¶ A breefe Treatise of of the Anatomie of mans body: Compyled by me Thomas Vycarie Esquire, and Sargeant Chirurgion to king Henry the eyght, for the vse and commoditie of al vnlearned Practicioners in Chirurgerie.
IN the name of God, Amen. Heere I shal declare vnto you shortly and breefly the sayinges, and the determinations of diuers auncient Authors, in three poyntes▪ very expedient for al men to knowe, that entende to vse or exercise the mysterie or arte of Chirurgerie. The first is, to knowe what thing Chirurgerie is: The second is, how that a Chirurgion should be chosen: And the thirde is, with what properties a Surgion should be indued.
THE fyrst is to know what thing Chirurgerie is. Heerein I doo note the saying of Lamfranke, whereas he sayth, Al thinges that man [Page] would knowe, may be knowen by one of these three thinges: That is to say, by his name, or by his working, or els by his very being and shewing of his owne properties. So then it followeth that in the same manner we may know what Chirurgerie is by three thinges. First by his name, as thus, The Interpreters write, that Surgerie is deriued oute of these wordes, Apo tes chiros, cai tou ergou, that is too bee vnderstanded, A hand working, and so it may be taken for al handy artes, But noble Ipocras sayth, that Surgerie is hande working in mans body, for the very ende and profite of Chirurgerie is hande working. Nowe the seconde manner of knowing what thing Chirurgerie is, it is the saying of Auicen to be knowen by his beeing, for it is verely a medecinal science: and as Galen sayth, he that wyl knowe the certentie of a thing, let him not busy him selfe to knowe only the name of that thing, but also the working and the effect of the same thing. Nowe the thirde way to knowe what thing Chirurgerie is, It is also to be knowen by his beeing [Page] or declaring of his owne properties, the which teacheth vs to worke in mannes body with handes: as thus, In cutting or opening those partes that be whole, and in healing those partes that be broke nor cut, and in taking away that that is superfluous, as warts, wennes, skurfulas, and other lyke. But further to declare what Galen sayth Surgery is, It is the laste instrument of medicine: That is to say, Dyet, Pocion, and Chirurgerie: of the whiche three, sayth he, Dyet is the noblest, and the most vertuous. And thus he sayth, whereas a man may be cured with Dyet onely, let there be geuen no maner of medicine. The seconde instrument is Pocion: for and if a man may be cured with Dyet and Pocion, let there not be ministred any Chirurgerie. The thirde and laste Instrument, is Chirurgerie, through whose vertue and goodnes is remoued and put away many greeuous infirmities and diseases, which might not haue bene remoued nor yet put away, neither with Diet, nor with Pocion. And by these three meanes it is knowen what thing Chirurgerie is. And this suffiseth [Page] for vs for that poynt. Nowe it is knowen what thing Chirurgerie is, there must also be chosen a man apt and mete to minister Surgerie, or to be a Chirur gion. And in this poynt al Authors doo agree, that a Chirurgion should be chosen by his complexion, and that his complexion be very temperate, and al his members wel proportioned. For Rasis sayth, Whose face is not seemely, it is vnpossible for him for to haue good manners. And Aristotle the great Philosopher writeth in his Epistles to the noble king Alexander (as in those Epistles more playnely doth appeare) howe hee should choose al suche persons as should serue him, by the forme and shape of the face, and al other members of the body. And furthermore they say, he that is of an euill complexion, there must needes folowe like conditions. Wherefore it agreeth that a Chirurgion must be both of a good and temperate complexion, as is afore rehearsed. And principally, that he be a good lyuer and a keeper of the holy cōmaundements of God, of whom commeth al cunning and grace, and that his body be not quaking, and his hands [Page] stedfast, his fingers long and smal, and not trembling: and that his left hand be as ready as his right hande, with al his lymmes able to fulfil the good workes of the soule. Nowe here is a man meete to be made a Chirurgion. And thoughe he haue al these good qualities before rehersed, yet is he no good Chirurgion, but a man very fitte and meete therfore. Now then to knowe what properties and conditions this man must haue before he be a perfect Chirurgion. And I doo note foure thinges moste specially that euery Chirurgion ought for to haue: The first that he be learned: the seconde, that he be expert: the thirde, that he be ingenious: the fourth, that he be wel manered. The first (I sayde) he ought to be learned, and that he knowe his principles, not onely in Chirurgerie, but also in Phisicke, that he may the better defende his Surgery. Also he ought to be seene in natural Philosophie, and in Grāmer, that he speake congruitie in Logike, that teacheth him to proue his proportions with good reason. In Rethorike, that teacheth him to speake seemely and eloquently: also in Theorike, that teacheth [Page] him to knowe thinges natural and not natural, & thinges agaynst nature. Also he must knowe the Anatomie, for al authors write against those Surgions that worke in mans body not knowing the Anatomie, for they be likened to a blind man that cutteth in a vine tree, for he taketh more or lesse then he ought to doo. And here note wel the saying of Galen the prince of Philosophers, in his Estoris, that it is as possible for a Surgion not knowing the Anatomie, to worke in mans body without error, as it is for a blind man to carue an Image & make it perfyt. The. ij. I said, he must be expert: for Rasus sayth, he ought to knowe and to see other men work, and after to haue vse and exercise. The thirde, that he be ingenious or wittie, for al things belonging to Chirurgerie may not be written, nor with letters set foorth. The fourth I sayde, that he muste be wel manered, and that he haue al these good conditions here folowing: First, that he be no spousbreaker, nor no drunkarde. For the Philosophers say, amongst all other thinges beware of those persons that followe dronkennes, for they be accompted for [Page] no men, bicause they liue a life bestiall: wherfore amongst al other sortes of people, they ought to be sequestred from the ministring of medicine. Likewise a Chirurgion must take heede that he deceiue no man with his vayne promises, for to make of asmal matter a great, because he woulde be counted the more famous. And amongest other thinges they maye neither be flatterers, nor mockers, nor priuie backbyters of other men. Likewise they muste not be proude, nor presumptuous, nor detracters of other mē. Likewise they ought not to be too couetous, nor no nigarde, & namely amongst their fréendes, or men of worship, but let them be honest, curteous, and free, both in worde and deede. Likewise they shal g [...]ue no counsayle except they be asked, and then say their aduise by good deliberation, and that they bewel aduised afore they speake, chefly in the presence of wise men. Likewise they muste be as priuie and as secrete as anye Confessour, of al thinges that they shal eyther heare or see in the house of their Pacient. They shal not take into their cure any maner of person, except he wyl be obedient vnto [Page] their preceptes, for he can not be called a pacient, vnlesse he be a sufferer. Also that they doo their diligence aswel to the poore as to the riche. They shal neuer discomfort their pacient, and shall commaunde all that be about him that they doo the same, but to his fréendes speake truthe as the case standeth. They must also be bolde in those thinges whereof they be certayne, and as dreadfull in al perilles. They may not chide with the sicke, but be alwayes pleasaunt and mery. They must not couet any woman by waye of vylanie, & specially in the house of their Pacient. They shal not for couetousnes of money take in hande those cures that be vncurable, nor neuer set any certaine day of the sickemans health, for it lyeth not in their power: folowing the distinct counsayle of Galen, in the amphorisme of Ipocras, saying, Oportet seipsum nō solum. By this Galen meaneth, that to the cure of euery sore there belongeth foure thinges: of which, the first and prin cipal belongeth to God, the second to the Surgion, the thirde to the Medicine, and the fourth to the Pacient. Of the which foure and if any one doo fayle, the [Page] Pacient can not be healed: then they, to whom belongeth but the fourth parte, shal not promise the whole, but bee first wel aduised. They must also be gracious and good to the poore, and of the rich take liberally, for bothe. And sée they neuer prayse them selues, for that redoundeth more to their shame and discredite, then to their fame & worship: For a cunning and skilful Chirurgion néede neuer vaūt of his dooings, for his works wyll euer get credite ynough. Likewise that they despise no other Chirurgion without a great cause: for it is méete that one Chirurgion should loue another, as Christe loueth vs al. And in thus dooing they shal increase both in vertue & cunning, to the honour of God and worldly fame. To whome he bring vs al. Amen.
¶ Heereafter foloweth the Anathomie of the simple members.
AND if it be asked you how many simple members there be, it is to be answered, eleuen, and two that be but superfluities of members: [Page] and these be they, Bones, Cartylages, Nerues, Pannykles, Lygaments, Cordes, Arteirs, Weines, Fatnes, Fleshe and Skinne: and the superfluities be the heares & the nayles. I shal beginne at the Bone, because it is the fundation, and the hardest member of al the body. The Bone is a consimile member, simple and spermatike, and colde and dry of complexion, insencible, and inflexible: and hath diuers formes in mans body, for the diuersitie of helpings. The cause why there be many bones in mans body is this: Sometime it is néedeful that one member or one lymme should moue without another. Another cause is, that some defende the principal members, as dothe the bone of the brest, and of the head: and some to be the fundation of diuers partes of the body, as the bones of the Ridge, and of the legges: and some to fulfyll the hollowe places, as in the handes and feete. &c.
The Grystle is a member simple and spermatike, next in hardnes to the bone, and is of complexion colde and drye, and insencible. The grystle was ordeyned for sixe causes, or profites that I fynd in it: The first is, that the continual mouing [Page] of the hard bone might not be done in a iuncture, but that the grystle should be a meane betwéene the Lygament and him: The seconde is, that in the time of concussion or oppression, the softe members or limmes should not be hurt of the harde: The thirde is, that the extremitie of bones and Ioyntes that be gristly, might the easelyer be folded and moued together without hurt: The fourth is, for that it is necessarie in some meane places to put a grystle, as in the throte bowel for the sounde: The fyfth is, for that it is néedeful that some members be holden vp with a grystle, as the liddes of the eyes: The sixth is, that some limmes haue a sustayning and a drawing abrod, as in the nose and the eares. &c.
The Lygament is a member consimple, simple, and spermatike, next in hardnes to the gristle, and of complexion cold and dry, and is flexible and insensible, and byndeth the bones together. The cause why he is flexible and insencible is this: If it had bene sensible, he mighte not haue suffred the labour and mouing of the ioynts: and if it had not ben flexible of his bowing, one lymme should not haue moued without another. The seconde [Page] profite is, that he be ioyned with sinews, for to make Cordes & Brawnes: The thirde helpe is, that he be a resting place to some sinewes: The fourth profite is, that by him the members that be within the body be sustayned, as the matrix and kidneys, and diuers other. &c.
The Sinew is a consimiler member, simple and spermatike, meane betweene harde and softe, and in complexion colde and drye, and he is both flexible and sensible, strong and tough, hauing his bes ginning from the braine, or frō Mynuca, whiche is the marow of the backe. And from the brayne commeth. vij. payre of Nerues sensatiues, and from Mynuca commeth. xxx. payre of Nerues motius, and one that is by him selfe, that springeth of the last spondel. All these senews haue both féeling and mouing, in some more, and in some lesse. &c.
A Corde or Tendon is a consimple or official member, compounde and spermatike, synowy, strong, and tough, meanly betweene hardenes and softnes, and meanely sensible and flexible, and in cō plexion colde and dry. And the Corde or Tendon is thus made: The synewes [Page] that come from the brayne & from Mynuca, and go to moue the members, is intermingled with the Lygamentes, and when the Synewes and Lygamentes are intermingled together, then is made a Corde. And three causes I perceyue why the Cordes were made: The fyrst is, that the Synewe alone is so sensible that he may not suffer the great labour and trauel of mouing, without the felowship and strength of the Lygament that is insencible, and that letteth his great féeling, and bringeth him to a perfect temperaunce, and so the Cordes moue the limmes to the wil of the soule. And this Corde is associated with a simple flesh, and so therof is made a brawne or a muskel, on whom he might rest after his trauel. And this Brawne is called a Muskle. Then when this Corde is entred into this brawne, he is departed into many smal threeds, the whiche be called wylle. And this wyl hath three properties: The fyrst is in length, by whose vertue that draweth it hath might: The soconde in breadth, by whome the vertue that casteth out hath might: The third in thwartnes, in whom the vertue [Page] that holdeth hath might: and at the ende of the Brawne those threedes be gathered together to make another muskel. &c
Nowe I wyl begynne at the Artere. This Artere is a member consimyle, simple and spermatike, hollowe and synowy, hauing his springing from the hart, bringing from the harte to euery member blood and spirite of lyfe. It is of complexion colde and drye. And al these Arteres haue two cotes, except one that goth to the Lunges, and he hath but one cote that spreadeth abrode in the Lungs, and bringeth with him to the Lunges blood, with the spirite of lyfe to nourishe the Lungs withal: and also that Artere bringeth with him from the lunges ayre to temper the fumous heate that is in the harte. And this Artere is he that is called Arteria venalis, because he hath but one cote as a vayne, and is more obedient to be delated abrode through al the lunges, because that the blood might the sooner sweate through him: wheras al other Arters haue two cotes, because one cote may not withstande the might and power of the spirit of life. Diuers other causes there be, which shal be declared in [Page] the Anathomie of the brest. &c.
