The whole course of chirurgerie wherein is briefly set downe the causes, signes, prognostications & curations of all sorts of tumors, wounds, vlcers, fractures, dislocations & all other diseases, vsually practiced by chirurgions, according to the opinion of all our auncient doctours in chirurgerie. Compiled by Peter Lowe Scotchman, Arellian, Doctor in the Facultie of Chirurgerie in Paris, and chirurgian ordinarie to the most victorious and christian King of Fraunce and Nauarre. Whereunto is annexed the presages of diuine Hippocrates.

THE EIGHT TREATISE OF diuers operations Chirurgicall and contayneth Seauen Chapters. By Peter Low Aerellien (Book 8)

• Chapter 1 Of bleeding and things therein to be obserued.
• Chapter 2 Of boxing, ventousing and their effectes.
• Chapter 3 Of horsleaches and their effectes.
• Chapter 4 Of setons and the way to apply them.
• Chapter 5 Of canters actuall, potentiall and their effectes.
• Chapter 6 Of bathes and their effectes.
• Chapter 7 Of frictions and their effectes.

The first Chapter, of bleeding and thinges therein to be obserued.

BLeeding which the Greekes call Phlebetomia and the Latins venaesectio or an incision of the veine arificially done, to euacuate, retaine and diuertise the blood & other humors cōtained with it in the body, of the which there is gret differēce acccording to the veines & blood as in the head, leggs or feete com. ap hori••. 25. et 47.* 1.1 Is a thing most ne∣cessarie to be knowne of all Chirurgians not onely for the healing of maladies, but also for conseruation of the bodie from sicknes, sometime both for healing & preseruing, for the which it is most nenessarye to knowe the number of the veines, also the true situation, to the end he take not one for an other, because sometime the situation is va∣riable, and in partes not accustomed verie vneasie to be opened, wee must also knowe the waye to open them

and what it is to consider afore and after, for the effectes, that followe thereupon wtich are these. It quickneth the spirrits, helps memorie, maketh the senses more sub∣till, clarifieth the voyce and sight, causeth digestion, e∣uacuates the euill blood and is an euacuation naturall of the humors of our bodies, by the which infinite mala∣dies are cured as is ample prooued by Gualterus and Ru∣fus.* 1.2 The number of the veines which wee open ordina∣ly, for Maladies is 41. to wit, 17. in the heade, 6. in the armes, 3 in ech one, 6 likewise in the hands, 4 in the fun∣dament, 2 in each side, 8 in the legges, and must be ope∣ned 3 wayes, the great long waies, the little ouerthwart, in the typ of the nose in pricking it, not lifting the skin.

Rules to be obserued in bleeding.

SOmtime bleeding is vsed for the preseruation of the bo∣die [ 1] from sicknes as yee haue hearde,* 1.3 which is not commonlye done in Children afore Fouretenth yeares of age, nor in old people after Fourescore, because the abun∣dance of blood is not great, nor the forces strong, neuer∣thelesse for the healing of sicknesses, which is the seconde commoditie of bleeding,* 1.4 wee let blood both Chil∣dren and old folk, and sometime rather the olde than the yong, as one of Threescore, will sometime better endure bleeding, than one of Thirtie, and a Chi••••e of a yeare olde twise in one day, and one of Thirtie Ten times in a daye. Secondlye wee must weigh the strength, for in strong [ 2] people wee bleede largely,* 1.5 those that are feeble and extinuat not so much, although Gaelen & others coūsell in vehement dolor & carbuncles,* 1.6 to draw blood vsque ad a∣nimae defectū, the which come great accidēnts, so not to be done.* 1.7 If the blood be euil & intēperate aduise for the cor∣rectiō hereof, with some l••arned Phisitiā, & also with Hen∣ricus.* 1.8 If the body be of good habitud nourished with good [ 3] iuyce, the veines great & full of blood, we drawe largely,

those that are of a weake and ill temperature and haue the veines small,* 1.9 and little blood, are to bleede lesse. Those [ 4] who are brought vp in hot countries, nourished with hot meates endure more bleeding,* 1.10 then those in cold coun∣tries▪ and their blood is more hot, so much more subiect [ 5] to hot apostemes and feuers, nor to cold as the other blee∣ding,* 1.11 which is vsed for preseruation of health, ought nos ••o be done, neither in winter, nor in sommer, but in the spring time▪ in which time many sicknesses are cured, as also the goute as testifieth Galen,* 1.12 and must bee done rather in the mornimg, than any othe•• time: yet that which is vsed for the healing of sicknesses may be done at all times and ho∣wers according as the sick requireth.* 1.13 If we are ordinarily accustomed to let blood when the hemorroides, & purga∣tions in women are retained otherwise, then they ought, [ 6] to eschewe great maladies, and is done sometime in the arme,* 1.14 otherwhiles in the legge and foote, as it shalbe fond expedient: and being accustomed to let blood for preuen∣ting of certaine diseases, doe it afore the disease come. The Astrologians are of the opinion, that the starrs, planets and [ 7] signes haue power in mans body and that euery humor of the body is gouerned by certaine signes,* 1.15 as the sanguine by Taurus virgo and Capricornus, the phlegmatick humor by Aries & Sagittarius, the chollerick by Cancer & Pisces, the melancholick by Libra and Aquarius. According to their opinion and sometime Phisitians also, also Constan∣tinus Aefricanus, wee must not let blood that part where the signe is, which things are not obserued of the most lear∣ned Phisitians and Chirurgians, as Hipp. Gaelen, Oribasius, Sardinius, Aetius, Paulus, Rasis, Auicen, Haly abbas, and diuers others Latins Greekes and Arabes. For when the body is greuously oppressed with maladie, wee must not stay for the course of the celestiall signes. There are some, who obserue the course of the Moone, except in greate necessitie, and the new Moone is better, than the old, yet it must bee considered, by reason of some other

euacuation, for the which olde women must bee bledde in the olde of the Moone, and young women in the newe: as noteth Gordonius in these wordes.

Luna vetus veteres, Iuuenes noua Luna requirit.

