The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

OF THE MEANES AND MANNER TO REPAIRE OR SUPPLY THE NATURALL or accidentall defects or wants in mans body. THE TWENTIE THIRD BOOKE. (Book 23)

CHAP. I. How the losse of the naturall or true eye may bee covered, hidden or shadowed.

HAving at large treated in the former Bookes of tumours, wounds, ulcers, fractures and luxations, by what meanes things dissolved and dislocated might bee united, things united separated, and su∣perfluities consumed or abated: Now it remaines that we speak * 1.1 of the fourth office or duty of the Chirurgian, which is to supply or repaire those things that are wanting by nature, through the default of the first conformation, or afterwards by some mis∣chance. Therefore, if that through any mischance, as by an in∣flammation, any mans eye happen to be broken or put out, & the humors spilt or wa∣sted, or if it be strucken out of his place or cavity wherein it was naturally placed, by any violent stroak, or if it waste or consume by reason of a consumption of the proper substance, then there is no hope to restore the sight or function of the eye, yet you may cover the deformity of the eye so lost (which is all you can doe in such a case) by this meanes: If that when you have perfectly cured and healed the ulcer, you may put another eye artificially made of gold or silver, counterfeited and enamelled, so that it may seem to have the brightnesse, or gemmie decencie of the naturall eye, in∣to the place of the eye that is so lost.

[illustration]

The formes of eyes artificially made of gold or silver, polished and enameled, shewing both the inner and outer side.

But if the patient be unwilling, or by reason of some other meanes cannot weare this eye so prepared, in his head, you may make another on this wise. You must have a string or wiar, of iron bowed or crooked, like unto womens eare-wiars, made to bind the head harder or looser as it pleaseth the patient, from the lower part of the head behinde above the eare, unto the greater corner of the eye, this rod or wiar must be covered with silke, and it must also be somewhat broad at both the ends, lest that the sharpenesse thereof should pierce or pricke any part that it commeth unto. But that end wherewith the empty hollownesse must be covered, ought to bee broader than the other, and covered with a thin piece of leather, that thereon the colours of the eye that is lost may be shadowed or counterfeited. Here followeth the figure or portraiture of such a string or wiar.

[illustration]

The forme of an iron wiar wherewith the deformity of an eye that is lost may bee shadowed or covered.

CHAP. II. By what meanes a part of the nose that is cut off, may be restored; or how in stead of the nose that is cut off, another counterfeit nose may be fasten∣ed or placed in the stead.

WHen the whole nose is cut off from the face, or portion of the no∣strils from the nose, it cannot bee restored or joyned againe: for it is not in men as it is in plants. For plants have a weake and fee∣ble * 1.2 heate, and furthermore it is equally dispersed into all the sub∣stance of the plant or tree, neither is it easie to be consumed or wa∣sted, for when the boughes or branches of trees are broken, torne, or cut away, they live neverthelesse, and will grow againe when they are set or graf∣ted; neither is there any seate for the heart rightly prepared in them from whence the heat must necessarily run, and disperse it selfe continually into all the parts there∣of. But contrariwise, the separated parts of more perfect living creatures, as of men, are incontinently deprived of life, because they have their nourishment, life, sense, and whole sustentation not of themselves, by faculties flowing or comming unto them from some other parts, neither are they governed by their own heat as plants, but by a borrowed heat, so that above or beside the naturall faculty of the liver, an∣other vitall faculty commeth unto it from the heart.

Wherefore in stead of the nose cut away or consumed, it is requisite to substitute another made by Art, because that nature cannot supply that defect: this nose so artificially made, must be of gold, silver, paper or linnen clothes glewed together, it must bee so coloured, counterfeited and made both of fashion, figure and bignesse, that it may as aptly as is possible, resemble the natural nose: it must be bound or stay∣ed with little threeds or laces unto the hinder part of the head or the hatte. Also if there be any portion of the upper lip cut off with the nose, you may shadow it with annexing some such thing that is wanting unto the nose, and cover it with the haire on his upper lippe, that he may not want any thing that may adorne or beautifie the face. Therefore I have thought it necessary to set downe the figure or forme of both these kindes.