The Ueyne is a symple member, in complexion colde and drye, and spermatike, like to the Artere, hauing his beginning from the Lyuer, and bringing from the Lyuer nutritiue blood, to nourishe euery member of the body with. And it is so to be vnderstanded that there is no more difference betweene these two vessels of blood, but that the Artere is a vessel of blood spiritual or vytal. And the Ueyne is a vessel of blood nutrimental, of the which Ueynes there is noted two most principal, of the which one is called vena porta, the other is called venacelis, of whom it is too much to treate of now, vntyll we come to the anathomie of the wombe. &c.
The flesh is a consimiler member, sim ple, not spermatike, and is ingendred of blood congeled by heate, and is in complexion hote and moyst. Of the which is noted three kindes of fleshes: that is to say, one is soft & pure fleshe: the seconde is muskulus or hard & brawny flesh: the thirde is glandulus, knotty, or kurnelly fleshe. Also the commodities of the fleshe be indifferent, for some be common to [Page] euery kinde of fleshe, and some be proper to one maner of fleshe alone. The profytes of the fleshe be many, for some defende the bodye from colde as dothe clothes: also it defendeth the body from harde thinges comming agaynst it: also through his moysture he rectifieth the body in sommer, in time of great heate. Wherefore it is to be considered what profitablenes is in euery kinde of fleshe by him selfe. And fyrst of simple and pure fleshe, whiche fulfylleth the concauities of voyde places, and causeth good forme and shape: and this fleshe is founde betweene the teeth, and on the ende of the yarde. The profite of the Brawny fleshe or muskulus fleshe, shal be spoken of in the Anathomie of the armes. The profites of the Glandulus fleshe are these: First, that it turneth the blood into a cullour like to him selfe, as doth the fleshe of a womans paps turne the menstrual blood into mylke: secondly, the Glandulus fleshe of the Testikles, turneth the blood into sparme: thirdly, the Glandulus flesh of the cheekes, that ingendreth the spittle. &c.
The next is of Fatnes, of the whiche [Page] I finde thrée kindes: The firste is Pinguedo, and it is a consimilar member, not spermatike, and it is made of a subtyl portion of blood congeled by colde: and it is of complexion colde and moyst, insencible, and is intermedled amongest the partes of the fleshe. The seconde is Adeppes, and is of the same kinde as is Pinguedo, but it is departed from the fleshe besydes the skinne, and it is as an oyle heating and moysting the skinne. The thirde is Auxingia, and it is of kinde as the others be, but he is departed from the fleshe withinforth about the kidneys, and in the intrayles, and it helpeth both the kidneys and the intrayles from drying by his vnctiositie. &c.
Then come we to the Skinne. The Skinne is a consimile member or officiall, partely spermatike, strong and tough, flexible and sencible, thinne and temperate, Wherof there be two kindes: One is the Skinne that couereth the outwarde members: and the other the inner members, whiche is called a Pannicle, the profitablenesse of whome was spoken of in the laste Lesson: But the Skinne is properlye wouen [Page] of Thréedes, Nerues, Ueynēs, and Arteirs. And he is made temperate, because he should be a good déemer of heate from colde, and of meystnes from drynes, that there shoulde nothing noye nor hurt the body, but it geueth warning to the common wittes thereof. &c.
The Heyres of euery part of mans body are but a superfluitie of members, made of the grosse fume or smoke passing out of the viscoues matter, thickened to the forme of heyre. The profitablenesse of him is declared in the Anathomie of the head. &c.
The Nayles likewise are a superfluitie of members, engēdred of great earthly smoke or fume resolued through the natural heate of humours, and is softer then the Bone, & harder then the Fleshe. In complexion they be colde and drye, and are alwayes waxing in the extremitie of the fyngers and toes. The vtilitie of them are, that by them a man shal take the better holde: also they helpe to clawe the body when it néedeth: Lastly, they helpe to deuide thinges for lacke of other tooles, &c.
¶ Heereafter foloweth the Anathomie of the compound members, and first of the head.
BEcause the head of man is the habitation or dwelling place of the reasonable soule of man, therefore with the grace of God I shal fyrst speake of the Anatomie of the head. Galen saith in the seconde Chapter De iuuamentes, and Auicen rehearseth the same in hys fyrst preposition and third Chapter, prouing that the Head of man was made neither for Wittes, nor yet for the Braynes, but onely for the eyes. For beastes that haue no heades, haue the orgayne or instrumentes of Wittes in their brests. Therefore God and nature haue reared vp the head of man onely for the eyes, for it is the hyest member of man: and as a beholder or watchman standeth in a highe Towre to geue warning of the enemies, so doth the Eye of man geue warning vnto the common Wittes, for the defence of all other members of the body. Nowe to our purpose. If the question be asked, how many things be there [Page] conteyning on the head, and howe many thinges conteyned within the head? As it is rehearsed by Guydo, there bee but fyue conteining, and as many conteined: as thus, The Heyre, the Skinne, the Flesh, the Pannicles, and the Bone, neither rehearsing Ueyne nor Artere. The which Anathomie can not be truly without them both, as thou shalt wel perceiue both in this Chapter, but specially in the next. And nowe in this lesson I shall speake but of Heire, Skinne, Fleshe, Ueines, Pannicles, and Bones, what profite they doo to man, euery of them in his kinde. Of the Heire of the head (whose creation is knowen in the Anatomie of the simple members) I doo note foure vtilities why it was ordeyned: the fyrst is, that it defendeth the Brayne frō too muche heate, and too muche colde, and many other outwarde noyances: The seconde is, it maketh the forme or shape of the head to seeme more seemelyer or beautyfuller. For if the head were not heyred, the face and the heade should seeme but one thing, and therefore the heyre formeth and shapeth the head from the face: The thirde is, that [Page] by the cullour of the heyre is witnessed & knowen the complexion of the Brayne: The fourth is, that the fumosities of the brayne might assend and passe lyghtlyer out by them. For if there were a sad thing, as the skinne or other, of the same nature as the heyre is, the fumosities of the brayne might not haue passed throwe it so lightly, as it doth by the heyre.
The Skinne of the head is more lazartus, thicker, and more porrus, than any other Skinne of any other member of the body. And two causes I note why, One is, that it keepeth or defendeth the brayne from too muche heate and colde, as doth the heyre: The other, it discusseth to the common wittes of al thinges that noyeth outwardly, for the heyre is insencible: The thirde cause why the skinne of the head is more thicker then any other skinne of the body, is this, that it keepeth the brayne the more warme, and is the better fence for the brayne, and it bindeth and keepeth the bones of the head the faster together.
Next followeth the Fleshe, the which is al Musculus or Lazartus fleshe, lying vpon pericranium without meane. [Page] and it is made of subtile Wylle, and of simple fleshe, Synewes, Ueines, & Arteirs. And why the fleshe that is al musculus or lazartus in euery member of a mans body was made, is for three causes: the fyrst is, that by his thicknes, he shoulde comforte the digestion of other members that lye by him: The seconde is, that through him euery member is made the more formelyer, and taketh the better shape: The thirde is, that by his meanes euery member of the body draweth to him norishing, the which others withholde to put foorth from them: as it shal be more playnlyer spoken of in the Anathomie of the wombe.
Next followeth Pericranium, or the couering of the bones of the head. But heere it is to be noted of a Ueyne and an Artere that commeth betweene the flesh and this Pericranium, that nourisheth the vtter part of the head, and so entreth priuily through the commissaries of the skul, bearing to the Brayne and to his Pannikles nourishing: of whose substaunce is made bothe Duramater, and also Pericranium, as shall be declared in the partes conteyned in the head, Here [Page] it is to be noted of this Pannikle Pericranium, that it bindeth or compasseth al the bones of the head, vnto whom is adioyned the Duramater, and is also a part of his substaunce, howbeit they be separated, for Duramater is nerer yt brayne, and is vnder the skull. This Pericranium was made principally for two causes: one is, that for his strong bynding together he should make firme and stable the féeble commissaries or seames of the bones of the head: The other cause is, that it shoulde be a meane betwéene the harde bone and the softe fleshe.
Nexte is the Bone of the Pot of the head keeping in the Braynes, of which it were too long to declare their names after al Authors, as they number them and their names, for some name them after the Gréeke tongue, and some after the Arabian, but in conclusion al is to one purpose. And they be numbred seuen bones in the pan or skul of the head: the fyrst is called the Coronal bone, in which is yt Orbyts or holes of the Eyes, and it reacheth from the Browes vnto the mid dest of the head, and there it meteth with the seconde bone called Occipissial, a [Page] bone of the hinder part of the head called the Noddel of the head, which two bones Coronal and Occipissiale be deuided by the Commissaries in the middes of the head. The thirde and fourth bones be called Parietales, and they be the bones of the sideling parts of the head, and they be deuided by the Cōmissories both from the foresayde Coronal and Occipissial. The fyfth and the syxth bones be called Petrosa or Mendosa: and these two bones lye ouer the bones called Parietales, on euery side of the head one, lyke skales, in whom be yt holes of the eares. The seuenth and last of the head is called Paxillarie, or Bazillarie, the whiche bone is as it were a wedge vnto all the other seuen bones of the head, and doth fasten them togeather. And thus be all numbred: the first is the Coronal bone, the seconde is the Occipissial, the thirde and the fourth is Parietales, the fyfth and the sixth is Petrosa or Mendosa, and the seuenth is Paxillari, or Bazillari. And this suffiseth for the fyue thinges conteyning.
¶ In this Chapter is declared the fiue thinges conteyned within the head.
NExt vnder the bones of the head withinfoorth, the first thing that appeareth is Duramater, then is Piamater, then the substaunce of the Brayne, and then Uermy formes and Retemirabile. But first to speake of Duramater, whereof, and howe it is sprong and made: First it is to be noted of the Ueine and Arteire that was spoken of in the laste Chapter before, howe priuyly they entred through the commissoris or seames of the head, and there by their vnion together, they doo not onely bring and geue the spirite of lyfe and nutriment, but also doo weaue them selues so togeather, that they make this pannicle Duramater. It is holden vp by certayne threedes of him selfe comming through the sayd commissories, running into Pericranium or pannicle that couereth the bones of the head. And with the foresayde Ueyne and Arteire, and these threedes comming from Duramater, is [Page] wouen and made this Pericranium. Also why this panicle Duramater is set from the skul, I note two causes: the first is, that if the Duramater shoulde haue touched the skul, it shoulde lightly haue bene hurt with the hardnes of the bone: The seconde cause is, that the matter that commeth of woundes made in the head pearsing the skul, shoulde by it the better be defended and kepte from Piamater, and hurting of the brayne. And next vnto this panicle there is another pannicle called Pia mater, or méeke mother, because it is so softe and tender vnto the brayne. Of whose creation it is to be noted as of Duramater, for the original of their fyrst creatiō is of one kind, both from the Hart and the Lyuer, and is mother of the very substaunce of the brayne. Why it is called Piamater, is, for because it is so softe and tender ouer the brayne, that it nourisheth the brayne and feedeth it, as doth a louing mother vnto her tender childe or babe, for it is not so tough and harde as is Duramater. In this panicle Pia mater is much to be noted of the great number of Ueynes and Arteirs that are planted, ramefying [Page] throughout al his substaunce, geuing to the brayne both spirite and lyfe. And this Pannicle doth circumuolue or lappe al the substaunce of the brayne: and in some places of the brayne the Ueynes and the Arteirs goo foorth of him, and enter into the diuisions of the brayne, and there drinketh of the brayne substaunce into them, asking of the hart to them the spirite of lyfe or breath, and of the Lyuer nutriment. And the aforesayde spirite or breath taketh a further digestion, and there it is made animal, by the eleboration of the spirite vital is turned and made animall. Furthermore, why there bee moo pannicles ouer the brayne then one, is this, If there had beene but one pannicle onely, eyther it must haue beene harde, or soft, or meane betweene both: If it had beene harde, it should haue hurt the braine by his hardnes: if it had beene soft, it shoulde haue beene hurt of the harde bone: and yf it had beene but meanely neyther hard not soft, it should haue hurt the braine by his roughnes, and also haue beene hurte of the harde bone. Therefore God and nature haue ordeyned two Pannicles, the [Page] one harde, and the other softe, the harder to be a meane betweene the softe and the bone: and the softer to be a meane betweene the harder and the braine it selfe. Also these Pannicles be colde and dry of complexion, and spermatike.