If hee whome wee would bloudde, be constipat, giue [ 8] him a clyster remollient, and consider,* 1.16 if the meate he hath eaten, be digested, and if the bloud be grosse, vse frictions to subtilize it and make it runne,* 1.17 if any great maladie hath preceded, or great euacuation, either of hemerroihdes or monethly course, fluxe of the belly or vomiting, waking, or great vsing of women, in these cases bleeding shoulde bee defeerred, except for great occasions, and then it must be moderately done. The sicke must haue his minde free from passions, chiefely feare, which retireth the bloud to the cen∣ter of the bodie: if he feare fainting, hee must eate an egge before, or a toste in wine and lie in his bedde.

Of the scituation of the 17. veines in the head, the way to open them, and their effectes.

THe first is called vena frontis preparata or recta, and proceedeth of the Iugular interne, scituated in the [ 1] middest of the Forehead, for the opening of the which, thou must binde the necke with a napkin, till the veine appeare, doing the like in all other veines of the head: nexte, drawe the lancet on the veine, open it aslope, take heede ye goe not too deepe, for feare of the Pericrane: and it is good for all inueterate dolors of the head, chiefly of the hinder parte of the head, for all diseases in the face, as rednesse, euill sauoured vlcers, inflamation on the eyes, phrensie. The second is called venapuppis scituated in the [ 2] hinder part of the head, open it in the same manner, as the other, and it is good for dolors in the head and sleepienesse. The third is called temporalis▪ acotheres or sterilis & taketh his origine from the Iugulars, scituated on the temples, and [ 3]

hath many braunches, and is opened for the Migrim, do∣lors of the eares, and Opthalmie and watering of the eyes. [ 4] The fourth is called auricular, scituated behinde the eares, open it as the others, shaue the haire and rubbe the parte with a hotte clo••h••,* 1.18 till the veine appeare, and it is good for deafenesse, paine in the eares, olde Catarres, Hemicranes, all vlcers maligne:* 1.19 if these veines be cutte, they cause a man to be sterile, as saith Hippo, Which thing was practised a∣mongst the Schites to effeminate them, and serue them like [ 5] women. The fift is called occular, and proceedeth of the interne Iugulars, scituated betwixt the eyes and nose, in o∣pening it: beware to goe to deepe, for feare of the muscle that moueth the eye, which being offended, often draweth the eye aside, as also Fistula. All the veines of the head should be opened with Flambettes, for feare of going too deepe. The opening of this is good for maladies of the face,* 1.20 affections of the eyes and eyeliddes, scabbes and red∣nesse [ 6] of the eyes. The sixte is called nasall, scituated on the tippe of the nose, betwixte the Cartilages opening it, goe deepe with the lancet, and it is good for heauinesse of the head, fluxions on the eyes and all rednesse of the face, yet it is not vsuall, neither was it opened by Galen, nor any [ 7] of the Greekes. The seuenth is called labier, scituated in the inner side of the lippe, the opening thereof is good for corruption of the gummes, fissures in the lippes, vlcers in [ 8] the nose or about it. The eightis the ra••••ull vnder the tongue, proceeding of the interne Iugular, and is opened ouerthwart, not going deepe, for feare to make the tongue immobill, because of some nerue motiue, which is neere to these veines, it is good for the Squinancie, inflamation of the Amigdalles,* 1.21 Vula and other affections of the mouth and throate, also for such as become dumbe and loose their [ 9] speach. The ninth is the Iugular, taking the origine from the veine caue, good for the Squinancie, fluxions on the throate, Suffocation, Leprosie, melancholicke Maladies,

and maligne Vlcers, and corrodent Hemicrane and Reume. Remember that all veines of the head must bee opened after rest. Auicen is of the opinion, that the veines of the head beeing opened, letteth generation, be∣cause of the animall spirites which dissippe.

Of the scituation of the three Veines in the arme, the way to open them and their Effectes.

THe first of the three Veines in the arme is called ce∣phalica, spatulina or capitalis, or humeralis as saith Ga∣len, [ 1] which is most hihh and externe in the arme, and hath neither veine, arter, nerue nor tendon vnder it,* 1.22 in ope∣ning of the which make a good issue, otherwise it is in danger to apostume, because that oft there remaineth lap∣pered bloud, for the thickenesse of the fleshe, it is good for all dolors and paine of the head, eyes, eares, throat and E∣pilepsie. The second is called mediana, or vena matricis or matricalis, mediastina, cardiaca, or purpurea, it is compo∣sed [ 2] of the basilicke and cephalicke scituated betwixt them,* 1.23 in the middest of the arme, vnder it is a nerue, or tendon of the muscle biceps, sometime both, for the which we must be warie and take good heede in opening it, for feare of Gan∣gren or conuulsion, or dolor, it must be opened athwart, and is good for all diseases that happen to the bodie, both supe∣rior and inferior. Once I saw in opening of this the nerue pricked, of the which within the space of foure dayes after there came a soft tumor in the omoplat, with a relaxation of the ioynt, as also all the ioyntes of the body, for the which the deepe perfounding is forbidden by Auicen and Rasis. The third is called basillica, or hepatica, venainterna, iecori∣na, regia, or vena axillaris and is scituated lowe downe in [ 3] the arme, accompanied with a great Arter vnder it,* 1.24 for the which you must haue a great care & beware of Auen••••isme.

Rasis forbiddeth to bleed in this veine, but in great necessi∣tie. It is opened for the obstructions of the lyuer, inflama∣tions in all the bodie,* 1.25 as also partes vnder the head, hardnes of the lyuer, dolor of the stomacke, pleuresie, difficultie of breath.

Of the three veines in the handes, their scituation, the way to open them & their effects.

THe first of the three veines is called cephalica, or ocularis, [ 1] and is scituated betwixt the thombe and formost finger, and is opened longwise, because it is little, good for dolors in the head and affections of the eyes.* 1.26 Galen saith, that the veines in the handes giue not much bloud, because they are but little braunches and therefore were not opened by the [ 2] mediciners Greeks. The second is called saluatella, titula∣ris or asellaris,* 1.27 and is onely a braunch of the basilicke, it is scituated betwixt the middle finger called medius and the third finger, called auricularis, and is good for the Iaundise and maladies of the lyuer, being bledde in the right hand, and the other in the lefte hande, called splenetica, for the affections of the milte. The third is called, funus brachij, [ 3] and is a braunch of the cephalicke, scituate on the finger medius, opened in default of the other two. These veines must be bathed in hotte water▪ in opening of them, as those in the feete.