[illustration]

The forme of a nose artificially made, both alone by it selfe, and also with the up∣per lip, covered at it were with the haire of the beard.

There was a Surgeon of Italy of late yeares which would restore or repaire the * 1.3 portion of the nose that was cut away after this manner. Hee first scarified the cal∣lous edges of the maimed nose round about, as is usually done in the cure of hare-lips:

then he made a gash or cavity in the muscle of the arme, which is called Biceps, as large as the greatnesse of the portion of the nose which was cut away did require: And into that gash or cavity so made, he would put that part of the nose so wounded, & bind the patients head to his arm as if it were to a poast, so fast that it might remain firme, stable and immoveable, and not leane or bow any way, and about forty dayes after, or at that time when he judged the flesh of the nose was perfectly agglutina∣ted with the flesh of the arm, he cut out as much of the flesh of the arme, cleaving fast unto the nose, as was sufficient to supply the defect of that which was lost, & then he would make it even, & bring it, as by licking, to the fashion & forme of a nose, as near as art would permit, & in the mean while he did feed his patient with ponadoes, gel∣lies, & all such things as were easie to be swallowed & digested. And he did this work of curing the place where the flesh was so cut out, only with certain balmes & agglu∣tinative liquors. A younger brother of the family of St. Thoan, being weary of a silver * 1.4 nose, which being artificially made, he had worn in the place of his nose that was cut off, went to this Chirurgian into Italy, & by the means of the fore-named practice he recovered a nose of flesh againe, to the great admiration of all those that knew him before. This thing truly is possible to be done, but it is very difficult both to the pati∣ent suffering, and also to the Chirurgian working. For that the flesh that is taken out of the arme, is not of the like temperature as the flesh of the nose is, also the holes of the restored nose cannot be made as they were before.

CHAP. III. Of the Placing of teeth artificially made in stead of those that are lost or wanting.

IT often times happeneth that the fore teeth are moved, broken or stricken out of their places by some violent blow, which causeth deformity of the mouth, and hinders plain pronunciation. Ther∣fore when the jaw is restored (if it were luxated or fractured) and the gums brought unto their former hardnesse, other teeth artifi∣cially made of bone or Ivory may bee put in the place of those that are wanting, and they must bee joyned one fast unto another, and also so fastened unto the naturall teeth adjoyning, that are whole; and this must chiefly bee done with a thread of gold or silver, or for want of either, with a com∣mon thread of silke or flaxe, as it is declared at large by Hippocrates, and also descri∣bed in this figure following. * 1.5

[illustration]

The figure of teeth bound or fastned together.

CHAP. IIII. Of filling the hollownesse of the Pallat.

MAny times it happeneth that a portion or part of the bone of the pallat, * 1.6 being broken with the shot of a gun, or corroded by the virulency of the Lues venerea, falls away, which makes the patients to whom this happe∣neth, that they cannot pronounce their words distinctly, but obscurely and snuffling: therefore I have thought it a thing worthy the labour to shew the meanes how it may be helped by art. It must be done by filling the cavity of the pallat with a plate of gold or silver a little bigger than the cavity its selfe is. But it must bee as thick as a French Crowne, and made like unto a dish in figure, and on the upper side, which shall be towards the braine, a little spunge must bee fastened, which, when it is moistened with the moysture distilling from the brain, will become more swolne and puffed up, so that it will fill the concavity of the pallat, that the ar∣tificiall pallat cannot fall down, but stand fast and firme, as if it stood of it selfe. This is the true figure of those instruments, whose certain use I have observed not by once or twice, but by manifold triall in the battels fought beyond the Alpes.

[illustration]

The figure of plates to fill or supply the defects of the Pallat.

[illustration]

The figure of another plate for the Pallat, on whose upper side there is a button which may be turned when it is put into the place, with a small Ravens bill, like this whose figure is here expressed.

CHAP. V. How to helpe such as cannot speake by reason of the losse of some part of the tongue.

