¶1] {MS fo 24v col. 1}I have here collected rules of practice, i.e. of surgery, for the honour of God, for the betterment of the Irish people, for the benefit of my pupils, and for the love of my friends and kindred. I have translated them from Latin books into Gaelic, i.e. on the authority of Galen in his last book of practice, Pantegni, and from the Book of Prognostics of Hippocrates, that is, the book of predictions, namely, things gentle, fragrant, profitable and of little harm, things which have been often tested by us and by our instructors. I pray God for those who will have this book; and lay it as a burden and a loving care on their souls that they extract not poorly from it, that they fail not for the want of these rules of practice, even though they gain nothing by doing it devotedly. I implore every doctor at the beginning of his work hat he remember God, the Father of Health, to the end that his work may be finished prosperously. And let him not be in mortal in, and let him beseech the patient not to be so either.
Let him implore the Heavenly Father, the physician and healer of all diseases, to prosper the work, and to save him from shame and discredit at that time. Let them the doctors wisely implore the patients to make their confession to the Prime Being, that they be not in mortal sin, and that they be anointed, so that they may be healed at the beginning of the disease, as no one knows what may come to him, and it is moreover better to cure the soul than the body, for it is nobler, and also it is more certain of gaining health to the body if the soul be pure, for it is through sin disease first came into the world. It is known that God directs various plagues towards the people that he desires to save and to bring to faith.1
Let him regulate thus with care how it is proper to see to food, drink and company according to the rule of the art.
¶2] Let no one take it upon himself to treat with care a person whose peritoneum, thigh, liver, breast partition, lower edge of the stomach, kidney, spleen or gall are damaged. It is a known fact that if a person is wounded in his entrails, they being damaged by spear, arrow, sword or knife but without being cut through, he can be cured so long as part of the entrail is intact. Take him in hand and wash the wound with lukewarm wine if there is dirt in it and then place it in the upper part of the gullet of some animal so that the undigested food in the stomach and the entrails comes out and runs out through the gullet. And let him not eat food for one day and a night except if a little lukewarm wine or strong ale be given to him to relieve his thirst, this to be given in the form of strong old ale or a thick liquid of wine or old ale. When you are certain he has nothing undigested and it has come out of him until no filth comes from under the edges of the wound to hinder its closing, then sew with a silken thread and let a long end of the thread come out on either side of the wound and sew the wound and the skin on its edge after righting the entrails and place a plaster around the wound and put him2 to bed. And give him early at breakfast two small cups of wine into which powder of the fur of a hare has been put and give him a little digestible food which is not food which constipates stools and let him not rise from his lattice bed until the end of the thread comes out easily with no pulling or resistance - that is a sign that the wound has closed.
¶3] It is a rule that a person who has cut a sinew or muscle cannot be cured without cauterising. Another rule if fever takes a wounded person it is a bad sign, because the accidental heat goes to digest the disease and leaves the wound and cools the edges and makes them numb. Another rule, if the wounded person who sheds a lot of blood gets cramp it is a sign of evil and of death and if he gets a cramp without bleeding at all it is bad, and it is better than purging him by bleeding. It is a rule that in summer white of egg only should be applied to the wound and in cold weather the white and yolk may be applied. The doctor should not open a wound in cold weather except by the side of a fire and in clean air. In summer indeed it should only be opened in a cool place. It should be noted that tow lin= flax is hot and wet and for this reason a plug of it should not be inserted except when the wound is suppurating. Hemp indeed is cold and dry and for this reason it should not be put in wounds nor should white of egg or the juice of plantain be spread on them for when the wound is healing a cold dry plug is most suitable for the wounds at that time; and a hot and wet plug is suitable when they are suppurating. It is known that if the edges of the wound are not swollen and a black or green appearance is on it that it is a sign of death and if it is swollen along with these appearances it is better, for that is only a sign of violent evacuation. These appearances without swelling or without contraction are a sign that the vital spirit cannot reach out to prepare the wounds and it is for this reason that the binding force is lacking and the wound is unable to heal. Here another rule, a wound membrane should not be allowed to grow when the moon is waxing for the membrane is at that time following the medium segment and if you must let it cicatrise at that time when the scab is forming put the point of your thumb on it to hold it down and then heal it by drinks which we will speak of later or by surgery. It should be noted that it is a bad sign of a wound if it does not smell or suppurate in the beginning and if it dries up also it is worse. It should be noted that unguents should not be applied to the surface nearest the membrane and if the membrane should happen to burst do not put a plumaciol or an exsiccator on it, but only a fine piece of linen or of silk cloth.
