The surgions directorie, for young practitioners, in anatomie, wounds, and cures, &c. shewing, the excellencie of divers secrets belonging to that noble art and mysterie. Very usefull in these times upon any sodaine accidents. And may well serve, as a noble exercise for gentle-women, and others; who desire science in medicine and surgery, for a generall good. Divided into X. parts. (Whose contents follow in the next page.) / Written by T. Vicary, Esquire, chyrurgion to Hen 8. Edw. 6. Q. Mary. Q. Eliz.

For Practice. It is necessary to know what Letch∣craft and Chyrurgerie is, with their severall parts thereto belonging in the Theorick and Practick. Very usefull for young Practitioners. PART. II. (Book 2)

Letchcraft is Chyrurgerie; that is, to heale a man of all manner of Sicknesse and to keepe him whole, so farre as craft may.

KNow that in Letchcraft, is con∣tayned two things; that is, both Physicke and Chyrurgerie.

Likewise, Letchcraft and Chy∣rurgerie, hath each of them two Parts, viz. Theoricke, and Practicke. Theorick to know, and Practicke to worke. The ground of the

Theoricke, is to know the Elements, and Hu∣mours that proceedeth from them, which is for mans health or against it.

Letchcraft, teaches us Causes, effects, and Signes: Signes to know the causes and effects; and therefore J treat of signes, and many signes doth belong to Physicke and Chyrurgerie, as Crisses, Urine, Pounces, Vomits, Sege, and other, &c.

Chyrurgerie, is in Wounds, Impostumes, and Algebra; and Chyrurgerie holdeth foure parts, viz. Wounds, and Impostumes, Alge∣bra, and Anatomie. And Antidotary is the fift; which is a kind of Salves against all kind of Sores that belongeth to Chyrurgerie.

Algebra is broken Bones, and bones out of joynt.

Antidotary of Chyrurgerie, is in Waters, Powders, Oyles, Oyntments, and Emplaisters most principall, some must bee repercussive, some Moleficative, some Maturative, some ge∣nerative, and some Corosive.

Anotomie is to know the Body of man throughout, and all his Members within and without. Two members hath every manner of man, viz. Principall, and Officiall; and foure principall every man hath, viz. Braine, Heart, Liver, and Stones; the Braine hath the

head and necke: the Heart, hath the Lungs, Brest, and Midriffe: the Liver hath the sto∣macke, and other members downe to the Reynes, as Guts, Gall, and the Kelle veyne, and Milt, the Milt upon the left side, and the gall upon the Liver: the Stones, hath Reynes, Bladder, and other Privities: and these are the foure principall members, Braine, Heart, Liver, and Stones; and without Braine, Heart and Liver, no man can live; and without Stones can no man engender, three things in the Stones is cause of engendring; Heat, Wind and humours, Heat commeth from the Liver, Spirit from the Heart, and humours from the Braines that man is made of, if any of these foure be faulty, that man can not as he should kindly engender.

These sixe vertues are rooted in the Liver, viz. Attractive, Digestive, Diminusive, Ex∣pulsive, Retentive, and a Simulative, that is in our English tongue; Drawing, and breaking out, putting, holding, and liking: For first, Nature draweth in that which it needeth to live by, and then all to breake it; and then departeth the good from the bad, and holdeth to it the good, and then dispierseth the good to all the members of the Body.

Officiall members bee those that have cer∣taine

offices in mans Body, where ever they be; as the Eye to see, the Eare to heare, the Hand to touch, the Mouth to speake, the Feet to goe, and many such other, &c.

