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 FRENCH CHI∣RVRGERYE OVT OF ALL the aunciente professors of Physicke, and Chirurgerye collected, and compacted together, vvith sundrye, and diverse figures of instrumentes, verye necessarie to the opera∣tione or vvorcke of Chyrurgerye.

Throughe Iaques Guillemeau of Orleans, publique Chyrurgi∣ane to the kinge, and sworene in his Chastelet at Paris.

The praeface. To the Chyrurgerye, contayninge foure Chapters.

• The discriptione, and originalle of Chyrurgerie, and vvhat the operatione of Chirurgerye is. Cap. 1.
• Of the prognosticatione, or foreknovvledge, and of the iudgemēt of the vvoundes. Cap. 2.
• Of the tokens and signes, hovv to knovve, vvhat partes of the bodye are hurte or vvounded. Cap. 3.
• Of the instructione hovv to give assured demonstratione, of all manner of vvoundes vvhats∣oever, before the iusticiaryes. Cap. 4.

❧ The discriptione, and originalle of Chyrurgerye, and what the operatione of Chyrur∣gerye is. Cap. 1.

HAvinge vvith my selfe resol∣ved, and purposed to discribe the operation of Chyrurge∣rye, first of all it seemed expe∣diēt vnto me to observe the∣se three necessarye thinges. Namelye and especiallye, vvhat Chyrurgerye is. Secondlye, hovv, and from vvhence, shee hath participatede and taken her originalle, and beginninge. Thirdlye vvhat the opera∣tione of Chyrurgerye is. Concerninge ther∣fore her beginninge & originalle, vnto all mē is it apparent and vve rightvvell knovve, that the inventione, and findinge out of all artes, and sciēces vvhatsoever, hath bin by all men in such greate esteē, and admiratione (vvhich Hippocrates in his boocke of aunciēte Physick vvitnesseth) that the inventors or aucthors of the same, have bin extolled even vnto the clovvdes, by the vvhich is vvitnessed, and testi¦fyed, this inventione te have bin so perpoli∣te, that it vvas adiudgede to be a thinge impos¦sible to be discovered and brought into light, by anye other, thē throughe some God, or at the least, by such a persone vvhich hath bin infused, vvith divine inspiratione: In soe much therfore, if this may be testyfyede of a∣nye artes vvith aeqvitye and right, it may true∣lye and bouldlye be sayede of this arte of Chy¦rurgerye, the inventors, and aucthors of the vvhich, have bin canonisede, esteemede and extellod as Gods, as for example ther hath bin Apollo, Aesculapius, and Hippocrates, vvhoe ha∣ve had divine honoure and reverence of all mē. The tvvo first of these aucthors, have al∣lonelye leerned, that part of Physicke, vvhich through externalle medicamētes, and by in∣scisions cured the infirmityes, and diseasses of mens bodyes. By the vvhich playnlye is to be vnderstoode and iudged, that Physicke at those times vvas not as then invēted created, or fovvnde out, vvhē that Chyrurgerye, vvas sufficiētlye practised and knovvne in all pla∣ces: the vvhich Homer testifyeth and vvitnes∣seth vnto vs in the seconde booke of his Ilia∣des, vvhere he affirmeth that the sonns of Aes∣culapius, Podalyrus, and Machaon, in the besie∣ginge of Troye have vvith ther handes han∣delede and cured manye and diuers vvoūded persōs vvithout molestinge or troublinge of themselves vvith anye internalle diseasses or sicknesses, as vvith agues, or vvith the plague, the vvhich notvvithstandinge praedominate∣de and vexede sore the vvhole hoste or cam∣pe of the Greeckes: and consequētlye Physick and the vse therof beinge knovvne, and in practise, Chirurgerye vvas verye confusedlye hādeled amongste Physicke. But for as much that it is verye difficulte & a harde thinge to excell in divers, and sundrye artes, and becau∣se it is impossible, the vvorcke of Physicke, Chyrurgerye, and Apothecarye for one man to doe, therfore the arte of Chyrurgerye is se∣cluded and separatede frō the other tvvo, ha∣vinge