CHance gave place and authority to this remedy, as to many other in our art. * 1.7 A certaine man dwelling in a village named Yvoy le Chastean, being some twenty foure miles from Bourges, had a great piece of his tongue cut off, by which occasion hee remained dumbe some three yeares. It happened

on a time that as hee was in the fields with reapers, hee drinking in a woodden dish, was tickled by some of the standers by, not enduring the tickling, hee suddenly broke out into articulate and intelligible words. He himselfe wondring thereat, and delighted with the novelty of the thing, as a miracle, put the same dish to his mouth just in the same manner as before, and then he spake so plainly and articulately, that he might be understood by them all. Wherefore a long time following he alwaies carried this dish in his bosome, to utter his mind, untill at length necessity, the mistris of arts and giver of wit, inducing him, hee caused a woodden instrument to be neatly cut and made for him, like this which is here delineated, which hee alwaies carryed hanging at his neck, as the onely interpreter of his mind, and the key of his speech.

[illustration]

An instrument made to supply the defect of the speech when the tongue is cut off.

The use of the Instrument is this.

A. sheweth the upper part of it which was of the thicknesse of a nine-pence, which he did so hold betweene his cutting teeth, that it could not come out of his mouth, nor bee seene. B. sheweth the lower part, as thick as a sixe-pence, which he did put hard to the rest of his tongue, close to the membranous ligament which is under the tongue. That place which is deprest and somewhat hollowed, marked with the let∣ter C. is the inner part of the instrument. D. sheweth the outside of the same. Hee hanged it about his necke with the string that is tyed thereto.

Textor the Physician of Bourges shewed me this instrument: and I my selfe made tryall thereof on a young man whose tongne was cut off, and it succeeded well, and took very good effect. And I think other Surgeons in such cases may do the like.

CHAP. VI. Of covering or repairing certain defects or defaults in the face.

IT oftentimes happeneth, that the face is deformed by the sudden fla∣shing of Gunpowder, or by a pestilent Carbuncle, so that one cannot behold it without great horrour. Such persons must be so trimmed and ordered, that they may come in seemely manner into the company of others. The lips if they bee either cut off with a sword, or deformed with the erosion or eating of a pestilent Carbuncle or ulcerated Cancer, so that the teeth may be seene to lye bare with great deformity. If the losse or consumption of the lip bee not very great, it may be repaired by that way which we have prescribed in the cure of hare, lips, or of an ulcerated Cancer. But if it be great, then must there be a lip of gold made for it, so shadowed and counterfeited, that it may not be much unlike in colour to the naturall lip, and it must be fastened and tyed to the hat or cap that the patient weareth on his head, that so it may remaine stable and firme.

CHAP. VII. Of the defects of the eares.

SUch as want their eares, either naturally or by misfortune, as through a wound, carbuncle, cancer, or the biting of wild beasts: if so be that the eare be not wholly wanting, wasted, consumed, or torne away, but that some portion thereof doth yet remaine, then must it not bee neg∣lected, but must have many holes made therein with a bodkin, and after that the holes are cicatrized, let some convenient thing, made like unto the piece of the eare that is lost, bee tyed or fastned unto it by these holes.

But if the eare bee wholly wanting, another must bee made of paper artificially glewed together, or else of leather, and so fastened with laces, from the toppe or hinder part of the head, that it may stand in the appointed place, and so the haire must be permitted to grow long, or else some cap worne under the hat which may hide or cover the deformity, unlesse you had rather have it to bee shadowed and counterfeited by some Painter, that thereby it may resemble the colour of a naturall eare, and so retein it in the place where it ought to stand, with a rod or wiar comming from the toppe or hinder part of the head, as wee have spoken before in the losse of the eye; and the forme thereof is this.

[illustration]

CHAP. VIII. Of amending the deformity of such as are crooke-backt.