Also such are called members as branches from the principall to the officiall, as the Arme, or Legge, that rooteth in the principall and brancheth to the officials: And so Nerves, Artiers, Veynes, Lygaments, Chords, Bones, Pannicles, and Gristles, Flesh and Skin to teach them▪their Office: But Nerves, Veynes, and Artiers bee most needfull, for they bee Wells and Rootes of all other Nerves com∣ming from the Braine, and Artiers from the Heart, and Veynes from the Liver into all the body: Nerves giveth to the Body feeling, and moving, and Artiers leaving, and Veynes increasing. A Veyne hath but one Tunacle, and an Artier hath two, in the one runneth Bloud, and in the other spirits, and all beating Veynes bee Artiers, the which J call Pulses, and all other be simple Veynes; and all such members saving Flesh alone are melancholi∣ous, and their nature is Sperme, but flesh is Sanguine; and therefore it may be sodered be it never so much cut, but the other said mem∣bers because their matter is Sperme, may ne∣ver be sodered if they be much cue.

Now will J speake of Wounds, which is the second part of Chyrurgerie.

ONe of these intentions hath every Surgi∣on. The first is, to containe that, that i•• evill, loosed; the second is, to loose that, that is evill contained; the third is, to take away that, that is too much; the fourth is, to in∣crease that, that is too little.

In these foure entents standeth all Chirur∣gery. The first is in Wounds, the second is Impostumes, the third and fourth Alg••br•• holdeth. Wounds be in many manners Sim∣ple, and Compound: Simple in the flesh a∣lone, and compound in seven manners. There be seven things that letteth a wound not light∣ly to heale, viz. Empostumes discrased, hollownesse, or bitten by a venemous Beast; and these letteth a Chirurgion suddenly to heale a wound; and if a Sinew bee cut or pricked, or wounded to the Bone, or if the wound bee hollow, or else discrased with a Fever, or bruised, or made by venemous Beasts, then mayest thou not as thou wouldest close up a wound. And if a wound lacke all these seven things, then it is simple.

Thus Medicine is Letchcraft; that is both

Physicke and Chirurgery. and every one of them hath first his Theoricke, perfectly to know, and afterwards his Practique, cun∣ningly to worke: the grounds of both which Qualities, are Elements, and Humours, and ••••••nes most needfull both of Urine and Pulses.

Thus much for the Theoricke.

Divers things very necessary for every Practitioner in Surgerie to have in a readinesse.

And first, for Instruments, viz.

NOvacula.	Sp••••ill••••.
S••alp••ll••••.	Lat•••• Sp••••ill••••▪
For••icis.	Stylu••.
Volsell••.	Acu••.
Ca••••li••ula Forata.	Fas••i••.

• Hab•••••• ad membra laqu•••• intepcipi••••d••.
• Panni••uli linei ad v••l••••ra abliga••••••.
• Lint••a conc••rpta. A••ris••alpiu••••.
• Forcip••s ad d••••tes ••v••ll••nd••s.
• Ferra••entu•• qu•• ••r••••i d••ntes, ••rad••••tur.
• ••n••inus, or (as C••lsu•• calleth it,) Hamul•••• ••••••••sum.

2. For sodaine Accidents.

HE must have in readinesse, Powders, Un∣guents, and Emplasters; They serve to stop Bleeding, to conglutinate Wounds, to clense foule and rotten Ulcers, to mollifie hardnesse, to produce a Cicatrix, and Skinne, to remove away all excrescent and corrupt Flesh, to cease paine, to strengthen Fractures and Luxations.

3. For Powders.

THey are of three sorts: The first, is to stay▪ Bleeding, as that which is framed of Bolus▪ Armoniae, of Rosis, of Mastickes, and Pollin.

The second is, for Fractures of the Scull, and hurts of other Bones, and is called Pulvis Cephalicus, and is framed of Radicibus ir••os, of Arist••l••••••iae, of Myrrhe, Aloes, and such like.

The third is, to remove away excrescent and corrupt Flesh; as Alumen ustu••, of Pul▪prae∣••ipit. Mer••urii, and such like.

4. For Ʋnguents.

HE must have Vnguentum Basilicon, which doth humect, digest, and cease paine.

Vnguentum album▪Rhasis, which doth Re∣frigerate, coole and dry.

Vnguentum Aureum called of some Regis, which doth Incarnate and conglutinate Wounds together.

Vnguentum Dialthea simplex, which doth Calefie, soften, humect, and also cease paine.

