Libro - Treatise For Nurses (1651)

E
ste libro electrnico es una parte del trabajo publicado en 1996

en espaol y traducido en 1997 al ingls titulado Directorio
de Enfermeros, de Simn Lpez, enfermero espaol, elabora-
do en 1651, con Transcripcin del Texto, Estudio, ndices de materias,
Glosario de Trminos y Bibliografa a cargo de Antonio Claret Garca
Martnez, Manuel Jess Garca Martnez y Juan I. Valle Racero. De
este mismo libro se hizo una nueva edicin en 2001.
Se incluye aqu el Estudio Introductorio traducido al ingls, las Ilus-
traciones del manuscrito, el ndice de Autores ms citados por Simn
Lpez y la Bibliografa incorporada.
Este libro electrnico no incluye la Transcripcin del Texto original
del enfermero Simn Lpez ni los ndices de Materias que se confec-
cionaron como parte de su estudio, que estn siendo actualmente
traducidos al ingls.
Directorio de Enfermeros es una obra fundamental para conocer y
entender la Enfermera espaola practicada en los siglos XVI y XVII
y su implantacin en el Nuevo Mundo y algunas zonas de Asia, como
Filipinas, desde Chile hasta el Sur de los Estados Unidos, como con-
secuencia de la presencia de enfermeros espaoles en todos esos lu-
gares.
Directorio de Enfermeros (1651), junto con Instruccin de Enferme-
ros (1617), tratados escritos por enfermeros y para enfermeros, cons-
tituyen una muestra extraordinaria del patrimonio universal de la
profesin enfermera.
Antonio Claret Garca Martnez
(Universidad de Huelva)
Manuel Jess Garca Martnez
(Universidad de Sevilla)
Alcal de Guadara (Sevilla, Espaa), enero de 2013
T
his eBook is a part of the work published in 1996 in Spanish
language and translated into English in 1997 entitled Trea-
tise for Nurses, by Simn Lpez, Spanish nurse, made out in
1651, with Text Transcription, Historical Study, Tables of Contents,
Glossary and Bibliography by Antonio Claret Garca Martnez, Ma-
nuel Jess Garca Martnez and Juan I. Valle Racero. Tis book had
a new edition in 2001.
Tis includes the Introductory Study (translated into English), Ma-
nuscript Illustrations, the Index of Authors quoted by Simn Lpez
and incorporated Bibliography.
Tis eBook does not include the Text Transcription or the Tables
of Contents, that were made as part of their study, currently being
translated into English.
Treatise for Nurses is a fundamental book to understand and
knowledge sixteenth and seventeenth centuries Nursing practiced in
Spain and its spread in the New World and parts of Asia, including
the Philippines, from Chile to Southern United States, as a result of
the presence of Spanish nurses in all those places.
Treatise for Nurses (Directorio de Enfermeros) (1651) and Training
for Nurses (Instruccin de Enfermeros) (1617) are treatises made out
by nurses and for nurses, and they are a universal and extraordinary
heritage of Nursing profession.
Antonio Claret Garca Martnez
(Universidad de Huelva)
Manuel Jess Garca Martnez
(Universidad de Sevilla)
Alcal de Guadara (Sevilla, Espaa), January 2013
Treatise for Nurses
(Directorio de Enfermeros)
Simn Lpez
(1651)
PUBLISHING PROJECT. HEALTH AND SOCIETY
Editorial Directors:
Mximo A. Gonzlez Jurado
President of the Spanish Collegiate Organization of Nursing
President of the Health and Society Foundation
Pilar Fernndez Fernndez
Director of the School of Health Sciences
Juan Vicente Beneit Montesinos
Director of the School of Nursing, Physiotherapy and Podology
of the University Complutense of Madrid
TREATISE
FOR NURSES
Simn Lpez
Edited by:
Antonio C. Garca Martnez
Manuel J. Garca Martnez
Juan I. Valle Racero

Cover illustration: handwritten cover for the title Treatise for Nurses
by Simn Lpez (17th)
Translated by: Kristen Keilty
Consejo General de Enfermera
Fuente del Rey, 2 (Esquina Ctra. de Castilla)
28023 Madrid
EDITORIAL SNTESIS, S. A.
Vallehermoso, 34. 28015 Madrid
Telfono (91) 593 20 98
ISBN: 84-7738-479-7
Depsito Legal: M. 922-1997
Impreso en Espaa - Printed in Spain
All rights reserved. No part of this publication may be reproduced or transmitted
in any form or by any means, electronic or mechanical, including photocopy,
recording, or any information storage and retrieval system, without permission
in writing from the publisher.
To Simn Lpez,
a nurse from the Seventeenth Century,
who did not see the publication in his lifetime of his
Treatise for Nurses
7
INDEX
Prologue ............................................................................................................. 9
Presentation ....................................................................................................... 11
Introduction ....................................................................................................... 13
Critical Study
Chapter 1. Towards a history of nursing ............................................................ 17
Chapter 2. Historical context a golden age for spanish Nursing (1550-1650) ..... 19
Chapter 3. Te author and the work .................................................................. 23
3.1. Te author .............................................................................................. 23
3.1.1. Simn Lpez, a nurse of the 17th Century .......................................... 23
3.1.2. Te personality and training of Simn Lpez shown through his wok ........ 25
3.1.3. Works and authors that appear in Treatise for Nurses ........................... 27
3.1.4. Index of authors and their works quoted in Treatise for Nurses ............ 31
3.2. Te work ................................................................................................ 38
3.2.1. Previous refections. Te study of the history of Nursing ...................... 38
3.2.2 Stucture and content ................................................................................. 39
3.2.3. Treatise for Nurses and nursing in the 17th century. Its functions ............. 42
3.2.4. Nursing and Medicine in Treatise for Nurses ............................................. 61
3.2.5. Final refections ........................................................................................ 69
3.3. Our study and edition ................................................................................. 71
3.3.1. Stucture of the book ................................................................................. 71
3.3.2. Te edition of the text .............................................................................. 72
3.3.3. Subject index and glossary of terms .......................................................... 73
(In red not included in this ebook)
Suma de los tratados, aprobaciones, censuras y prlogo ...........................................
Tratado primero .................................................................................................
Tratado segundo ................................................................................................
Tratado tercero ..................................................................................................
Tratado cuarto ...................................................................................................
Tratado quinto ..................................................................................................
Tratado sexto ....................................................................................................
Tratado sptimo ................................................................................................
Tratado octavo ..................................................................................................
Indice de todos los captulos de este libro ..........................................................
ndice de las cosas ms notables de este libro ....................................................
Subject index:
Anatoma y Fisiologa ...................................................................................
Simn Lpez / Edited by Antonio C. Garca, Manuel J. Garca, Juan I. Valle
8
Botnica, Teraputica y Alimentacin ..........................................................
Ejercicio de Enfermera: Tcnicas, Tareas, Cuidados .....................................
Materiales y tiles .......................................................................................
Patologa .....................................................................................................
Varios ..........................................................................................................
Glossary ...........................................................................................................
Handwritten illustrations ................................................................................. 75
Authors most quoted in the book ..................................................................... 89
General Bibliography ....................................................................................... 95
9
PROLOGUE
Although it is true that the history of nursing never interested other pro-
fessions, an increasingly greater number of researchers carry out in depth
studies in historical investigation permiting us to approach the origins of a
profession whose human, cultural and organizational patrimony should be
difused in its actual dimension.
Te history of a profession must be known, so that we understand the
present, complex in many occasions, and to knowingly be able to design
ones future, adapting to the needs of a changing world, in that which the
technological evolution demands a more and more rapid adaptation.
Te present work: Treatise for Nurses is a classic in Nursing, those in
charge of the critical edition have worked with rigour, professionalism and
enthusiasm. I am sure this work will constitute a true discovery for Spanish
Nursing.
Te authors of this edition present a work that combines historical
knowledge with that of todays discipline of Nursing. It is also carefully
conducted, carried out by three scholars whose high level permits an ex-
ceptional reading.
Tis book constitutes, all in all, a must for nurses as well as for anyone
interested in Health Sciences.
Te work developed by the editors incorporates an introductory study
which ofers a global vision of nursing knowledge of the period, as well as
diferent indexes, enabling one to easily consult those aspects that are consid-
ered interesting.
Treatise for Nurses forms a part of the collection Health and Society,
an editorial project of the Collegiate Organisation of Nursing, which cons-
titutes one of the objectives gathered in its Five-Year Plan (1994-1999).
Today this plan is an actual project with 12 publications.
10
I am sure that this book will enrich the bibliographical patrimony of our
profession.
Mximo A. Gonzlez Jurado
President of the Collegiate Organisation of Nursing
11
PRESENTATION
Te history of public health in Spain is a feld which is being frequen-
ted more and more by researchers. But, if the authors that have worked in
the history of Medicine are numerous it is worth mentioning the pioneer
work of Professors Lain Entralgo, Garca Ballester, Granjel and his disciples,
among others, what has been carried out in the assistant care feld is litt-
le. Fortunately, the situation is beginning to signifcantly change.
Along with the work carried out by those authors among those stan-
ding out are the editions of classical medical texts by several professors of
the University of Salamanca and Vallodolid, among others, in recent years
those of the Nursing Schools have been incorporated, with their Con-
gress and Conference of the History of Nursing, and that of the Andalu-
sian Group for the Investigation of the History of Nursing, which Antonio
C. Garca Martnez, Manuel J. Garca Martnez and Juan I. Valle Racero
coordinate, editors of Hiades, History of Nursing Journal, pioneer in its
kind, with the book which I have the honour to prologue, of the Library
of Classics of Spanish Nursing.
One need not mention that all these publicatons clearly surpass the
feld which we could call the History of a specifc professional activity, to
go deeper into, given its human implications, the feld of Social History
in its broadest sense.
Te book which the Library inaugurates Treatise for Nurses by Simn
Lpez is one of those texts that, due not to completely explicable rea-
sons, until now has not deserved the attention of researchers. It is, as the
reader can easily confrm, a fundamental book on Nursing, from the 16th
century to the 17th century.
After a detailed analysis of the diverse aspects of Nursing of the period
of Simn Lpez and the personality of its author, the writers study the
structure of the book and publish a carefully conducted edition, until
now inedited, of the original. Te book fnishes with and this is without
a doubt one of the principle contributions of the authors, precise indexes
of subjects, divided into eleven sections (Anatomy, Botany, Nursing Duties,
etc.) and a very useful glossary of terms which enormously helps to com-
prehend the text.
12
However, since this work is signifcant, which in my opinion is clear, it
could mean a start of a project that, given the enthusiasm and accredited
skill of its pioneers, is destined to continue bearing its fruits, just as ripe
as we present them today. In fact, after this frst edition others will follow
who will publish other manuals and instructive essays for nurses and biog-
raphers of those who have stood out due to their labour in the Nursing feld
San Juan de Dios, Bernardino de Obregn, Pedro de Betancourt, etc.
histories and chronicles of orders, congregations and associations whose
primordial goal was to care for the ill, and other historical texts of interest
for the Nursing profession.
I believe, in short, that initiatives such as Classics of Spanish Nursing
Library, with important books such as Treatise for Nurses, will help to know
more in depth the practice and history of Nursing in our country.
Manuel Gonzlez Jimnez.
Professor of Medieval History
University of Seville
13
INTRODUCTION
From the pen of Simn Lpez, nurse and barber who lived in the 17th
century and worked in several Castilian hospitals, Treatise for Nurses ap-
peared, a fundamental book for knowing and comprehending Nursing
of this period. In this context, the 16th and 17th century supposed a
considerable advance in shaping and establishing Nursing as a profession,
defned and diferentiated from other professional activities to those that it
was closely linked: barber, minor surgeon, blood-letter, etc.
With the advances in medicine and the infuence of humanistic ideas
in this feld, Nursing experimented a considerable transformation, notably
contibributing to the appearance and expansion of diferent orders and
congregations of Nursing which, in Spain above all, reached a considerable
peak. Te Order of San Juan de Dios, the Congregation of Obregn Nurses
or the Order of the Balemitas gave a considerable thrust to Nursing as an
independent and well focused discipline, widening the actual nurses feld,
and adding management, teaching and research to their habitual caring
tasks.
Yet the teaching and investigation tasks in Nursing were not an achieve-
ment exclusively of health care institutions; other nurses who were not tied
to them also understood the need to put into order the knowledge that
Nursing students should receive and even to contribute the benefts of their
own experience to widen this knowledge. It is here where we can include
the book we have edited: Treatise for Nurses. In this manner, writing Nurs-
ing manuals serves to cover an important part of the professions defnition
as an independent discipline.
With the edition of Treatise for Nurses, a manuscript and inedited
work, the Library of Classics of Spanish Nursing begins its course, whose
principle objective is to show researchers and others interested those texts
that, due to their antiquity and signifcance, could be considered classic
works of Spanish
Nursing: Nursing manuals, formative texts and nursing biographies,
histories of Nursing Orders and Congregations and other texts of interest
to the profession. Te entirely editied texts will include, according to each
14
case, indexes of subjects and introductory studies, very useful tools for the
researcher.
All in all, we hope that this library does not turn into an end in itself,
but into a means for carrying out more extensive research of the history of
Spanish Nursing.
Antonio C Garca Martnez
ManuelJ. Garca Martnez
Juan I. Valle Racero
CRITICAL STUDY
17
1
TOWARDS A HISTORY OF NURSING
Te existing studies on hospital issues are numerous, going back to,
above all, the Middle Ages and up to the present (hospital, economic and
legislation organization, etc.). Studies of medical subjects in their diverse
aspects are also abundant. But we run into difculty when we try to ap-
proach studying the personnel who directly worked in caring for the ill,
at the hospital level as well as the private level; in their home: who they
were, what training they had, what their legal standing was, how they
lived, what their names were, etc., in short, who directly cared for the ill
once the doctor had given his clinical diagnosis. Studies concerning this
sanitary staf are drastically reduced to a few works, in their majority
dependent upon historical research of Medicine and Sanitary legislation.
In the 70s and 80s an assembly of books were published, serving as a stan-
dard for posterior works whose central objective was to study the care per-
son, as it were, the person who attends the ill throughout their illness, and
who is as ancient a character as illness itself. However, remaining aspects
of this personnel are abundant, and only a systematic task of publishing
sources, in the frst place, as a subsequent analysis and investigation can
contribute new information on the historical past of Spanish Nursing.
