A needefull, new, and necessarie treatise of chyrurgerie briefly comprehending the generall and particuler curation of vlcers, drawen foorth of sundrie worthy wryters, but especially of Antonius Calmeteus Vergesatus, and Ioannes Tagaltius, by Iohn Banister ... Hereunto is anexed certaine experiments of mine ovvne inuention, truely tried, and daily of me practised.

The differences of Vlcers and vvher∣of they be taken.

THe differences of Ulcers are diuersly taken, but especially of three causes, viz. from the causes prouoking them, frō the members, and from the accidentes or

dispositions ioyned with thē. Other take them onely of two, as from the causes and accidentes, and also from the natural dis∣positions them selues, to whiche they are enwrapped, and passe ouer those differen∣ces, whiche are taken of the members or labouringe partes, because they belong not to an vniuersall treatise. These there∣fore be the diuers sortes of Ulcers, & true differences taken of the causes, that is to wit, a virulent Ulcer, a corroding Ulcer, a filthy rotten or putrified Ulcer, a hol∣lowe & depe Ulcer, and Ulcer full of holes and a cancred Ulcer. And the differences which do come of the accidētes & natural dispositions, to which the woundes them selues be ioyned, are also diuers. Which of the Chirurgiās of later time are thus described. viz. an Ulcer w^t intēperatnes, whiche y^e Grecians call Discratū, a dolo∣rous Ulcer, an Ulcer with a swelling or tumor against nature (commonly called impostumation) a broken Ulcer, an Ul∣cer ouergrowen with superfluous fleshe, which y^e Grecians call〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, a hard Ulcer, a cankred Ulcer, a hollowe vlcer, ••n Ulcer corrupt at the bone, an Ulcer

with diuers separatiōs, & an Ulcer called Cacoethes, which is a wicked, cruel, & ve∣ry hard Ulcer to be healed, and others of that sorte. But these many and diuers dif∣ferences of Ulcers, are not supposed of Galene to be true differences of Ulcers, but only agreeings of other effectes with the Ulcer, of which sorte are, the cankred Ulcer, the ouergrowen, putrefied and hol∣lowe Ulcers. And the Ulcer with some swelling, as the Ulcer called Phlegmo∣nodes, and Resipelatodes, or the cankred rottennes, the inflāmation of bloude, the canker, and residue of that sort, are of the kinde of effectes besides nature, corrup∣ting the actions whiche seuerally and by them selues may existe and bee. For that thing (saith Galen) which can consiste se∣uerally, shall neuer be the difference of an other.

Let this therefore be as a precepte and rule, by whiche thou maiste discerne whe∣ther the difference of an effect be any other∣thing, or the enwrapping of an other na∣turall motion, but after an other sort. Al∣so the vexing and dolorous Ulcer, and the filthie vlcer, are called (as it were cer∣taine

differēces of vlcers whē as in deed they are not true & proper differēces, but the ioyning rather of an accident with an vlcer. &c. In like sorte the Ulcer called Vlcus cacochymon, is an Ulcer repleni∣shed with euill iuyce, or troubled with a rheumatick matter ther caused, being ioy¦ned with theffect. Many such therfore are vsurped of common Chirurgians & Phi∣sicians, for the differēces of Vlcers which are in deede no differences, but onely (as Galene saith) binding together other dis∣positions, or the effectes of that which is compounded. The proper and true diffe∣rences of a simple Ulcer are taken of the nature thereof. And that (saith Galen) is a simple Ulcer, which doth only exist, that is, wherto no other affect or accidēt is ioy∣ned.* 1.1 It shall not therfore be a simple Ul∣cer if any other part be exulcerated, or be ••exed with a rheumatick matter, or euill ••uyce, or altogether without natural tem∣••erature, full of hollownes. &c.

Therefore the differences taken of the ••ature of the vlcers are moste proper,* 1.2 & ••f the substaunce of the thing, and cōming ••utwarde. They are taken of the substāce

of the thing whiche are brought from the fourme & bignes or quātitie of y^e diuisiō, & from y^e measure of space.* 1.3 Frō the forme, as the streight Ulcer, the Ulcer declined or bowed, the rounde or compassed vlcer, the wrythen and the crooked vlcer: from the bignes of the diuision or quantitie, as a great vlcer, a litle vlcer of the measures or spaces, as a long vlcer, a short vlcer, a broade vlcer, a narrowe vlcer, a highe vl∣cer, or an vlcer in the toppe or height of a∣ny parte, a depe vlcer, an equall vlcer, an vnequall vlcer.

And the differēces of the vlcers cōming extrinsecall,* 1.4 are taken of the time, of the waye of generation, as all the vlcer or scarce part thereof cannot be seen or be∣holden, the differences of the tyme, as a newe vlcer, or olde vlcer. Of the reason of the generation, as a cut vlcer, a brokē vl∣cer, an vlcer partly cut, partly broken. O•• the placing in thaffected part, as an vlcer euidently appearing or out of sight, an vl∣cer hidden within or not appearing. Also an vlcer in the beginning of the muscle, in the middest, or in the end of the muscle. The differences of vlcers taken of the af∣fected

place, though they are to be iud∣ged. vlcers, yet not (as Gal. saith) of their owne propre nature, as the aforesayd dif∣ferences are taken: for the places where∣in the vlcers doe consiste are similar, and organicall, therfore to shewe the differen∣ces of places wherein the vlcer is, the di∣uision must be after this sorte, from thaf∣fected place. An vlcer in the similar orga∣nick or instrumentall part, deuiding also the differences of vlcers in the similar parte after this sorte. viz. Ulcers in the veines, vlcers in the arteries, vlcers in y^e skinne, and vlcers in the muscles, for the muscle and the similar part, is easie to be discerned by sense. And the differences of the affectes in the organicke parte, are of this sorte. The vlcer of the eare, the vlcer in the Iawes, the vlcer in the sharpe or rough arterie, vlcer of the lunges, vlcer of the brest, vlcer of the yarde, vlcer of the fundament and seate, and so forthe in lyke order discoursing the singuler partes of the body, whiche wee call instrumentall. And this is the complete and absolute di∣uision of a simple and only vlcer, and of an vlcer to whome no other affect is ioyned

in his differences taken of his propre na∣ture. Also if any affect or disposition doe consiste by it selfe, as Phlegmon, Gangr••∣na, or putrefaction, there cannot the diffe∣rences of vlcers be taken thereby, or at least bee so called properly. But for be∣cause it is spokē of Galen at least in 600. places, let vs not holde any cōtention vp∣pon the names.* 1.5 For if any man should cal the putrefied vlcer, y^e corrosiue vlcer, Gā∣grena, Erisipelas, the cancrous vlcer, the holed or cornered vlcer, the vlcer with pu∣trefaction at the bone, the vlcer called Ca∣coethes, the painfull vlcer, and all others of that sorte: If any man (I saye) should prescribe these as differēces of vlcers, we ought not to contende with him, so that he minister right curation to euery of thē. And they are called differences of vlcers taken of that wherto they are ioyned, that is to saye, the differences of the thinges conteined with the disease: the differen∣ces of the thinges conteined with the ac∣cidentes: and the differēces of the things conteyned with the causes and others (if any be) of like sort.

Notes

• * 1.1

  Vndepro∣priae vlc. differ. su∣mendae.
• * 1.2

  Different. vlcerum sunt magis propriae.
• * 1.3

  Forma vl∣cerum.
• * 1.4

  Diffe. vlc. extrinsec.
• * 1.5

  Non esse de nomini¦bus contē∣dendum.