Of the foure veines in the Funda∣ment and their Effectes.

IN each side of the Fundament are scituated two veines hemerroihdalles, and are opened for affections, or me∣lancholicke maladies.

Of the foure veines in the legges their situation and effectes.

THe first of these foure veines is called Popletica & cō∣meth from the veine Femorall, as all the rest, it is situ∣ated [ 1] in the bending of the ham, open it for all affecti∣ons in any part contained in the inferior venter. The secōd is called Saphena, situated within the foote, nere or aboue [ 2] anckle on the inside, in opening of it, ye must not profoūd deepe because the partes are neruous, and so must mortal accidents. Note that all veines in parts neruous, must bee opened longwise, except sciatica which must be opened a little athwart, yet Gvlen saith that all veines in parts ner∣uous must bee opened longwise, and are not so much sub∣iect to euill accidents: this being opened is good for af••ec∣tions of the kidneis, matrix, gonorrhea maling that returns in againe,, and prouoketh the purgation in women. Bee circumspect in blooding the foote, for it weakeneth more than any other, as saith Auicen, therfore I vse alwaies to wommen a tablet cordiall or else they eate some-what a∣fore. The thirde is called Sciatica, situated aboue the an∣ckle, & is opened athwart as ye haue heard, good for [ 3] sciaticks, dolors in the thighes and anckles. The fourth is called Medium or renall, and is situated vnder the bending [ 4] of the foote, and is opened for such maladies, as the other. Some say that aboue euery knee about three fingers there are two great veines, which Arabes call Salsores, and say if the ••••ick be bled in them, he dyeth presently, anh Galen is not of their opinion.

Thinges which are to bee considered to bleede well.

FIrst the Chirurgian must be in a light place either natu∣rally, or with candle also his owne sight should be good as sayth Haly Abbas, and must haue a ligator,* 1.28 that goeth

twise about the arme, an inch broad, also hee must haue a tound staffe to hold in his hands, in like maner a litle oyle to rub on the veine to make it souple, also annoint the lan∣cet with sallet oyle, before the blood which will appease the paine, he must haue diuers lancets, of the which some are large▪ some round pointed, when the paine is superfi∣ciall, also when neede is to make a good issue and euacu∣ation,* 1.29 which we vse in putride feuers, and when the blood is thick and the sick strong: some must be long sharp poin∣ted to open when the veines are deepe and hidden, as al∣so to make little issues in small superficiall veines, & when neede is to make deriuation as if the person spit blood, or bleede at the nose. The issue you make, must bleede long to diuert it, we make the issue little in people, that are out of their wits, that the issue may be soone consolide, by rea∣son that such people lose the bandage,* 1.30 and oft blod much. The incision must be made one of 3 waies, to wit, in lēgth, breadth & oblique, making alwaies an incisiō in midst of the veine, not cutting it altogether which if it be, the blood cōmeth not wel, but alongst the arme, and the extremity of the veines retireth one from another.* 1.31 Then let him make the issue as it should be, & cause the blood come well out, rub first the arme, thou woldest blod gētly with a hot cloth or thy hand, thē knit it with thy legature a little aboue the elbow, let the binding be steady, & show it selfe the bet∣ter, then the sick party shall close his hand, that the veines may shew the better, thereafter if it be the right arme the Chirurgian shall take it with left hand, neare to the part, where he intendeth to make the issue, holding his thomb on the veine that it stirre not, for oftentimes it rolleth, and slydeth from the launcet, sometime it yeildeth being full of wynd. This being done he shall marke the place, with the formost finger of the right hand, making a little marke with his naile on the verine, then he shall take the launcet betwixt the thomb & the formost finger in the midst of it, and to the end that he tremble not, he shall leaue the o∣ther

three fingers on the arme and leaue the finger and thomb, that holdeth the lancet on the left thomb, which holdeth the veine, then open the veine softly slyding the poynt of it in the veine not suddenly, if the vaine be not o∣pened at the first time, prick suddenly againe a little aboue or vnder the first, ye may do the same if the hole be not great enough to let out the blood in a reasonable quanti∣ty. The veine opened in that manner,* 1.32 the party shall hold the staffe in his hand, that he may rest his hand, & the blood come out the better. Hauing drawen such quā∣tity of blood, as the cause requireth. He shall presse out that which remayneth, if there come out any fat, as oft happeneth in grosse people, thou shalt put it in agayne, that done, put a pece of c••oth in 3 or 4 fingers double on the wound, and wet it in water, bynd the arme with a band of an inch broad, that goeth 3 or 4 times about the arme, winding it about aboue the elbow, and vnder that it neyther be too straight, nor too slack. If the veins be small blood thē after meate, rather than before, for thē they are more full of blood,* 1.33 doe not eat nor drink of an ho∣wer after.

Thinges to bee considered after the veine is opened.

OFtentimes chanceth after the veine is wel opened, that the blood commeth well forth and afterwards suddē∣ly doth cease, hapneth through too straight ligature saith Auerrois, or else for an apprehēsion & somtime through wrong & euill situatiō of the arme, in these points ye must slack the ligature, comfort the party & situat the arme right somtime the cause is in the thicknes & grossnes of the blod for the which rub the place incised with a litle oyle. If the party be weake, which shalbe knowne by the chang∣ing his coulor and the blood running alongst the arme, in this yee shall loose the legature, close the wound, lay the sick on his back, cast water in his face & vineger to

smell to giue him a little wine, within a while after loose the band and let him blede, till yee haue got such quanti∣tie of blood, as shal bee requisite, stirre not nor labour thy arme that carrie it in figure triangulare sleepe not two ho∣wers after. Let the blood stand, to know the nature of it, for in our bodie, there are diuers sorts very vatiable, accor∣dinh to the diuersitie of the age, the complexion, country, kinde of the sicknes and partes of the bodie.* 1.34 Wee shall iudge the nature and qualitie of the blood three waies, first by coulor, by the tast, and substance. As for the color good naturall blood should be red, sweete as phlegme naturall, and me••ne substance, when it congealeth not, it is a signe that some of the other humors are with it, when it is redde cleare and gluttering, it signifieth abundāce of choller, whē it is blackish, abundance of melancholy naturall or adust which stoppeth it to congeale, the fatnes of the blood kee∣peth it also from congealing.