Te decade of the 90s has given a new impulse to historical research
of Nursing to a national level. In recent years diverse Nursing journals
have published works on Spanish Nursing history and specifc sections
of this material have even opened up, which, if this continues as hoped,
within not so many years we will be able to have a collection of very inter-
esting and valuable works at our disposal.
18
Within this context, it is necessary to publish diferent texts (Nursing
manuals, legal norms, institution regulations dedicated to Nursing, etc.)
that have been compiled throughout the centuries and that have served
as a guide to the generations of nurses that have preceding us. Only
with a carefully conducted edition and, if possible, provided with good,
complete indexes, can one advance in this feld. Te start of this project of
editing complete texts attempts to contribute to this research dynamic and,
in this manner, the complete edition of the Treatise for Nurses, with its cor-
responding introductory study,. could be of great value for subsequent in
depth studies of Spanish Nursing in the 16th and 17th centuries
From the beginning of the 90s, the job of several national groups and in-
dividual researchers who have been carrying out an intense labour in this sense
stands out. Directed by the Universidad Complutense of Madrid, the Perma-
nent Seminary of the History of Nursing has been organizing Conferences on
Spanish Nursing since 1992, which reached its peak last year with the holding
of the Second National Congress on the History of Spanish Nursing. Like-
wise, it is worth mentioning the establishment of foundations which develop
outlines for working on the history of Nursing among their activities, such
is the case of the Index Foundation of Granada. In the same manner, diverse
periodical publications have been showing a growing interest in works of his-
torical character, as Nursing Index, of Granada, Hygia, of Sevilla, Matrons Today,
of Madrid, or the appearance in 1994 of Hades, Journal of the History of
Nursing, devoted exclusively to historical research of this material. Without a
doubt, the dozens of works gathered already have borne their frst fruits, although
there is still a long way to go.
19
2
HISTORICAL CONTEXT. A GOLDEN
AGE FOR SPANISH NURSING
(1550-1650)
We are aware of the danger of labeling a certain historical period; certain
phenomenons customarily escape the chronological background pointed
out, or the geographical limits taken into account do not precisely ft into
the reality dealt with. However, at times it is necessary to run the risk with
the purpose of structuring history and facilitating its understanding, besides
highlighting with certain milestones the periods considered as transitions.
We have defned the period dating from 1550 to 1650 as A Golden Age
for Spanish Nursing; we have named it as such because in this century a se-
ries of signifcant events occured in Spain for Nursing, events that marked,
to a great extent, its development. Basically, they are the following:
Constitution and expansion of Spanish orders and congregations devoted
exclusively to patient care. Te Hospital Order of San Juan de Dios, the Con-
gregation of the Poor Patient (or Obregones), and the Belamit Order, founded
by Pedro Bethancour stand out.
Compiling of Nursing manuals or texts written by and for nurses.
Development of functions which are considered today as basic in Nursing:
Caring, Teaching, Research and Management-Administration.
Tese three phenomenons are sufciently relevant so as to consider this
period the transition point of Medieval Nursing to Modern Nursing.
a) Constitution and expansion of Spanish orders and congregations devoted exlusively
to patient care.
In 1550 Juan Ciudad (San Juan de Dios) dies, but after him remains
a group of Brothers who develop their ideal conception of life with the
constitution of a Congregation, afterwards Order, for the caring for the ill.
20
Today, the Order of San Juan de Dios has hundreds of ofces spread over the
world and attends thousands of patients with various pathologies.
In 1599 Bernardino de Obregn dies, founder of the Minimum Con-
gregation of the Poor Patient (Obregones). A congregation expanded
throughout the whole Iberian Peninsula, whose central ideal of life was caring
for the poor patient. A Nursing manual is written about the core of the move-
ment which represents the frst written text for and by nurses a milestone
for Spanish Nursing. Tis congregation disappears at the middle of the last
century after three centuries of dedication to Nursing.
With a distinct American orientation, the Tenerife native Pedro de
Bethancour founds the Orden Belemita in the second quarter of the 17th
century. Hospitals are raised in diferent parts of America and at the same
time Spanish models of health care assistance are expanded throughout the
New World.
Tere are three clear exponents of the thrust that in the 16th and 17th
centuries develops in Spanish Nursing. While in a great part of Europe reli-
gious reforms promote the disappearance and transformation of many insti-
tutions that regularly attended the poor a fact certain authors denominated
Dark Age of Nursing in the Iberian Peninsula a very signifcant re-launching
occurs in Nursing, developing and expanding models of assistance.
b) Compiling of Nursing manuals or texts written by nurses.
Within this environment of prosperity in Spanish Nursing, the writing of
manuals oriented to the education of nurses plays an important role. In this
context, it is worth mentioning the essay of the Obregon nurses Instruc-
tion of Nurses which was edited four times between 1617 and 1728, and
that which we present here, Treatise for Nurses, by Simn Lpez. Although it
has remained inedited, it refects the level reached by Spanish Nursing of the
period.
Te appearance of these Nursing texts has a multiple value. In the frst
place they show the frst attempts to focus the nurses own knowledge and,
to a great extent, the professions defnition. Tey establish the nurses re-
lationship with other professionals (doctors, apothecaries, surgeons) and
performance guidelines in respect to these others. Likewise, the manuals
attempt to free the caring practices from the many superstitions and beliefs
that through the ages flled the curative arts, reducing them to a minimum.
In short, these 17th century texts represent a very signifcant step towards
the development of modern Nursing.
Treatise for Nurses
21
c) Development of the functions which today are considered basic in Nursing:
care assistance, teaching, investigation and management-administration.
In the 16th and 17th centuries a certain glimpse can be seen of the devel-
opment of several Nursing functions that could ft in with what are con-
sidered central outlines of the Nursing profession today. Along with the car-
ing tasks traditionaly carried out by the practitioners, one must add, and
above all in the framework of the new orders and congregations that appear,
the functions of Teaching, Investigation and Management-Administration.
Already in large medieval hospitals the process of teaching among those
who cared for the sick was developed: knowledge passed on from Nurses to
other Nurses. But still, administrative and investigative aspects were often
out of the nurses reach. However, with the appearance of the Nursing orders,
the management of hospitals as well as the development of Nursing (inves-
tigation) began to fall on Nurses. Te Brothers of the Order would be those
who founded hospitals, who sought resources for their management, who, in
short, directed the economy of the hospitals for their correct functioning. In the
same manner, the Brothers wrote down and compiled the necessary informa-
tion in order to train the rest of their companions, besides experimenting with
new techniques and care.
To sum up, we consider that the preceding period described (the 16th
and 17th centuries) refects an authentic Golden Age for Spanish Nursing.
Te text reproduced in this work shows the peak reached by Nursing in our
country more than three centuries ago.
23
3
THE AUTHOR AND THE WORK
3.1. The author
3.1.1. Simn Lpez, A Nurse of the 17th Century.
We have very little biographical data on Simn Lpez, author of the
work on Nursing which concerns us. Te data referred to here is taken from
his Treatise for Nurses, fnished in the middle of the 17th century, according to
the author in the prologue, and can give us an idea, however slight, of his
personality and training.
When he completed the frst draft of the book, in 1651, Simn Lpez
must have been of mature years, demonstrated by the 26 years of experi-
ence he had accumulated throughout his practice in several Castilian hospi-
tals as a nurse. Seventeen years later, in 1668, according to the data appearing
on the censure of Doctors Lazaro Gutirrez and Pardo, both professors at the
University of Valladolid, the defnitive manuscript was completed.
Of Simn Lpezs birthplace we dont know; yet several references through-
out the work can be found, where the author identifes himself with Castile:
our Castile; this does not occur when he speaks of other provinces or regions
of Spain. Also one notices the use of the Spanish diminutive ico, ica in
some terms (tirica, mesica, bainica, braserico, etc.)
Te following quotations serve as an example of what is mentioned above,
when explaining the characteristics of bread and cheese and their importance
when he describes the diet or the use of a utensil:
Te average bread, which we call in Castile is considered by some
to be the most healthy. (791).
Fresh cheese, says Galen, in book 10 of De Simples, is not as bad as
stale cheese, because it contains all contrary faculties, which is cold and
humid in the second stage; this is what is said of the cheese of our
Castile (805).
Take a little sliver [tirica in Spanish] of a can (338).
24
We know that when he is writing this work, he is practicing nur-
sing, although we dont know in which hospital:
I will mention another way of making ligatures for ordinary beds,
as those in convents and in hospitals; it is very appropriate and everyone
should have, especially where there are ordinary patients, and it has al-
ways been useful to me in these occasions and at present I have and I
use... (351).
Before he was a nurse he worked as a barber, as he points out in the
cover of Treatise for Nurses and in various quotations throughout the pie-
ce. Te fact that he does so suggests the ofcial and social recognition that
this profession must have had in this period:
Arranged in eight treatises, by Simn Lpez, barber of an unknown
hospital...(cover).
Now let us mention a curiosity [in blood-letting] as I am a barber,
having little surgery experience in the passage of my lifetime...(208).
In chapter 35, dedicated to carrying out blood-letting, a practice un-
dertaken by the barber and in which the nurse played a helping role, Simn
Lpez mentions that years ago it was a secular practice, which implies
that in the moment of writing the essay he may have been in some type
of clerical order:
...for which is the cause of faintings and other accidents and grave
stomach spleens, as I have seen so many times when I was a layman and
carried out blood-letting. (217)
But his occupation, as he calls it, was that of a nurse: to this trade he would
devote a great part of his life and to which he dedicated all his knowledge
and efort, representing them in this work. His preoccuption for educat-
ing good nurses, capable and human, continues throughout the whole
book:
a curious nurse should know everything, so that he is suitable in his
trade -it is very important for the caring of the ill-. (606).
Te nursing trade and patient care had an objective: the patient
himelf; the patient turns into the centre and core of the Nursing pro-
fession. Terefore, Simn Lpez constantly alludes to the human aspect
of the patient, of his sufering, treating him as a whole, in this sense coin-
ciding with modern theories of Nursing that tend to consider biological,
psychological and mental health. Tis is shown in several passages:
Treatise for Nurses
25
since [the patient] should not trust just any blood-letter, he should
always look for the best one, the health of the patient is not less important,
and if this remedy is badly carried out, his health will not improve; he
will have to look for the best blood-letter later on.(212)
One should not be like those nurses I have seen who take food to [the
patients] and dont care to urge them to eat. And I pray to God that the
nurse is not like others I have seen that had so little goodness that they
only set the food and drink down and went of without helping them eat
or drink. It is a great shame that there are such nurses.(424)
3.1.2. Te personality and training of Simn Lpez shown Trough his work.
Very cultured and concerned about training, possessing a wide range
of knowledge of diverse subjects as refected in his Treatise for Nurses
Simn Lpez consulted a great number of classical and modern authors,
doctors, apothecaries, surgeons and philosophers in Latin as well as in
Spanish to enrich his work. Te information acquired from these pro-
fessionals, including nurses themselves their experience in the feld and
their lectures are sources that the author employed to write this treatise
on Nursing:
With this in mind, and carefully and diligently attempting to resu-
me the most practical and versed methods in medicine, being qualifed
due to my experience, excellent books and the many conferences I have
had with several Doctors of Salamanca, Valladolid and in other regions
where I have practiced, together with this feld that of barber, somewhat
of surgery, more than twenty six years... (Prologue p. 7).
In one of the personal approvals included in the work, signed by Doc-
tor Lzaro, in his words Simn Lpezs long experience as a nurse is recog-
nised:
...the many years that he has practiced in this pious feld, together
with consulting other Doctors, has made him an expert in the method
of administering medicine and helping...(p. V).
Together with the above, and to complete a sketch of this nurses per-
sonality, training, thoughts and his idea of Nursing, based on the text
we have, we would select the following references to give a fnishing touch
on his biography:
26
In various occasions he recognises his ignorance of an issue or a
subject with a humble and modest attitude:
I confess my ignorance. I did the same at the beginning of my
nursing career, being accustomed to what I had seen [for laying
out the deceased](605).
Wisemen say that, even if one were 100 years old, one always has
something to learn; I say this because after having written this book,
I learnt from a young nurse (and experimenting in what chapter 133
treats) what I had not known...(606)
I do not fnd any other way, more modest or that which causes less
problems, than what referred to here, leaving this to the disposal of
cleverer minds...[for changing the patients sheets](176).
He was a restless person, an analyst, concerned with contributing
innovative elements to his feld, intending to improve the quality of
patient care. His experience and constant references to an essential
way to act, with a solid and recognised base (good Medicine) are
found in this work:
I have not found any other way to give the patient his drink; if I
found a better way, I would not mind it being done...[giving food and
drink to a frenzied patient](345).
Now we shall state some essential rules founded in Medicine, ob-
served in experience and for delirious patients... [rules the nurse must
observe while caring for a delirious patient](356).
Te references and terms used in latin would suggest his enlightened
character, being very knowledgeable in humanities:
According to the Doctor community, nephritic pain or nephritic
passion is a material illness, and what in Greek and Latin is called
Rerum Calculus, a generic name...(545).
...Ministri enim idonei assideant aportet...[Galen, on nurses](Pro
ogue, p. XI).
Uita breuis ars longa ocasio praeceps, experimento periculosum...
[Commentary on First Aforism of Hippocrates] (Prologue, p.XI).
Treatise for Nurses
27
Te critical spirit, at times harsh, towards nurses and other profes-
sionals who assist in the hospital and for reasons of ignorance,
sometimes due to carelessness or malpractice in applying such or
such technique and in other cases even harming the patient is
found in the work:
I see and experiment so little care and cleanliness when giving syr-
up to the ill, that I thought it would not be a useless act if I declared
it, mainly for the beginning nurses(202).
So many misfortunes and fatal ends have occured and occur today
with frenzied patients, by not caring for them with diligence and atten-
tion, that it seems like I will never cease to refer to them, due to the lack
of care and ignorance of nurses or assistants(348).
And likewise, upon seeing and experimenting, there are so few in these
times who try to get good nurses, being so important in Medicine(Pro-
logue, p.VII).
From what has been said, [feeding the patient who will be bled]
one has to blame the imprudent nurses, by giving the patient what he
wanted in such occasions and others, show as much indiscretion as
those same patients(217).