alsoe her ovvne professors and practi∣tioners. The vvhich because that it may be∣rightlye vnderstoode, it is to be noted and ob¦served, that in the oulde and auntient times, by Chyrurgerye, the thirde parte Therapeu∣ticae vvas not vnderstoode, even as vvee in these times take it, & as consequentlye shalbe shevved: But they vnderstoode by this vvor∣de Chyrurgerye nothinge els, then that on∣lye, vvhich throughe the operatione of the hādes is finishede and brought to passe vvher¦fore it is yet manifestlye vvritten by the aun∣ciēt professors, that by Chyrurgians vvas no∣thinge else vnderstoode then certayne ser∣vantes, vvhich in those times vveare callede Chyrurgians, not because they had the per∣fecte science, or knovvledge of Chyrurgerye, but because they earned there sustenance and livinge through the vvorckinge of ther han∣des. Novv to conceave aright vvhat Chy∣rurgerye is, it is expediēt and necessarye, that vve ascēde somvvhat higher, and industrious∣lye seerch & trye vvhat Physicke is seinge ma∣nifestlye that Chyrurgerye is therof seperated and secluded.

Physick therfore is nothinge else (as Hippo∣crates in his booke De arte vvitnessethe) then a knovvledge, or science, vvhich teacheth, hovv to cure anye sicknesses to frustraete, and anni∣hilaete there impregnable forces, because of themselves they are incurable.

This Physicke agayne hath sundrye par∣tes, of the vvhich the first is Physiologia, vvhich handelethe and treatethe, of the structure and situatione of mans bodye, vvherin is to be re∣garded and noted on the seaven vnnaturalle thinges. The secòde is Hygiena, that is a Nour∣ce, and fosterer, or praeserver, of our health, vvhich instructeth, hovv vve shovvlde conti∣nuallye preserve our presente health, & keepe the sovvnde bodye liber, and free from all dis∣easses, & sicknesses: and this consistethe in sixe vnnaturalle thinges. The thirde is Pathologia, vvhich treatethe of the cause, and occasione of the sicknesses & of the accidentes vnto the sa∣me, the vvhich three thinges are agaynste na∣ture. The fourth is called, Simiotica, and trea∣teth of the demōstratinge signes or tokēs, not onlye of that vvhich is all readye passed, but alsoe of that vvhich is as yet to come, in respec¦te as vvel of sicknesse, as of health. The fifth is Therapeutica, that is the curinge or sanable par∣te of Physicke, vvhich instructeth, & learneth, hovve to repelle and cure sicknesses, and dise∣ases, & restore agayne to former health: This praenominated Therapeutica is redivided and agayne dealed in three partes, the first vvherof is called, Dietetica, vvhich teacheth, hovv to ob¦serve a sober & good diete: The secōde parte, Pharmacia, vvhich instructed vs, hovv to com∣povvnde our medicaments. And the third part is callede Chirurgia, vvhich cureth or hel∣pethe the affected patients through manualle or handlye operation for Chirurgia hath his derivatione of a Greecke vvorde, and is com∣povvnded of Cheir vvhich signifyeth a hāde, and Ergō vvhich betokeneth operatione: ne∣ther may vve by this vvorde Chirurgia not on lye vnderstande, all operations vvhich are on∣lye effected by the handes, but most of all and especiallye, all that is done, or may be done o∣ne mans bodye tovvarde the curinge of all ex∣ternall diseases.

