THE
Compleat
Surgeon
:
OR
,
THE
Whole
ART
OF
SURGERY
Explain'd
,
&c.
CHAP.
I.
Of
the
Qualifications
of
a
Surgeon
,
and
of
the
Art
of
Surgery
.
WHO
is
a
Surgeon
?
A
Person
skill'd
in
curing
Diseases
incident
to
Humane
Bodies
by
a
methodical
Application
of
the
Hand
.
What
are
the
Qualifications
of
a
good
Surgeon
in
general
?
They
are
three
in
Number
:
viz.
Skill
in
the
Theory
,
Experience
in
the
Practical
part
,
and
a
gentle
Application
of
the
Hand
.
Why
ought
a
Surgeon
to
be
skilful
?
Because
without
a
discerning
Faculty
he
ca●
have
no
certainty
in
what
he
doth
.
Why
must
he
be
experienc'd
?
Because
Knowledge
alone
doth
not
endue
hi●
with
a
dexterity
of
Hand
requisite
in
such
〈◊〉
Person
,
which
cannot
be
acquir'd
but
by
Experience
,
and
repeated
Manual
Operations
.
Why
must
he
be
tender-handed
?
To
the
End
that
by
fit
Applications
he
ma●
asswage
those
Pains
which
he
is
oblig'd
to
cau●●
his
Patients
to
endure
.
What
is
Chirurgery
or
Surgery
?
It
is
an
Art
which
shews
how
to
cure
th●
Diseases
of
Humane
Bodies
by
a
methodic●●
Manual
Application
.
The
Term
being
deriv●●
from
the
Greek
Word
〈◊〉
〈◊〉
〈◊〉
〈◊〉
〈◊〉
,
signifying
a
Ha●●
and
〈◊〉
〈◊〉
〈◊〉
〈◊〉
〈◊〉
,
a
Work
or
Operation
.
After
how
many
manners
are
Chirurgical
O●●rations
usually
perform'd
?
Four
several
ways
.
Which
be
they
?
I.
Synthesis
,
whereby
the
divided
Parts
〈◊〉
re-united
;
as
in
Wounds
.
II.
Diaeresis
,
t●●
divides
and
separates
those
Parts
,
which
,
〈◊〉
their
Union
,
hinder
the
Cure
of
Diseases
,
s●●●
is
the
continuity
of
Abscesses
or
Impostu●●
which
must
be
open'd
to
let
out
the
pu●●●
lent
Matter
.
III.
Exaeresis
,
which
draws
ou●●●
the
Body
whatsoever
is
noxious
or
hurt●●●
as
Bullets
,
Arrows
,
&c.
IV.
Pros●●●sis
adds
some
Instrument
or
Body
to
sup●●●
the
defect
of
those
that
are
wanting
;
such
are
Artificial
Legs
and
Arms
,
when
the
Natural
ones
are
lost
.
It
also
furnishes
us
with
certain
Instruments
to
help
and
strengthen
weak
Parts
,
such
as
Pessaries
,
which
retain
the
Matrix
in
its
proper
place
when
it
is
fallen
,
Crutches
to
assist
feeble
Persons
in
going
,
&c.
What
ought
to
be
chiefly
observed
before
the
undertaking
an
Operation
?
Four
things
;
viz.
-
1.
What
the
Operation
to
be
perform'd
is
?
-
2.
Why
it
is
perform'd
?
-
3.
Whether
it
be
necessary
or
possible
?
And
-
4.
The
manner
of
performing
it
.
How
may
we
discern
these
?
The
Operation
to
be
perform'd
may
be
known
by
its
Definition
;
that
is
to
say
,
by
explaining
what
it
is
in
it self
:
We
may
discover
whether
it
ought
to
be
done
,
by
examining
whether
the
Distemper
cannot
be
cur'd
otherwise
:
We
may
also
judge
whether
it
be
possible
or
necessary
,
by
a
competent
Knowledge
of
the
Nature
of
the
Disease
,
the
Strength
of
the
Patient
,
and
the
Part
affected
:
Lastly
,
the
manner
of
performing
it
may
be
found
out
,
by
being
well
vers'd
in
the
Practice
of
Surgery
.
What
are
the
Fundamental
Principles
of
Surgery
?
They
are
Three
in
number
:
viz.
-
1.
The
knowledge
of
Man's
Body
.
-
2.
That
of
the
Diseases
which
require
a
Manual
Operation
.
-
3.
That
of
proper
Remedies
and
Helps
upon
every
Occasion
.
How
may
one
attain
to
the
Knowledge
of
Humane
Bodies
?
By
the
study
of
Anatomy
.
How
may
one
learn
to
know
the
Distempers
relating
to
Surgery
,
and
the
Remedies
appropriated
for
them
?
Two
several
ways
;
viz.
-
1.
By
the
reading
of
good
Books
,
and
Instructions
receiv'd
from
able
Masters
of
that
Art
.
-
2.
By
practice
and
the
Observation
of
what
is
perform'd
b●
others
upon
the
Bodies
of
their
Patients
.
What
are
the
Diseases
in
general
that
belong
〈◊〉
Surgery
?
They
are
Tumours
,
Impostumes
,
Wound●
Ulcers
,
Fractures
,
Dislocations
,
and
generall●
all
sorts
of
Distempers
whereto
Manual
Operations
may
be
applyed
.
What
are
the
Instruments
in
general
which
a●
commonly
used
in
Surgery
for
the
curing
of
Diseases
?
They
are
Five
;
viz.
the
Hand
,
Bandages
Medicines
,
the
Incision-Knife
,
and
Fire
.
What
is
the
general
Practice
which
ought
to
be
observ'd
in
the
Application
of
these
different
helps
?
Hippocrates
teacheth
us
,
in
saying
,
that
whe●
Medicines
are
not
sufficient
,
recourse
may
b●
had
to
the
Incision-Knife
,
and
afterward
t●
Fire
;
intimating
that
we
must
proceed
by
degrees
.
Are
there
any
Distempers
that
may
be
cured
〈◊〉
the
Surgeon's
Hand
alone
?
Yes
,
as
when
a
simple
and
small
Dislocation
〈◊〉
only
to
be
reduced
.
CHAP.
II.
Of
Chirurgical
Instruments
,
portable
and
not
portable
.
WHAT
do
you
call
portable
and
not
portable
Instruments
?
Portable
Instruments
are
those
which
the
Surgeon
carries
in
his
Lancet-Case
with
his
Plaister-Box
;
and
not
portable
are
those
that
he
doth
not
carry
about
him
,
but
is
oblig'd
to
keep
at
home
;
the
former
being
appointed
for
the
ready
help
which
he
daily
administers
to
his
Patients
,
and
the
others
for
greater
Operations
.
What
are
the
Instruments
which
a
Surgeon
ought
to
have
in
his
Plaister-Box
?
These
Instruments
are
a
good
pair
of
Sizzers
,
a
Razor
,
an
Incision-Knife
streight
and
crooked
,
a
Spatula
,
a
greater
Lancet
to
open
Impostumes
,
and
lesser
for
letting
Blood
.
They
likewise
carry
separately
in
very
near
Lancet-Cases
,
a
hollow
Probe
made
of
Silver
or
fine
Steel
;
as
also
many
other
Probes
,
streight
,
crooked
,
folding
,
and
of
different
thickness
;
a
Pipe
of
Silver
or
fine
Steel
,
to
convey
the
cauterizing
Button
to
a
remote
Part
,
without
running
the
hazard
of
burning
those
that
are
near
it
;
another
Pipe
or
Tube
serving
instead
of
a
Case
for
Needles
,
which
have
Eyes
at
one
end
for
sowing
;
a
Carlet
,
or
thick
triangular
Needle
;
a
small
File
;
a
Steel
Instrument
to
cleanse
the
Teeth
;
a
Fleam
;
a
pair
of
crooked
Forceps
to
draw
a
Tooth
;
a
Pelican
;
a
Crow's
Bill
;
several
sorts
of
Raspatories
;
a
Hook
to
hold
up
the
Skin
in
cutting
,
&c.
What
are
the
Instruments
which
a
Surgeon
ought
to
keep
in
his
Repository
to
perform
the
greater
Operations
?
Some
of
them
are
peculiar
to
certain
Operations
,
and
others
are
common
to
all
.
The
Instruments
appropriated
to
particular
Operations
,
are
the
Trepan
for
opening
the
Bones
in
the
Head
or
elsewhere
:
The
Catheters
or
Probes
for
Men
and
Women
afflicted
with
the
Stone
,
or
difficulty
of
making
Water
.
Extractors
,
to
lay
hold
on
the
Stone
in
Lithotomy
,
and
to
gather
together
the
Gravel
;
large
crooked
Incision-Knives
,
and
a
Saw
,
to
make
Amputations
of
the
Arms
or
Legs
;
great
Needles
with
three
Edges
,
to
be
used
in
making
Setons
;
small
Needles
to
couch
Cataracts
;
other
Needles
;
thin
Plates
and
Buckles
to
close
a
Hair-Lip
,
&c.
May
not
the
Salvatory
be
reckon'd
among
the
portable
Instruments
?
Yes
,
because
the
Balsams
,
Ointments
,
and
Plaisters
contain'd
therein
,
are
means
whereof
the
Surgeon
makes
use
to
restore
Health
.
CHAP.
III.
Of
Anatomy
in
general
;
and
in
particular
of
all
the
Parts
whereof
the
Humane
Body
is
compos'd
.
WHAT
is
Anatomy
?
It
is
the
Analysis
or
exact
Division
of
all
the
Parts
of
a
Body
,
to
discover
their
Nature
and
Original
.
What
is
requisite
to
be
observ'd
by
a
Surgeon
before
he
goes
about
to
dissect
a
Body
?
Two
things
;
viz.
The
external
Structure
of
the
Body
,
and
the
Proportion
or
Correspondence
between
the
outward
Parts
,
and
those
that
are
within
.
Why
so
?
Because
without
this
exterior
and
general
Knowledge
,
the
Surgeon
wou'd
be
often
mistaken
in
the
Judgment
he
is
to
pass
concerning
a
Dislocation
or
Wound
,
inasmuch
as
it
is
by
the
Deformity
which
he
perceives
in
the
Member
,
that
he
knows
the
Dislocation
,
as
it
is
also
by
the
means
of
the
Correspondence
which
the
outward
Parts
have
with
the
inward
,
that
he
is
enabled
to
draw
any
certain
Consequences
relating
to
a
Wound
,
which
penetrates
into
the
Body
.
What
is
a
Part
?
It
is
that
whereof
the
whole
Body
is
compos'd
,
and
which
partakes
of
a
common
Life
or
Sensation
with
it
.
How
many
sorts
of
Parts
are
there
in
a
Humane
Body
?
We
may
well
reckon
up
Fifteen
distinct
Parts
,
which
are
the
Bone
,
the
Cartilage
,
the
Ligament
,
the
Tendon
,
the
Membrane
,
the
Fibre
,
the
Nerve
,
the
Vein
,
the
Artery
,
the
Flesh
,
the
Fat
,
the
Skin
,
the
Scarf-Skin
,
the
Hair
,
and
the
Nails
.
What
is
a
Bone
?
It
is
the
hardest
and
driest
Part
of
the
whole
Body
,
and
that
which
constitutes
its
principal
Support
.
What
is
a
Cartilage
or
Gristle
?
It
is
a
yielding
and
supple
Part
,
which
partakes
of
the
Nature
of
a
Bone
,
and
is
always
fasten'd
to
its
Extremities
,
to
mollifie
and
facilitate
its
Motion
.
What
is
a
Ligament
?
It
is
a
Membranous
Contexture
usually
sticking
to
the
Bones
to
contain
them
;
as
also
sometimes
to
other
Parts
,
to
suspend
,
and
retain
them
in
their
proper
place
.
What
is
a
Tendon
?
It
is
the
Tail
or
Extremity
of
the
Muscles
,
made
by
the
re-union
of
all
the
Fibres
of
their
Body
,
which
serves
to
corroborate
it
in
its
Action
,
and
to
give
Motion
to
the
Part.
What
is
a
Membrane
?
It
is
a
Nervous
Part
,
the
use
whereof
is
to
adorn
and
secure
the
Cavities
of
the
Body
on
the
inside
,
and
to
wrap
up
or
cover
the
Parts
.
What
is
a
Fibre
?
They
are
fleshy
Lines
of
which
the
Body
of
a
Muscle
is
compos'd
.
What
is
a
Nerve
?
It
is
a
long
,
white
,
and
thin
Body
,
consisting
of
many
Fibres
,
enclos'd
within
a
double
Tunick
,
and
design'd
to
carry
the
Animal
Spirits
into
all
the
Parts
,
to
give
them
Sense
and
Motion
.
What
is
an
Artery
?
It
is
a
Canal
compos'd
of
Four
Coats
,
that
carryeth
with
a
kind
of
Beating
or
Pulse
even
to
the
very
Extremity
of
the
Parts
,
the
Blood
full
of
Spirits
,
which
proceeds
from
the
Heart
,
to
distribute
to
them
at
the
same
time
both
Life
and
Nourishment
.
What
is
a
Vein
?
It
is
a
Canal
made
likewise
of
Four
Tunicles
,
which
receives
the
Arterial
Blood
,
to
carry
it
back
to
the
Heart
.
What
is
Flesh
?
It
is
a
Part
which
is
form'd
of
Blood
thicken'd
by
the
natural
Heat
;
and
that
constitutes
the
Body
of
a
Muscle
.
What
is
Fat
?
It
is
a
soft
Body
made
of
the
Unctuous
and
Sulphurous
part
of
the
Blood
.
What
is
the
Derma
or
Skin
?
It
is
a
Net
compos'd
of
Fibres
,
Veins
,
Arteries
,
Lymphatick
Vessels
and
Nerves
,
which
covers
the
whole
Body
,
to
defend
it
from
the
Injuries
of
the
Air
,
and
to
serve
as
an
universal
Emunctory
:
It
is
very
thin
in
the
Face
,
sticking
close
to
the
Flesh
,
and
is
pierc'd
with
an
infinite
number
of
imperceptible
Pores
,
affording
a
Passage
to
insensible
Transpiration
.
What
is
the
Epiderma
,
or
Scarf-Skin
?
It
is
a
small
fine
Skin
,
transparent
and
insensible
,
having
also
innumerable
Pores
for
the
discharging
of
Sweat
,
and
other
Humours
by
imperceptible
Transpiration
:
It
is
extended
over
the
whole
inner
Skin
,
to
dull
its
too
exquisite
Sense
,
by
covering
the
Extremities
of
the
Nerves
which
are
there
terminated
.
It
also
renders
the
same
Skin
even
and
smooth
,
and
so
contributes
very
much
to
Beauty
.
What
is
the
Hair
?
The
Hairs
are
certain
hollow
Filaments
planted
in
the
Glandules
of
the
Skin
,
from
whence
their
Nourishment
is
deriv'd
.
They
constitute
the
Ornament
of
some
Parts
,
cover
those
which
Modesty
requires
to
be
conceal'd
,
and
defend
others
from
the
injury
of
the
Weather
.
What
is
a
Nail
?
The
Nails
are
a
Continuity
of
the
Skin
harden'd
at
the
end
of
the
Fingers
,
to
strengthen
and
render
them
fit
for
Work
.
CHAP.
IV.
Of
the
general
Division
of
a
Humane
Body
.
HOW
is
the
Humane
Body
divided
before
it
is
dissected
,
in
order
to
Anatomical
Demonstration
?
Some
Anatomists
distinguish
it
into
Similar
and
Dissimilar
Parts
,
appropriating
the
former
Denomination
to
all
the
simple
Parts
of
the
Body
taken
separately
,
as
a
Bone
,
a
Vein
,
a
Nerve
,
&c.
but
they
attribute
the
Name
of
Dissimilar
to
all
those
Members
that
are
compos'd
of
many
Similar
or
Simple
Parts
together
;
such
are
the
Arms
,
Legs
,
Eyes
,
&c.
wherein
are
contain'd
all
at
once
,
Bones
,
Veins
,
Nerves
,
and
other
parts
.
Others
divide
it
into
containing
and
contained
Parts
,
the
former
enclosing
the
others
,
as
the
Skull
includes
the
Brain
,
and
the
Breast
the
Lungs
;
whereas
the
contained
Parts
are
shut
up
within
others
;
as
the
Entrails
within
the
Belly
,
the
Brain
within
the
Skull
,
&c.
Others
again
divide
the
whole
Body
into
Spermatick
and
Sanguineous
Parts
;
the
former
being
those
which
are
made
at
the
time
of
Formation
;
and
the
latter
all
those
that
are
grown
afterward
by
the
Nourishment
of
the
Blood
.
Are
there
not
also
other
Methods
of
dividing
the
Humane
Body
?
Yes
:
Many
Persons
consider
it
as
a
Contexture
of
Bones
,
Flesh
,
Vessels
and
Entrails
,
which
they
explain
in
four
several
Treatises
,
whereof
the
first
is
call'd
Osteology
,
for
the
Bones
;
the
second
Myology
,
for
the
Muscles
;
the
third
Angiology
,
for
the
Veins
,
Arteries
,
and
Nerves
,
which
are
the
Vessels
;
and
the
fourth
Splanchnology
,
for
the
Entrails
.
But
lastly
,
the
most
clear
and
perspicuous
of
all
the
Divisions
of
the
Body
of
Man
,
is
that
which
compares
it
to
a
Tree
,
whereof
the
Trunk
is
the
Body
,
and
the
Branches
are
the
Arms
and
Legs
.
The
Body
is
divided
into
three
Venters
,
or
great
Cavities
,
viz.
the
Upper
,
the
Middle
,
and
the
Lower
,
which
are
the
Head
,
the
Breast
,
and
the
lower
Belly
.
