¶Here begynneth the .iiii. boke of the Terapen­tyke, of claude Galyen prynce of Physycke.

VUe haue sayd that there is a kynde of dysease, that is called solution of cōty­nuyte, whiche cōmeth in to all parties of the body of mankynde. Howbeit it [Page] hath not one name in them al. For solutyon of cō tynuyte in the flesshy parte is called vlcere, in the bone, fracture. The grekes call it catagma. In y^e synewe, conuulsion, the grekes cal it, spasma. There be other kyndes of solutions of continuite, that the grekes cal Apospasma, rhegma, and thlasma. That is to wyte thlasma in the ligament, Apos­pasma, and rhegma in the vessels and muscles, bycause of any vyolent stroke or greuous fall, or any other great mocyon. ¶The solution of contynu­yte called ecchymosis in greke cōmeth most often with concussyon and ruption. Somtime solution of cōtynuyte cōmeth by opera [...]yon of the oryfices o [...] the vesselles, in greke named Anostomosis. Also [...] cōmeth bycause that the grekes call it dyapede­ [...]s. Other solutions of con [...]ynuyte happeneth of e [...]oysion in greke called Anabrosis. But it is a dysposytyon alredy medled and composed with an o­ther kynde of dysease that consysteth in the quan­ [...]te of the partyes, as before hath ben shewed, [...] we haue spoken of holowe vlceres whiche [...]ede of two causes, that is to wete of excysyon [...]d of eroysion. It is notorious in what man [...]r [...]cysion cōmeth. yf eroysion habounde inwardely [...]s caused of catochimie. yf outwardly it is done [...]her by strōge medycyne or by fyre. It behoueth [...]hen as before is sayd to take hede dylygētly and dysc [...]rne the symple dyseases fro the compounde. For to a symple dysease a symple healynge is due, And [...]o a composed dysease a healynge vnsymple. [Page] Also we haue sayd before what Methode must be kept for to heale the composed dyseases. Howbeit it is not ynoughe to knowe the generalyte of the sayde Methode / but behoueth to be exercyced in all the partyes therof, seynge that in the same is nede (by maner of spekynge) of sondry partyculer Methodes, bycause y^t euery kynde of dysease hath his owne Methode. Than that whiche resteth of of the curatyon of vlceres must be perfourmed in this boke, takynge the begynnyng here. ¶Euery vlcere is ey [...]her symple and alone without other dysposytyon or affectyon begynnynge with it, or precedent, or suvsegemēt, or it is with some other dysposycyon, or dyuers / wherof some haue nat all onely excyted the sayde vlcere, but haue augmen­ted it. The other are without the which the sayd vlcere may nat be cured / & of them haue we trea­ted here before. ¶We shall treate in this present boke the dysposycyons which augmenteth the vl­cere / in the whiche lyeth double councell of cura­cyon / that is to wyte, eyther to take the sayde dys­posycyons all holly out of the body / or to surmoūt the incōmodite that aboundeth [...]. The whiche thynge maye be easely done / yf the dysposycyon be lytell. But yf it be great the vlcere maye nat come to cycatryce vntyll that remedy be put to the sayd disposycyon, wherby we must dylygently consyder what the sayde affeccyons and dysposycyons be / and howe many in nombre, in takynge our begynnyng as is aforsaid. ¶Euery vlcere is be it alone [Page] or with holownesse requyreth and demaundeth that the flesshe subiect be natural / and that there be nothynge betwene the lyppes and extremytees that ought to be conglutynate / which oftētymes happeneth, so that heare, a spyder threde, matter, oyle, or suche lyke thyng letteth the knyttyng. And those thynges are as symptomes and accydentes of the sayde vlceres / which yf they be present may hynder and let the curacion, yf they be nat, they let nat / but the dysposycyon of the flesshe subiecte is cause of that whiche foloweth. For with the same flesshe / and by the same the lyppes that were asonder are closed and the holownesse fylled. It beho­ [...]eth than that the sayd flesshe be kyndely, bycause that these two thynges maye well & cōmodyously [...] made parfyte. Than shal it be kyndly yf it kepe it selfe temperatly / the which thynge is cōmon to all other partyes. Wherby it behoueth that the flesshe subiecte be holly temperate / aswell to close [...]he viceres as to fyll theym with [...]lesshe / but is it [...]oughe of that? Must nat the blode that gathe­ [...]h to it be good also? and moderate in quātyte? [...] semeth thi [...] to be trewe / for it lacketh asmoch [...]t the corrupte blode be as holsome for the clo­ [...]sge, and as to fulfyll the flesshe / as somtyme it [...]keth erosion and exulcere the body. And yf it be [...] habundaunt in quantyte it engendreth exe­ [...]ment in the sores / and as is aforesayd letteth and hyndreth the curacyon. ¶And also there be thre maners of vlceres dyffycyle for to be healed. [Page] The fyrste maner haboundeth by the vntempe­raunce of the flesshe subiecte. The seconde by the vyce and yll qualyte of the blode gatherynge to it. The thyrde for the ouer great measure and quantyte of the sayd blode. Ought nat the dyuysyon to be made thus? or otherwyse / that is to wyte the cause wherfore some vlceres are stubburne and defycyle to be healed is for the mystemperaunce of y^e flesshe vlcerate, or for the gatheryng of humours ¶Yet agayne, the mystempered flesshe ought to be deuysed in two dyfferences. The fyrste is whan the subiect flesshe is out of nature in an onely qualyte. The seconde is whan with the euyl qualyte it hath tumour agaynst nature. ¶The flowyng of humours is dyuyded in two dyfferences, that is to wyte in the qualyte of gatherynge y^e humours, & in the quantyte. Somtyme dyuers of the sayde dysposytyons are medled togyther, and somtyme all. But the Methode for to cure thē all togyther ought not to be gyuen but eche one by it selfe. As yf the intemperaunce of the flesshe be drye & fylthy moderate it with bathynge, and wetynge in tem­perate water. But at all and as many tymes that this remedy shalbe vsed, the ende of the bathynge and wetynge shalbe forth with that the partycle becometh ruddy and ryse in a lumpe. Than sease y^t bathynge & moystynge. For yf ye bath it any more ye shall close the humour agayne that was lo­sed out, And so ye shall profyte nothynge. Lyke wyse the moystynge faculte of medycyns ought to be [Page] greater then it is cōmaunded in hole party yf the flesshe be more moyste, than naturall habytude. Ye must haue regarde to the contrary, for the fa­culte of medycyns ought to be desyceatyfe, and in no wyse to vse any water. But yf ye must wasshe the sore take wyne or posca, that is to saye oxycraton, or the decoction of some sharpe herbe. Lyke­wyse ye shall coole the pryde of the flesshe that is to hote, and heate that whiche is to colde. ¶Ye shall knowe suche vntemperaunces partly by the colour, and partly by touchynge, and partly by felynge the dyseased. For somtyme they feale great heate in the party, somtyme manyfest coldenes, & delyte them in hote or colde medycyns. And some­tyme appereth rednes, and somtyme whytenesse. But it is an impertynent thynge to this worke to dystynke these thynges. In the whiche worke we shewe not the Methode to knowe the affectyons, [...]ut for to heale them. In suche wyse that by one consequence of wordes, we be come vnto the sayd Methode to knowe the affectyons. Retourne we [...]han to our purpose. ¶Yf any partyes are vlcera­ [...] with swellynge agaynste kynde, fyrste the swel­ [...]ynge must be cured, What ought to be the cura­ [...]yon of all swellynge we shall say hereafter [...] Pre­ [...]ntly we shall treate of whiche is cōuycte and cō mune to the curatyons of vnkynde humoures or swellynges with the vlceres. yf the lyppes of the vlceres are dyscoloured onely, or somwhat hardened, they muste be cut vnto hole fleshe. But whan [Page] suche dysposycyon or affection hath to procede further / there must be had delyberacyon, to knowe yf all the party dyscoloured and hardened vnkyndly ought to be cut, or yf it ought to be cured by longe space of tyme. And without any dowbte in suche case it is necessarye to knowe the pacyentes wyll. For some had leuer to be longe in healynge than to suffre incysyon. And other are redy to endure all thyngꝭ / so that they may be soone healed. ¶Lykewyse here shall be spoken of the curacyon of euyll humours that gathereth in the partes of y^e sore places, in as moche, and bycause that it is an hu­mour gnawynge aboute succorosyfe. But in as moche as it is a wycked humour or ouer encrea­synge in quantyte / the curynge therof shal be spo­ken of in his owne place. ¶Than whan the hu­mours that gathereth in the vlcerate partyes is nat very fer of, nor in quantyte, nor qualyte, it be­houeth to dyuert & dryue away, that is in restrey­nyng and to coole the heate of the partyes that are before the sore place. Lyke maner ye must be­gyn the lygature at the vlcerate party, in ledynge it towarde the hole partye / as Hyppocrates wyl­leth in the fractour of bones. Also that the salues that are layde to the sayde vlceres must be more vndryeng than they that are layd to a syngle sore. And yf the flux or rēnynge wyll nat stop with sal­ues, seke the cause of the sayde fluxyon, and take it fyrste away. Yf the fluxyon come by weykenes and feblenes of the party that receyueth it, y^e sayd weykenes [Page] must be cured. And such curacyon also shall be propre for y^e vlcerate party. But yf cause of the sayd fluxyon haboūde eyther by ouer moch blode, or fylthynesse of all the body, or of any of the supe­ryour partyes, ye must fyrst delay the sayd causes. The weykenes of the partye for the which gathe­reth to moche humour haboundeth holly of the intemperancy. And nat all togyther of intempe­rancy / wherof foloweth that the vlcerate flesshe is onely intemperate / & nat weyke and feble. And somtyme chaunceth both the one and other, that is, both vntemperate and weyke. For y^e great vn­temperaunce is cause of the weykenes of payned party. The which vntemperaūcy shal be cured (as it is beforesayd) in coolynge the heate, moystynge the dryth, warmyng the colde, & dryeng the moyst. And yf the place be to colde and moyste togyther / in warmyng and dryenge also togyther. And so of the other vntemperaunces in doynge away euer the qualyte that surmoūteth by his contrary qualyte. The reason is / euery thyng that behaueth it wel, & is accordyng to nature / nat onely in quycke [...]hynges, or plantes, but also in all other thynges, [...] moderate (whiche the Grekes cal symmetron) and without excesse of all vycyous humours. For [...]he thyng wherfro nothyng can be taken, nor put [...]o it, neyther any partye, nor any qualyte, it is all parfytely moderate. Contraryly, the thynge that must be taken fro, or somwhat put to it, is nat in a natural estate, wherto is nat possyble to retour­ne, [Page] but in doynge awaye the excesse, and puttynge to it that it lacketh. ¶In an other place we shall speke of the ouer moche or lacke of y^e partyes / but whan any qualyte is ouer excessyue, it is nedefull that the other qualite contrary be ouercome. And that the corrupcyon vntemperaūcy be delayed, in restorynge the sayde qualyte that was ouercome. For in colyng that which was to hote, thou shalt restore that whiche lacketh / and dymynysshe that whiche was to moche haboundant. Thus it is necessarye that the enracyon of the thynges that are put fer fro theyr naturall beynges, by some in temperacy be made by thyngꝭ of contrary vertne. And thus the flesshe / or any party therof