And as cōcerninge this vvorde operatione, it is nothinge else, then an artificialle and nor∣maticke applicatione, vvhich is brought to passe, and vvrought by the handes, one mans bodye, vvhervvith the decayed health is reite∣rated, and agayne restored. And if vve vveare desirous to knovve vvhat the office, & dutye of a true chyrurgiane is, or vvhat his operati∣ons are, hovv and in vvhat manner he must vvorke, & effecte them, and vvhat conditions are expected, at a chyrurgians hādes, I have di∣scribed them fullye, & at large in my generall table, and discriptione of Chirurgerye, vvher∣fore I vvil make in this place noe more mēti∣one of them.

❧ 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.

❧The tokens howe to knowe which partes of the bodye are wounded Cap, 3.

TTe vvoundes most common∣lye are knovven by ther first aspecte, alsoe sometimes the place of the vvoūde certifyeth vnto vs, vvhat partes are inter¦nallye vvounded: But seinge that it often times chauncethe, that these vvoundes', vvhich to our estimatione be not profounde or deepe, penetrate vnto the inter¦nall partes, vve vvil heere therfore recite the signes, by the vvhich vve may knovve, vvhat internall partes, vvithin the bodye aré vvoū∣ded, because ther by vve may knovve, vvhe∣ther the patiēte may be cured of them or not.

If soe be that the Braynes or else ther Mem∣brane is vvoūded, thē ther issueth bloode out of ther Noses, vvith some alsoe out at there Eares & commonlye ther follovveth a vomi∣tinge of choler: some lye almoste out of the memorye & beside thēselves that althoughe you call & crye vnto them, they give noe an∣svvere: others seē in ther faces as if they vvea∣re afrighted & feared: some turne and vvinde there eyes, this vvay and that vvaye, as if they vveare touched & stricken by Gods hāde, the thirde or the fifth daye most commōlye they fall into madnes & Phrenesie: other gette the Spasmū, before they dye: some there are vvhich plucke the medicamētes from there Heades, soe that the vvounde commeth to lye bare, & vvaxeth coulde.

VVhē as the backe bone is hurte, or vvoū∣ded, thē beginnethe the patiēt to be feéble & lame in his synnes, or else he getteth cōvulsi∣one of synues, vvhich is called Spasmus: leeseth the sence of feelinge, somtimes the patiēt can nether retayne his vrine, Sperma, or Stole, but of it selfe departeth from him.

If the Harte be vvoūded, ther issueth out of the vvounde, greate store of blacke, dence, or thicke bloode, & especiallye vvhen the right side of the Harte is hurte: But vvhen the left syde of the Harte is hurte, then issuethe out of the vvounde fine & subtile redde bloode the pulse of the patiēt is verye debile & feeble, & variable, & is verye pale coloured in his face: The coulde svveate in all his bodye bursteth out, and hath a verye vnsaverye smelle, evē as vve may note in other sicknesses of longe cō∣tinuance. His handes and feete beginne to be coulde, out of the vvhich present death en∣sueth.

VVhē the Lunges are hurte, thē breatheth the patiēt vvith greate difficvltye, & divers ti∣mes reiterateth, & dravveth anevve his breath as if he there by sought & indevoured to doe him selfe som solace & cōforte: he voydeth of ten times through his mouth frothye bloode, & throughe the vvoūde fayre, redde, & vitalle bloode, vvith peepinge & hissinge breathe: he endevoureth for the most parte to lye one his vvoūded syde: others often times erecte them in ther bed vvith out anye occasione: Some lyinge one the vvounded syde, can speeke, but turninge thēselves one ther sovvnde syde are quite deprived of there speeche: sometimis they are bloesinge in ther faces, & sometime cleane pale, and at the last issueth out of the mouth of the vvounde greate quantitye of fil∣thye matter,