Of Arteriotemie or in incision of the Arter.

LIke as for diuers maladies we blud the veines, so we do in some arters. Arteriotomia is a detractiō of blood by the diuisiō of the arter,* 1.35 which was not vsed by our auntiēts saue onely Menodotus, but is greatly in vse now, chiefly those in the tēples & behind the eares, for great fluxion of of catarrs on the eies, brest, & maladies of the head ingē∣dred of a hot fluxion inueterated, & vaparous spirrits, as are cōtained in these arters. In opening them, first I shaue the haire & rub the part the necke with a napkin as the veine, making a little incision in the bodye of the arter, as in the veine, not cutting it altogether, draw such quātity of blod, as is needefull, then stay it, and put on the wound an em∣plastrum of mastick, or halfe a beane clouen, with a com∣presse & bandage. Some feare this kind, for that the blood is ill to stay and also for an Aneufrisme, it is good in long dolors of the side,* 1.36 & all dolors, that procede frō a hot pitu∣itous substāce, also for swining giddines & long defluxion on the eyes.

The 2. Chapter, of Boxing and Ventousing.

VEntousing which the Latines call Ʋentosatio, is no other thing but application of an instrument, either for the e∣uacuation of some humor vnder the skinne, or to diuerte the course of an humor to some other parte, and to draw a∣way such thinges, as is hurtfull, that nature cannot chace forth, and also to drawe out winde in some parte of the bo∣die. It is called cucurbitula, or pixis, made of brasse,* 1.37 horne, glasse, wood or earth in diuers formes some shorte, some long necked, for the most part wide bellied, and are called ventoses a ventre, as saith Auicen: some are bigge, some lesse, according to the proportion of the member, the mouth is reasonable wide, the lippes round and thicke, and are applied most commonly in diuers partes of our bodie. They are sometime applyed with scarrification & extracti∣on of bloud, otherwhiles without scarrification, as also on diuers parts of our bodie, according to the cause, as to draw out some hurtfull humor of the bodie, with scarrification and extraction of bloud. First we apply them in the necke to euacuate the humor from the head, for heauinesse of the head, fluxions on the eyes, affections of the face, and stincke in the mouth: secondly wee apply them on the middest of the necke behinde, for difficultie of breath and cough: thirdly vnder the chinne and sides of the necke for dolors and vlcers of the mouth, corruption of the gummes & Mi∣grim, Opthalmie, sore teeth. Fourthly on the shoulders for diseases in the Thorax, pleuresie, spitting of bloud, affecti∣ons on the shoulders, of repletion, for many affections of the head and throat. Fiftly on the region of the reines, good for apostumes and dolors of the reines & lyuer. Sixtly on the middest of the armes, for dolor in those partes, and in stead of bloudding, and is vsed both in olde and young. Seuenthly on the os sacrum and thereabouts, & is good for the hemerroides, and fistules in the fundament. Eightly on

the middest and rootes of the thighes, and is good to pro∣uoke the monethly course, for Strangurie, dolors of the matrix, bladder and kidneis. The ventouses without scar∣rification, which we call drie ventousing, are applyed for the most part in a xi. places. First on the open of the head, for [ 1] relaxation of Vuula,* 1.38 and to stay the rheume, as saith Galen. [ 2] Secondly, vpon the hypocondres, to diuerte the bleeding at the nose, as saith Galen, when the right nosethrill bleedeth, put the ventouses on the region of the lyuer, if the left side, on the milt, so in like manner on all partes that bleede, wee put the ventouses on the parte opposite for the communi∣cation that the vesselles haue one with an other. Thirdly [ 3] on the pappes, to diuerte the purgations that runne much, and for the ventositie about the lyuer.* 1.39 Fourthly in the be∣ginning [ 4] of the nerues for Palsie. Fiftly on the nauell for the windie collicke.* 1.40 Sixtly on the flancke for ventositie of the [ 5] [ 6] milte. Seuenthly, on the nauell or wombe, to reduce the intestine, or matrix fallen, and ventosities in the bellie, and [ 7] dolors which happen in time of purgations.* 1.41 Eightly wee [ 8] apply them on vritors, to drawe downe the stones and gra∣uell [ 9] to the bladder. Ninthly on the eares and mouth of [ 10] vlcers to drawe out any thing contayned therein, also for drawing out of poyson.* 1.42 Tenthly, if any where there is mattir deepe, to drawe it out to the superfice, as in bubons venerians, also in parotides maligne, or in any other parte where neede is to drawe any thing to the superfice. Ele∣uenthly, [ 11] on the necke for Squinancie.

Thinges requisite before the applying of Ventouses.

FIrst, if the body be plethoricke, it must be taken away by bleeding, otherwise the ventousing is noysome, next, if the bloud or humors be thicke, we vse to foment the

place with hotte water, & rubbe it long with a hotte cloth, that ye neuer scarrifie, except the application of the drie ventouses haue preceded,* 1.43 because the bloud must first bee drawne to the place, before it be vacuated, that it be not ap∣plyed in the bath, but an houre or two after.

The way to apply the ventouses.

THe Ventouses are applyed with hardes being fastened to the bottome with a little waxe, or emplaister, to holde it, that it fall not on the skinne, that being done, light them and apply them on the parte, Some vse two or three piece•• of waxe candles put on a piece of a carde, mo∣ney or golde, the breadth of a crowne, being lighted, set them on the middes of the parte, thereafter apply the ven∣touse, and beeing applyed a certaine space, ye shall, for to take it away, presse the fleshe vnder the lippe of it,* 1.44 to let in the ayre, and so it shall fall, which beeing done, make cer∣taine scratches in the skinne with a launcet, sometime ma∣ny, otherwhiles fewe: in delicate folke and children,* 1.45 wee make fewe scarrifications, if the bloud be thicke, make the scarrifications profound, if the humor and bloud be subtill, the scarrifications must bee superficiall, and apply the ven∣touses as before, let it remayne a reasonable time, and eua∣cuate the bloud, as ye shall finde expedient, if not suffici∣ently at one time, ye may reiterate twise or thrise, alwayes scarrifiyng, especially when there is venenositie or malig∣nitie in the place, by reason of the bloud being thicke and grosse. That beeing done, it shall be very necessary and expedient to drie the place with a softe cloth, annoynt it with oyle of roses, butter, cerat Galen, or rosat Mesnes,* 1.46 and sleepe an houre after.