THe bodies of many, especially young maids or girles (by reason that they are more moist and tender than the bodies of boyes) are made crooked in processe of time, especially by the wrenching aside and crookednesse of the backe-bone. It hath many causes, that is to say, in the first con∣formation * 1.8 in the wombe, and afterwards by misfortune, as a fall, bruise, or any such like accident, but especially by the unhandsome and undecent situation of their bo∣dies, when they are young and tender, either in carrying, sitting or standing (and es∣pecially when they are taught to goe too soone) saluting, sewing, writing, or in do∣ing any such like thing.

In the meane while, that I may not omit the occasion of crookednesse, that hap∣pens seldome to the country people, but is much incident to the inhabitants of great townes and cities, which is by reason of the straitnesse and narrownesse of the gar∣ments

that are worne by them, which is occasioned by the folly of mothers, who while they covet to have their young daughters bodies so small in the middle as may be possible, plucke and draw their bones awry, and make them crooked. For the li∣gaments of the back-bone being very tender, soft and moist at that age, cannot stay it strait, and strongly, but being pliant, easily permits the spondels to slippe awry in∣wards, outwards, or sidewise, as they are thrust or forced.

The remedy for this deformity is to have breast-plates of iron, full of holes all o∣ver them, wherby they may be lighter to wear; and they must be so lined with bom∣bast, that they may hurt no place of the body. Every three moneths new plates must be made for those that are not yet arrived at their full growth, for otherwise by the daily afflux of more matter, they would become worse. But these plates will do them small good that are already at their full growth.

[illustration]

The forme of an iron Breast-plate, to amend the crookednesse of the Body.

CHAP. IX. How to relieve such as have their urine flow from them against their wills, and such as want their yards.

IN those that have the strangury, of what cause soever that malady commeth, the urine passeth from them by drops, against their wils and consent. This accident is very grievous and troublesome, es∣pecially to men that travaile: and for their sakes onely I have in∣vented the instrument here beneath described. It is made like un∣to * 1.9 a close breech or hose, it must be of latin, & to contein some four ounces; it must be put into the patients hose, between his thighs, unto which it must be tied with a point by the ring. Into the open and hollow mouth of this instrument, which is noted with the letter C. the patient must put his yard, & into this concavity or hollownesse goeth a stay somewhat deep, it is marked with the letter B. and made or placed there, both to hold or beare the end of the yard, and also by his close joint that it must have unto the vessell, to stay the urine from going backe againe, when it is once in. But the letters A. and D. doe signifie all the instrument; that the former part, and this the hinder part thereof. Now this is the shape thereof.

[illustration]

The figure of an instrument, which you may call A Bason, or receptacle for the Urine.

Those that have their yards cut off close to their bellies, are greatly troubled in making of urine, so that they are constrained to sit downe like women, for their ease. I have devised this pipe or conduit, having an hole through it as big as ones finger, which may be made of wood, or rather of latin.

A. and C. doe shew the bignesse and length of the pipe. B. sheweth the brink on the broader end. D. sheweth the outside of the brinke. This instrument must be ap∣plied to the lower part of ospectinis: on the upper end it is compassed with a brink for the passage of the urine, for thereby it will receive the urine the better, and carry it from the patient, as he standeth upright.

[illustration]

The description of a pipe, or conduit, serving instead of the yard in ma∣king of water, which therefore wee may call an arti∣ficiall Yard.

CHAP. X. By what meanes the perished function or action of a thumbe or finger may be corrected and amended.

WHen a synew or tendon is cut cleane asunder, the action in that part, whereof it was the author, is altogether abolished, so that the member cannot bend or stretch out it selfe, unlesse it bee holpen by art: which thing I performed in a certain gentleman belonging to Annas of Mont∣morency, * 1.10 generall of the French Horsemen, who in the battle of Dreux received so great a wound with a back-sword, upon the outside of the wrest of the right hand, that the tendons that did erect or draw up the thumb were cut clean in∣sunder, & also when the wound was throughly whole and consolidated, the thumb was bowed inwards, and fell into the palme of the hand, so that he could not extend or lift it up, unlesse it were by the helpe of the other hand, and then it would present∣ly fall downe againe; by reason whereof he could hold neither sword, speare, nor Javeline in his hand, so that he was altogether unprofitable for war, without which he supposed there was no life. Wherefore hee consulted with me about the cutting away of his thumbe, which did hinder his griping, which I refused to doe, and told him that I conceived a meanes how it might bee remedied without cutting away. Therefore I caused a case to bee made for it of Latine, whereinto I put the thumbe: this case was so artificially fastened by two strings that were put into two Rings, made in it above the joint of the hand, that the thumbe stood upright, and straight out, by reason whereof he was able afterwards to handle any kinde of weapon.