Vnguentum Apostolorum, which doth deterge, mollifie, dry, and remove away cor∣rupt and superfluous Flesh: And of like faculty almost is Mundificativum ex api••, and Aegyptiacum.

5. For Emplasters.

DIachilon compositum, which doth ripen Apostumes, and doth mollifie and resolve hardnesse, and doth digest, and also absterge.

Diacalciteos, commonly called Diapalma, which doth conglutinate Ulcers, produceth Cicatrix and skinne, and according to the opinion of Galen, is very fit for the curing of Phlegme.

Emplastrum de Betonica, which is also called De Janua, it doth unite and joyne to∣gether

the fractures of the skull, it covereth the bones with flesh, it draweth out Spels and splinters of bones, it doth also absterge, digest and dry, with the like.

Of five H••arbes which a good Chyrurgion ought alwayes to have.

THere be five Herbes that a good Chirur∣gion ought to have all the yeare, and they be good for wounded men; and these Herbes must be dryed and made into powder, and so kept all the yeare, viz. Mouse-eare, Pim∣pernell, Avence, Valerian, and Gentian, of each a like quantity, but take of Mouse-eare the weight of all the other hearbes, when they be dryed, take d••mi. spoonfull in untiment, or in some other liquor which is according to the sicknesse, and let him drinke it, and the Medi∣cine is as good as a Salve for any wounded man, as may be had for to heale him. Also the herbes that draweth the wound, are O••∣••ulus Christi, Mather, Buglosse, red Cole∣worts, and Orpine.

These be the soveraigne pepper hearbes for the Fester, h••arbe Robert, Buglosse, Sannacle, Hempropes, Morrell, Rew, and Savorie, but sake good heed of these hearbes in the use of them, and yee shall worke the better.

Some Physicall observations tending to Physicke and Surgerie, and times convenient for letting of Blood.

To preserve Health.

IF a man will observe, hee may go∣verne himselfe at foure times in the Yeare, so that hee shall have little need of Let••hcraft, as thus▪

In the Spring, from March till May at which time increaseth the good sweet▪ 〈…〉〈…〉 Blood, through good meates and 〈…〉〈…〉 good wholsome savours.

In Summer, from May till June, at which time beginneth the bitter juyce of Choller▪ then use coole meats, and drinkes, and bee not violent in exercise, and forbeare women.

In Harvest, from June till November, at which time increaseth Melancholy; then bee purged by a Medicine Laxative, and afterward use light Meats and drinkes, such as will in∣crease good Blood.

In Winter, from November till Mar••h▪

at which time increaseth Flegme, through weaknesse of Humours, and corruption of ayre; Then the Pose beginneth to grow, then heat is in the Veynes, then is pricking in the sides, then is time to use hot Meats and good drinkes▪ and spices, as Pepper, Ginger, &c. but doe not wash thy Head.

For as a learned Physitian saith; Hee that taketh much Physick when he is young, will much repent it when he is old.

For letting of Blood.

AS in all other parts of Physicke so great care ought to be had in letting of Blood. First, skilfully and circumspectly is to be con∣sidered and certainly knowne the cause. As whether it be needfull and good for the Pati∣ent, to purge his body of some unnaturall and naughty, and superfluous humour. For other∣wise, letting of Bloud is very dangerous, and openeth the way to many grievous Infirmities. And note generally▪ that it is not convenient, eyther for a very leane and weake man, or for a very fat and grosse man to be let bloud, nei∣ther for a Child under 14. yeares of age, nor an old man above 56. Especially, in decrepit old age.

Now there remaineth to be considered, how it standeth with the patient inwardly, for his Complexion and Age, and outwardly, for the time of the Yeare, time of the Day, and also for Dyet.

For Complexion.

Let bloud the Phlegmatick, the Moone being in Aries or Sagitarius.

Let bloud the Melancholick, the Moone in Libra or Aquarius.

Let bloud the Cholerick, the Moone being in Cancer or Pisces.

Let blood the Sanguine, the Moone in ey∣ther of the aforesaid Signes.

