The noble experyence of the vertuous handy warke of surgeri, practysyd [and] compyled by the moost experte mayster Iherome of Bruynswyke, borne in Straesborowe in Almayne ... Item there after he hath authorysed and done it to vnderstande thrugh the trewe sentences of the olde doctours and maysters very experte in the scyence of surgery, as Galienus, Ipocras, Auicenna, Gwydo, Haly abbas, Lancfrancus of mylen, Iamericus, Rogerius, Albucasis, Place[n]tinus, Brunus, Gwilhelmus de saliceto, [and] by many other maysters whose names be wryten in this same boke. ... Item yf ye fynde ony names of herbes or of other thynges wherof ye haue no knowlege, yt shall ye knowe playnly by the potecarys. Item here shall you fynde also for to make salues, plasters, powders, oyles, and drynkes for woundes. Item who so desyreth of this science ye playne knowlege let hym oftentymes rede this boke, and than he shall gette perfyte vnderstandynge of the noble surgery

¶ Of the wounde in the belly. Ca. l. (Book 50)

SOm tyme is the wounde in the belly before / and som tyme be hynde / And the wounde y^e es besore & through the webbe or fle¦me ther the boweles lay in. that one is callyd Myrach and that other is a thynne panycle / and is callyd Syfac / and lyeth within Myrach / and kepyth in hym the guttys / & on the hyn∣der parte is the. v. spondeles of the renne / & the flesshe ther vnder. ¶ Also is ther woun∣des within / as in the many fold / in the gut∣tes / and in the mawe / and in the renne / and in the moder (or matrix) and in the bladder / The woundes in the belly is somtyme that gothe not out / and somtyme gothe there out that fleme callydzirbus / and the guttes / or other lyke. ¶ And the woundes happenyth somtyme with a sworde / and somtyme w^t a launce / and somtyme with an arow / and somtyme with other instrumētys / that slyt chyd o•…•…ttyth. Som woundys be great & som small cut with a dagger / som twhart / & som cleuyd in lengthe. Som lytell / som great / some wyde / and som narowe. And this poynttys must ye know••r ye begynne to cure the woūde. ¶ And herafter folowyn¦ge be the tokens of the wounde / wherby ye shall know what membrys ther be wonn∣ded without or within the body. ¶ The to∣ken of y^e woūde in y^e bely going not through it is knowen by the syght / and by y^e pronfe / as that ther comyth not out. ¶ The token of the woūde of a strtche y^e is goyng within / that is be knowen as y^t proufe gooth deppe in warde / & as zirbus / or y^e guttes / or any other goth•…•…t. ¶ The token that zirbus hath bene longe out / as it is chaūgyd / that is as his substaunce is blacke and stynkyn∣ge. ¶ That token that the guttes is woun∣dyd / that is as the dyrte gothe out / And if the great guttes / or small guttes be woun∣dyd / is knowen through the place of y^e woū¦de. aboue the nauell is the small guttes / & vnder the nauell is y^e great guttes. ¶ The token that y^e mawe is woūdyd I haue sayd in y^e fore wrytyn chaptre. ¶ The token 〈◊〉〈◊〉 the lyuer is woundyd / is to know in y^e 〈…〉〈…〉 comynge of the bloode / and the wounde is in the ryght syde ¶ The token y^t the mylt is woundyd / that is the out comynge of styn∣kynge / and is in the left syde. ¶ The token that the renes be woundyd / is knowen by out comynge of watry bloode. Galienus sayd that the wounde and sowynge is more peryllous in the myddys of the belly / than in the sydes. ¶ The wounde that gothe not through shalbe helyd / with the grene woū¦dyd plaster or bawme / lyke an other woun¦de / as is lerned in the. xii. and. xiii. chaptre. In lyke wyse shal be cured y^e through going woūde within / as ther no lymmys be woū¦dyd / than alone y^t the woūde gothe thrugh Myrach / and Sysa•• / this woūde is cured in the same maner afor sayd / & it must haue another sowynge. ¶ The sowynge of the

