Music and Geometry. The "de disciplina scholarium" mentioned in the text is falsely ascribed to Boetius. It is quoted again 23/27.

7/39. Arderne repeatedly draws attention to the effect of the mind on the body, and makes it appear that what we now call neurasthenia was not unknown in his experience. Cf. 6/23, 8/3, 60/16, 64/32.

8/27. The operation of fistula recommended by Arderne is described in the Forewords (p. xvii) to this volume. Arderne purposely gives fancy names to the instruments and to the remedies he uses as part of a fixed design to keep his methods secret. This secrecy was a common feature of the medical profession until quite recently-indeed it still lingers in parts where medical men dispense "our ointment" or "our linctus." Arderne especially feared the competition of other leeches, cf. 15/9 and 30/3, of the Barbers, cf. 71/16, and of the laity, cf. 103/3, for when he used the charm against tic, tetanus and delirium tremens, he not only disguised the words in Greek characters but he made nonsense of them, "ne a laicis perspicietur." 8/29. The sequere me was a flexible probe, and was named appropriately enough because it was the guide to be followed.

9/4. The acus rostrata, or "snowted needle," was a grooved director along which the scalpel was passed. The snowted or curved end fitted into a hole in the cochlearia or shield which was introduced later in the operation to protect the opposite side of the rectum at the moment the fistula was divided. This snouted needle was made of silver.

9/12. The tendiculum, or dilator, made of boxwood, was used chiefly to keep the ligature taut whilst the fistula was being divided. For this purpose it was provided with a hole into which fitted (9/16) the wrayste or "vertile," much in the same way that the peg fits into a violin. The ends of the ligature were passed round the wrayste, which was then twisted until the frænum cæsaris was tight enough.

9/20. The frænum Cæsaris, or ligature, constricted the rectal side of the fistula. It seems to be merely a vestigium of an obsolete operation for the cure of fistula. Albucasis used it as an écraseur, and Arderne had sufficient reverence for authority not to discard it. But the operation he describes is one of simple division. The tendiculum, the wrayste and the frænum Cæsaris, therefore, are useless because as soon as the division was complete, they all fell out of the wound. Cf. 24/26. They steadied the parts whilst the incision was made, but they complicated the operation by giving the surgeon two instruments to hold in his left hand (the acus rostrata and the tendiculum) whilst he held the scalpel in his right hand. The cochlearia must always have been held by the assistant--the fellow of the leech-as Arderne calls him,-the surgeon's mate-as the Elizabethans knew him.

9/24. The siringa is probably only a clyster-pipe. Two forms are given, the one with side-openings, as was then used, the other an improved form recommended by Arderne as the result of his own experience (cf. 74/38) in which there is only a single terminal orifice.

11/1. Aposteme is an early form of the word which afterwards became Imposthume. It means a suppurating inflammation or an abscess.

11/6. Arderne's pathology of fistula is excellent and is clearly the result of observation. He has seen and treated cases of ischio-rectal abscess, and has observed how such abscesses have become chronic and ended in a fistula.

11/18. The axillary glands were the emunctories of the heart: the inguinal glands of the liver: the cervical glands of the brain.

11/19. Chawellez is quite an unusual word, and except for the Latin version it would be incomprehensible. The Latin gives the English gloss "fauces." It seems, therefore, to be a form derived from the same source as "Chawylbone" which the Promptorium Parvulorum renders Mandibula.

11/20. Gilbertyn is Gilbert the Englishman, known to all readers of Chaucer because he is named in the Prologue (1. 429) with Bernard and Gatesden. Gilbertus Anglicus flourished about 1210, and is said to be the first practical English writer on medicine though Master Richard preceded him. Dr. Payne in his Fitzpatrick lectures in 1904 says that Theodoric took his description of leprosy from Gilbertyn, a description evidently at first hand and in many respects very accurate. Gilbert wrote a compendium or Laurea of medicine, printed at Lyons 1510 (cf. 55/10), and a Commentary upon the verses of Gilles de Corbeil "De Urinis" (cf. 59/32). A commentary in English upon these same verses and attributed to John Arderne exists in manuscript in the Hunterian Library at Glasgow (No. 328).

