The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. I.* 1.1 Reckons up the branches or propagations of the vena portae or the Gate-vein, and explains an Aphorism of Hippocrates, that makes very much to the purpose.

LEt us come now to the History of the veins, in which we will begin with the vena portae or gate-vein, as that which spreads not so wide and far as the cava or hollow one. For it is wont to be distributed only through the lowest belly,* 1.2 and not at all to propagate it self out of it; nor does it branch through all parts of that, but such only as are appropriated to the nutritive faculty, namely the Li∣ver, the bladder of Gall, the Stomach, the Spleen, the Sweet-bread, Kall, Guts, and Mesentery; for the Hollow-vein sends its propagations to the rest, as the Reins, Bladder, and those parts which serve for generation.* 1.3 But that the manner of this distri∣bution may be more easily understood, for our better method in teaching, likening the whole vein to a tree, we will divide it into four parts, one of which we will call the Roots, as that part which is in the Liver; another the Trunk, which continues it self on and is not divided; a third the Branches into which the Trunk is divided; a fourth, Twigs or Surcles, such small veins as the Trunk shoots out at its sides; before it be divided into its branches. Which terms ought diligently to be observed, because we have endeavoured by the propriety of these words to give light to this obscure Treatise concerning the veins. But that they may more easily be committed to memory, and all that concernes this business be written with more brevity, following some very learned later Authors, we will give e∣very part its name from the place of its insertion.

From the outside then of the Liver some very little hairy veins are prolonged towards its inner region, and by little and little meet together into greater branches,* 1.4 so that at length they become five, which again gathered together like roots about the middle of the hollow side of the Liver, but somewhat hinderly near to to the back, make a notable stock or Trunk, which at length issuing forth near to those eminencies of the Liver, which by the Greeks are termed 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 Gates, is cal'd the Gate-vein, and now deserves the name of a Trunk.

This Trunk parting now from the Liver descends somewhat obliquely towards the left side, under the Gut called Duodenum, where above the Rack-bones it gets a firm seat;* 1.5 but before it be divided into branches, two twigs sprout from it;* 1.6 the first of which being very small, arising out of the uppermost and fore part of the Trunk, as soon as it is come forth from the Liver, is scattered into the neck and body of the bladder of Gall, or into it outer coat, with a numerous succession of very little branches, such as we have said above are called hairy veins. This twig is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in Latin you may render it vesicalis, the vein of the bladder of Gall. Vesalius sayes there are two branches, which run through the bladder of Gall, whence they are called by some Cysticae gemellae, the twin veins of the Gall, but this makes no great matter. The second twig being greater then the former, but lower, arising from the same fore part, and more to the right, is inserted into pylorus or the lower mouth of the stomach, into whose hinder part, which looks towards the back, it scatters many small branches, from whence it is commonly called Gastricus,* 1.7 the sto∣mach-branch, but perhaps for memories sake it may be better termed Pyloricus, or branch of

the lower mouth of the stomach, because there are others also which are called Stomach-branches.

These two twigs being thus propagated, the Trunk runs downwards, and inclining all the way somewhat to the left is divided into two notable branches, a right, and a left one: the left is some thing higher then the right, but lesser; the right lower, but greater: the left spreads it self through the stomach, the kall, one part of the Colon or colique gut, and the spleen; the right through the guts and Mesentery; that is called Splenica or Spleen-vein, or the linear one; this the Mesenterick.