¶4] It is a rule here that the same remedy should not be given at the growing and at the increase and at the stasis and at the decrease of the imposthumes and to every humoral gathering that is in one place at the beginning of its collecting, expellents should be applied, such as barley flour, and white of hen's egg and juice of plantain and the juice of houseleek and henbane and nightshade and their like which are best spread on hemp. On the growing of the imposthumes, digestives should be applied to them such as the bran of wheat boiled in wine and applied to them in plumaciols and make them frequent stupes with this wine. Another rule, do not apply expellents at the beginning of the matter if it becomes numb, for if the matter is poisonous and is expelled from that place it might happen to go to some principal member of the body and corrupt the person. If the matter is at the stasis and caused by cold apply maturatives to it such as wheat flour and salt and cumin and oil and grease of cocks and drakes and mix this and apply it. If the matter is ripe you should only open it as is customary with every "liunidhti" or other imposthume. Every firing that is done by burning apply fresh grease melted or unsalted butter to it with white combed wool until its black discharge falls off and then apply corrosives of pure clean wax and the leaves of ivy and plumaciols between them and keep the foliage like this till the end of a hundred days; if proud flesh grows round the edges break garlic and apply it to it tepid, and it will corrode the proud flesh in a day and night.
¶5] Note here that it is sufficient help for a person who has scrofula if it come from the brain, i.e. to apply a nut to the back of the head having made a hearth fire before and make a stupe for him of rue as usual.
¶6] Should a pearl or a web rise on the eye do not make any remedy for it except an ordinary purgative and then a bath. Do not undertake the pulling of a tooth from the head though it gives great trouble except it be loose, for if you were to pull it there would be danger of the flowing of the humours from the brain to the spiritual members or of injuring the brain itself.
¶7] It is a rule if the bone of the forearm be broken with its marrow or the marrow of any important bone the patient is doomed to die or specially to lose that limb. Note here that the member should not be tied up tightly at first so that the circulating of the spirits should not be prevented from purging the wound. Note here if some vital member be pierced so that it reaches to the marrow, butter or grease should not be applied lest it smell or corrupt further and flax or a linen cloth should be applied. Note here if watery blood comes from the break of a bone of a vital member it is a sign of death.
¶8] A drink here on which all practitioners agree; that it is sufficient cure for wounds and ulcers, and apply leaves of kale to the mouth of the wound, if he vomit the drink at the first drinking it is not for his life but for evil. If it is summer open it three times a day and wash the wound in cold urine or in vinegar and apply fresh leaves every time it is opened, avoid wine and women and hot wet foods and drinks and hot dry foods, cold food in hot weather and hot food in cold weather. Take tansy and the tops of red cabbage, hemp seed or tops of green hemp and the tops of red nettles and the tops of briars and strawberries in equal quantities and a quantity equal to them all of madder and break them up and put them in a measuring vessel, an equal amount of all the plants broken up; add white wine on top of them, and give the full of a hen's eggshell, or something a little more if the patient be strong and give it three times in the twenty-four hours and open the wound each time and wash it as we have said each time; if he retains this drink as long as a person would travel in a day, i.e. three miles without vomiting and can cut a rush with his teeth, then that man should be taken back by us and he will get up. And if he vomit and become weak give it to him again once or twice and if he vomit it every time until the end of three hours, even though you be fond of him, do not take him back for it is certain he is a dead man and unless he vomit that drink it is not necessary to apply a plug to the wound but only leaves of kale.
¶9] A drink here for worms in a dry fistula and for bloody contusions and for lumpy imposthumes and for wounds, i.e. cabbage and tansy and strawberry plant, pulp of briars, wild celery and plantain, savin and other junipers, wormwood, houndstongue, wood betony, eyebright, wood mallows, stitchwort, violets, red nettle, agrimony, vervain, hemp, seed of cranberry, equal quantities of each of them and as much as them all of agrimony and give it in wine and is customary in drinks for wounds, and boil it until a third disappears in the boiling and add plenty of honey clarified in a vessel with a narrow mouth so that its force may be the more potent.
¶10] An ointment for every wound in which is a bone or a cut sinew and it is good for piles, i.e. take herb Walter, daisy, avens, strawberry plant, agrimony, corn blue-bottle, lily of the valley, olive, plantain, upright cudweed, St. John's Wort, the burnet, mouse-ear, blue flower, wood sanicle, wood betony, tansey, cinquefoil, marigold, juniper, leaves of bramble or its pulp, equal quantities of each and their force will remain for a year, and boil them in May butter, and dissolve the equivalent of three grains of beans in wine or in strong old ale or in the aforementioned drink and drink it on rising, and take another draught at bedward and if he has a wound place leaves of kale on it and open it twice a day and wash it in the urine of a youth.