Next is the Brayne, of which it is marueylous to be considered and noted, how this Piamater deuideth the substaunce of the Brayne, and lappeth it into certen selles or diuisions, as thus: The substaunce of the braine is diuided into thrée partes, or ventrikles, of which the foremost part is the moste: the seconde or middlemost is lesse: the third or hindermost is the least. And from eche one to other be issues or passages that are called Meates, through whom passeth the spirit of life too and fro. But here ye shal note that euery Uentrikle is diuided into two partes, and in euery parte God hath ordeyned and set singular and seueral vertues, as thus: First in the foremost Uentrikle God hath founded and set the common Wittes, otherwise called the fyue Wittes, as Hearing, Séeing, Féeling. Smelling, and tasting. And also there is in one part of this Uentrikle, the vertue [Page] that is called Fantasie, and he taketh al the formes or ordinaunces that be disposed of the fiue wittes, after the meaning of sensible thinges: In the other parte of the same Uentrikle is ordeyned and founded the Imaginatiue vertue, the whiche receyueth of the common Wittes the fourme or shape of sensitiue thinges, as they were receyued of the common wittes withoutfoorth, representing their owne shape and ordinaunces vnto the memoratiue vertue. In the middest sel or ventrikle there is founded and ordeyned the Cogitatiue or estimatiue vertue: for he rehearseth, she weth, declareth, and déemeth those things that be offered vnto him by the other that were spoken of before. In the thirde Uentricle and last there is founded and ordeyned the vertue Memoratiue: in this place is registred and kept those things that are done and spoken with the senses, and keepeth them in his treasurie vnto the putting foorth of the fyue or common wittes, or orgaynes, or instrumentes of animal workes, out of whose extremities or sowar partes springeth Mynuca, or marowe of the spondels: of whom it shall [Page] be spoken of in the Anatomie of the necke and backe. Furthermore it is to be noted, that from the foremost Uentrikle of the brayne springeth seuen payre of sensatiue or féeling senews, the which be produced to the Eyes, the Eares, the Nose, the Toung, and to the Stomack, and to diuers other partes of the body: as it shal be declared in their anatomies. Also it is to bee noted, that aboute the middest ventrikle is the place of Uermi formis, with curnelly fleshe that filleth, and Retemirabile, or wonderful caule vnder the Pannicles, is sette or bounded with Arteirs onely whiche come from the harte, in the whyche the vitayle spirite by his great labour is turned and made animal. And ye shal vnderstande that these two be the best kept partes of al the body, for a man shal rather dye, then any of these should suffer any manner of greefes from withoutfoorth, and therefore God hath set them farre from the hart. Héere I note the saying of Haly Abbas, of the comming of smal Arteirs from the hart, of whom (sayth he) is made a marueylous net or caule, in the which caule is inclosed the [Page] Brayne, and in that place is layde the spirite of feeling, from that place hath the spirite of feeling his fyrst creation, and from thence passeth to other members. &c. Furthermore ye shal vnderstād that the brayne is a member colde and moyst of complexion, thinne, and meanely viscous, and a principal member, and an official member, and spermatike. And fyrst why he is a principal member, is, because he is the gouernour or the treasurie of the fyue wittes: And why he is an official member, is, because he hath the effect of féeling and stering: And why he is colde and moyst, is, that he shoulde by his coldnes and moystnes abate and temper the exceeding heate and drought that commeth from the harte: Also why it is moyst, is, that it shoulde be the more indifferenter and abler to euery thing that shoulde be reserued or gotten into him: Also why it is soft, is, that it should geue place and fauour to the vertue of stering: And why it is meanely viscous, is, that his senewes should be strong and meanely toughe, and that they shoulde not be letted in their working throughe his ouermuche hardnes. Heere Galen [Page] demaundeth a question, whiche is this, Whether that feeling and mouing bee brought to Nerues by one or by diuers? or whether the aforesayde thing be brought substancially or radically. The matter (sayth he) is so harde to searche and be vnderstoode, that it were much better to let it alone and passe ouer it. Aristotle intreating of the Brayne, sayth, The Brayne is a member cōtinually mouing and ruling al other members of the body, geuing vnto them both feeling and mouing: for if the Brayne be let, al other members be let: and if the Brayne be wel, then al other members the body be the better disposed. Also the brayne hath this propertie, that it moueth and followeth the mouing of the Moone: for in the waxing of the Moone the Brayne followeth vpwardes, and in the wane of the Moone the brayne discendeth downwardes, and vanisheth in substaunce of vertue: for then the Brayne shrinketh togeather in it selfe, and is not so fully obedient to the spirit of feeling. And this is proued in menne that be lunatike or madde, and also in men that be epulentike or hauing the falling sicknesse, that [Page] be moste greeued in the beginning of the newe Moone, and in the latter quarter of the Moone. Wherefore (sayth Aristotle) when it happeneth that the Brayne is eyther too drye or too moyst, then can it not worke his kinde: for then is the body made colde: then are the spirites of lyfe melted and resolued away: and then foloweth féeblenes of the wittes, and of al other members of the body, and at the laste death.
¶ Heereafter foloweth the Anatomie of the Face.
THE Front or the Forhead conteyneth nothing but the Skinne and Musculus fleshe, for the panicle vnderneth it is of Pericranium, and the bone is of the Coronal bone. Howebeit there it is made broade as yt there were a double bone, whiche maketh the forme of the Browes. It is called the Forhead or Front from one Eare to the other, and from the rootes of the Eares of the head before vnto ye browes. But the cause why the Browes were set [Page] and reared vp, was, that they shoulde defende the Eyes from noyaunce withoutfoorth: And they be ordeyned with heare to put by the humour or sweat that commeth from the head. Also the Browes do helpe the Eyeliddes, and do beautifie and make fayre the face, for he that hath not his Browes heyred, is not séemely. And Aristotle sayth, that ouer measurable Browes betokeneth an enuious man: Also high browes and thicke betokeneth hardnes: and browes with little heare betokeneth cowardnes: and meanly sigfieth gentlenes of hart. Incisions about these partes ought to be done according to the length of the body, for there the Muscle goeth from one Eare to the other. And there if any incision should be made with the length of the Muscle, it might happen the Browe to hang ouer the Eye without remedie, as it is many times seene, the more pitie. The browes be called Supercilium in Latin, and vnder is the Eye liddes, whiche is called Cilium, and is garnished with heyres. Two causes I finde why the eye liddes were ordeyned: The fyrst is, that they shoulde kéepe and defende the Eye from [Page] duste and other outwarde noyances: the seconde is, when the eye is wéery or heauy, then they should be couered and take rest vnderneath them. Why the heyres were ordeyned in them, is, that by them is addressed the formes or similitudes of visible thinges vnto the apple of the eye. The Eare is a member semely and grystlye, able to be folden without, and is the orgayne or instrument of hearing: It is of complexion colde and drye. But why the eare was set vp out of the head, is this, that the soundes that be very fugitiue, should lurke and abyde vnder his shadowe, tyl it were taken of the instrumentes of hearing: Another cause is, that it should keepe the hole that it standeth ouer from thinges falling in that might hinder the hearing. The senewes that are the Orgayns or Instrumentes of hearing, spring each from the Brayne, from whence the seuen payre of senewes do spring, & when they come to the hole of the Eare, there they writhe lyke a wyne presse, and at the endes of them there be like the head of a worme, or like a little teat, in whiche is receyued the sounde, and so caried to the common [Page] wittes. The Eyes be nexte of nature vnto the Soule: for in the Eye is seene and knowen the disturbances & gréefes, gladnes and ioyes of the Soule, as loue, wrath, and other passions. The Eyes be the instrumentes of sight. And they bee compounde and made of ten things: that is to say, of seuen Tunicles or Cotes, and of three humours. Of the whiche (sayth Galen) the Brayne and the head were made for the Eye, that they might be in the hyest place, as a beholder in a towre, as it was rehearsed in the Anatomie of the head. But diuers men holde diuers opinions of the Anatomie of the Eyes: for some men accompt but three tunikles, and some sixe. But in conclusion they meane all one thing: For the very truth is, that there be counted and reckoned seuen Tunikles, that is to say, Sclirotica, Secondyna, Retyna, Vnia, Cornua, Arania, and Coniunctiua: and these three humours, That is to say, humor Vitrus, humor Albigynus, and humor Crystallinus. It is to be knowen howe and after what maner they spring: You shal vnderstande that there springeth of the brayny substaunce of his formost [Page] Uentrikles, two senewes, The one from the right side, and the other from the left, and they be called the fyrst payre, for in the Anatomie they be the first paire of senewes that appeare of al seuen. And it is shewed by Galen, that these senews be hollowe as a reede, for two causes: The fyrst is, that the visible spirit might passe freely to the Eyes: The second is, that the forme of visible thinges mighte freely be presented to the common wits. Nowe marke the gooing foorth of these senewes: When these senewes goo out from the substaunce of the Brayne, he cōmeth through the Piamater, of whose substaunce he taketh a Pannicle or a Cote: and the cause why he taketh that Pannicle, is to keepe him from noying, and before they enter into the skul, they meete and are vnited into one senewe the length of halfe an inche: and then they depart agayne into two, and eche goeth into one eye, entring through the brayne panne, and these senews be called Nerui optici. And three causes I finde why these Nerues are ioyned in one before they passe into the Eye: First, if it happen any diseases in one eye, the other [Page] should receyue all the visible spirite that before came to bothe: The seconde is, that all thinges that we see shoulde not seeme two: for if they had not beene ioyned together, euery thing shoulde haue seemed two, as it doth to a worme, and to other beastes: The thirde is, that the Senewe might stay and helpe the other. But heerevpon Lamfranke accordeth muche, saying, that these two Senewes come together to the Eyes, and take a Panikle both of Piamater and of Duramater, and when they enter into the Orbyt of the Eye, there the extremities are spread abroade, the which are made of three substances: that is to say, of Du ramater, of Piamater, and of Nerui optici. There be ingendred thrée Tunikles or Cotes, as thus, Of the substāce that is taken from Duramater is ingendred the fyrst cote that is called Secondina: and of Nerui optici is ingendred the third cote that is called Retina: and eche of them is more subtiller then other, & goeth about the humours without meane. And it is to be vnderstoode, that eche of these three Tunicles be deuided, and so they make sire: That is to [Page] say, iij. of the partes of the brayne, and three of the parts outwardes, and one of Pericranium that couereth the bones of the head, whiche is called Coniunctiua. And thus you maye perceyue the springing of them: as thus, Of Duramater springeth Sclirotica and Cornua: of Piamater springeth Secondina & Unia: and of Nerui optici springeth Coniunctiua. No we to speake of the humors whiche be three, and their places are the middle of the Eyes: Of the whiche the fyrst is Humor Uitrus, because he is lyke glasse, in colour very cleare, redde, liquit, or thinne, and he is in the inward side next vnto the brayne: and it is thin, because the nutritiue blood of the Crystalline might passe, as water through a sponge should be clensed and made pure, and also that the visible spirite mighte the lightlyer passe through him from the Brayne. And he goeth about the Cristaline humour, vntil he méete with Albuginus humour, which is set in the vttermost parte of the Eye. And in the myddest of these humours Uitrus, and Albuginus, is set the Crystalline humour, in whiche is set principally the syght of [Page] the Eye. And these humours be separated and inuolued with the Pannicles aforesayde, betweene euery Humour a Panicle. And thus is the Eye compound and made. But to speake of euery Humour and euery Pannicle in his due order and course, it would aske a long processe, and a long Chapter, and this is sufficient for a Chirurgion. Nowe to begin at the Nose: You shall vnderstande that from the Brayne there commeth. ij. Senews to the holes of the brayne pan, where beginneth the concauitie of the Nose, and these two be not properly senewes, but organes or instrumentes of smelling, and haue heades lyke teates or pappes, in whiche is receyued the vertue of smelling, and representing it to the common wittes. Ouer these two is set Colatorium, that we cal the Nose thrils: and it is set betweene the Eyes, vnder the vpper parte of the Nose. And it is to be noted, that this concauitie or ditche was made for two causes: The fyrst is, that the ayre that bringeth foorth the spirite of smelling might reste in it, tyll it were taken of the organ or instrument of smelling: The seconde cause is, that [Page] the superfluities of the Brayne might be hydden vnder it, vntill it were clensed: And from his cōcauitie there goeth two holes down into ye mouth, of which there is to be noted three profites: The fyrste is, that when a