* 1.8Now the Spleen-vein, after it is thus come forth from the Trunk, is carried athwart, being underpropt by the membrane of the Kall, toward the Spleen, into which before it be con∣sumed, it shoots forth certain twigs, both from its upper part, and from its lower; from its upper part one, that ascending obliquely to the left side of the Stomach that looks toward the back, is divided into three propagations, of which the outermost on either side are conveyed into the Stomach, and presently scatter into more twigs; but the middle one ascending through the same hinder part spreads it self through the upper region of the Stomach, and compasses the left orifice or mouth, round about like a crown, from whence it is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 or Coronaria,* 1.9 the Crown-vein of the Stomach. This a∣gain sends forth continually some small branches upwards to the end of the Gull et, and others downwards through the Stomach. All this branch is called Gastricus, the Stomach branch, because it is the greatest, and most capacious of all those, which come to the Sto∣mach.* 1.10 From the lower part of the Spleen branch arise two twigs; one, which is small, sending forth other little sprigs to the right side of the lower membrane of the Kall, and the colique Gut annexed thereunto, is commonly called Epiplois Dextra, you may Lat in it Omentalis, the right Kall-vein. Another answering to that branch, which arises from the higher part of the Spleen-vein, and begets the Crown-vein, is inserted in the lower membrane of the Kall, and presently after its rise is di∣vided into two branches, which parting one from another a great distance beget many other twigs, which are spent upon the lower membrane of the Kall, which like a Mesen∣tery ties the colique Gut to the back, as also upon that part of the colique Gut, which-is so tyed.* 1.11 It is called Epiplois, or Omentalis postica, the hinder Kall vein. After the Spleen-branch has thus scattered many twigs, now drawing near to the Spleen it is cleft into two branches, an upper, and a lower one; which are broken into others in the very Paren∣chyma or flesh of the Spleen. From the upper, sometimes before it enters the Spleen, sometimes when it is already entered, there sprouts forth a double or three sold twig, very famous among the writers of Physick, which they commonly call vas breve the short vessel, but we the Venal, to distinguish it from the Arterial vessel that answers to it: this is in∣serted into the left side of the bottom of the Stomach, sometimes also higher and about the left orifice or mouth. Which is the cause why some Physitians, and commonly Anato∣mists too have foolishly thought, that the melancholick humor is returned from the Spleen through this vessel back into the Stomach, to provoke appetite. But you may of∣ten finde bodies,* 1.12 in which it is altogether wanting. From the lower branch, which goes to the nether part of the Spleen, one propagation arises, which being pretty big, and notable is reflected toward the right hand, like the foregoing, and compasses the bottom of the Stomach to the left side, and also sends many little branches to the higher mem∣brane of the Kall on the left side;* 1.13 it is called Gastro-epiplois sinisira, the left Stomach and Kall-vein. There is also another notable branch, which is found in most to arise from the lower Spleen branch; very seldome from the spleen it self. This is carried down∣wards, and scattering twigs over all the left side of the colique Gut, goes on further by the whole length of the strait Gut, and at length determines in the membranous sub∣stance thereof, and in the fundament with many little twigs. Physitians makes mention of this very often,* 1.14 and call it Haemorrhoidalis interna, the inner emroid vein, to distinguish it from the outer, which is derived from the Hollow-vein. It is truly and properly called the Emroid vein; I say, properly, and truly, because sometimes they call by that name the veins of the nostrils, gums, and mouth, that cast forth blood, and without pain. In this large sence the Philosopher took it 3. de part. animal. where he makes menstrous purga∣tion [unspec 1] also a species of the emroids. But the Emroids properly so called by Physitians are dilatations of this vein in the fundament, caused as well by black and yellow choler, as also by a salt phlegm, as by the melancholick humor. And these are of two kinds; Caecae, blind piles which cast out no blood, but swell out like the stone of a grape into the fun∣dament [unspec 2] or out of it: Others apertae, open which cast out the blood, which they contain. The learned Hippocrates hath left us a peculiar book, a golden one indeed, concerning the cure of these. The remaining part of the Spleen-branch is spent upon the whole Spleen, and therein is scattered into divers and very small propagations, entring the very flesh of it about the hollow, and middle line. And these are the sprigs which g••ow out of the Spleen-branch.

The Mesenterick vein, or right branch of the Gate-vein is joyned to the Mesentery, as soon as it comes from the back, and is divided into two chief branches, which passing