3.1.3. Works and authors that appear in Treatise for Nurses.
His concern for acquiring a solid training in his feld brought him to
consult no few treatises on diverse subjects. Tis is manifested in the long
list of authors and works consulted by Simn Lpez and quoted in the
pages of Treatise for Nurses.
...and in this the Doctors I have consulted concerning this point
agree... [on several remedies for frenzy](328).
After having written this, I remembered that I had read in the
Treatise on watered wine, by Doctor D. Gernimo Pardo, this man-
ner...(255).
Arriving to this point, I remembered a phase of Daza, in his book
On Abscesses, speaking about the quality of resolute Medicine... (26).
28
For sitica, Doctor Luis Rodrguez, frst professor of medicine, with
whom I dealt for several years in Salamanca, applied the plaster...(558).
And if the reader wants to know something concerning this [of infu-
sions], read Gernimo de la Fuente, apothecary, in his Tiroinio Pharma-
copeo(397).
Te author himself comments in the prologue of his work that one of the
sources used for writing his Treatise for Nurses was found from reading diverse
works on various subjects. We have elaborated a list with the authors as a whole
and their corresponding works upon which Simn Lpez comments in certain
places in the book. His use of many references of modern and classical authors
and works, doctors, philosophers and surgeons demonstrates that he wanted to
give a scientifc orientation as well as show his own preparation in the book.
Likewise, we believe this bibliographical reference list is interesting since,
after consulting the works that are included in it, one gets a good view of
nursing and medicine of the period, its scientifc content, the still existing
superstitions and beliefs inherited from the past, the popular customs in san-
itary material, the prevailing errors in diferent subjects, etc.
Te use of bibliographical references and margin notes which make
the text clear are done with great detail and precision, indicating, in most
cases, the author and the work, the chapter and corresponding page where
the text is described.
Te results of the quantitative analysis we have carried out on the authors
and works that Simn Lpez refers to in his treatise are the following:
Te number of works that appear quoted is 92.
Te number of authors, 50.
Te total of bibliographical references, 200.
Treatise for Nurses
29
Te works of Claudius Galen are the most quoted, with a total of 60 refer-
ences, followed by those of Luis Lobera de Avila, with 19; Avicenna, with
16; Hippocrates and Andrs Laguna, with 9; Juan Valverde de Amusco and
Juan Fragoso, with 8; and Francisco Daz, with 6. Te philospher Aristotle is
quoted 4 times together with the rest. With a slight glimpse at the anterior
data one can see how the classical authors (Hippocrates, Galen, Avicenna) still
prevail in the frst decades of the 17th century, along with their theories on
becoming ill and disease itself. Along these include the enlightened Spanish
doctors of the Renaissance, fundamentally Doctors Lobera, Laguna, Valverde,
Fragoso and Daz.
Hippocrates: born in Cos Island (460?-377
B.C.). He was the greatest doctor of antiquity,
having been called Te Father of Medicine
Claudius Galen: Born in Pergamus (130-
210 A.C.). He was the most famous doc-
tor of Antiquity after Hippocrates.
Avicenna: Te most famous of all Araba
docto9rs of Middle Age, called the Prince of
the Doctors. His name was Ibn Sina and he
was born in Chiraz (Persia) in 980.
Nicols Monardes: Born in Seville (Spain,
1493?-1588). Naturalist and doctor, he re-
ceived his doctorate at the University of Al-
cal de Henares and practiced for manu years
in his native city.
Te training of Simn Lpewz is based on a wide range of knowledge of
classical, medieval and renaissance doctores. Te major works of those doctors
enriched the assiduous lectures on nursing at the beginning of the 17 century.
30
Te authors most quoted in Nurses Directory
Classical Authors Quotations
- Claudius Galen 60
- Hippocrates 9
- Aristotle 4
Medieval Authors
- Avicenna 16
Renaissance Authors
- Luis Lobera de Avila 19
- Andrs Laguna 9
- Juan Valverde de Amusco 8
- Juan Fragoso 8
Aiming to train nurses in diferent subjects, Simn Lpez calls upon the
authors mentioned; on Pharmacy he consults the works Tiroinio Pharma-
copeo, by De la Fuente, Apothecary Practice, by Gutirrez de Arvalo, published
in the Kingdoms capital in 1634, along with On Nature, Qualities and
Grades of Simple Medicine, by Fragoso, and the classical doctors Hippocrates,
Galen and Avicenna, who wrote on almost everything concerning medicine.
On urology, the famous treatise Understanding Surgery (which includes a study
of uro-logical pathology) by the Burgos Doctor Francisco Daz, Understanding
Surgery, by Romn, or On Surgery, by Juan de Vigo.
Terapeutics, with an emphasis on diet control, is mentioned in the
majority of the authors, those standing out are the famous works On Fooch
by Galeno; Administrating Health, by Doctor Lobera, published in the middle
of the 16th centruy 1551; Treatise on the Quality of the Simple, by the
famous Arab doctor Mesu, or the works of Pliny, called Te Elder, a doctor
and naturalist widely read in the Middle Ages and by humanists of the Re-
naissance. Tis author gathered together the primitive therapies used by the
frst settlers of the Iberian Peninsula (along with the Glossary of Terms, a
brief biographical sketch is included on each of these authors.
Treatise for Nurses
31
3.1.4. Index of authors and their works quoted in Treatise for Nurses.
ABENOHAR
- Colecta, Book 5 (655).
ALBERTO MAGNO
- Vegetables (846).
ALLABAS
- Teriaca. Book 5 (655).
- Idem. (775)
ANDRADE, FATHER
- Historical Itinerary, fol.874 (481)
THEOPHASTRO AND BARTOLOME ANGLIO
- On History Plantarum (714).
DONATO ANTONIO
- De Uinaceorum facultatibus et usu (522).
ARISTOTLE
- De Sensu (181).
- Book 13, ch.4 (37)
- Cuesti. 6, sect. 10 (750).
- De secretis secreto (831).
ARNALDO
- Tract. de uinis (826).
AVERROES
- 5, Colliget (688).
- Idem (717).
- Idem (786).
AVICENNA
- Tract. 4 ch.7, fol.4 (422).
- Book 1, ch. 16 (655).
- Book 2. On Flesh, ch. 146 (680).
- Idem (679).
- Idem (718).
32
- 2, Canon of Medicine (681).
- 2, Canon of Medicine, ch. On Flesh (700).
- 2, Canon of Medicine (750).
- 2, Canon of Medicine, Treatise 2 (783)
- 2, Canon of Medicine (787). - 2, Canon, ch. 698 (822).
- Book 2. Proper (684).
- Idem. (741).
- Idem. (838).
- Sen. 4 of 1 (752)
- Ch. On walnuts (781).
AVILA LUIS DE
- Silba (676)
BRBARO, HERMOLAO
- Corolario (714).
BERA
- De simp. (703).
BRUYERINO
- De Reibaria (777).
- Idem. Book 6, ch. 13 (801).
- Idem. Book 8 (799).
- Idem. Book 11 (781).
CELSO, CORNELIO
- Book 3, ch. 7 (422)
CSPEDES, ANDRES DE
- Book on the Factory of Alxibes, ch. 66 (613).
DAZA CHACN, DIONISIO
- On Abscesses (192).
- Idem (26) .
- Idem (466).
- Idem Book 2, fol. 155 (841).
DAZ, FRANCISCO
- On urine (On urological surgery). Book 1, fol. 75 col.1 (393).
Treatise for Nurses
33
- Idem. Book 1 (549).
- Idem. Book 2, ch.3 (291)
- Idem (373).
- Idem. Book 2 (546).
- Urine problems (545).
DIOSCRIDES, PEDANIUS
- Book 2, ch. 64 (805).
FRAGOSO, JUAN
- Aphorism of Hippocrates (278).
- Simples (On nature, qualities and grades of simple medicine),
fol.272 (231).
- Idem (676) .
- Idem (778).
- Idem (703).
- Idem (753).
- Simple Antidotes (745).
- Idem (840).
FUENTE, GERONIMO DE LA
- Tiroinio Pharmacopeo (397).
GALEN, CLAUDIUS
- On Food, ch. 1 (375).
- Idem. Book 1 (787).
- Idem. Book 2 (715), (740), (747), (797), (810), (821).
- Idem. Book 3 (816).
- Idem. Book 4, ch. 9 (655).
- Idem. Book 4, ch. 19 (655).
- Idem. Book 7 (801).
- Idem. Book 8 (819).
- On Simple Medicine fac, ch.8 (608)
- Idem. Book 1 (780).
- Idem. Book 2 (757).
- Idem. Book 6 (231), (697), (734), (811).
- Idem. Book 7 (714), (725), (728), (775), (780).
- Idem. Book 8 (682), (719), (733), (739), (762), (776), (794),
(737).
- Idem. Book 10 (805), (815).
- Idem. Book 11 (713), (750), (812).
34
- On curative art ad Glauconem, ch. 14 (178).
- On illnesses, Book 4 (210).
- On Teriaca (479).
- On the diferences of fever, ch. 5 (479).
- Epi. Sect. 3., Com. 58. Book 3 (422).
- Deibus. (679).
- Idem 2 (734), (742).
- Idem. Book 2 (773).
- Idem. ch. Proper (786).
- Euchimoya y Cacochimia (727).
- De Chrisibus. Book i (758).
- Rules on Acute Illnesses. 3 (774).
- Idem. Comment on Particle 3 (826).
- Idem (828).
- Idem 3 (833).
- De composi. pharun (795).
- De simp. Medici ad paternianum, ch. 23 (810).
- Comment on Aphorisms (830).
- De el Methodo (837).
- Comentary on Aforism 1. of Hippocrates (XI).
- De morbis vulgaribus. Book 6 (X).
GORDON
- Book on medical fowers (455).
GUTIERREZ DE AREVALO, PEDRO
- Apothecary practice (656).
HIPPOCRATES
- De morbis Vugaribus, ch. 4 (279).
- Idem. Sectio 4, text 8 (XI).
- Idem. Book 1, sectio 3, text 19 (XII).
- Idem. Book 6, sectio 3, text 43 (XII).
- 4 Particle of Aphorisms, text 15 (291).
- Aphorism (677).
- Aphorism 1. (VII), (X).
- De Epidem. Book 5, text 52 (760).
HUERTA
- Comentary to Pliny. On Natural History, Book 8 (375).
Treatise for Nurses
35
ISAC
- Book Proper, ch.27 (765).
- Idem. ch. Diets (845).
JUBERA
- De exemplar vel. reformatio medicamentos (748).
KEMPIS, THOMAS DE
- Disillusioned Doctor, ch. 5 (VIII).
LAGUNA, ANDRES
- Comentary on Discrides (397).
- Idem. Book 1, ch.131 (769).
- Idem. Book 2 (789).
- Book 3, ch. 440 (714).
- Idem. Book 5, ch. 100 (78). - Idem (688)
- Idem (752).
- Idem (825).
- On Fungus (747) .
LAZARO GUTIERREZ, JUAN
- Aforism of Hippocrates (281).
LOBERA DE AVILA, LUIS
- De Simples, ch. De coles (705).
- Idem (716) .
- Idem (739).
- Idem (741).
- Idem (751).
- Idem (760).
- Idem (765).
- Idem (777).
- Idem (778).
- Idem (802).
- Idem (819).
- Idem (822).
- Idem (819).
- Idem (822).
- Health Administration (731).
- Proper (quotes Almanzor) (751).
- Sen. 1 of 4 (quotes Gentil) (751).
36
- De unis. Book 1 (836).
- Silva, ch. Pan. (184).
- Idem (407).
- Idem Book 1, ch. 34 (358).
LUSITANO, AMATO
- entura 6, Curatione 100 (750).
MONARDES, NICHOLAS
- De Suli, ch. 2 (654).
NICANDRO
- De Triaca (779).
NUEZ
- On the Plague (IX).
PARDO, GERONIMO
- Treatise on watered wine (255).
- Idem (255). - Idem (830).
PAULO
- Book 7 (730).
PERAMATO, PEDRO
- On Evacuations (218).
Treatise for Nurses
37
Directorio de Enfermeros (Treatise for Nurses frst page).
Te frst draft was fnished in 1651.
38
PLINY SECUNDUS, GAIUS
- Natural History ch. 37 (37).
- On foods, Book 2 (707).
- Book 21, ch. 17 (714).
- Book 23, ch. 8 (782).
RASSIS (RHAZES)
- Of the Continent. Book 25 (730).
ROMAN
- Understanding Surgery (121).
SCHODRERO, JUAN
- Book 3 ch. 9 (676).
SERAPION
- On simples, ch. 273 (714).
TORRES
- On Morbo Galico (466).
- Idem, ch. 37 (121).
VALVERDE DE AMUSGO, JUAN
- Anatomy of the human body. Book 3, ch. 10 (102).
- Idem (1) .
- Idem (365).
- Idem. Book 1, ch. 15 (62).
- Idem. Book 1, ch. 90 (409).
- Idem. Book 3, ch. 9 (69).
- Idem. Book 4, ch. 9 (37).
- Idem. Book 6, ch. 12 p. 95 (44).
VALLES, FRANCISCO
- On Epidemics. Book 5 (758).
- Commentary on Aphorism 1 by Hippocrates (u).
VICARIO, BARTOLOME
- De aegrotantium opimo assistente (VI).
VIGO, JUAN DE
- On Surgery. Book 9 (789).
YSAE
- Indictis particularibus (718).
AZACUTO
- Book 3. of Practices, observation 140 and onward (VII).
Treatise for Nurses
39
3.2. The Work.
3.2.1. Previous Refections. Te Study of the History of Nursing.
Virginia A. Henderson states in her book Te Nature of Nursing, Refections
25 years Afterwards (McGraw-Hill Interamericana de Espaa, S. A., Ma-
drid, 1994, pp. 7-10) that after having visited numerous countries in recent
years and seeing the great disparity existing between the number of nurses
and the preparation Nursing, it gets more difcult to accept a universal
defnition of what Nursing is. Perhaps we should accept the conclusion that
it depends on the resources of each country involved and the people it serves.
Te conclusion that this distinguished researcher of world wide Nursing has
reached, having dedicated various decades of her life in studying the analysis
of the conception and nature of Nursing in depth, points out the difculty of
fnding a defnition of the concept of Nursing.