wherin is fluxyon bycause of weykenes, ought to be cured in this maner. And whan the intemperaūcy is cured, heale the vlcere. Curynge the temperaūcy as yf it had come without vlcere. By the which thynge it is manyfest that all such curacyon is nat propre to vlcere, but to intemperacy. Lykewyse yf any corrupte fluxyon happen in the vlcerate partyes / as well by y^e occasyon of any partycle as of all the body wherto the blode or any yll humours do ga­ther. Fyrste remedy must be had, eyther to the party that is cause of y^e fluxyon, or also to al the body. Thus than we shall heale fyrste the varyces that are often ouer the sore place / bycause that anone after we maye heale the soore. Lykewyse in them that haue dysease in the mylte, or of any other no­table party. Fyrst it behoueth to cure the sayd partye / [Page] and than after we shall come to the curacyon of the sore or vlcere / howbeit none of y^e curacyons therof is nat propre vnto an vlcere, but to some o­ther affection and dysposycyon, eyther that engendreth vlcere, or that nouryssheth & conserueth it. ¶Nowe it is tyme to make an ende that no straū ge cause (or as it is nowe sayde) the fyrste iudiciall is iudycatryce of curacyon, but the curatyfe iudi­ciall affection & dysease. But the thynges y^t ought to be done particulerly are founde, eyther that the fyrste iudicial sheweth eyther of the nature of the sore party, or of the temperaūce of the ayre / and of other lyke thynges. For to speke bryefly no indy­cacyon maye be taken of thynges that be nat yet parmanent. But in as moche as for to knowe a dysease that is nat euydent by reason nor by wyt, we ar often constrayned to enquyre of the externe and prymityfe cause. For this occasion the vulgar meneth that the sayde prymytyfe cause is indyca­tyfe of curacyon, the which is all other. As it appereth clerely that may well & parfytly be knowen. For yf ecchymosis, or vlcere, or erisipclas, or putryfaction, or phlegmone be in any parte, it a super­flue thynge to enquyre the effycyent cause of suche [...]yseases, but yf it be yet present and remaynynge. [...]or in this matter we wyll heale that whiche is done all redy / and shulde prohybyte the effycyent cause to procede any ferther. And yf the sayd effy­cyent cause which hath produced the effect therof hath no lenger beynge, we shall do away the sayd [Page] effecte. For to do away the cause that is no more / it shulde nat be possyble for vs, whan we wolde do it away, bycause that the curacyon apperteyneth to the thynge present, as prouydence to the thyng to come / but that which we feare nat that it may hurt neyther for the present nor for the cōmynge is out of both the offyces of y^e arte, that is to wyt, of curacyon and of prouydence. Wherfore in such a thynge ought to be no serchyng of any iudicial, neyther to cure nor to puruey, but (as sayd is) the knowlege of the prymytyfe and externe cause onely vtyle in the dyseases to vs vnknowen. Neuer­thelesse the Empirykes take somtyme the prymy­tyfe cause as partye of all the cours of the dysease (that is called in Greke syndrome) wherin they haue obserued and experymēted the curacyon / as in them that haue ben hurte with a mad dog, or ve­nymous beastes. Thus doth also some Dogma­tystes / which do affyrme to heale such dyseases by experyence onely without racyonall indicion / for they enquyre the cause prymytyfe as partye of all the syndrome, and vnyuersall cours. But the pry­mytyfe cause serueth nothynge to the indicion of curynge, althoughe it be vtyle to the knowlege of the dysease, to them that haue knowen the natu­re of venymous beastes by vse and experience, and therof taketh curatyfe indicion. For put the case that I knowe that the venyme of a Scorpyon be of a colde nature. And for that cause as of a colde thynge that I take indicacion of the remedy, howbeit [Page] the case is such that I haue no sygne wherby I do vnderstande that the body is hurte of a scor­pyon. It is manyfest yf that I knowe that y^e sayd body is hurt with a scorpion that I wold enforce me to warme all the body / and also the party stynged without abydyng for any other experyence in takynge myne indicion of the nature of the thyn­ge. For lyke as we haue shewed in the boke of me­dycamentes / wherin it behoueth to be exercyted who soeuer wyll take any fruyte of these present cōmentaries. No such faculte can be founde with out experyence. Sothely it shuld be a gyfte of fely [...]yte so that any hauyng the syght of Litargiri, of Castoreum, or Cantiride forthwith to vnderstāde theyr vertues. But lykewyse as in all thynges is cōmytted errour, as well by excesse, as by lacke, so is it presētly. For yf they that afferme that the vertues of medicamentes is nat yet knowen / & that after so greate experyence. And the other y^t esteme the sayde vertues to be knowen by one experyence [...]lone, do gaynsay eche other. For the fyrste speake [...]er lyghtly and to īprudently, yf it be īprudence to afferme a thynge impossyble, and the other are all togyther stupydes, sturdy, & lytygious. But for this present tyme we wyll say no more, bycause I haue spoken more playnly in y^e thyrde boke of temperamentes / aud also in the boke of medycamen­tes. Neuerthelesse for knowlege of y^e diseases some prymytyfe causes are proffytable / but after y^t the present dysease is all togyther knowen / than the [Page] cause prymytyfe is totally vnutyle. ¶Nowe haue we abouesayd / that it behoueth nat to medle and confounde both the doctrynes togyther / but the emperyke ought to treate by it selfe / & the rationall also by it selfe. We muste nowe call to mynde (bycause we haue preposed in these present cōmentaryes) to treate all onely the doctryne rationall. Albeit that to some thyngꝭ that we say we do nat adde that them all and absolutely be nat true, but onely after the sentence of the Methodyke secte / howbeit euery one of hymselfe ought to reason it, and for to adde it. And at this present tyme we haue added that any cause externe and prymytyfe is profytable to the indicacion curatyfe / albeit that it serueth well to the knowlege of the dysease. And we confesse that the cause prymytyfe is a party of the syndrome, and of all the emperykes cours is that they cure all dyseases, by reason or by expery­ence. But in all that we wyll say hereafter it shall nat be necessary to adde suche wordes. ¶Than let vs retourne to oure fyrste purpose in takynge the pryncyple certayne and vndowbtfull / wherof also we haue vsed heretofore / there as we haue sayde that the dysease that requyreth to be cured iugeth the ende wherunto the Cyrurgien ought to entende / and of the same all other indications ben ta­ken / wherby ye maye vnderstande pryncypally of the vlceres, wherof we haue begon to speake, that the sayd indication hath no maner of societe with the cause prymytyfe. For put we the case that any [Page] vlcere be come of a fluxyon in any party than it is manyfest that y^e sayd vlcere procedeth of corrupt humours / for nature is wont for to do so in dyseases / whan she purgeth the body she sendeth all the corrupcyon to the skynne / in suche a maner that the sayd skynne is vlcerate / & all the body purged. ¶ What is than the curacyon of suche vlceres? Certaynly as of other vlceres wherin no corrupte affec [...]ion or dysposition (that the Grekes call Ca­coctes) is adioyned. And yf it be so, it is euydent y^t none indication is taken of the cause that hath excited and made the vlcere. But yf the vycyous hu­mour remayned some indication myght be taken of the sayd cause / or otherwyse it shulde be a deafe thynge that y^t thynge whiche is no more beynge shulde requyre curacyon [...] Or yf any thynge iudged and shewed curacyon / where there no maner of [...]de. Wherfore it is a straunge thynge / & all ho­ [...]e agaynst reason to say that the indication cura­ [...]fe ought to be taken of the cause externe & pry­my [...]yfe. And for bycause that the sayde indication [...] nat taken of the same cause / it is euydent that [...] ought to be taken of the cause that is present. ¶But what is such indication fyna [...]y? Certaynly who that shulde well and pr [...]prely speake / it is [...]hat thynge that belongeth to prouidence, who so wolde be abused with the vocable. The grekes cal it Prophylactice. For y^e curation of vlceres eyther beyng onely syngle vlceres, or beyng with holow­nesse (yf ye esteme and consydre dylygently) is par­fyte [Page] in eschewynge and foreseyng the thyngꝭ that may anoy nature. And the sūme in effect when all is done, it is the worke of nature, as is closynge of a sore vlcere / and regeneracyon of flesshe. In the which thynges belongeth all the cure to that parte of the arte medycynall / that is called Prophy­lactyce in Greke / y^t is to say prouydence / although that vulgaryly it hyght, healynge. ¶And therfo­re this party that is named prouydence is deuy­ded in to two kyndes. The fyrste is it that doth a way the dysease that is present. And the other w^t stādeth the dysease that is nat yet in estate. Thus the yonge leaches vnderstande nat that theyr contencyon and dysputynges is of names. Howebeit that yf they were studyous of thynges / they shuld inuent and knowe that there be two fyrste dyffe­rences of the functions and actions of medycyne. That is to wyte, eyther to cure & heale the dysea­ses all redy greuous / or to let and withstāde them that are nat yet present. ¶ Than is there no man but he wyll saye that to cure and to heale is none other thynge / but to do away the diseases all redy present and greuous / be it but that is done in do­ynge awaye the thynges that do let the worke of nature, or by medycamentes. But prouydence is none other thynge but to let that the sayde dysea­ses come nat. And certaynly they that by reason & Methode admynyster the arte of medycyne do cu­re y^• vlceres that come afore of corrupt humours / in purgynge the sayde humours / and also in doynge [Page] away the thynges that letteth the worke of nature. And proprely to say these two maners of cu­ryng ar called Prophilactykes in Greke. For they let (as is aforesaid) that the fylthynes engendreth nat at the sore / or ouer moche moyste corruption. It behoueth nat than thus miserably to stryue of the names. But rather it is more conuenyent to gyue some good Methode to cure the vlceres, su­che as I haue gyuen (after my iugement) as well in the boke precedent as in this. But I merueyle me moche of the [...]ole hardynes of Thessalus wry­tynge so of the curacyon of vlceres, that is named Cacocthe that is to say wycked. ¶The cōmuny­ [...]es of vlceres that last longe tyme that are vncurable / or that retourne after the cycatryce induct ben very necessarye, in lykewyse as in vlceres that maye nat growe togyther and be closed. It must be estemed what is the cause that letteth and pro [...]yteth the sayd cleuyng, or growyng togyther / [...] whiche cause ought to be done awaye. But in [...]hem that renewe y^e cycatryce induct / it behoueth [...]o kepe y^e sayd cycatryce, that is to wyt in strength [...] confortynge the suffrynge membre / or all the [...]ody in cōmune / and in ordrynge it that it endure [...]at lyghtly, by the remedies appropryate therto. ¶And after that Thessalus hath proposed suche wordes in the begynnynge of his boke of Cyrur­ [...]ery, he wryteth afterwarde more playnly of this matter, in this wyse. The vlceres that endure longe, & that may nat be healed, or that renewe and [Page] come agayne after the cycatryce, gyue suche