The leech should have also a good stock of and should most strictly counsel about the patient. ¶ Also 1 Quamvis. my lyf I haue sene but fewe laborante in þis vice heled in any sikenes: perfore it is to be-war to wise men pat pei entremette no3t with sich. ffor whi; be wise man seip, All pinges ar hard to a waik hert man, for þai 4 trow euermore yuellez to be nyze to pam; þei drede euermore, þai suffre no pingis, þai are euermore vnstable and vnwise; perfore a versifiour seip of tham, ' Quominus 1 nil pacior paciendi me tenet horror': pat is pof-al I 8 suffre no-ping, vgglynes of suffryng holdeth me. it spedeth pat a leche kunne talke of gode talez and of honest that may make pe pacientes to laugh, as wele of the merry tales, biblee as of other tragedie3; & any othir þingis of which it 12 is not to charge while; þat þey make or induce a lizt hert to pe pacient or pe sike man. Discouer neuer the leche vnwarly the counsellez of his pacientes, als wele of men as of wymmen, ne2 sette no3t oon to anoper at nozt, þof-al 16 he haue cause, þat he be no3t gilty of counsell; ffor zif a keep his own man se pe hele wele anoper mannes counsel he wil trist better in pe. Many pinges, forsope, bene to be kepte of a leche, wipoute pese pat ar seid afore, pat may no3t 20 be noted here for ouer moche occupying. But it is not to dout pat if þe forseid be wele kepte pat-ne þai shal giffe a gracious going to pe vser to pe hizte of worship and of wynnyng3; for Caton seip, Virtutem primam puta 24 3 quia ea esse compescere linguam': The first vertu trow you to be to refreyne pe tong. Aftur al pise it houeth that he knowe pe names of pe instrumentis pat perteneth to pe cure of þe fistule, withoute whiche a leche may noзt wele 28 spede hym. Of whiche pe first is called Sequere me' -'follow me'-whose shap is shewed wher pe instrumentez ar paynted [fig. 1]. And it is called 'Sequere me' for it is pe first instrument pertenyng to þat werk; for a lech 32 ow for to serche per-with pe way of pe fistule whider it gop, wheper by pe middez of longaon or no3t. And it ow to be made on pe same maner as wymmen vseþ in pair heuedez, and of pe same metal; and it ow to be 36 in capitismal þat it may ligtly be plied & replied. And be pe heuedez 5 als little as pai may wele be, elle3 pai mit nozt wele entere pe moup of pe fistule for pe streitnes of it. The names of the instruments used in the operation for fistula: the probe, 2 MS. pe. exercenti bus. 5 capita. ffor why; oft tyme3 ffistule in ano hath rizt smale holez, so pat som tyme pai shew no3t but pat per appereth bolnyng in pe moupes of pam. Afterward is per 4 anoper instrument, pat is called Acus rostrata,' a the grooved director, back] snowted nedle, for it hath pe tone heued like a snowte, and in pe toper an yze like a nedel by whiche predes ow to be drawen agayn by middez of þe fistule, as it shal 8 be seid within in his place. And it ow to be of siluer, as it is paynted; and it ow to be no gretter ne lenger in þe snowte pan as it is paynted, but it ow to be longer atte pe left, pat it contene in al 8 ynches in lenghþe.1 The 12 prid instrument is called 'tendiculum,' and it ow to be the dilator, made of boxe or of anopir competent tree, nouper lenger ne gretter pan his shap is paynted. And it ow to haue an hole purgh in þe side, as it is peynted, the peg, 16 In whiche hole be per putte *2 in a wrayst,3 by midde3 * leaf 144, of whiche wraiste in pe ouer ende shal be a litel hole purgh whiche shal be putte pe two endez of grete prede four folde, goyng atte firste by pe towel and pe hole of 20 pe fistule; whiche prede is called ffrenum cesaris, and the whiche also goyng atuyx pe wraiste, in wraistyng þe skynne atuyx þe tewel & pe fistule be faste constreyned aboue pe snowte of pe nedel, vnto þat kittyng be done. 24 Siringa' is an holow instrument by pe middez, and it ow to be made of the shappe as it is peynted here, nouper gretter ne lenger, but euen after pe shappe as it is peynted here; ne haue it no3t but oon hole in þe neper 28 ende or smaller ende, as it is peynted here [see p. 10, Plates II and III]. 2 The words from here to the end of this page are reproduced in facsimile in Plate III. the "Syringe." PLATE II.-The instruments used by John Arderne in the cure of fistula. (1) The probe-sequere me; (2) The snouted needle-acus rostrata; (3) The dilator-tendiculum; (4) The strong thread-Frænum Cæsaris; (5) The peg-vertile-fitting into the hole in the wide part of the tendiculum; (6) The syringe in general use with lateral openings; (6a) Arderne's modification of the syringe with a terminal opening only. [From Sloane MS. 2002, leaf 24.] |