Another refection that must be taken into account when carrying out an
historical study of the Nurses duties in a given country, in this case ours,
is that Nursing, as any other feld or profession, has gone through changes in
its conception, its social orientation and its relationship with other disci-
plines. For example we quote the use of a technique, that of blood-letting,
a task carried out by the barber-bleeder in the 16th and 17th centuries.
When this professional disappeared, such a function was taken over by the sur-
geon or the practitioner and nowadays by the nurse.
In 1857, in our Country, it is believed, due to the well known Moya-
no Law, the titles of Practitioner and Midwife, and in 1915 Nurse become
ofcial, preceding Sanitary Technical Assistant, and at the same time Regis-
tered Nurse, having existed now for two decades. Another example, signifcant
and momentous in the historical development of Nursing, is the Midwife, an
ancestral profession, regulated laborally and juridicially in the margen of
Nursing until the present century, and which is now among its specialties.
Tis historical evolution of the Spanish Nursing Profession which takes
place in barely half a century, with changes in its fundamental concept and its
functions, corrobates the idea mentioned above of the problem we face when
analysing the work of nurses in the 17th century with a modern vision of
Nursing.
However, apart from the evaluations above, it is indeed accepted and rec-
ognised in our time that nursing work throughout the centuries has had
a common characteristic, following a constant, invariable and difnitive
course: giving and administering care.
40
With these points, we enter the study of the work that the nurse carried
out three and four centuries ago, under the guidelines of the great teacher of
nursing, Simn Lpez and his documented work, Treatise for Nurses.
3.2.2. Structure and Content.
Directory of Nurses and Craftsmen of Charity works to cure illnesses of the body
is a work manuscripted, inedited and identifed with the signature 259,
and is placed in the Library of the University of Salamanca.
It includes 565 pages of text, besides the 22 other pages which make
up the index of the work or Summary of everything treated in this Nursing
Book, three approvals and censures, carried out by D. Juan de Ro Noriega,
Professor of Anatomy of the University of Salamanca, D. Juan Lzaro Guti-
rrez, Professor of Medicine of the Royal University of Valladolid and doctor
of the Holy Ofce in this city, and D. Geromo Pardo, Professor of Medendi
Method, also of Valladolid and doctor at the Royal General Hospital, and the
prologue, directed especially to nurses. Also, a last page is included with an
explanatory note of the author about the division of the work.
Te date of the conclusion, Simn Lpez points out, was in 1651,
when he presented the frst draft to Doctor De Ro Noriegas approval (the cen-
sure-approval of this Professor is dated in February of the following year,
1652). Te following approvals of Dr. Lazaro and Dr. Pardo took place in
1668, in April and October, respectively. Simn Lpez justifes this difer-
ence in years due to having to correct, add and take out some material:
...in this manner these same Doctors advised me, after having ap-
proved [the frst manuscript], to take out many issues that were not
relevant to nurses and that I dispose of another book that did not contain
abbreviations nor rules and that I gather everything that had been co-
rrected and written in margins; I did this in this manner, for I believed
they were right...(page VII).
Terefore, the work we present is the second and defnitive book, with
the added corrections. Why it was not edited is unknown.
Our work was carried out on microflm, not having seen any need for pagi-
nation. Pages 318 and 510 of the manuscript are blank. Troughout this
book, in a few of its pages, there are erasings and crossing-out marks, ma-
king the transcription notably difcult. However, the handwriting, clear
and legible, generally did not present any doubts. Te manuscript does not
include any illustration.
Te author has structured the book into 150 chapters of unequal lengths,
distributed in eight essays (essay 5.
0
, on diferent types of fever, is the most
Treatise for Nurses
41
extensive, totaling 144 pages; the shortest is essay 3., with 31 pages). Two
indexes complete the work, one with the titles of the chapters and the
other on subjects, in alphabetical order. Likewise, the book is divided into
small blocks, 846 in total, which make it easier to locate a determined sub-
ject and which we have entirely respected in transcribing and elaborating
the indexes of subjects. One of these blocks, number 355, is missing and
number 676 is repeated twice.
Te structure of the book, with titles for each of the eight essays, their
length, the distribution and number of chapters, is the following:
Cover.
Approval of Doctor D. Juan de Ro Noriega.
Opinion and censure of Doctor D. Juan Lzaro Gutirrez.
Opinion and censure of Doctor Geromo Pardo.
Prologue (11 pages):
- To nurses, to whom I must speak in this whole book.
- What is the feld of a charitable nurse.
- Confrming with authorities and on experiences how necessary a nurse
is to Medicine.
Note to the reader.
Essay 1. (Chapters 1 to 19; 52 pages). On contingent cases, in which
include all kinds of ointments and what can be done in all kinds of dis-
eases with the proper Method, according to the good order of Medicine.
Essay 2. (Chapters 20 to 33; 50 pages). On other contingent cases in
minor illnesses, with some remedies in the beginning of these.
Essay 3. (Chapters 34 to 40; 31 pages). On how syrups should be giv-
en and how to assist with blood-letting, enemas and suppositories.
Essay 4. (Chapters 41 to 56; 37 pages). On stomach fushes with
normal and adnormal dysentery).
Essay 5. (Chapters 57 to 108; 144 pages). On high tertian fevers, with
their administering, and how we must operate in times of the plague
and its preventions.
Essay 6. (Chapters 109 to 137, 72 pages). On other diseases,
chronic as well as hereditary and accidental.
Essay 7. (Chapters 138 to 148; 40 pages). On the quality of water and
which is the best, and of all kinds of boiled water that the patient drinks
and the manner to boil it according to its weight and measurement.
Essay 8. (Chapters 149 and 150; 76 pages). On the quality of simple
maintenance which helps our conservation.
Index of all the chapters of this book and futhermore other signifcant
subjects.
42
Index of the most notable things in this book declared in alphabetical
order and numbers at their margen.
Troughout the 150 chapters, the work carried out by the Nursing per-
sonnel of the period is shown: its functions assistance (caring for the ill
in serious accidents, in the presence or absense of the doctor), teaching, in-
vestigating, administering, techniques and procedures, materials and diverse
instruments, preparation, indication and administration of various medicial
preparations, along with the knowledge one must possess on diverse sub-
jects (anatomy, diet very important, therapy, physiology, pathology, bot-
any, etc.).
Although it was not printed, even when being ready for printing the cause
is unknown (old age, the authors death, economic problems for print-
ing...), it is still a magnifcent exponent, a worthy testimonial document on
Nursing, written three centuries ago, with its limitations, its social recognition,
its own functions and those dependent upon other professionals practicing in
the hospital (doctors, surgeons and barbers).
Looking briefy at the index of subjects that we have elaborated on and that
acompany the work gives us an idea of its content: activities carried out by the
nurse, the material he used, the diseases and conditions of the period some of
these practically unknown in our time, such as smallpox, authors that appear
in the book, some of them the authors contemporaries and others classical, and
other aspects which will be analysed in the present introductory study.
3.2.3. Treatise for Nurses and Nursing in the 17th century. Its functions.
Treatise for Nurses is a work carried out, according to that expressed by the
author throughout the book, with the aim to train and instruct those be-
ginning in the feld of nursing as well as those who are already practicing in the
profession. Te spanish term Directorio, with forms part of the title, already
gives us an idea of its aim (directory means what serves to direct a certain
science or business; instruction to govern:
It seems of little importance to make a rule out of this, but it is not,
especially for beginners in this feld, for those who carry out this work [to
knowingly fll the syringe and administer the enema] (237).
Te nurses, to whom I must speak in this whole book. (Prologue,
p. VII).
Tis aim is clearly manifested throughout this work, especially in the
Treatise for Nurses
43
pages of the prologue, where Simn Lpez, quoting of doctors, philoso-
phers, past and contemporary of the author to back him up, defnes the nurses
job, his functions and tasks and, besides, dedicates an extensive section to
justify the antiquity as well as the necessity of Nursing:
Te principle attempt is to verify the great need of attending the pa-
tient, what we normally call the nurse, and it is so important, even the au-
thority of the Prince of Medicine, Hippocrates, supports this belief, which
in the frst of his Aforisms... (Prologue, p. X).
Te functions of the nurse are described by Simn Lpez in his Prologue (p.
IX), below the heading What the feld of a charitable nurse is, functions
that are accepted and recognised by the doctors themselves. He narrates to
us in the following manner:
Nurses, according to Doctors (and Doctor Nez Lpez in his book
On the Plague), are executers of what the Doctor orders and informers
of what the patient does or has. And likewise, their duty is to anoint all
parts of the body, administer suppositories, give syrup and drinks, carry
out purging, rinsing and cleaning, ligatures, tourniquets, and fnally, give
lunches and dinners with puntuality, discretion and cleanliness...
In the following list the duties and functions are summarized, which accord-
ing to Simn Lpez, in his Prologue, the nurse recognised and carried out:
Give the prescriptions ordered by the doctor.
Observe the patient, watch his progress and inform the doctor.
Provide everything necessary for the good outcome and progress of the
illness.
Hygiene and cleaning of infrmaries and lodgings.
Watch carefully for correct air ventilation, avoiding bad odor.
Assist the patient in emergencies, in absence of the doctor or surgeon.
Apply ointments.
Administer suppositories.
Give syrup and drinks.
Carry out purging.
Carry out rinsing, cleaning and ligatures.
Make tourniquets.
Administer lunches and dinners with proper hygiene.
Other varias tasks: ... and there are others.
Along with the duties mentioned above, throughout the book other tasks
of no less importance are stated, those that cover the diverse basic needs of the
44
patient (hygiene, sleep and rest, temperature regulation, phychology and
others).
And on the importance of instruction and training of the nurse, Simn
Lpez continues his narration and states the following:
Besides this, it is necessary to advise, note and read a lot (to beco-
me skillful) of the information and many ways of executing the many
remedies and advice that are referred to in this book and ask for an
accident...
Te fact that the nurse must know how to read and write is expressly point-
ed out by the author, given that the nurse must write down the appearance of
certain symptoms, fever for example, important for being able to carry out the
corresponding therapeutical methods.
Functions of Nursing.
In this book on Nursing we fnd a clear limitation of functions among
each of the professionals who practice in the hospital. So, the doctor, who
together with the nurse are the professionals most referred to in the book,
is the one who gives the diagnosis and treats the illness, prescribing the cor-
responding medicine and therapeutical remedies. Te apothecary is in
charge of concocting the prescribed medicine, although, in many cases, it is
the nurse himself who carries this task out, if it isnt especially difcult. Te
surgeon is the professional who carries out, almost always, the surgical inter-
ventions and major cures. Te task of blood-letting and small operations is
carried out by the barber-bleeder, who is a legally recognised professional and
who must pass an examination before the corresponding tribunal examina-
tor Protobarberato and obtain a practicing license. Tese professions
have evolved with rime, some of them disappearing, such as the barber-bleeder,
and some of them appearing, such as the practitioner, two centuries after-
wards.
Te nursing feld in the 17th century is clearly defned in the pages of the
book. Simn Lpez summarizes in his prologue, in a general perspective, the
tasks and functions of the nurse and whose most detailed analysis we will
see later on. However, we inform here in summary, that the nurse was in
charge of caring for the patient, covering his basic needs (feeding, elimination,
hygiene etc.), administering prescribed medicine (using diferent ways and
means), watching and following the pathological progress and informing
the doctor of everything.
Te functions of each of the professionals mentioned appear quite delim-
ited throughout the work, respecting each professionals framework scrupu-
Treatise for Nurses
45
lously at times. In several occasions Simn Lpez mentions something that
is not the job of the nurse, indicating that he should not interfere with other
professions.
Te following quotation, alluding to the role the nurse should play in
the case of a serious accident, such as a grave fall, serves as an excuse to point
this out:
After this, the Doctors usually order the patient to be bled, if ne-
cessary, to be given drinks and be cured of the contusions and bruises
or injuries, if there are any, therefore the doctor must be called, so that he
orders the bloodletting, and the Surgeon, so that he cures the contu-
sions and injuries, which is not the task of the nurse, nor should the nurse
interfere in what he does not understand, because if the nurse were a barber
by profession, he would do what he knew how(113).
For apple resin plasters, which Doctors tend to prescribe for eye
problems, I leave the Doctor to prescribe and the apothecary to make, and
in this manner, I will only mention the job of the nurse, which is to put
them on (118).
I will fnish this chapter by telling the nurse that I do not state here
how to make an infusion because it is very difcult, and so I leave it to
the apothecary, who in this subject is very skillful, since this is his feld
(397).
By the way, as can be seen in the frst reference mentioned, blood-letting
continued to be one of the important therapeutical uses in Medicine, a
remedy used since ancient times.
Te fact that each professionals framework was limited implied, at the
same time, assuming responsibilities in case of error or incompliance in re-
spective duties:
...[the nurse] although being always guided by [the doctors] or-
der and mandate, and always following this guide still caused injury,
it will not be on his account [for administering sour milk] (275).
In the book a distinction is made between nurse and assistants; we
think that with this the author intends to distinguish a person with a higher
level of training (nurse), who lends care in a more formal manner (formal care)
and who, in short, is directly responsible for the patient, from the other, (as-
sistant), whose limited tasks are auxiliary and dependent upon the former:
...which I will inform the nurses and assistants, since it is necessary
that everyone knows it [for laying out a cadaver](605).
46
whose assistance is extremely necessary and to the Doctor and Sur-
geon, who are those who carry this out [for the croup], as the nurse and
those who assist him(461).
In the same manner, in certain passages, especially when a technique is
carried out, a fgure appears, that which the author calls nurses assistant,
who helps in the task, and we dont know if this is the same patient assistant
already referred to or another person. Tis helper carries out certain jobs that
are not very specialised or complex:
Having done this with suitable help, the nurse tells the assistant
to get on top of the patients bed, putting one foot on one edge and
another on the other edge... [to administer a suppository to a apo-
plectic] (535).
The dirty sheets are taken off when the patient is lying
lengthwise, for which two people are necessary, the nurse and the
assistant(175).
On one occasion, when Simn Lpez explains the meaning of critical
day o judgement day in acute illnesses, he mentions the romance nurse.
Tis term, romanista, tends to be used, in the case of surgeons, in refer-
ring to those of less training, less preparation, in short, with less studies:
...and this will do for romance nurses, leaving circumstances and
delicate work for Doctors(165).
Curiously the term nurse appears throughout the book on countable
occasions in the masculine:
...of everything said one must blame the imprudent nurse (en-
fermero) or the nurse (enfermera) [when feeding the patient before
blood-letting)(217).