mans mouth is close, or when he eateth or sleepeth, that then the ayre might come through them to the Lunges, or els a mans mouth should alwayes be open: The seconde cause is, that they helpe to the relation of the forme of the Nose: for it is sayd, a man speaketh in his Nose when any of these holes be stopped: The thirde cause is, that the concauitie might be clensed by them when a man snuffeth the Nose, or draweth into his mouth inwardly. The Nose is a member consimple or official, appearing without the face, somewhat plicable, because it shoulde the better be clensed. And it is to be perceyued that it is compounde and made of shinne and Lazartus fleshe, and of two bones standing in maner trianglewise, whose extremities be ioyned in one part of the Nose with the Coronal bone, and the nether extremities are ioyned with two grystles, and another that diuideth the Nose [Page] thrilles within, and holdeth vp the nose: Also there be two concauities or holes, that if one were stopped the other should serue: Also there is in the Nose two Muskles, to helpe the working of hys office. And Galen sayth, that the Nose shapeth the Face moste: for where the Nose lacketh (sayth he) al the rest of the face is the more vnseemely. The Nose should be of a meane bignes, and not to exceede in length, or breadth, nor in highnesse. For Aristotle sayth, yf the Nose thrills be too thinne, or to wyde, by great drawing in of ayre, it betokeneth great straightnes of hart, and indignation of thought. And therefore it is to be noted, that the shape of the members of the body, betokneth and iudgeth the affections and wyll of the Soule of man, as the Philosopher sayth. The temples be called the members of the head, and they haue that name because of continuall mouing. And as the science of the Anatomie meaneth, the spirite vital is sente from the hart to the brayne by Arteirs, and by veynes and nutrimental blood, where the vessels pulsatiues in the temples be lightly hurt. Also the temples [Page] haue dentes or holes inwardely, wherin he taketh the humour that cōmeth from the brayne, and bringeth the eyes asléepe, and if the sayde holes or dentes be pressed and wroung, then by trapping of the humour that continueth, he maketh the teares to fal from the Eye. The Chéeks are the sideling partes of the face, and they conteyne in them Musculus fleshe, with Ueynes and Arteirs, and aboute these partes be many Muscles. Guydo maketh mention of. vij. about the chekes & ouer lyp. And Haly Abbas sayth, there be. xij. Muscles that moue the nether Iawe, some of them in opening, and other some in closing or shutting, passing vnder the bones of ye temples, And they be called Temporales: And they be right noble and sensatiue, of whose hurte is muche peril. Also there be other Muskles for to grinde and to chewe. And to al these Muscles cōmeth Nerues from the brayne to geue them féeling and mouing: and also there commeth to them many Arteirs and Ueines, and cheefly about the temples, and the angles or corners of the Eyes and the Lippes. And as the Philosophers say, the chéefe beautie [Page] in man is in the cheekes, and there the complexion of man is most knowen, as thus, If they be full, ruddy, and medled with temperate whitnes, and not fat in substaunce, but meanely fleshly, it betokeneth hotte and moyst of complxion, that is, sanguin and temperate in culler. And if they be white coloured, without medling of rednes, and in substaunce fat and soft, quauering, it betokeneth excesse and superfluitie of colde and moyst, that is flematike: And if they be browne in colour, or cytrin, yelowe, redde, and thin, and leane in substance, betokeneth great drying and heate, that is cholerike: And if they be as it were blowen in colour, and of little fleshe in substaunce, it betokeneth excesse and superfluitie of drynes and colde, and that is melancolie. And as Auicen sayth, the Cheekes doo not only shewe the diuersities of complexions, but also the affection and wil of the hart: for by the affection of the hart, by sodaine ioy or dréede, he waxeth eyther pale or redde. The bones or bony partes, fyrste of the cheekes be two: of the Nose outwardely, two: of the vpper Mandibile, two: within the Nose, three: as thus, [Page] one diuiding the Nosethrilles within, and in ech Nosethril one, and they séeme to be rowled like a wafer, and haue a holownesse in them, by whiche the ayre is respyred and drawen to the lunges, and the superfluitie of the brayne is purged into the mouth wardes, as is before rehearsed. But Guydo and Galen say, that there be in the face nyne bones, yet I can not finde that the nether Mandible should be of ye number of those nyne, for the nether Mandible accompted there, proueth them to be ten in number, Of which thing I wyl holde no argument, but remit it to the sighte of your Eyes. The partes of the mouth are fyue, that is to say, the Lippes, the téeth, the toung, the Uuila, and the Pallet of the mouth. And first to speake of the lippes, they are members consimile or official, ful of Musculus fleshe, as is aforesayde, and they were ordeyned for two causes, one is, that they should be to the mouth as a doore to a house, and to keepe the mouth close tyl the meate were kindly chewed: The other cause is, that they should be helpers to the pronouncing of the speache. The teeth are members [Page] consimile or official, spermatike, and hardest of any other members, and are fastened in the cheeke bones, and were ordeyned for three causes: First that they should chewe a mans meate, or it should passe downe, that it might be the sooner digested: The seconde, that they should be a helpe to the speache, for they that lacke their Teeth doo not perfectly pronounce their wordes: the thirde is, that they should serue to beasts as weapons. The number of them is vncertayne, for some men haue mo, and some lesse, they that haue the whole number haue. xxxij. that is to say. xvj. aboue, and as many beneath, as thus, two Dvvallies, two Quadripulles, two Cannines, eyght Morales, and two Cansales. The Toung is a carnous member, compounde and made of many Nerues, Lygamentes, Ueines and Arteirs, ordeyned principally for thrée causes: The first is, that when a man eateth the Toung mighte helpe to turne the meate tyll it were wel chewed: The seconde cause is, that by him is receiued the taste of sweete and sowre, and presented by him to the common wittes: The thirde is, that by him [Page] is pronounced euery speach. The fleshly parte of the toung is white, and hath in him nine muskles, and about the roote of him is Glandulus, in the whiche be two welles, and they be euer ful of spittle to temper and keepe moyst the toung, or els it would waxe dry by reason of his labour. &c. The Uuila is a member made of a spongeous fleshe, hanging downe from thy ende of the Pallet ouer the goulet of the throte, and is a member in complexion colde and dry, and oftentimes when there falleth rawnes or muche moystnes into it from the head, then it hangeth downe in the throte, and letteth a man to swallowe, and it is broade at the vpper ende, and smal at the nether. It was ordeyned for diuers causes, One is, that by him is holpen the sounde of speache, for where the Uuila is lacking, there lacketh the perfect soūd of speache: Another is, that it mighte helpe the prolation of vomites: another is, that by him is tempered and abated the distemperaunce of the ayre that passeth to the Lunges: another is, that by him is guyded the superfluities of the brayne that commeth from the coletures [Page] of the Nose, or els the superfluities should fal down sodenly into the mouth, the which were a displeasure. The Pallet of the mouth conteyneth nothing els but a carnous Pannikle, and the bones that be vnderneath it haue two diuisions, One along the Pallet from the diuision of the Nose, and from the opening of the other Mandible vnto the nether ende of the Pallet, lacking halfe an inch, and there it diuideth ouerthwart, and the first diuision is of the Mandible, and the seconde is of the bone called Paxillarie or Bazillarie, that sustayneth and byndeth al other bones of the head together. The skinne of the Pallet of the mouth is of the inner parte of the stomack and of Myre, and of Ysofagus, that is the way of the meate into the stomacke. The way how to know that such a pannicle is of that part of the stomacke, may be knowen when that a man is touched within the mouth, anone he beginneth to tickle in the stomacke, and the neerer that he shal touche vnto the throte, the more it abhorreth the stomocke, and often times it causeth the stomacke to yeld from him that is within him, as when a [Page] man doth vomite. Also in the mouth is ended the vppermoste extremitie of the Wesande, which is ca led Myre or Isofagus. And with hym is conteyned Trachia arteria, that is, the waye of the ayre, whose holes be couered with a lap like a tong, and is gristly, that the meate and drinke mighte slyde ouer him into Isofagus: The whiche grystle when a man speaketh it is reared vp, and couereth the way of the meate: and when a man swaloweth the meate, then it couereth the way of the ayre, so that when the one is couered the other is discouered. For if a man open the waye of the ayre when he swalloweth, if there fal a crum into it, he shal neuer cease coughing vntil it be vp agayne. And this suffiseth for the necke, face.
¶ Heereafter foloweth the Anatomie of the Necke.
THE Necke foloweth next to be spoken of. Galen proueth that the Necke was made for no other cause but for the Lunges, for al thinges [Page] that haue no Lungs haue neither necke nor voyce, except fishe. And you shal vnderstande, that the necke is all that is conteyned betweene the head and the shoulders, and betweene the chinne and the brest. It is compounde and made of foure thinges, that is to say, of Spondillus, of Seruicibus, of Gula, & of Gutture, the which shal be declared more playnely hereafter, and through these passe the waye of the meate and of the ayre, but they be not of the substance of the necke. The Spondelles of the necke be seuen, The fyrst is ioyned vnto the lower parte of the head, called Paxillarie or Bazillarie, and in the same wise are ioyned euery Spondel with other, and the laste of the seuen with the fyrst of the Backe or Ridge: and the Lygamentes that keepe these Spondels together are not so hard and tough as those of the backe: for why? those of the necke be more feebler and subtiller: The cause is this, for it is necessary otherwhile that the head moue without the necke, and the necke without the head, the whiche might not well haue beene done if they had beene strong and boystrous. Of these aforesayd seuen [Page] Spondels of the necke, there springeth seuen payre of Senewes, the whiche be deuided into the head and into the Uysage, to the shoulders, and to the armes. From the hole of the first spondel springeth the fyrst payre of senewes, betwene the fyrst spondel and the seconde, and so foorth of al the rest in like maner as of these. Also these senewes receyue subtil wylle of the senews of the Brayne, of the which wylle, and senewes, and fleshe, with a pannikle, make the composition of Muskels, Lazartes, and Brawnes, the which three thinges be al one, and be the instrumentes of voluntarie mouing of euery member. The Muskles of the neck after Galen are numbred to be. xx. mouing the head and the necke. Likewise it is to be noted, that there be three maner of fleshes in the necke: the first is Pixwex or Seruisis, and it is called of Chylder Golde heire, or yellowe heire, the whiche are certayne longitudinales lying on the sides of the Spondels from the head downe to the latter Spondel. And they are ordeyned for this cause, that when the Senewes be wéery of ouer muche labour with mouing and trauayle, [Page] that they might rest vpon them as vpon a bedde. The second fleshe is musculus, from whome springeth the Tendons and cordes that moue the head and the necke, whiche be numbred twentie, as is afore declared: The thirde fleshe replenisheth the voyde places. &c.
The thirde parte of the necke is called Gutture, and it is the standing out of the Throte boll. The fourth part is called Gula, and the hinder parte Ceruix, and hath that name of the Philosophers because of the marowe comming to the Ridge bones, It is so called, because it is as it were a seruaunt to the brayne: For the necke receiueth and taketh of the brayne influence of vertue of mouing, and sendeth it by senewes to other parts of the body downwardes, and to al members of the body. Heere you shal vnderstand, that the way of the meate, & Mire or Isofagus is al one thing, and it is to be noted, that it stretcheth frō the mouth to the stomacke, by the hinder part of the necke inwardly, fastned to the spondels of the necke, vntyl he come to the fyfthe spondel, and there he leaueth the spondel and stretcheth tyl he come to the formost [Page] part of the brest, & passeth through Diafragma tyl it come to the mouth of the stomacke, and there he is ended. Furthermore it is to be noted, that this Wesande is compounde and made of two Tunikles or Cotes, that is to say, of the inner, and of the vtter. The vtter tunikle is but simple, for he néedeth no retention but onely for his owne nourishing: but the inner Tunikle is compounde and made of Musculus Longitudinal Wyl, by which he may drawe the meate from the mouth into the stomack, as it shal be more playnely declared in the Anatomie of the stomacke. Furthermore Cana pulmonis via trachia arteria, al these be one thing, that is to say, the throte boll, and it is set within the necke besides ye Wesand towardes Gula, and is compounde of the grystle knytte eache with other. And that pannikle that is meane betweene the Wesand and the throte bol, is called Ismon. Also ye shal vnderstand, that the great Ueines which ramefie by the sydes of the necke to the vpper part of the head, is of some men called Gwidege, & of others Vena organices, the incision of whom is perillous. [Page] And thus it is to be considered, that the Necke of man is compounde and made of skinny fleshe, Ligamentes and bones. And this suffiseth for the necke and the throte.