indi­cations. That is to wyt / in them come nat to cy­catryce, it behoueth the lettyngꝭ of the vnyon and coalescence / and renewe the vlcerate place. And after that ye haue made it lyke vnto a fresshe wounde / it must be healed agayne as a bledynge vlcere. And yf the sayd cure profyte in nothyng, ye ought to mytygate thynflāmation / and make all other dylygence. But the vlceres that come to closynge and open agayne in y^e actes and outwarde sores / ye ought to heale them, lyke vnto thē wher there is fresshe brennynge. And afterwarde ye ought to lay vpon the sayd vlceres a playster made of mytygant thynges, vntyll that the yre and fyersnesse be abated. After this done ye ought to helpe to dresse the cycatryce. And than that ye make the partyes about it waxe reade / in wrappyng it aboute with a malagme (that is to wyt a salue malactyke) the whiche is made of Mustarde / or with some other medycament that may chaunge the sayd parties, and make them to be the lesse subiecte to dysease. And yf they ceas nat ī this maner / ye ought to haue cure of all the body / in strengthyng it with dy­uers exercytacyons, iestynges, and vociferacions, in cōmyttynge them that kepe hym to such thyn­ges. Also by maner of lyuyng, dymynuyng, or augmentyng by degrees / in begynnyng at vomytyn­ge made by Rayfortz. Ye shall also vse whyte Ele­bore, and all other thynges, wherof we vse in dys­seases and dyffycyle to do away that are subiect to [Page] reason and maner of lyuyng / beholde here the saying of Thessalus. ¶Nowe we must esteme the stupydyte or audacyte of the man. I say the stupidite yf he thynke to say well / and the boldnes yf he fole hym selfe culpable to saye nothynge. And by this meanes hopeth to abuse and deceyue the readers. But tell me Thessalus / what is the indicacyon curatyfe taken of olde sores? In good soth I neuer founde curation that was indicate and shewed of the olde vlceres, nor of new, nor also of the tyme in what dysease that it be / but of the affection & dys­posycion that I haue purposed to heale. For totally yf we regarde tyme / as yf the indycacyon cura­ [...]fe were taken of it, the seconde day we shuld gy­ue all other indication than the thyrde. And lyke­wyse to gyue the .iiij. day another, than the .v. and so of the .vj. and all other dayes folowyng. And by [...]he meane we shall no more consydre the dyseases that we cure. And the indication shall no more be [...]ken of them / wherby we coulde neuer thynke a [...]aunger reason. Howe than are the cōmunytees [...] vlceres necessary that endure a great whyle, se­ [...]g that y^e tyme of it selfe can indicate in nothyn­ [...] For whan one vlcere is with erosyon, that cō ­ [...]eth of euyl humours / we shall nat take for that [...]he monethes after another indication, but that which we haue taken at the very begynnyng, and for a trouth I wyl nat parmit that such an vlcere shuld abyde longe tyme / but at the fyrste I wolde take the cause therof away. For it is leful y^e moste [Page] often to knowlege the dysease at the begynnynge, and it is necessary that the indication be taken of the sayd dysease. But I can nat coniect what may shewe and ensygne the tyme more than the nom­bre of dayes, but that Thessalus wyll saye that to haue knowledge of such vlceres / we must tary the tyme / but in such a maner he shuld be an ydyot all togyther. That is to wyt, yf he cōfesse openly that of other thynge the indication curatyfe is taken / and of other the knowledge of the dysease. For al­though that the tyme serueth somwhat to y^t dys­ease / neuerthelesse the indication curatyfe is nat taken of the tyme. But wherof serueth it yf any vlcere be inueterate, to do away that whiche let­teth the coition and coalescence, and to renew the place that is payned? For a man inepte yf by a fyl­thy fluxyon (that the Grekes cal cacoethe) the lyppes are disposed in such or such maner / what shalt thou proffyte yf thou cut it before thou hast prouyded to stop y^e fluxyon? That is to wyte / thou shalt make the vlcere wyder than it is / as some do that cure vlceres in the same maner / bycause that as longe as the cause lasteth that before made the vlceres harde and flynty. Other thynge shal nat co­me of thexcysyon of the sayd vlceres but amplyfy­cacion. For them that thou cuttest shal be agayne as hard and stony as they were before, albeit that the prudent and wyse Thessalus (God knoweth) hath nat added this word, that is to wyt, that the partye of the vlcere that is stony and harde & vn­coloured [Page] ought to be cut, but cōmaūdeth by abso­lute sentence and diffynytife, that we ought to cut that which letteth the closynge of the vlcere, and renew it, yf he counceled to do away y^e causes that let and hyndre the agglutynacyon. And that this reason and maner were antyke I wold nat excu­se hym. For it is a precept and cōmaundement al­moste of all the auncyent maysters / whiche haue wryten by any reason and Methode of the cure of vlceres that it behoueth to do away the effycyent causes of the said vlceres, lyke as of al other sores, [...]or to say that in vlceres the cause effycyent muste [...] fyrst done away, & nat in other diseases, it were of no purpose. But totally in all dyseases wherin the effycyent cause remayneth styll, it behoueth to begyn the curacyon at the same cause. And yf the [...]ayd Thessalus hath left to tel all the causes that let the coition and conglutination, & that he hath [...]nely spoken of the labyes (as he hath shewed af­ [...]warde) it appereth that he ignoreth, more than [...] knoweth nat what belongeth to the curacyon [...] vlceres. For it is possyble that the same cause [...] alone, wherfore the vlcere may nat be cured, as [...] sayd the intemperancy that is in the vlcerate [...]tyes, w^tout any tumour agaynst nature maye [...] the cause. It is also possyble that the sayde in­temperancy be coniunct with tumour, the which natwithstandyng requyreth nat al togyther that the labyes shulde be cut. It may so be that varix / that is to say a swollē vayne that is aboue it may [Page] be the cause, or that the mylte is augmented, or some dysease of the lyuer, or the weykenes of the party greued, the which is none other thynge but a clere and notable vntemperatnes, or euyll and vycyous humour in all the body that the Grekes call Cacochynne. The which is the greatest cause of all them that maye vnproffyte and anoye in the vlceres. As moche also may greue the vlceres the superhaboundaunce of humours egal to the same that the Grekes cal Phethora. ¶Yf Thessalus cō maunde to do awaye euery of these causes aboue sayde, I alowe hym, as he that consenteth and is conformed to the auncyentꝭ. But also yf he be nat of the opynyon that onely the labyes shuld be do­ne away, I say that of many thyngꝭ he hath kno­wen one alone, which is so euydent that the shepeherdes are nat ygnoraunt therof. For yf a shepe­herde sawe the labies of a sore, harde, flynty, wan, and blacke, or of any other notable vyce of colour, he wold haue no dowbte for to cut it. Than for to cut is a redy and easy thynge / but for to heale by medycamentes is a greater thynge / & that requyreth workemanshyp. Neuertheles Thessalus ne­uer knewe what the labyes are that may be softe­ned by medicamentꝭ. For all confesse that he hath swerued from this party of the arte. And thus (as hym selfe sheweth) it semeth that he had neuer experyence nor rational scyence of any medicamētꝭ, whiche is a manyfest thynge of the boke that he hath made of medycamentes. ¶But to the pro­cesse [Page] of this worke we shall treate of the passages whic [...] he hath nat wryten well.

ANd nowe we wyll dyspose vs with delybera­cyon to speake of the curacyon of inueterate vlceres, the which he hath treated in saying aforesayde. Certaynly it had ben better to haue called them Cacoethe, that is to say wycked, and nat in­neterate, and than declare theyr nature, and expos [...] the cause of theyr generacyon, and curacyon of eche of them. That is to wyt, fyrste the cōmune cu [...]acion of al vlceres, in asmoche as they be vlceres, [...]e which I haue wryten in the thyrde boke next [...]fter the partyculer and propre curacyon of eche of them, after the kynde of the effycyent cause, as I haue taught in this present boke. And howbeit [...]at Thessalus hath done nothynge of all these [...]nges, yet he estemeth y^t the vlcerate place must [...]ewed. Than whan y^t it is made as a fresshe [...]nde, to heale it as a blody & rawe vlcere, what [...] / yf he be exercysed in the workes of the arte [...] vnderstandeth nat euydently that suche do­ [...] hath ben wryten by hym that neuer healed [...] Is it possyble that any maye heale a inue­ [...]e vlcere as it that is cruent and full of blode, [...] y^• he hath made it lyke a fresshe wounde? shal [...] in drawyng the labyes of the vlcere togyther by rolles, or ioynynge them by stytches, or sooner neyther by the one nor the other / but by medyca­ment apt and conuenable in vlceres cruent & blo­dy [Page] with lygature? What is he that knoweth nat that an vlcere Cacoethes is caued, seyng that it is made by erosyon? Is it possyble than (O foole and imprudent Thessalus) that an vlcere caued may growe togyther and be agglutynate before that the cauyte be replete with flesshe? Is nat that to cure an vlcere as a grene woūde? Than hast thou wryten in vayne / that y^e indicacyon to cure caued vlceres is nat closyng, but fyllynge. And howbeit that euery vlcere Cacoethes and wycked were nat caued of it selfe and of the owne nature / neuertheles whan it is made as cruent in cuttynge the la­byes (as thou cōmaundest) necessaryly it is made caued / and acquyreth ryght great dystaunce of labyes / in such maner that I can nat se howe thou mayst conglutyue it and make close as that whi­che is cruent. For yf thou assay to approche them by force and vyolence, the labyes that are fer asonder, is of necessyte that there come a phlegmon / and also the sayde labyes may nat mete and close togyther, which as me semeth is onely to be vnder stande of Thessalus. Than afterwarde he addeth these wordes / yf the vlceres be nat bounde y^t thou mytygate the phlegmon. For it is necessary that they be nat vynculate / but bycause that the same also be gyuē to Thessalus, and that we passe ouer without so curyous examynacyon. It is euydent to euery one that he foloweth nat the cōmunyte that hym self hath gyuen. For yf we take y^• which let [...]th we shall take no more any thynge of the cō ­munyte [Page] of inueterate vlceres, in asmoche as they be suche. Natwithstandynge this, put we the case that it be so, and let vs se what foloweth. Thessa­lus wryteth in this maner. ¶The vlceres that come to cycatryce, and open agayne shall be healed in the acceys and vlceracyon / in suche maner as they that lately haue be vexed & greued by phleg­mon. Than after he sayth / ye must cause readnes to come to y^e partyes that are aboute it by a play­ster, that is to saye reuollytyfe, whiche is made of mustarde sede. What sayst thou made fole? yf the fluxyon be bytter and hote, must the party be ma­de reade with mustarde sede? In suche wyse y^t that which the said party ought to haue of the fluxion [...]t shall obtayne forthwith by thy salue? That is, [...]hat it be all vlcerate and reade. For the auncyen­ [...] made the weykenesses of y^e partyes that was [...]me of colde, or habundaūce of humour without [...]anyfest heate in makyng reade them. But thou [...] rubryfycacyon in all sores. Fyrste w^tout ma­ [...] any