Te most frequent terms used when the author speaks to the nurse are
charitable, prudent, organized, curious, punctual, clean and others that,
in some way, represent several of the physical and moral qualities that the
former should possess.
For analyzing the work carried out by the nurse in the 17th century in our
country, their tasks and functions were grouped together and included in 4 big
groups, corresponding to the functions that todays Nursing feld recognizes
(assistance, teaching, investigations and management-administration).
Te great similarity between Nursing refected in this work and that which
is practiced in our days stands out, not only due to the tasks carried out in
Treatise for Nurses
47
their entirety, but to the general orientatiori that was given to it (along with
caring for his physical needs, those oriented to the spiritual viewpoint of the
patient, his human and social side were also considered). In short, the in-
dividual and his three perspectives are contemplated in the book: biological,
phychological and social.
As for the nurses work plan, in relationship to other professionals
who were dedicated to sanitary activities within the hospital (doctor, surgeon,
blood-letter, apothecary, etc.), we point out, the great coincidence with to-
days Nursing, as we can see here:
Independent function of the nurse.
- Patient care (carrying out his specifc duty, using the corresponding tec-
niques):
...and so here the nurse only gives suppositories, massages and
makes ligatures(467).
And advise the nurse that while the sweating lasts he must not lea-
ve the patient until it stops. I say this, because if while he sweats the sweat
is not wiped often...(162).
- Observation of the patient (gathering and registering data in an interview):
And in this manner, the prudent nurse asks the following questions
before giving it to him [carrying out purging]. If he had been purged
before, if he retains the purges that were given to him...(578).
At frst fnd out from the patient how this happened to him, because
one fnds out from his answer, more or less what it is...[a foreign object
in the throat](199).
- Observation of the patients progress, of the appearance of new symp-
toms (Nursing register):
...the nurse must be extremely careful in faithfully knowing at
what time of day it gets cold. And in this manner, respecting when it
gets cold, it must be timed, to feed as well as to give remedies...(452).
I add that, when the nurse sees a patient with a high temperature
and some sweating, and on a critical day...(159).
In this case, one must check if the patient is vomiting, if he vomits
48
often or in spouts...(297).
- Acting in absence of the doctor:
In this occasion [colic illness and acute pain], if there is not a doc-
tor at hand, the nurse can help induce the vomiting by beginning with
light vomits...(298).
What the nurse can do at the beginning and where there is not a
doctor [attending.a apopletic](533).
- Development of the Nurses proper functions (assistance, teaching,
investigation, administration).
Dependent foncions.
- Comply with the prescriptions of the other professionals (doctors,
surgeons):
...all of which will not be done without the Doctors order [use of
a determined ointment for high fevers](103).
I leave many [ointments], which the Doctor will prescribe at due
time, and these will not be administered with out his order(33).
Interdependent functions.
- Collaborating with these professionals. Example: helping the barber
to carry out the blood-letting:
In brain commotion the Doctors order the blood-letting of both
arms at the same time... Tree or four people are necessary, two barbers,
for each arm, two nurses to shed light and hold the basins where the
blood must fall...(211).
- Inform the doctor on the clinical progress of the patient:
Due to all this it is necessary that the nurse is informed, for which
the patient will help with his report, and with this the nurse can assist
the patient and better inform the Doctor for fnding the cure(450).
Treatise for Nurses
49
a) Attending function.
Te attending function of Nursing was set out to cover the elemental
or basic necessities of the patient considering this through care assis-
tance and using certain techniques and procedures. Evidently it is the
most widely treated throughout the work, since it implies all the tasks,
techniques, procedures and, in short, the attending labour of the nurse.
In the following table the activities carried out by the nurse in the work
of Simn Lpez are gathered; we have grouped them based on the elemen-
tal or basic necessities of the human being. Te author, while analyzing a
certain pathology, explains the nurses job, the technique to be used to
administer medicine or the prescribed therapeutic remedy. Te explana-
tion of each activity is found in the text of the book itself; we limit our-
selves here to recognize them, classifying and grouping them in diferent
sections to demonstrate the great testimonial richness of the nurses duties
possessed in this treatise on Nursing.
1.a. Feeding:
Giving food and drink to the patient.
Giving food and drink to the incapacitated patient or one who
refuses to eat, by way of a funnel.
Giving food and drink to the patient who has a postrated appe-
tite.
Planning a diet for each patient. Pointing out its great importance.
Giving milk to diferent patients.
Giving water in each illness.
Elaborating with and supervising meals and medicinal preparations.
1,b. Oxygenation:
Facilitating respiration in determined pathological processes.
Administering medicine and therapeutic methods to improve
breathing.
50
1.c. Elimination:
Administering diets or suppositories. Various types.
Administering purges.
In general, facilitating elimination (urine, faeces).
1.d. Temperature regulation:
Giving grape or olive resin to provoke sweating in some illnesses.
Watching for positive sweating.
Employing methods for maintaining body temperature.
1.e. Maintenance of circulation. Hemodynamics:
Te nurses performance in case of blood congestion.
Performing when faced with a haemorrhage.
Taking the pulse and distinguishing the pathology.
Te nurses performance in those processes that alter vital signs (fain-
ting, coma, vascular accidents apoplexy, etc.).
1.f. Hygiene. Explanation of the technique:
Bathing the patient.
Changing the patients shirt while in bed.
Changing the patients sheet while in bed.
Airing the infirmary or the patients lodging.
Applying methods of hygiene, cleaning and disinfection in case of
epidemics.
Applying hygienic methods when preparing medicine (washing hands...).
Cleaning the dirty and sour tongue.
Cleaning the mouth by washing and rinsing.
Sprinkling or applying cloth medicinal bags and quince jelly for
mouth washing.
1.g. Rest and sleep activity:
Administering sleeping syrup to the patient who cannot sleep.
Te nurses performance during deep sleep.
Keeping watch over the patient at night. Not letting him sleep more
Treatise for Nurses
51
than prescribed in certain illnesses.
1.h. Physical safety. Physical excercise:
Tying the frenetic patient down.
Taking preventative measures in case of contagious illnesses.
Applying ligatures to the patient.
Assisting the patient to do physical excercise in certain diseases.
1.i. Covering the psychological and religious needs of the patient:
Giving religious assistance to the patient in case of danger.
Talking to the patient, making him happier and cheering him up.
Putting music on, in some illnesses.
Advising the patient.
Establishing a trusting relationship with the patient.
l.j. General:
Patient care.
Carrying out the prescriptions of the doctor and surgeon.
Supervising other professionals (barber, blood-letter).
Collaborating with other professionals.
Arranging the patients problems in order of importance.
Administering, by diferent natural vias, the prescribed therapeutic
medicine (ocular, nasal, oral, rectal, external), in diferent illnesses
and conditions, by way of:
- Suppositories.
- Medicinal brews.
- Eye-drops.
- Preserves.
- Safeguards.
- Ri nsi ng.
- Plasters.
- Poultices.
- Gargling solutions.
52
- Infusions.
- Syrups.
- Sugary compositions.
- Medicinal biscuits.
- Pi l l s.
- Powders.
- Purges.
- Incense, fumigating.
- Medicinal infusions.
- Ointments.
- Vapors.
- Vomit inducers.
Applying roasted or cooked meat on diferent parts of the body.
Applying Spanish fy powders and later cleaning the sores produced.
Applying cupping glasses in certain conditions.
Applying a rams head to the head of the patient (in certain pathologies).
Applying a puppy or dove, alive or roasted, to the head of the pa-
tient.
Applying the lungs of a sheep, fox and hedgehog to the patient.
Gathering data on the patients illness, asking him questions.
Bathing the patient as a therapeutic measure, according to the ill-
ness.
Performing in diferent accidents (haemorrhage, fainting, falling)
in the presence or absence of the doctor or surgeon.
Perforating smallpox sores.
Rinsing.
Giving tourniquets.
Applying sneezing medicine.
Applying mud to the patient in certain illnesses.
Placing bandages, sadles, caps and small needles for ulcers.
Performing in the case where foreign objects are found in the
patients throat.
Carrying out minor cures.
Treatise for Nurses
53
Preparing the material before carrying out a determined technique.
Keeping watch over the patient after carrying out a technique
(example: after blood-letting).
Confrming the death of the patient, by way of certain signs.
Preparing the cadaver, laying it out.
b) Teaching function. Te teaching of Nursing, objective of the book relating to nurse.
Te fundamental objective of the book is to train and instruct future
nurses; and at the same time, to serve as a guide for those who already are
practicing in the nursing feld. In this manner the author states in the frst
pages of the book:
Terefore try, with the grace of God and to instruct those who
begin practicing in this feld of nursing, to search and obtain the
best method, manner and order for knowing how to apply this
medicine...(Prologue, p. (VIII).
Te work includes, along with the knowledge of Nursing itself (theo-
retical and practical), other diferent subjects (anatomy, pathology, therapy,
botany, dietetics, pharmacy, medicine), necessary for the nurses whole
training.
Given that the aim of the book is to educate and transmit knowledge,
its author has given it a didactic focus, therefore employing a clear and con-
cise language, using explanatory examples, comparisons and other didactic
resources that, in short, facilitate in understanding such knowledge. Tat
manifested above becomes more important when considering Nursing a
prominent practice, in which a minimum talent is needed to carry out
a certain technique. In this manner, the use of a great number of didactic
resources that facilitate the understanding of the theory and its shaping the
practice is necessary for teaching this discipline.
Let us stop here to see, with some textual quotations, the didactic and
elegant vision and literary style that the nurse Simn Lpez has employed
though-out the whole book.
Detailed description and precise use of language:
So that the urine does not pass to the cushions, one must use ber-
rionda blankets, very furry, that are made in Palencia and in Valladolid,
that serve while waiting for other good blankets(295).
As can be seen, not only the material the nurse should use to avoid get-
54
ting the cushion wet with urine (berrionda blankets) is mentioned, but
the type and place where it is manufactured (Palencia and Valladolid) is
specifed besides. Te term berrionda blankets (in our time spelled verrion-
da in Spanish) means tougher blankets, stifer than normal ones and whose
function is to serve as a protector to those of better quality.
Use of refrains, sentences and popular sayings:
...on which Doctors say a sentence: fall fevers, long or mor-
tal(449).
and here the old saying goes: Good water, colourless, odourless
and tasteless and that which sees the sun (607).
Te sense of humour, sometimes ironic, can be seen in several references:
And getting all this dirty, he will be moved to another, and in
this way the diarrhea will decease or the patient will [hygiene for the
patient confned to bed who has diarrhea. (294).
And having seen the ignorance many times of some people, and
because of their feld they should know, I thought of opening up their
eyes (and here not with caustic medicine) with reason...(125).
Te use of comparison, utilizing known objects of daily use, facilitates
the understanding of the subject explained:
To apply these powders in the nose of these patients, it is necessary
to use a wide jasmin stick, about a rods length and shaped like a horn
[applying a sneezing medicine](342).
Te use of example as a didactic resource:
As an example, a patient who has a growing fever and gets chills
or an increasing fever at two oclock in the afternoon, which can still
come without the chills.... [for calculating the hour in which the nurse
must apply a determined remedy](452).
Let us confrm this with an example. If this used clothing were
put on a healthy person, he would surely become ill on contact... [the
need to change the contaminated clothing of a patient](172). Simn
Lpezs interest in teaching the future nurse is not only limited to the
teaching of a nursing technique, but, in some cases, to the construction
Treatise for Nurses
55
of a utensil or instrument for carrying out the mentioned technique.
Tis occurs, for example, in the cleaning of the tongue, when it is nec-
essary to use an instrument that takes out the grime:
I will mention here an example on how pieces of silver or tin must
be. Take a small sliver of tin, about the length of seven fngers and the
width of a pair of barbers scissors, and double it...(338).
Teaching a Nursing technique or procedure.
So that the future nurse or professional understands the manner in which
to carry out a certain technique or procedure, the author of Treatise for Nurs-
es follows a teaching method. Before explaining the technique, he attempts
to show why something is done in a certain way and not in another:
Now we mention the reasons for doing this in this way and not in
another(125).
...because in any other way done, one is always called...(121).
If we compared the Nursing practiced in a hospital in our time to that
contained in this work of the 17th century, we would notice the great
number of coincidences. Any Nursing manual of procedures used today
would contain the following sections:
Previous hygiene for carrying out a technique. Washing hands:
...and keeping it in the water for about an hour and a half or two
hours, and afterwards (and having washed his hands), the linen bag will
be rubbed and taken out [for preparing an infusion](399).
Preparation of the material before carrying out a technique or procedure:
On what should be prepared before administering supposito-
ries...(236).
Before purging, one must prepare white and red vinager..., a cloth
for wetting it, a small stick to stir the purge when it must be given, and
a glass of water to wet it with afterwards, and a basin...(569).
When a determined technique is explained, for example, applying oint-
ment on a certain part of the body (liver or spleen), the author begins
56
with informing the nurse on the location of the organ or region to oint,
in a comprehensive manner and without leaving any doubts:
And for fnding out where the liver is, tell him to put the fngers of
his right hand on his mouth (as we show courtesy to others) and, whe-
rever the elbow falls, the liver is located there. And in the same manner
one uses the left hand to show where the spleen is(l7).
Administering purging was a very important job carried out by the nur-
se. In fact, purging, along with blood-letting, constituted what was called
major remedies of Medicine, being prescribed by doctors in numerous
pathology processes and various accidents. Chapters 133, 134 and 135 of
the work are dedicated to explaining to the nurse the technique of purging,
material preparation, complications, etc. Employing this technique can ser-
ve as a model on the methodology that Simn Lpez applies in his book.
Te following is a summary of the procedure and method followed by
the author to explain to the nurse the appropriate manner to administer this
therapeutic remedy which is purging:
Prescription on behalf of the doctor (573).
Preparation of the patient the day before (attending, a light supper,
rest)(574).
Measures that the nurse must keep the day of the purging. Prepara-
ton of material. Interviewing the patient and asking him a series of
questions, in reality, getting a brief history of the patient and acting
in consequence (575-578).
Carrying out the technique (position of the patient, preventative mea-
sures to avoid chilling, giving the purge, wetting it later with water or
wine, sitting the patient back, covering him with clothing if in winter,
preventing vomiting by applying a cloth damp with vinegar) (580).