The third Chapter, of Horsleaches or Bloudsuckers and their Effectes.

THese little beastes, which the Latines call Sanguisuga or Hirudines, in our toungue Horsleaches, are little wormes, the length of two inches or three, great, like to a goose quill, well knowne to all Chirurgians, ingendred in fresh water, pondes, pooles, of the which there are two sortes, the one maligne, as those which are bread in rotten standing water, where carrion hath bene cast, of the which come great accidentes, as tumor, inflamation, vlcers, a∣postumes venenous, as we reade of one Messelinus, who dyed by putting one on his knee. Therefore wee must ab∣stayne from those, that haue the head greater then the rest of the body, and are greene coloured, glittering, with blew rayes on the backe, the rest of the bodie being blacke: we must chuse such as are found in cleane water, in pondes and sandie ground, that haue their head little and bodies small, round,* 1.47 red bellied, the backes rayed like threedes of golde, such shall bee kept a day or two in cleane water, to purge them afore they be applyed, as also to cause them drawe the better. Some keepe them ten or twelue dayes, chaunging the water once in two or three dayes, after the which man∣ner they may be kept a whole yeere in glasses or pottes of earth,* 1.48 chaunging the water once in x. dayes, wee vse them for the same purpose, as scarrifications, and in such places where ventouses cannot bee applied, as in the lippes, gummes, legges, fundament, mouth of the matrix, & such partes as are emptie of fleshe, as nose, fingers, toes, also a∣bout olde vlcers, and apostumes of the emunctoires and o∣thers that are venenous, rubbing the parte ye put them on, till it grow redde.* 1.49 They draw onely superficially the bloud which is in the flesh, and so are good pro morbis subter cuta∣neis, if they be applied on the fundament, they make eua∣cuation from all the members. The part where wee applie them must be cleane,* 1.50 otherwise they will not bide, there∣after take them with a piece of cleane cloth, handle them

softly, not touching them with the bare hand, hold their head to the part you would haue them bite, for the more easie doing thereof, we put a drop of Pigeons or Chickins blood, on the part, or pricke the part a little to cause the blood to come out, then if you would haue them drawe much, cut the endes of them with the sheeres to let the blood runne, otherwise, when they fall of, apply freshe in their place, or put on twoo or three in the begining▪ as ye find expedient. To make them fall sooner, yee shall put a corne of salt, or drop of vineger on their heade, or a fewe ceudres, or seperate them with a horse haire. If after the fall, the place bleede much, wee apply cotton, or burnt cloth, or cloth wet in cold water, or halfe a beane clouen and bound on it. If there be venenositie in the part,* 1.51 after they fall we foment the place with water and salt, some∣time a cornet, or little ventouse.

The fourth Chapter of Seton, the qualities of it, and way to apply it,

SEton, which the Latins call Seta is no other thing, but a little cord. which in old time was made of haire, or thread, and now of silk or cloth, or wollen yarne & is dra∣wen through the skin with a needle for the purpose, in sundry parts of our bodies for diuers occasions as ye shall heare. First and most commonly we apply it in the neck,* 1.52 [ 1] betwixt the and fift thirde vertebre, sometime lower downe and is good to diuert & draw away fluxion on the eyes, Cattarrs which come from the head, and fall on the stomack, and gummes, lightes, back,* 1.53 and other parts of the body. Secondly we apple it on the nauell, when it [ 2] is swollen with water and humors. Thirdly in the codds, [ 3] for waterie tumors contayned in those parts, as also for those that are Hydropick, Fourthly we apply them on [ 4] wounds, which passe out through for the better euacua∣tion of the matter, they are applyed eyther as did our aun∣tients,

or without fire,* 1.54 as now is commonly done, for the doing whereof we set the sick in a chaire, then one taketk the neck behind or other part where ye will ap∣ply it, equallie in his hands, neyther more on the one side, nor the other, the one hand lower downe and the other more vpward, leauing a space betwixt the hands. Then the Chirurgian shall take hold of the same with his pincers for that purpose, therafter p••rce it with a sharp needle through both the holes of the pincers, being first threaded with the Seton or Cord, beware yee prick not the Muscle of the Neck, thereafter holding the skin with the pincers cause the sick moue his head, so ye shall easily perceiue if the Muscle be taken hold of, and if it be, let go the gripe, and take onely the skin and draw through the Needle and Seton which shalbe an ell in length or there-abouts, great like a Goose quill, take the Needle and let the Seton remaine, and rubbe it with digestiue, fresh Butter or Cerat Galen with an emplaster of Cerat or such like for Two or Three dayas, thereafter Diapal∣ma or Beronica, some put onely Woodbynd leaues, dra∣wing it a little euery day in the Morning and at Night it being almost neare the end, ye shall draw it the other way by this meanes it will serue a Moneth or Sixe weeks. When ye will change it, sow an other new Seton to the end thereof in such sort, that it slipp not in the through going, so cut away the old, and leaue the new, and so continue so long as shalbe expedient, that is till the humor be well euacuated, vsing in the meane time some meete remedies vntill the humor be diuerted, intercep∣ted and euacuated. Some vse this a yeare or Two accor∣ding to the greatnes of the disease, purge the body afore ye apply it, and after it is taken away.

The fift Chapter, of Canters Actuall and Potentiall.