The signes of a vvounded Liver are these; nālye that out of there right syde they avoyde a greate quātitye of bloode: Both sydes of the bodye, are as it vveare plucked tovvarde the backe bone: The patiēt is verye pale in his face as if he vveare halfe deade: His eyes are fal∣len invvardes, and hath intollerable payne, beinge ignorant throughe his impatientie vvhat he shal doe: he ist best at ease vvhen he lye thone his bellye: he hath a verye prickinge & stinginge payne, vvhich dravveth tovvarde his breste, and also toevvarde the sy∣des of the same. Heavinge and contractinge his shoulders togeather must he breathe, and

somtimes throughe, parbrakinge he avoyde∣the choller. Hath a verye violent, & fervent pulse, he is easylye incēsed to ire, & sorrovve: somtimes he hath an ashe coloured face, his vrine alsoe sōtymes verye bloodye: his stoels like matter, and dye most cōmonlye, vvith the Hickcoughe.

VVhē the kidnyes are hurte, then descēdeth & as it vveare by degrees cōmethe the payne into the flanckes, and soe forvvarde vnto the testicles: the patient can verye difficultlye be released of his vrine, he pisseth bloode, or at the least his vvater is bloodye. Somtimes his vrine is quite retaynede, by the vvhich occasi∣one, the patiēte beinge extreamlye svvollene dieth.

If the Milte be hurte or vvounded, then the bloode issueth out of the left syde of the paciē¦te, & is blak of coloure. The same syde, & alsoe the stomacke beginne to be indurated, & har∣de: the patiēt vvaxeth thirstye & the payne re∣tracteth it selfe tovvardes the breste, as in the vvoundes of the Liver.

Novv the VVombe beinge hurte the vvo∣mā hathe greate payne in her flanckes, in her Haunches, & in her hippes: she avoydeth bloo¦de partlye throughe the vvounde, and partlye throughe her privityes, after the vvhich som∣times follovveth a parbrakinge of Cholera O∣thers cā not speake: some lye out of memorye others vvhich doe not rage, say that they are troubled vvith greate payne in there sinnues, & in ther Eyes: & vvhen they dravve tovvarde deathe, they are troubled vvith the same acci∣dētes, vvhich vve have recited of the Harte.

VVhen the middle reefe or Diaphragma is vvoūded, thē are the sydes of the patiēt dravv∣ne, & shruncke vpvvardes: they have excee∣dinge greate & violent payne, internallye in the backe bone: they have verye retardate bre¦athe, and there issueth out of the vvounde fro∣thye bloode.

The entrance of the stomacke beinge hurte the patiente beginnethe to have the hick vp, & avoydeth choller: vvhen as he eateth or drinc∣keth, he casteth it strayghte vvay frō him agay∣ne: he hath a smalle, feeble, & obscure pulse: he getteth a little coulde svveate, vvith a coo∣linge of all externalle partes.

The stomacke, & that gutte Ieiunum, have hoth of them one manner of token, because that there meate & drincke issueth out of the mouth of the vvounde somtimes beinge hal∣fe digested, and altered in Chylum: they feele a payne, as if a man vvoulde rente & teare there Harte out of there bodyes: they gett hardnesse in ther sydes, sōtimes alsoe parbraketh the pa∣tient Cholera, vpvvards throughe the mouth, & his spittle is bloodye: betveen these tvvo is noe other difference, then that the gutt Ieiunū hath his place & situatione somvvhat lovver then the stomacke.

The bladder beīge hurte, vve feele payne, in the flanckes: that parte of his bellye a little a∣boue his privityes extendethe & stretchete it selfe: in steade of vrine the patiēt pisseth bloo∣de, or else the vrine issueth forthe of the vvoū∣de: the entrance of the stomacke is perturbed & out of ordre, vvherfore the vvounded vo∣mite Cholera, or at the least are afflicted vvith the hick cough: they beginne to vvax coulde in handes & feete, and consequentlye ensueth death.

❧ Instructione, how to give a certayne reporte of all woundes whatsoever before the ma¦gistrates. Cap. 4.