The
Arms
are
distributed
into
the
Arms
properly
so
called
,
the
Elbow
and
Hands
;
and
the
Legs
in
like
manner
into
Thighs
,
Shanks
,
and
Feet
:
The
Hands
being
also
subdivided
into
the
Carpus
or
Wrist
,
Metacarpium
or
Back
of
the
Hand
,
and
the
Fingers
;
as
the
Feet
into
the
Tarsus
,
Metatarsus
,
and
Toes
.
This
Division
is
at
present
follow'd
in
the
Anatomical
Schools
.
CHAP.
V.
Of
the
Skeleton
.
WHY
is
Anatomy
usually
begun
with
the
Demonstration
of
the
Skeleton
,
or
Contexture
of
Bones
?
Because
the
Bones
serve
for
the
Foundation
,
Connexion
,
and
Support
of
all
other
Parts
of
the
Body
.
What
is
the
Skeleton
?
It
is
a
gathering
together
,
or
Conjunction
of
all
the
Bones
of
the
Body
almost
in
their
Natural
Situation
.
From
whence
are
the
principal
differences
of
the
Bones
derived
?
They
are
taken
from
their
Substance
,
Figure
,
Articulation
,
and
Use
.
How
is
all
this
to
be
understood
?
First
then
,
with
respect
to
their
Substance
,
there
are
some
Bones
harder
than
others
;
as
those
of
the
Legs
compared
with
those
of
the
Back-Bone
.
Again
,
in
regard
of
their
Figure
,
some
are
long
,
as
those
of
the
Arm
;
and
others
short
,
as
those
of
the
Metacarpium
.
Some
are
also
broad
,
as
those
of
the
Skull
and
Omoplatae
or
Shoulder-Blades
;
and
others
narrow
,
as
the
Ribbs
.
But
with
respect
to
their
Articulation
,
some
are
joined
by
thick
Heads
,
which
are
received
into
large
Cavities
,
as
the
Huckle-Bones
with
those
of
the
Hips
;
and
others
are
united
by
the
means
of
a
simple
Line
,
as
the
Chin-Bones
.
Lastly
,
with
relation
to
their
Use
;
some
serve
to
support
and
carry
the
whole
Body
,
as
the
Leg-Bones
,
and
others
are
appointed
to
grind
the
Meat
;
as
the
Teeth
;
or
else
to
form
some
Cavity
,
as
the
Skull-Bone
,
and
those
of
the
Ribs
.
What
are
the
Parts
to
be
distinguished
in
the
Bones
?
They
are
the
Body
,
the
Ends
,
the
Heads
,
the
Neck
,
the
Apophyses
,
the
Epiphyses
,
the
Condyli
or
Productions
,
the
Cavities
,
the
Supercilia
or
Lips
,
and
the
Ridges
.
The
Body
is
the
greatest
Part
,
and
the
middle
of
the
Bone
;
the
Ends
are
the
two
Extremities
;
the
Heads
are
the
great
Protuberances
at
the
Extremities
;
the
Neck
is
that
Part
which
lies
immediately
under
the
Head
;
the
Apophyses
or
Processes
are
certain
Bunches
or
Knobs
at
the
Ends
of
the
Bones
,
which
constitute
a
Part
of
them
;
the
Epiphyses
are
Bones
added
to
the
Extremities
of
other
Bones
;
the
Condyli
or
Productions
are
the
small
Elevations
or
Extuberances
of
the
Bones
;
the
Cavities
are
certain
Holes
or
hollow
places
;
the
Supercilia
or
Lips
are
the
Extremities
of
the
Sides
of
a
Cavity
,
which
is
at
the
End
of
a
Bone
;
the
Ridges
are
the
prominent
and
saliant
Parts
in
the
length
of
the
Body
of
the
Bone
.
How
are
the
Bones
join'd
together
?
Two
several
ways
,
viz.
by
Articulation
and
Symphysis
.
How
many
sorts
of
Articulations
are
there
in
the
Bones
?
There
are
generally
two
kinds
,
viz.
Diarthrosis
and
Synarthrosis
.
What
is
Diarthrosis
?
Diarthrosis
is
a
kind
of
Articulation
which
serves
for
sensible
Motions
.
How
many
kinds
of
Diarthroses
,
or
great
Motions
are
there
?
There
are
Three
,
viz.
Enarthrosis
,
Arthrodia
,
and
Ginglymus
.
Enarthrosis
is
a
kind
of
Articulation
which
unites
two
Bones
with
a
great
Head
on
one
side
,
and
a
large
Cavity
on
the
other
;
as
the
Head
of
the
Thigh-Bone
in
the
Cavity
of
the
Ischion
or
Huckle-Bone
.
Arthrodia
is
a
sort
of
Articulation
,
by
the
means
whereof
two
Bones
are
join'd
together
with
a
flat
Head
receiv'd
into
a
Cavity
of
a
small
depth
.
Such
is
the
Head
of
the
Shoulder-Bone
with
the
Cavity
of
the
Omoplata
or
Shoulder-Blade
;
and
that
of
the
Twelfth
Vertebra
of
the
Back
with
the
first
of
the
Loins
.
Ginglymus
is
a
kind
of
Articulation
which
unites
two
Bones
,
each
whereof
hath
at
their
Ends
a
Head
and
a
Cavity
,
whereby
they
both
receive
and
are
received
at
the
same
time
,
such
is
the
Articulation
in
the
Bones
of
the
Elbow
and
the
Vertebrae
.
What
is
Synarthrosis
?
Synarthrosis
being
opposite
to
Diarthrosis
,
is
a
close
or
compacted
Articulation
,
destitute
of
any
sensible
Motion
.
How
many
sorts
of
Synarthroses
,
or
close
Articulations
are
there
?
There
are
Three
,
viz.
Sutura
,
Harmonia
,
and
Gomphosis
.
A
Suture
is
that
which
joins
together
two
Bones
by
a
kind
of
Seam
or
Stitch
,
or
by
a
Connexion
of
their
Extremities
dispos'd
in
form
of
a
Saw
,
the
Teeth
whereof
are
reciprocally
let
one
into
another
:
Such
are
the
Sutures
of
the
Skull-Bones
.
Harmonia
is
the
uniting
of
two
Bones
by
a
simple
Line
;
as
the
Bone
of
the
Cheek
with
that
of
the
Jaw
.
Gomphosis
is
a
kind
of
close
Articulation
,
which
unites
two
Bones
after
the
manner
of
Nails
or
Wooden
Pins
fixt
in
the
Holes
made
to
receive
them
:
Such
is
that
of
the
Teeth
in
their
Sockets
.
What
is
Symphysis
?
Symphysis
is
the
uniting
of
two
Bones
by
the
interposition
of
a
Medium
,
which
ties
them
very
streight
together
,
being
also
threefold
:
Such
is
the
Connexion
of
the
Knee-Pan
or
Whirl-Bone
of
the
Knee
,
and
the
Omoplata
or
Shoulder-Blade
.
Are
not
these
three
kinds
of
Articulations
or
Symphyses
distinguish'd
one
from
another
?
Yes
;
for
tho'
they
are
all
made
by
the
means
of
a
third
Body
intervening
,
which
joins
them
together
;
nevertheless
every
one
of
these
various
Bodies
gives
a
different
Denomination
to
its
respectivé
Articulation
:
Thus
the
Articulation
which
is
caus'd
by
a
Glutinous
and
Cartilaginous
Substance
,
is
properly
call'd
Synchondrosis
;
as
that
of
the
Nose
,
Chin
,
Os
Pubis
,
&c.
But
an
Articulation
which
is
made
by
a
Ligament
is
termed
Synneurosis
,
as
that
of
the
Knee-Pan
.
Lastly
,
that
which
is
wrought
by
the
means
of
Flesh
,
bears
the
Name
of
Syssarcosis
;
as
the
Jaw-Bones
,
the
Os
Hyoides
,
and
the
Omoplata
or
Shoulder-Blade
.
Have
the
Bones
any
sense
of
Feeling
or
Motion
?
They
have
neither
;
for
their
sense
of
Pain
proceeds
from
nothing
else
but
their
Periostium
,
or
the
Membrane
with
which
they
are
cover'd
,
and
their
Motion
is
perform'd
only
by
the
Muscles
that
draw
them
.
Doth
the
Marrow
afford
any
Nutriment
to
the
Bones
?
No
,
all
the
Bones
are
nourish'd
by
the
Blood
,
as
the
other
Parts
;
but
the
Marrow
is
to
the
Bones
what
the
Fat
is
to
the
Flesh
;
that
is
to
say
,
it
is
a
kind
of
Oil
or
Unctuous
Substance
,
which
moistens
,
and
renders
them
less
brittle
.
Are
all
the
Bones
of
the
same
Colour
?
No
,
they
follow
the
Temperament
and
Constitution
of
the
Persons
.
How
many
in
number
are
the
Bones
of
the
Humane
Skeleton
?
There
are
two
hundred
and
fifty
usually
reckon'd
,
viz.
61
in
the
Head
,
67
in
the
Trunk
or
Chest
,
62
in
the
Arms
and
Hands
,
and
60
in
the
Legs
and
Feet
;
but
the
true
Number
cannot
be
exactly
determin'd
,
by
reason
that
some
Persons
have
more
,
and
others
fewer
;
for
some
have
more
Ossa
Sesamoidea
,
Teeth
and
Breast-Bones
than
others
:
Again
,
some
have
many
indentings
in
the
Lambdoidal
Suture
,
and
others
have
none
at
all
.
Can
you
rehearse
the
Number
of
the
Bones
of
the
Head
?
There
are
Fifteen
in
the
Skull
,
and
Forty
six
in
the
Face
.
The
Fifteen
of
the
Skull
are
the
Coronal
for
the
fore-part
of
the
Head
;
the
Occipital
for
the
hinder-part
;
the
two
Parietals
for
the
upper-part
and
each
side
;
the
two
Temporals
for
the
Temples
;
the
Os
Sphenoides
or
Cuneiforme
,
which
closeth
the
Basis
or
bottom
of
the
Skull
;
the
Os
Ethmoides
,
or
Cribriforme
,
situated
at
the
Root
of
the
Nose
;
and
the
four
little
Bones
of
the
Ear
on
each
side
,
viz.
the
Incus
or
Anvil
;
the
Stapes
or
Stirrup
;
the
Malleolus
or
Hammer
;
and
the
Orbiculare
or
Orbicular
Bone
.
Of
the
Forty
six
of
the
Face
,
Twenty
seven
are
counted
in
the
Upper-Jaw
,
viz.
the
two
Zygomatick
,
or
the
two
Bones
of
the
Cheek-Knots
;
the
two
Lachrymal
in
the
great
Corners
of
the
Eyes
toward
the
Nose
;
the
two
Maxillar
,
that
receive
the
Upper-Teeth
,
and
which
form
part
of
the
Palate
of
the
Mouth
,
and
the
Orbits
of
the
Eyes
;
the
two
Bones
of
the
Nose
;
the
two
Palate-Bones
which
are
at
its
end
,
and
behind
the
Nostrils
;
the
last
being
single
is
the
Vomer
,
which
makes
the
Division
of
the
lower
part
of
the
Nostrils
;
and
there
are
generally
Sixteen
Upper-Teeth
.
The
Lower-Jaw
contains
Nineteen
Bones
,
viz.
sixteen
Teeth
;
two
Bones
that
receive
them
;
and
the
Os
Hyoides
,
which
is
single
,
and
fix'd
at
the
Root
of
the
Tongue
.
How
are
the
Teeth
usually
divided
with
respect
to
their
Qualities
?
Into
Incisive
or
Cutters
,
Canine
or
Dog-Teeth
,
and
Molar
or
Grinders
:
There
are
eight
Incisive
,
and
four
Canine
,
which
have
only
one
single
Root
;
as
also
twenty
Molar
,
every
one
whereof
hath
one
,
two
,
or
three
Roots
.
Can
you
recite
the
Number
of
the
Bones
of
the
Trunk
or
Chest
?
There
are
generally
thirty
and
three
in
the
Spine
or
Chine-Bone
of
the
Back
,
viz.
seven
Vertebra's
in
the
Neck
,
twelve
in
the
Back
,
five
in
the
Legs
,
five
,
six
,
and
sometimes
seven
in
the
Os
Sacrum
,
three
or
four
in
the
Coccyx
,
and
two
Cartilages
at
its
end
.
There
are
twenty
nine
in
the
Breast
,
viz.
twenty
four
Ribs
,
two
Clavicles
or
Channel-Bones
,
and
commonly
three
Bones
in
the
Sternum
.
The
Hip-Bones
are
likewise
divided
into
three
,
viz.
Ilion
,
Ischion
,
and
Os
Pubis
.
Do
you
know
the
Number
of
the
Bones
of
the
Arms
?
There
are
thirty
and
one
Bones
in
each
Arm
,
that
is
to
say
,
the
Omoplata
or
Shoulder-Blade
;
the
Humerus
or
Shoulder-Bone
;
the
two
Bones
of
the
Elbow
call'd
Vlna
,
and
Radius
;
eight
little
Bones
in
the
Carpus
or
Wrist
;
five
in
the
Metacarpium
or
Back
of
the
Hand
;
and
fourteen
in
the
Fingers
,
three
to
every
one
except
the
Thumb
,
which
hath
only
two
.
Can
you
give
us
a
List
of
the
Bones
of
the
Leg
in
their
Order
?
There
are
thirty
Bones
in
each
Leg
,
viz.
the
Femur
or
great
Thigh-Bone
,
the
Knee-Pan
or
Whirl-Bone
on
the
top
of
the
Knee
;
the
Tibia
,
greater
Focile
,
or
Shin-Bone
;
and
the
Perone
or
Fibula
,
or
lesser
Focile
,
which
are
the
two
associated
Bones
of
the
Leg
;
seven
little
Bones
in
the
Tarsus
;
five
in
the
Metatarsus
;
and
fourteen
in
the
Toes
;
that
is
to
say
,
three
to
every
one
,
except
the
great
Toe
,
which
hath
only
two
.
Thus
the
Number
of
Bones
of
the
Humane
Skeleton
amounts
to
two
hundred
and
Fifty
,
without
reckoning
the
Sesamoides
,
the
Indentings
of
the
Skull
,
and
some
others
which
are
not
always
to
be
found
.
CHAP.
VI.
Of
Myology
,
or
the
Anatomy
of
the
Muscles
of
a
Humane
Body
.
WHAT
is
a
Muscle
?
It
is
the
principal
Organ
or
Instrument
of
Motion
;
or
it
is
a
Portion
of
Flesh
,
wherein
there
are
Veins
,
Arteries
,
Nerves
,
and
Fibres
,
and
which
is
cover'd
with
a
Membrane
.
How
many
parts
are
there
in
a
Muscle
?
Three
,
viz.
the
Head
,
the
Belly
,
and
the
Tail
:
The
Head
is
that
part
thro'
which
the
Nerve
enters
;
the
Belly
is
the
Body
or
Middle
of
the
Muscle
;
and
the
Tail
is
the
Extremity
,
where
all
the
Fibres
of
the
Muscle
are
terminated
to
make
the
Tendon
or
String
which
is
fasten'd
to
the
Part
whereto
it
gives
Motion
.
Have
all
the
Muscles
their
Fibres
streight
from
the
Head
to
the
Tail
?
No
,
some
have
them
streight
,
others
transverse
,
and
others
oblique
or
circular
,
according
to
the
several
Motions
to
which
they
are
appropriated
.
How
many
sorts
of
Muscles
are
there
with
respect
to
their
Action
?
There
are
two
different
kinds
,
viz.
the
Antagonists
and
the
Congenerate
;
the
former
are
those
that
produce
opposite
Motions
;
as
a
Flexor
and
an
Extensor
,
a
Depressor
and
a
Levator
.
The
Congenerate
are
those
that
contribute
to
one
and
the
same
Action
;
as
when
there
are
two
Flexors
or
two
Extensors
,
and
then
one
supplies
the
defect
of
the
other
;
whereas
when
one
of
the
Antagonist
Muscles
is
cut
,
the
other
becomes
useless
,
and
void
of
Action
.
How
is
the
Action
of
a
Musole
perform'd
?
It
is
done
by
Contraction
and
Extension
;
the
former
causeth
the
Anargonist
to
swell
,
and
the
other
compels
it
to
stretch
forth
in
length
.
What
is
Aponeurosis
?
It
is
the
continuity
of
the
Fibres
of
a
Tendon
which
makes
a
Connexion
that
serves
to
strengthen
the
Muscle
in
its
Motion
.
CHAP
VII
.
Of
the
Myology
,
or
Anatomy
of
the
Muscles
of
the
Head
.
HOW
many
Muscles
are
there
appointed
to
move
the
Head
,
and
which
be
they
?
The
Head
is
mov'd
by
the
means
of
fourteen
Muscles
,
seven
on
each
side
;
of
these
,
two
serve
to
depress
it
,
eight
to
lift
it
up
,
and
four
to
turn
it
round
about
.
The
two
Depressors
are
call'd
Sternoclinomastoidei
;
they
take
their
Rise
in
the
Sternum
,
at
the
Clavicles
,
and
proceed
obliquely
to
join
the
Apophysis
Mastoides
.
Of
the
four
Elevators
on
each
,
side
the
first
is
the
Splenius
,
which
begins
at
the
five
Vertebrae
of
the
Back
and
the
three
lower
ones
of
the
Neck
,
and
ascending
obliquely
,
cleaves
to
the
hinder
part
of
the
Head
.
The
second
,
named
Complexus
or
Trigeminus
,
having
its
beginning
as
the
Splenius
'
,
sticks
in
like
manner
to
the
hinder
part
of
the
Head
,
and
they
form
together
a
figure
resembling
that
of
S.
Andrew's
Cross
.
The
third
is
the
Rectus
Major
,
which
proceeding
from
the
second
Vertebra
of
the
Neck
,
shoots
forward
to
join
the
hinder
part
of
the
Head
.
The
fourth
is
the
Rectus
Minor
,
which
begins
at
the
first
Vertebra
of
the
Neck
,
and
ends
likewise
in
the
hinder
part
of
the
Head
.
