Book 1:
An Introduction, or Compendious Way to Surgery.

An element is the smallest and simplest portion of which a thing is composed. The four first and simple bodies are called elements: Fire; Air, Water, and Earth, which make up the matter of everything under heaven, mixed perfectly or imperfectly. Such elements are only to be conceived in your mind, being it is not granted to any external sense to handle them in their pure and absolute nature. 

Which was the cause that Hippocrates expressed them not by the names of substances, but of proper qualities, saying, Hot, Cold, Moist, Dry; because every element consists of these four things to varying degrees, as you may understand by Galen in his “Book of Elements”. 

For example, in the Air we observe two qualities: Heat, and Moisture, both principal, and not remitted by the mixture of any contrary quality, for otherwise they are not simple. Therefore you might ask, what hinders that the principal effects of heat show not themselves as well in the Air, as in the Fire? As we said before, although the Air has as great a heat according to his nature, extent and degree, no otherwise than Fire does, yet it is not so great in its active quality. The reason is, because that the calfactory force in the Air is hindered, and dulled by society of his companion and adjoined quality, that is Humidity which abates the force of heat, as on the contrary, dryness quickens it. The elements therefore are endowed with these qualities.

Fire is hot and dry

Air is hot and moist

Water is cold and moist

Earth is cold and dry

These four Elements in the composition of natural bodies retain the qualities they formerly had, but that by their mixture and meeting together of contraries, they are somewhat tempered and abated. But the elements are so mutually mixed one with another, and all with all, that no simple part may be found; no more than how in a mass of Emplaister Diacalcitheos you can show any axungia, oil, or litharge by itself – all things are so confused and united by the power of heat, mixing the smallest particulars with the smallest, and the whole with the whole, in all parts.

You may know and perceive this concretion of the four Elementary substances in one compound body, by the power of mixture, in their dissolution by burning a pile or heap of green wood. For the flame expresses the fire, the smoke the air, the moisture that sweats out at the ends, the water, and the ashes, the earth: you may easily perceive by this example so familiar and obvious to the senses what dissolution is, which is succeeded by the decay of the compound body; on the contrary, you may know that the coagmentation, or uniting and joining into one of the first mixed bodies is such, that there is no part sincere, or without mixture. For if the heat which is predominant in the fire, should remain in the mixture in its perfect vigor, it would consume the rest by its pernicious neighborhood; the like may be said of Coldness, Moisture, and Dryness; although of these qualities, two have the title of Active, that is, Heat, and Coldness, because they are the more powerful; the other two Passive, because they may seem more dull and slow, being compared to the former. The temperaments of all sublunary bodies arise from the commixture of these substances & elementary qualities, which have been the principal cause that moved me to treat of the Elements. 

But I leave the force and effects of the Elementary qualities to some higher contemplation, content to have noted this, that of these first qualities (so called, because they are primarily and naturally in the four humors), others arise and proceed, which are therefore called the second qualities: as of many these, Heaviness, Lightness, variously distributed by the four Elements, as the Heat or Coldness, Moistness or Dryness, have more power over them. For of the Elements, two are called light, because they naturally affect to move upwards: the other two heavy, by reason they are carried downward by their own weight. So we think the fire the lightest, because it holds the highest place of this lower world. The Air, which is next to it in site, we account light. For the water, which lies next to the Air, we judge heavy. And the earth, the center of the rest, we judge to be the heaviest of them all. Hereupon it is, that light bodies, and the light parts in bodies, have most of the lighter elements; as on the contrary heavy bodies have more of the heavier. 

This is a brief description of the Elements of this fragile world, which are only to be discerned of other Elements, as it were arising or flowing from the commixture of the first; for besides these, there are said to be Elements of generation and elements of mans body. Which as they are more corporeal, so also are they more manifest to the sense. By which reason Hippocrates being moved, in his Booke de Natura humana, after he had described the nature of Hot, Cold, Moist and Dry, he comes to take notice of these by the order of composition. Wherefore the Elements of our generation, as also of all creatures which have blood, are seed and menstrual blood. But the Elements of our bodies are the solid and similar parts arising from those elements of generation. Of this kind are bones, membranes, ligaments, veins, arteries, and many other manifest to the eyes, which we will describe at large in our Treatise of Anatomie.