dyfference, yf the vlcere be nat cured ey­ [...] by the weykenes of the partye, or by the ma­ [...] of the fluxyon, & than thou tournest the ordre. [...] after that thou hast brent y^e party by mustar­ [...], and hast proffyted in nothynge, than thou [...] to the curacyon of all the body. Howebeit [...]t after my iudgement, all the countryes be or­deyned and stablysshed in such thynges, as wel by reason as by experyence. That is to wyte that all the body be fyrste emptyed of supfluytees, or that [Page] any dare admynyster any bytter or hote medyta­ment to the partye. For all those medycamentes drawe vnto them from all the body lyke vnto the cucurbitule, that is to say ventose or boxyng. And thus yf thou do nat empty fyrste all the body thou shalt leaue mater of fluxyon to the bytter medycament / which thynge the emperyke confesse / and so do the dogmatistes, & the most auncyent doctours haue estemed it so. For in as moche as Thessalus hath made mencyon of them, it shal be no straun­ge thynge to cyte and alledge them as wytnesses. That is nat leafull to heale the eye well before all the rest of the heade, nor the heade before all the body. Such was y^• sentence of Arystotyll & Plato in the curacyon of dyseases. Lykewyse of Hypocrates, Dyocles, Praxagoras, and Plistonicus / but Thessalus alone gaynsayth this opynyon / and cō meth fyrste to the composycyon of mustarde / and than he hath sollycytude of all the body / without shewynge any thynge wysely. For as yf it were le­full after to haue ones purged all the body / forth­with to fede it with holsome and good meates, of vocyferacyons, and exercytacyons, and of iestyn­ges / and of the maner of chaunge of lyuynge / by certayne cyrcuytes and actes. Than of the vomy­tes made by Rayffortz / and for sūme and conclu­syon he hath ordeyned the elebora. It is hym selfe that hath promysed to heale al diseases easely, but I can nat vnderstande howe that any hath so wel healed, eyther in more longer space of tyme, or by [Page] more vnprofytable labour. ¶Nowe than lyke as we haue seen by vsage and experyence / put we the case that there be any to whom it behoueth to cu­re an vlcere malygne and Cacoethes / put we the case also that there is any other that is in health / but bycause he hath scratched hymself in any party, as on the arme, and sodaynly is rysen a blyster or pustule. Than w^tin a whyle after there cōmeth an ytche to the party / and after the pustule is broken there cōmeth an vlcere dyscoloured with fre­ [...]yng vnegally / and that such thynges is come in. iiii. dayes fro the begynnyng. To this purpose let the mayster Thessalyen answere me / in what ma [...]r it behoueth to heale suche an vlcere. I call it [...]ntyerly malygne & cacoethes. And therfore forth [...]th I wyll consyder what is the disposycyon and [...]fe [...]ion of al the body. For I wyl inuent of what [...]de the humour superflue shal be; as well by the [...]mptomes of y^e vlcere / as by the sygnes of all the [...]. Than forthwith I wyll purge the sayde su­ [...]e humour / w^tout taryeng y^t all y^• elbow of y^• [...]ent get any dysease / stoburne & waywarde to [...]yon. But the sectatours of Thessalus / that [...] wyt they that obserue his preceptꝭ wyll tary [...] vlcere be olde, bycause it maye retourne to [...] wonderous, and merueylous cōmunyte of in­ [...]rate vlceres, as yf it were nat moche better to [...]howe the cōmunyte of contumace & waywarde vlceres / the which wold indyke the curacyon, and nat of the inueterate vlceres. Afterwarde y^• sayd [Page] Thessalyēs wold do one of both / eyther they wold cut the vlcere and make it as it were fresshe, and approche the partyes as for to knyt them, or elles they wolde fyrste vse of the salue that is made of mustarde. And all that proffite nat, they wyl haue theyr refuge to vocyferacyons, & gestacyons, and other exercytacyons, and to the maner of lyuyng that chaungeth by cyrcuytes / and after they wyll moue vomytynge by rayffert / and yf the vlcere be nat cured by suche thynges they mynystre elebore called veratrā in latyn. And yf the elebore serue of nothynge / they sende the pacyent in to Lybie for the chaūge of ayre, vndoubtedly Thessalus ought to adde this worde. After this excellent and syn­guler curacyon of frowarde and rebel vlceres. For of trouth the Thessalyens stay in vocyferacyons, gestacy [...]ns, & other lyke thynges, as yf they shuld couer the euyll habytude of the body (whiche the Grekes call Cachexte) and nat the vyce of the hu­mour (that the Grekes cal Cacochymie) Is it nat merueyle yf they confesse nat to knowe the vlcere Cacoethes as soone as it is made / and that they tary tyll it be olde? And that often they vse cyca­ [...]ryce / and open many tymes or they vnderstande what to do? seynge also that they counceyll them that haue the feuers in what maner soeuer it be / to passe the excesse that ought to come the thyrde day or no? God knoweth howe they haue wel and parfytly knowen the contemplacyon of the Cryse, and in what maner they may fore [...]e the great encreasynge [Page] of the sore. What cōmeth therof moste often? Of a certaynte it cōmeth that the pacyentꝭ abydeth in theyr beddes / and consume throughe theyr defaulte / which myght haue ben healed the seconde daye. Of a trouthe nat ones, or twyes, or thryes alonely, but .vj.C. tymes haue we wasshed many febricitans incontinent after y^• fyrste actes, which we haue seen done by our preceptours and maysters. And consequētly haue permytted them to lyue without feare in their maner accustomed, as they that shuld no more haue the feuer, whom wyse Thessalus that hath exigited y^e fyrste dyete, that is to wyt nat to eate in thre dayes shuld ha­ [...]e dryed vp and consumed in makyng them sterue for hungre in thre dayes lōge. Than as I coniect he wolde fede them a lytell on the fourth day / and [...]o nourysshe them by lytel and lytel / in suche wyse th [...]t the .vj. or .vij. day they shuld scantly be able to [...] aboute theyr customable besynes, they that ne­ [...] had the feuer but ones onely. Of trouth he cō [...]med his pacyentes alway in theyr dyseases / the [...]iche ryght easely myght haue ben holpen. For [...] so were that the vlcere began to swell at y^e be­ [...]nyng, it myght haue ben holpen in few dayes, [...]hessalus wolde suffre it to rēne a yeare or more. [...] taryed often so long tyll the sayd vlcere often [...]e produced cycatryce / and wolde often open it to wit yf it were contumaced. Than after that he had begon y^e curacyon he purgeth nat forthwith the body, but fyrste of all vsed his salue of mustar­de, [Page] and than his Iestes, vocyferacyon, & certayne maners of lyuyng, & than his vomyte of rayffort. And fynably of the Elebore what it is? any other thyng than to lyngre a hole yere? That is to wyt (by the lyuyng god) whan the pacient may be healed in .vj. dayes or in .vij. at the moste / shulde we prolonge a moneth to knowe yf the vlcere be Ca­coethes and wycked / and than that we shulde be­gyn the curacyon? But what necessyte was it to speke of the propre cōmunyte of vlceres iueterate, seynge that they are mutyle in the curacyon / albe it that it were lefull to wryte, nat of the cōmunyte indicatryce, but of the curacyon of vlceres, nat in­ueterate, but contumaced and rebell. For it happeneth that some vlceres and diseases are contumacy and rebellyon to heale. Howbeit indicacyon curatyfe is nat taken of this contumacy and rebel­lyon. But it is the disease that gyueth the fyrste indicacyon of healyng. And of the sayd fyrste indycacyon are founde the remedies as I haue declared. That is the maner to heale by Methode, as that we do in folowyng the auncyentes, yf it so be that Methode is an vnyuersall way, which is cōmyng to all partytuler thynges. ¶Here is Thessalus be gyled, for he weueth that all y^• knowledge of them that do any thyng by Methode, is Methode / surely it behoueth that he that doth any thyng by Methode haue notyce and knowledge of the lyke and vnlyke. Neuerthelesse that is nat Methode / that is [...]o wyt the sayde notyce of lyke and vnlyke. Also [...] [...] [...] [Page] Arystotyll and Platon affermeth it nat / whiche Thessalus dare falsely alledge. But at this tyme is nat conuenyent to reffute & reproue suche pur­poses / wherfore I wyll retourne agayne vnto the Methode curatyfe, promyttyng to shew that the­re is a pryncyple of Methode in all curacions, and that the way that ledeth fro this pryncyple to the ende is semblable in all partyculer thynges, wher by (albeit that in all dyseases it semeth that there is one propre and pryue Methode to heale) neuer­thelesse in all thynges there is one cōmyn gendre / for it behoueth alwayes to begyn at the indyca­cyon that is taken of the dysease that we entende to heale. And than we must esteme and dyscerne yf the cause of the disease be ceased a redy, or yet pre­sently it augmenteth & maketh the sayde dysease. Yf the sayde cause be alredy ceased, we must come so y^e Methode wherof hath ben treated in y^e thyr­de boke of this worke. But yf the sayde cause yet presently make the dysease, the Methode is trea­ted in the .iiij. boke. By the whiche Methode thou shalt fynde the remedyes of a phlegmon and of a [...]euer, and shortly to speake of all maladyes. That [...]s to wyt, yf nothynge is done, thou shalt nat take [...]ayne to enquyre the precedent causes / but shalt begyn onely at the dysease. But yf any thynge be done presently thou shalt prepose two fynalytees of curacyon. And than do the other thynges by order, as it is sayd. ¶Nowe it behoueth to merueyl of Thessalus dyscyples / nat for bycause they fayle [Page] in such thynges, but bycause they do vse these na­mes, Dyspathies, Metasyncrises, Imbecyllitees, [...]yrmytudes, and sondry other such names. And yf ye questyon them what suche names meane / they wote nat what to answere. For to knowe what it sygnyfyeth that they call in all inueterate vlceres Metasyncrynien ten exu in Greke / they answere nat with one accorde, nor clerely, nor prudently, yf that it were an auncient name, or vsurped by any of the Grekes, at aduenture we myght vnderstande of that they haue wryten, what thyng it sygnyfyeth. But bycause it is a propre name vnto theyr stupydite, that is to wyt, that is come of the supposycyon and Hypothese of Asclepiades lyke as their other decrees, is it nat then iust & reasonable that they iustyfy theyr dreames? That is to wyt, from whens this that is sayd Syncrinestai ta somata [...]ai diacrinestai. As ye wolde sayd medle & dyuyde the body. And that it were onely leafull to vsurpe suche names, to them that call and constytute the lytel body Atomes, and the poores, and conduytes or the indiuidnes, & vacuyte. And fynably the im­patable and inalterable thynges to be the fyrste elementes. As that for certayne they vsurpe and contynually vse such maners. Moreouer Thessa­lus in his Canon whan he confermeth the pryncyples reneweth some thyng besyde that which was put in wrytynge by Themyson and Asclepiades / and ensigneth clerely what he wyl say, for he hath nat estemed all togyther as As [...]epiades. That is [Page] to wyt euyn in such wyse as in Symmetrye, that is to say, that in competent and cōmoderacyon of smal conduites lyeth and consisteth the helth. And in Ametrie, that is to saye / in vncompetence and immoderacyon in them the dysease. Also that cu­racyon or sanacyon is none other thynge but a retourne to the fyrste symmetrye or cōmoderacyon of the sayd conduytes / but he weneth that all