The
two
Muscles
on
each
side
,
which
move
the
Head
circularly
,
are
the
Obliquus
Major
and
Minor
;
the
greater
Oblique
taking
its
rise
from
the
second
Vertebra
of
the
Neck
,
goes
to
meet
the
first
;
but
the
lesser
Oblique
hath
its
Origine
in
the
hinder
part
of
the
Head
,
and
proceeds
to
join
the
other
obliquely
in
the
first
Vertebra
.
How
many
Muscles
are
there
in
the
Lower-Jaw
,
and
which
be
they
?
The
Lower-Jaw
hath
twelve
Muscles
which
cause
it
to
move
;
that
is
to
say
,
six
on
each
side
,
whereof
four
serve
to
close
and
two
to
open
it
.
The
first
of
the
Openers
is
the
Latus
which
beginning
at
the
top
of
the
Sternum
,
Clavicle
,
and
Acromion
,
cleaves
on
the
outside
to
the
bottom
of
the
Lower-Jaw-Bone
.
The
second
of
the
Openers
is
the
Digastricus
,
which
takes
its
rise
in
a
Fissure
lying
between
the
Occipital-Bone
and
the
Apophysis
Mastoides
,
from
whence
it
passeth
to
the
bottom
of
the
Chin
on
the
inside
.
The
first
of
the
Shutters
is
the
Crotaphites
or
Temporal
Muscle
,
which
hath
its
Origine
at
the
bottom
,
and
on
the
side
of
the
Os
Coronale
,
the
Os
Parietale
,
and
the
Os
Petrosum
,
from
whence
it
is
extended
till
it
cleaves
to
the
Apophysis
Coronoides
of
the
Lower-Jaw
,
after
having
passed
above
the
Apophysis
of
the
Zygoma
:
Its
Fibres
are
spread
from
the
Circumference
to
the
Center
and
it
is
covered
again
with
the
Pericranium
,
which
renders
its
Wounds
very
dangerous
;
so
that
the
least
Incisions
as
can
be
,
ought
to
be
made
therein
.
The
second
is
the
Pterygoideus
or
Aliformis
Externus
,
whose
rise
is
in
the
Apophysis
Pterygoides
,
from
whence
it
sets
forward
till
it
stick
between
the
Condylus
and
the
Coronal
of
the
Lower-Jaw
.
The
third
is
the
Masseter
,
which
hath
two
Sources
or
Beginnings
,
and
as
many
Insertions
;
the
first
Source
thereof
is
at
the
Cheek-Knot
or
Ball
of
the
Cheek
,
and
the
second
at
the
lower
part
of
the
Zygoma
.
The
first
Insertion
is
at
the
outer
Corner
of
the
Jaw
,
and
the
second
in
the
middle
part
,
by
that
means
forming
the
Figure
of
the
Letter
X.
The
fourth
is
the
Pterygoideus
or
Aliformis
Internus
,
which
hath
its
beginning
in
the
Apophysis
Pterygoides
,
and
is
terminated
in
the
inner
Corner
of
the
Jaw
;
so
that
Mastication
or
Chewing
is
perform'd
by
the
means
of
these
four
Muscles
.
How
many
Muscles
are
there
in
the
Face
,
and
which
be
they
?
There
are
two
for
the
Forehead
,
call'd
Frontal
,
whose
Origine
is
in
the
upper
part
of
the
Head
,
from
whence
they
descend
by
streight
Fibres
,
until
they
are
fasten'd
in
the
Skin
of
the
Forehead
near
the
Eye-Brows
,
where
they
are
re-united
:
Their
Action
or
Office
is
to
draw
the
Skin
of
the
Forehead
upward
,
whereto
they
stick
very
close
.
There
are
also
two
others
call'd
Occipital
,
which
have
their
Beginning
in
the
same
place
with
the
preceeding
,
but
they
descend
backward
,
and
cleave
to
the
Skin
of
the
hinder
part
of
the
Head
,
which
they
draw
upward
.
There
are
two
Muscles
to
each
Eye-Lid
,
one
whereof
is
termed
the
Attoll●ns
or
Elevator
and
the
other
the
Depressor
.
The
Elevator
takes
its
rise
in
the
bottom
of
the
Orbit
of
the
Eye
,
and
is
fastned
by
a
large
Aponeurosis
to
the
edge
of
the
upper
Eye-Lid
.
The
Shutter
or
Depressor
,
call'd
also
the
Orbicular
,
hath
its
Origine
in
the
great
Canthus
,
or
Corner
of
the
Eye
,
passeth
over
the
Eye-Lid
upward
,
and
is
join'd
to
the
lesser
Corner
of
the
same
Eye
,
being
extended
along
its
whole
Compass
.
The
Eyes
have
each
six
Muscles
,
viz.
four
Recti
and
two
Obliqui
;
the
Recti
,
or
streight
Muscles
are
the
Elevator
,
the
Depressor
,
the
Adductor
,
and
the
Abductor
.
The
first
of
these
call'd
Elevator
,
or
Superbus
,
draws
the
Eye
upward
,
as
it
is
pull'd
downward
by
the
Depressor
or
Humilis
;
the
Adductor
or
Bibitorius
draws
it
toward
the
Nose
,
and
the
Abductor
or
Indignarorius
toward
the
Shoulder
:
All
these
small
Muscles
have
their
Originals
and
Insertions
in
the
bottom
of
the
Orbit
through
which
the
Optick
Nerve
passeth
,
and
are
terminated
in
the
Corneous
Tunicle
,
by
a
very
large
Tendon
.
The
first
of
the
Oblique
ones
is
term'd
the
Obliquus
Major
,
and
the
other
Obliquus
Minor
,
because
they
draw
the
Eye
obliquely
.
These
Muscles
cause
Children
to
squint
when
they
do
not
act
together
.
The
Obliquus
Minor
is
fasten'd
to
the
outward
part
of
the
Orbit
near
the
great
Corner
,
and
draws
the
Eye
obliquely
toward
the
Nose
:
But
the
Obliquus
Major
is
fixt
in
the
inner
part
of
the
Orbit
,
and
ascends
along
the
Bone
to
the
upper
part
of
the
great
Corner
,
where
its
Tendon
passeth
thro'
a
small
Cartilage
nam'd
Trochlea
,
and
is
inserted
in
the
little
Corner
with
the
lesser
Obliquus
Minor
,
to
draw
the
Eye
obliquely
toward
the
lesser
Corner
.
The
Ear
,
altho'
not
usually
endu'd
with
any
sensible
Motion
,
nevertheless
hath
four
Muscles
,
viz.
one
above
,
and
three
behind
;
the
first
being
situated
over
the
Temporal
,
and
fasten'd
to
the
Ear
to
draw
it
upward
:
The
three
others
have
their
beginning
in
the
Mammillary
Apophysis
,
and
are
terminated
in
the
Root
of
the
Ear
,
to
draw
it
backward
.
There
are
also
three
Muscles
in
the
inner
part
of
the
Ear
,
whereof
the
external
belonging
to
the
Malleus
or
Hammer
lies
under
the
exterior
part
of
the
Bony
Passage
which
reacheth
from
the
Ear
to
the
Palate
of
the
Mouth
,
being
fixt
in
a
very
oblique
Sinuosity
which
is
made
immediately
above
the
Bone
that
bears
the
Furrow
,
into
which
is
let
the
Skin
of
the
Tympanum
or
Drum
.
The
internal
Muscle
lies
hid
in
a
Bony
Semi-Canal
,
in
the
Os
Petrosum
;
one
part
of
which
Semi-Canal
is
without
the
Drum
,
and
clos'd
on
the
top
with
a
Passage
that
leads
from
the
Ear
into
the
Palate
.
But
the
other
part
within
the
Drum
advanceth
to
the
Fenestra
Ovalis
,
and
is
inserted
in
the
hinder
part
of
the
Handle
of
the
Malleus
.
The
Muscle
of
the
Stapes
or
Stirrup
is
also
hid
in
a
Bony
Tube
,
almost
at
the
bottom
of
the
Drum
,
and
fixt
in
the
Head
of
the
Stapes
.
The
Nose
hath
seven
Muscles
,
that
is
to
say
,
one
common
and
six
proper
;
the
common
constitutes
part
of
the
orbicular
Muscle
of
the
Lips
,
and
draws
the
Nose
downward
with
the
Lip
.
Of
the
six
proper
Muscles
of
the
Nose
,
four
serve
to
dilate
it
,
being
situated
on
the
outside
,
and
two
to
contract
it
,
which
are
placed
in
the
inside
.
The
two
first
Dilatators
of
a
Pyramidal
Figure
,
take
their
rise
in
the
Suture
of
the
Forehead
,
and
are
fasten'd
by
a
large
Filament
to
the
Alae
of
the
Nose
.
The
two
other
Dilatators
resembling
a
Myrtle-Leaf
have
their
Source
in
the
Bone
of
the
Nose
,
and
are
inserted
in
the
middle
of
the
Ala.
The
two
Restrictors
are
Membranous
,
beginning
in
the
internal
part
of
the
Bone
of
the
Nose
and
adhering
to
the
inner
Ala
of
the
Nostril
.
The
Lips
have
thirteen
Muscles
,
viz.
eight
proper
,
and
five
common
:
Of
the
proper
there
ar●
four
for
the
Upper-Lip
,
and
as
many
for
the●
Lower
;
with
two
common
for
each
,
and
th●
odd
one
.
The
first
of
the
proper
of
the
Upper-Lip●
bears
the
Name
of
the
Incisivus
,
its
Origine
being
in
the
Jaw
,
in
the
place
of
the
Incisive
Teeth
and
its
Insertion
is
in
the
Upper-Lip
.
The
second
is
the
Triangularis
,
Antagonist
t●
the
former
;
its
Rise
is
on
the
outside
,
at
th●
bottom
of
the
Lower-Jaw
;
and
it
is
implanted
in
the
Upper-Lip
,
near
the
Corner
of
the
Mouth
.
The
third
being
the
Quadratus
,
springs
fro●
the
bottom
of
the
Chin
before
,
and
cleav●
to
the
edge
of
the
Lower-Lip
.
The
fourth
is
the
Caninus
,
Antagonist
to
th●
Quadratus
,
beginning
in
the
Upper-Jaw-Bo●●
and
being
terminated
in
the
Lower-Lip
near
t●●
Corner
of
the
Mouth
.
The
first
of
the
common
is
the
Zygoma●cus
,
the
Origine
whereof
is
in
the
Zygoma
,
a●
its
Insertion
in
the
Corner
of
the
Mouth
,
〈◊〉
draw
it
toward
the
Ears
;
so
that
it
is
th●
Muscle
which
acts
when
we
laugh
.
The
second
of
the
common
is
the
Buccina●
or
Trumpeter
,
which
is
swell'd
when
one
sounds
Trumpet
.
It
hath
its
rise
at
the
Root
of
〈◊〉
Molar
Teeth
of
both
the
Jaws
,
and
is
extend●
quite
round
about
the
Lips
.
The
odd
Muscle
,
or
the
thirteenth
in
number
,
is
the
Orbicular
,
which
makes
a
Sphincter
round
about
the
Lips
to
close
or
shut
them
up
.
The
Wula
or
Palate
of
the
Mouth
hath
four
Muscles
,
whereof
the
two
first
are
the
Peristaphylini
Externi
,
taking
their
rise
from
the
Upper-Jaw
,
above
the
last
Molar
Tooth
,
and
being
ty'd
to
the
Palate
by
a
thin
T●●don
.
The
two
others
are
the
Peri●●phy●ini
Interni
,
which
have
their
beginning
in
the
Apophysis
Pterygoides
on
the
inside
,
and
likewise
●●ck
〈◊〉
th●
Palate
.
The
Tongue
,
altho'
all
over
Musculous
and
Fibrous
,
yet
doth
not
cease
to
have
its
peculi●●
Muscles
,
which
are
eight
in
Number
.
The
first
of
these
is
call'd
Genioglossus
,
taking
its
rise
in
the
lower
part
of
the
Chin
,
from
whence
it
is
extended
till
it
cleave
to
the
Root
of
the
Tongue
before
,
to
cause
it
to
go
out
of
the
Mouth
.
The
second
is
term'd
Styloglossus
,
its
Rise
being
in
the
Apophysis
Styloides
,
from
whence
it
passeth
to
the
side
above
the
Tongue
,
to
lift
it
up
.
The
third
bearing
the
Name
of
Basiglossus
,
commenceth
in
the
Basis
or
Root
of
the
Os
Hyoides
,
and
thence
insinuates
it self
into
the
Root
of
the
Tongue
,
to
draw
it
back
to
the
bottom
of
the
Mouth
.
The
fourth
is
the
Ceratoglossus
,
deriving
its
Original
from
the
Horn
of
the
Os
Hyoides
,
and
cleaving
to
the
side
of
the
Tongue
to
draw
it
on
one
side
:
The
Action
of
these
Muscles
of
both
sides
together
,
causeth
an
Orbicular
Motion
in
the
Tongue
.
To
these
some
add
a
fifth
Pair
of
Muscles
,
call'd
Myloglossus
,
which
serves
to
draw
it
obliquely
upward
.
What
is
the
Action
of
the
Os
Hyoides
in
the
Throat
,
and
how
many
Muscles
hath
it
?
The
use
of
the
Os
Hyoides
is
to
consolidate
the
Root
of
the
Tongue
;
and
it
hath
five
Muscles
on
each
side
,
which
keep
it
as
it
were
hung
up
.
The
first
of
these
,
call'd
the
Geniohyoideus
hath
its
beginning
in
the
Chin
on
the
inside
,
and
adheres
to
the
top
of
the
Os
Hyoides
,
which
it
draws
upward
.
The
second
is
the
Mylohyoideus
,
whose
Origine
is
in
the
inner
side
of
the
Jaw
,
from
whence
i●
cleaves
side-ways
to
the
Root
of
the
Os
Hyoides
,
which
it
draws
upward
,
and
to
one
side
.
The
third
is
the
Stylohyoideus
,
which
after
it
hath
taken
its
rise
in
the
Apophysis
Styloides
,
is
fasten'd
to
the
Horn
of
the
Os
Hyoides
,
to
draw
it
toward
the
side
.
The
fourth
is
the
Coracohyoideus
,
which
springing
up
from
the
Apophysis
Coracoides
of
the
Omoplata
,
cleaves
to
the
Root
and
side
of
the
Os
Hyoides
,
to
draw
it
downward
and
to
the
side
.
The
fifth
is
the
Sternomohyoideus
,
that
hath
its
beginning
in
the
Bone
of
the
Sternum
on
the
inside
and
is
inserted
in
the
Root
of
the
Os
Hyoides
,
which
it
draws
downward
.
How
many
Muscles
hath
the
Larynx
?
There
are
fourteen
,
viz.
four
Common
,
and
ten
Proper
.
The
first
Pair
of
the
Common
is
the
Sternothyroideus
or
Bronchycus
,
which
proceeding
from
the
inside
,
and
the
top
of
the
Sternum
,
ascends
along
the
Cartilages
of
the
Wind-Pipe
,
and
is
terminated
in
the
bottom
of
the
Scutiformis
or
Buckler-like
Cartilage
,
which
it
draws
downward
.
The
second
is
the
Hyothyroideus
,
which
ariseth
from
the
Root
of
the
Os
Hyoides
,
and
is
inserted
in
that
of
the
Scutiforme
.
This
Muscle
serves
to
lift
up
the
Larynx
,
as
also
to
dilate
the
bottom
of
the
Scutiformis
,
and
to
close
its
top
.
The
first
Pair
of
the
Proper
is
the
Cricothyroideus
Anticus
,
which
deriving
its
Original
from
the
hinder
and
upper
part
of
the
Cricoides
,
or
Ring-like
Cartilage
,
is
fixt
in
the
upper
and
lateral
part
of
the
Scutiformis
,
to
close
or
shut
it
up
.
The
second
is
the
Thyroides
.
The
third
is
the
Crioarytenoideus
Lateralis
,
which
proceeds
from
the
side
of
the
Cricoides
within
,
and
is
fasten'd
to
the
bottom
and
side
of
the
Arytenoides
,
which
it
removes
to
dilate
the
Mouth
of
the
Larynx
.
The
fourth
is
the
Thyroarytenoideus
,
which
arirising
from
the
fore-part
on
the
inside
of
the
Scutiformis
,
is
terminated
on
the
side
of
the
Arytenoides
,
to
close
the
Orifice
of
the
Larynx
.
The
fifth
is
the
Arytenoideus
,
which
having
its
Source
in
that
place
where
the
Cricoides
is
united
to
the
Arytenoides
is
inserted
in
its
upper
and
lateral
part
,
to
close
the
Larynx
.
How
many
Muscles
hath
the
Pharynx
?
It
hath
seven
,
the
first
whereof
is
the
Oesophagieus
,
which
takes
its
rise
from
the
side
of
the
Scutiformis
or
Buckler-like
Cartilage
,
and
passing
behind
the
Oesophagus
or
Gullet
,
is
fasten'd
to
the
other
side
of
the
Cartilage
.
It
thrusts
the
Meat
down
by
locking
up
the
Pharynx
as
a
Sphincter
.
The
second
named
Stylopharingaeus
,
springs
from
within
the
Acute
Apophysis
of
the
Os
Sphenoides
,
or
Cuneiforme
,
and
is
inserted
obliquely
in
the
side
of
the
Pharynx
,
which
it
dilates
by
drawing
it
upward
.
The
third
,
call'd
Sphenopharyngaeus
,
proceed●
from
the
Apophysis
Styliformis
,
and
is
terminate●
in
the
side
of
the
Pharynx
,
which
it
dilates
by
drawing
its
sides
.
The
fourth
Pair
is
the
Cephalopharyngaem
.
which
ariseth
from
the
articulation
of
the.
Head
with
the
first
Vertebra
,
and
closeth
the
Larynx
.
How
many
Muscles
are
there
in
the
Neck
,
a●●
which
be
they
?
There
are
four
Muscles
in
the
Neck
〈◊〉
each
side
,
viz.
two
Flexors
,
and
two
Exte●sors
.
