Lanfrank's "Science of cirurgie". Edited from the Bodleian Ashmole ms. 1396 (ab. 1380 A.D.) and the British museum Additional ms. 12,056 (ab. 1420 A.D.) by Robert V. Fleischhacker, DR. PHIL. Part I--Text.
Lanfranco, of Milan, 13th cent., Fleischhacker, Robert von.
Apostyms of þe necke and of þe þrote /

Apostyms þat ben in þis place, or it is wiþoutforþ in þe senewis, or in þe braun, or it is wiþinneforþ bi þe place þat a mannes mete goiþ doun, or bi þe þrote, or it is bitwixe þe .ij. placis in a place þat is clepid ismon.*. [ismon. Sinonom. Barth., p. 26, "Ysinon est inter ysofagum et tracheam arteriam." Read Ysmon. From [gap: 1] , neck, narrow passage. See [gap: 1] in Stephanus Thesaur. De propr. rer., lib. V., cap. 24, Add. 27,944, fol. 49 bk.: "& it happiþ þat þis euel matere is somtyme al i-gedred wiþinne þe skynne þat departiþ þe weye of þe breeþ from þe weye of þe mete & drynke, þat hatte isophagus & bredeþ squynancye, þat sleeþ in on day."] & comounli þe enpostyms þat ben in þis place, comeþ of blood, or of fleume, & ful seelden it comeþ of colre, & more lattere of malancoli. Þe humours þat ben in þe cause,*. [See page 194, note 8.] þou schalt knowe bi signes aforseid / If þe matere be in þe braun of the necke wiþoutforþ, þat þou miȝt knowe [folio 139b] bi schewing of þe enpostym wiþoutforþ. & bi þese signes þou schalt knowe whanne þe enpostym is wiþoutforþ, if þer is no letting in ysophagus þere þe mete schulde go adoun, & if wijnd be not stoppid, þan þou miȝt wite wel þat þe enpostym is wiþoutforþ, & also bi þe schewing þat is outward / And if þe enpostym is wiþinne, þan þe pacient schal not swolowe adoun his mete, ne drawe wel his breeþ / If þe enpostym þat is wiþinne swelle greetly, his iȝen wolen swelle þerwiþ, & he schal not suffre his tunge in his mouþ, & he ne schalPage  218 not speke, & þer wole go out miche spume of his mouþ / Þanne summe lechis þat ben hardi wolen putte a smal tree in his þrote & breke þe enpostym, & in þat maner þe pacient mai be delyuered; saue þis maner worching is not sure, for in þis maner manie men dieþ, & þe deeþ comeþ not of þe sijknes, saue it is defaute in þe leche*. [it is defaute in þe leche, Lat. medico imputatur.] / Þis maner sijknes þat is so hid wiþinneforþ, it mai be helid wel in þe bigynnyng in þis maner*. [Much of our author's treatment is borrowed from Avicenna, Lib. III., Fen. 19, Cap. 11, ed. Ven. 1527, fol. 188.] / If þe enpostym be hoot, þou schalt lete him blood in þe veine þat is clepid basilica, & if þe patient haþ had þe [folio 140a] sijknes longe or þou come to him, þan þou schalt lete him blood in þe middil veyne of þe arm þat is clepid mediana, & he schal blede so longe til he swoune almoost, & principali if he be strong & ful of fleisch / In þe .ij. dai þou schalt lete him blood in þe veines vndir þe tunge / & loke þat þou do no þing aftir her counseil þat seien þat in þe firste bigynnyng þou schalt lete him blood in veines vndir þe tunge, & after þat in þe heed veine or in sum oþere place. For in þis manere leting blood, if his bodi were replet, he miȝt liȝtli be achekid// ¶ Whanne þou hast lete him blood as it is aforseid, þan make him a gargarisme wiþ a decoccioun of ro., sumac,*. [sumac, Fr. Sumac; Arab. Summāq. "Sumach or Sumack, a kind of rank-smelling Shrub that bears a black Berry, made use of by Curriers to dress their Leather." Phillips.] balaustiarum, lentium, & gallarum wiþ þe which be distemperid þerwiþ diameron,*. [diameron, [gap: 1] . Vigo Interpretation, "Diamoron, a confection made of mulberries."] or tordis of a sparow, or of an hen, or þe tord of an hound þat etiþ manie boonys & noon oþer mete,*. [By this kind of food the album græcum, the white dung of a dog is produced.] or a childis tord dried while it is soukyng. ¶ Also take an houndis tord þat etiþ oonly boonis & of hennis, satureye*. [satureye, savory. Wr. Wül. 609, 30 (xv), sauereye.] ana, & make þerof poudre & distempere it wiþ water & hony, & make þerof a gargarisme, & he schal drinke water of barley, & he schal no þing ete, saue a þing maad of wheete-bran [folio 140b] in þis maner*. [Lat.: nihilque comedat nisi candarusium factum de furfure in hunc modum. Matth. Sylv.: "Candaros vel candarusium—est ordeum cui non est cortex," from [gap: 1] , grain, groat.] / Take newe bran of whete & caste þeron hoot water & hele it & lete it stonde so an hour, & þanne grinde it in a morter wiþ a pestel & cole it, & þanne seþe it wiþ a litil salt & ȝeue it þePage  219 pacient / & do þeron penidis.*. [penidis, Vigo Interpr. "Penidie are made of the Apothecaries wyth suggre wrethen lyke ropes." Fr. penide; Lat. penidium, from [gap: 1] : spool on which the woof is wound.—Compare diapenidion in Piers the Plowman, ed. Skeat, 1886, II. p. 77, note.] & if he mai not swolowe it adoun, þanne sette a litil ventuse in þe welle of his necke*. [MS. tofore inserted but deleted.] with fier & þan he schal swolowe, & anoynte al his necke tofore & bihinde wiþ oile of camomille. & vpon þe anoyntyng leie wolle vnwaischen,*. [wolle vnwaischen, vn, in margin. Lat. lana succida. Lewis, Latin Dict., gives a reference from App. Apologia: recens lana tonsa succida appellata est.] & make a sutil plastre of a nest of irundinis, & is good for þe squinacie,*. [squinacie, Lat. squinatia, quinsy. See Cathol. Angl., p. 357, note.] & is maad in þis maner / Take a nest of irundinis & boile it longe in watir, & þanne cole it þoruȝ a seue þat þe grete gobetis moun be cast awei / Þan take þe rotis of lilie & seþe hem in oþer water & rotis of bismalue, & þe rote of brionie & leues of malue & bismalue, & violet, & peritorie.*. [peritorie, Lat. parietaria; wall-pellitory.] & whanne þei ben boilid, grinde hem wel, & medle hem wiþ water of irundinum þat is forseid, & do þerto leueyne & mele of fenigreci, & þan do þerto oile or grese, & make herof an enplastre / Þis enplastre is good to resolue enpostym & make it quitture, wheþer [folio 141a] it be wiþinne or wiþoute, & make it abrood upon a clooþ & leie it vpon hoot. & anointing is good wiþ oile of camomille medlid wiþ butter þat it be oold & not salt, & after þe anoyntyng leie þervpon wolle vnwaische // ¶