through the Mesentery betwixt its two coats, are each of them cleft into an infinite num∣ber of small branches, and they again into less twigs, which going to the Guts make up those veins so famous among Physitians, that are called the Mesaraick-veins. The first of these branches is called the right Mesenterick vein from the right side,* 1.15 wherein it is placed, and is likewise twofold, whence it came to pass, that Vesalius, and almost all o∣thers, who follow him, reckon three Mesenterick veins. This branch is inserted into the Jejunum or empty Gut, the Ileum, or circle Gut, the caecum or blinde Gut, and the right side of the Colique Gut, where it lies next to the reins, and Liver; and although both its branches shoot forth many propagations from themselves, so that it is very hard to express any number of them, as well because they vary much by reason of their subjects, as also because they do not observe the very same order and course, yet it hath been observed, that for the most part there are fourteen, which afterwards are scattered into an infinite com∣pany of other twigs. These when they are come to the Guts, only gape with their lit∣tle mouths into their Coat, and enter not the cavity it self, that being compassed about within with a certain crust. But as in most parts of our body, the divarications or divisi∣ons of the vessels are attended with certain glandules, partly that they may make the safer progress, partly lest they should sink down, and withall the flow and ebb of the blood so very necessary be hindered; so here also the divisions of the vessels, which are scattered through the Mesentery, are bolstered up with certain glandules, which with their pro∣pagations observe such an exact propagation, that the greater glandules do sustain the greater branches, and the less the lesser. When these glandules swell with a Scirrhus, the vessels being prest close together, and the distribution of the chylus through the veins, and consequently of the blood through the body being hindered, there follows a Con∣sumption, and pining of the whole body. The left Mesenterick vein is distributed into the middle part of the Mesentery, and also that part of the Colique Gut,* 1.16 which runs from the left region of the Stomach as far as to the strait Gut. The haemorrhaidalis interna, or inner Emroid vein, of which we spake a little before, sometimes arises from this vein, as Vesalius hath observed, which affording some sprigs to the Colique Gut, at last running forward through the whole length of the strait Gut, determines in the fundament. But before the Mesenterick Trunk be divided into these two branches,* 1.17 it first sends forth two propagations, one of which is called Gastro-epiplois dextra, or the Right Stomach and Kall-vein, which creeps through the right bottom of the Stomach, before, and behinde, as also through the upper membrane of the Kall: the other called by others Intestinalis, or the Gut-vein, by us the Duodena, reaches to the middle of the Gut Duodenum; and the beginning of the Empty Gut or Jejunum, and descends all along through them.

The chief use of the Gate-vein is to nourish those parts,* 1.18 which are seated in the lowest belly, and need a thicker and more faeculent blood, such as are all those parts which serve for nutrition. For their blood ought to be thicker, that it might be hotter, when heat is alwaies more powerful in a thicker body: so then the Roots of the Gate-vein nourish the Liver, the Trunk nourishes the Pancreas or Sweet-bread; of the Twigs, the Cy∣sticus, or Gall-twig nourishes the bladder of the Gall; the Spleen-branch, all the en∣trails which serve for nutrition, except the Mesentery, and the Guts; the Twig Pyloricus, or of the lower mouth of the Stomach, the Gastricus or Stomach-branch, both the Stomach and Kall-veins, and the short vessel nourish the stomach. For I do not think that the short vessel was made by nature for the carrying back of melancholick humors to the Stomach, but chiefly fot its nourishments sake; when that blood, which is generated in the Spleen, is not a melancholy and excrementitious humor, but rathet the best, although somewhat thicker then other blood, and that because the parts that are to be nourished by the Spleen branch, needed a thicker blood, then they which are to be nourished by the Mesenterick. Both the Stomach and Kall-veins nourish the upper membrane of the Kall; the right and the hinder Epiplois, or the Kall-veins, the lower. The Spleen is nourished by those two branches, into which the Spleen-vein is cleft, and which enter its parenchyma, or flesh through its middle line: the Mesentery, and almost all the Guts by the two Mesen∣terick branches; the Gut Duodenum by the propagation called Duodena; but the empty Gut, the Ileum or circle Gut the blind Gut, and the right side of the Colique or Colon by the right Mesenterick-branch. The left side of the Colique, and all the strait-Gut by the haemorrhoidal vein; but the middle part which lies under the Stomach, by the hin∣der Kall-vein. The second use is to attract the Chylus, and carry it to the Liver;* 1.19 whose veins are most famous for the making of blood. But the same veins which nourish the Mesentery branch, do also attract the Chylus, as we shall shew you hereafter, when we shall insist upon the History of it.* 1.20 The third use is to empty out the excrements from the body through the Guts. Thus we see that the cholerick humor is sometimes poured forth out of the Liver through the Mesenterick-branch in the bloody flux, and cholerick loosness, and the melancholick dregs through the Emroid-vein.* 1.21 The fourth use is to help the concoction of the Liver. Thus we see that the thicker part of the Chylus, which is called melancholy, is attracted by the splenick branch, not that the seat of melancholy is

in the Spleen, but that it may be more attenuated, and better concocted by the benefit of the Arteries, which are most abounding in the Spleen, and so not disturb, or hinder the concoction which is famed to be in the veins of the Liver, as it usually happens, that whensoever the Spleen is troubled with any disease, the work of making blood is presently harmed.