The
Flexors
are
the
Scalenus
and
th●
Rectus
or
Longus
;
and
the
Extenders
are
th●
Spinatus
and
the
Transversalis
.
The
Scalenu
or
Triangularis
hath
two
remo●
Sources
,
viz.
one
in
the
first
Rib
,
and
the
oth●●
in
the
Clavicle
,
and
is
fasten'd
to
the
third
an●
fourth
Vertebra
of
the
Neck
.
The
Rectus
or
Longus
begins
in
the
side
of
th●●
four
upper
Vertebra's
of
the
Back
,
and
is
join●●
to
the
upper
Vertebra's
of
the
Neck
,
and
the
hinder
part
of
the
Head
.
The
Spinatus
hath
its
Origine
in
the
fourth
an
fifth
upper
Vertebra's
of
the
Back
,
and
is
fasten●
to
all
the
six
lower
Vertebra's
of
the
Neck
.
The
Transversalis
springs
forth
out
of
the
upp●●
Vertebra's
of
the
Back
,
and
cleaves
to
the
Ext●●mity
of
the
four
Vertebra's
of
the
Neck
.
CHAP.
VIII
.
Of
the
Myology
or
Anatomy
of
the
Muscles
of
the
Chest
;
or
of
the
Breast
Belly
,
and
Back
.
HOW
many
Muscles
are
there
in
the
Breast
,
and
which
be
they
?
The
Breast
hath
fifty
seven
Muscles
,
that
is
to
say
,
thirty
that
serve
to
dilate
it
,
twenty
six
whose
Office
is
to
contract
it
,
and
the
Diaphragm
or
Midriff
,
which
partakes
of
both
Actions
.
The
thirty
which
dilate
the
Breast
are
equally
plac'd
to
the
number
of
Fifteen
,
viz.
the
Subelavius
,
the
Serratus
Major
Anticus
,
the
two
Serrati
Postici
,
and
the
eleven
external
Intercostals
.
The
twenty
six
which
contract
the
Breast
are
likewise
equally
rank'd
to
the
Number
of
thirteen
on
each
side
,
viz.
the
Triangularis
,
the
Sacrolumbus
,
and
eleven
internal
Intercostals
.
The
Subclavian
takes
up
the
whole
space
between
the
Clavicle
and
the
first
Rib
:
It
s
Original
being
in
the
internal
and
lower
part
of
the
Clavicula
,
and
its
insertion
in
the
upper
part
of
the
first
Rib.
The
Serratus
Major
is
a
large
Muscle
having
seven
or
eight
Indentings
or
Jaggs
.
It
takes
its
rise
in
the
interior
Basis
of
the
Omoplata
or
Shoulder-Blade
,
and
its
Jaggings
are
inserted
in
the
five
lower
true
Ribs
,
as
also
in
the
two
upper
spurious
Ribs
.
The
Serratus
Posticus
Superior
,
begins
wi●●
a
large
Aponeurosis
in
the
Apophyses
of
the
th●●
lower
Vertebrae
of
the
Neck
,
and
of
the
first
〈◊〉
those
of
the
Back
;
then
passing
under
the
Rhomboid
,
it
is
join'd
obliquely
by
four
Indentings
〈◊〉
the
four
upper
Ribs
.
The
Serratus
Posticus
Inferior
,
commence●
in
like
manner
with
a
large
Aponeurosis
in
the
Apophyses
of
the
three
lower
Vertebra's
of
the
Back
,
and
of
the
first
of
those
of
the
Loins
,
an●
is
afterwards
fasten'd
by
four
Digitations
to
th●
four
lower
Ribs
.
The
eleven
External
Intercostal
Muscles
are
situated
in
the
spaces
between
the
twelve
Ribs
passing
obliquely
and
on
the
outside
from
the
bad
part
to
the
fore
part
.
They
take
their
rise
below
the
Upper
Rib
,
and
have
their
Insertion
above
the
lower
Rib.
The
Triangularis
is
the
first
of
those
that
contract
the
Breast
,
and
possesseth
the
inward
part
of
the
Sternum
:
It
s
Original
is
in
its
lower
part
and
its
Insertion
in
the
top
of
the
Cartilages
of
the
two
upper
Ribs
.
The
Sacrolumbus
hath
its
Source
in
the
hinder
part
of
the
Os
Sacrum
,
as
also
in
the
Vertebra's
of
the
Loins
,
and
ascending
from
thence
,
insinuates
it self
into
the
hinder
part
of
the
Ribs
to
every
one
of
which
it
imparts
two
Tendons
one
whereof
sticks
on
the
outside
,
and
the
other
on
the
inside
.
This
Muscle
is
fleshy
within
,
and
fibrous
without
.
The
Eleven
Internal
Intercostals
,
contrary
to
the
External
,
derive
their
Original
from
the
top
of
every
lower
Rib
,
and
ascend
obliquely
from
the
back-part
to
the
fore-part
,
till
they
are
join'd
to
the
lower
Lip
of
every
upper
Rib
:
Thus
these
Internal
Muscles
,
with
the
External
,
form
,
by
the
opposition
of
their
Fibres
,
a
Figure
resembling
a
Burgundian
Cross
.
The
Diaphragm
or
Midriff
is
esteem'd
as
the
fifty
seventh
Muscle
of
the
Breast
,
and
serves
as
well
for
its
dilatation
as
contraction
.
It
separates
the
Thorax
or
Chest
from
the
lower
Belly
,
and
is
tied
circularly
to
all
the
Extremities
of
the
Bastard
Ribs
,
immediately
under
the
Xiphoides
,
or
Sword-like
Cartilage
.
Modern
Anatomists
have
discover'd
that
the
Diaphragm
is
compos'd
of
two
Muscles
,
viz.
one
Upper
,
and
the
other
Lower
;
so
that
the
Upper
cleaves
to
the
Extremities
of
the
Spurious
Ribs
,
and
is
terminated
in
a
flat
Tendon
in
the
middle
,
which
hath
been
always
taken
for
its
Nervous
part
.
The
Lower
begins
with
two
Productions
,
the
longest
whereof
being
on
the
right
side
,
ariseth
from
the
three
upper
Vertebra's
of
the
Loins
,
and
the
other
on
the
Left
from
the
two
Vertebra's
of
the
Back
,
till
it
is
lost
in
the
Aponeurosis
of
the
Upper
Muscle
.
How
many
Muscles
are
there
in
the
Back
and
the
Loins
,
and
which
be
they
?
There
are
three
in
each
side
,
viz.
one
for
Flection
,
and
the
other
for
Extension
.
The
Triangularis
is
the
Flexor
,
taking
its
rise
in
the
hinder
part
of
the
Rib
of
the
Os
Ilion
,
and
the
inner
part
of
the
Os
Sacrum
,
in
passing
from
whence
it
is
joined
to
the
last
of
the
Bastard
Ribs
,
and
to
the
transverse
Productions
of
the
Vertebra's
of
the
Loins
.
The
Extensors
are
the
Sacer
,
and
the
Semispinatus
,
which
make
the
Waste
streight
,
and
are
so
interwoven
along
the
Back-Bone
,
that
one
would
imagine
that
there
were
as
many
Pairs
of
Muscles
as
Vertebra's
,
affording
Tendons
to
all
.
The
Sacer
springs
from
behind
the
Os
Sacrum
,
as
also
from
the
hinder
and
upper
Extremity
of
the
Os
Ilium
,
and
is
inserted
in
the
Spines
of
the
Vertebra's
of
the
Loins
and
Back
.
The
Semi-spinatus
hath
its
Source
in
the
Spines
of
the
Os
Sacrum
,
and
is
join'd
to
all
the
transverse
Productions
of
the
Vertebra's
from
the
Back
to
the
Neck
,
being
exactly
situated
between
the
Sacer
and
the
Sacrolumbus
CHAP.
IX
.
Of
the
Myology
,
or
Anatomy
of
the
Muscles
of
the
lower
Belly
.
HOW
many
Muscles
are
there
in
the
lower
Belly
,
and
which
be
they
?
There
are
generally
ten
,
five
on
each
side
,
that
is
to
say
,
two
Obliqui
,
one
ascending
,
and
the
other
descending
;
one
Transversus
,
one
Rectus
,
and
two
Pyramidal
,
of
which
last
,
nevertheless
,
there
is
sometimes
only
one
,
and
sometimes
none
at
all
.
The
Obliquus
Descendens
,
which
is
the
first
,
hath
its
Original
by
digitation
in
the
sixth
and
seventh
of
the
true
Ribs
,
in
all
the
spurious
Ribs
,
and
in
the
transverse
Apophyses
of
the
Vertebra's
of
the
Loins
,
and
comes
near
to
the
Serratus
Major
Anticus
of
the
Breast
;
from
whence
it
proceeds
to
the
external
Rib
of
the
Os
Ilion
,
and
is
terminated
by
a
large
Aponeurosis
in
the
Linea
Alba
or
White
Line
,
which
separates
the
Muscles
that
are
on
each
side
of
the
Abdomen
or
lower
Belly
.
The
Obliquus
Ascendens
ariseth
from
its
Source
in
the
upper
part
of
the
Os
Pubis
,
and
in
the
Ridge
of
the
Hip-Bone
,
till
it
cleaves
to
the
Apophyses
of
the
Vertebra's
of
the
Loins
in
the
Extremities
of
all
the
Ribs
,
and
in
the
Xiphoides
or
Sword-like
Cartilage
,
and
is
terminated
in
the
White
Line
by
a
large
Aponeurosis
.
The
Rectus
being
situated
between
the
Aponeuroses
of
the
Obliquus
,
takes
its
rise
in
the
Cartilages
of
the
Ribs
,
in
the
Xiphoides
and
the
Sternum
,
and
enters
into
the
Os
Pubis
,
having
many
nervous
parts
to
corroborate
it
in
its
length
.
The
Transversus
having
its
beginning
in
the
transverse
Apophyses
of
the
Vertebra's
of
the
Loins
,
is
fasten'd
to
the
internal
Rib
of
the
Os
Ilium
,
and
within
the
Cartilages
of
the
lower
Ribs
,
and
is
terminated
by
a
large
Aponeurosis
in
the
Linea
Alba
,
passing
over
the
Re●lus
,
and
sticking
to
the
Peritonaeum
.
The
Oblique
Muscles
,
and
the
Transverse
,
have
Holes
toward
the
Groin
,
to
give
Passage
to
the
Spermatick
Vessels
of
Men
,
and
to
a
round
of
the
Matrix
in
Women
;
so
that
Ruptures
or
Burstenness
happen
through
these
par●●
in
both
Sexes
,
although
the
Holes
of
thes●
three
Muscles
are
not
situated
one
over-again●
another
.
The
Pyramidal
,
so
named
by
reason
of
its
Figure
,
is
situated
in
the
lower
Tendon
of
th●
Rectus
,
its
Origine
being
in
the
upper
and
external
part
of
the
Os
Pubis
;
but
it
is
terminate
in
the
White
Line
,
three
Fingers
breadth
abo●●
the
Pubes
,
and
sometimes
even
in
the
Navel
felf
.
These
Muscles
are
not
found
in
all
Bodies
for
there
are
sometimes
two
,
sometimes
only
one
and
sometimes
none
.
The
use
of
the
Muscles
of
the
lower
Belly
to
compress
all
the
contain'd
parts
,
in
order
〈◊〉
assist
them
in
expelling
the
Excrements
.
How
many
Muscles
are
there
in
the
Testicles
?
They
have
each
of
them
one
,
call'd
Cremaster
this
Muscle
takes
its
rise
from
the
Ligaments
of
the
Os
Pubis
,
and
by
the
dilatation
of
i●●
Tendon
covers
the
Testicle
,
which
it
draws
upward
.
How
many
Muscles
hath
the
Penis
?
It
hath
two
Pair
,
viz.
the
Erectores
or
Di●●ctores
,
and
the
Dilatantes
:
The
Erectores
ari●●
from
the
internal
part
of
the
Os
Ischion
,
und●●
the
beginning
of
the
Corpora
Cavernosa
,
whe●●
they
are
inserted
,
and
retake
their
Fibres
i●
their
Membranes
.
The
Dilatantes
or
Acceler●●tores
have
their
Source
in
the
Sphincter
of
th●
Anus
,
and
slipping
from
thence
obliquely
under
the
Vreter
,
are
join'd
to
the
Membrane
of
th●●
Nervous
Bodies
.
How
many
Muscles
are
there
in
the
Clitoris
?
It
hath
two
Erectors
which
spring
forth
from
the
Protuberance
of
the
Os
Ischion
,
and
are
inserted
in
the
Nervous
Bodies
of
the
Clitoris
.
There
are
also
two
others
suppos'd
to
be
its
Elevators
,
which
proceed
from
the
Sphincter
of
the
Anus
,
and
are
terminated
in
the
Clitoris
.
How
many
Muscles
are
there
in
the
Anus
?
There
are
three
,
viz.
the
Sphincter
,
and
two
Levatores
.
The
Sphincter
is
two
Fingers
broad
,
to
open
and
close
the
Rectum
.
This
Muscle
being
double
,
is
fasten'd
in
the
fore-part
to
the
Penis
in
Men
,
and
to
the
Neck
of
the
Matrix
in
Women
,
as
also
behind
to
the
Coccyx
,
and
laterally
to
the
Ligaments
of
the
Os
Sacrum
,
and
the
Hips
.
The
two
Levatores
arise
from
the
inner
and
lateral
part
of
the
Os
Ischion
,
and
are
fasten'd
to
the
Sphincter
of
the
Anus
,
to
lift
it
up
after
the
expulsion
of
the
Excrements
.
The
Bladder
hath
also
a
Sphincter
Muscle
to
open
and
shut
its
Orifice
.
CHAP.
X.
Of
the
Muscles
of
the
Omoplatae
,
or
Shoulder-Blades
,
Arms
,
and
Hands
.
HOW
many
ways
doth
the
Omoplata
or
Shoulder-Blade
move
,
and
what
are
its
Muscles
?
The
Omoplata
moves
upward
,
downward
,
forward
,
and
backward
,
by
the
means
of
four
proper
Muscles
,
which
are
the
Trapezius
,
the
Rhomboides
,
the
proper
Levator
,
and
the
lesse●
Pectoral
,
or
Serratus
Minor
Anticus
.
The
Trapezius
or
Cucullaris
hath
its
beginning
in
the
back
part
of
the
Occiput
,
or
hinder
part
of
the
Head
,
in
the
Spines
of
the
six
lower
Vertebra's
of
the
Neck
,
and
of
the
nine
upper
of
the
Back
,
in
passing
from
whence
it
is
implanted
in
the
Spine
of
the
Omoplata
or
Shoulder-Blade
,
and
the
external
part
of
the
Clavicula
,
as
far
as
the
Acromion
.
This
Muscle
produceth
many
Motions
by
reason
of
its
different
Fibres
drawing
the
Shoulder-Blade
obliquely
upward
downward
,
and
forward
.
The
Rhomboides
is
situated
over
the
Trapezius
its
rise
being
in
the
Apophyses
of
the
three
lower
Vertebra's
of
the
Neck
,
and
of
the
three
upper
of
the
Back
,
but
it
is
afterward
join'd
to
the
whole
Basis
or
Root
of
the
Omoplata
,
which
it
draws
backward
.
The
proper
Levator
commenceth
in
the
Tr●●verse
Apophyses
of
the
four
first
Vertebra's
of
the
Neck
,
by
different
Progressions
,
but
is
afterward
re-united
,
and
inserted
in
the
upper
Corner
of
the
Omoplata
,
which
it
draws
upward
.
The
lesser
Pectoral
,
or
Serratus
Minor
Anticus
,
is
situated
under
the
great
Pectoral
,
its
rise
being
by
Digitation
or
Indenting
in
the
second
,
third
,
and
fourth
of
the
upper
Ribs
,
and
its
Insertion
in
the
Apophysis
Coracoides
of
the
Shoulder-Blade
,
which
it
draws
forward
.
How
many
Motions
are
there
in
the
Humerus
,
or
Arm
;
which
be
they
,
and
what
are
its
Muscles
?
The
Arm
performs
all
sorts
of
Motions
by
the
help
of
nine
Muscles
:
For
it
is
lifted
up
by
the
Deltoides
and
the
Infra-Spinatus
;
it
is
depress'd
by
the
Largissimus
,
and
the
Rotundus
Major
;
it
is
drawn
forward
by
the
Pectoralis
Major
,
and
the
Coracoideus
;
it
is
drawn
backward
by
the
Infra-Spinatus
,
and
the
Rotundus
Minor
:
It
is
drawn
near
the
Ribs
by
the
Subscapularis
,
and
its
circular
Motion
is
performed
when
all
these
Muscles
act
together
successively
.
The
Deltoides
or
Triangular
hath
its
beginning
in
the
whole
Spine
of
the
Omoplata
,
the
Acromion
,
and
half
the
Clavicula
,
and
by
its
point
cleaves
with
a
strong
Tendon
to
the
middle
of
the
Arm.
The
Infra-Spinatus
takes
its
rise
in
the
Cavity
that
lies
above
the
Spine
of
the
Omoplata
,
which
it
fill
●●●ssing
over
the
Acromion
,
until
it
is
join'd
to
the
Neck
of
the
Shoulder-Bone
,
which
it
surrounds
with
a
large
Tendon
.
The
Largissimus
,
otherwise
call'd
Ani-scalptor
,
covers
almost
the
whole
Back
,
proceeding
from
a
large
and
Nervous
Stock
,
in
the
third
and
fourth
lower
Vertebra
of
the
Back
,
the
five
Vertebra's
of
the
Loins
,
the
Spine
of
the
Os
Sacrum
,
the
hinder
part
of
the
Lip
of
the
Hip-Bone
,
and
the
external
part
of
the
lower
Bastard-Ribs
,
in
passing
from
whence
it
insinuates
it self
into
the
lower
Corner
of
the
Omoplata
,
as
also
into
the
upper
and
inner
part
of
the
Humerus
.