¶ The Anatomie of the Shoulders and Armes.
AND fyrst to speake of the bones: It is to be noted, that in the shoulder there be two bones, that is to say, the Shoulder bone, and the Cannel bone, and also the adiutor bone of the arme are ioyned with ye shoulder bones, but they are not numbred among them, but amongst the bones of the armes. In the composition of the shoulder, the fyrst bone is Os spatula, or shoulder blade, whose hinder part is declined towards ye chinne, & in that ende it is broade & thin, & in the vpper part it is round, in whose roundnes is a cōcauitie, which is called ye boxe or coope of the shoulder, into which entereth the Adiutor bones, and they haue a bynding togethers with strong flexible Senewes, and are conteyned faste with the bone called Clauicula, [Page] or the Cannel bone: and this Cannel bone stretcheth to bothe the shoulders, one ende to the one shoulder, and another to the other, and there they make the cō position of the shoulders. The bones of the great arme, that is to say, from the shoulder to the fingers endes, be. xxx. The fyrst is the Adiutor bone, whose vpper ende entreth into the concauitie or boxe of the shoulder bone: It is but one bone hauing no felowe, and it is hollowe and ful of marowe, and it is also crooked because it shoulde be the more habler to grype thinges, and it is hollowe because it should be lighter and more obedient to the steering or mouing of the Brawnes. Furthermore, this bone hath two emynences, or two knobs in his nether extremitie, or in the iuncture of the Elbowe, of the which the one is more rising then the other, and are made lyke vnto a Polly to drawe water with, and the endes of these bones enter into a concauitie proportioned in the vppermoste endes of the two Focel bones, of whiche two bones the lesse goeth from the Elbowe to the Thombe, by the vppermoste part of the arme, and the greater is the [Page] nether bone from the Elbowe to thē little finger. And these two bones be conteyned with the Adiutor bone, and bee bounde with strong Ligamentes, and in like maner with the bones of the hande. The whiche bones be numbred. viij. the iiij. vppermost be ioyned with the. iiij. nethermost towardes the handes: and in the thirde warde of bones, be. v. and they are called Ossa patinis, and they are in the palme of the hande. And to them be ioyned the bones of the Fingers and the Thombes, as thus, in euery fynger. iii. bones, and in the thombe two bones: that is to say, in the fingers and thombe of euery hand. xiiij. called Ossa digitorū, in the palm of the hand. v. called Patinis, and betweene the hande and the wryste viij. called Racete, and from the wryst to the shoulder. iij. bones: al which beeing accompted together, ye shal finde thirtie bones in eche hand and arme. To speake of Senewes, Lygamentes, Cordes and Brawnes: Here fyrst ye shal vnderstand that there commeth from Mynuca thorowe the Spondels of the necke foure senewes, which most playnly do appeare in sight, as thus, one commeth into the [Page] vpper parte of the arme, another into the nether parte, and one into the inner side, and another into the vtter side of ye arme, and they bring from the brayne and from Minuca both féeling and mouing into the armes, as thus, The senewes that come from the Brayne and from the marow of the backe that is called Minuca, when they come to the iuncture of the shoulder, there they are mixed with the Lygamentes of the selfe shoulder, and there the Lygamentes receyue both féeling and mouing of them, and also in their medling together they are made a Corde or a Tendō. Thrée causes I find why the senewes were medled with the Lygamentes, The first cause is, that the excellent féeling of the senewes, whiche many waies be made weery by their continual mouing, should be repressed by the insenciblenesse of the Lygaments: The seconde is, that the littlenesse of the Senewes shoulde be fulfilled through the quantitie of the Lygaments: The third is, the féeblenesse of the senewe, that is insufficiente and too féeble to vse his offices, but by the strength and hardnes of the Lygamentes. Nowe to declare [Page] what a Corde is, what a Ligament, and what a Muskle or a Brawne, it is ynough rehearsed in the Chapter of the Simple members. But if you wyl thorough the commaundement of the Wyl or of the Soule, drawe the arme to the hinder part of the body, then the vtter Brawne is drawen together, and the inner is inlarged: And likewise inwards, when the one brawne dothe drawe inwardes, the other doth stretche, & when the arme is stretched in length, then the Cordes be lengthened: but when they passe the iuncture of the shoulder and of the Elbowe, by thrée fingers breadth or thereabout, then it is deuided by subtill wyl, and medled with the simple fleshe, and that whiche is made of it is called a Brawne. And three causes I finde why that the simple fleshe is medled with the Corde in the composition of the brawne: The fyrst is, that the aforesayde Wylle might drawe in quiet through the temperaunce of the fleshe: The seconde is, that they temper and abate the drought of the cord with his moystnes, the which drought he getteth through his manifold mouing: The thirde is, that the forme [Page] of the brawny members shoulde be the more fayre, and of better shape: wherfore God and nature haue clothed it with a Panikle that it might the better be kept. And it is called of ye Philosophers Musculus, because it hath a forme like vnto a Mcuse. And when these Brawnes come neere a Ioynt, then the Cordes spring foorth of them, and are medled with the Lygaments agayne, and so moueth that Ioynt. And so ye shall vnderstande, that alwayes betweene euery two Ioyntes is ingendred a Brawne, proportioned to the same member and place vnto the last extremitie of the fingers, so that aswell the least iuncture hath a proper féeling and mouing when it needeth, as hath the greatest. And after Guydo there be numbred. xiij. in the arme and hande, as thus. iiij. in the Adiutor, mouing the vpper part of the arme: and. iiij. in the Focels, mouing that part of the arme: and fiue in the hande, mouing the fyngers. Now to speake somewhat of the Ueynes and Arteirs of the arme: It is to be vnderstoode, that from Venakelis there commeth two braunches, the one commeth to the one arme pyt, and the other [Page] commeth to the other. And nowe marke the spreading, for as it is of the one, so it is of the other, as thus, whē the braunch is in the arme pyt, there he is deuyded into two braunches, the one braunche goeth along in the inner side of the arme vntil it come to the bought of the arme, and there it is called Bazilica or [...]patica, and so goeth downe the arme til it come to the wryst, and there it is turned to the backe of the hand, and is found betwene the little fynger and the next, and there it is called Saluatella. Nowe to the other braunche that is in the arme hole, which spreadeth to the vtter side of the shoulder, and there he deuideth in two, ye one goeth spreading vp into ye carnous parte of the head, and after discendeth through the bone into the Brayne, as it is declared in the Anatomie of the head: The other braunche goeth on the outwarde side of the arme, and there he is deuided in two also, the one parte is ended at the hande, and the other part is folded about the arme, tyl it appeare in the bought of the arme, and there it is called Sephalica, from thence it goeth to the backe of the hande, & appeareth betweene the thombe [Page] and the formost fynger, and there it is called Sephalica occularis. The two braunches that I spake of, whiche be deuided in the hinder part of the shoulders, from eche of these two (I say) springeth one, and those two meete together and make one veyne, which appeareth in the bought of the arme, and there it is called Mediana, or Cordialis, or Commine. And thus it is to be vnderstoode, that of vena Sephalica springeth vena occularis, and of vena Bazilica springeth vena Saluatella, and of the two veynes that méete springeth vena Mediana, and in ramefying from these fyue principal Ueines springeth innumerable, of the whiche a Chirurgion hath no great charge, for it suffiseth vs to knowe the principals.
To speake of Arteirs, you shall vnderstande, that wheresoeuer there is founde a Ueine, there is an Arteire vnder him: and if there be founde a great Ueyne, there is found a great Arteir, and where as is a little Ueine there is a little Arteir: For whersoeuer there goeth a veine to geue nutriment, there goeth an Arteir to bring the spirite of lyfe. Wherfore it is to be noted, that the Arteires lye [Page] more deeper in the flesh then the Ueines doo: for they cary and kepe in them more precious blood then doth the Ueine, and therefore he hath neede to be further from daungers outwardly: and therefore God and nature haue ordeyned for him to be closed in two cotes, where the Ueine hath but one. &c.
The Brest or Thorax is the Arke or Chest of the spiritual members of man, as sayth the Philosopher, where it is to be noted, that there be soure thinges conteyning, and eyght conteyned, as thus, The foure conteyning, are, the Skinne, Musculus fleshe, the Pappes, and the Bones: The partes conteyned, are, the Hart, the Lunges, Panikles, Ligamentes, Nerues, Ueines, Arteirs, Mire or Isofagus. Nowe the skinne and the fleshe are knowen in their Anatomie. It is to be noted, that the fleshe of the Pappes differeth from the other fleshe of the body, for it is white, glandulus, & spongeous: and there is in thē both Nerues, Ueines and Arteirs, and by them they haue Coliganes with the hart, the lyuer, the brayne, and the generatiue members. Also there is in the brest, as old Authors [Page] make mention, lxxx. or. xc. Muskles, for some of them be common to the necke, some to the shoulders, and to the spades, some to Diafragma or ye Mydriffe, some to the Ribbes, some to the Backe, & some to the brest it selfe. But I fynde certayne profitablenes in the creation of ye Paps, aswel in man as in woman: for in man it defendeth the spirituals from annoyannce outwardly: and another, by their thicknes they comfort the natural heate in defience of the spirites. And in women there is the generation of milke: for in women there commeth from the Matrix into their Brestes manye Ueines which bring into them menstrual blood, the whiche is turned through the digestiue vertue from red colour into white, like the colour of the Pappes, euen as Chylley comming from the stomocke to the Lyuer is turned into the colour of the Lyuer. Nowe to speake of the bones of the Brest: They be sayde to be triple or threefolde, and they be numbred to be seuen in the Brest before, and their length is according to the breadth of the brest, and their extremities or endes be grystlie, as the ribbes be. And in the [Page] vpper ende of Thorax is an hole or a concauitie, in which is set the foote of the Furklebone or Canel bone, and in the nether ende of Thorax, agaynst ye mouth of the stomache, hangeth a gristle called Ensiforme: and this grystle was ordeyned for two causes, One is, that it shuld defende the stomacke from hurte outwardly: The seconde is, that in time of fulnes it should geue place to ye stomacke in time of neede when it desireth. &c. Now to speake of the parts of the backe behindefoorth: There be. xij. Spondels, through whom passeth Mynuca, of whō springeth. xij. payre of Nerues, brnging both feeling and mouing to the Muscles of the Brest aforesayde. And here it is to be noted, that in euery syde there be. xij. Rybbes, that is to say. vij. true, and. v. false, because these. v. be not so long as the other. vij. be, and therefore be called false Rybbes, as it may be perceiued by the sighte of the Eye. Likewise of the partes that be inwardly, and fyrst of the Hart, because he is the principal of al other members, and the beginning of life: he is set in the middest of the brest seuerally by him selfe, as Lord and King of [Page] al members. And as a Lorde or King ought to be serued of his subiectes that haue their liuing of him: So are al other members of the body subiectes to the Hart, for they receyue their liuing of him, and they doo seruice many wayes vnto him agayne. The substaunce of the Hart is as it were Lazartus fleshe, but it is spermatike, and an official member, and the beginning of life, and he geueth to euery member of the body both blood of life, and spirite of breath and heate: for if the Hart were of Lazartus fleshe, his mouing and steering should be voluntarie and not natural, but the contrarie is true, for it were impossible that the Hart should be ruled by Wyl onely, and not by nature. The Harte hath the shape and forme of a Pyneapple, and the brode ende thereof is vpwardes, and the sharpe ende is downewardes, depending a little towardes the left side. And here it is to be noted, that the Hart hath blood in his substaunce, whereas al other mē bers haue it but in their Ueines & Arteirs: also the hart is bounde with certayne Ligamentes to the backepart of the brest, but these Lygamentes touche [Page] not the substaunce of the Hart, but in the ouerpart they spring foorth of him, and is fastened, as is aforesayde. Furthermore the Hart hath two Uentrikles or concauities, and the left is hyer then the right, and the cause of this holownesse is this, for to keepe the bloud for his nourishing, and the ayre to abate and temper the great heate that he is in, the which is kept in his concauities. Nowe here it is to be noted, that to the right Uentrikle of the harte commeth a veyne from the great veyne called Venakelis, that receyueth al the substaunce of the blood from the Lyuer. And this veine that commeth frō venakelis entreth into the hart at the right Uentrikle, as I sayde before, and in him is brought a great portion of the thickest blood to nourishe the Hart with, & the residue that is left of this, is made subtil through the vertue of the hart, and then this blood is sent into a concauitie or pytte in the myddest of the Harte betweene the two Uentrikles, and therein it is made hote and pured, and then it passeth into the left Uentrikle, and there is ingendred in it a spirit that is clearer, brighter, and subtiller then any corporal [Page] or bodely thing that is ingendred of the foure Elementes: For it is a thing that is a meane betweene the body and the soule. Wherfore it is likened of the Philosophers, to be more liker heauēly thinges then earthly thinges. Also it is to be noted, that from the left Uentrikle of the Hart springeth two Arteirs: The one hauing but one cote, and therefore it is called Arterea venalis: and this Arteir carieth blood frō the Hart to the Lungs, the which blood is vaporous, that is tried and left of the Harte, and is brought by this Artery to the Lunges to geue hym nutriment: and there he receyueth of the Lunges ayre, and bringeth it to the hart to refreshe him with. Wherefore Galen sayth, that he fyndeth that mans harte is natural and frendly to the Lungs, for he geueth him of his owne nutrimental to nourishe him with, and the Lunges rewarde him with ayre to refreshe him with agayne. &c. The other Arterye that hath two cotes, is called vena Arterialis, or the great Artery that ascendeth and dissendeth, and of him springeth al the other Arteirs that spreade to euery member of the body, for by him is vnified [Page] and quickneth al the members of the body. For the spirite that is reteyned in them, is the instrument or treasure of al the vertue of the soule. And thus it passeth vntil it come to the Brayne, & there he is turned into a further digestion, and there he taketh another spirite, and so is made animal, and at the Lyuer nutrimental, and at the Testikles generatiue: and thus it is made a spirite of euery kinde, so that he beeing meane of all maner of operations and workinges taketh effect. Two causes I fynde why these Arteirs haue two cotes: One is, that one cote is not sufficient nor able to with stande the violent mouing and steering of the spirite of lyfe that is caryed in thē: The seconde cause is, that the thing that is caried about from place to place, is of so precious a treasure that it had the more neede of good keeping. And of some Doctors this Arteir is called the Pulsatiue veyne, or the beating veyne: for by him is perceyued the power & might of the Hart. &c. Wherfore God and Nature haue ordeyned that the Arteirs should haue two cotes. Also there is in the Harte three Pelikels, opening and [Page] closing the gooing in of the Harte blood and spirite in conuenient time. Also the Hart hath two little Eares, by whome commeth in and passeth out the ayre that is prepared for the Lunges. Also there is founde in the Hart a Cartilaginus auditament, to helpe and strength the selfe Harte. Also the Harte is couered with a strong Pannikle, which is called of some Capsula cordes, or Pericordium, the which is a strong case, vnto whome commeth Nerues, as to other inwarde members. And this Panicle Pericordiū springeth of the vpper Pannicle of the Midriffe. And of him springeth another Panikle called Mediastinum, the which departeth the Brest in the middest, and kéepeth that the Lunges fal not ouer the Hart. Also there is an other Pannikle that couereth the Ribbes inwardly, that is called Plura, of whom the Midriffe taketh his beginning. And it is sayde of many Doctors, that Duramater is the originall of all the Pannicles within the body: and thus one taketh of another. &c.