After carrying out the technique, give a half spoonful of anis, three
Sevillian olives and other things that are specifed so that the pa-
tient retains the purge (581).
Not letting the patient sleep after the purging ((582).
Applying the nurses hand over the patients stomach so that it
works more rapidly (583).
Measures to keep on the day of the purging (regarding to the at-
mosphere, diet, eet.) (584-585).
Measures to carry out by the nurse in case of possible complica-
tions the purge is not retained or is retained for too long, vo-
miting, and measures to take applying a suppository, giving
brews... (586-591). Continuing with explaining diferent types of
Treatise for Nurses
57
purges (slow and minor) that are administered for some illnesses
(serious and simple fevers) (592597).

As can be seen, this deals with a methodology, of a process carried out
in a very similar way to how it is done today, except for, logically, the diferen-
ces concerning scientifc knowledge and methods used. One must realise
that medicine of the period was essentially symptomatic, more concerned
with treating symptoms rather than causes, given the ignorance of all that
concerning etiology, transmission mechanisms of illnesses.
Relating to patient:
Sanitary Education: teaching certain techniques so that he can do them
himself (taking medicinal brews, gargling, taking medicine), in order to
improve his health and prevent the illness:
And if the patient can do this, the nurse will teach him how to do
it, taking care to change basins and glasses with cold water...(337).
...and show the patient how to take medicinal brews and how to
gargle and other things that will be said to be carried out, all of which
will occur in many places, so I will not detain here any longer(467).
Advising the patient on the diferent aspects of his illness, stressing the
importance of an appropriate food and drink diet, etc.:
Vigilating the feeding and other things that are administered and
done is so important for all kinds of patients...(450).
...the good rule to follow for these patients is preventative medi-
cine, not giving heavy and salty foods and a lot of wine [advice to the
patient who has gout and sciatica](559).
Relating to community:
Sanitary Education: teaching of hygienic and environmental
methods and public health, (disinfection in case of contagious di-
seases and epidemics, air purifcation, house hygiene, etc.):
58
It is convenient, and necessary and very important, that at this
time [during an epidemic or plague] that there no bad smelling areas,
as bathrooms, fsheries and manuring areas, in cities and towns, con-
vents and houses...;also one must make sure that there are no rotten
fruit and vegetables or dead animals, because all this helps and stren-
gthens the corrupt air...(484).
Do not do anything if, in this occasion of the plague, a wide and
deep pit is not made in that which all kinds of flth is thrown... In the-
se pits, and upon flling them, one must put a layer of lime in powder,
and on top of that, throw all the flth and later cover it with dirt and
another layer of quicklime...(486).
Showing the individual healthy preventative measures and correct
behavior to avoid contacting determined diseases:
Te second advice or warning is for healthy people, advising them
to be very careful not to drink....(642).
c) Function of investigation.
Te importance of investigation and experimentation is stressed
throughout the book. In many of the nursing techniques that Simn L-
pez describes one can see his contributions in form of advice, personal
investigation, etc. His long practice in the nursing feld almost three
decades, permitted him to carry out observations on diferent tests of a
certain technique or material needed to be carried out, for example. Te
author, recognizing this, refects upon it in many parts of the book:
I always experimented and I always do it, when pills must be given,
the easiest way to give them is like the wafers given at mass, and in this
way...(603).
Te vapour of resin is so pernicious that if I had not experimented
with several that I have taken I would not believe it(523).
A great observer and investigator, as has been mentioned, the author com-
bines the conclusions of his personal experience in diferent felds (hydrology,
botany, therapeutics, etc.), applying a scientifc methodology, in todays sense
of the word. One of the various examples that show this is the following ex-
periment carried out by the author and whose objective was to compare and
Treatise for Nurses
59
corroborate the quality of water, in diferent fountains and places (this being an
issue of great importance in therapeutics in the 16th and 17th centuries, due to
its use and application in diferent forms and medical preparations). For doing
this, after boiling the diferent samples, experimenting, and comparing the re-
sults some water weighed more than other water in funcdon with its mineral
and contaminating components... he stated which water contained or not the
quality conditions to which it had been attributed:
Having noted these things, one sets a general rule about these
experiences, and it is that all water that has white little excrements and
weighs less, this is the best of all the water one can experiment with, as
I experimented also, carrying out the same tasks; I have experimented
with some famous fountains, boiling and weighing [the water], as al-
ready mentioned, and I experimented that some did not own up to
their reputation.(616).
Te results of his investigations, practices and conclusions serve to sup-
port the text. In the following examples he points this out:
I have experimented with several ways to feed frenetic patients and I
have not found a better way than that which I have mentioned(347).
To clean the eyes due to discharge, the best remedy I have ex-
perimented with is to use lukewarm water, since this relieves the
pain...(120)
...Some silver or empty can chips as those I have used for many
years are best...[utensils employed by the nurse to clean the ton-
gue](338).
Te cause being known, I try to dispose of things in a diferent
manner, taking the resin out of the room frst (experience is a great
thing, not only to manage like this, but to manage others) [for giving
resin in diferent illnesses](523).
One observes in the book, and in this manner the author himself points
out on the cover, the use of a valid methodology, recognized by the science
of the period (art and Method), and a logical reasoning when carrying out
any Nursing activity or technique. Simn Lpez attempts to justify why
the nurse must carry this out in one way and not in another:
Now let us state the reasons why this should be done in this man-
ner and not in another. Many times I have seen the ignorance of some
who, by their job should know, that I wanted to open their eyes (and
60
not with caustic medicine) to reason, so that they try [the nurses] to do
this as the art and Method of Medicine state [to administer a certain
to the patient](125).
Treatise for Nurses....With the practice of knowing how to apply
medicine ordered by the Doctors, with the best art methods there are
(cover of the book).
I will state the reason why it must be done in this way and not in
another [appropriate technique for administering tonic powders to the
patient](333).
Te reason for putting him like this, is that in this position
hard faeces are lowered to the bowels and therefore the enema enters
without any impediment [the patients posture for administering an
enema](245).
d) Function of management-administration.
Although the function of management-administration is that which
least appears in the book, since the author fundamentally centres on the
other three, and is basically an assisting nurse and not an administrator, he
does not ignore nor discredit the function. Tis is shown by the fact that he
mentions obtaining resources, supervising duties and other diverse aspects:
Obtaining the necessary needs to assist the patient:
And, together with this, a lot of foresight in acquiring the things
that must be given to the patient, so that the work is not badly done
due to the lack of these (Prologue, p. IX).
Te sense of economy, concretely in saving material, medicine, etc.,
is found in the pages of Treatise for Nurses:
...and the things are wasted [when a nurse does not correctly admi-
nister medicine] (333).
I state that for cleaning the patient and saving clothes...(294).
Te function of supervising the work carried out by other professio-
Treatise for Nurses
61
nals is, likewise, a task carried out by the nurse:
In the blood-lettings that are done for brain commotions (gene-
rally serious falls, when the patient lost concience for many hours), I
have seen some of the barbers ignorance, therefore I will also inform
the nurse how this must be done, so that he will not consent to any
other method (210).
Hair must be cut very subltly with scissors and not with a knife, as
I have seen some ignorant people do, due to the attention the knife
and hot water with which it must be washed give, and so, the nurse
must not let the barber cut it in any other way... [cutting hair to apply
a defence to the delirious patient](308).
Te nurses responsibility for receiving food in good condition, for
the patients good, is manifested:
...rams and sheep sick with scabies, mumps or stones and also those
that are in heat, and, fnally, any diseased animal or bird is not only bad, but
poisonous and dangerous and should not be given with a good conscience
and, so, the nurse must be very careful not to receive any of the above men-
tioned for the patient, because it will cause tremendous harm.(283).
Te function of management-administration, within the framework of
the Nurses duty of the 16th and 17th centuries, is shown, for example, in
Nursing carried out by the congregations and orders who devoted them-
selves to this need (Order of San Juan de Dios, Minimum Congregation of
Poor Patients, and others). Tese Institutes administrated their own hos-
pitals and were in charge of everything relating to management (acquiring
resources, accounting, etc.).
3.2.4. Nursing and Medicine in Treatise for Nurses.
Te work of Treatise for Nurses is written in the height of the 17th century,
which is included within the period that historians of Medicine (L. S. Granjel,
History of Medicine. Salamanca, 1975, p. 167) call Modern Medicine and, more
concretely, Baroque. In this century the concepts of illness is elaborated upon,
new scientifc bases are established, surpassing the Galenic tradition. However,
the latters strong infuence is still felt in the frst decades of this century, strongly
maintaining the conception of getting ill and diseases inherited from the past,
as can be seen by the continuous references on the works of the classical doctors
62
Hippocrates, Galen that Simn Lpez makes throughout his book.
In the European sphere, we briefly mention that in this century new
doctrines appear with those that medicine tries to detach itself from
the (grecoarab tradition): iatromechanic and iatrochemical schools, con-
tributing new concepts on disease. In the first, iatromechanic school,
the humoral interpretation of the disease is attempted to be substi-
tuted by a doctrine based on considering the tension state of motive
fibers, a fundamental element in the architecture of the human being;
the Italians are its major representatives. The iatrochemical school in-
terprets disease as a result of disorders caused in fermentation, a ba-
sic biological process of the living organism, its major exhibitor was
Franois dele Boe.
In the Baroque era new bases are formulated in modern Physiology and
Pathology: the Harvey physiology method, microscopic Anatomy of Mal-
pighi, posology principles of Sydenham and Boerhaave, with the frst de-
scription of a bacteria by Leuwenhoek...
Te professor Agustn Albarracn Teuln (Disease in the modern
world, 16th and 17th centuries, in History of Disease, Centre of Studies
Wellcome-Spain. Madrid, 1987, p. 183) afrms that the pathology of the
modern world begins with an attitude difcult to classify, in that which the
respect for the inherited tradition, the keeness for originality and the ver-
ifcation repecting Galen, above all, and Hippocrates and the Arabs them-
selves is combined, permitting one to overlook the errors, omissions and
distortions of these classical doctors. Tis does not mean a complete break
with the past commonplace of the Renaissance, it means initiating a
difcult stage that will consume three centuries throughout those which tra-
ditional pathology begins to be substituted by a new pathology, in whose
elaboration is combined with empiricism and speculative reason.
In our country, the reading of the classics, (Hippocrates, Galen, Avi-
cenna) still essential in medical training, justifes translations and com-
mentaries. Tis is shown in the diferent authors referred to by Simn
Lpez (Valles; Lzaro Gutirrez, the doctor who censured and approved
the work on Nursing; Fragoso and others).
Treatise for Nurses can give us a general vision of Spanish Nursing and
Medicine of the period in that which it was written: in the middle of the
17th century. For this, let us select some references that deal with diferent
aspects of these professionals.
At the end of the 16th and the beginning of the 17th century, the
theories of the classical doctors are still valid concerning animal spirits, as
a vital cause and origen of all movements:
Treatise for Nurses
63
the particular paralysis is when half of the head is paralyzed and an
arm or the tongue is twisted, in which their movement and feeling is
lost due to the humors that prohibit animal spirits from giving feeling
and natural movement to the nerves(538).
Tis theory is shown again when Simn Lpez explains to the nurse the
concept of pulse and how it is taken. Te same, defended by Galen, will
remain valid throughout the whole Middle Ages. As can be seen, medical
concepts are mixed with other philosophical concepts:
Te pulse, according to that defned by the Doctors along with Galen,
is a heart movement and of the arteries that from it are born, consisting
of dilation and compression so that the heat of the heart is joined and the
animal spirits are bred; it is said that the animal spirits are bred because these
are bred from the vital organs, which are animal material(499).
Te theory of the four humors is still found in this century; due to
this, and relating to Cosmogony, the characteristics of the humors that
impregnated all things conformed with the human beings temperament,
distinguishing, therefore, the four types of temperament: sanguine, colic,
phlegmatic and melancoly. According to this, the predominant humor
determines the characteristics of the personality:
Te pulse of the phlegmatic is thick and slow, since its tempera-
ment is cold and humid, for which their operations are slow and thick
and is the worst humor for everything. Te sanguine has a slight or
thin pulse, since the blood is hot, humid and moderate(500).
Te theory of colours, in which the colour infuences the positive res-
oludon of a determined pathology, also appears in the work. Te idea of the
infuence of colour on diseases dates back to ancient times, remaining a pop-
ular belief until practically the present. Placing red cloths or blankets in the
windows or in the bedroom, when a child has the measles, is a custom that
has been maintained until recently in our society. Doctor Michael Hertl,
in his Paediatric Manual for Nurses, when speaking of old customs, says
(p.359): Also by means of colours (red for girls and blue for boys) it was believed
that spirits could be checked. Diseases especially related to these beliefs were
smallpox and measles, as mentioned in the work which concerns us:
Doctor Lzaro, in his censure, stating what should be done in this case,
and is in use in the good rule of medicine, is that the pockmarked patient
64
must look at coloured cloths or blankets, being placed in front and on top
of the patients bed...; the reason for this is left to the wise Doctors.(438).
Te complexity of therapy and medicine, its classifcation into diferent
groups according to its performance mechanisms and the manner of adminis-
tering it, at times is difcult to comprehend, at least for people outside the med-
ical sciences. Te theory of gradation still remains valid, in which four grades
are established, in function with their temperature. Andres Laguna, a doctor
quoted various times in the work, in his translation of Dioscorides, states:
With luck we can say that some of them are hot or cold, dry or
humid, in the frst grade; others in the second; others in the third,
and fnally others in the fourth, which is the highest of all (Medicine
and History. 3.. period. Notebook n.36, p. 8).
Arriving at this point, I remembered a statement of Daza, in his
book On Abcesses, speaking of the quality of resolute medicine and
repellent medicine, how they should be applied, and he says: Re-
pellent medicine, when cold, should be applied cold. Hot medicine
should be applied when hot(26).
Apricots are cold and humid in the second grade and, therefore, are
best for warm stomachs...(802).
Te importance of the knowledge of urine, of its characteristics (colour,
odour, sediment, etc.) for the diagnosis and prognosis of an illness, has been
constant in Medicine since ancient times. Te image of a doctor observing a
recipient with the patients urine, and from which his prognosis will be taken,
is frequent in medieval and renaissance paintings and miniatures. In Treatise for
Nurses a chapter is dedicated, number 108, to defning urine, its characteristics,
in the healthy as well as in the sick, and its pathological translation:
If the urine is the colour of azafran and smells bad, this signifes jaundi-
ce, which is a disease made by cholera and the cause is that....(506).