The
Rotundus
Major
,
or
Teres
Major
,
having
its
Origin
in
the
external
Cavity
of
the
lower
Corner
of
the
Omoplata
,
is
confounded
with
the
Largissimus
,
and
adheres
with
it
by
the
same
Tendon
to
the
upper
and
inner
part
of
the
Humerus
,
a
little
below
the
Head
.
The
greater
Pectoral
hath
its
Source
in
hal●
the
Clavicula
,
on
the
side
of
the
Sternum
;
covers
the
fore-part
of
the
Breast
,
and
is
fasten'd
by
a
short
,
broad
,
and
nervous
Tendon
,
to
the
to●
of
the
Shoulder-Bone
,
on
the
inside
,
between
the
Biceps
and
the
Deltoides
.
The
Coracoideus
or
Coracobrachyaeus
,
beginning
in
the
Apophysis
Coracoides
of
the
Omoplata
o●
Shoulder-Blade
,
adheres
to
the
middle
of
the
Arm
on
the
inside
,
which
with
the
Pectoral
〈◊〉
draws
forward
.
The
Infra-Spinatus
fills
the
Cavity
which
lies
below
the
Spine
of
the
Omoplata
,
its
Origine
being
in
the
lower
Rib
of
the
Omoplata
,
from
whence
it
passeth
between
the
Spine
and
the
Rotundus
Minor
,
to
cleave
to
the
Neck
of
the
Shoulder-Bone
,
which
it
embraceth
,
and
draw
backward
.
The
Rotundus
Minor
,
or
Teres
Minor
,
proceed
from
the
lower
Rib
of
the
Omoplata
,
and
adheres
to
the
Neck
of
the
Shoulder-Bone
with
the
Infra-Spinatus
to
draw
it
in
like
manne●
backward
.
The
Sub-scapularis
or
Immersus
is
situated
entirely
under
the
Omaplata
,
proceeding
from
th●
internal
Lip
of
the
Basis
or
Root
of
the
same
Omoplata
,
and
being
terminated
in
the
Neck
〈◊〉
the
Arm-Bone
,
which
it
causeth
to
lie
close
〈◊〉
the
Ribs
.
How
many
Motions
are
there
in
the
Cubitus
〈◊〉
Elbow
,
and
what
are
its
Muscles
?
The
Cubitus
or
Vlna
is
endu'd
with
two
sor●●
of
Motions
,
viz.
that
of
Flection
and
that
〈◊〉
Extension
,
the
former
being
perform'd
by
the
help
of
two
Muscles
,
that
is
to
say
,
the
Biceps
,
and
the
Brachiaeus
Internus
;
and
the
later
by
eight
others
,
which
are
the
Longus
,
the
Brevis
,
the
Brachiaeus
Externus
,
and
the
Anconcus
.
The
Biceps
is
a
Muscle
with
two
Heads
,
one
whereof
proceeds
from
the
Apophysis
Coracoides
,
and
the
other
from
the
Cartilaginous
edge
of
the
Glenoid
Cavity
of
the
Omoplata
or
Shoulder-Blade
:
These
two
Heads
descend
along
the
fore-part
of
the
Arm
,
and
are
united
in
one
and
the
same
Body
,
from
whence
springs
forth
a
Ligament
,
which
is
inserted
in
a
tuberosity
situated
in
the
upper
and
fore-part
of
the
Radius
.
The
Brachiaeus
Internus
is
a
small
fleshy
Muscle
,
lying
hid
under
the
Biceps
,
which
takes
its
rise
in
the
upper
and
fore-part
of
the
Humerus
,
and
is
implanted
in
the
upper
and
inner-part
of
the
Radius
,
to
bend
the
Elbow
with
the
Biceps
.
The
first
of
the
four
Extenders
is
the
Longus
having
two
Sources
,
viz.
one
situated
in
the
lower
Rib
of
the
Omoplata
,
near
its
Neck
,
and
the
other
descending
to
the
hinder-part
of
the
Arm
,
till
it
is
tyed
to
the
Olecranum
or
Ancon
,
by
a
strong
Aponeurosis
,
which
is
common
thereto
,
with
the
Brevis
,
and
the
Brachiaeus
Externus
.
The
Brevis
or
short
Muscle
of
the
Elbow
arising
from
the
hinder
and
upper-part
of
the
Humerus
,
is
fasten'd
to
the
Olecranum
with
the
Longus
.
The
Brachiaeus
Externus
is
a
fleshy
Muscle
which
proceeds
from
the
hinder
part
of
the
Humerus
,
and
adheres
to
the
Olecranum
with
th●
Brevis
and
the
Longus
.
The
Anconeus
or
Cubitalis
being
situated
behind
the
Fold
of
the
Cubitus
,
is
the
least
Muscle
of
all
;
it
springs
from
the
Extremity
of
th●
Arm-Bone
,
at
the
end
of
the
Brevis
and
the
Longus
,
and
in
descending
is
inserted
between
th●
Radius
and
the
Cubitus
or
Vlna
,
three
or
four
Fingers
breadth
below
the
Olecranum
.
How
many
Muscles
hath
the
Radius
,
and
wh●●
are
its
Motions
?
The
Radius
is
endu'd
with
a
twofold
Motion
by
the
means
of
four
Muscles
:
Of
the●●
the
Rotundus
and
Quadratus
cause
that
of
Pronation
,
as
the
Longus
and
the
Brevis
that
of
Supination
.
The
Pronator
Superior
Rotundus
,
or
round
Muscle
of
the
Radius
,
commenceth
from
the
inne●
Apophysis
of
the
Shoulder-Bone
,
in
a
very
fleshy
Stock
,
and
is
terminated
obliquely
by
a
Membranous
Tendon
in
the
middle
and
exterior
part
〈◊〉
the
Radius
.
The
Pronator
Inferior
Quadratus
;
springing
fort●
from
the
bottom
and
inside
of
the
Cubitus
,
i●
fixt
in
the
lower
and
outward
part
of
the
Radius
by
a
Tail
as
large
as
its
Head
.
This
Muscle
lying
hid
under
the
others
near
the
Wrist
,
〈◊〉
that
which
jointly
with
the
Rotundus
,
turns
th●
Arm
with
the
Palm
of
the
Hand
downward
,
which
is
the
Motion
of
Pronation
.
The
Longus
is
the
first
of
the
Supinators
,
whose
Origine
is
three
or
four
Fingers
breadth
above
th●
external
Apophysis
of
the
Arm-Bone
;
from
whence
it
passeth
along
the
Radius
,
and
cleaves
to
the
inner-part
of
its
lower
Apophysis
.
The
Brevis
,
or
the
second
of
the
Spinators
arising
from
the
lower
part
of
the
Inferior
Condylus
,
and
the
external
of
the
Humerus
,
is
twisted
round
about
the
Radius
,
going
forward
from
the
hinder-part
till
it
is
united
to
its
upper
and
fore-part
.
This
Muscle
,
with
the
Longus
,
serves
to
turn
the
Arm
and
the
Palm
of
the
Hand
upward
,
and
produceth
the
Motion
of
Supination
.
How
many
sorts
of
Motions
belong
to
the
Wrist
,
and
what
are
its
Muscles
?
Two
several
Motions
are
perform'd
by
the
Wrist
,
viz.
one
of
Flection
,
and
the
other
of
Extension
,
three
Muscles
being
appropriated
to
the
former
,
and
as
many
to
the
later
:
But
it
ought
to
be
observed
,
that
a
strong
Ligament
,
call'd
the
Annular
,
appears
here
,
which
,
surrounding
all
the
Tendons
of
the
Muscles
as
it
were
a
Bracelet
,
holds
them
together
,
and
elsewhere
serves
to
unite
the
two
Bones
of
the
Elbow
.
The
three
Flexors
or
Bending
Muscles
of
the
Wrist
are
the
Cubitaeus
Internus
,
the
Radiaeus
Internus
,
and
the
Palmaris
.
The
Cubitaus
Internus
derives
its
Original
from
the
part
of
the
Arm-Bone
,
passeth
under
the
Annular
Ligament
,
and
is
ty'd
by
a
thick
Tendon
to
the
small
Bone
of
the
Wrist
,
which
is
plac'd
above
the
others
.
The
Radiaeus
Internus
proceeds
from
the
same
place
with
the
Cubitaeus
,
and
is
fasten'd
to
the
first
Wrist-Bone
which
supports
the
Thumb
.
It
lies
along
the
Radius
,
and
passeth
under
the
Annular
Ligament
.
The
Palmaris
is
reckon'd
among
the
Flexors
of
the
Wrist
,
although
situated
in
the
Palm
of
the
Hand
.
It
ariseth
from
the
inner
Process
or
Knob
of
the
Arm-Bone
,
and
is
united
by
a
large
Tendon
to
the
first
Phalanges
of
the
Fingers
,
sli●ping
under
the
Transverse
or
Annular
Ligame●●
and
sticking
under
the
Skin
of
the
Palm
of
the
Hand
.
The
three
extending
Muscles
of
the
Wrist
〈◊〉
the
Cubitaeus
Externus
,
and
the
Radiaeus
Extenus
or
the
Longus
,
and
the
Brevis
.
The
Cubitaeus
Externus
taking
its
rise
from
〈◊〉
hinder-part
of
the
Elbow
,
passeth
under
the
Annular
Ligament
,
and
adheres
to
the
upper
a●●
outward-part
of
the
Bone
of
the
Metacarpus
th●
stayeth
the
little
Finger
.
The
Radiaeus
Externus
,
or
the
Longus
,
havin●
its
Origine
in
the
edge
of
the
lower
part
of
th●
Arm-Bone
,
slides
from
thence
along
the
Rad●●●
on
the
outside
,
extends
it self
under
the
Annul●●
Ligament
,
and
cleaves
to
the
Wrist-Bone
,
whi●●
stayeth
the
Fore-Finger
.
The
Brevis
or
short
Muscle
of
the
Wrist
spring
from
the
lower
part
of
the
same
Edge
;
afterwa●●
it
runs
along
the
Radius
,
passeth
under
the
An●●lar
Ligament
,
and
is
terminated
in
the
Bone●
the
Carpus
or
Wrist
,
which
stayeth
the
Middle
Finger
.
But
we
must
take
notice
,
that
beside
these
six
Muscles
,
there
is
also
Caro
quaedam
qu●drata
,
or
a
square
piece
of
Flesh
under
the
P●●maris
,
which
seems
to
arise
from
the
Thenar
,
an●
sticks
to
the
eighth
Wrist-Bone
.
It
is
suppo●●
that
this
Musculous
piece
of
Flesh
serves
with
the
Hypothenar
of
the
little
Finger
,
to
make
th●
which
is
call'd
Diogenes's
Cup.
How
many
Motions
are
there
in
the
Fingers
,
a●
what
are
their
Muscles
?
The
Fingers
are
bent
,
extended
,
and
turn'd
from
one
side
to
the
other
by
the
means
of
twenty
three
Muscles
,
whereof
ten
are
proper
,
and
thirteen
common
:
The
former
are
those
that
serve
all
the
Fingers
in
general
,
and
the
other
those
that
are
particularly
serviceable
to
some
of
them
:
The
Common
are
the
Sublimis
,
the
Profundus
,
the
common
Extensor
,
the
four
Lumbricales
,
and
the
six
Interossei
.
The
Sublimis
or
Perforatus
,
arising
from
the
internal
part
of
the
lower
Process
of
the
Humerus
or
Shoulder-Bone
is
divided
into
four
Tendons
,
which
run
below
the
Annular
Ligament
of
the
Wrist
,
and
are
inserted
in
the
second
Phalanx
of
the
Bones
of
the
four
Fingers
,
after
having
stuck
in
passing
to
those
of
the
first
Phalanx
,
to
help
to
bend
it
.
It
is
also
observ'd
that
every
one
of
these
Tendons
hath
a
small
cleft
in
its
length
,
to
let
in
the
Tendons
of
the
Profundus
.
The
Profundus
or
Perforans
lies
under
the
Sublimis
,
deriving
its
Original
from
the
top
of
the
Cubitus
and
Radius
.
It
creeps
along
these
two
Bones
,
and
is
divided
into
four
Tendons
,
which
pass
under
the
Annular
Ligament
,
and
slip
into
the
Fissures
of
the
Tendons
of
the
Sublimis
,
to
adhere
to
the
third
Phalanx
of
the
Fingers
,
which
they
bend
with
the
Sublimis
:
So
that
these
two
Muscles
make
together
the
bending
of
the
Fingers
.
The
Extensor
Magnus
is
that
which
extends
the
four
Fingers
.
It
springs
from
the
external
and
lower
Process
of
the
Arm-Bone
,
and
is
divided
into
four
flat
Tendons
,
which
pass
under
the
Annular
Ligament
,
and
cleave
to
the
second
and
third
Phalanx
of
the
Fingers
.
The
four
Lumbricales
or
Vermiculares
are
〈◊〉
the
Palm
of
the
Hand
,
to
draw
the
Fingers
〈◊〉
the
Thumb
:
They
proceed
from
the
Tend●●
of
the
Profundus
,
and
the
Annular
Ligamen●
extend
themselves
along
the
sides
of
the
Finge●●
and
are
inserted
in
their
second
Articulation
,
〈◊〉
cause
the
drawing
toward
the
Thumb
.
The
three
Interossei
Interni
,
and
the
three
E●●terni
,
are
situated
between
the
four
Bones
of
t●●
Metacarpium
,
as
well
on
the
inside
of
the
Ha●●
as
without
:
They
have
their
beginning
in
〈◊〉
Intervals
or
Spaces
between
the
Bones
of
th●
Metacarpium
,
are
united
with
the
Lumbrical
,
a●
fixt
in
the
last
Articulation
of
the
Bones
of
〈◊〉
Fingers
,
to
produce
the
Motion
of
drawing
ba●●
or
removing
from
the
Thumb
.
The
Thumb
is
mov'd
by
five
particular
M●●cles
;
one
whereof
serves
to
bend
it
,
two
to
●●tend
it
,
one
to
remove
it
from
the
Fingers
,
a●●
another
to
draw
it
to
them
.
The
Flexor
of
the
Thumb
takes
its
rise
fro●
the
upper
and
inner
part
of
the
Radius
,
passe●●
under
the
Annular
Ligament
,
as
also
under
〈◊〉
Thenar
,
and
adheres
to
the
first
and
second
Bo●●
of
the
same
Thumb
to
bend
it
.
The
two
Extensors
of
the
Thumb
are
〈◊〉
Longior
and
the
Brevior
:
The
former
proceed●
from
the
upper
and
outward
part
of
the
C●●tus
,
ascends
above
the
Radius
,
and
is
ty'd
w●●
a
forked
Tendon
to
the
second
Bone
of
〈◊〉
Thumb
.
The
Brevior
hath
the
same
Orig●●●
with
the
Longior
,
keeps
the
same
Track
,
pass●●●
under
the
Annular
Ligament
,
and
is
terminated
〈◊〉
the
third
Thumb-Bone
.
The
Thenar
removes
the
Thumb
from
the
Fingers
,
and
forms
that
part
which
is
call'd
the
Mount
of
Venus
:
It
hath
its
Source
in
the
first
Bone
of
the
Carpus
or
Wrist
,
and
the
Annular
Ligament
,
and
is
inserted
in
its
second
Bone
.
The
Antithenar
draws
the
Thumb
to
the
other
Fingers
,
having
its
Origine
in
the
Bone
of
the
Metacarpus
,
that
stayeth
the
middle
Finger
,
and
its
Insertion
is
in
the
first
Bone
of
the
Thumb
.
The
Muscle
which
serves
to
extend
the
Fore-Finger
,
is
call'd
Indicator
:
It
proceeds
from
the
middle
and
outer
part
of
the
Cubitus
,
and
is
fixt
by
a
double
Tendon
in
the
second
Articulation
of
the
Fore-Finger
,
as
also
in
the
Tendon
of
the
great
Extensor
of
the
Fingers
.
That
which
draws
the
Fore-Finger
to
the
Thumb
is
term'd
Adductor
:
It
commenceth
in
the
fore-part
of
the
first
Thumb-Bone
,
and
is
terminated
in
the
Bones
of
the
Fore-Finger
.
That
which
removes
the
Fore-Finger
from
the
Thumb
is
known
by
the
Name
of
Abductor
,
which
arising
out
of
the
external
and
middle
part
of
the
Bone
of
the
Elbow
,
and
passing
under
the
Annular
Ligament
,
cleaves
to
the
Lateral
and
outward
part
of
the
Bones
of
the
Fore-Finger
.
The
Little-Finger
hath
two
proper
Muscles
,
viz.
an
Extensor
and
an
Abductor
.
The
Extensor
springs
from
the
lower
part
of
the
Condylus
of
the
Arm-Bone
,
and
is
fasten'd
by
a
double
Tendon
in
the
second
Articulation
of
the
Little-Finger
,
and
in
the
Tendon
of
the
Extensor
of
all
the
others
.
The
Abductor
,
call'd
also
Hypothenar
,
hath
〈◊〉
beginning
in
the
small
Bone
of
the
Wrist
,
whic●
is
situated
over
the
others
,
and
is
terminated
〈◊〉
the
first
Bone
of
the
Little-Finger
on
the
ou●
side
.
CHAP.
XI
.
Of
the
Muscles
of
the
Thighs
,
Legs
,
and
Feet
.
WHAT
are
the
Motions
of
the
Thighs
?
The
Thigh
performs
five
kinds
of
Mo●●ons
;
for
it
is
bent
,
extended
,
drawn
within
si●
and
without
,
and
turn'd
round
:
All
these
Mo●●ons
are
produc'd
by
the
means
of
fourteen
Mu●cles
,
viz.
three
Flexors
,
three
Extensors
,
thr●●
Adductors
,
three
Abductors
,
and
two
Obturat●●
for
the
Circular
Motion
.
The
Flexors
of
the
Thigh
are
the
Psoas
,
Ili●cus
,
and
Pectineus
.
