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

CHAP. XV. Of the Guts.

THe Guts thc instruments of distribution and expulsion, are of the same substance and composure with the stomacke, but that the site of the coates of the stomacke is contrarie to those of the guts. For that which is the innermost coate of the stomacke is the outermost of the guts, and so on the contrary. The figure of the guts is round, hollow and capacious, some more, some lesse according to the diverse bignesse.

But for the quantitie of the guts, some are small, some great, more or lesse, accor∣ding to the varietie of bodies. But they are sixe in number, for there be three small; the Duodenum, the Iejunum, or emptie gut, and the Ilion. Three great, the Blind, the Collicke, and the Right gut. All which have had their names for the following rea∣sons; the first, because it is extended the length of twelve fingers, like another sto∣macke, without any turning, or winding; of which greatnesse it is found in great bo∣died men, such as were more frequenly to be met withall in Galens time, than in this time of ours, in which this gut is found no longer than seven, eight, or nine fingers at the most, The cause of this length is, that there may be a free passage to the gate veine, comming out of the liver, as also to the artery and nerve which runne into it. For seeing that this gut may sometimes rise to the top of the liver, it would possesse the space under the bladder of the gall (with which it is often tinctured) if it had any revolutions that way, which is the passage for such like vessels. Others give another reason of this figure, which is, that there should bee nothing to hinder the easie and fit distribution of the perfectly concocted Chylus to the liver.

The second is called Iejunum, or the empty gut, not because it is absolutely so, but because it containes little in comparison of the other. There is a triple cause of this emptines; the first the multitude of the meseraick veines and arteryes which are about it, whereupon there is a greater and quicker distribution of the Chylus. The second is the vicinity or neighbourhood of the liver strongly drawing the Chylus con∣teined in it; the third is the flowing downe of the cholericke humor from the bladder

of the Gall into it, which ever and anon by its acrimony cleanses away the filth, and by continuall flowing sollicites it to expulsion. The third is called Ileon because it lyes betweene the Ilia or flankes, it differs nothing from the rest in substance and magnitude, but in this one thing, that there is more matter contained in it than in the rest, by reason of the paucity of the vessels terminated in it, that it is no marvell that there can be no exact demonstration made of them. The fourth is called Caecum or the Blind, because it hath but one passage to send out and receive in the matter. This gut hath a long and strait production, which according to the opinion of some (though altogether erroneous) often falls downe into the Scrotum in the rupture, or relaxation of the Rim of the Belly; for that production in the lower belly strongly stickes to the Peritonaeum or Rim, which hinders such falling downe. But Galen seemes by such a blind gut to haue meant this long and narrow production, and certainely so thinkes the common sort of Anatomists, but here Vesalius justly reprehended Galen. Wherefore Sylvius that he might free Galen of this fault, would haue us by the blind gut to understand the beginning of the collicke gut. The fift is called Colon (or col∣licke gut) because it is greater and more capacious than the rest. The sixt and last, the Right gut, by reason of the rightnes or straightnes of the passage. This in beasts especially, hath a certaine fatnesse in it to make the passage slippery, and lest the gut should be exulcerated in the passage, by the sharpenesse of hard and acrid excre∣ments.

The site of these guts in thus, The Duodenum upon the backebone bends to the right hand; the Ieiunum possesses a great part of the upper umbilicall region, diffu∣ses it selfe into both sides with windings, like to these of the gut Ileum, even to the flankes. The gut Ileon is situate at the lower part of the umbilicall region, going with many turnings and windings, even to the hollownesses of the holy-bone above the bladder and side parts of the Hypogastrium, which they call the flankes.

The Blind bends to the right hand, a little below the kidney, above the first and fourth Vertebra of the loines. The Colon or Collicke gut is crooked and bent, in the forme of a Scythian bow, filling all the space from the blind gut, below the right kidney, even to the hollownes of the liver, and then it goes by the gibbous part of the stomacke above the small guts, even to the hollownesse of the spleene; from whence sliding under the left kidney, with some turnings, it is terminated upon the Vertebra's of the loines.

By all which turnings and windings of the collicke gut, it is easie to distinguish the paine of the stone of the kidneies, which remaines fixt in one certaine place, from the collicke wandring through these crooked passages we mentioned. The right gut tends with an oblique site towards the left hand, upon the holy bone even to the very fun∣dament. They have all one and a common connexion; for they are all mutually joined together by their coats, because there is but one way from the gullet even to the fun∣dament, but they are joyned to the principall parts by their nerves, veines, and arte∣ries.

But a more proper connexion is that, where the Duodenum on the upper part of it, is joyned with the Pylo••us; but on the lower part, to the Ieiunum, and the parts lying under it, by the coate of the Peritonaeum. The Ieiunum, or emptie gut, is ioyned to the Duodenum and Ileon. The Ileum with the emprie and blind guts. The blind with the Ileon and Colon, and with the right side of the backebone where it is tied more straitly. The Colon with the blind and right guts, and in his middle part, with the kidneies and the gibbous part of the stomacke; whereby it comes to passe, that be∣ing distended with wind in the collike, it overturnes and presses the stomacke, and so causes vomiting.