CAnter called by the Latins Canterinum is a thing which hath vertue to burne rhe fleshe, bones, or any part, where it is applyed, whereof there are two sorts to wit, ac∣tuall and potentiall. The actuall is that which actually doth burne, and is made of Gold, Siluer, brasse, Iron or Lead, in diuers fashions,* 1.55 according to the maladie and part, where they are applyed as ye haue heard in wounds and vlcers, yet most commonly they are vsed for Foure causes, first in staunching of blood in veines and arters, se∣condly for Gangrens and Mortification, Carbuncles and Bubones excepting alwayes when there is no inflamma∣tion in the part, thirdly in bones that are rotten, for it is enemy to rottennts & helpeth the separation of the bones, fourthly in maling vlcers, and byting of venemous beasts.* 1.56 The canter potentiall, which the Latins call Canterium Potentiale, or Pyroticum is that which hath the force by extreame heate to burne the part where it is applyed, but actually as the other and is composed of diuers matter that are for the most part, extreame hot, like as Cartharide••, Ʋitrioll, Tartar, Arsnic, Orpiment, Sublimat, strong wa∣ter, oyle of vitrioll, Cloues, Sage, and Brimstone, or of dy∣uers oth••r thinges, as the ashes of the Oake or Figge tree, of Vines, or Beane stalkes, quick lyme, salt Nitre, Armo∣niack, Axungia vi••ri, Granley, all which ye may vse to∣gether, or some of them in water, which we call Capitel∣lum or Lixiui••um, and is eyther strong or weake, accor∣ding to the Ingredientes. For the making of the which, ye shall take a certaine of these thinges, and steepe them in water three or foure dayes, sturring it Morning and Eue∣ning, thē passe it through a cloth, & seeth it on the fire in a pan of brasse, till it be cōgealed to salt, which being taken

from the fire shalbe cut in little peeces, and put in glas∣ses close stopt that no ayre enter in. The way to make diuers sorts of Canters is thus, take the ashes of the vine, quick lyme, graneley, axungia vitri, an. halfe a pound, al∣lom and vitrioll roman of ech 6 ounces, steepe them in 15 pintes of water in an earthen pot the space of 5. or 6. dayes, stirring it euery day as yee haue heard, then power out the water and leaue the grounds keepe it in glasses, or seeth it, till it grow to salt as ye haue heard, if it grow thick put thereto halfe an ounce of opi•••• dissolued in aquauitae, which both appeseth the dolor and maketh the scarre soft. An other excellent way is, Rec. axungiae vitri li. se. salis gemmae onc. 6. sublimati onc. se. cineris sarmentorū et trun∣corum fabarum an. li. se. aquae li. 10. infundantur et fiat ca∣pi tellum,* 1.57 in fine coctionis ••dde drag. 2. opij. Otherwise thus take ashes of oake and vine, graneley, stalkes of beanes an. like quantitye, steepe them in water and make your Ca∣pitell, putting thereto a little quick-lyme, this Canter is commonly vsed by Seuerinus Pineo & Hierome de la Now Doctors in Chirurgerie.* 1.58

Cantion in applying of Canter.

THe Canters are appyed in diuers places, taking heede to the complexion of the person, and nature of the part, by reason it worketh sooner in one part than an other: in bodies Cacochymick, purge and bleede afore ye apply them, beware of neruous and membranous partes, ends of the muscles, veines and arters.

Certaine places where Canters are ap∣plyed for sundry diseases.

THey are applied for the most part in all the partes of the heade for diuers diseases, as on the fore-head at

the ioyning of the suture sagittall with the coronall, pene∣trating to the boane & is good for Fluxion on the eyes, the Migrim and other dolors of the head, the Epilepsie, diffi∣cultie of breath, Opthalmie, rednesse of the face, paine of the teeth, eares and ••quinancie. We applie them behinde and aboue the eares, taking heed of the muscle cratophite, for the more assuraunce of the which cause, the sicke must close and open his mouth, that we may perceiue where the saide muscle endeth by the motion thereof. Wee applie in the necke and arme for Catarrhes and distillations of the head, to drawe it away, and stoppe it from falling on the thorax or some chiefe Parte, and are put on the inside of the arme, about the middest, neere the veines and arters, but not touching veine, arter, nor nerue, for assurance of the which, holde your finger on the parte, cause the sicke to moue his arme, so yee may easily perceiue if there bee any thing vnder it. Wee apply them on the legges, within 3. inches to the knee, either on the inner or outside, as the dis∣ease requireth, and is good for the Sciaticke and vlcers in the legges & feete. They are also applyed in diuers other partes of the body to giue issue to the matter contayned, and where there is vehement dolor, or humor or maligne vapor, and in the emunctoires to giue issue to the humor, which shall be done afore the ripenesse thereof.

The way to applie Canters.

FIrst marke the place with thy finger or a spot of incke, next, make a little emplaister, hauing a little hole in the middest, either broad or long, as ye shall thinke good, put on the emplaister in such sort, that the marke of the incke appeare through the hole, and then applie your canter, ac∣cording to the quantitie ye would haue the issue of, and put an other emplaister aboue, and binde it, letting it remaine, till it worke the effect you require: if the first hath not gone

deepe enough, apply another on the same after the foresaid manner, which being done take away the emplaister, and lay on the place to separate the burnt from the whole, a little oyle of roses, turpentine, butter and a little iris of Flo∣rence, or otherwise a little butter alone, or basilicon. Some after the first emplaister is taken off, cutte away that which is burnt with a Bistorie, others cutte it crosse wise, therafter put to the medicament, and it falleth easily of it selfe, being fallen, the issue must be holden open, till such time the sick∣nesse be whole,* 1.59 for the which it was made. Some to holde it open, put a great peaze or balle of golde or siluer, of the same greatnesse. I vse certaine balles, which last sixe mo∣nethes and are made thus. Take waxe onc. 3. verde greece, orpiment, and hermodactes an. onc. 2. sublimat. and pouder of cantharides an. onc. se. with a litle res••n. In stead of the emplaister, I vse a certaine cloth made with certaine stuffe, which lasteth fiue or sixe monethes, likewise wiping it, and vsing sometime one side, sometimes another, and is made thus. Rec. empl••stri triaformacili, se▪ cerae albae onc. 2 campho∣rae onc. 2. litargiri auri puluerizati onc. 2. spici nardi onc. 1. olei oliua••um onc. 1. se misce omnia simul: thereafter dippe a cloth therein, and cutte it in peices to serue, as yee haue heard, it is good for colde humors vlcered. Sometime wee are con∣strained to continue these thinges longer, and euery yeere we place them sometime higher, lower and sidewise, that the mattir may auoide the better. Sometime they waxe hard and callous, which is consumed by such remedies as ye haue heard set downe in callous Vlcers, the excrescence of fleshe which sometime groweth, is taken away by such remedies, as ye haue heard in Vlcers.

The sixte Chapter, of Bathes and their Effectes.