11/21. Ol. roset. Oil of roses entered largely into the mediæval pharmacopoeia as a soothing application. The ceruse here ordered to be mingled with it is carbonate of lead, and the litharge is protoxide of lead. The lotion thus had the soothing and astringent properties which is still attributed to lead lotion or Goulard extract.

11/24. Wombe. Arderne speaks consistently of the belly as the womb both in men and women; when he speaks specifically of the womb in women he employs the term Marice. Cf. pp. 80/39, 85/4 and 86/26.

11/27. Arderne, like his contemporaries, recognises two forms of Mallow. The Althea rosea-which he calls "tame" mallow (cf. 12/15), because it was grown in the garden, and Malva silvestris-the wild mallow.

11/32. A Nastar of tree. Arderne fortunately gives the English equivalent for Nastar in the manuscript No. 112 (T. 5, 14), fol. 77, contained in the Hunterian Library, Glasgow, and says, "Nastare species est clysteris sive enematis 'a glister pipe.'" A Nastar of tree, therefore, is a wooden enema nozzle. The wood may be either boxwood, hazel or willow. His description of the bladder and its method of preparation is given later on; cf. 75/1 et seqq.

12/1. After auctores. The author is probably Serapion the younger who wrote a large work on pharmacology, which was translated from Arabic into Latin under the title "Liber de medicamentis simplicibus" or "De temperamentis simplicium." He lived about the end of the eleventh century. For Serapion the elder see 55/29, p. 124.

12/9. Diaquilon. Three forms of diachylon plaster were used. One called Rhazes plaster; a second Mesue's, and the third diachylon commune. Arderne here recommends Mesue's diachylon which contained mucilage of Althea and oil of camomile amongst many other ingredients.

12/15. M. The symbol M. is used for Manipulus in dispensing drugsa handful—and the handful was either large or small. The small handful or pinch was denoted by the letter P. for Pugillus, and it was usually estimated at about the eighth part of the Manipulus.

12/21. Lana succida is sufficiently described in the text. It seems to have been a crude method of obtaining what is now called lanolin. An undressed fleece is still used in folk-medicine.

ARDERNE.

I

Let it be closed afterwards in the manner of a letter so that it cannot be opened easily, & for this reason

Why written I used to write it in greek letters that it might not be

with Greek

letters.

understanded of the people. And if any one carries that 12 charm written fairly in the name of God almighty, & believes, without doubt he will not be troubled with cramp. Let it be held in respect on account of the Lord who gave virtue to words, to stones & to herbs, & let it 16 be made secretly that every one should not know the charm lest perchance it should lose the virtues given by God.

105

APPENDIX

[MS. Rawlinson, B. 102, leaf 30, back.]

Grant to R. de Rupella of land in the Cantred of Tirmany, Connaught, given to him by the Black Prince.

Sciant presentes et futuri quod ego Iohannes de Arderne dedi concessi et hac presenti carta confirmaui Domino Richardo de Rupella pro homagio et servicio suo totam terram meam cum omnibus pertinentijs suis sine aliquo retenemento quam habui in illo Theodo quod vocatur Crohun in Cantredo de Tirmany in Connatia de dono et feoffamento domini Edwardi illustris Regis Angliæ primogeniti in escambium manerij sui de Willinghale et Plesingho cum pertinentijs suis habendam et tenendam de me et heredibus meis eidem domino Richardo et heredibus suis et eorum assignatis adeo libere et quiete sicut idem dominus Richardus tenet terram suam de Clonedach' quam habet de dono et feoffamento predicti domini Edwardi et sicut plenius et liberius et integrius continetur in Carta quam idem dominus Edwardus de dicta terra mihi confecit reddendo inde per Annum mihi et heredibus meis ipse dominus Ricardus et heredes sui et eorum Assignati vnum denarium ad Pascha et faciendo pro me et heredibus meis predicto domino Edwardo et heredibus suis servicium feodi vnius militis pro omnibus servicijs consuetudinibus sectis exactionibus et omnibus demandis secularibus. Et ego Iohannes et heredes mei warrantizabimus acquietabimus et defendemus eidem domino Richardo et heredibus suis et eorum Assignatis totam predictam terram cum omnibus pertinentiis suis sine aliquo retenemento per predictum servicium sicut predictum est contra omnes homines et feminas inperpetuum. Et vt hec mea donatio firma et stabilis permaneat huic Carte Sigillum meum apposui. Hijs testibus, Dominis Iohanne de Ripar', Roberto de Vfforde, Ricardo de Tany, Willelmo de Wokingdon, Rogero de Bello Campo, Richardo de Ispanya, Militibus, Waltero de Essex, Thoma Iocelyn, Iohanne de Rupell', et Alijs.