ALl such vvhich before anye magistrates, of anye vvoūded or sicke personne, vvil & are disposed to give reporte & in∣structione, shallby noe mea¦nes intrude themselfves, befo¦re that of the magistraete they shalbe reques¦ted therto, & sent for, seinge that most com∣monlye proferede vvitnesse is repraehēdable: & he that taketh such a thinge in hande ought first of all to visite and see the patient, because he might ripelye and dilligētlye consider of al thinges, namelye & especiallye one the great∣nes of the dissease, one the situatione, & place of the same, not onlye, as thē may give good instru••one, but alsoe, one all occasiōs, & on the praedictione & fore sayinge of the vvoun∣des, vvithout havinge vnadvisedlye therin has¦ted him selfe: for it is a harde and difficulte matter, to give a perfecte & cōplet iudgement of the end of all vvoūdes, or other sicke persō∣nes, because of the accidentes vvhich might chaunce thervnto, for those vvoūdes, vvhich vve doe not esteeme of sōtimes are occasione of death, & cōtrarylye those of the vvhich vve expected nothinge but death, are yet notvvith¦standinge cured. VVe knovve, that some ther are cured & healed, notvvithstandinge althou¦ghe they vveare vvounded in the Membrane or pellicle of the Braynes yea & some vvhich vveare hevvede in the substāce of there Bray∣nes: as I alsoe remember some to have bin cured, vvhich vveare hurte in the luges, in the Middlereefe, in the Liver, in the smalle guttes or ētralles, the Bladder, the Kidnyes, or in the Matrix or vvombe. Althoughe vve accordin¦ge to the iudgemēt & reason of the aunciente professors, esteeme such vvoundes to be dead∣lye & incurable. Contrarylye vve se some mē men dye of smalle and vndiepe vvoundes: vve must therfore in such thinges make a distinc∣tion amonge the vvounded for some ther are vvhich are of soo goode a temperature,

and state of bodye, that of a greate and large vvounde vvhich in anye other mans bodye vvear praesent dea the, they are cured: contra∣lye there are others vvhich beinge vvounded in anye externalle partes, vvhich are nothin∣ge nocēte or daūgerous to the lyfe of the pa∣tient, vvithout anye penetratione, of the vvhich, notvvithstandinge they chaunce to dye, ether of the badde cōstellatione, or con∣stitutione of the time, or by the refluxione of anye badd humors vnto the vvounded parte.

Althoughe therfore, that some vvoundes are curable, and alsoe of a good constitutiō & dispositione, vvithout anye badde or cōtrarye signe therin to be marked, but for all that vve may not give anye absolute iudgement or re∣porte of the same, but muste onlye say that the vvounde is curable, soe farre forth as the∣re be nothinge praetermittede, vvhich consis∣teth and belongeth as vvell in the patient as vnto the Chyrurgiane vvhich hathe him in∣handes, it belongeth alsoe vnto the circūstan∣tes, and vnto other externall thinges.

VVe must thefore suspēde our iudgemēt, and keepe it in secrete for a season, vvithout givinge anye absolute reporte the first daye, because that the good or badde signes cā not soe sone reveale and disclose themselves: vve must alsoe cōsider that all vvoundes must ha∣ve ther originalle, ther increasinge, and there estate, and duringe this time, seeke by all me∣anes possible to represse the vntemperate∣nes, vvhich is fallen into the vvounded parte, throughe the blovve, throughe the external ayre, vvhich striveth vvith nature, agaynst the vvhich nature strengthenethe and forty∣fyeth her selfe, to expell and drive avvay the foresayed vntemperatenesse, duringe the vvhich time, vve can not certaynlye knovve, vvhich of thē shall obtayne the victorye, thē onlye some time therafter, vvhenas the fo∣resayed vntemperatenesse maketh her selfe knovvne, throughe anye signes vvhich shee revealeth in the concurringhe humors be∣cause nature, throughe certayne sygnes, doth demonstrate that shee hath obtayned victo∣rye, and is become the mistresse of that vntē∣peratenesse. These signes and tokēs are espe∣ciallye knovvne, by the matter afore hād: and because that the purulence or matter, is not engendred the first daye, it necessarilye follo∣vveth that on the first daye, vve give not anye absolute reporte of a vvounde, but must first consider, vvhether it is bent, because that na∣ture one the dayes of Crisis demonstrateth her selfe, by the vvhich vve may iudge of the end of the sicknes. The first, and certanest daye of the Crisis is, the seventhe, for the fourth, is not indeede the day of the Crisis, but vvel the demonstratinge day of the seaventh, vvhich is the vpright and trevve day of the Crisis. Af∣ter the seventh, follovvethe the eleventh, of the vvhich the seaventh is the demonstratin∣ge daye, then the fourteenth daye follovveth, after that the tvventithe, and then the last is the fortithe: For if that before the fortith daye, vve perceave noe badd signes, it is then evidēt and playne enoughe, that the vvoun∣de vvilbe easylye cured.