[illustration]

The forme of a thumbe or finger-stall of iron or latine, to lift up or erect the thumbe, or any other finger that cannot be erected of it selfe.

If that in any man the finewes or tendons which hold the hand upright, be cut asunder with a wound, so that hee is not able to lift up his hand, it may easily bee e∣rected or lifted up with this instrument that followeth, being made of an equall, streight, thin, but yet strong plate of latine, lined on the inner side with silke, or any such like soft thing, and so plac't in the wrest of the hand, that it may come unto the palme, or the first joints of the fingers, and it must bee tyed above with convenient stayes, and so the discommodity of the depression, or hanging of the hand, may bee avoyded; therefore this instrument may be called the Erector of the hand.

[illustration]

The Erector of the Hand.

CHAP. XI. Of helping those that are Vari or Valgi, that is, crooke-legged or crooke-footed, inwards or outwards.

THose are said to bee Varous, whose feet or legs are bowed or crooked in∣wards. * 1.11 This default is either from the first conformation in the wombe, through the default in the mother, who hath her legs in like manner croo∣ked; or because that in the time when she is great with child, she common∣ly sits with her legs a crosse: or else after the child is born, & that, either because his legs be not well swathed, when he is laid into the cradle, or else because they bee not well placed in carrying the infant, or if he be not wel looked unto by the nurse when he learneth to goe, for the bones of infants are very tender, and almost as flexible as Waxe.

But contrariwise, those are called valgi, whose legs are crooked or bowed out-wards. * 1.12 This may come through the default of the first conformation, aswell as the other, for by both, the feet and also the knees may bee made crooked; which thing, whosoever will amend, must restore the bones into their proper and naturall place, so that in those that are varous hee must thrust the bones outwards, as though hee would make them valgous, and in those that are valgous, hee must thrust the bones inwards, as though hee would make them varous: neither is it sufficient to thrust them so, but they ought also to be retained there in their places after they are so thrust, for otherwise they being not well established, would slip back againe.

They must bee stayed in their places by applying of collers and bolsters on that side whereunto the bones doe leane and incline themselves; for the same purpose boots may be made of leather, of the thicknesse of a testone, having a slit in the for∣mer part all along the bone of the leg, and also under the sole of the foot, that being drawne together on both sides, they may be the better fitted, and sit the closer to the leg. And let this medicine following be applyed all about the leg. ℞. thuris, mastich. * 1.13 aloës, boli armeni, an. ℥i. aluminis roch. resinae pini siccae, subtilissimè pulveris. an. ʒiii. fa∣rinae volat. ℥iss. album. ovor. q. s. make thereof a medicine. You may also adde a lit∣tle turpentine, lest it should dry sooner, or more vehemently than is necessary. But you must beware, and take great heed lest that such as were of late varous or valgous should attempt or straine themselves to goe before that their joynts be confirmed, for so the bones that were lately set in their places, may slip aside againe. And more∣over,

untill they are able to goe without danger, let them weare high shooes tyed close to their feet, that the bones may be stayed the better and more firmely in their places, but let that side of the soale of the shooe be underlayed whither the foote did incline before it was restored.

[illustration]

The forme of little bootes, whereof the one is open and the other shut.

CHAP. XII. By what meanes armes, legs, and hands may be made by art, and placed in stead of the naturall armes, legs, or hands that are cut off and lost.