belly•• is in m••my maners / And Galienus cōmaūded the sowynge all thus. ¶ In the fyrst threst the nedyll in the one lyppe of the wounde / and to wche with y^e nedyl Syfac / and af••e•• that trest the nedyll through My∣rach and knet it on the wounde. And in the secōde stytche / lette y^e nedyll godin through the one lyppe / through that hole Myrach & Syfac / and that shalbe knet without / and goo so forth tyll yt be all sowen / & Galienus sayd another sowynge / and Albucasis folo•• with the sowynge / and it is more comonly & lyghter. The sowynge is in this maner / ye shal sowe the border of y^e lyppys togyder and to euery stytche a knotte / as moche as it nedyd. Albucasis sette the maner with the nedyl and sowynge / as is aforsayd / but lette the nedyll stytche in it / and wynde the thryd about the nedyll / as is aforsayd in y^e xiij. chaptre. Lanfrancus & Henricus sayd another maner / that ye shall ••iytche with a nedyll the thryde without in the lypre or y^e wounde / and stytche it through Myrach / & Syfac / and so as y^e stytche may be ordred ryght / therafter sow the other parte of the lyppe outwarde agayne / & cut of the endys of the threde / and let it belonge Inowgh / and after that sow in suche maner / and let bytwene y^e stytchis a space of atwhart fyn∣ger / and as that is done / make one knot of the. iiij. stytchys / and so goo for the in the so∣wynge of the hoole wounde / and through the sowynge of Syfac / that hath no flesihe / be cured with the helpe of Myrach / and w^t the woūde outwardly / and the bandes of y^e brest may we occupye to this woundys of the belly / ther no lymmys be woūdyd / nor comyth out: ¶ Whan the guttes is woūdyd ouer twhart / or is in pecis / thā it is dedly / yf it be lengthe woundyd / it may be holpen. ¶ If that the woūde / of y^e belly is not grete Inowgh / than shall ye make it greater / as I shall shewe you herafter / than shall you take out pro{per}ly the guttes / and sow it ther after as it is nedeful / w^t a skynners nedyll / Jamericus / Theodoricus / Rogerius lay elder pypes in the guttes / vnder the seme / y^t y^e seme rotte not. Wilhelmus & some other / lay therin a part of a cryer of a throte goll of a beest / as the. iiij. maysters sayth / But Lanfrancus & Guide they thynke it not be prof▪ table / for that nature is inclyned to outdrawynge straunge thyngys / and thus yt helpe not therfore it was layd / and it is better that the guttes be sowyd / as a fore is sayd / and that it be clensyd of the vnclēnes / and that powder shall hastely be layd on y^e seme / and is made in this maner▪

¶ A powder.

¶ Take Mastick / Dragantum / Gommi arabice / of eche anounce. Dragons blode / Mumie / of eche halfanounce. than shall ye the guttes put inagayne / as I shall lerne you / and after that shal ye sow y^e vtter skynne / and also that fleme / ther y^e guttes lyeth in / and in the vttermost seme / lay that pow¦der in delendynge of the same. And mayster Milhelmus de saliceto sawe a knyghthur tinge hym selfe with a knyfe iu his belly y^t the gutttys ronne out / and the guttys was wounded in the lengthe. And to the same was fette Ottobanus of Papia / the why∣che gaue hym yll conforte saynge y^t he must dye / for cause he wolde put in agayne the guttys / and they ware so grreatly swollen that they myght not come magayn. Than cam the frendes of the pacyent prayng hym to come to the wounded parsone. And as Wylhelmus sawe the pacyent / than he cō•• maunded to brenge warme wyne / for the tyme was to short for to seede water with Camomylle / and Anyse. And with the wy

ne he wasshyd the guttys there y^e dyrte cam out / than sowed he y^e guttys to gyder agay¦ne / and he layde on the seme the aforesayde powder. And thā he wolde put in agayn y^e guttys / and they was so sore swollē y^t they cowde natbe hādelyd / for the woūde was to narowe / than he cutte the woūde greter with a sharys / and put the gutttys therin agayne / and he sowed the fleme / and also y^e skynne. and than he helyd the knyght that he lyfde many yeres after / & hath chylderne by his wyfe. ¶ Comyth the Lyuer out of y^e wounde / & is deppe woundyd in his sub∣staūce than lysed she his workynge / therfo¦re it is dedly / for the woundes may not be helyd for the superfluyte of the blood / why the is the foūdament and mater of the lyfe But is she not wounded in ony parte that belongyth to her / than put in agayne the ly¦uer & the woūde shalbe curyd lyke another wounde. ¶ Is the lyuer alytell wounded and not sore / thā shall it behelyd of a good Surgean lyke another wounde. And it must becured hastly er it chaūgyd / whyle it is fresshe. ¶ If the Mylte be woun∣ded / ye must well serche in what {per}te of here substaunce she is wounded / And is there apyce cut of / than fulfyll the other place of y^e hole mylt. but not as y^e port be cut ouer ••whart / & as y^e wounde of y^e mylte is hard and thereof cometh the water sprynge (or ydropisys) / and euer feblenes of y^e mawe. And hangeth the mylte out / than put it in agayn / And as zyrbus gothe out that is y^e fleme / and is that corrupted / thā bynde or knotte that ther is corrupte / as Galyenus sayth / an cut it of after the knottynge vnto the neder parte of the belly / and ye shall le∣ue out of the belly the ende of y^e knottynge that the threde of the sowyng of the guttys may be plucke out agayn as the woūde is clensyd. As y^e seme is made in zyrbus / thā put in to the belly that same zyrbus agayn and sowe the wounde in the belly shortly. & let it not open tyl the inner wounde be hole also Jamerius Rogerius Lanfrācus com¦maundyd. and the cause is this. Ther is no thyng that doth so moche hurte the inner ••i¦mes or membres as doth the towchynge of the vttermoost ayre / of the whyche ayre it chaungyth / and gettyth yll accydentes of payn / and hardnes of the guttes / therafter they may gette the crampe / and after to dye In the woundes in the guttys prasyth som maysters the glyster of stronge blacke co∣loured warme wyne / and prycypally as y^e guttes hath many hooles. And all his mee¦tes to the. viii. dayes shalbe thynne. for it comyth not to rottyng / but to helynge to gy¦der. And herto the. iiij. maysters praysyd afterfolowinge. Lay wheet brāne an how re and than take it out agayn / and do there to this drynes.