[This is entered in the Bodleian Catalogue at Oxford under the heading "Arderne Iohannes, chirurgus." Cf. Forewords, p. x.]

* 12/21. The persistence of these simple remedies is shown by Miss Edith Durham's interesting account of Higher Albania (Lond. 1909, p. 93). She says, speaking of a comminuted fracture of the leg treated by an old Franciscan at Vukli :-" He then plugged and dressed the wound with a salve of his own making-the ingredients are extract of pine resin, the green bark of elder twigs, white beeswax and olive oil. The pine resin would provide a strong antiseptic. The property of the elder bark I do not know.... In gunshot wounds he was very expert. For 'first aid' his prescription was: Take the white of an egg and a lot of salt, pour on to the wound as soon as possible and bandage. This only temporary till the patient could be properly treated with rakia (the local alcoholic drink) and pine salve as above. The wound was to be plugged with sheep's wool, cleaned and soaked in the salve. The dressing to be changed at night and morning and at midday also if the weather be very hot. Should the wound show signs of becoming foul, wash again with rakia as often as necessary. This treatment he had inherited from his grandfather who had it from his. The exact proportions and way of making salve he begged to be excused from telling me as they were a family secret." Every word of this passage would have been approved by Arderne. He would have recognised his Unguentum sambuci (cf. 30/21), the egg medled (cf. 28/4) with salt would have been nothing new to him, the cleaning of the sheep's wool he might have considered an improvement upon his own lana succida (cf. 12/20), as he had an open mind (cf. 35/4), and he would have endorsed thoroughly the old priest's disinclination to give away the secret of a preparation (cf. 15/8).

12/40. Wormed, i. e. warmed.

13/20. Ragadiez was the name given to fissures formed round the anus and vulva. It is used here to denote chronic ulceration. Frousingez seems to be a mere repetition of ragadiez, as it does not occur in the Latin texts.

13/24. An ulcus undesiccable is an ulcer which continues to form pus in spite of treatment. Mediæval surgeons were very skilful in frightening themselves with names.

14/4. There were two Geoffrey Scropes living in the latter half of the fourteenth century. (i) Sir Geoffrey Scrope, knighted before Paris, 1360. He was the eldest son of Sir Henry le Scrope of Masham, Co. York, the first Lord Scrope, who was Governor of Guisnes and Calais in 1360. This Geoffrey Scrope was slain at Piskre, Lithuania, in 1362 (cf. 67/34). (ii) Sir Geoffrey le Scrope, son of Stephen, second Lord Scrope, who was living in 1409, but had died sine prole before 1418. The brother of this Geoffrey le Scrope was Stephen le Scrope, Archdeacon of Richmond in Yorkshire, who died September 5, 1418.

14/20. It is clear from this and the following lines that Arderne had seen and noted cases of uræmia following upon long-continued urethral fistulæ. The headache, giddiness, dull pain in the loins and vomiting which occur during the later stages of renal disease are all duly noted.

14/38. Bernard de Gordon was teaching at Montpellier in 1285, and was living in 1318. He wrote the "Lilium medicinæ," but Arderne here shows that he was absolutely ignorant of Anatomy.

15/8. This is another good instance of the secrecy which characterised the practice of surgery at this period. It was still a trade to be taught, and it was many years before it became a profession to be learned. (Cf. 8/25 and 71/15.)