BAthing, as by the learned Hierodotus is at large decla∣red, is a washing and steeping of the whole body, for the better preseruation and conseruation of mans health, and recouerie of that which is lost, which was had in great vse and custome amongest the Auncientes, as among the Greekes, also among the Arabes and Latines, and is also very much vsed and practised in all Nations in these our dayes: whereof there are two sortes, one naturall, and an other artificiall. The naturall are saide to bee such, as come and proceede naturally out of the ground,* 1.60 and are alwayes warme and hotte of themselues, but yet are reported to be of diuers sorts qualities and vertues according to the diuer∣sitie of the places, from whence the water commeth and proceedeth, as if it come from Salt, Allom, Sulphur, Brasse, Copper, Golde, Iron and such like.* 1.61 The Salt is good for pi••uitous, colde and humide Maladies, Hydropsie, dolors, paynes and aches of the belly, stomacke, matrix and kid∣neis, also it is good for all Catarrhes, Epilepsie, dolors of the bladder, head, stomacke and eares, whites of women and scabbes generally through all the body, as is at large dis∣coursed and s••t downe by Galen.* 1.62 The Alluminous are drying and heating, and is good for all colde and humide diseases and sickenesses, vomiting of bloud, staying the he∣merrhoides, the monethly course of women, aborting with childe, varices on the legges▪ hydropsie, maligne vlcers, ••otten waterie ••umors, for all sortes of vomiting. The Sulphurous are drying in the 4. degree,* 1.63 & heale the partes neruous, which are cold & humide, soften the hard parts, ap∣pease dolor, & comfort the stomacke & milte, they are good for the stone and strangu••ie, for all cold & humide maladies,

Palsies, Hydropsies, Apoplexies, yet they must bee mode∣rately vsed. Those, whose minerall is iron and steele, are colde,* 1.64 stipticke and drie, good for hotte and humide mala∣dies, as Gow••es, and dolors of the articles debillitie, and softnesse of the stomacke and milt, apostumes in the eares, monethly course, fluxe of vrine, hemerro••hdes, outcom∣ming of the fundament, & all vlcers in the bladder, as saith Fuchius.* 1.65 The Copperous, which heate, resolue, cleanse, consolide, are good for colde and humide diseases, dolors of the guttes, maligne vlcers, and members contused, also for maladies in the mouth, inflamation in the throat and a∣migdalles, all sickenesse of the eyes. Those that haue their minerall golde,* 1.66 are hotte and drie & good for the col∣licke, voluulles, fistules, gowte, maligne vlcers, colde sto∣mackes, the stone, rupture, scabbes, leprosie, diseases of the eyes▪ stincke in the mouth, palpitation of the heart, as saith Fuchius.* 1.67 The Leade being the minerall, they are good for all maligne vlcers, canckers, fistules, diuers affections of the skinne, kidneis and blader, whites in women & hemer∣roihdes. There are some mixed with diuers of these to∣gether, as in Lorraine, Burgundie, and diuers partes of Al∣maine and Italie, of the which W••ckerus and Fuchius haue amply written.* 1.68 The artificiall bathes are artificially made, by imitation of the naturall, to supplie the want thereof, as of running water and mixtion of one or moe of these mi∣nerals, diuersifiyng & appropriating them according to the disease, sometime to heate iron and steele redde hotte, and ••lake it in the water, & so it participateth the vertue. Some time by mixing of hearbes, flowers, roo••es, sometime sim∣ply, sometime the decoction of them, sometime of milke or wine, according to the disease, as to appease dolor, to soften, to open the conduites, to loose or binde in all these sortes.* 1.69 Sometime we vse water called balneum aquae dulois, of the which come great effectes, so that it bee alwayes warme, it is good for all outward affections of the bodie, it heateth, appeaseth dolor, openeth the pores of the skinne,

tempereth and euacuateth ill humors prouoketh the pur∣gations and hemorrhoides in women, discusseth and dige∣••eth the excrements, softneth the hard partes, humecteth all the parts of the body, prouoketh sleepe, corroborateth the ventricle, & helpeth the concoction & naturall heate, good for all affections of the matrix, inflammation of the lightes, good for all intemperie, except the humide, dolor of the head and eyes, maladies of the lightes, lassitude of the stomack and back, for all fluxions and members vlce∣red, for all scabbes and vices in the skin of both olde and yong, it softeneth the articles, clarifieth the voice, moueth vrine, bringeth the flesh and skin in good temperature, it mundifieth and is good for hectick feuers and phrensies as saith Hippocrates, it discusseth flatnosities, and sharpe ex∣crements, the watee must not be too hot, for it healeth & closeth the pores, and so letteth the excrements vnder the skin to come foorth.

Caution before Bathing.

NOtwithstanding of the great benefit, which commeth of it, it must bee moderately vsed, the excessiue vsing hereof offendeth the heart, causeth syncope, taketh away appetite, loseth the ioyntes, resolueth the naturall heate, prouoketh nee••ing, it moueth humors and offendeth the vlcers as saith Galen. The bathe must be made in this sort, first there must be a vessell of the length of the party of two so b••e broad, of height two and a halfe or three, it must be almost full of water. After he hath remained a while in the bath, fill it with warme water, the vessell aboue with a couerlet, shee••e, or some such like thing, hauing remai∣ned therein as long as is needefull, the partie shall come forth of the bath and dry himselfe with hot clothes, put a hot sh••••te abou•• him and couer all his body warme, so he will swea••e, which being dryed he shall rise and hold him warme all that day. If he will he may afterwardes doe in

like manner the after noone,* 1.70 and so continue three or sixe dayes as shalbe thought expediēt, entring sometime once a daye, otherwhiles twise, adde commonly to the water chiefly in the spring and sommer, when they are in vertue these hearbs, mallowes, marsh-mallowes, violetts, parie∣••arie, fumit••rie, Dragon or Buglossie, Plantine, patience, a∣grimonie, beare foote, hearts toung, betonie, toses, which all or some of these may be sodden a little afore they bee put in the bath.

Thinges to be obserued before ye en∣ter into the Bath.