Te signifcant infuence of disciplines such as astrology and alchemy in
the 17th century is seen in diferent passages:
...because as acute illnesses follow the moons movement, cronic ill-
nesses (which are these) follow the suns movement [quartanas](455).
Some tend to possess this illness [epilepsy] when the moon is grow-
ing, which is a sign, according to Doctors, that comes from a lot of mois-
Treatise for Nurses
65
ture; others get it in the waning of the moon, which is very cold, without
much moisture and, therefore, Doctors call them lunatics(568).
Nursing also fnds itself immersed in this atmosphere in where po-
pular beliefs, scientifc and reasoned methodology, home remedies
some of them cruel as recognized by the author himself, complicated
chemical and medical compounds, new medical theories and the use of
traditional charms are all shared:
Te most popular remedy for getting rid of the coral gout is the
fngernail of the great beast called the elk, shaping it into a ring and
placing it on the ring fnger of the left hand(571).
Perfuming the epileptic with myrrh, if the illness were real, he will
later fall into it...[for distinguishing the real epileptic](572).
If one must apply a small pigeon, the nurse must try to obtain the
kind that fies, because the others are not good for this end, and bring it
to the lodging alive, having already shaven the head...; later take some
scissors and cut well and put the point under the adams apple and
pushing it to the neck, with great speed...(323).
Te religious infuence is felt in all mans activities, fundamentally in Med-
icine. Tis infuence is manifested, above all, in the cases of great epidemics of
the plague, when Medicine does not give efective solutions. In such cases one
resorts to religion, imploring the saints and other celestial bodies.
Te plague, an epidemic disease and scourge to Humanity, had various out-
breaks in the 17th century in the Iberian Peninsula: the frst spread from the
Santander port in 1599, not declining until 1604; the second was prolonged
from 1646 to 1652 and afected wide regions of Analusia, Valencia and Cata-
lonia; the third, from 1676 to 1682, caused tens of thousands of deaths. Not
surprisingly, then, one resorted to prayers. Simn Lpez states in respect:
Devotion to the Virgin Saint in times of the plague, with which
many were liberated. Tis devotion is very authentic, for being of two
learned as well as spriritual men...(481).
...the best remedy that I fnd for the so sudden and atrocious
plague is that which I will now state, which will be the frst remedy,
since we always must begin with spiritual remedies, putting ourselves
in Gods hands, making a good general confession and many acts of
repentance[in case of high plague fever] (480).
66
Tis strong religious infuence is found in the many daily activities: at
work, in language, etc. A prayer (Te Lords Prayer, Te Creed) is emplo-
yed as a measure of time:
...when applying it [the mirror in front of the deceased to confrm
the death] make sure the nose and mouth are clean and doing it several
times for as long as one says Te Lords Prayer...(531).
...nicely spreading the ointment, taking as much time as saying
two Creeds, so that the oils are absorbed... [applying ointment on the
stomach] (52).
Despite the references above, however, we fnd in Simn Lpez a per-
manent concern for teaching the scientifc Medicine of the period, by always
adjusting himself to, let us say ofcial, medical knowledge, attempting to
separate it from witch doctors and people without the appropriate acade-
mic recognition. We often fnd, when describing a technique or pathology,
the use of phrases such as the doctrine of Doctors is... or it is in the good
rule of Medicine...:
Tere is little to say in these diseases, but so that the nurse knows
what to do, it is good to know that it is the doctrine of the Doctors that
in the good rule in these diseases...(559).
And in this manner, to say that they fell is an old wives tale, because
falling or injuring the tailbone is mortal, according to Valverde, in his
Anatomy...(62).
Te preoccupation of a nurse who is well trained and who knows about
diferent subjects, especially those relating to Medicine, is constantly refected in
the whole book. Tis medical knowledge permits him to distinguish the symp-
toms of a disease, its progress and other aspects, and acting in consequence:
So that the nurse can know with more certainty in which days the
patient is apt to sweat, I believe I have mentioned, in order to be careful
when calling upon the Doctor. Te most critical days, in acute illnesses,
are those...(165).
Te signs that appear when they come [smallpox and measles],
according to its seriousness, are restless sleep, itching of the nose, rest-
lessness...(428).
Te common signs that Doctors mention to know if one is dead or
alive, are reduced to four. Te frst is sponged cotton..(531).
Treatise for Nurses
67
Te three major therapeutic mainstays on which Medicine was established
since antiquity were blood-letting, purging and diet. In Treatise for Nurses Simn
Lpez gives a good account of the diet, on the characteristics and composition
of foods, dedicating a whole essay, the eighth, besides numerous references
throughout the work. Te diet, as a therapeutic and preventative method, ac-
companies each one of the pathologies studied in the essay:
On food and drink in this [tifus] disease...(421).
On food and drink in this smallpox and measles disease...(442).
In the dietetic feld, the nurse played a very important role, since he
not only was in charge of preparing and giving food and drink, at times
a very difcult job -in case of frenetic or other problem patients-, but he
also had to prescribe them according to his knowledge and the state of
the patient. Simn Lpez devotes a great number of pages to water, its
chemical-physical characteristics and types, the whole seventh essay; this
can give us an idea of its specifc importance within the diet. Te nurse
is informed on everything concerning water, the diferent ways it can be
prepared, (boiling, infusions, etc.), conservation, manners of adminis-
tering, etc.
Physical exercise is also contemplated as a therapeutic method. When
the nurse carried out a technique or gave a medicine, if it was called for, the
patient was advised to take walks and exercise:
...and if such patients sit up, do exercise after having taken [the
purge]...(596).
Doctors speak of these patients of enemas, to walk or stand up, they
say, and carry out moderate exercise, not to hurt swelled parts...(529).
Within the pathology included in Treatise for Nurses, various chapters are
dedicated to infectious diseases, given their seriousness and consequences.
Te nurse is instructed to carry out the corresponding therapeutic meth-
ods, stressing the importance of preventative measures, in the case of epi-
demics of plague, croup and others:
Tis is a remedy of great importance for the nurse and those that as-
sist such patients, and that they be extremely careful in assisting, so that
the patient is not harmed...[in assisting the patient with croup](463).
Te chapter on fevers and temperatures (simple, double, and tertian, etc.)
also stands out due to its importance, pointing out the role of the nurse when
dealing with these. It is interesting to point out that the nurse must observe the
68
feverish patient, noting the day and hour the temperature comes, for classifying
it, and according to this, keeping it or not (good sweat and bad sweat). Te reso-
lution of the illness depends a great deal on carrying this out.
Te corresponding index which is elaborated and included at the end of the
book ofers a wider range of knowledge on diferent diseases and illnesses of the
period; Simn Lpez points out the nurses role in each one of them.
Some of the therapeutic methods used in this period may appear superf-
cial or lacking in foundation today. Tis was the logical consequence of the
level of knowledge one possessed on sanititary issues and the strong infu-
ence of many traditions and popular beliefs. Tis is seen in the two following
examples: the frst, the advice of Doctor Lzaro, professor of Medicine at
the University of Valladolid, on the importance of the patient taking milk
directly from the animals udders, although this produces a certain aversion;
the second example combines several remedies used to control haemorrhag-
ing, shooting a pistol or arquebus in the place where the patient was found.
Both show the ignorance of Medicine in subjects as contamination due to
the environments air, since everything relative to the existence of germs was
unknown, or the intimate mechanisims of blood clots. But by experience,
it was known that air played an important role in transmitting an illness,
therefore one tried to avoid it and advised sucking the milk directly from the
womans breast or the animal (goat, donkey, cow) and, in the second case,
after shooting a weapon, and when picking up the patient unprepared, a
strong impression was produced, and, the suppression of the haemorrhage
was the immediate consequence. Another method that had the same objec-
tive was that of applying cold wet cloths to sensitive parts of the body, to the
testicles in men and the breasts in women. Such a remedy is based on the
same principle of provoking a vasoconstriction).
Te Doctor Lzaro mentions, in his comments, saying that it is
best that the patient sucks the milk from the udder and, to avoid the
patients aversion and the animals bad odour, oint with aromatic herbs
all disgusting parts of the animal...(380).
...Shooting a pistol or arquebus in the patients room or at the door
without him knowing or seeing tends to be a remedy. If the patient were
in bed, he must not get up, wet some cloths in cold water and apply them
many times to the testicles, and to the breasts for women(509).
Te concern for the the patient is consistent throughout whole book;
this point has already been pointed out. Respect for the patient must pre-
side over all medical and nursing performance. To show this the author
constantly alludes to preserving the patients intimacy when employing a
Treatise for Nurses
69
certain technique:
...So, at all times it is good to have the modesty to avoid corres-
pondence and the discretion that one must keep in such cases [for
changing sheets](176).
When a crippled patient must have a bath, underwear or a towel
should be put on him, for decency...(133).
Concerning the the type of patient, Treatise for Nurses refers to inju-
red patients, nursing babies, young children, women, pregnant women, wo-
men, convalescents (neutral patients), uncontrolled convalescents, hospital
patients, patients of religous communities (convents, monastaries, etc.),
without forgetting healthy people, complying with, as mentioned in the
section on the teaching function, a preventative labour:
...but if it is a baby who is sucking milk, then the wet nurse must be
careful of all the food and drink she takes...[smallpox and measles](442).
If he is healthy, note if he has a good and robust build and, if he is a
baby, child or adult...[for containing the blood in a nosebleed](507).
Abundant medical brews and emolients for communities and hos-
pitals where there are normally patients...(231).
In some uncontrolled convalescents, in diseases as well as in conva-
lescence, the stomach is usually relaxed...(62).
For many causes suppositories are used in medicine, for children
as well as for pregnant women(248).
3.2.5. Final Refections.
As a fnal refection, we fnish this analyis of Treatise for Nurses, a work, we
remember, concluded in the middle of the 17th century, quoting Florence
Nightingale (1820-1910) and her idea on what nursing should be (from
her book Notes on Nursing. What it is and is not. Ediciones Cientfcas y
Tcnicas, S.A., Barcelona, 1991, p.2). At the same time, and with our wish
to recognize the value of Spanish Nursing, we remind the reader of some
of the defnitive points of the concept of Nursing that prevail in Simn
LpezB book, and compare it to that of Nightingale. Te founder of mod-
ern Nursing states the following: I use the word nursing for the lack of
a better term. It has been limited to mean little more than administering
70
medicine and applying poultices. But it should mean the appropriate use
of air, light, heat, cleaning, tranquility and selecting a diet and its admin-
istering, and with the least strain for the patient.
We show a brief comparative outline between both concepts of Nursing:
It has been limited to mean little more than administering medici-
ne and applying poultices -F. Nightingale-.
In efect, both duties, administering medicine and applying poultices,
were carried out by Nursing, refected in Treatise for Nurses, as can be seen
throughout the present introductory study. (Prologue, p. IX) (414).
But it should mean the appropriate use of air, light, heat -E Nightin-
gale.-
It is not less important, for curing the patient, to purify the air, when
it is hot as well as cold, and likewise the patients room must be fresh,
clear and spacious, and one should not start a fre as some want. Te air
must be pure and fresh, which is best for the illness -S. Lopez- (468).
Te cleaning,
Te nurse must be extremely careful, at this time, to sweep the in-
frmaries, lodgings or rooms, wet them with fresh water and afterwards
with water and vinegar...(485).
Cleaning the infrmaries and rooms must be carried out with great
attention, making sure there are no dirty glasses around, which should
always be clean...-S. Lpez-(485).
Te tranquility,
Te third responsibility of the nurse is to make sure there is not
any noise or shouting, because it is very bad for these patients, and espe-
cially wild movements...(357).
...the nurse should approach in silence, from time to time, to check
on the bleeding...(219).
Te nurse should try, when the patient recovers consciousness, to
avoid upsetting him and that others upset him, because this, and sad-
ness, can cause a lot of harm, for which it is good to tell him pleasant
Treatise for Nurses
71
and happy things. Music, among other things, is very favourable...-S.
Lpez-(537).
And selecting the diet and its administering, with the least strain
for the patient -F. Nightingale-.
Te moderation in food and drink, their quality and quantity and
diferent favours helps mans health a lot...(282).
... and, fnally, administer the lunches and dinners with punctu-
ality, craftiness and cleanliness -S. Lpez-(Prologue, p. IX).
In all this an extraordinary similarity is observed between the Nursing
promoted by Florence Nightingale and by Simn Lpez, despite a chrono-
logical diference of more than two centuries between the two. Tis gives us
an incentive to carry out more in depth and continued studies which lead
us to the roots of modern Nursing in Europe.
3.3. Our study and edition.
Starting out a project, especially of a nature of Library of Classics of
Spanish Nursing, always generates uncertainties, doubts and fears. Te ini-
tial planning tends to lead to unforeseen results in the beginning, but it is
the dynamics itself of the investigation that marks the fnished product, in
this case, the shape of the book.
3.3.1. Structure of the book.
Te publication of the frst volume of Library marks, in great lines, the
basic structure of the numbers which will follow, although, logically, always
conditioned by new ideas which can improve the results. In this manner,
the edition of classic texts on Nursing will be structured in:
a) An historical context in where the edited work is inserted.
b) A study on the author and the book.
c) The specification of norms and conventionalisms used in trans-
cribing the text.
d) The edition of the work itself.
e) Indexes of subjects.
72
f ) Glossary (circumstantially, and if the complexity of the text requires it).
With this structure we hope to situate the reader in the historical mo-
ment in that which the work is carried out and ofer the specialist and
researcher several edited texts in their entirety that can be a starting point
for new investigations.
3.3.2. Te edition of the text.
Treatise for Nurses is a a text written in the 17th century; as such, it
possesses a vocabulary and manner of puntualising that do not necessarily
correspond to the norm presently established by the Spanish Royal Aca-
demy of Language, besides lacking accents. Tis makes the reading, at
times, difcult, with its extremely long and unpunctuated paragraphs.
In order to facilitate the reading and understanding we have included
certain modifcations from the original, but always respecting the original
meaning. Essentially, they are the following:
Accenting the words according to the present rule.
Todays punctuation (periods, semi-colons and commas).
Including or transforming some of the spelling that, due to its ab-
sence or diferent form, make the reading difcult (for example
auer in the text, haber of today).