¶ The Anatomie of the Lunges.
THE Lunges is a member spermatike of his fyrst creation, and his natural complexion is colde and dry, and in his accidental complexion he is colde and moyste, lapped in a Nerueous Pannikle, bicause it should gather togeather the softer substaunce of the Lunges, and that the Lunges might féele by the meanes of the Pannicle, that whiche he mighte not feele in him selfe. Nowe to proue the Lunges to be colde and drye of kinde, it appeareth by hys swift steering, for he lyeth euer wauing ouer the hart, and about the harte. And that he is colde and moyst in rewarde, it appeareth wel, that he receyueth of the brayne many cold matters, as Cataries, and Rumes, whose substance is thinne. Also I fynde in the Lunges three kinds of substaunce: One is a Ueyne comming from the Liuer, bringing with him the Crude or rawe parte of the Chylle to féede the Lunges: Another is Arterea venalis, comming from the hart, bringing [Page] with him the spirite of lyfe to nourishe him with: The third is Trachia arteria, that bringeth in ayre to the Lunges, and it passeth through al the left part of them to doo his office. The Lunges is deuided into fiue Lobbes or Pellikels, or fiue portions, that is to say, three in the right side, and two in the left side. And it was done for this cause, that if there fel any hurt in the one part, the others shoulde serue and doo their office. And three causes I finde why the Lunges were principally ordeyned: First, that they should drawe colde winde, and refreshe the hart: The seconde, that they shoulde chaunge and alter, and purifie the ayre before it come to ye hart, least the hart were hurte and noyed with the quantitie of the ayre: The thirde cause is, that they shoulde receyue from the harte the fumous superfluities that he putteth foorth with hys breathing. &c. Behinde the Lunges towarde the Spondels, passeth Mire or Isofagus, of whom it is spoken of in the Anatomie of the necke. And also there passeth both Ueynes and Arteirs, and al these with Trachia arteria, doo make a Stoke, replete vnto the Gullet with [Page] Pannikles, and strong Lygaments, and Glandulus fleshe to fulfil the voyde places. And last of al is the Midriffe, and it is an official member, made of two Pannikles, and Lazartus flesh, and his place is in the middest of the body, ouerth wart or in bredth vnder the region of the spirituall members, departing them from the matrix. And thrée causes I finde why the Midriffe was ordeyned: First, that it should diuide the spirituals from the nutrates: The seconde, that it should kéepe the vital colour or heate to dissende downe to the nutrates: The last is, that the malicious fumes reared vp from the nutrates, should not noye the spirituals or vytals. &c.
The wombe is the region or the citie of al the Intrils, the whiche reacheth from the Midriffe downe vnto the share inwardly, and outwardly from the Reynes or Kydnes, downe to the bone Pecten, about the priuie partes. And thys wombe is compounde and made of two thinges, that is to say, of Syfac & Myrac. Syfac is a Paunicle, and a member spermatike, official, sensible, senowy, compoūd of subtil Wyl, and in complexion colde [Page] and drye, hauing his beginning at the inner Pannicle of the Midriffe. And it was ordeyned because it shoulde conteyne and bind together al the Intrals, and that he defende the Musculus so that he oppresse not the natural members. And that he is strong and tough, it is because he should not be lightly broken, and that those thinges that are conteyned goo not foorth, as it happeneth to them that are broken. &c. Myrac is cō pound and made of foure things, that is, of skin outwardly, of fatnes, of a carnous pannicle, and of Musculus fleshe. And that it is to be vnderstanded, that all the whole from Sifac outwarde is called Myrac, it appeareth wel by the wordes of Galen, where he commaundeth, that in al woundes of the wombe to fewe the Sifac with the Myrac, and by that it proueth that there is nothing without the Sifac but Myrac. And in this Myrac or vtter parte of the wombe, there is noted eyght Muscles, two Longitudinals, proceeding from the sheelde of the Stomacke vnto Os Pecten: two Latitudinales comming from the backe wardes to the wombe: and foure Tranuerse, [Page] of the which two of them spring from the Ribbes on the right side, and go to the left side, to the bones of the Haunches, or of Pecten: and the other two spring from the Ribbes on the left syde, and come ouer the wombe to the righte partes, as the other before doth. Heere it is to be noted, that by the vertue of the subtyl wyl that is in the Musculus longitudinal, is made perfect the vertue attractiue: and by the musculus Tranuerse is made the vertue retentiue: and by the musculus Latitudinale is made the vertue expulsiue. It is thus to be vnderstoode, that by the vertue attractiue is drawen downe into the Intrals al superfluities, both water, wynde, and dyrt: By the vertue retentiue all thinges are withholden and kept, vntil nature haue wrought his kinde: And by the vertue expulsiue is put foorth al thinges, when Nature prouoketh any thing to be done. Galen sayth, that woundes or incisions be more perillous in the middest of the wombe then about the sides, for there the partes be more tractable, then any other partes be. Also he sayth, that in wounds persing the womb there shal not be made [Page] good incarnation, except Sifac be sewed with Myrac. Nowe to come to ye parts conteyned within: Fyrst, that which appeareth next vnder the Sifac is Omentum, or Zirbus, the which is a pannicle couering the stomacke and the Intrals, implāted with many Ueynes & Arteirs, and not a little fatnes ordeyned to keepe moyst the inwarde partes. This Zirbus is an official member, and is compound of a veyne and an Arteir, the which entreth and maketh a line of the vtter tunikle of the stomacke, vnto whiche tunikle hangeth the Zirbus, and couereth al the guttes downe to the shayre. Two causes I finde why they were ordeyned: one is that they shuld defend ye nutratiues outwardly: the seconde is, that through his owne power & vertue he should strength & cōfort the digestion of al the Nutrates, because they are more féebler then other members be, bicause they haue but a thin wombe or skinne. &c. Next Zirbus appeareth the Intrals or guttes, of which Galen saith, that the Guttes were ordeined in the fyrst creation to conuey the drosse of the meate and drinke, & to clense the body of their superfluities. And here it is to be noted that there be sixe portiōs [Page] of one whole Gutte, which both in man and beast beginneth at the nether mouth of the stomacke, and so continueth foorth to the end of the Fundament. Neuerthelesse he hath diuers shapes and formes, and diuers operations in the body, and therfore he hath diuers names. And here vpon the Philosophers say, that ye lower wombe of a man is like vnto the wombe of a swine. And lyke as the stomack hath two tunikles, in like maner haue al the Guttes two tunikles. The fyrst portion of the Guttes is called Duodenum, for he is. xij. ynches of length, and couereth the nether parte of the stomacke, and receyueth al the drosse of ye stomacke: The seconde portion of the Guttes is called Ierunium, for he is euermore emptie, for to him lyeth euermore the chest of the Gal, beating him sore, and draweth forth of him al the drosse, & clenseth him clene: The iij. portion or gutte is called Yleon, or smal gutte, and is in length. xv. or. xvj. Cubites. In this gutte oftentimes falleth a disease called Yleaca pas [...]io. The iiij. gut is called Monoculus, or blind gut, and it seemeth to haue but one hole or mouth, but it hath two, one neere vnto the other, for by the one al thinges go in, [Page] and by the other they goo out agayne: The fyft is called Colon, and receyueth al the drosse depriued from al profitablenesse, and therefore there commeth not to him any veynes Miseraices, as to the other: The syxte & last is called Rectum, or Lōgaon, and he is ended in the Fundament, and hath in his nether end foure Muscles, to holde, to open, to shutte, and to put out. &c. Next is to be noted of Mesenterium, the which is nothing else but a texture of innumerable veynes Miseraices, ramefied of one veyne called Porta epates, couered and defended of Pannicles and Ligamentes comming to the Intrals, with the backe ful of fatnes and glandulus fleshe. &c.
The stomacke is a member compound and spermatike, senowy and sensible, and therein is made perfect the fyrst digestion of Chile. This is a necessarie member to al the body, for if it fayle in his working, al the members of the body shal corrupte. Wherefore Galen sayth, that the stomacke was ordeyned principally for two causes: The first, that it shoulde be to al the members of the body, as ye earth is to al that are ingendred of the earth, that is, that it shoulde desire sufficient [Page] meate for al the whole body: The seconde is, that the stomacke shoulde be a sacke or chest to al the bodie for yt meate, and as a Cooke to al the members of the body. The stomacke is made of two pannicles, of which the inner is Nerueous, and the vtter Carneous. This inner panicle hath musculus longitudinales that stretcheth along from the stomacke to the mouth, by the which he draweth to him meate and drinke, as it were handes. Also he hath Tranuers wyl, for to withholde or make retention. And also the vtter pannicle hath Latitudinal wyl, to expulse and put out: and that by his heate he shoulde helpe the digestiue vertue of the Stomacke, and by other heates geuen by his neighbours, as thus, It hath the lyuer on the right side, chafing & heating him with his lobes or figures: & the Splen on the left syde with his fatnes, & veynes sending to him melancolie, to exercise his appetites: and aboue him is the Harte, quickening him with his Arteries: Also the brayne, sending to him a braunche of Nerues to geue him feeling. And he hath on the hinder parte, dissending of the partes of the backe many Lygamentes, with the which he is [Page] bounde to the Spondels of the backe. The forme or fygure of the Stomacke is long, in likenes of a gowrde, crooked: and that both holes be in the vpper part of the body of it, is, because there should be no going out of it vnaduisedly of those thinges that are receyued into it. The quantitie of the stomacke commonly holdeth two pitchers of water, and it maye suffer many passions, and the nether mouth of the stomacke is narrower then the vpper, and that for three causes: the first cause is, that the vpper receyueth meate great and boystrous in substaunce that there béeyng made subtile it might passe into the nether: The second is, for by him passeth al the meates, with their chilositie from the Stomacke to the Lyuer: The thirde is, for that through him passeth al the drosse of the Stomacke to the guttes. And this suffiseth for the Stomacke. &c.