* The passage from lf. 141, l. 5 till lf. 141, bk., l.8 (p. 220. l. 15), is repeated in lf. 143, with some alterations. The corresponding words from the Latin are quoted to show the independent character of the two versions. l. 18, 19. If þe — — manere] It is good if þe enpostym be wiþinne or þe more partie be withynne, & if it mai not be resolued ne do awei wiþ repercussiuis, þan it is good to vse gargarisms, þat ben maturatifs, maad in þis maner. (Bonum est etiam si apostema fuerit interius, aut maior eius pars, cum tempus prolongatur quod non repercutitur nec resoluitur: vti maturatiuis gargarismatibus ut hoc.) 20, 21. seþe — — cole hem] putte hem in water & seþe hem in water (coque in aqua). 21. or] & medle þerwiþ. 21, 22. medled wiþ butter] & butter & wijn. þat makiþ — — enpostym] þis wole make enpostym þat is withynne in þe þrote maturatif (maturat omne intrinsecum apostema siue in gutture siue in stomacho siue in intestinis fuerit generatum).

1, 2. þe aswaging] cesing. and if] if. 2. schewe] be seen. 3, 4. be — — arterie] be wel war of veynes & arterijs. 4. whanne it is opened] þan. 5. and] om. 6, 8. wiþinneforþ — — galle] al wiþinne & wole not breke wiþ þe gargarism þat is aforseid of butter & figis & water & wijn, þan þou schalt breke him wiþ a medicyn þat haly þe abbot vside as wiþ a gargarism of gallarum. (Si fuerit intra, nec rumpatur: cum gargarismate prædicto de butyro, ficuum aqua et vino rumpatur cum ingenio subtili Haly ab. scilicet cum gargarismate stypticorum sicut decoctionis gallarum.) 9. & seþe — — þerof a gargarism] om. 10. wole breke] brekiþ þe. 11. þan þou schalt bringe out þe mater] drawe out þe quitture. 11, 12. & — butter] & a litil butter þerinne. 12. & make þerof] & herof he schal make. 12, 13. & lete him vse þis gargarism] om. matere be drawe out & þan] quitture be drawen awei after þat. 14. of liquorice — tamarisci] wiþ liquoris & thamarisci soden in watir.

If þe enpostym be wiþinne, it is good þat me leie þerto no repercussiuis, saue vse gargarismis maad in þis manere / ℞, ficus siccas, semen malue, semen lini, seþe þese in water & þan cole hem, & make þerof a gargarisme; or water of figis medlid wiþ butter, þat makiþ maturatif eueri maner enpostym.