The
Psoas
or
Lumbaris
is
situated
inwardly
the
Abdomen
,
on
the
side
of
the
Vertebra's
.
proceeds
from
the
transverse
Apophyses
of
〈◊〉
two
lower
Vertebra's
of
the
Back
,
and
of
〈◊〉
upper
of
the
Loins
,
and
lying
on
the
inner
Fa●
of
the
Os
Ilion
,
sticks
to
the
lesser
Trochanter
〈◊〉
Rotator
.
The
Iliacus
Internus
hath
its
Origine
in
all
〈◊〉
Lips
of
the
inner
Cavity
of
the
Os
Ilion
,
and
b●●ing
joyn'd
by
a
Tendon
to
the
Lumbaris
,
is
inse●●ed
with
it
in
the
lesser
Trochanter
.
The
Pectineus
takes
its
rise
from
the
fore-part
of
the
Os
Pubis
,
and
is
united
before
to
the
Thigh-Bone
a
little
below
the
lesser
Trochanter
.
The
Extensors
of
the
Thigh
are
the
Glutaeus
Major
,
Medius
,
and
Minimus
.
The
Glutaeus
Major
springs
forth
out
of
the
lateral
part
of
the
Os
Sacrum
,
as
also
the
hinder
and
outer
part
of
the
Os
Ilion
and
Coccyx
,
and
e●ters
into
the
Thigh-Bone
,
four
Fingers
breadth
below
the
great
Trochanter
or
Rotator
,
being
the
thickest
of
all
the
Muscles
of
the
Body
.
The
Glutaeus
Medius
,
deducing
its
Original
from
the
hinder
and
outward
part
of
the
Os
Ilion
,
is
inserted
three
Fingers
breadth
below
the
great
Trochanter
.
The
Glutaeus
Minimus
ariseth
from
the
bottom
of
the
Cavity
of
the
Os
Ilion
,
and
is
fasten'd
to
a
small
Hole
near
the
great
Trochanter
.
The
Adductors
of
the
Thigh
are
the
Triceps
Superior
,
Medius
,
and
Inferior
.
The
Triceps
Superior
hath
its
beginning
in
the
top
of
the
Os
Pubis
,
and
is
terminated
in
the
top
of
a
Line
,
which
is
on
the
inside
of
the
Thigh
.
The
Triceps
Medius
proceeding
from
the
middle
of
the
Os
Pubis
,
is
inserted
in
the
Thigh-Bone
a
little
lower
than
the
Triceps
Superior
.
The
Triceps
Inferior
hath
its
Source
in
the
bottom
of
the
Os
Pubis
,
and
is
implanted
in
the
Thigh-Bone
,
a
little
lower
than
the
Triceps
Medius
.
Some
Anatomists
make
only
one
Muscle
of
these
three
,
attributing
thereto
three
Originals
and
three
Insertions
.
These
Muscles
serve
to
draw
the
Thighs
one
against
another
.
The
Abductors
of
the
Thigh
are
the
Iliacus
Externus
,
or
Pyriformis
,
the
Quadratus
,
and
the
Gemelli
.
The
Pyriformis
arising
from
the
upper
and
lateral
part
of
the
Os
Sacrum
,
and
the
Os
Ilio●
cleaves
to
the
Neck
of
the
great
Trochanter
.
The
Quadratus
or
square
Muscle
of
the
Thig●
takes
its
Origine
from
the
external
Promine●●
of
the
Os
Ischion
,
and
adheres
to
the
outward
p●●
of
the
great
Trochanter
.
The
Gemelli
or
Twin
Muscles
arise
from
t●●
small
Knobs
in
the
hinder-part
of
the
Ischi●●
and
insinuate
themselves
into
a
small
Cavity
〈◊〉
the
Neck
of
the
great
Trochanter
.
The
Circular
Motion
of
the
Thigh
is
pers●med
by
the
means
of
two
Muscles
,
named
〈◊〉
Obturatores
Externi
and
Interni
.
The
Obturator
Internus
springs
from
the
i●●●
Circumference
of
the
Oval
Hole
of
the
Ischi●●
and
its
Tendons
passing
between
the
two
Gem●●
are
inserted
in
a
small
Cavity
at
the
Root
of
〈◊〉
great
Trochanter
or
Rotator
.
The
Obturator
Externus
ariseth
from
the
o●●
ward
Circumference
of
the
same
Hole
of
〈◊〉
Ischion
,
and
is
terminated
in
the
side
of
the
oth●●
near
the
great
Trochanter
.
What
are
the
Motions
of
the
Leg
,
and
what
〈◊〉
its
Muscles
?
The
Leg
is
mov'd
four
several
ways
,
that
〈◊〉
to
say
,
it
is
bent
,
extended
,
and
drawn
inwa●●
and
outward
,
by
the
means
of
eleven
Mus●●
viz.
three
Flexors
,
four
Extensors
,
two
Adduc●●●
and
two
Abductors
.
The
three
Flexors
of
the
Leg
are
the
●●ceps
,
the
Semi-nervosus
,
and
the
Semi-mem●nosus
.
The
Biceps
hath
two
Heads
,
the
longer
wh●●
of
cometh
out
of
the
bottom
of
the
Promin●●
of
the
Ischion
,
and
the
other
from
the
middle
and
exterior
part
of
the
Femur
,
and
is
terminated
in
the
outward
and
upper
part
of
the
Epiphysis
of
the
Perone
or
Fibula
.
The
Semi-nervosus
hath
its
Origine
in
the
Knob
of
the
Ischion
,
and
is
join'd
backward
to
the
top
of
the
Epiphysis
of
the
Tibia
.
These
three
Muscles
are
plac'd
in
the
back-part
of
the
Thigh
below
the
Buttocks
.
The
four
Extensors
of
the
Leg
are
the
Rectus
,
the
Vastus
Internus
,
the
Vastus
Externus
,
and
the
Crureus
.
The
Rectus
or
streight
Muscle
of
the
Leg
takes
its
rise
from
the
fore-part
and
the
bottom
of
the
Ilion
,
and
descends
in
a
right
Line
:
It
covers
with
its
Tendon
,
which
is
common
to
the
three
following
,
the
whole
Knee-Pan
,
and
adheres
to
the
top
of
the
Tibia
,
on
the
fore-part
.
The
Vastus
Internus
,
being
situated
on
the
inside
of
the
Thigh
,
hath
its
beginning
in
the
top
of
the
Thigh
inwardly
,
and
a
little
below
the
lesser
Trochanter
or
Rotator
:
Afterward
it
is
ty'd
to
the
Tibia
by
a
large
Tendon
,
common
thereto
with
the
preceeding
.
The
Vastus
Externus
is
plac'd
on
the
outside
of
the
Thigh
,
springing
from
the
top
and
the
fore-part
of
the
Femur
,
being
united
by
the
same
Tendon
with
the
two
preceeding
.
The
Crureus
proceeds
from
the
top
,
and
the
fore-part
of
the
Thigh-Bone
,
between
the
two
Trochanters
;
then
covering
the
whole
Bone
,
it
is
also
fasten'd
to
the
Leg-Bone
with
the
three
preceeding
Muscles
,
after
having
cover'd
the
Knee-Pan
with
their
common
Tendon
,
which
serves
likewise
as
a
Ligament
the
Knee
.
The
two
Adductors
of
the
Leg
are
the
S●●torius
and
the
Gracilis
.
The
Sartorius
or
the
Longissimus
draws
the
〈◊〉
inward
,
deriving
its
Original
from
the
upp●●
Spine
of
the
Ischion
;
from
whence
it
desce●
obliquely
thro'
the
inside
of
the
Thigh
,
a●
cleaves
to
the
top
on
the
inside
of
the
Tibia
.
The
Gracilis
hath
its
Origine
in
the
sore-pe●●
at
the
bottom
of
the
Os
Pubis
,
and
its
Inse●●
in
the
top
of
the
Tibia
on
the
inside
.
The
two
Abductors
of
the
Leg
are
the
Fas●●
lata
,
and
the
Poplitaeus
.
The
Fascia
lata
,
or
the
Membranosus
,
is
as
were
a
kind
of
large
Band
,
which
covers
〈◊〉
the
Muscles
of
the
Thigh
.
It
proceeds
from
〈◊〉
outward
Lip
of
the
Os
Ilion
,
is
ty'd
by
a
la●●
Membrane
to
the
top
of
the
Perone
or
Fi●●
and
sometimes
descends
to
the
end
of
the
Fo●●●
The
Poplitaeus
,
or
Sub-poplitaeus
,
ari●●
from
the
lower
and
external
Condylus
of
〈◊〉
Thigh-Bone
,
passeth
obliquely
from
the
ou●
to
the
inside
,
till
it
is
lost
in
the
upper
and
in●●
part
of
the
Leg-Bone
under
the
Ham.
What
are
the
Motions
of
the
Foot
,
and
〈◊〉
are
its
Muscles
?
The
Foot
performs
two
Motions
by
the
〈◊〉
of
nine
Muscles
,
as
being
bent
by
two
,
and
〈◊〉
tended
by
seven
.
The
two
Flexors
are
the
Crureus
Anticus
,
〈◊〉
the
Peronaeus
Antieus
.
The
Crureus
or
Tibiaeus
Anticus
,
is
plac'd
long
the
Tibia
,
and
takes
its
rise
from
its
up●●
and
fore-part
:
Afterward
it
is
bound
by
〈◊〉
Tendons
to
the
first
Os
Cuneiforme
,
or
Wedge-like
Bone
,
and
to
that
of
the
Metatarsus
or
Instep
,
which
stayeth
the
great
Toe
,
after
having
pass'd
under
the
annular
Ligament
.
The
Peronaeus
Anticus
springs
from
the
middle
and
outward-part
of
the
Perone
or
Fibula
,
and
insinuating
it self
thro'
the
Cleft
which
is
under
the
external
Malleolus
before
,
sticks
to
the
Bone
of
the
Metatarsus
that
supports
the
little
Toe
.
The
seven
Extensors
of
the
Foot
are
the
two
Gemelli
,
or
the
Soleus
,
the
Planta●●s
,
the
Crureus
Posticus
,
and
the
two
Peronaei
Postici
.
The
Gemelli
are
the
Interior
and
the
Exterior
;
the
former
having
its
Source
in
the
inner
Condylus
,
and
the
other
in
the
outward
and
lower
of
the
Thigh-Bone
;
from
whence
they
extend
themselves
till
they
are
fasten'd
to
the
Talus
or
Ankle-Bone
by
a
Tendon
common
to
them
,
with
the
two
following
.
The
Soleus
ariseth
from
the
top
on
the
back-part
of
the
Leg-Bone
and
Perone
,
and
confounding
its
Tendon
with
that
of
the
Gemelli
,
sticks
close
to
the
Talus
.
The
Plantaris
,
which
lies
hid
between
the
Gemelli
and
the
Soleus
,
hath
its
Origine
from
the
Exterior
Condylus
of
the
Thigh-Bone
;
then
uniting
its
Tendon
with
the
preceeding
,
it
adheres
to
them
;
and
this
common
Tendon
is
call'd
Chorda
Achillis
.
The
Crureus
or
Tibiaeus
Posticus
,
springs
from
the
back-part
of
the
Leg-Bone
,
from
whence
extending
it self
downward
,
it
passeth
thro'
the
Fissure
in
the
Internal
Malleolus
,
and
cleaves
to
the
inner-part
of
the
Os
Scaphoides
.
The
Peronaei
,
or
Fibulaei
Postici
,
are
otherwi●●
call'd
the
Longus
and
the
Brevis
,
whereof
o●
proceeds
from
the
upper
and
almost
fore-part
〈◊〉
the
Perone
,
terminating
in
the
upper-part
of
〈◊〉
Bone
,
that
supports
the
great
Toe
in
the
M●tatarsus
,
and
the
other
from
the
lower
p●●●
of
the
Perone
,
adhering
in
like
manner
to
〈◊〉
Bone
with
which
the
little
Toe
is
sustain'd
.
With
what
Motions
are
the
Toes
endu'd
,
how
m●ny
Muscles
have
they
,
and
which
be
they
?
The
Toes
are
bent
and
extended
,
as
al●
drawn
inward
and
outward
,
by
the
means
〈◊〉
twenty
two
Muscles
,
of
which
sixteen
are
Co●mon
,
and
six
Proper
.
The
former
are
t●●
Flexors
,
two
Extensors
,
four
Lumbricales
,
a●●
eight
Interossei
.
The
first
Flexor
is
nam'd
S●limis
,
and
the
other
Profundus
.
The
Sublimis
or
Perforatus
derives
its
Orig●nal
from
the
lower
and
inner-part
of
the
Ta●●
and
is
fixt
in
its
proper
place
by
four
c●●
Tendons
,
which
are
inserted
in
the
upper-part
〈◊〉
the
Bones
of
the
first
Phalanx
of
the
four
To●●
It
is
situated
under
the
Sole
of
the
Feet
.
The
Profundus
or
Perforans
hath
its
begining
in
the
top
and
back-part
of
the
Leg-Bo●●
and
Perone
,
slips
under
the
Malleolus
Inte●●●
thro'
the
Sinus
Calcaris
,
and
makes
four
Tend●●
which
pass
thro'
the
Fissures
of
the
Tendon
of
〈◊〉
Sublimis
,
and
cleaves
to
the
Bones
of
the
〈◊〉
Phalanx
of
the
Toes
,
to
bow
them
.
The
first
Extensor
is
call'd
the
Common
,
〈◊〉
the
other
the
Pediaeus
.
The
Common
Extensor
,
or
the
Longus
,
ta●●
its
rise
from
the
top
and
fore-part
of
the
Ti●●
in
the
place
of
its
joyning
with
the
Perone
Fibula
,
and
divides
it self
into
four
Tendons
,
which
after
having
pass'd
under
the
Annular
Ligament
,
are
inserted
in
the
Articulations
of
every
Toe
.
The
Pediaeus
or
the
Brevis
,
being
plac'd
over
the
Foot
,
proceeds
from
the
Annular
Ligament
,
and
the
lower-part
of
the
Perone
,
and
sends
forth
four
Tendons
,
which
are
sixt
to
the
first
Articulation
of
the
four
Toes
on
the
outside
,
Thus
this
Muscle
,
together
with
the
Longus
,
causeth
their
Extension
.
The
four
Lumbrical
Muscles
of
the
Toes
arise
from
the
Tendons
of
the
Prosundus
,
and
a
Mass
of
Flesh
at
the
Sole
of
the
Feet
.
They
are
joyn'd
by
their
Tendons
with
those
of
the
Interossei
Interni
,
and
adhere
inwardly
to
the
side
of
the
first
Bones
of
the
four
Toes
,
to
incline
them
toward
the
great
Toe
.
The
Abductors
,
or
those
Muscles
that
remove
the
Toes
from
the
great
Toe
,
are
the
eight
Interossei
,
whereof
four
are
call'd
Externi
,
and
as
many
Interni
.
The
former
take
their
rise
in
the
Spaces
between
the
Bones
of
the
Metatarsus
,
and
are
terminated
outwardly
in
the
side
of
the
first
Bones
of
the
Toes
.
The
Internal
lie
in
the
bottom
of
the
Foot
,
and
take
up
the
Spaces
between
the
five
Bones
of
the
Metatarsus
.
They
arise
from
the
Bones
of
the
Tarsus
,
and
the
Intervals
between
those
of
the
Metatarsus
,
and
are
implanted
with
the
four
Lumbricales
inwardly
,
in
the
upper-part
of
the
Bones
of
the
first
Phalanx
of
the
four
Toes
.
Of
the
six
Proper
Muscles
of
the
Toes
,
there
are
four
appointed
for
the
great
Toe
,
which
cause
it
to
perform
the
Motions
of
Flexion
,
Extension
,
and
drawing
forward
or
backward
The
two
others
are
the
Adductor
of
the
second
Toe
to
the
great
Toe
,
and
the
Abductor
of
the
little
toe
,
call'd
Hypothenar
.
The
Proper
Flexor
of
the
great
Toe
,
arising
from
the
top
of
the
Perone
or
Fibula
,
on
the
ba●●
part
,
passeth
thro'
the
Ancle-Bone
on
the
inside
to
the
sole
of
the
Foot
,
and
is
fasten'd
to
the
Bone
of
the
last
Phalanx
.
The
Proper
Extensor
of
the
great
Toe
spring
from
the
middle
of
the
fore-part
of
the
P●rone
,
passeth
over
the
Foot
,
and
hath
its
Insertion
in
the
upper-part
of
the
Bone
of
th●
great
Toe
.
The
Proper
Adductor
of
the
great
Toe
,
〈◊〉
the
Thenar
,
taking
its
rise
inwardly
on
the
side
of
the
Talus
,
the
Ossa
Schaphoidea
and
Innomin●ta
,
extends
it self
over
the
outward-part
of
the
Bone
of
the
Metatarsus
,
which
stayeth
the
great
Toe
,
and
adheres
to
the
top
of
the
second
Bone
of
the
great
Toe
,
which
it
draw
inward
.
The
proper
Abductor
of
the
great
Toe
,
o●
the
Antithenar
,
draws
it
toward
the
other
Toes
.
It
derives
its
Origine
from
the
Bone
of
the
Metatarsus
,
which
supports
the
little
Toe
,
slides
obliquely
over
the
other
Bones
,
and
cleaves
to
the
first
Bone
of
the
great
Toe
on
the
inside
.
The
Adductor
appropriated
to
the
second
Toe
hath
its
Source
in
the
first
Bone
of
the
great
Toe
,
on
the
inside
,
and
sticks
close
to
the
Bones
of
the
second
Toe
,
which
it
draws
to
the
great
Toe
.
The
Abductor
of
the
little
Toe
,
or
the
Hypothenar
,
proceeds
from
the
outward
part
of
the
Bone
of
the
Metatarsus
,
that
stayeth
the
little
Toe
,
and
is
inserted
in
the
top
of
the
little
Toe
,
on
the
outside
,
to
remove
it
from
the
others
.