the state and condicion of the sayd conduytes must be chaunged. And of this opynyon is proceded y^e na­me of Metasyncresis, which may sygnyfy as mo­che as Metaporopoesis in Greke. That is to say, mutacyon of the state of pores & smal conduytes. Howbeit it was nat leful for hym to vse the name of Dogmatystes, in places where he cōmaundeth to eschue the vncertayne and darke names & one­ly haue the vnderstandyng attentyfe in the cōmu­nytees whiche appere euydently. Than his dyscy­ples and seruauntes answere that he must nat be herd as a dogmatyke / whan he vseth of these na­mes, Mais alephos, that is to say, symply. For of a trouth some of his dyscyples are accustomed to susteyne and defende hym in this maner / in reuo­kynge vs agayne to another name, that is Arphi­ [...]a, whiche we translate, symplenes. The whiche name (of a trouth) I can vnderstande what it sygnyfyeth. For yf he dyd sende vs agayne to a name more vayne (that is in Greke vioticos) the whiche they expose doth signyfy as moch as semblably to the vulgare of men. Truely as moch shuld it be to [Page] say Aphelos nat duely nor ryghtwysly / but with­out arte or scyence. For the men that are the moste lyghtest and quycke of speche vse names of artes and sciences, vnder some sence that hath no foun­dacyon. And whan they are demaūded what they mene, they can neyther tell nor showe. The which thynge th [...]se Thessalyens confesse to be theyr de­cent custome, the which thyng we do obiect them, and for certayne they wyll also confesse that they vnderstande nat partfytly & exactly what is Me­tasyncrysis, yf it be sayd of y^e mutacyon of poores, that in Greke is called Poropoia, in dede it shulde haue some vnderstanding, and sygnyfy somwhat, but vayne in many maners, bycause that our bo­dyes are nat composed of corpules motes / nor of poores. And yf they were true, yet shulde it nat be possyble to shew in what maner Mustarde myght chaunge or alter the state & condycyon of the poo­res. And yf any can shew it, yet shuld he nat be consentynge and confermed to theyr secte, seyng that they saye, to be content with the apparent cōmu­nitees, wherby that they vse no more such names, and that they hyndre and let vs no more, for it is leaful without the name of Metasyncrysis, to say in other wordes the curacyon of froward vlcere [...], as the Emperykes do. ¶Also we haue shewed in the seconde boke, howe the sayde Thessalyens ar [...] lykewyse abuse at the vocable Atonias, that is to say, Imbecilite, for they take the name as the emperykes, for it sygnyfyeth none other thynge, but [Page] that the actions is nat kepte. But yf they propose that there is any facultees and vertues that go­uerneth man, whiche we afferme, and almoste all the auncyentes, besydes that they gaynsay to the preceptes of Asclepiades, they propose vncertayne thynges, of the which the Auctours agre nat wel togyther / howebeit they cōmaunde to flye suche thynges. ¶But tell me Thessale clerely, what be­t [...]keneth this vocable Metasycresem? yf thou say that it betokeneth to chaunge the poores & small conduytes, thou begylest thy selfe, and vsurpest vncertayne thynges / yf thou say that it is as moche to saye, as to yelde the party of y^e body stedfast and hole, or al the man, thou sayst no more to this purpose than the Emperykes, excepte the nowne. For they knowe wel that man becōmeth hole by other remedyes, but they knowe nat by what cause and reason the remedyes restore helth. For none of the Emperyke can tell yf the faculte of medycament chaungeth the poores / nor yf it make symmetrie and cōmoderacyon / nor yf it altereth the qualyte of the pacyent party, howbeit the Emperykes are discrete yf they say y^t they knowe onely one thyng, that is to wyt, yf they haue noted and obserued often tymes, that vtylyte hath folowed whan y^e me­ [...]ycament of Mustarde hath be mynystred to such a sore, and in such tyme. Neuertheles they speake nat of Methode, nor reyse theyr browes at it. And be nat pleased with suche notyce, and myssaye nat the auncyentes, nor dysprayse nat Hyppocrates, [Page] nat estemynge hym as nothynge / but they alowe hym and afferme that he hath sayde all verytable thynges. But yf Thessalus here that myspryseth Hypocrates, and al the other maysters, vnderstandeth nat that all the preceptes that he hath wry­ten of the frowarde and rebell vlceres ben Empe­rykes. Albeit yf he wrote them wel & cōmodiously it shulde be somwhat profytable / but it appereth nat that he hath done so / seyng that he parnerted the ordre of remedyes / and vsed remedyes for the party, or that al the body was prepared. In good soth it is a sygne and argument of an vntaught and great ygnoraunce (seyng that in this thynge almost all the maysters of medycyne do agre, albeit that in sondry thyngꝭ they iarre) that is to wyt, that all the body muste be emptyed and purged of all his out waxynges, or that any partye be take subiecte to the stronge and vehement remedyes. ¶For who soeuer wolde iudge, eyther by expery­ence or by reason (for there is none other thyrde maner to iudge, nor in what arte soeuer it be, nor in any partye of lyfe) he shall fynde y^t it is a great incōmodyte to mynystre to y^e sore party any salue or plaister that is bytter and hote, or he prouideth for all the body, which fyrste requyreth his propre cure. For the sayd medycamēt draweth to it from all the body in y^e maner as cucurbyte and ventose doth the excrementes and superfluytees. And so it cleueth and stycketh to the sayd party greued and sore, in suche wyse that with great payne it may [Page] be scantly pulled of. ¶Wherfore it must be asked of these Thessaly [...]ns, from wkens y^e sayd fantasy came to Thessalus to wryte fables and toyes, as touchyng the curacyon of frowarde and rebell vl­ceres, seynge that none Emperyke, nor racyonall hath so wryten before. Albeit neyther Thessalus, nor any of his dyscyples and sectatours dare nat afferme that suche ordres or remedyes do agre w^t expexyēce or with reason. Moreouer they can nat shewe in what maner of tyme indyke and nat the disease, nor also (that is yet more) howe Th [...]ssalus is nat all holly folysshe and dul, that iudgeth that the cause must be estemed y^t letteth and kyndreth the cycatryce of vlceres, the whiche cause is to be done awaye / and lykewyse seeth nat that it suffy­seth, and that y^e length of tyme of vlceres s [...]rueth of nothynge / with this he considereth nat that he must do thus, nat onely in vlceres, but also in all other dyseases, as the auncyentes do admonysshe. But they answere nothyng to these purposes, but that they say alwayes, that we do nat vnderstan­de them wel, as yf they knew parfytely y^e thought of Hyppocrates, and of all the auncyentes. And afferme that Thessalus hath a good opynyon whē he sayth that there is a cōmunyte of y^e inueterate vlceres, and that Hyppocrates vnderstode it so in the boke of vlceres, which wryteth in this maner. It is profytable that the blode do flowe contynu­ally from y^e olde sores, in what maner that it hath ben seen nedefull. ¶At all aduentures than what [Page] may come to speake sōmaryly of the sentence and intelligence of Hyppocrates, thoughe I haue nat promysed that I wolde speake of it in this place / but that which I wyll say shall be of the interpre­tacyon, of the wyt & knowledge of the auncyentꝭ. The whiche as we haue sayde as yet hath gyuen no seet, but studyenge w^t symple and pure thought to inuent some thyng profytable to helth, it is wel semynge that they haue founde some thynges by vse & some by reason. Than dyd they wryte theyr inuencyons many tymes without gyuynge any reason to theyr inuencyons, & somtyme they dyd, the which they haue done for cause of the profyte of the readers. For they trusted to be profitable to theyr successours, as to the good and ryght vsage of inuented thynges to knowe the reason of theyr inuencyon) and haue wryten it dyligently. To the contrarye, where they haue estemed that it shulde be superflue to recyte, they haue obmysed and left some. ¶Nowe it is well knowen to all after that I holde my peace, that the auncyentes haue well loued shortnes of speche, and pryncypally for that cause. Nat a lonely Hyppocrate, but also all the o­ther auncyentes. Somtyme w^tout makynge mencyon of the myddel moste added the thyrde thynge. For yf the fyrste thyng be sygne of the seconde, the thyrde necessaryly foloweth after the seconde. For this cause the fyrste they put y^e thyrde, obmyttyng and leauyng the seconde. ¶I haue shewed sondry tymes howe the auncyentes and chyefly Hyppo­crates [Page] haue wryten suche thynges. And he that wyll knowe and parfytely vnderstande the maner of interpretynge, that the auncyentes had, ought to be exercysed in theyr style and maner of wrytynge. For this tyme I wyl expose onely that which [...] I haue purposed / that is to wyte the vlceres the which (after wel and duely to haue done all thyn­ges requysyte) althoughe they be nat cured, the maysters in medycyns call them Cacoethe in gre­ke, we call the malygne or wycked, stoborne and rebell. ¶Nowe haue we spoken in the boke afore what curaciō of vlceres is. Thā these vlceres here all are called Caroethe, inueterate, and dinturnes in vsynge such names indyfferently. Lykewyse for to knowe the dysease Cacoethe is (that is to saye waywarde, stoborne or rebellyous for to heale) it maketh somwhat with y^e other sygnes, neuerthe­ [...]esse the dyuturnyte, or that the said vlceres be cal [...]d dyuturnes, of longe contynuaunce. And inue­ [...]rate, as waxen olde / and in dede ar [...] suche that [...] maner of conuenyent indycacyon of curynge / [...] it must be inuented bycause that the vlcerate [...]arty is yll ordred and paynfull. That inuented, [...]he maner of curynge is euydent. But thou must [...]ye, howe so? Of a trouth yf thou heale the vlce­ [...]ate parties, prouided that they onely are payned, but yf all the body habounde in vycyous, and cor­rupt humour. In emptyenge & clensynge the sayd humour / for truely the sygne of the vycyous hu­mour is the dyuturnyte of the vlcere, but y^e inuen­cyon [Page] of that which is vtyle and expedyent cōmeth nat fyrste of the dyuturnyte, but of the malyce of the humour / wherby these thre thynges folowe eche other by ordre. That is y^e sygne, thaffection, and the curacyon. The sygne is the dyuturnyte, thaffection is the vyce of the humour, and the cu­racyon is the euacuacyon of the sayd humour / by this meane ye shal fynde that the auncyentes many tymes after the fyrste anone make mencyon of the thyrde, leuyng the myddylmoste. As Hyppocrates dyd whan he said it is vtyle to cause the blowe flowe often out of vlceres inueterate in what ma­ner that it be, so that the thyng be seen behouefull nat that the dyuturnyte indyketh the curacyon / but the vyce of the blode. For a lytel after he sayth thus. The vyce of the blode hyndereth greatly the healyng of the sayde vlceres. Also putrefaction of blode / and all thyng that is come by transmuta­cyon of blode letteth all other vlceres for to heale. Anone after whan he speaketh of vlceres that co­me nat to festring he sayth this wyse. The vlceres may nat be closed togyther yf the lyppes and par­tyes that are rounde aboute it become swarte or blacke, bycause of the rotten blode, or varyce (that is to say a tumyde vayne) that causeth the fluxion yf ye heale nat the sayd partyes that be aboute it. Afterwarde he wryteth of the cure of the varices. And furthermore he maketh mencyon of the purgacyon of all the body, as well in other woundes, as in them where there is feare and daunger of [Page] rottēnesse (called in Greke spha celos) and also in serpentz vlceres, and in al Eschirmenes, that is to say that are eaten and reade. ¶And thus Hyppo­crates is accustomed to name the vlceres that be reed by any humour. And also whan he speketh of them that ensueth he sayeth in suche wordes. In euery vlcere where as chaunceth to come Erysip­clas / all the body must b [...] purged. And fynally yf ye rede dylygently the boke of vlceres, ye shall fyn­d [...] that he taketh indicacyon of the dysease alway, as somtyme of the tyme, but that is to knowe the disease. And that it is so, ye may knowe it at the beg [...]nnyng of the sayd boke, which is such. It b [...]ho­u [...]th nat to moyste y^• vlceres, what so [...]uer they be, but with wy [...]e. Then telleth he the cause saying. For the dry vlcere is y^e nerest of helth, & the moyste to [...]orenes. Then anone after he sayth / for y^e vlcere [...] moys [...]e, but y^• is drye is hole, & therfore in all the [...]e, in asmoch as he hath constitued y^• ende of al [...]e [...]ure of vlceres to be drynesse / forth w^t he hath [...]