It is best therfore that vve doe not reporte or give anye iudgement before the seaventh day be passed by, in vvhich time, the accidētes beginne to reveale thēse 〈◊〉〈◊〉 ••her on as thē vve must have a specia•• 〈◊〉〈◊〉 ••de and care, vvhether ther be more good, then badde acci∣dētes afore hādes, or the contrarye, vve must consider one these signes, three manner of vvayes: For they reveale themselves ether in the qualitye of the bodye, of the vvounded parte, or in the livinge, and vitalle in the ani∣maele, or naturalle actions: Or in the excre∣mētes, vvhich are common, or in the vvhole bodye, alsoe in the particulare excrementes, vvhich the vvoundes reiecte and repelle from them. The signes vvhich reveale themselves in the qvalitye of the bodye, are considered, vvhen vve regarde on the figure, and one her coloure: the animaele, and spirituale actions, consiste in the stirringe, in feelinge, and in re∣ason. The vitall, or the livinge actions, con∣sist in the pulse: and the naturalle actions, cō∣siste, in the appetite, in the digestinge, and in the expellinge and drivinge forth of the ex∣crementes. The common excrements of the vvhole bodye are the filthynes of the No∣se, the teares out of the Eyes, spittle out of the mouth, or the substāce and filthye matter of the guttes, the vrine, or that vvhich vve op∣vvards parbrake: The particulare excremen∣tes, are filthe, matter, ād the bloode: in vvhich excrementes, vve must marke and note the quantitye, the consistence, colour, smelle, and sometimes alsoe one the taste: seinge that if ther be more goode, that is soe much the bet∣ter: vve must alsoe note, that throughe the ac∣tiōs vve may best iudge of the forces. Havin∣ge thus therfore togethere considerede and noted all these thinges, the Chyrurgiane shal be able to geve his sentence and reporte cer∣taynlye, ether of lyfe, or of deathe, of lamnes or criplenes.

Notes

• The invē¦tion of sciences.
• Chyrur∣gerye is aunciēter then Phy∣sicke.
• Divers miscon∣strvinges of this vvorde Chyrur∣gerie.
• Descrip∣tione of Physicke.
• Partes of Physicke.
• The par∣tes of The¦rapeutica
• What this vvorde o∣peratione signifie∣the.
• 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.
• Signes vven the braynes are hurt.
• Sygnes vvhē the backe bo¦ne is hur∣te.
• Signes vvhē the harte is vvoūded.
• The vvounds of the Lungs.
• The Liver beinge hurt.
• Of the vvounds of the kidnies.
• The mil∣te beinge hurte.
• The vvō∣be beinge hurte.
• The Mid¦dle reefe,
• The en∣trance of the sto∣macke,
• The sto∣make & the gutts,
• Hurtes of the blad∣der,
• Codside∣ratione to be had before the giuin¦ge of re∣porte,
• Some mē dye of a small vvound.
• The iud∣gement must be provident lye given.
• Whē that the repor¦te must be done.