A
List
of
all
the
Muscles
in
the
Humane
Body
.
-
The
Fore-head
hath
two
Muscles
2
-
The
hinder-part
of
the
Head
2
-
The
Eye-Lids
4
-
The
Eyes
12
-
The
Nose
7
-
The
Ears
on
the
outside
8
-
The
Ears
on
the
inside
6
-
The
Lips
13
-
The
Tongue
8
-
The
Wula
,
or
Palate
of
the
Mouth
4
-
The
Larynx
13
-
The
Pharynx
7
-
The
Os
Hyoides
10
-
The
Lower
Jaw
12
-
The
Head
14
-
The
Neck
8
-
The
Omoplatae
or
Shoulder-Blades
8
-
The
Arms
18
-
The
Elbows
12
-
The
Radii
8
-
The
Wrists
12
-
The
Fingers
48
-
The
Breast
,
or
the
Parts
of
Respiration
57
-
The
Loins
6
-
The
Abdomen
or
lower
Belly
10
-
The
Testicles
2
-
The
Bladder
1
-
The
Penis
4
-
The
Clitoris
4
-
The
Anus
3
-
The
Thighs
30
-
The
Legs
22
-
The
Feet
18
-
The
Toes
44
-
Total
425
CHAP.
XII
.
Of
the
Anatomy
of
the
Nerves
,
Arteries
,
and
Veins
in
general
.
WHAT
is
the
Structure
of
the
Nerves
?
The
Nerves
are
round
white
Bodies
enclos'd
in
a
double
Membrane
,
communicated
to
them
from
the
two
Meninges
of
the
Brain
:
Their
Office
is
to
convey
the
Animal
Spirits
into
all
the
Parts
.
Where
is
the
Root
and
first
beginning
of
all
the
Nerves
?
All
the
Nerves
take
their
Original
from
the
Medulla
Oblongata
,
and
that
of
the
Spine
.
How
is
the
distribution
of
them
made
thro'
th●
whole
Body
?
It
is
directly
perform'd
by
Conjugations
o●
Pairs
,
whereof
one
goes
to
the
Right-hand
,
and
the
other
to
the
Left
:
There
are
nine
Pairs
o●
them
that
proceed
from
the
Medulla
Oblongata
and
enter
into
the
Skull
;
and
a
Tenth
that
comes
from
the
Marrow
which
lies
between
the
Occipital
and
the
first
Vertebra
of
the
Neck
.
It
passeth
thro'
the
Hole
of
the
Dura
Mater
,
thro'
which
the
Vertebral
Artery
enters
,
to
distribute
its
Branches
into
several
Parts
.
To
what
Vse
are
the
nine
Pairs
of
Nerves
appropriated
,
which
proceed
from
the
Root
of
the
Brain
?
They
are
chiefly
design'd
for
the
Senses
,
and
also
for
the
Motion
of
their
Organs
,
of
which
the
Ancients
discover'd
only
seven
.
The
first
Pair
of
Nerves
is
call'd
the
Olfactory
,
and
serves
for
the
Smelling
.
The
second
Pair
is
the
Optici
or
Visorii
Nervi
,
and
bestows
upon
the
Eyes
the
Faculty
of
seeing
.
The
third
is
term'd
Motorii
Oculorum
,
being
serviceable
for
the
Motion
of
the
Eyes
.
The
fourth
Pair
is
nam'd
Oculorum
Pathetici
,
which
shews
the
Passion
of
the
Mind
in
the
Eyes
,
whereto
it
imparts
a
String
as
well
as
to
the
Lips
.
The
fifth
is
call'd
the
Gustative
,
and
appropriated
to
the
Taste
,
because
it
sends
Twigs
more
especially
to
the
Tongue
,
as
also
to
the
Forehead
,
Temples
,
Face
,
Nostrils
,
Teeth
,
and
Privy-Parts
.
The
Sixth
is
likewise
for
the
Taste
,
and
goes
to
the
Palate
.
The
seventh
is
the
Auditive
Nerve
,
that
enters
into
the
Os
Petrosum
,
where
it
divides
it self
into
many
Branches
,
which
when
gone
forth
,
are
distributed
to
the
Muscles
of
the
Tongue
,
Lips
▪
Mouth
,
Face
,
Fore-head
,
Eye-Lids
,
&c.
The
eighth
is
the
Os
Vagum
,
or
wandering
Pair
,
which
is
united
to
the
Intercostal
Nerve
,
as
also
to
the
Recurrent
,
Diaphragmatick
,
Mesenterick
,
&c.
The
ninth
Pair
,
after
having
form'd
a
True
with
the
eighth
,
disperseth
its
Twigs
sever
ways
,
whereof
one
is
join'd
with
the
Twig
〈◊〉
the
tenth
,
to
be
distributed
together
into
〈◊〉
Muscle
Stern●hyoideus
,
and
into
the
Tongue
.
The
Intercostal
and
Spinal
are
not
Pairs
Nerves
,
but
only
Branches
or
Twigs
of
othe●
Pairs
.
What
is
the
Distribution
and
Vse
of
the
th●●
Pairs
of
Nerves
that
proceed
from
the
Spinal
M●row
?
There
are
seven
that
go
forth
from
the
sev●●
vertebra's
of
the
Neck
,
twelve
from
those
〈◊〉
the
Back
,
five
from
the
Loins
,
and
six
fro●
the
Os
Sacrum
,
according
to
the
following
Pr●gression
.
The
first
of
the
seven
Pairs
of
Nerves
of
〈◊〉
Neck
proceeds
from
between
the
Occipital
Bo●●
and
the
first
Vertebra
,
nam'd
Atlas
,
its
Fibres
b●ing
lost
in
the
Muscles
of
the
hinder-part
of
〈◊〉
Head
and
Neck
.
The
second
Pair
springs
from
between
the
f●●●●
and
second
Vertebra
of
the
Neck
;
the
Fibr●●
whereof
are
lost
in
the
Muscles
of
the
Head
,
a●●
in
the
Skin
of
the
Face
.
The
third
Pair
issueth
from
between
the
seco●●
and
third
Vertebra
of
the
Neck
;
and
its
Fib●●●
are
lost
in
the
Flexor
Muscles
and
Extensors
〈◊〉
of
the
Neck
.
The
fourth
,
fifth
,
sixth
,
and
seventh
Pairs
proceed
from
between
the
Vertebra's
,
as
before
,
〈◊〉
their
Fibres
are
lost
in
the
Neck
of
the
Omo●●ta
,
in
the
Arm
,
and
in
the
Diaphragme
or
M●●riff
.
Here
it
ought
to
be
observ'd
by
the
w●●
that
the
Arms
receive
Branches
not
only
from
〈◊〉
four
last
Pairs
of
the
Nerves
of
the
Neck
,
but
also
from
the
two
first
Pairs
of
the
Back
,
which
are
extended
even
to
the
end
of
the
Fingers
:
Whence
it
happens
that
in
the
Palsie
of
the
Arms
,
Remedies
are
usually
apply'd
to
the
Vertebra's
of
the
Neck
;
and
that
in
Phlebotomy
or
letting
Blood
,
care
must
be
taken
to
avoid
pricking
the
Nerve
,
which
accompanies
the
Basilick
Vein
in
the
Elbow
.
The
twelve
Pairs
of
Nerves
that
have
their
Beginning
from
between
the
Vertebra's
of
the
Back
,
are
each
of
them
divided
into
two
Branches
,
as
the
others
;
and
their
Branches
are
distributed
in
like
manner
to
the
Muscles
of
the
Breast
,
and
to
those
of
the
Back
and
Abdomen
.
The
five
Pairs
which
take
their
Rise
from
between
the
Vertebra's
of
the
Loins
,
have
thicker
Branches
than
the
others
,
and
the
distribution
of
them
is
made
to
the
Muscles
of
the
Loins
,
Hypogastrium
,
and
Thighs
.
Of
the
six
Pairs
of
Nerves
that
proceed
from
the
Os
Sacrum
,
the
four
Upper
with
the
three
Lower
of
the
Loins
,
send
forth
Fibres
of
Nerves
to
the
Thigh
,
Leg
,
and
Foot
;
and
the
two
last
Pairs
impart
Nerves
to
the
Anus
,
Bladder
,
and
privy
Parts
.
What
is
the
Structure
of
the
Arteries
?
The
Arteries
are
long
and
round
Canals
,
consisting
of
four
sorts
of
Tunicks
or
Membranes
,
which
have
their
Rise
from
the
left
Ventricle
of
the
Heart
,
from
whence
they
receive
the
Blood
,
and
convey
it
to
all
the
Parts
of
the
Body
for
their
Nourishment
.
What
is
the
Construction
of
these
four
Tunicks
or
Membranes
of
the
Arteries
?
The
first
being
thin
and
Nervous
in
its
outward
Superficies
,
is
in
the
Inside
a
Plexus
or
Interlacement
of
small
Veins
and
Arteries
,
and
Fibres
of
Nerves
,
which
enter
into
the
other
following
Tunicks
,
to
nourish
them
.
The
second
sticking
close
to
the
former
,
is
altogether
full
of
whitish
Glandules
,
that
serve
to
separate
the
serous
Particles
of
the
Blood
.
The
third
is
intirely
Musculous
,
and
interwoven
with
Annular
Fibres
.
The
fourth
is
very
thin
,
and
hath
its
Fibres
all
streight
.
Whence
proceeds
the
Pulse
or
beating
of
the
Arteries
?
It
is
deriv'd
from
the
Heart
,
and
exactly
answers
to
its
Motion
of
Diastole
and
Systole
.
By
what
Name
is
the
first
Trunk
of
the
Arteries
call'd
,
and
what
is
the
Effect
of
the
Distribution
made
thence
to
the
whole
Body
?
The
first
Trunk
of
the
Arteries
is
nam'd
Aorta
,
or
the
thick
Artery
,
which
proceeds
immediately
from
the
left
Ventricle
of
the
Heart
,
whereto
it
communicates
before
its
departure
from
the
Pericardium
,
one
or
two
small
Branches
call'd
the
Coronary
:
Afterward
it
is
divided
into
two
Branches
,
whereof
one
goes
upward
,
and
is
term'd
the
Ascending
Artery
;
and
the
other
downward
,
under
the
Denomination
of
the
Descending
Artery
.
The
Ascending
Artery
ariseth
upward
along
the
Aspera
Arteria
or
Wind-Pipe
,
to
the
Clavicles
,
and
is
there
divided
into
two
Branches
,
call'd
the
Subclavian
Arteries
,
one
whereof
goes
forward
to
the
Right
side
,
and
the
other
to
the
Left
;
and
they
both
send
forth
on
each
side
divers
Branches
,
which
take
their
Names
from
the
several
Parts
,
whereto
they
are
distributed
;
such
are
the
Carotides
or
Soporales
Interni
&
Externi
,
which
pass
to
the
Head
;
the
Mediastina
;
the
Intercostal
;
the
Axillar
,
and
others
.
The
Descending
Artery
,
before
its
departure
from
the
Breast
,
affords
certain
Branches
to
the
Pericardium
,
Diaphragm
,
and
lower
Ribs
;
afterward
it
penetrates
the
Diaphragm
,
and
constitutes
seven
double
Branches
.
The
first
is
of
those
that
are
call'd
Coeliack
,
and
which
go
to
the
Liver
and
Spleen
.
The
second
Branch
contains
the
Vpper
Mesenterick
.
The
third
the
Emulgent
,
which
pass
to
the
Reins
.
The
fourth
the
Spermatick
,
which
are
extended
to
the
Genitals
.
The
fifth
the
Lower
Mesenterick
.
The
sixth
the
Lumbar
.
And
the
seventh
the
Muscular
.
But
assoon
as
the
great
Trunk
is
come
downward
to
the
Os
Sacrum
,
it
divides
it self
into
two
thick
Arteries
nam'd
the
Iliack
,
which
are
distributed
on
both
sides
,
each
of
them
making
two
Internal
and
External
Branches
,
which
likewise
impart
Sprigs
or
lesser
Arteries
,
to
the
Bladder
,
Anus
,
Matrix
,
and
other
adjacent
Parts
:
Then
the
Master-Branch
forms
the
Crural
Arteries
on
the
inside
of
the
Thighs
,
which
are
communicated
by
multiplying
their
Number
even
to
the
ends
of
the
Toes
,
in
passing
over
the
External
Ancle-Bones
of
the
Feet
.
What
is
the
Structure
of
the
Veins
?
The
Veins
are
long
and
round
Canals
made
of
four
kinds
of
Tunicks
or
Membranes
,
whose
Office
it
is
to
receive
the
Blood
that
remains
after
the
Nourishment
is
taken
,
and
to
carry
it
back
to
the
Heart
to
be
reviv'd
.
What
is
the
Form
of
the
four
Tunicks
that
make
the
Canals
of
the
Veins
?
The
first
is
a
Contexture
of
Nervous
and
streight
Fibres
.
The
second
is
a
Plexus
of
small
Vessels
that
carry
the
Nourishment
.
The
third
is
all
over
beset
with
Glandules
thro'
which
are
filtrated
the
serous
Particles
of
the
Blood
contain'd
in
the
Vessels
of
the
second
Tunicle
.
The
fourth
is
a
Series
of
Annular
and
Musculous
or
Fleshy
Fibres
.
Which
are
the-most
numerous
,
the
Arteries
or
the
Veins
?
The
Number
of
the
Veins
exceeds
that
of
the
Arteries
;
and
there
are
scarce
any
Arteries
without
Veins
accompanying
them
.
Where
is
the
Beginning
and
Original
of
all
the
Veins
?
All
the
Veins
have
their
Root
in
the
Liver
,
and
two
of
the
three
great
Trunks
that
proceed
from
thence
,
are
call'd
Vena
Portae
,
and
Vena
Cava
;
and
the
third
is
twofold
,
viz.
the
ascending
and
the
descending
.
The
Vena
Portae
is
distributed
to
all
the
Par●●
contain'd
in
the
lower
Belly
,
and
terminated
i●
the
Fundament
;
where
it
makes
the
Internal
Haemorrhoidal
Veins
.
The
Vena
Cava
is
immediately
divided
into
two
thick
Branches
,
one
whereof
ariseth
upward
to
the
Right
Ventricle
of
the
Heart
,
and
form●
the
ascending
Vena
Cava
;
as
the
other
goes
downward
to
the
Feet
,
and
constitutes
the
descending
.
What
is
the
Distribution
of
the
ascending
Ven●
Cava
?
It
perforates
the
Diaphragm
,
goes
to
the
Heart
,
and
ascends
from
thence
to
the
Clavicles
after
having
communicated
to
the
Midriff
in
passing
,
a
small
Branch
call'd
the
Phrenicus
;
as
also
one
or
two
to
the
Heart
,
nam'd
the
Coronary
;
and
some
others
to
the
upper
Ribs
,
besides
the
single
Branch
,
term'd
Azygos
,
only
on
the
right
side
.
But
the
Trunk
of
the
ascending
Vena
Cava
,
being
once
come
up
to
the
Clavicles
,
is
divided
into
two
Branches
,
well
known
by
the
Name
of
the
Subclavian
,
one
whereof
Shoots
forth
toward
the
Right
side
,
and
the
other
toward
the
Left
;
and
they
both
make
various
Ramifications
like
to
those
of
the
thick
ascending
Artery
,
by
producing
the
Cervicalis
or
Soporalis
,
and
the
Internal
and
External
Jugulars
that
go
to
the
Head
;
as
also
the
Axillars
,
which
pass
to
the
Arms
and
Shoulders
,
forming
the
Cephalick
,
the
Median
,
and
the
Basilick
on
the
inside
of
the
Elbow
.
The
descending
Vena
Cava
in
like
manner
accompanieth
the
Ramifications
of
the
Aorta
,
or
thick
descending
Artery
,
to
the
fourth
Vertebra
of
the
Loins
,
where
it
sends
forth
two
Branches
,
nam'd
the
Iliack
,
one
whereof
goes
to
the
Right
side
,
and
the
other
to
the
Left
,
both
inwardly
and
outwardly
;
imparting
divers
Twigs
or
lesser
Branches
to
all
the
Parts
contain'd
in
the
Abdomen
or
lower
Belly
,
even
as
far
as
the
Fundament
,
where
it
makes
the
External
Haemorrhoidal
Veins
.
Afterward
the
outward
Branch
of
the
Iliack
descends
in
the
Thigh
,
to
form
the
Crural
,
and
others
,
as
far
as
the
Saphaena
,
together
with
those
that
are
situated
at
the
end
of
the
Feet
.
CHAP
XII
.
Of
the
Anatomy
of
the
Abdomen
,
o●
lower
Belly
.
WHAT
is
the
clearest
Division
of
the
Hum●●
Body
into
various
Parts
,
and
that
which
〈◊〉
most
follow'd
in
the
Anatomical
Schools
?
It
is
that
which
constitutes
three
Venters
,
tha●
is
to
say
,
the
Upper
,
the
Middle
,
and
the
Lo●er
,
which
are
the
Head
,
the
Thorax
or
Breas●
and
the
Abdomen
or
lower
Belly
,
together
wi●●
the
Extremities
,
which
are
the
Arms
and
Legs
▪
What
is
the
lower
Belly
?
It
is
a
Cavity
of
the
Body
that
contains
th●
nourishing
parts
,
as
the
Reins
,
the
Bladder
,
an●
all
those
that
are
appropriated
to
Generation
〈◊〉
both
Sexes
.
What
is
to
be
consider'd
outwardly
in
the
low●●
Belly
?
It
s
different
Regions
,
and
the
several
pa●●
therein
contain'd
.
What
are
these
Regions
?
They
are
the
Epigastrick
,
the
Vmbilical
,
an●
the
Hypogastrick
.
What
is
their
Extent
?
It
is
from
the
Xyphoides
or
Sword-like
Cartilage
to
the
Os
Pubis
,
the
division
whereof
in●●
three
equal
Parts
,
constitutes
the
three
different
Regions
;
the
Epigastrium
being
the
first
upward
,
the
Vmbilicus
the
second
,
and
the
Hyp●gastrium
the
third
.