ūde the ꝑticuler thyng [...] admonysshing vs many [...]ymes of y^e sayd ende / for when he wryteth in this maner. Euery vlcere y^t is dyuyded w^t a cuttyng in [...]ument or sharp poynted receyueth medycamēt [...]is mynysire at y^e begynnyng in blody & rawe vl­ [...]s, y^t which medycament in greke is called En­hameon, or otherwyse a drying medicine y^t letteth it to come to suppuracyon / for it becōmeth dryer bycause of the fluxyon & shedynge of y^e blode, & yet agayne Hyppocrates sayth. All vlceres y^t are pur­ged [Page] ī tyme behoueful, so y^t they come alway to more drynesse, in the moste parte of them come none o [...]ergrowynge nor superfluyte of flesshe, but that there is bruse, and agayne. Yf any vlcere may nat cleue or growe togyther, the moyste flesshe is the cause. ¶In all these passages Hyppocrates admonyssheth vs of the fyrste indicacyon curatyfe of vl­ceres. For of a very trouth the curacyon of an vl­cere (yf as) & beyng but vlcere is meane and mode­rate dryinge, wherof the demonstracyon hath ben gyuen in the boke afore, but the curacyon [...]f an vlcere y^t is coniunct w^t another affection, wherof the cure ought to procede, is nat lyke an vlcere alone, but the fyrste curacion shal be of y^e same affection, and the seconde of y^e vlcere. For yf there be eyther phlegmon or swart colour, or ecchimosis, or erisipclas, or tumour, y^t is called [...]edema in the vlcerate party, fyrst ye must begyn y^e curacyon at one of the sayde affections, howbeit euery one knoweth well y^t the vlcere somtyme nat onely is nat wel & cōmodiously cured, but becōmeth moche greater, for yf in the parties roūde about y^e vlcere there is eyther bruse, phlegmon, or other tumour, we must fynde the propre curacyon of the said affection, & haue it for a certayne y^t it is nat possyble to heale y^e vlcere, yf y^e place where it is be nat cured fyrste. And therfore Hyppocrates putting vs in memory y^t which he had treated in y^e begynnyng of his boke to wryte al y^e other thingꝭ cōprised aboue, y^t are [...]sēt whē he sayth. Euery vlcere y^t is dy [...]yded w^t a cuttynge [Page] instrument, or sharpe poynted receyueth medyca­ment called Erhaemon & dyssycatyfe that letteth the vyle matter. But yf the flesshe be contused or cut remedy must be gyuen, in such wyse that it co­me soone to suppuracyon / for in so doyng [...] it shall be the lesse gr [...]ued with phlegmon. And al [...]o it is [...]e [...]essary that the flesshe that hath ben contused, and incis [...]d, the whiche putryfyeth, and cōmeth to suppura [...]yon, in collyquieng and meltyng, and af­ter that the newe flesshe is engendred. ¶By these w [...]rdes Hyppocrates sheweth manyfestly that al d [...]seases of the vlcerate partyes ought to be desic [...]t [...] except them that we wyl sodaynly brede pus, t [...]at is to say rotten matter / and passyng forth [...]e teach [...]th vs that pus or suppuracyo [...] is made w^t [...]ome pu [...]t [...]faction. Nowe all thynges putrifie by heate and moystnes / and therfore the Cathaplas­m [...]s made of barly meale (se [...]ng that they chaufe and moyste) we shal m [...]nystre, to all dyseases whe­ [...]t is expedyent to engendre pus. For the barly [...]ea [...]e with water and o [...]le, and lykewyse breade [...]ith oyle, or also a fomentacyon with moch hote water, and the strength of the salue called Tetra­ [...]ne make, and fynally all thynges that warme [...]nd moyste, forthwith engendre rotten matter or pus. And for y^e cause in y^e parties where as phleg­mon is, yf there be all redy vehement pulsacyon / in such wyse that there is no more hope of the cu­rac [...]on of the sayd partyes without suppuracyon all the auncyentes appl [...] the sayd suppuratyfe medycynes, [Page] and nat sooner. The which thynge Hyp­pocrates sheweth playnly in y^e wordes beforesaid, wherby he byddeth to drye moche the woūded partyes without brusure. And they that be with brusyng, it behoueth to brynge them soone to suppu­racyon. ¶Moreouer whan he sayeth, that all vl­ceres that be nat well and duely purged, & begyn alway to brede & encrease, in them the flesshe ouer groweth greatly / but they that are purged as it behoueth, and alwayes cōmeth to drines, in them the flesshe ouergroweth nat, but yf that there be contusyon. Of trouth to [...]he purpose, whan he ad­deth, but yf that there be contusyon, he reduceth vs to mynde of that he hath sayde before. That is to w [...]t all vlceres requyre for to be dryed, but they where as is brusynge. For yf ye do lay to the par­tyes where as is phlegmon, a Cataplasme that is hote and moyste, it is nat done by the fyrste & pryncypal reason. That is to saye, as remedy to y^e sore, but asswagynge of the symptome and grefe. For the remedies of phlegmon ar of dissicatyfe vertue. ¶Herken nowe what Hyppocrates sayeth. The playsters of tumours called Cedemata, and phlegmons that consysteth rounde aboute, be verbascū soden, and leaues of trifolium rawe, and the leues of Eperitron soden pol [...]m. All these medycamen­tes haue vertue dissycatyfe, as we haue shewed in the bokes of symple medicynes. And the sūme and shorte cure of the partyes where as phlegmon is, is done by the remedies that doth away all y^e hole [Page] dysease. Or yf y^e said remedyes haue left any thyn­ge remanyng y^t cōmeth to matter, it is nedeful to haue another medycament bytter & strong, y^t may make suppuracion. Or y^t the skynne y^t is aboute it be thynne, & that y^u wylt nat y^t the pacyent be soo­ner delyuered o [...] i [...], ye must make incysyon / but of the cure of phl [...]gmon by barly meale is sooner le­nition than curacyon, & fyghteth agaynst the dys­ease, & of y^e dyfierence of such thyngꝭ we shall sp [...]ke hereafter more at large. ¶N [...]we me thynketh to haue manyfest [...]y shewed how Hyppocrates hath cōmaunded y^t all vlceres ought to be dyssyccate, & that he hath ordeyned & confermed y^t it is the end of the curacyon. In asmoche as the indicacyon is taken of the dysease, & nat of the ty [...]e. And yf any desyre to haue greater persuasyon, let hym red [...] dylygently al the b [...]ke of Hyppocrates, that he hath wryten of vlceres. For he shal vnderstande clerely that there is one generall indycyon of all vlceres, that is to wyt y^t which we haue shewed in the precedent boke. And also y^t there is none indycacyon that is taken of tyme, nor at vlceres, nor a [...] p [...]leg­mon, nor at other greues. And therfore we are cō men to the purpose & place to speke. It is a thyn­ge iust and trewe to shewe that Hippocrates hath ben inuentour, nat onely of that we haue sayd be [...]ore, but also of all other thynges that is for to be knowen to hym that ought to hele an vlcere well. For it appereth that he hath inuented the reason and maner to heale the symple vlceres, and that [Page] are without other affection, which lyeth and con­sisteth in dissiccacion [...] But also partyculerly by the kyndes of euery dysease. For eyther the vycyous humours flowe no more in the sore partye, or els it floweth styll. Yf it flowe no more, it behoueth onely to succour and remedy the party that is payned. That is to wyte yf it appere pale, blacke, or read, it must be scarified and made to blede. Then afterwarde (bycause that I maye vse his wordes) must be layde therupon a sponge more dryer then moyst. I thynke that no persone is ygnoraūt that this partycle (that is to wyte than) hath in this place any strength of denyall, as yf he sayde thus drye and nat moyste. And afterwarde ought to be applyed remedyes dyssyccatyues. And than (yf it be requisyte) for to drawe blode agayne, and forth with after make suche thynges as is abouesayde, vnto the tyme that the helth be all togyther got­ten. And yf the lyppes of the vlcere appere harde and stony, they must be cutte, wherof is spoken in this wyse. Yf the vlcere that are cyrculer and roū ­de be caued somwhat, it behoueth to cut in maner of a cyrcle the partyes that are cōmen in swellyn­ge, which in Greke is called call apostema. Eyther a hoole or halfe a cyrcle accordynge to the length. Also it is wrytten of all tumours that are con­iunct with an vlcere how it ought for to be cured, Lykewyse of the varyces / for by the occasyon of them the vlcere is waywarde and rebel to be hea­led, yf that any humoure of the sayde varyces do [Page] flowe in the vlcerate partyes. In lykewyse whan the fluxyon of humour cōmeth [...]rom all the body, he byddeth that all the bodye be purged without takyng of any indicacion of tyme. And for certay­ne it shuld be a laughyng thynge that so many of dyuers and often contraryes shulde be taken of a cōmunyte. For put the case that any indycyon of tyme be taken / yet fynally it must be sayd what it is, and compryse it in a sūme / as Thessalus doth (nat onely we) whiche hath alway an indycyon of the dysease of the body that is stopped, that is to wyt that it be vnlosed / and another vnlosed of the body to be stopped. Lykewyse in the vlceres, y^t that is fylthy requireth to be clensed, that y^t is caued to be fylled, that y^t is egal to be festred. And that that ouergrowen f [...]esshe, that it be had away, as Thes­salus selfe is authour. Let hym shewe than that there is a thynge proporcyoned in the dyuturne and inueterate vlceres, as there is ī all them afo­resayd, whiche is nat possyble to hym, for he byd­deth that they shulde be cut. But what is that racyonall indycyon taken of tyme / and than to vse remedyes of Mustarde / of the whiche he taketh and vsurpe [...]h this vayne worde Metasycrisis? af­ter that he prouoketh vomytes, by Raffortz. And at the last whan he fyndeth none other remedy to vse Elebore? Of the which thynges shal be spoken more playnly hereafter, whan we shall shew that no indicacyon in what dysease soeuer it be nat ta­ken of tyme. Albeit that y^e tyme is somtyme sygne [Page] of the dysease. ¶But I fynde agayne a [...] Hyppo­crates, wherof I merueyle of his great dylygence in all other thynges, and chyefly y^• he hath nat forgoten y^t whiche is pryncypally to be consydered, of the mayster in medicyns touchyng to indicacion. Nat onely in one dysease or two, but in all. That is to wyt the indycacyon y^t is taken of the mygh­tynes of the dysease, which the Methodykes onely haue nat left (whiche is no merueyle) but also dy­uers of the racyonalles, & Emperykes