* 1.71FIrst as counselleth Antillus a verie auntient medicine, the partie should be fasting, or else foure howers after meat,* 1.72 for as saith Hippocrates, a man must not enter in ha∣uing his bellie full of meate and drinke, so it is meetest time in the morning, or foure howers after noone. Nexte ye must beware that no noble part be offended, nor much debilitated, for if the humor bee moued by the bathe, the pores & waies dilated, the humor goeth easily to the part offended. The partie must also before he enter be purged, no weake body should enter the rein. While he is in it, hee must keepe himselfe warme, the bathe must be meanely warme, neither too hot nor cold, for if it be too hot, it clo∣seth the pores of the skin, letteth the foorth cōming of the excrements,* 1.73 & heateth the blood. Hippocrates coūselleth to be silent in the bathe & in no waies cōmoned, if he wax feeble, he may take a litle wine or a sop of bread dipped in it, or some pruns to quēch his thirst, as coūselleth Cassius in his problemes, let him dry the sweat of his face & tēples & behind the eares. He must not stay so long the first day, as the rest,* 1.74 Hierodotus counselle••h to remaine halfe an hower at the first, afterwards an how•••• or two. After the cōming forth, the party must be well dried chiefly his head as coun∣selleth Hippocrates, for humidity is as gret an enemy to the head as cold, he must haue the passage open to the naturall excremēnts, & not eat of one houre after he come foorth of the bathe.

The seauenth Chapter, of fric∣tions and their effectes.

OF rubbing and frictions Galen hath amply written in his bookes de tuenda sanitate, as also Aetius, Paulus,* 1.75 and Oribasins, with sundrie other learned men, who haue vsed them for diuers occasions, & in diuers manners, some∣time with oyntmentes and oyles, which was in great vse amongst the Romaines and Greekes. Those who were olde vsed rubbing with oyle of irinum, camomelinum & nardinum. Hippocrates commendeth the same very much, for, saith he it hath the force to binde, loose,* 1.76 increase flesh and diminish the same, for harde rubbing doth loose and mollifie, much rubbing diminisheth the flesh, meane rub- doth augment and increase flesh. They are vsed for diuers other occasions, as ye haue heard, namely to loose and o∣pen the pores and conduits of the skin, to make thyn hu∣mors, and auoyd all obstructions, for the diuerting of flux∣ion from any part of the body, and especially frō the head. They must be done with a cloth or sponge, first softly and easily, sometime to continue till the flesh swell & become red, and may be done at all times, and chiefly in the mor∣ning, begining at the lower parts, so to ascend to the head, which is accompted generall rubbing. If any particulare part be diseased, rubbe onely the place affected whereby in sundry diseases diuers effectes are wrought.

Notes

• * 1.1

  Hippocrrates.
• * 1.2

  Heliogabilus •• serm. parti•• ••.
• * 1.3

  Age.
• * 1.4

  Rasu••.
• * 1.5

  Strength.
• * 1.6

  Hip. li 1. apho.
• * 1.7

  Lib. 2
• * 1.8

  Habitude
• * 1.9

  Gal le sangui. missione.
• * 1.10

  Countrie. Lanf••an. Gal. li. de arthritide.
• * 1.11

  Time. Hip. 7. apho.
• * 1.12

  Oribasi. arnold
• * 1.13

  Gal. de curandi ratione per san¦guine m••ssion. cap. 21.
• * 1.14

  Vse & custome
• * 1.15

  Signes.
• * 1.16

  afore bleeding.
• * 1.17

  Lanfrancus.
• * 1.18

  Albucrasis.
• * 1.19

  Lib. de aere et aqua.
• * 1.20

  Auice••. Haly Abbas.
• * 1.21

  H••ly Abbas.
• * 1.22

  Albucrasis. li. 4
• * 1.23

  Rafis. Oribafi∣us. Auicen. Ha∣ly Abbas.
• * 1.24

  Gal. Ra••••s.
• * 1.25

  Lib. 28
• * 1.26

  Lib. de sangui∣nis miss.
• * 1.27

  Gal. de secti-
• * 1.28

  Lib. 9.
• * 1.29

  Rasis.
• * 1.30

  ••asis. ••••tapallia.
• * 1.31

  Aetius lib. 3. Haly Abbas lib. 1.
• * 1.32

  Guliel. de salu••¦to.
• * 1.33

  Gal. Auic Aue∣rois.
• * 1.34

  Arist. lib. 2. de partis anmal. cap. 4. Gal. lib. de atra bile et de simp. med.
• * 1.35

  Caelicis.
• * 1.36

  Gal lib. 1. chro. Paul. lib. 6.
• * 1.37

  Albucrasis.
• * 1.38

  15. therapeutic.
• * 1.39

  Bartapallia.
• * 1.40

  Cuido.
• * 1.41

  Auicen 3. canod
• * 1.42

  Haly Abbas. lib. 9.
• * 1.43

  Gal. Auicen.
• * 1.44

  Albucrafis. Haly Abbas
• * 1.45

  Galen.
• * 1.46

  Albucrafis li. 2.
• * 1.47

  Arnoldus de villa noua. Haly Abbas.
• * 1.48

  Auicen. Theo∣docritus.
• * 1.49

  Albucrasis lib. 11.
• * 1.50

  4. apho. cem. 1.2.3. et 12.
• * 1.51

  Albuc. lib. 5.
• * 1.52

  Skinkins.
• * 1.53

  Guido.
• * 1.54

  Hip. Albuc.
• * 1.55

  Albuc. Cel. Hip
• * 1.56

  Albucra••••s.
• * 1.57

  Le fort de Len∣ry.
• * 1.58

  S. Pineo. H. Delanow.
• * 1.59

  Celsus. lib. 4. cap. 22.
• * 1.60

  Natural bathes
• * 1.61

  Salt. c.
• * 1.62

  Alluminou••.
• * 1.63

  Sulphuro••••.
• * 1.64

  Ironand steele.
• * 1.65

  Copp••rous.
• * 1.66

  Golde.
• * 1.67

  Leade.
• * 1.68

  Artificiall bathes.
• * 1.69

  Gal. de sauitate ••uenda lib. 3. Hip. Celsus. F••chius.
• * 1.70

  Hierodotus lib de temediis fo∣ris abhibendis.
• * 1.71

  Antillus.
• * 1.72

  Hip. apho. 54.
• * 1.73

  Hypp.
• * 1.74

  Hierodotus.
• * 1.75

  Paulu. Oribasins.
• * 1.76

  Hippocrates.