The Lyuer is a principal member, and official, and of his first creation spermatike, complete in quantitie of blood, of him self insencible, but by accidence he is sencible, and in him is made the seconde digestion, and is lapped in a Senowy pannicle. And that he is a principall [Page] member, it appeareth openly by the Philosophers, by Auicen, and Galen. And it is official as is the stomacke, and it is of spermatike matter, and senowy, of the which is ingendred his Ueynes. And because it was little in quantitie, nature hath added to it cruded blood, to the accomplishment of sufficient quantity, and is lapped in a senowy pannicle, And why the Lyuer is cruded, is, because yt Chile which commeth from the stomacke to the Lyuer, should be turned into the colour of blood. And why the Lyuer was ordeined, was, because that al the nutrimental blood shoulde be ingendred in him. The proper place of the Lyuer is vnder the false Ribbes in the righte side. The forme of the lyuer is gibbous or bunchy on the backside, & it is somwhat hollow like the insyde of an hande. And why it is so shapen, is, that it should be plycable to the stomacke, like as a hande dothe to an apple, to comforte her digestion, for his heate is to the stomacke as the heate of the fyre is to the Potte or Cauldron that hangeth ouer it. Also the Lyuer is bounde with his pellikles to the Diafragma, and with strong Lygamentes. And also he hath Colyganes with the [Page] Stomack and the Intrals, and with the Hart and the Raines, the Testicles and other members. And there are in hym fiue Pellikles like fiue fingers. Galen calleth the Liuer Massasanguinaria, conteyning in it selfe foure substances, Natural and Nutrimental. The naturals is sent with the blood to all partes of the body to be ingendred and nourished. And the nutrimentals be sequestrate and sent to places ordeyned for some helpinges. These are the places of the humors, the blood in the Lyuer, Choler in the chest of gal, Melancolie to the Splen, Flegme to the Lunges and the Iunctures, the watery superfluities to the Reynes and the Uesike. And they goo with ye blood, and sometime they putrifie and make Feuers, and some be put out to the skin, and be resolued by sweat, or by skab, by Pushes, or by Impostumes. And these foure natural humours, that is to say, Sanguin, Choler, Melancoly, & Fleme, be ingendred and distributed in this maner: First ye shal vnderstande that from the Spermatike matter of the Liuer inwardly, there is ingendred two greate veynes, of the whiche the first and the greatest is called Porta, and commeth [Page] from the concauitie of the Lyuer, of whō springeth al the smal veynes Miseraices, and these Miseraices be to Vena porta as the braunches of a tree be to the stocke or tree. For some of them be conteyned with the botome of the stomacke, some wyth Duodenum, some with Ieiunium, some with Yleon, & some with Monoculus, or Saccus. And from al these guttes they bring to Vena porta the succozitie of Chiley gooing from the stomacke, & distribute it into the substaunce of the Lyuer. And these veynes Miseraices be innumerable. And in these vaynes is begon the seconde digestion, and ended in the Lyuer, like as is in the Stomacke the fyrst digestion. So it proueth that Vena porta and vena Miseraices serue to bring al the succozitie of the meate and drinke that passeth the Stomacke to the Liuer, and they spreade them selues thorough the substaunce of the Liuer inwardly, and al they stretche towards the gibbos or bowing part of the Liuer, and there they méete and goe al into one vnitie, & make the second great veine called Venakelis or Concaua, or Vena ramosa, al is one, and he with his rootes draweth [Page] out al the blood ingendred from the Lyuer, and with his braunches ramefying vpwardes and downewardes, carieth and conueyeth it to al other members of the body to be nourished with, where is made perfect the thirde digestion. And also there goeth from the Lyuer veines bearing the superfluities of the thirde digestion to their proper places, as it shal be declared hereafter.
Nowe to speake of the Gal, or the chest of the Gal: it is an official member, and it is spermatike and senowy, and hath in it a subtil wyl, and it is as a purse or a pannicular vesike in the holownesse of the Lyuer, about the middle pericle or lobe, ordeyned to receyue the Cholerike superfluities which are ingendred in the Lyuer. The which purse or bagge hath three holes or neckes: by the fyrste he draweth to him from the Lyuer the choler, that the blood be not hurt by the choler: by the seconde necke he sendeth to the bottome of the stomacke Choler to further the digestion of the stomacke: And by the third neck he sendeth the choler regularly from one gutte to another to clense them of their superfluities and drosse: and the quantitie of the purse may [Page] conteyne in it halfe a pinte. &c.
And next is the Splen, or the Milte, the whiche is a spermatike member, as are other members, and official, and is the receptory of the melancolious superfluities that are ingendred in the Liuer. And his place is on the lefte side, transuerslye lincked to the stomacke, and his substaunce is thinne. And two causes I finde why he was ordeyned there: The first is, that by the melancolious superfluities that are ingendred of the Lyuer which he draweth to him, he is nourished with: The seconde cause is, that the nutritiue blood should by him be made the more purer and cleane, from the drosse and thicking of melancolie. &c.
And next of the Reynes and Kidnes: It is to be vnderstoode, that within the region of the Nutrites backwardes, are ordeyned the Kidnes, to clense the blood from the waterie superfluities, And they haue ech of them two passages, or holes, or neckes: by the one is drawen the water from Uenakelis by two veynes, whiche ar called vena emulgentes, the length of a fynger of a man, and issueth from the Liuer: and by the other is sente the same water to the Bladder, and is called [Page] Poros vrithides. The substaunce of the Kidnes is Lazartus fleshe, hauing Longitudinal wyl. And their place is behinde on eache side of the Spondles, and they are two in number, and the righte Kidney lyeth some what hyer then the lefte, and is bounde fast to the backe with Lygamentes. The Philosopher sayth, that mans kidneys are like to the kidnes of a Cowe, ful of harde knottes, hauing in him many harde concauities, and therefore the sores of them be harde to cure. Also they are more harder in substaunce then any other fleshy member, and that for two causes: one is, that he bee not muche hurt of the sharpnesse of the vrin: The other is, that the same vrin that passeth from him might the better be altered and clensed throughe the same. Also there commeth from the harte to eche of the kydnes an Arteir, that bringeth with him blood, heate, spirite, and lyfe. And in the same maner there commeth a veyne from the Lyuer, that bringeth blood to nourishe the kydnes, called blood nutrimental. The grease of these kydnes or fatnes is as of other inwarde members, but it is an official member, made of thinne blood, congeled & cruded [Page] through colde: and there is ordeyned the greater quantitie in his place, because it should receyue and temper the heate of the kydnes, which they haue of the byting sharpnesse of the water. Nowe by the kydnes vpon the Spondels passeth Venakelis, or venacaua, which is a veyne of a great substaunce, for he receyueth al the nutrimental blood from the Lyuer: and from him passeth many smal pypes on euery side, and at the Spondel betwéene the Shoulders he deuideth him selfe whole into two great braunches, the one goeth into the one arme, and the other into the other, and there they deuide them selues into many veynes and branches: as it is declared in the armes.
¶ The Anatomie of the Hanches, and their parts.
THe Hanches are the lower parte of the wombe, ioyning to the Thies, and the secret members. And three thinges there are to be noted thereof: the first is of the partes conteining: the seconde is of the partes conteyned: and the thirde is of the partes [Page] proceeding outwardes. The partes conteyning outwardly, be Myrac and Sifac, the Zirbus, and the bones. The partes conteyned inwardly, are, the Vezike, or bladder, the spermatike vessels, the Matrix in women, Longaon, Nerues, Ueynes, and Arteirs dissending downwards The partes procéeding outwardes, are, The Buttockes, and the Muscles dissending to the Thies, of whiche it is to be spoken of in order. And first of the partes conteyning: as of Myrac, Sifac, and Zirbus, there is ynough spoken of in the Anatomie of the wombe. But as for the bones of the Hanches, There be of the partes of the backe three Spondels of Ossa sacri, orof the Hanches, & three cartilaginis spondels of Ossa caude, called, The tayle bonne. And thus it is proued, that there is in euery man, woman, and childe. xxx. spondels, and thus they are to be numbred: In the Necke, vij. in the Ridge, xij. in the Reynes, v. & in the Hanches, vj. And it is to be noted, that euery spondel is hollowe in the middest, through which holownesse passeth Nuca from the Brayne, or the marowe of the backe. And some Authors say, that Mynuca is of the same substaunce that the [Page] Braene is of, for it is like in substaunce, and in it selfe geueth to the Nerues both the vertue of mouing and féeling. And also euery Spondel is holed on euery side, through the which holes both Arteirs and veynes, doo bring from the hart and the Lyuer both lyfe & nourishment, like as they doo to the brayne: and from the pannicle of Minuca or the marowe of the backe, through the holes of the sides of the spondels, springeth forth Nerues motiues, and there they intermedle them selues with the strong Lygamentes that be insencible, and so the Lygamentes receyue that feeling of the Nerue, which the Nerue taketh of Mynuca. And by this reason many Autors proue, that Mynuca is of the same substaunce that the Brayne is of, and the panicles of the Nuca is of the substance of the pannikles of the Brayne. &c. And eche of these spondels be bounde fast one with another, so that one of them maye not wel be moued without another. And so al these spōdles together, cōteined one by another are called ye Ridgbone, which is the fundation of al the shape of the body. They with the laste spondel be conteyned or ioyned to the bones of the [Page] Hanchēs, and they be the vpholders of al the spondles. And these bones be smal towardes the tayle bone, and broade towardes the Hanches, and before they ioyne and make Os pectinis. And so they be brode in the partes of the Iles, and therefore some Authors calleth it Ilea. And ech of these two bones toward the lyuer hath a great rounde hole, into the whiche is receyued the bone called Vertebra, or, The whorle bone, Also besides that place there is a great hole or way, through the which passeth frō aboue Musculus, veynes, and Arteirs, and go into the Thees. And thus it is to be noted, that of this bone Pecten, and the bone Vertebra, is made the iuncture of the Thye.
Now to speake of the parts conteined, The first thing that commeth to sight, is the Bladder, the which is an official mē ber, compounde of two Neruous Pannicles, in complexion colde & dry, whose necke is carnous, and hath Muscles to withholde, and to let go: And in men it is long, and is conteyned with the yard, passing through Peritoneum, but in women it is shorter, and is conteyned within the Vulua. The place of the bladder is [Page] betweene the bone of the Share and the tayle gutte called Longaon, and in women it is betweene the foresayde Bone and the Matrix. And in it is implanted two long Uessels comming from the kidnes, whose names be Porri vrichides, bringing with them the Urin or water from the kidnes to the bladder, whiche priuily eutreth into the holes of the pannicles of the bladder, by a natural mouing betweene tunicle and tunicle, and there the vrin fyndeth the hole of the nether tunikle, and there it entreth priuily into the concauitie of the bladder, and the more that the bladder is filled with vrin, the straighter be the two tunicles comprised togeather, for the holes of the tunicles be not euen one agaynst another, and therefore if the bladder be neuer so ful, there may none goe backe agayne. The forme of it is rounde, the quantitie of it is a pitcher full, in some more, and in some lesse. &c. Also there is founde two other vessels called, vaza seminaria, or the spermatike vessels. And they come from Uenakelis, bringing blood to the Testikles, as wel in man, as in woman, in the which by his further digestion it is made sparme or nature in men. They [Page] be put outwarde, for the Testikles be without, but in women it abydeth within, for their Testicles stande within, as it shal be declared hereafter.