For Age.

• Let blood Youth; from the Change to the second quarter.
• Middle-age, from the 2. quarter to the full.
• Elder-age, from the full to the last quarter.
• Old-age, from the last quart▪ to the change.

Time of the Yeare.

Spring good. Autumne different.

Time of the Moneth.

• Let not blood, The Moone in Taurus, Gemini, Leo, Virgo, or Capric••rne.
• The day before nor after the change and full.
• Twelve houres before and after the quarters.
• The Moone with Jupiter, or Mars, evill aspected.

Time of the Day.

Morning after sun-rising fasting; Afternoon, after perfect digestion; the ayre temperate, the wind not South, if it may be.

Dyet after Bleeding.

Sl••••pe not presently, Stirre not violently; Vse no venery, Feed, thou warily.

Notwithstanding, for the Phrensie, the Pe∣stilence, the Squinancy, the Plurisie, the Apo∣plexi••, or a continuall Head-ach growing of cholerick blood, a hot burning Feaver, or any other extreame paine; In this case, a man may not tarry a chosen time, but incontinently with all convenient speed▪ hee is to seek for remedy; but then Blood is not to bee let in so great a quantity, as if that a chosen and fit time were to be obtained.

Good to—

• Prepare humours, the Moon in Gemini, Libra, or Aquarius.
• Vomit, the Moon in Aries, Taurus, or Capr.
• Purge by Neezing, the Moone in Cancer, Le••, or Virgo.
• Take Clysters, the Moone in Aries, Librae, or Scorpio.
• Take Gargarismes, the Moone in Cancer, or

• Stop rheumes and Flux, the Moon in Taurus, Virgo, or Capric••rn••.
• Bathe for cold Diseases, the Moone in Aries, L••••, or Sagitarius.
• Bathe for hot Diseases, the Moone in Cancer, Scorpio, or Pisces.
• Purge with Electuaries, the Moon in Cancer.
• Purge with Potions, the Moone in Scorpio.
• Purge with Pilles, the Moon in Pisces.

For an Unguent or Plaister, is best to bee applyed, when the Moone is in the imaginary Sig••e attributed to the members whereunto it is applyed.

Of the Nine Tastse.

SAlt, Sharpe, and Bitter, Sower, Savory, and Eager, Sweet, Walloweth, and Fatty-Three of them bee of Heat, three of Cold, and the last three be of temperature. A cut chafeth, heateth, and fleyeth: Temperature delighteth, Lycorise, Annis, Ginger, Worme∣wood, and Suger: these bee Examples: a cut raweth, heateth, and fleyeth, and Nature there against ripeth, and twineth, and putteth out: make your Medicine such, that for one putting out, double twining, and foure riping.

Melancholy is dry and cold, sower and

earthly coloured, his Urine is thinne and dis∣coloured, his Pulse is straight, and short in digestion, and a full stomacke, loathsomenesse, and sower belching, a swelling wombe, and sides, heavie, dead, and sluggish limbes, and melancholious Urine commeth of a young wench that faileth in her flowers, or have them not as shee ought to have.

Fleame, cold and moyst, white, and weake in colours, his Urine is discoloured and thicke, his Pulse is short and broad; raw stomacke; and full, loathsome, and unlusty, watry mouth, much spitting, heavy head, sluggie, and slumbry, with cold hands and feete, and chiefly in the Night.

Sanguine is moyst, and hot, sweet, and ruddy coloured, alway his Body is full of heate, namely in the Veynes, and they bee swelling, and of face he is ruddy, and in sleepe hee seemeth fiery: Medicine for him is bloud let upon the Currall or Liver Veyne, and simple dyet, as Tyson, Water Grewell, and sower bread.

Choller is hot, and dry, yellow, greene and bitter, Urine is discoloured, and thinne, his Pulse is long and straight, much watch, heavy head ache, and thirst, bitter mouth, and dry, singing cares, and much gnawing in the

Wombe, and other while costiffenesse, and burned Sege, and vomit, both yellow and greene, as is that colour.