¶11] A powder here which is made in the month of August and store it up for a year and give it to the injured person as much as a grain of bean in white wine or in mead of goat's milk in the way we have mentioned before.
¶12] These are the plants, i.e. agrimony, wood betony, wood sanicle, eyebright, nettle, tansy, roots of silverweed, avens, agrimony, betony, strawberry plant, plantain, tormentil, upright cudweed (cudweed?), lily of the valley, ox-eye daisy, daisy, ribwort plantain, tops of red cabbage, houndstongue, devil's bit, pulp of briars and bramble, seed of hemp; and make an ointment of these in butter as we have said before and give it like the aforementioned ointment and it is thus you can reduce these plants best, i.e. in a mortar carefully and put them in a cool dry place in a draught, without sun, without dampness and spread them out in a vessel with a narrow mouth, a vessel with a wide mouth is better until it dries, and reduce it well again and sieve it as a powder through a hair-cloth vessel and preserve it thus and give as much as a grain of bean of this powder in whey of goat's milk made in white wine or in white wine itself and drink it as we said before and if he is to live it will come out over the wound on the morrow and apply leaves of red cabbage to the wound; if he is doomed he will vomit at once, and if not give it again as soon as possible and if he vomit again give it another time and if he vomit again pay no attention to him for he is doomed.
¶13] To draw iron or bone or a thorn out of a wound whatever part of the body it is in, take the roots of teasel or its foliage and reduce it well and mix it with white of egg and apply it. Item reduce polypody and mix it with pig's lard and apply it to the wound in front of the weapon and it will draw it out . Item put the entrails of a swallow with its plumage in an earthenware vessel and put an earthenware covering in the mouth of the pot and put it in an oven or on a fire until it becomes powder and mix that powder with vinegar and put it as a poultice on the wound and it will draw it powerfully; Take lard of a beast and put it on it and it will do the same. If you wish to prove whether he is doomed or not or that he is curable or not give him juice of plantain and if he is doomed he will vomit and if not he will not vomit. The juice of thistle or mouse-ear does the same. Wine boiled with ox-eye daisy does the same and drink it and apply a pultice of the same of it.
¶14] Here is information as to how a plaster should be made for wounds and ulcers; to keep them open and clean and to eat up the proud flesh and reduce the poison, i.e. take juice of walwort and wormwood and juice of briar and of red nettle and of march equal quantities of each and as much as them all of honey and white of egg and mix them along with flour of rye and knead it well until it is thick and apply it with the gloves to the ulcer or the wound. If the wound be deep apply it with a plug and if the wound is healed up over the hurt apply a poultice of barley meal and white of egg to it and this will open the wound. Take flour of rye meal and honey and the flour of goat's droppings and mix them and put them on the wound and if it heals up too quickly it opens it again and if it is open too long it will close it. In order to heal ulcers take comfrey and flour of wheaten meal and honey and butter, mix and apply to the ulcer.
¶15] Here a plaster for wounds, i.e. take old lard and pitch and resin and wax new melted equally and melt them on the fire and take the juice of stritchwort and wood sanicle and mix them up and sieve them through a clean linen cloth, boil up once and leave them to simmer and mix until it thickens and that plaster is unequalled. To heal ulcers and wounds melt fresh grease and take flour of wheat or rye and an equal quantity of wine and boil them in one way and simmer and mix till they thicken and this plaster is good. Another plaster here for the same, i.e. take the juice of march and white of egg and honey equally and mix them with flour and add the flower of frankincense and an equal quantity of rye flour if necessary. Another plaster, take grease and the lights or fat of a sheep or a goat, frankincense and resin and new melted wax and pitch of the anvil and blend together and sieve through a linen cloth and let them mix until they redden and use them in the manner of the other plasters. Here is a choice plaster for closing every wound that cannot be healed, i.e. take aloes and myrrh and olibanum and mastix, one ounce of each and pitch and new melted wax and colofonia and two ounces of each thing in every measure of it, and melt everything that can be melted and mix them until they get cold and that is a choice plaster for wounds.