althoughe it be in dyuers maners. For when they say y^t they haue obserued the euacuacyon of the cours of to moche blode / they confesse manyfestly y^t they haue no regarde of other thynges y^t appere in the sores for to come to such euacuacyō, which y^t I say therfore y^e purgacyon is euacuacyon, the which is nat indicate by the cours of to moche flowyng of blo­de, but also for bycause y^t (althoughe y^t there be no cours of redoundyng blode) we must somtyme co­me & haue refuge to the sendyng of blode, in greke called phlebotomy? For when the disease is great, with the force of strengthes there is none but he make phlebotomy, yf he be expert in the workes of the arte. And sothly we se y^t the emperykes cōmeth to the sendyng of blode when any is fallen from a hye place. Or when there is any partyes sore bru­sed & hurte w^t any wounde thoughe y^t the pacyent were hole & sounde before & without superhabun­daunce of blode. By the whiche it appereth y^t it is nat the redoundyng of blode y^t indicateth the phlebotomye, [Page] but it is the myghtynes & vehemency of the dysease, & the force of the strengthes, acceptyn­ge alway children. And by an other reason, as yf a man be hole & sounde & in no wyse hurt & is ful in habundaunce of blode, for all y^• it is nat necessary to take his blode from hym. For to some, fastynge may satysfye, to another small eatyng, to another [...] flux of the wombe, or purgacion, or hauntynge of batthes, to another onely besynes, or habundaunt fretyng may be ynoughe. But the phlebotomye is nat necessary to such folkes, as the emperykes say also. Lykewyse purgacyon is nat cōuenable in the onely habundaunce of vycyous humour. But lyke as the phlebotomye is made eyther for habūdaunce of blode, or for the magnytude & fyersnes of the dysease, also the purgacyon is made for the habundaunce of some other humour, & for the vehemen­cy & force of the dysease. ¶ As touchynge the mys­syon of blode we haue treated in another boke, & shall treate hereafter. In this present boke I wyl speke of the purgacyon. For they y^t be dyseased de­syre it. Nat onely bycause y^t it euacueth the super­flue humour & noysome, wherw^t they be greued, but also to put it out & be clēsed. And for this cau­se Hyppocrates aswel in his other workes as in y^t that he hath wryten of vlceres considereth the ve­hemency & strength of the dysease to y^e indication of purgyng sayth thus. ¶Purgacyon by the bely is profytable to many vlceres, to the woundes of the heade & of the bely, & of the artycles, or also yf [Page] there be daūger of rottēnes in the bone, or where sutares behoueth, or also to gnawyng. Lykewyse to serpent vlceres & other affections y^t maketh the vlceres long in healyng. And also where as rollyn­ges must be vsed, in all suche affections behoueth purgacyons. ¶By these wordes it is clerely she­wed y^t purgacyon is ꝓfytable to all vlceres & woū des, at al & euery tyme y^t they are greatest. For in asmoche y^t nat onely the sayde affections, but also other be made greuous & great in thre maners. That is to wyt eyther for y^• exc [...]llency & nobylyte of the party, & myghtynes of the dysease, or bycause y^t the sayd maladyes & affections are Cacoethe, y^t is wycked. Hyppocrates hath made mencyon of all these thynges by them selfes. That is when he sheweth of woundes of the heade, & bely, the dyg­nyte & excellency of the party y^t is hurt. ¶I thyn­ke y^t it is manyfest to all y^t here must be vnderstan­de nat onely the inwarde bely, but also the supe­ryour. For in diuiding y^e tronke which is betwene the necke & the legges, is two great capacytees. The fyrste is contayned vnder the Thorax. The seconde vnder the fondement, y^t is to the mēbrane y^t is stretched vnder labdomen, & for certayne y^e woū ­de y^t hath perced w^tin the Thorax, or w^tin the ars hole is very daungerous, pryncipally yf any of the inwarde partyes be woūded. ¶Lykewyse there is but few but he knoweth well y^t all woundes of the artycles are Cacoethes and wycked. The whiche thynge the Emperykes vnderstande by onely experyence. [Page] And they y^t haue studyed to haue the scyence of the nature of the body, vnderstande it by the nature of y^e hurt partyes. For in the synewes and bony places & without flesshe there is daunger of payne, wakyng, & pryuacyon of rest, & also of con­ [...]ulsyon. Such woundes abouesayd, & such as be stytched, y^t is to say y^t are so great y^t they haue nede to be sowed, or at leest wayes of byndynge or rol­lynge requyre purgacyon. &We haue sayd in the next boke afore y^t all the great vlceres ought to be conioyned, eyther by seames or by byndyngꝭ, lyke wyse y^t the vlceres where there is daunger of the corruption of y^e bones are w^t magnytude of phlegmon. Also they y^t are w^t erosion be cacoethes & wycked, & procede of euyl humours. And also cankers cōmeth of bylyous excrementes. That is to wyte coleryke superfluite, & al other olde vlceres cōmeth of such a cause / wherfore in all y^e vlceres aforesaid Hyppocrates cōmaūdeth to purge by y^e bely, and folowyng after he addeth these wordes. In all vl­ceres wherto erisipclas is cōmen the body must be purged in the party moste vtyle for the vlcere, so y^t the purgacyon be made eyther by the vpper par­ties or by the inwarde, wherof he hath taught vs the dyff [...]rence in the boke of humours / where he by [...]deth to retourne to the contrary partyes & deryuat to the syde. And when there is great fluxion y^t it behoueth to make another vlcere in the con­trary parties, & therof he speketh in the said boke, wherof yf yet agayne yf the fluxyon be īpetuous & [Page] great we shal make reuulsion in the contrary partyes, y^t is to wyt yf the vlcere be in the vpper par­tyes, by purgacyon downwarde, yf the vlcere be in the inwarde partyes, in purgynge the vpper bely. But yf the fluxion be stopped all redy, in such wyse y^t it is drawen to, & fixed in the membre, it is more expedyent to dryue it out by the next places, seyng that the translacyon & transporte is by y^e partyes y^t be next it. Seyng also y^e thaccesse & actraction of the purgyng medycament is more easy & prompte nere then fer. The which reason belongeth also to another party of y^e art, y^t is to wyt of y^t which treateth of the purgacyon of humoures, as it is well knowen to all, & therfore hereafter it shall be necessary to repete it, and make it all parfyte [...] ¶Nowe wyl I shew y^t the force or yf ye wyl cal it the myghtynes, or fyersnes, ought to be stablysshed & ordeyned by indicatrice of phlebotomye, or of purgaciō, and y^t Hyppocrates was y^e fyrste inuentour of the sayd indicacyon, which I wyll shewe as touchyng to other dyseases in the bokes y^t folowe, & in this present boke I wyl treate of vlceres. ¶ I haue all redy spoken clerely of the purgacyons. For syth it is so y^t euery dysease is greuous & fyers in .iij. ma­ners, y^t is eyther by precellence & noblenes of y^e partye, or for the strength & magnytude of y^e affection & dysease or for y^e wyckednes & frowardnes of the same, called ī greeke Cacoethia. Hyppocrates hath made mēcyon of all these thyngꝭ where as he spa­ke of purgacyons, but some perchaunce shall say. [Page] Howe than? doth nat Hippocrates perswade somtyme for to drawe the blode for the same causes abouesaid? It semeth y^t he cōmaundeth them thus, but in few wordes, & neuertheles nat without de­monstracyon, as he is accustomed, & also all the o­ther auncyentes. Thou shalte vnderstande y^t it is thus. Fyrste yf thou rede agayne his wordes y^t are such. In all vlceres newly made, but yf it be in the bely, it is expedyent y^t forth w^t it flowe in blode ey­ther more or lesse. For by y^t meane the vlcere shall be lesse greuous by a phlegmon, & also the places y^t are about it. ¶ And after these wordes y^t be wryten ī his boke of vlceres (yf y^u hast mynde of it) y^t he hath often proposed it in his other bokes. Howe y^t medycyne ought to be īmytatour nat onely of nature, but also to those thyngꝭ y^t are ꝓfitable when they come to theyr, ꝓpre & natural flyryng y^u shalt clerely vnderstande y^e mynde of Hyppocrates, that is, y^t blode must be drawen when the woundes are great. For yf it be expedient y^t the blode flowe in suche vlceres, & that be nat leten slowe, y^u must adde & supply that y^t is nedefull. T [...]ese wordes y^t he wryteth after the declaryng thus, & conioyneth them forth w^t to them abouesayd. It is profytable y^t the blode be leten flowe many tymes from the inuetera [...] viceres (in what soeuer maner y^t s [...]all be seen opportunate) aswel in the vlcere, as in the parties about it. For in asmoche as he hath sayd before y^e blode ought to be taken from euery grene woun­de, seing y^t he made no mētion of veterate vlceres, [Page] it wold haue we [...]ed to some y^t he had onely spoken of grene or fresshe woundes, wherby he hath well added y^t it behoueth to drawe blode from y^e inueterate & olde sorꝭ. ¶Now syth it is so y^t the doctryne y^t we haue taken of hym is ꝑpetual & alway trew, that is how fluxyon ought to be drawen (the whiche begynneth) as y^e contrary parties, & that whi­che is all redy fyxed in the partye ought to be purged, eyther by the sayd paynfull party, or by y^e next party to it. ¶It is nowe easy to vs to conclude of the detraction of blode, how from the begynnyng it ought to be doone in the partye ferre of & moste dystaunt, & then in the vlcerate parties. Lykewyse yf ye adde to the abouesayd thynges y^t Hyppocra­tes admonysshed to empty the superflue humour, somtyme ye shal vse detraction of blode, y^t is when the blode surmounteth. Somtyme ye shal gyue a medycament y^t hath vertue to purge y^e humours coleryke or melancolyke, or els phleume. Hauyng euer in mynde in all these workes howe none of them is the curacyon of vlceres. In asmoche & as vlcere. But rather of cacomye y^t is coniunct w^t the vlcere, or of Pletore, or of phlegmon, or of herpes, & other lyke dysposycyon, w^tout to forget y^t any of the accydentes of the vlcere gyue any force of his propre indication, as magnytude. ¶In the boke afore we haue spoken of vlceres, wherin we haue exposed all the differences of vlceres, how many, & what they be, & what is the indycacyon of eche of them. Howbeit I haue nat spoken in y^e sayd boke [Page] howe somtyme to purge is taken of the force & ve­hemence of the disease, bycause it shuld be to longe demonstracyon. Also in the sayde boke I haue nat conioyned y^e cure of al the body w^t the vlceres, but I haue wryten it in this present boke, in asmoche as it is good & vtyle for y^e thyng proposed. For the parfyte & absolute exposycyon of this kynde of in­dicacion, which we haue sayd is taken of y^e mygh­tynes & strength of the dysease, shal be also treated of hereafter. Lykewyse of the indication taken of the age, and also of it y^t is taken of purging of hu­mours. And lykewyse the indicacion y^t is taken of the payned parties shal be parfytly declared in the bokes y^t foloweth. For as nowe we haue onely made mencion of the curatyfe indicacion, which may be taken of the nature of the sayde partyes, y^t is to wyt of y^e temperaunce & substaūce, w^tout touching of y^t which is taken of the situacyon of the fourme & fygure, of the vtylyte & vsage, & of y^e felyng sharp & dull, ¶ Nowe then let vs speke of the sayd indi­ [...]acions y^t is profytable to the curation of vlceres. The party y^t is sharp of felyng ought asmoche as [...]s possyble to be cured w^tout dolour or payne. The [...]ater of suche remedyes