Each Humour may cause a Fever or an Im∣postume, and then the Urine is more coloured, and the liquour thinner: and ever as that sicknesse defieth, the Urine waxeth thicker, and the colour lower, till it come to Cytrin or subrufe.

Melancholy causeth a Quartaine, and Fleame a Quotidian. Sinec and Causon have ever Continues, the other three may be so, and otherwhile Interpolate, continue ever holdeth on, and Interpolate resteth other∣while; continue is with the Veynes, and In∣terpolate is without the Veynes, both two wayes may bee simple and also compound, simple of one matter, and one place, or com∣pound of divers places.

The Tertians of these Fevers be such, as the same humors be of, and also Urine and Pulse: All saving they bee stronger in Fevers and Impostumes then they be without, and there∣fore their Medicine must bee more discreet, but generally Dyet thus: Sowre bread, and Water-grewell, and Tyson, and fleyed Fish and Wine, and Almond milke, and all white meate saving whay, generall digestive in

Summer, and in hot time, as in Oxizacia; and generall digestive in Winter and all cold time, as Oxcineil••: And generall expulsive is, d•• s••cca r••sarum, a cut with Turbit, and Sca∣mony, ana. Scruple two, and generall dor∣mitary is insquiamany, and double medled with Populions, and foment him with Roses, ••••a, double Sugar flaketh thir••••.

Signes of Sicknesse by Eg••stion.

IF the meat come from a man in manner as hee did eate it, the Stomack is weake, and the Bowels be lubricated, it is an evill signe.

If the Egestion looke like Earth, it is •• s••gne of death.

If the Egestion doe not stinke, it is an evill signe.

If the Egestion doe looke like lead, it is an evill signe.

If the Egestion bee blacke as Inke, it is an evill signe.

If the Egestion bee blacke, and looke like Sheepes trickles, there is abundance of adu•••• Choller, and paine in the Spleene.

If the Egestion be yellow, and no Saffron eaten before, the body is r••pleat with Choller and Cytren water.

If the Egestion have straines of bloud, there is impediment in the Liver and the Bowels.

If the Egestion bee bloudish, there is ulce∣ration in the Guts.

If the Egestion looke like shaving of Guts, beware then of an extreame Fluxe and debility of the Body.

If a man be too Laxative it is not good, for in such persons can be no strength but much weaknesse.

If a man be costive and cannot have a na∣turall egestion once a day, he cannot be long without Sicknesse.

Signes of Life or Death by the Pulses.

Spigm••s is named the Pulses, and there be twelue Pulses the which doe take their Originall at the Vitall spirits: Three of which belong to the Heart, the one is under the left Pap, the other two doe lye in the Wrists of the armes directly against the Thumbs.

The Braine hath respect to seaven Pulses, foure be principall; and three be Minors, the foure principall are thus scituate; in the Tem∣ples two, and one going under the Bone called the right Furkcle, and the other doth lye in the corner of the right side of the Nose, one of the

three Minor Pulses in the corner of the left side of the Nose: And the other two lye upon the Mandibles of the two Jawes, the Liver hath respect to the two Pulses which lye upon the Feet.

By these Pulses, expert Physitians and Chyrurgions by their knocking and clapping, doe judge what principall member is diseased or whether the Patient be in danger.

If any of the principall Pulses doe beate truely, keeping an equall course as the minute of a clocke, then there is no perill in the Patient, so be it they keepe a true course; or pulse without any pause or stopping; which is to say, if the Pulse give five knockes and cease at the sixth knocke: or else seven and pause at eight, or else knocke tenne and lea••e over the eleventh, and begin at the twelfth, the Patient is in perill, else not; for it is not in the agility, as too swift or tardie beating of the Pulse, but in the pausing of the same con∣trary to its course, that the Patient is in perill.

In such causes let the Physitian be circum∣spect, and carefull, for Sincopies in the Patient, let him sit upright in his Bed with Pillowes, and let one sit at his backe to give him drinke, and let the Patient smell to Amber greece or Rosewater and Vin••ger, or else rub the Pulse with Aqua Vitae.