* 1.22But because there has been mention made here of the Emroid veins, it seemed that it would not be unreasonable if I did refer to this place the explanation of a most excellent Aphorism, which is the twelfth of the sixth Section, when it cannot be understood with∣out the History of Anatomy, and is not so faithfully explained by others, as was neces∣sary. Hippocrates writes in it, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, he that is cured of old Emroids, unless one of them be preserved, is in danger of falling into a Dropsie, or Consumption. In explanation hereof we will first doubt of the Aphorism, then we will dispute of the manner whereby a Dropsie, or Consumption follows upon the Cure of old Emroids. But we may not without cause doubt of the truth of it, because the same Hippocrates in a Book concerning the Emroids, which I think to be very much his own, whatsoever Mercurialis say, though otherwise a most learned man, bids us to burn the Emroids, and forbids us to leave any unburnt, but to burn them all. And truly Aetius in his 14. Book, desirous to reconcile these two places, at those words 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, unless one be preserved, being overcome, thinks that a manner of diet is to be understood, not an Emroid, as if Hippocrates should say: Thou shalt not cure one that hath long had the Emroids, unless the Patient will diligently ob∣serve a convenient manner of diet prescribed by thee; for otherwise there is danger of his falling into a Dropsie, or Consumption. But Galen in his Comment upon that Apho∣rism writes expresly, that Hippocrates sayes, that unless one Emroid be preserved, such dan∣ger will ensue, and makes no mention at all of diet. And, what is more, daily experi∣ence sufficiently witnesses, that such mischiefs do ensue, though never so exact a diet be kept, and the reason taken from the manner, wherein they happen, and which we shall presently explain, does abundantly manifest it. Whence it is evident, that these two places of Hippocrates are left still in controversie and contradicting one another from this answer of Aetius. But the right answer will be, if we say, that Hippocrates when he writes in his book of the Emroids, that for a perfect cure they must all be burnt, speaks not of old Emroids, but of such only as are lately come, or when nature has already endeavoured to expel the humor, which was otherwise purged out of the Emroids some other way, whether it be by issues, or by a Fistula, or some ulcer in the Leg. For such may be very well cured and without danger of Consumption, or Dropsie, the rather, if the en∣trails be yet whole and sound, and especially if a good rule of diet follow. Nor does the cure of all old Emroids necessarily bring on a Dropsie or Consumption, but only for the most part they threaten a danger of these diseases to ensue; for sometimes the melancho∣lick matter being hurried up into the brains, there follows madness, as it happened to Al∣cippus, in Hippocrates 4. Epidem. For, sayes he, this Alcippus having the Emroids was forbidden to be cured, for after the cure he fell mad, but an acute Feaver following it, he was reco∣vered. For explanation of the second doubt, first let us hear Galen, for he in his Commen∣tary upon the Aphorism, sayes

That the Emroids came by reason of faeculent and me∣lancholick blood, which the Liver drives down to the mouths of certain veins, and so this way being stopt, an abundance of gross humors burdens the Liver, and stifles the natural heat, which being extinguisht, no more blood is generated, but only water, which nature afterwards driving it into the Abdomen, o•• paunch, makes a Dropsie. But if the Liver send that abundance of melancholick humor to the Lungs, some vessel being broken, there follows a Consumption.

This interpretation of Galen, besides that it seems very obscure to us, is not altogether agreeable to truth. For first, it is false in my judgment, which Galen sets down in his Comment, that it is impossible, that the Emroids should be caused without an abundance of faeculent and thick blood; when it may be proved both by reasons, and authority, that they come also from choler and phlegm. By the authority of Hippocrates, who in the beginning of his Book concerning the Emroids, witnesses that this disease is caused in this manner; to wit, when choler, or phlegm falling down into the veins of the Strait-Gut, heats the blood, which is in the veins. For these veins being heated attract the blood out of the little veins that are near, and when they are filled, the inward part of the Seat swels, and the heads of the veins appear out of it. But by reason it is proved thus; when madnesses are caused by phlegm, or choler, as Hip∣pocrates witnesseth in his Book De Morbo Sacro, the same Author in the 6. Aphorism, 21. professes that that madness is taken away, if there follow swellings of the veins, or Emroids in those that are so mad. Now the madness would not be taken away, if melancholick humors did only come forth by the Emroids; for then the cause of the disease would not be purged out. But I my self also have seen formerly in Germany some Noblemen, that were troubled with salt catarrhs, afterwards recovered by a great flux of the Emroids; that I am of opinion, that not only melancholy, but also salt phlegm and choler are wont to be purged out by the Emroids. Wherefore if it happen, that one, who has been long trou∣bled