¶16] To eat up proud-flesh, i.e. take rust of brass and verdigris and flower of burnt brass and make a powder of these and apply it for four consecutive days to the wound and after these four days apply powder of cuckoopint and flowers of copper mixed with flour of rye and put the powder on the wound and it will heal proud-flesh. Reduce garlic and apply it to the wound and it will corrode the flesh and clean the ulcer. Mix the juice of milfoil with salt and it will do the same. If you wish to check the blood mix honey and wine and wash the wound in it and it will clean it. To dry ulcers and wounds take the juice of plantain and the tops of red kale and mix with honey and it will heal and the physicians say that there is no remedy that is better.
¶17] Practice here on the treatise from the Pantegni of Galen on surgery; and firstly how to draw out iron or bone or a thorn from a wound, i.e. take the juice of red cabbage and boil it up fine and add the powder of red wax then and put it as a poultice on the wound and it will draw out strongly whatever thing may be in it of bone or wood or iron. Item take the juice of the leaves of woodbine and the same powder and apply them and it does the same. If it be polypody itself that is applied mix it with old lard and it does the same. Item bind the powder or the poultice of polypody under the feet of a woman with child and it will draw the child alive or dead from her. Item take the powder of the fur of a hare and mix it with the white of egg and apply it to the wound and it will draw it out.
¶18] To check the bleeding of a vein chew saffron and apply it to the ulcer. Item split a grain of bean in two and put to the mouth of the vein and it will check the blood. Item make powder of woodlice and apply it to the ulcer and it will check the blood. Item, put the pulp of elder in the nose and it will check bleeding from the nose or from ulcers. Item for ulcers give him fifteen grains of the powder of white henbane to drink in wine and this will check the blood in whatever place it may be. Item apply the powder of burnt carbonate of lead (colchium?) to the ulcer. A poultice to reduce poison or the swellings of ulcers, i.e. take mallow and boil it and squeeze the water out of it and reduce it and mix it with barley meal and pig's lard and apply this poultice to the swelling or to the ulcer and it will draw the swelling and harm out of it. Item take the juice of fennel and march and wormwood and wallwort and elder and boil them with wine and honey and mix wheaten meal with it and apply it to the swelling or the ulcer and it will draw the swelling and the harm out of it. Item to clean ulcers and reduce swellings that come from a hot cause, i.e. take leaves of mallow and wormwood and boil them in wine and apply them to the ulcer and it will clean it. Item to clean ulcers, i.e. take the juice of milfoil and ribwort plantain and comfrey and plantain and herb Robert and wash the ulcer with it and it will clean its pus and its slime.
¶19] A poultice here that cures the bad mauling of mad dogs and poisonous reptiles and for every wound that gets poisonous, i.e. juice of march and honey and rye flour and apply it. Item apply the same poultice and the powder of goat's droppings mixed to the ulcer which heals over the sore and if it is healed over, it will open with that poultice and if not it will close with it.
A poultice here that prevents the wound turning to an ulcerated fistula and to running and to wet matter and to draw broken bones and heal a splinter on the top of a bone, i.e. mix a poultice of leaves of woodbine with pig's lard and apply to the ulcer and it cures those kinds. Item for the same give equal quantities of litharage and orpiment and oil and boil until it is thick and apply it as a poultice to the ulcer. Item boil wormwood in water or in wine and put it on the ulcer and it is good for this kind. Item, to check the bleeding of ulcerated fistulas and to corrode proud-flesh and to expel worms from a dry fistula, i.e. verdigris and rock salt, half the quantity of the same with the verdigris and make a powder of them and dissolve them in old lard and mix that powder with the ointment and its force will remain in it for a year and this ointment will cure ulcerated fistulas and heal the proud-flesh of ulcers and it is also good for scab.
¶20] Note here a powder for corroding proud-flesh, i.e. the powder of blue stone (colchycum?) and the powder of copperas and the powder of verdigris and the powder of burnt salt. Item put human excrement in an egg shell on the cinders until it turns to ash and this powder mixed with honey is very good, in a case of proud-flesh and it is customarily applied to cancer. A drink for the same, i.e. take agrimony and calamint and whitlow grass and rue and betony, mountain sage and equate these plants and boil them in wine and honey to clean the liquid and drink them for nine months and it will cure ulcers and cancers and wounds that are doing badly. For the swelling of wounds caused by cold, i.e. boil lily of the valley in wine and add salt in a case of swelling of the feet and the calves which swell through walking. Item for swelling caused by heat, i.e. boil wormwood and mallows in water and apply it to the swelling and it will cure. Item an ointment for a swelling that comes from cold, i.e. make an ointment of Auria Alexandrina and oil of laurels and that is good. Against every harm that is caused by cold, i.e. boil a fox or a fat dog until its flesh dissolves and put this grease on collecting it on the place in which the pain is.