Also, when you touch the Pulse, marke under which finger it strikes most strongest, as thus; If the Pulse under the little finger, be feeble and weake, and under the rest more weake, it is a token of Death: But con∣trariwise, if under the little finger strong, and under every finger stronger it is a good signe.

And if you feele the Pulse under the fore∣finger strike untill the eleventh stroke and it faile in it, is a good signe, but if he beate swift and unorderly, an evill.

Of the foure Humours.

1. Signes of Sicknesse by Blood.

SLownesse, Idlenesse, Dulnesse, yawning or gaping, stretching forth the armes, no de∣light or pleasure, sweet spittle mingled with bitternesse, much heavie sleepe with dreames of red colour, or bearing of burthens great and heavie, perturbation of the sences, red face with much sweat, little or no appetite to meat with red grosse stinking Urine.

Of these Signes are knowne, stinking Fea∣vers, Pestilence, Squinancie, and Bloody-fluxe.

For Remedy, if the Blood be distempered, helpe it with things cold and dry; for blood is moist, hot, and sweet.

2. Signes of Melancholy sicknesses.

PAle colour in the Face, sowrenesse in the mouth, belching wind, little sleepe, that horrible, and infernall dreames, much thought, pensivenesse and care, a desperate mind, more leaner then before in the body, straitnesse in the stomack▪ Elvishnesse in countenance, snap∣pish in words; starting, coldnesse, and feare∣full, white and thin Urine.

These signes testifie▪ Quartaine, Morphew, Lepre, Canker, Madnesse, and hardnesse of the Spleene.

For Remedy, if it bee of red Choller, give things cold, moist and sweet; for red choller is bitter and fiery.

3. Signes of Cholerick diseases.

YEllow colour in the Skin, bitterness in the mouth, pricking in the mouth of the sto∣macke, supernaturall heat, loathsomnesse to meat, lamentation or great griefe of mind. Drinesse, coveting drinke of divers kinds, Vo∣mits

of yellow and greene, small or no sleepe, but fearefull and fiery dreames of strife.

These bee signes of the Jaundies, Tertians, Plurisies, Madnesse, and Collicks.

For Remedy, if it bee of blacke Choller, or Melancholy, give things hot and moyst, and sweet; for adust choller is sharpe and cold.

4. Signes of Flegmatick diseases.

SLuggishnesse and dulness of Memory, for∣getfulnesse, much spitting, 〈…〉〈…〉, paines in the Head, especially in the hinder part, swelling in the Face and cheeks, evill di∣gestion▪ white Dropsie-like in colour, patience with doltishnesse, lacking lively quickne••se, dreaming of going naked, drowning, or of Snow.

The diseases, Quotidians, Dropsies, Palsey, and the Falling sicknesse.

For Remedy, if the Disease be of salt Flegme give things sweet, hot and dry, thus saith So∣ramis. And thus much for Remedies against the distemperance of each humour.

Notwithstanding, where there is abundance of cold Flegme not mixt with Choller, there things very sharpe and hot bee most conveni∣ent; as tart Vineger with hot Roses and seeds,

or Wines, strong and rough Honey, being boy∣led in the one and in the other.

Or where Choller is mixt with Flegme, sir∣rop made with Vineger and Suger, boyled sometimes with Seeds, Herbes, and Rootes, which may dissolve Flegme and digest it is ve∣ry good.

Certaine Observations for Women.

WHen Womens brests diminish being with Child, is a token the child is dead.

If a woman with Child bee sodainly taken with any grievous sicknesse, her life is in great danger.

If a woman with Child be let Blood, it kil∣leth the child, the nearer the birth the greater is the danger.

It is perilous for a Woman with Child to have a great Lax, or loosenesse.

A woman having a Convultion in tempe∣rate times of her termes, is perilous.

The C••alx of Egge-shels ministred in broth asswageth the paine and griping in a woman, after her deliverance of child.