legges, the vvhich notvvithstandinge at A∣vignon vve finde cleane contarye.

As farre as the vvounded person keepe and continue his perfecte Sence, and memorye nether gettethe anye agues, vve may then as∣sure our selves, that the vvounde vvil quick∣lye and easylye be curede. VVe ought not thetfore to discourage the patiente, al∣thoughe, he have an ague by the greate vvoū∣de, as longe as the inflammatione is yet befo∣re hande, and as longe as there engenderethe anye matter. But an ague is verye daunge∣rous, vvhē she issuethe from a small vvounde and especiallye, vvhen she hath longe conti∣nuance, after the inflammatione, and supura∣tione, or vvhen she incitateth the patient vn∣to Phrenesye. VVhen the patient parbra∣kethe against his vvil, greene galle, or imme∣diatlye vvhen he hath receaved the blovve, or at the time vvhile the inflammatione is as yet duringe, that is alsoe a badde signe, especiallye in these vvhich are vvounded in a synnue, or in annye sinnuishe place: But the parbrakin∣ge, or vomitinge, vvhich commeth by the fre¦vvil of the patiente. is nothinge suspicious, es∣peciallye in those, vvhich are vsed to vomitin¦ge, if that a man praesentlye after meales, or af∣ter that the inflammatione is come, or the vvounde being in the heade, doe not come to vomite. The Chyrurgiane must vse greate foresight, in givinge iudgemēt of the vvoun∣des of the Heade, for the aunciente Chyrur∣gians, have alvvayes esteemed thē doubtful∣le & suspect, because of other badde acciden∣tes vntil the Fifteenth day, and the moderne and, ionge professors, vntill the hundred the day.

The Iurists, or lavvyers, have constituted and ordayned fifteene dayes, for the iudge∣ment of the vvoundes of the Heade, to kno∣vve of a certayntye, vvhether the patient by occasione of that vvoūde came to dye or not or by reasone of his ovvne faulte, or by any other occasione. Because therfore, that the yonger Chyrurgiane, shall not be over ras∣he, in givinge of his iudgement, leaste he co∣me te glyde and falle into anye badde repor∣tes, or in anye repraehensione. As much as appartayneth vnto me, I have knovvne so∣me, vvhich have continued in a verye good estate vnto the thirteenth, fourteenth, or vn∣till the fifteenth day, and then have fallen in∣to agues, and manye other accidentes, by the vvhich they in the end chaūced to dye. VVee must alsoe note, that all naughtye and badde, accidents most of all publishe themselves, at the full Moone, more then at other times, be∣cause as then all maner of moysture grovveth and increaseth more, then in the decreasinge of the Moone, & alsoe more in the sommer, then in the VVinter.

The signes and tokens of the deadlye frac∣tures of the sculle, are agues in the VVinter, before the fourteenthe daye, and in the som∣mer before the seaventhe day: Item, a naugh∣tye and badde colloure of the vvounde: little matter of the same: mortificatione of that vvhich is inflamed: slimye or viscouse consi∣stence of that vvhich is corrupted: drieth ari∣ditye in the skinne of the heade, as it is in a peece of pouldrede fleshe, vvith a brouvvne, leadishe, and blacke colloure, vvhich signi∣fyeth the beginninge of the corruptinge and putrifyinge of the sculle, vvhich thē vvaxeth ravve, as vve may see, vvhen it is rotten, and grovvne blacke: vvheras before it vvas even and smoothe. Finallye vve see therin, a pa∣le, and yellovvishe colloure, to vvitt vvhen the foresayede bone is vvholye corrupted & rotten, throughe the purulent matter, vvhich vvas suncke to the grovvnde of the vvounde, and vvas there gathered together.

The patient beginneth to rage, he hath little pimples one his tonge, he getteth alsoe convulsione of synnues, one the contrarye syde of the vvounde: some fal inte an Apo∣plexia vvheron follevvethe deathe. The Practitioners of our times, have observed in all vvoundes, vvhether allreadye therin vve∣are a Paralisis, or els therafter happened ther∣vnto: and onethe contrarye syde a Convulsi∣one,

or somtimes also in the vvounded part a Convulsione, and in the other syde a Paralisis, sometimes also in both the partes, ether a Cō∣vulsione, or Paralisis, and somtimes one each syde ether a Convulsione, or a Paralisis, vvit∣hout the contrarye syde beinge in anye sorte thervvith infected. The goode signes of he∣alinge, in the fractures of the Heade, after that it is trepanede, or els after that the brokē par∣cells of bones, are taken out of the Heade, are these namelye vvhen that the Membrane of the Braynes hath her naturalle colloure, and her naturalle motione & stirringe: vvhen the engendringe and grovvinge Fleshe is redde. VVhen that the patient may easylye turne a∣boute his Necke, and alsoe easylye vvagge his lovver chavve bone. But in somuch as the Membrana hath noe stirringe, and is blacke, le∣adishcolourede, & lividouse or vvith anye o∣ther badde coloure taynted & defylede: Then the patient ragethe, vomiteth exceedinglye, falleth into a Paralysis, or in Spasmo, if that the Fleshe of the vvounde be leadishe colourede the necke & the chavvebone bothe of thē stād stiffe all these are verye bad signes. And vvhē the vvoōde, is at a good estate, thē beginneth the fleshe of the Membrane, or of the sculle to grovve, and to vvax dubble, and filleth all the voyde places vvith fleshe, that have binne open betvveene the bones, yea & somtimes covereth even as it vveare vvith pomgranate Kernells the scull it selfe.

Notes

• The vse of iudgement.
• Hippocratesin his Porrhet.
• What a Chyrur∣giane ought to knovve in giving iudgemēt
• All greate vyoundes are dan∣gerous,
• A great vvounde is taken three mā∣ner of vvayes.
• Woundes vvhich are estee∣med incu¦rable.
• Woundes that be difficulte to cure,
• Woundes that are daunge∣rous.
• The figu∣re or for∣me of the vvoundes
• What the vvoundes of the hip¦pe are,
• What vve ought to iudge out of the ac∣cidents of vvoūdes.
• Accidētes of a de parted svvellin∣ge.
• The con∣vulsione in vvoun¦des is ve∣rye daun∣gerous.
• Thrustes in the syn¦nues are very daū∣gerous.
• The Or∣ganicke partes, vvhich are vvho∣lye cut of can noe more be restored agayn.
• Other cō¦sideratiōs to be his in prog¦nostica∣tinge.
• Signes to the con∣trarye.
• Conside∣ration for the vvonds of the hea∣de.
• The sig∣nes of the deadly fractures of the sculle.
• Badde si∣gnes.