NEcessity oftentimes constraines us to find out the meanes whereby we may help and imitate nature, and supply the defect of members that are perished and lost. And hereof it commeth that we may performe the functions of going, standing and handling with armes and hands made by art, and undergoe our necessary flexions and extensions with both of them. I have gotten the formes of all those members made so by art, and the proper names of all the engines and instruments wherby those artificially made are called, to my great cost and charges, of a most ingenious & excellent Smith dwel∣ling at Paris, who is called of those that know him, and also of strangers, by no other name than the little Loraine, and here I have caused them to bee portrayed or set downe, that those that stand in neede of such things, after the example of them, may cause some Smith, or such like workman to serve them in the like case. They are not onely profitable for the necessity of the body, but also for the decency and comeli∣nesse thereof. And here followeth their formes.

[illustration]

The forme of an hand made artificially of iron.

[illustration]

This figure following sheweth the back-side of an hand artificially made, and so that it may be tyed to the arme or sleeve.

[illustration]

The forme of an arme made of iron very artificially.

[illustration]

The description of legs made artificially of iron.

[illustration]

The forme of a woodden Leg made for poore men.

A. Sheweth the stump or stock of the woodden leg. BB. Sheweth the two stayes which must bee on both sides of the leg, the shorter of them must bee on the inner side. CC. Shew∣eth the pillow or bolster whereon the knee must rest in the bottome between the two stayes, that so it may rest the softer. DD. Sheweth the thongs or girths with their round buckles, put through the two stayes on either side to stay the knee in his place firm and im∣moveable, that it slip not aside. E. Sheweth the thigh it selfe, that you may know after what fashion it must stand.

It happens also many times, that the patient, that hath had the nerves or tendons of his leg wounded, long after the wound is whole and consolidated, cannot goe but with very great paine and torment, by reason that the foot cannot follow the muscle, that should draw it up. That this maladie, may be remedied you ought to fasten a lin∣nen band made very strong, unto the shooe that the patient weareth on that his pai∣ned foot, and at the knee it must have a slit where the knee may come forth in bowing of the leg, & it must be trussed up fast unto the patients middle, that it may the better lift up and erect the foot in going. This band is marked in the figure following with the letters AA.

[illustration]

CHAP. XIII. Of amending or helping lamenesse or halting.

HAlting is not onely a great deformity, but also very troublesome and grie∣vous. Therefore if that any man be grieved therewith by reason that one of his legs is shorter than the other, it may be holpen by putting under his short foot this sitting crutch, which we are now about to describe. For by the helpe of this, he shall not onely goe upright, but also more easily and with lit∣tle labour or no pain at all. It was taught mee by Nicholas Picard Chirurgian to the Duke of Loraine. The forme thereof is this.

[illustration]

A. Sheweth the staffe or stilt of this crutch, which must bee made of wood. B. Sheweth the seat of iron whereon the thigh resteth, just under the buttocke. C. Sheweth a prop which stayeth up the seat whereon all the weight of the patients body resteth. D. Shew∣eth the stirrop, being made of iron, and bowing crooked upwards, that the foot may stand firm, and not slip off it when the patient goeth. E. Sheweth the prop that stayeth or hold∣eth up the stirrop to strengthen it. F. Sheweth the foote of the stilt or crutch made of i∣ron with many pikes, and compassed with a ring or ferule, so to keepe it from slipping. G. The crosse or head of the crutch which the patient must put under his arme-hole to leane upon, as it is to be seene in the figure.

The End of the Twentie third Booke.

Notes

• * 1.1

  The fourth du∣ty of a Surgeon.
• * 1.2

  Why the parts of plants being cut off, may grow againe, but those of man cannot.
• * 1.3

  A strange cure for a cut off nose
• * 1.4

  A history.
• * 1.5

  Sect. 〈◊〉〈◊〉. lib. de art. sent. ••5.
• * 1.6

  The causes and hurt that ensues of the lost pallat.
• * 1.7

  A remedy found out by accident. A history.
• * 1.8

  Causes of croo∣kednesse.
• * 1.9

  An instrument for such as can∣not hold their water.
• * 1.10

  A history.
• * 1.11

  What varus is.
• * 1.12

  What valgus is.
• * 1.13

  A plaster to hold fast rest. red bones.