Page  220Whanne þe enpostym is rotid; þat þou schalt knowe bi þe aswaging of þe akynge, & if þe enpostym schewe wiþoutforþ, þanne opene it wiþ an instrument, & be war þat þou hurte no senewe, ne no veine, ne noon arterie. & whanne it is opened, make it clene wiþ mundificatiuis þat schulen be seid in þe antidotarie / And if þe enpostym be wiþinneforþ, þan þou schalt not breke it wiþ þis gargarisme þat is aforseid, saue þou schalt make a gargarism þat haly vside / Take galle, acacie, psidiarum, balaustie, aluminis iamini*. [Sinonom. Barth., p. 1, "Alumen iamem, A. scissum, Alimen de pluma, idem."—Matth. Sylv. "Iamen est prouincia Iameni uel Aliamen."] & seþe hem in water & cole it & make [folio 141b] þerof a gargarism, for þis gargarism wole breke enpostym / Whanne þe enpostym is broke, þan þou schalt bringe out þe mater wiþ hoot water, & dissolue þerinne butter & oile of violets, & make þerof a gargarism, & lete him vse þis gargarism til al þe matere be drawe out, & þan after þat make him a gargarism of liquiricie,*. [liquiricie, lycoryce, Pr. Parv., p. 303. See lyquoris in 2nd version.] yreos & tamarisci / If þe matere be coold, þan þou muste vse hottere gargarism, & þan þou muste vse mundificatiuis þat per be þerinne mirre, sarcocolle,*. [Sarcocolla "Is the Gumme or liquore of a tree growyng in Persia." Halle. Table, p. 109.] þat schulen be seid in þe antidotarie in þe chapiter of mundificatiuis. ¶ It falliþ sumtyme þat for reume þat falliþ adoun of a mannis heed, þer wexiþ in þe rote of þe tunge a maner round þing in þe gretnes of an almaunde, & lettiþ a man þat he mai not wel drawe his breeþ ne ete his mete / & in þis maner þou schalt cure him as it is forseid wiþ þingis þat voidiþ þe matere & wiþ resoluynge þingis. ¶ I wole sette in þis place a cure þat bifel in þe citee of mediolanensis of a ladi þat was .L. wynter oold, & hadde a squinacie of fleume þat occupiede al hir necke tofore wiþinne & wiþoute,Page  221 [folio 142a] saue wiþoutforþ þe swelling was moost, & þe womman miȝte not speke, ne swolowe in no mete. & þis womman was vndir þe cure of a ȝong man pat was my scoler, and he cowde not wel fare þerwiþ, & þo he was in dispeir of hir lijf, I was sent after & foond hir in wickide staat,*. [in wickide staat, in statu pessimo.] for sche eet no mete in manye daies tofore, & sche durste not slepe for drede, lest sche schulde be achekid. Þan I tastide hir pous, & it was wondir feble, & I tastide þe place of þe enpostym, & I knewe wel þat sche schulde be raþere achekid þan þe enpostym wolde breke wiþoute or withynne, for þe matere was so greet / & þan I took a rasour, & lokide where þe matere was moost gaderid for to engendre quitture, & it was moost able vndir þe chyn, & I felide þe place wiþ myn hond & tastide it aboute þat I miȝte be war of nerues & arterijs, & þere I made a wounde, & þere I drowe out matere þat was corrupt, & it was foul stynkynge matere, & al miȝte I not avoide anoon. & þo þe pacient hadde bettere hir breeþ, & hir pous was confortid, [folio 142b] for þe lungis miȝte take yn eir, & þerwiþ þe herte was comfortid, & þan I ȝaf hir broþ, & þat ȝede out þoruȝ þe wounde þe moost part. Þo I studiede how I miȝte best do, & I lete make a pipe of siluir, and putte it in at hir mouþ & passide forþere þan þe wounde was, þat it miȝte fulfille þe place of þe þrote. & þan I leide al aboute hir necke mundificatiuis & maturatiuis for to quitture þe toþer deel of þe matere, & so I kepte it til þer come out of þe wounde a greet gobet of viscous matere & stynkyng, & was schape as it were a greet gutt. & þerinne þe firste matere was engendrid, & whanne þis was oute, þe stynking wente awei þerwiþ, & þe womman bigan to be stronger, & whanne þe wounde was maad clene I driede it vp & soudide it; & in þis maner þe pacient was maad hool. ¶ Whanne þou fyndist coold matere rotid in þe forseid placis, þou schalt not abide til þe enpostym breke him-silf, saue þou schalt opene it as it is aforseid / & if it be not rotid, þan make it more maturatif, & opene it as it is aforseid / And þis þou muste wite þat þou miȝte [folio 143a] not abide to longe wiþ þe openyng: for þe herte & þe spiritual lymes ne mowe not longe endure wiþouten eir.