Because this is a manuscript text, one can fnd difculties in bad hand-
writing in certain passages, erase marks and crossing-outs and other de-
fciencies typical of this type of text; still, Simn Lpezs great care has
made the book comprehensible and the text does not present serious pro-
blems for transcribing.
In the same way, the page numeration that Simn Lpez included in
the book has been maintained 846 in total and has been used as a topo-
graphic reference for carrying out our own subject indexes.
As to the rest, we have respected the vocabulary and sentence structures
everywhere possible, in order to ofer the text in its original beauty and
with the least amount of modifcations.
Treatise for Nurses
73
3.3.3. Subject index and Glossary of terms.
Without a doubt, subject indexes constitute a very important tool for
understanding the text in depth. Although its realization is a slow and
arduous task, its value overcomes the difculty, for which we include ex-
tensive indexes at the end of the book, structured into eleven sections. Tey
are constituted by numeric values:
Subject indexes for Treatise for Nurses
Subject Number of entries
Anatomy and Physiology 210
Botany, Terapeutics and Food 934
Nursing duties: Techniques, tasks, care 438
Materials and utensils 351
Pathology 574
Various:
- Ani mal s 105
- Methods 49
- Metals/minerals 24
- Namelist 90
- Professions/felds 41
- Place-names 38
Total: 11 indexes 2,874 entries with
more than 10,000 ref-
erences in total
With these indexes we hope to ofer the most complete outlook of the
content of Treatise for Nurses.
Te book concludes with a Glossary of terms. Te chronological and
74
cultural distance that separates todays reader from that of the 17th cen-
tury is great, therefore a large number of terms and expressions that are not
of recent use appear in the text. Tis fact makes it necessary to include
the Glossary, which will help in understanding certain passages and expla-
nations ofered by Simn Lpez. It includes more than 150 very specifc
and specialized terms which represent Nursing techniques, concepts and
expressions that are not of use or which have changed in their forms.
HANDWRITTEN ILLUSTRATIONS
Treatise for Nurses
77
Index of chapters in this book
78
Preface of the manuscript book. Similarly, targeting nurses, Simn Lpez
said both the need for these professionals as their tasks and functions.
Treatise for Nurses
79
Te ointments are one of the most common remedies used in the ill
treatment in sixteenth and seventeenth centuries.
80
Diferent types and ways in making ointments
Treatise for Nurses
81
Te nurse should know everything about bloodletting,
but he should not practice them
82
How to do the embrocacin,
pouring into the diseased area medicinal substances
Treatise for Nurses
83
Remedies for fevers and contagious diseases
84
Symptoms of any ill shortly before he died,
and it must be known by every good nurse
Treatise for Nurses
85
For administration of purges
86
Te diferent types of water that must be given to sicks
Treatise for Nurses
87
Te last chapter, the eighth, is dedicated to diet and nutrition
89
AUTHORS MOST QUOTED IN THE BOOK
Averroes (Ibn Rushd). Arab philosopher from Cordoba (1126-1198). He stu-
died Philosophy, Law, Physics, Astrology, Mathematics and Medicine. He was
mayor of Seville (around 1169) and of Crdoba. Consulted by Yusuf concer-
ning Aristotles doctrine, he wrote the famous Commentary, in which he ex-
pounded on the nature of material at great length. His philosophical doctrines
were condemned by the University of Paris in 1240, refuted by Saint Tomas
and condemned again by Leon X in 1513. He was also considered one of the
wisest men of his time in Medicine. He wrote a very important treatise, trans-
lated into Latin with the title Colliget. His other works include: Te Book of the
Triaca, Exposition of the seven books of Galen on fevers, etc.
Avicenna. Te most famous of all Arab doctors of the Middle Ege, he was called
Prince of Doctors. His name was Ibn Sina and he was born in Chiraz (Persia)
in 980. Due to his prestige as a doctor he was appointed director of the Great
Hospital of Bagdad. He wrote more than 100 books, but his work par exce-
llence was Canon of Medicine, whose original in Arabic was printed in Rome
in 1593. He wrote on diferent subjects (Philosophy, Teology, Medicine,
Poetry, Geology, etc.). Tis enlightened wiseman died from pleasure abuse in
1037.
Daza Chacon, Dionisio. Born in Valladolid in the beginning of the 16th cen-
tury and it is only known that he died at a very mature age. He was educated
in surgery in Valladolid and in Salamanca, practiced in the army of Emperor
Charles and afterwards in the court of Philip II. He worked in Flanders as a
military surgeon and assisted in the battle of Lepanto. He wrote Practice and
Teory of Surgery in Romance and Latin, whose frst part was published in Va-
lladolid in 1580 and the second part, in the same city, in 1595.
Daz, Francisco. Born in Rioseras (Burgos, Spain) in the second decade of the
16th century, he was a scholar, as Fragoso, in Alcal, where he got his degree
in 1555. He was also Chamber Surgeon from 1570 to 1590, when he died.
His work Compendium of Surgerywas edited in Madrid in 1575 and includes
an anatomic summary and detailed study of the great syndromes of surgery
of the period. His works are completed with several references on clinical me-
dicine, including urology: Compendium of urological surgery and Essay on all
kidney, bladder, fesh of the penis and urine diseases.
90
Dioscorides. Pedanius Dioskurides was born in Anazarbus (Cilicia) in the half
of the frst century. Pharmacist and Greek medical doctor at the service of
the Romans, he was the author of De materia medica, in fve books, known
as Dioscorides, in use up to the Renaissance. Tis work is signifcant for phar-
macology, botany and chemistry, since it includes the description of food and
medicinal products of animal, vegetable and mineral origen. It contains the
study of some 600 plants that he had the opportunity to collect and analyse
in his travels to all parts of the Roman Empire.
Fragoso, Juan. Native of Toledo (Spain), scholar in Alcal and Chamber Surgeon
from 1570 until his death in 1597. He wrote Universal Surgery, edited in
Madrid in 1581. Te work is made up of six books which include a summary
of Anatomy, a clinical description and treatment of tumors and abscesses, in-
juries, ulcers and fractures. He also wrote Glosas, On the nature, qualities and
grades of simple medicine, Declarations that Surgeons must make on diferent
diseases and many forms of deaths, of a medical-legal nature.
Galen, Claudius. Native of Pergamum, born in 130 and died near 210. He was
the most famous doctor of Antiquity after Hippocrates; disciple of Ascrion,
he went to Alexandria where he perfected his knowledge. Afterwards he went
to Rome where he worked as a doctor for the gladiators, using his training of
Osteology and Surgery. He was banished from this city, victim of an unfair
trial; subsequently called upon by Emperor Marco Aurelio to cure a stomach
problem, later to occupy the post of Supreme Doctor of the palace. He was
considered the creator of a new Medicine and as such he was worshipped
throughout the whole Middle Ages. A very prolifc author, he wrote almost
400 works, of which 150 are conserved. He carried out important original
contributions, in the feld of Anatomy as well as in Physiology, such as the
study of diseases and their treatment. He demonstrated the kidneys secretory
function of urine and the mastication and movements of the chest and arms
due to the larynix muscles. Among his works are: Utility of parts and On na-
tural faculties. He considered disease a functional alteration due to an organic
disorder and health as a result of the balance of economy. His principal merit
consists of having created medical philosophy, showing in the last work men-
tioned above the rational base of the art of curing. Other works include: De
constitutione artis administrationibus; De usu partum; De experientia medica,
etc.
Hippocrates. Native of the island of Cos (460?-377 B. C.), he was the greatest
of all doctors of Antiquity, having been called the Father of Medicine. Tis
is explicable partly due to the fact that he was the great compiler of prece-
Treatise for Nurses
91
ding medical knowledge and he set forth Corpus Hippocraticum in an encyclo-
paedic manner. As the son of Herakleides, a doctor, who iniciated him into
Medicine, he travelled throughout Greece. He established himself in Athens
where he practiced the profession for many years until going to Larisa, where
he died in 377 B. C. He wrote many noteworthy works; the most important
and genuine are titled: Treatise on air, water and places; Prognostics; Treatise on
fractures; Treatise on joints, and Aphorisms. During the Middle Ages he was
used as the European Medical banner, or standard, as opposed to that of the
Mahommedan or Jewish. His medical theory is founded on the alterations of
the organisms humors and, although including imaginary concepts, it leads
to a healthy and logical practice of the art of curing.
Laguna, Andres. Born in Segovia (Spain) in 1499 and died when he was 60 years
old. He was one of the most distinguished Spanish doctors of the Renaissan-
ce. He studied in Salamanca and Paris and was appointed at the Court of
Charles I in 1539. Between 1540 and 1545 he practiced in the city of Metz,
later residing in Rome as doctor to the popes Paul III and Julius III. In 1554
he lived in Antwerp, then returned to Segovia one year before his death. He
wrote various versions on Galen: Epitome Omnium Galeni Pergameni Operum
and Life of Galen (Venice). He also wrote Spanish versions of Hippocrates and
Dioscorides, among others. His most celebrated work was Anatomica metho-
dus seu de sectione corpori humano.
Lobera de Avila, Luis. Doctor of Carlos I, among his works Remedies of human
bodies and Silva of experiences (1542) stands out, in which he explains etiopatho-
logy, clinic and treatment of the most known afictions, grouped together, as
was typical of the period, according to a topographic criteria. He expounded
on psychiatric pathology, sterility and its possible causes (Book on health and
sterility administration, 1551), the plague (Book on Curative and Preservative
Assistance, Alcal, 1542), syphilis (Book on the four cortesan diseases, 1544), bo-
tany applied to Medicine (Book on the experiences of Medicine, 1544), hygiene
and dietetics (Noblemens banquet, 1530) and other subjects.
Mesue (Abu-Zacarias Yahiah ben-Masiah). Arab doctor (776?-855), called Te
Elder, frst doctor of the caliph Harum, holding this post throughout the
reign of six caliphs. In his house he founded a sort of Medical Academy and
Mamun put him in charge of reuniting and translating Greek, Syriac and
Persian scientifc and literary works to Arabic since he knew these three lan-
guages. He wrote, among others, the works: Te Great Pandects of Medicine;
General Pharmacopoeia; Treatise on Improving the Race of Sheep, etc. He was
the director of the Bagdad Hospital.
92
Monardes, Nicolas. Native of Seville (Spain) (1493?-1588), naturalist and doc-
tor, he received his doctorate at the University of Alcal de Henares and prac-
ticed for many years in his native city. Without leaving Spain he studied the
natural productions of America, which were sent to him along with references
that he later assembled in a small museum, one of the oldest known, in 1554.
He was well reputed in and outside of Spain, deserving the praise of Pope
Gregory XIII. Linneo, in order to honour his memory, gave the name of mo-
narda to a class of plants. His principal work was titled First, second and third
parts of medicinal history. On the objects brought from our West Indies which
serve in Medicine, in whose Sevillian edition of 1580 includes other essays pu-
blished before; likewise his posthumous work, in three books, is noteworthy:
On various secrets and experiments of medicine.
Pliny. Gaius Plinius Secundus, called Te Elder, was born in Novum Comum
(Como), in the Transpadane Gaul near the year 23 A. D., under the reign of
Tiberius. A tireless worker, Pliny wrote numerous books, but the only one
that has come down to us is his Historia natura/is, an immense compilation
of more than two thousand works. It is dedicated to Tito, son of Vespasiano,
and divided into 37 books. It demonstrates an unlimited patience and labour,
but the natural science it contains is second hand, and the strict style does not
always express the authors thought with clarity. Tis work was widely read in
the Middle Ages and by humanists of the Renaissance, contributing news of
the therapeutic empiricism practiced by the primitive settlers of the Iberian
Peninsula.
Rasis (Razi, Rhazes, Muhamad Ben Zacaria Abu Beck Rasis). Native of Bas-
ra (850?-923?), a celebrated Arab doctor, he practiced in Spain and directed
hospitals in Bagdad and Razi. Te author of two medical encyclopaedias, his
most famous work is Mansury or Liber ad Almansorem, which includes 10
books and is dedicated to Prince Almanzor. After traveling through Egypt,
Tunisia, Algeria and Morocco he reached Spain, entering as a student in the
Hospital of Crdoba. On his return to the Orient, Te Caliph of Bagdad put
him in charge of building a hospital. It is said that, in regard to this assign-
ment, Rasis hung pieces of meat in ther corners of the city, after several days
he examined the scraps and set up the hospital in that district where the meat
had taken the longest time to spoil. He is known for discovering, among other
physiological discoveries, the pupilar refex.
Valverde de Hamusco, Juan. Te principal Spanish anatomist of the Renaissan-
ce. He was born, the date being unknown, in Amusco, province of Palencia.
He carried out his scientifc training in Padua, under the teaching of Realdo
Treatise for Nurses
93
Colombo. In 1556, in Rome, Valverde published his History on the composi-
tion of the human body. Although assigned to the new orientation imposed by
Vesalio on morphological research, one cannot consier the Spanish anatomist
his simple follower; his work is, to a great extent, a result of personal investiga-
tions, in some he discovered several errors and omissions in the Vesalian text.
Valverde earned out disections, anatomopathological fndings and pysiologi-
cal experiences. His castilian language contains many popular expressions, to
those which confer the category of technical terms.
Valles, Francisco. Francisco Valls (1524-1592), another great medical perso-
nality of the century, was born in Covarrubias (Burgos, Spain); he was head
of the department at the Universidad Complutense in 1555. In 1572 he was
appointed Chamber Doctor of Philip II, a post he occupied until his death.
Part of his signifcant work includes his versions on Galen (Claudii Galeni
Pergameni de locis patientibus, Libri sex, cum scholiis, 1551, Galeni ars medici-
nalis commentariis, 1567, Commentaria in libros Galeni de diferentia febrium,
1569), Aristotle (Controversiarum Medicarum ac Philosophicarum Commenta-
ria, 1556, De sacra Philosophia), Hippocrates (Comments on Epidemics), diver-
se clinical subjects (De urinis, pulsibus et febribus, 1556), therapeutics (Metho-
dus medendi, 1589, and Treatise on distilled water, weights and measurements,
1592, directed by Philip II).
95
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Libro - Treatise For Nurses (1651)

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Libro - Treatise For Nurses (1651)

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ste libro electrnico es una parte del trabajo publicado en 1996

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