Lastly, the right gut is annexed with the collicke gut and fundament. At the end whereof there is a muscle fastened, of figure round and circular called the Sphincter, arising from the lower Vertebra's of the holy bone and rump, by the benefit of which as of a dore or gate, the excrements are restrained at our will, lest man borne for all honest actions, without all shame, in every time and place, should be forced every where to ease his belly. For such as have lost the benefit of this muscle by the palsy, have their excrements goe from them against their wills. There is a body situate

at the end of the right gut, of a middle substance betweene the skinne and flesh, as it were arising from the mixture of them both, like the extremities of the lippes, of the same use with the Sphincter, but that it is not altogether so powerfull. But there are also certaine veines situate about it called the Haemorrhoidall, of which we will speake in their place.

Besides, there are two other muscles that descend to the end of this gut, being broad and membranous on each side, one arising from the side and inner parts of the share and hippe-bones, which inserted above the Sphincter pull up the fundament fal∣ling downe, wherefore they are called Levatores Ani, or the lifters up of the funda∣ment. Wherefore when as either they are too weake, or resolved, or the fundament oppressed with the weight of flegmaticke, salt, chollericke and sharpe humors, the gut is scarse restored into its place, that there is neede of the helpe of the fingers for that purpose.

The guts follow the temper of the stomacke. Their action is the distribution of the Chylus by the meseraicke veines (which of dutie belongs to the three small guts) and the receiving the excrements of the Chylus, and retention of them, till a fi•…•…ime of expulsion, which belongs to the third quarter. Besides, these small guts finish up the worke of concoction, begun in the stomacke, although they be not altogether made for that use. But nature is often accustomed to abuse the parts of the body for some better use.

[illustration]

The fisth figure of the lower belly.

A. The brest blade, Cartilago En∣siformis.

BB. The Rim, with the midriffe and broken ribs bent outwards.

CC. the gibbous part of the liver.

D. a ligament tying the liver to the midriffe.

E. part of the umbilicall veine.

FF. the stomack fild full of meate.

G. a part of the spleene.

H. the blind gut of the late wri∣ters, for the Ancients tooke the toppe of the colon for it.

I. the beginning of the great or thicke guts.

I. and so to K. sheweth the passa∣ges of the collicke gut from the right kidney to the liver. And so the collicke and the stone on this side are in one place, and therefore hardly distinguished.

K. to L. the same collicke gur li∣eth under the whole bottome of the stomacke, which is the reason that those which are troubled with the collicke cast so much.

L. to M. The passage of the Colon from the spleene to the share bone, by the left kidney, a way, which maketh the paine of the stone and the Collick on the left side very hard to distinguish. N. The Colon ending in the right gut. O. The beginning of the right gut unto the bladder. P. Q. The sunken or fallen side of the Colon at P. and his Chambers or Cells at Q. R. S. T. The lesser guts, especially lying under the Navil. a. a. The two umbilicall arteryes. b. The bottome of the bladder. * The connexion of the bladder and the Perito∣naeum.

But we must note, that for the composure of the guts, they have onely trans∣verse fibers, for expulsions sake, unlesse that at the beginning of the Colon, and the end of the right gut, you may see certaine right fibers added to the transverse to streng∣then them, left these guts should chance to be broken and torne by the passage of hard excrements, and the laborious endevour of expulsion (specially in brute beasts.)

But if any aske, how they have retention, being they want oblique fibers, he may know that the faeces are retained in the right gut, by the force of the Sphincter muscle, but oft times in the blind, by their hardnesse and abundance, whereby they sticke in the passage; but in the rest, by reason of their conformation into many windings and turnings. The length of the guts, is seven times more than the length of the whole body; to this length they have windings, least the nourishment should quickly slide away, and least men should bee withdrawne by gluttony from action and con∣templation. For so wee see it comes to passe in most beasts, which have one Gut, stretched straight out from the stomacke to the fundament; as in the Lynx and such other beasts of insatiable gluttony, alwayes, like plants, regarding their food.

Notes

• Their sub∣stance.
• Figure.
• Their number
• The Duode∣num.
• The Iejunum.
• Ileon.
• Caecum.
• Colon.
• Rectum:
• Their site,
• The distincti∣on betweene the collicke and the stone in the kidnies. Their con∣noxion.
• Why vomiting ha••pens in the collicke.
• The S••incter muscles of the fundament.
• Gal. lib. 5. de usu partium. ••ap. 〈◊〉〈◊〉▪
• Levatores Ani.
• The action of the guts.
• Their fibers.
• How the guts become fit to retaine.
• Their length.