¶ A Powder.

Take floure of sterche / Dragantum 〈◊〉〈◊〉 miarabici / Dragons blood: Consolidama ior or Ambra: the here of an hare / and gyue hym twyse or thryse at euery daye. Is the pacyent feble than gyue hym the soppys of sap therin is soddē chykēs / & yf ther be sayd in Dragantum. & Gommi arabici: it were very good / and water therin is sodden Frā¦kencense: Masticke / and this pray seth Wil¦helmus and Rogerius. If ther be ony par∣sone stytcheth or woundyd thar hys gut∣tes come out / and they be not hastly puti•• agayne that they be vnclene / swellyng and chaungynge by the ayre / than shall ye take warme water therin is sodden Camomylle floures / Ameis. or take warme wyne why¦che hath no befulle ryppe / as Lanfrancus sayd / therin shall ye wet a sponge and than

warme the guttys therwith / & salue y^e gut les w^t rose oyle / & put the guttys agayne in to the belly. ¶ Theodoric•• cuttyth open a pyg / or another beest in y^e middes in tweyn & layd it as warme on the guttys so often y^t the guttes may lessyd of the swellyng / that it may come in agayn. If y^e guttes be fallen on y^e groūd y^t it be foule / thā lay it in warm gootys mylke / & clense it therin / & than put it agayne in to y^e belly. Be the guttys swol¦len and the wounde be small y^t the guttys wyll not in agayn / than cōmaūded Galie. Milhelm•• / Lanfrāc•• / & more other / y^t the woūde in the belly shal be cut so grete that the guttys may be put in agayne.

¶ To this cuttynge is cōuenyent y^t instru∣mēt callyd Samgatoria crokydlyke a syc¦kyl / before on the crokynge sharpe / but not sharp on the poynte / & Albucasys set it in a pycture as here standed.

[illustration]

¶ The pacyent shall lay on his back & hye agaynst the woūde / and the surgean shall wysely cut y^e woūde y^t the other guttes com not out / & than put in agayne the guttys y^t is out. And y^e Surgean must haue a good seruan̄t which shal takē hede of the guttys w^tout with his hande softly / & than take y^e wounde in the myddes & cut the woūde wy¦der / & put therin agayne the guttys / than sowe it as is aforsayd. Therafter defende y^e seme & the wounde (as Galyen{is} sayd) with Formacis that is callyd sanguinolentis / y^t in other membres y^e woūde makyd faste / ly¦ke as dothe the powder y^t holdeth the seme / & the plumacioles w^t wyne / and the plaster w^t other drynes that makyth flesshe. Co myth ther payne of the cuttyng or sowyng as it happeneth oftē tymes (as Auicē. sayd in his. iij. Canon of the cure ofydropisis) y^t of y^e cuttynge cometh payne and pryckyng Therfor it is good to put therin oyle of dyll or camomyl / & vpō the place of the cuttyng lay y^e plaster made of lynseed / hye malowe seede / femgreke / of eche lyke moche. And som other maysters as Henricus for takyn ge away the payne & swellynge / they sethe wyne with salt therin / and so moch branne that it be thycke / & they putteth in a bagge and layd thervpon as hote as the pacyence may suffre. Somtymes is done therto the aforsayd oyle / & do it so often tyll the payne be gone. ¶ The matter that is lette in the belly and can not come through the seem ye need it not to fere greatly / for the moysines can not be moche / & they membres hath not moche blood as Wilhelmus sayth / the na∣ture resoluyth and cōsumyth the moystnes & sendyth to the flanckys / and ther it be en∣ryd lyke another ipostume in y^e same place.