with the Emroids, be cured afterwards, that choler and phlegm, ei••her breed, ob∣structions in the Liver, or Spleen, or being gathered together in some plenty by stretching the vessels contained in the Abdomen, or paunch, breaks through them, or by their quality corrodes and eats their way out, and makes a Dropsie in the Abdomen; or else by raising obstructions in the Liver, and extinguishing the natural heat, generates much water, and serous humor in stead of blood, which passing through the veins, make a species of the Drop∣sie called Lucophlegmatia; but if the humor go back to the Breast, or Lungs, it breaks through, or eats out their vessels, and hence follows a spitting first of blood, then of cor∣rupt matter, and from thence at last a Consumption, as Hippocrates teaches in his Aphorism. But in this place it is first of all to be observed, that there are two sorts of propagations of veins, which make the Emroids: for there are some propagations of the Gate-vein, of which we have already treated; but there are others of the Hollow-vein, which arise from the Iliacal branches, of which we are to speak hereafter. Now if the forementioned humors, whether melancholick, or cholerick, or phlegmatick and salt, flow through the propagations of the Gate-vein, the internal Emroids are caused, which being cured, the matters flow back into the branches of the Gate-vein, that are scattered through the lower Belly into which the veins being loaden with these humors unburden themselves, & make a species of the Dropsie called Ascites. But if they flow through the branches of the Hollow-vein, they cause the external Emroids, and these being cured against the Precept of Hippocra∣tes, there is danger of a Consumption to ensue, because from hence there is an easie passage of the peccant matter through the Hollow-vein to the Lungs, nigh to the Heart. And this is that which we have of a good while observed, that many, who have been long troubled with Fistula's of the Fundament; and afterwards cured, through the ignorance of Physi∣tians, have faln into a spitting of blood, and then into a Consumption. Nay, we remem∣ber, that a Maid was once cured by us in Germany, which had a Fistula in the middle of her Hip, and for three years had sought help from many in vain, but being cured she fell at length after three or four month into a spitting of much blood. Although she was scarce ten years old, I let her blood presently in the foot of that side on which she had been troubled with the Fistula, and purging her body, and laying on a cautery near the place, in which the Fistula had been, I easily freed her in this manner from imminent danger of a Consumption. This spitting of blood happened from no other cause, but that sharp and cholerick matter, which when it could no longer finde a way out by the Fistula, got up afterwards to the Lungs through the branches of the Hollow-vein. But Hippocrates sayes expresly, that there is danger of a Dropsie, or Consumption to follow, because it some∣times falls out, that neither of these happen, but rather some other disease insues, as it happened to Alcippus, who fell in to a madness, and from that into an acute Feaver: some∣times also the bloody flux follows, and other mischiefs. Sometimes also it happens, that they who are so cured, are preserved still in health, by abundance of urine, sweatings, re∣medies, and a good rule of diet.

Notes

• * 1.1

  Note that the Letters, which are enclosed thus [] refer to the par∣ticular tables at the end of that Treatise, wherein they are set.
• * 1.2

  Through what parts the Gate vein is disper∣sed.
• * 1.3

  The division of the Gate-vein into the roots, Trunk, bran∣ches and twigs
• * 1.4

  The Roots.
• * 1.5

  The Trunk.
• * 1.6

  The twigs, that grow out be∣fore the divisi∣on of the Trunk. Custicus.
• * 1.7

  Gastricus.
• * 1.8

  The two branches. Splenica. Circles rising from the upper part of the Splenick-branch.
• * 1.9

  Coronaria.
• * 1.10

  Circles rising from the lower part of the Splenick-branch. Epiplois Dex∣tra.
• * 1.11

  Epip••ois posti∣ca. The division of the Splenick branch. A propagation of the upper branch.
• * 1.12

  A propagation of the lower branch.
• * 1.13

  Gastro-epiplois sin••stra.
• * 1.14

  Haemorrhoidalis interna.
• * 1.15

  The right Me∣senterick branch.
• * 1.16

  The left Me∣senterick.
• * 1.17

  Propagations that arise be∣fore the divisi∣on of the Me∣senterick. Gastro-epiplois
• * 1.18

  Dextra. Intestinalis. The first use of the Gate-vein.
• * 1.19

  The second use.
• * 1.20

  The third use.
• * 1.21

  The fourth.
• * 1.22

  The explana∣tion of a cer∣tain Aphorism of Hippocrates.