is treated in the bokes y^t be wryten of symple medycamentes. But the par­ [...]ye y^t is but of small felynge receyueth stronger re­medyes, yf the disease requyre it so. Now we must consydre the strength of the pryncipal membre, as we shal say more at large when we speke of phlegmon. But yf it be nat a pryncypall membre, it is [Page] lefull surely & without daūger to lay to it such maner of medycament as mytygate & asswage, the grekes call it Calastyce, we shal speke of it playnly h [...]eafter. At this present tyme we wyl shew y^e reason & maner to heale, which is taken of y^e situaciō & fygure of the partyes, & than we wyl impose the ende of this fourth boke. ¶For this cause we ha­ue cogitate & inuēted y^t we must gyue medicamētꝭ to drynke to hym y^t hath his vētricle vlcerate, whiche vulgarily is called y^e stomacke, & yf the bulke y^t properly is called y^e stomacke, y^t the grekes cal cesophagus be vlcerate, the sayd medycamentꝭ ought nat to be taken & swalowed at ones, but by lytel & lytell in contynuyng, bycause of the passage, & also of the touchyng there come vtylyte in the vlceres y^t are in y^t party, & nat for to contayne the sayd medycamentes y^t be adherent, as in the vlceres of the ventricle. ¶Lykewyse we haue indicate & shewed by the sytuacyon & fygure of the sayd party y^t such medycamentꝭ ought to be made grosser & thycke, & more gleymy & cleuyng, bycause y^t the bulke is a passage of the thynges y^t is eaten & dronken. For y^t cause it hath nede of remedyes y^t may draw to it, & almoste in all partes to be coagulate & cleuyng, & nat such as are thȳne & easy to rēne & flete lyghtly. And also the cours & thycke medycamentes do crud & make concrecyon in y^e partyes of the bulke or oesophage, & they y^t be gleymy do cleue to. Lykewyse in vlceres y^t are in y^e thycke & inwarde guttes haue more nede of remedyes which are cast out & [Page] put out by the syege, in asmoche as the said thyck [...] are next to y^e syege. But of the vlceres y^t are in the intestynes vpwarde & thynne, bycause they be fer­dest from the syege, & are set in y^e myddle situacion, requyre both the two medycyns, y^t is to wyt, those y^t are receyued by y^e mouth, & those be infused and cast out by the syege. ¶Nowe for certayne the cō ­mune indicacion of all y^e interyour partes is y^t we ought to chuse those thyngꝭ y^t be moste famylyer to the nature of man, be they metes or medycyns. And y^t we leaue & cast away all contrary thynges. Albeit y^t in the vlceres whiche be in the outwarde parties, the vsage of such medycament be nat noysom as is aerugo, aes vstū, & aeris squama & cad­mia, & pāpholix cōmonly called thutie, & argenti spuma, y^t is litargiri, & ceruse. Such & lyke medy­camentꝭ ought nat to be vsed nor admynystred to the vlceres of y^e inwarde partyes, of whose nature we haue wryten in the boke of tēperamentes, and in the boke of the symple medycynes. ¶And yf ye wyl bryng y^e vlcere to a festre or cleuynge ye ought to chuse tarte meates & gleymy y^t haue no maner of erosyon. But yf ye wyll clense the vlcere ye must chuse thynges y^t absterge or wasshe moderatly, as rawe hōny, which aboue al thyng is clēsing thus. As touching scarre potions & meates they are cō ­monly knowē ouer all. I cal austere which in gre­ke hyght (styphon) y^t is to say a lytell adstryngent. For soure or vytter is it y^t is tarte (in greke stryph [...]ion.) ¶The medycyns y^t may be taken surely and [Page] without daunger is treated of in the bokes of medicamentes. Neuertheles we wyl say some formulary for the inwarde vlceres such medycamentes are holsome, as hypocistis, & balaustium, y^t is the floure of tame pomgarnets, & galla, & malicoriū, y^• is the huske or pyl of the pomgarnet, terra samea, et leminū, y^t is terra sigillata, & the pyth of Rhus, y^t is symac, also the iuce of roses, & achatia, & other lyke, which anoy nat the bowels & inwarde ꝑties. And ye must shew & gyue y^e sayd medicamentes w^t some decoction of tarte thynges, as decoction of quinces, of lentister, or of the hyghest boughes of rubus, or of vynes burgeons, or grene myrtylles, or w^t tarte wyne. ¶It is now manyfest & none is ygnoraūt, y^t he must beware of drynkynge of wyne yf there be phlegmon, or els there is no daunger. In lykewyse it is wel knowen & euydent y^t the said medycamentꝭ must be prepared & receyued w^t the decoctions, & moyste thyngꝭ. Also ye must medle togyther fraga, cauthu, & gēme, chyefly to y^e vlceres y^t are in the bulke & resophage. Also it was cōmaū ded to make gargarysynes to the vlceres y^t are in the parties called fauces & pa [...]ysthmia, but in the vlcere y^t is in the sharpe artere called tracheia, the pacyent must be layde vpryght, & kepe the medycament longe tyme in his mouth in losyng all y^• muscles y^t be in y^t place. For in so doynge some parte of the medycament wyll flowe by lytel & lytel in to y^e artere sēsibly & manyfestly. As we may know whē the sayd artere is well disposed after the nature of [Page] it, y^t somwhat of y^e which is dronken rēneth & pas­seth throughe it. But lykewyse as in helth & good lust it must be kept y^t it influe nat to moche, so in it must in dysease for feare y^t it engēdre nat y^e cough. For as longe as the humoure descendeth in euery parte nygh the tunycles of y^e artere as water doth by a wal it exciteth nat y^e cough, but yf some thing passe in the myddes of the way of the spert, y^t is the ayre, forth w^t it bredeth the coughe. All the indica­cyons of it is taken of y^e situacyon & fourme of the partye. Lykewyse also hūny must be medled in all medicamentes destined & ordeyned to the vlcere of the Thorax & the lunges. For yf ye vse onely tarte medycyns they wyll remayne in y^e bely. Thē thyn­strument of the dygestyon and distrybucyon of the sayd medycamentꝭ ouer all the body shal be hūny. Also of theyr sodayne passynge as a vehicule, with y^t there is hūny it noyeth nat the vlcere. Lyke ma­ner all and as many tymes as there is vlcere in y^e bladder & in y^e raynes it must be myxed w^t the me­dycamentes of the vlceres, nat w^t hūny, but with some dyurytyke medycamentes, y^t is such as pro­uoketh & styrreth to pysse. ¶I thynke that y^t is patent & manyfest to euery man, after y^t I holde my peace, y^t is to wyt y^t they can knowe & dyscerne the vlcerate partyes by theyr substaunce, action, vty­lyte, position & fygure, the which hath ben shewed playnly in the boke of the sygnes of y^e payned par­tyes, but this is nat now y^t tyme to speke of them. ¶I wyll retourne to y^e Methode curatyfe, & I say [Page] that nat onely the thyngꝭ abouesaid, but also ma­ny other are the indicyons of the fygure, & sytua­cyon of the partyes. For ye can nat well & cōmodyously bynde the sore party, but yf fyrste ye haue ta­ken indicacyon eyther of y^e fygure, or of the sytua­cyon, or of both two togyther. Nor ye can nat set the pype of a clyster ryght w^tout such indycacyon. It is also many tymes necessary to make iniectiō of the medycamentes in the bladder by the yerde, wherfore it is no nede to make mencyon here y^t totally ye can nat wel vse a syring of bras y^t the gre­kes call Cathering, but yf ye knowe parfytely the posycyon, & fygure of all the bladder. ¶Than in all these thynges it appereth clerely y^t the payned place indicateth moche to all the curacyon, but of the ruptions (y^t the grekes cal Regmatha) dyuers indicacions are concurraūt to one purpose, & pryncypally y^e indicacion y^t is taken of y^e posicion ought to be examyned. For seynge y^t the rupcyons be hyd in the depth of y^e body, therfore they requyre other curacions than the vlceres y^t appere outwardly, & bycause y^t all holly & alway such rupcyons be with ecchymosis or ecchymonia, & somtyme w^t contu­syon about the broken flesshe, therfore there be dyuers indicacyons curatyues therin, for alway the curatyfe indicacions are correspondent to y^e nom­bre of y^e affections & dyseases, which we shal shew more playnly when we speake of phlegmon, howe the dyseases y^t are in y^e depe places requyreth stronger medycamentꝭ, than they y^t be at y^e superfluyte [Page] of the body. Than for the least I do thynke for to be manyfest and pacyent, y^t it is necessary that the strength of medicamentꝭ y^t are mynystred outwarde be resolued & dymysshed when the party y^t shuld be holpen & remydyed is hyd in the dypenes of the body, & therfore it behoueth asmoche to intende & augment the vertue of the said medycament, as it shulde be remyssed & dymynysshed in y^e depth of the body. Certaynly all acchymosis or ecchymonia indycateth vacuacyon for remedy of y^e cure, wherby it hath nede of medycamentꝭ moderatly hote and dry, for they y^t dry excessyuely, of trouth do dygest & resolue at y^e begynnyng more euydently than they y^t be weyke, but also some party of the dysease scy­ryous, & dyffycyle to heale, we shal speke of it here­aft dylygently, for as now we haue spokē ynough, after as it belongeth to the matter. ¶Of trouth all the medicamentes & oyntmentes, y^t moysteth & heteth more then they y^t all the grekes call chala­stica, y^t is to say laxatyfes, also amonge the sayde medycamentes all they y^t declyne somwhat to drynesse, neuertheles be nat yet clere nor manifest contraction (they be called syntatica in greke) such medycamentes ben the remedyes of all ecchymosis. But ye must take good hede y^t the medycamentes applycate to the ruptions y^t are in depenesse of the body haue stronge vertue, and y^t they be sourer & digestyfe, y^t is resolutyfe. (And for to say sōmaryly) y^t such medycamentes to be of greater force & effy­cace, in asmoch as lecchymosis is ferther of, from [Page] the skynne vnto the depenes of the body. In suche affections & dyseases the vsage of the herte bytu­leth, y^t is to say ventose shuld nat be inutyle, which is an instrumēt inuented & excogitate of maysters for to make vyolent attraction. ¶And when ec­chymosis is all dygested & resolued, than it is par­mytted to drye the broken flesshe, moche, & to con­ioyne it w^t lygature, & to do all y^t is conuenable to coalesse & close an vlcere togyther. Than yf ecchy­mosis be soone digested & resolued y^• broken flesshe gathereth togither & waxeth playne easyly, but yf the sayde ecchymosis tary longe or it be resolued, moche fylthynes bredeth in it, & occupyeth y^e space y^t is betwene the labyes or lyppes of the vlcere, so y^• the rupciō can nat close, wherfore it foloweth y^t all these thynges abouesayd admonyssheth vs for all causes, how smal soeuer they be. For though that some hath had rygour, y^t is to say vnegall concus­syon of all y^e body, or that it hath nat made good concoction, or y^t it hath had the feuer, or y^t it hath ben ouer weryed or fatygate, anone it shall haue payne in the sayd partye where as the ruption is. For bycause of the sayd ruption haue ben vnyed & nowryssneth togither, but haue alonely ben approched one to another, wherby it foloweth y^t a lytell thyng may departe them easyly, & fyll the place w^t superflue humour, but what engendreth it in such rupcyons contynually but now ecchymosis, & lyke vnto the fyrste, that is to wyte when y^• flesshe was fyrste broken, except y^t presētly ecchimosis is made [Page] of more toughe & subtyl corrupcyon, & at y^• begyn­nyng it was made of blode. And herfore now it digesteth & resolueth more easyly thā it dyd at y^e be­gynnynge. And thus that whiche we haue sayd hytherto shall suffyse for the dysputacyon of vlceres. The [...]fore as nowe I make an ende of this fourth boke.