Next foloweth the Matrix in women: The Matrix in woman is an official member, compounde and Nerueous, and in complexion colde and dry. And it is the felde of mans generation, and it is an instrument [...], that is to say, a thing receyuing or taking: and hee proper place is betweene the bladder and the gutte Longaon, the likenes of it is as it were a yarde reuersed or turned inwarde: hauing testikles likewise, as aforesaid: also the Matrix hath two concauities or selles, and no moe, but al beasts haue as many selles as they haue pappes heades. Also it hath a long necke lyke an vrynal, & in euery necke it hath a mouth, that is to saye, one within, and an other without. The inner in the tyme of conception is shutte, and the vtter parte is open, as it was before: and it hath in the middest a Lazartus pannicle, whiche is called in Laten Tentigo. And in the crea tion of this Pannicle is founde two vtilities: The first is, that by it goeth forth the vrin, or els it should be shed throughout [Page] al the Vulua: The seconde is, that when a woman doth set hir thies abrode it altereth the ayre that commeth to the Matrix for to temper the heat. Furthermore, the necke that is betweene these two foresayde mouthes, in her concauitie hath many inuolutions and pleates, ioyned together in the maner of Rose leaues before they be fully spread or ripe, and so they be shut togeather as a Purse mouth, so that nothing may passe foorth but vrin, vntil the time of chylding. Also about the middle of this necke be certain veynes in Maydens, the which in tyme of deflouring be corrupt & broken. Furthermore, in the sides of the vtter mouth of the mouth are two testicles or stones, and also two vessels of sparme shorter then mans vessels, and in time of coyt the womans sperme is shed downè into the bottome of the Matrix. Also from the Lyuer there commeth to the Matrix many veynes, bringing to the childe nourishing at the time of a womans beeing with childe: and those veynes, at suche time as the Matrix is voyde, bring therto superfluities from certayne members of the body, whereof are ingendred womens flowres. &c.
[Page] And forasmuche as it hath pleased almightie God to geue the knowledge of these his mysteries and workes vnto his Creatures in this present worlde, Here I purpose to declare what thing Embreon is, and his creation. The noble Philosophers, as Galen, Auicen, Bartholomeus, and diuers other writing vpon this matter, say, That Embreon is a thing ingendred in the mothers wombe, the original wherof is ye sparme of the man and the woman, of the which is made by the might and power of God, in the mothers wombe a chylde, as hereafter more at large shal be declared. First the feelde of generation called the Matrix, or the mother, is knowen in the anatomie, whose place is properly betwixt the Bladder and Longaon in the womā, in which place is sowen by the tillage of man a couenable matter of kindly heate, for kindly heate is cause efficeens bothe of dooing and working, and spirite that geueth vertue to the body, and gouerneth and ruleth that vertue: the which séede of generation commeth from al the partes of the body both of the man and the woman, with consent & wyl of al members, and is shed into the place of conceyuing, [Page] where through the vertue of Nature it is gathered together in the selles of the matrix or the mother, in whom by the way of the working of mans seede, and by the way of suffering of the womans seede mixte together, so that eche of them worketh in other, and suffereth in other, there is ingendred Embreon. And further it is to be noted, that this sparme that commeth both of man and woman, is made & gathered of the most best and purest drops of blood in all the body, and by the labour and chafing of the testikles or stones this blood is turned into another kinde, and is made sparme. And in man it is hotte, white, & thicke, wherfore it may not spread nor runne abroade of it selfe, but runneth and taketh temperaunce of the womans sparme, which hath contrarie qualities, for the womans sparme is thinner, colder, and féebler. And as some Authors holde opinion, when this matter is gathered into the right side of the matrix, then it happeneth a male kinde, and likewise on the lefte the female, and where the vertue is most, there it sauoureth most. And further it is to be noted, that lyke as the Renet of the Chéese hath by him selfe the [Page] way or vertue of working, so hath the mylke by waye of suffering: and as the Renet and mylke make the chéese, so doth the sparme of man and woman make the generation of Embreon, of the which thing springeth by the vertue of kindly heate, a certayne skinne or caule, into the which it lappeth it selfe in, where with afterwardes it is tyed to the mothers wombe, the whiche couering commeth foorth with the byrth of the childe, and if it happen that any of the skinne remaine after the byrth of the childe, then is the woman in peril of her lyfe. Furthermore it is sayde, that of this Embreon is ingendred the Hart, the Lyuer, the Brayne Nerues, veynes, Arteirs, Cordes, Lygamentes, Skinnes, Gristles, & Bones, receyuing to them by kindly vertue the menstrual blood, of whiche is ingendred both fleshe and fatnes. And as wryters say, the fyrst thing that is shapen be the principals, as is the Harte, Lyuer, and Brayne. For of the Hart springeth the Arteirs, of the Lyuer the Ueynes, and of the Brayne the Nerues: and when these are made, Nature maketh & shapeth Bones and grystles to kéepe & saue them, as the bones of the head for the [Page] Brayne, the Brest bones and the Ribbes for the Harte and the Lyuer. And after these springeth al other member one after another. And thus is the childe bred foorth in four degrees, as thus, The first is, when the sayde sparme or seede is at the fyrst as it were mylke: The seconde is, when it is turned from that kinde into another kinde, is yet but as a lumpe of blood, and this is called of Ypocras, Fettus: The thirde degrée is, when the principals be shapen, as the Hart, lyuer, and Brayne: The fourth and laste, as when al the other members be perfectly shapen, then it receyueth the soule wyth life and breath, and then it beginneth to moue it selfe alone, Nowe in these foure degrees aforesayde, in the fyrst as milke it continueth, vij. dayes: in the seconde as Fettus, ix. dayes: in the thirde as a lumpe of fleshe ingendring the principals the space of, ix. days: and the fourth vnto the tyme of ful perfection of al the whole members, is the space of, xviij. dayes: So is there, xlvj. dayes from the day of conception vnto the day of ful perfection and receyuing of the soule, as God best knoweth.
Now to come agayne to the Anatomie [Page] of the Hanches: Then come we to Longaon, otherwise called, The tayle gutte, whose substance is panniculer, as of al the other bowels, the length of it is of a spanne long, stretching nigh to the Raynes, his nether parte is called Annis, that is to say, The towel. And about him is found two Muscles, the one to open, the other to shutte. Also there is founde in him fiue veynes or braunches of veynes, called vena emoraidales, and they haue coliganes with the bladder, wherefore they are partners in their greeues. And when this Longaon is raysed vp, then ye may sée the veynes and arteirs, and senowes, howe they be braunched and bounde downe to the nether partes. The partes procéeding outwardly, are, Didimus, Peritoneum, the Yarde, the Testikles, and the Buttockes. And fyrst it shal be spoken of the yarde, or of mans generatiue members, the whiche dureth vnto that parte that is called Peritoneum, the which place is from the Coddes vnto the Fundament, wherevpon is a seame. Wherfore sayth the Philosopher, Mans yard is in the ende and terme of the share. The yarde is an official member, [Page] and the tyller of mans generation, compounde and made of skinne, brawnes, Tendons, veynes, arteirs, senewes, and great Lygaments: and it hath in it food passages, or principal issues, that is to say, one for the sparme, and another for the vryn. And as the Philosophers say, the quantitie of a common yard is viij. or, ix. ynches, with mesurable bignes proportioned to the quantitie of the matrix. This member hath, as sayth Auicen, three holes, through one passeth incensible polissions and wynde, that causeth the yard to ryse: the other two holes be declared before. Also the yard hath a skinne, and about the head thereof it is double, and that men call Prepusium, and this skinne is mouable, for through his consecration the spermatike matter is the better and sooner gathered together, and sooner cast foorth from the Testicles: for by him is had the more delectation in the dooing. And the formost part of the head of the yard before is made of a subtil brawny fleshe, the whiche if it be once lost, it is neuer restored agayne, but it may wel be skinned. &c.
The Coddes is a compounde member, [Page] and an officiall, and though it be counted amongst the generatiue members, yet it is called a principal member because of generation. This purss was ordeined for the custodie & comfort of the testikles and other spermatike vesselles. And it is also made of two partes, of the inner, and the vtter. The vtter is compound and made of skinne, and lazartus, longitudinal, and transuersal, in like maner as is the Myrac. The inner parte of the Coddes is of the substaunce of the Sifac, and are in similitude as two pockets drawen together by them selues, and they differ not from the Sifac: and there be two, bicause if there fal any hurt to the one, the other should serue. The Testikles or stones be two, made of glā dulus fleshe or curnelly fleshe. And furthermore, through the Didimus cōmeth to the Testikles from the Brayne, Senowes, and from the Hart Arteirs, and from the Lyuer veynes, bringing vnto them both feeling and steering, lyfe and spirite, and nutrimental blood, and the most purest blood of al other members of the body, whereof is made the sparme by the labour of the Testicles, the which is [Page] put foorth in due tyme, as is before rehearsed.
The Groynes be knowen: they be the emy iunctures or purging place vnto the Lyuer, and they haue curnelly fleshe in the plying or bowing of the Thyes. The Hippes haue great brawny fleshe on them, and from thence dissende downwards brawnes, cordes, and lygaments, mouing and bynding together the thies, with the Haunches themselues.
¶ The Anatomie of the Thyes, Legges, and Feete.
THE Legge reacheth from the Ioynt of the Thie vnto the extremitie of the Toes, and I wyl deuide it in partes, as the armes were deuided: One parte is called Coxa, or Thigh, and that is al that is conteyned from the ioynt of the Haunche vnto the Knee: The seconde part is called Tibia, and that reacheth from the Knee to the Ankle: The thirde is the little foote, and that is from the Ankle, vnto the end of the Toes. And here it is to be noted, [Page] that the Thigh, Legge, and Foote, are compounde and made as the great arme or hande, with skinne, fleshe, veynes, arteirs, senewes, brawnes, tendons, and bones, whereof they are to be spoken of in order. Of the skinne and fleshe there is ynough spoken of before. And as of veynes and arteirs, in their discending downewardes at the laste spondels they be deuided into two partes, whereof the one parte goeth into the right Thye, and the other into the lefte: and when they come to the Thye they be deuided into other two great braunches: the one of them spreadeth into the inner side of the Legge, and the other spreadeth into the vtter syde, and so braunching dissende downe the Legge to the ankles & feete, and be brought into foure veynes, which be commonly vsed in letting blood, as hereafter foloweth. One of them is vnder the inner ankle towarde the heele, called Soffena, and another vnder the vtter ankle, called Siattica, and another vnder the hamme, called Poplitica, the fourth betweene the little Toe and the next, called Kenalis. And it is to be noted of these foure great veynes in the legges of the manyfolde daungers that mighte [Page] fal of them, as oft it happeneth. There be many other braunches which a Chirurgion nedeth not much to passe vpon. The Senewes spring of the last spondel, & of Os sacrum, and passeth through the hole of the bone of the Hippe, and dissendeth to the Brawnes, and moueth the Knée & the ham, and these dissende downe to the ankle, and moue the foote, and the brawnes of the feete moue the Toes, in lyke maner as is declared in the bones of the handes. The first is called Coxa, that is The thye bone, and he is without a fellowe, and is ful of marow, and is round at eyther ende: The roundnes that is at the vpper ende is called Vertebrum, or Whurle bone, and boweth inwardes, and is receyued into the boxe or hole of the hanche bone: and at the lower & towards the Knee there it hath two roundes, which be receyued into the concauities of the bone of the legge at the knee, called the great Fossels. There is also at the knee a rounde bone called, The knée panne. Then foloweth the legge, wherin is two bones, called Focile maior, and Focile minor, the bygger of them passeth before, making the shape of the shinne, & it is called the shinne bone, and passeth [Page] downe making the inner ankle. The lesse passeth from the knee backwardes, dissending downe to the vtter ankle, and there formeth that ankle. &c. The bones of the foote are, xxvj. as thus, Fyrst, next the ankle bone is one, called in Laten Orobalistus: next vnder that towardes the Heele is one, called Calcany: and betweene them is another bone called Os nauculare: In the seconde warde there be foure bones, called Raceti, as be in the handes. In the thirde & fourth warde be, xiiij. called Digitori: and. v. called Pectens at the extremities of the Toes, next to the nayles. And thus be there in the foote, xxvj. bones, with the Legge from the Ankle to ye Knee, two in the Knee, and one rounde and flat bone, and in the Thye one. And thus shal you finde in the whole Legge and Foote, xxx. bones. And this suffiseth for young Practicioners.