What
are
the
Parts
contain'd
in
the
Epigastrium
,
and
what
Place
do
they
possess
therein
?
The
Parts
contain'd
in
the
Epigastrium
are
the
Liver
,
the
Spleen
,
the
Stomach
,
and
the
Pancreas
or
Sweet-bread
,
which
lies
underneath
:
The
Stomach
takes
up
the
middle
before
,
the
Liver
being
plac'd
on
the
Right
side
,
and
the
Spleen
on
the
Left
;
so
that
these
two
sides
of
the
Epigastrick
Region
,
are
call'd
the
Right
and
Left
Hypochondria
.
What
Parts
are
there
contain'd
in
the
Vmbilicál
Region
,
and
what
is
their
situation
?
They
are
the
most
part
of
the
thin
Intestines
or
small
Guts
,
viz.
the
Duodenum
,
the
Jejunum
,
and
the
Ileon
,
which
have
their
Residence
in
the
middle
,
where
they
are
encircled
with
a
Portion
of
the
two
great
Guts
,
Coecum
and
Colon
,
that
take
possession
of
the
Sides
,
otherwise
call'd
the
Flanks
.
The
Reins
or
Kidneys
are
also
in
this
Place
,
above
,
and
somewhat
backward
.
What
Parts
are
there
contain'd
in
the
Hypogastrium
,
and
of
what
Place
are
they
possest
?
The
greater
part
of
the
thick-Guts
,
Coecum
,
and
Colon
,
are
enclos'd
therein
,
with
the
entire
Rectum
;
there
is
also
a
Portion
of
the
Ileon
,
which
hides
it self
in
the
sides
of
the
Ilia
,
or
Hip-Bones
:
In
the
middle
under
the
Os
Pubis
,
the
Bladder
is
situated
on
the
Gut
Rectum
in
Men
,
and
the
Matrix
in
Women
lies
between
the
Rectum
and
Bladder
.
After
what
manner
is
the
opening
of
a
Corps
or
dead
Body
perform'd
at
a
publick
Dissection
?
It
is
begun
with
a
Crucial
Incision
in
the
Skin
from
underneath
the
Throat
downward
,
traversing
from
one
side
to
another
in
the
Umbilical
Region
;
then
this
Skin
is
pull'd
off
at
the
four
Corners
,
and
the
Panicula
Adiposa
is
immediately
discover'd
:
Under
this
Fat
lies
a
Fleshy
Membrane
,
call'd
Membrana
Carnosa
;
and
after
that
,
the
common
Membrane
of
all
the
Muscle●
of
the
lower
Belly
.
Thus
we
have
taken
:
View
of
what
Anatomists
commonly
term
the
five
Teguments
,
that
is
to
say
,
the
Epiderma
o●
Scarf-Skin
,
the
Derma
or
true
Skin
,
the
Panicula
Adiposa
,
the
Panicula
Carnosa
or
Membrane
Carnosa
,
and
the
common
Membrane
of
the
Muscles
.
The
five
Teguments
being
remov'd
,
we
meet
with
as
many
Muscles
on
each
side
,
viz.
the
descending
Oblique
,
the
ascending
Oblique
,
the
Transverse
,
the
streight
,
and
the
Pyramidal
,
by
the
means
whereof
the
Belly
is
extended
and
contracted
.
Afterwards
appears
a
Membrane
nam'd
Peritonaeum
,
which
contains
all
the
Bowels
,
and
covers
the
whole
lower
Belly
,
being
strongly
fasten'd
to
the
first
and
third
Vertebra's
of
the
Back
.
The
Fat
skinny
Net
which
lies
immediately
under
the
Peritonaeum
,
is
call'd
Epiploon
and
Omentum
,
or
the
Caul
;
it
floats
over
the
Bowels
,
keeping
them
in
a
continual
Suppleness
necessary
for
their
Functions
,
maintains
the
Heat
of
the
Stomach
,
and
contributes
to
Digestion
.
It
remains
to
take
an
Account
of
the
Bowels
viz.
the
Stomach
,
Mesentery
,
Liver
,
Spleen
,
Kidneys
,
Bladder
,
and
Guts
,
together
with
the
Parts
appointed
for
Generation
,
which
in
Men
are
the
Spermatick
Vessels
,
the
Testicles
,
and
the
Penis
;
and
in
Women
,
the
Spermatick
Vessels
,
the
Testicles
or
Ovaries
,
the
Matrix
,
and
its
Vagina
or
Neck
.
What
is
the
Stomach
?
It
is
the
Receptacle
of
the
Aliments
or
Food
convey'd
thither
thro'
the
Oesophagus
or
Gullet
,
which
is
a
Canal
,
or
kind
of
streight
Gut
that
reacheth
from
the
Throat
to
the
Mouth
of
the
Stomach
.
The
Stomach
it self
is
situated
immediately
under
the
Diaphragm
or
Midriff
,
between
the
Liver
and
the
Spleen
,
having
two
Orifices
,
whereof
the
Left
is
properly
call'd
Stomachus
,
or
the
Upper
,
and
the
Right
(
at
its
other
Extremity
)
Pylorus
,
or
the
lower
Orifice
.
It
s
Figure
resembleth
that
of
a
Bag-Pipe
,
and
the
greater
part
of
its
Body
lies
toward
the
Left
side
.
It
is
compos'd
of
three
Membranes
,
viz.
one
Common
,
which
it
receives
from
the
Peritonaeum
;
and
two
Proper
;
the
two
uppermost
being
smooth
,
and
the
innermost
altogether
wrinkled
.
What
is
the
Pancreas
or
Sweet-bread
?
It
is
a
Fat
Body
,
consisting
of
many
Glandules
wrapt
up
in
the
same
Tunicle
,
being
situated
under
the
Pylorus
or
lower
Orifice
of
the
Stomach
:
It
helps
Digestion
,
and
hath
divers
other
uses
;
but
its
principal
Office
is
to
separate
the
serous
Particles
of
the
Blood
,
to
be
convey'd
afterward
into
the
Gut
Duodenum
,
by
a
Canal
or
Passage
,
nam'd
the
Pancreatick
.
This
Juice
serves
to
cause
the
Chyle
to
ferment
with
the
Choler
,
in
order
to
remove
the
grosser
Particles
from
those
that
ought
to
enter
into
the
Lacteal
Vessels
.
Into
how
many
sorts
are
the
Guts
distinguish'd
?
There
are
two
sorts
,
viz.
the
thin
and
the
thick
.
How
many
thin
or
small
Guts
are
there
?
Three
;
that
is
to
say
,
the
Duodenum
,
the
Jejunum
,
and
the
Ileon
.
How
many
thick
Guts
are
there
?
Three
likewise
;
viz.
the
Coecum
,
the
Colon
and
the
Rectum
.
Why
are
some
of
them
call'd
thin
Guts
,
and
others
thick
?
Because
the
thin
are
smaller
,
being
appointed
only
to
transport
the
Chyle
out
of
the
Stomach
into
the
Reserver
;
whereas
the
thick
are
more
large
and
stronger
,
serving
to
carry
forth
the
gross
Excrements
out
of
the
Belly
.
Are
the
six
Guts
of
an
equal
length
?
No
,
the
Duodenum
,
which
is
the
first
of
the
thin
Guts
,
is
only
twelve
Fingers
breadth
long
▪
The
Jejunum
,
being
the
second
,
so
call'd
because
always
empty
,
is
five
Foot
long
:
The
third
is
nam'd
Ileon
,
by
reason
of
its
great
Turnings
which
oblige
it
to
pass
to
the
Os
Ilion
,
wher●
it
produceth
a
Rupture
;
it
extends
it self
almost
twenty
Foot
in
length
.
The
first
of
the
thick
Guts
,
known
by
th●
Name
of
Coecum
,
is
very
short
,
and
properly
only
an
Appendix
or
Bag
of
a
Finger's
length
That
which
follows
is
the
Colon
,
being
the
largest
of
all
,
and
full
of
little
Cells
,
which
are
fill'd
sometimes
with
Wind
and
other
Matters
that
excite
the
Pains
of
the
Colick
.
It
encompasseth
the
thin
Guts
,
in
passing
from
the
top
to
the
bottom
of
the
Belly
,
by
the
means
o●●
its
great
Circumvolutions
,
and
is
from
eight
to
nine
Foot
long
.
The
last
is
the
Rectum
o●
streight
Gut
,
so
nam'd
,
because
it
goes
directly
to
the
Fundament
:
It
is
no
longer
than
ones
Hand
,
but
it
is
fleshy
,
and
situated
upon
the
Os
Sacrum
,
and
the
Coccyx
or
Rump-Bone
.
What
is
the
Peristaltick
Motion
of
the
Guts
?
It
is
the
successive
Motion
and
Undulation
,
whereby
the
Guts
insensibly
push
forward
from
the
top
to
the
bottom
,
the
Matters
contain'd
in
them
;
and
that
Motion
which
on
the
contrary
is
perform'd
from
the
bottom
to
the
top
,
is
term'd
the
Antiperistaltick
,
as
it
happens
in
the
Iliack
Passion
,
or
twisting
of
the
Guts
,
call'd
Domine
Miserere
,
by
reason
of
its
intolerable
Pain
.
What
is
the
Mesentery
?
It
is
a
kind
of
Membrane
somewhat
fleshy
,
which
is
join'd
to
the
Spine
in
the
bottom
and
middle
of
the
Belly
,
and
by
its
folding
,
keeps
all
the
Guts
steady
in
their
place
;
it
is
all
over
beset
with
red
,
white
,
and
Lymphatick
Vessels
;
that
is
to
say
,
those
that
carry
the
Blood
,
Chyle
,
and
Lympha
,
which
serves
to
cause
this
last
to
run
more
freely
,
and
to
ferment
.
Three
notable
Glandules
are
also
observ'd
therein
,
the
greatest
whereof
lies
in
the
middle
,
and
is
nam'd
Asellius's
Pancreas
;
the
two
other
lesser
are
call'd
Lumbar
Glandules
,
as
being
situated
near
the
Left
Kidney
.
From
each
of
these
Glandules
proceeds
a
small
Branch
;
and
both
are
united
together
to
make
the
great
Lacteal
Vein
,
or
Thoracick
Canal
.
This
Tube
conveys
the
Chyle
along
the
Vertebra's
of
the
Back
to
the
Left
Subclavian
.
Vein
;
from
whence
it
passeth
into
the
ascending
Vena
Cava
,
and
descends
in
the
Right
Ventricle
of
the
Heart
,
where
it
assumes
the
form
of
Blood
;
fro●●
whence
it
passeth
to
the
Lungs
thro'
the
Pulmonary
Artery
;
then
it
returns
to
the
Hear
thro'
the
Pulmonary
Vein
,
and
goes
forth
agai●
thro'
the
Left
Ventricle
of
the
Heart
,
between
the
Aorta
or
great
Artery
,
to
be
afterward
distributed
to
all
the
Parts
of
the
Body
.
This
i●
the
ordinary
Passage
for
the
Circulation
of
th●
Chyle
,
and
the
Sanguification
of
the
Heart
.
What
is
the
Liver
?
The
Liver
,
being
the
thickest
of
all
the
Bo●●els
,
is
plac'd
in
the
Right
Hypochondrium
,
at
th●
distance
only
of
a
Fingers
breadth
from
the
Diaphragm
;
its
Figure
much
resembling
that
of
〈◊〉
thick
piece
of
Beef
:
It
is
Convex
on
the
outside
,
and
Concave
within
;
its
Substance
is
so●
and
tender
,
its
Colour
and
Consistence
being
lik●
coagulated
Blood
:
It
is
cleft
at
bottom
,
and
divided
into
two
Lobes
,
viz.
one
greater
,
an●
the
other
less
:
Its
Office
is
to
purifie
the
Ma●
of
Blood
by
Filtration
;
and
it
is
bound
by
two
strong
Ligaments
,
the
first
whereof
adheres
〈◊〉
the
Diaphragm
,
and
the
second
to
the
Xiphoid●
or
Sword-like
Cartilage
.
Two
great
Veins
tak●
their
Rise
from
hence
,
viz.
the
Vena
Portae
,
an●
the
Vena
Cava
,
which
form
innumerable
Branches
,
as
it
were
Roots
in
the
Body
of
th●
Liver
.
The
Gall-Bladder
is
fasten'd
to
the
ho●low
part
thereof
,
and
dischargeth
its
Chole●
into
the
Gut
Duodenum
,
thro'
the
Vessels
that
be●●
the
Name
of
Meatus
Choledochi
,
or
Ductus
Bi●●ares
.
This
Choler
is
not
a
meer
Excremen●
but
on
the
contrary
of
singular
Use
in
causin●
the
Fermentation
of
the
Chyle
,
and
bringing
to
perfection
.
What
is
the
Spleen
?
The
Spleen
is
a
Bowel
resembling
a
Hart's
Tongue
in
shape
,
and
situated
in
the
Left
Hypochondrium
,
over-against
the
Liver
:
Its
length
is
about
half
a
Foot
,
and
its
breadth
equal
to
that
of
three
Fingers
;
its
Substance
being
soft
,
as
that
of
the
Liver
,
and
its
Colour
like
dark
coagulated
Blood
:
It
is
fasten'd
to
the
Peritonaeum
,
Left
Kidney
,
Diaphragm
,
and
to
the
Caul
on
the
inside
;
as
also
to
the
Stomach
by
certain
Veins
,
call'd
Vasa
Brevia
;
nevertheless
these
Ligatures
do
not
hinder
it
from
wandering
here
and
there
in
the
lower
Belly
,
where
it
often
changeth
its
place
,
and
causeth
many
dreadful
Symptoms
by
its
irregular
Motions
.
It
s
Office
is
to
Subtilize
the
Blood
by
cleansing
and
refining
it
.
What
are
the
Reins
?
The
Reins
or
Kidneys
are
Parts
of
a
Fleshy
Consistence
,
harder
and
more
firm
than
that
of
the
Liver
and
Spleen
:
They
are
both
situated
in
the
sides
of
the
Umbilical
Region
,
upon
the
Muscle
Psoas
,
between
the
two
Tunicks
of
the
Peritonoeum
;
but
the
Right
is
lower
than
the
Left
:
Their
Shape
resembleth
that
of
a
French
Bean
,
and
they
receive
Nerves
from
the
Stomach
,
whence
Vomitings
are
frequently
occasion'd
in
the
Nephritical
Colicks
:
They
are
〈◊〉
asten'd
to
the
Midriff
,
Loins
,
and
Aorta
,
by
the
Emulgent
Arteries
;
as
also
to
the
Bladder
by
the
Vreters
.
The
Right
Kidney
likewise
adheres
to
the
Gut
Caecum
,
and
the
Left
to
the
Colon.
Their
Office
is
to
filtrate
or
strain
the
Urine
in
the
Pelves
or
Basons
,
which
they
have
in
the
middle
of
their
Body
on
the
inside
,
and
to
cause
it
to
run
thro'
the
Vessels
call'd
Vreters
into
the
Bladder
.
Immediately
above
the
Reins
on
each
side
,
is
a
flat
and
soft
Glandule
,
of
the
thickness
of
〈◊〉
Nut
;
they
are
nam'd
Renal
Glandules
,
or
Ca●sulae
Atribiliariae
,
because
they
contain
a
blackish
Liquor
,
which
(
as
they
say
)
serves
as
i●
were
Leaven
for
the
Blood
,
to
set
it
a
fermenting
.
What
is
the
Bladder
?
It
is
the
Bason
or
Reserver
of
Urines
,
of
a
Membranous
Substance
as
the
Stomach
,
bei●●
plac'd
in
the
middle
of
the
Hypogastrick
Region
;
so
that
it
is
guarded
by
the
Os
Sacr●●●
behind
,
and
by
the
Os
Pubis
before
:
Two
Par●
are
to
be
distinguish'd
therein
,
viz.
it
s
Botto●
and
Top
;
by
its
Membranous
Bottom
it
〈◊〉
join'd
to
the
Navel
,
and
suspended
by
the
mea●
of
the
Vrachus
,
and
the
two
Umbilical
Arter●●
which
degenerate
into
Ligaments
in
adult
P●●sons
:
As
by
its
fleshy
Neck
,
longer
and
crooke●
in
Men
,
and
shorter
and
streight
in
Wom●
it
cleaves
to
the
Intestinum
Rectum
in
the
former
,
and
to
the
Neck
of
the
Womb
in
the
later
.
Lastly
,
its
Office
is
to
receive
the
Uri●●
to
keep
them
,
and
to
discharge
them
fr●●
time
to
time
.
What
are
the
Genitals
in
Men
?
They
are
the
Spermatick
Vessels
,
the
Tes●cles
,
and
the
Penis
.
The
Spermatick
Vessels
a●
a
Vein
and
an
Artery
on
each
side
;
the
form
proceeding
from
the
Aorta
,
or
thick
Artery
the
Heart
;
and
the
other
from
the
Branches
the
Vena
Cava
of
the
Liver
.
These
Arte●●
and
Veins
are
terminated
in
the
Body
of
〈◊〉
Testicles
,
which
are
two
in
Number
,
enclos'd
within
the
Scrotum
The
Office
of
the
Testicles
is
to
filtrate
the
Seed
,
which
is
brought
thither
from
all
the
parts
of
the
Body
,
thro'
the
Spermatick
Vessels
,
called
Praeparantia
,
and
afterwards
to
cause
it
to
pass
thro'
others
nam'd
Deferentia
,
to
the
Vesiculae
Seminales
,
from
whence
it
is
forc'd
into
the
Vreter
,
thro'
two
small
and
very
short
Canals
.
The
Penis
or
Yard
is
a
Nervous
and
Membranous
Part
,
well
furnish'd
with
Veins
and
Arteries
,
containing
in
the
middle
the
Canal
of
the
Vreter
:
Its
Extremity
,
which
consists
of
a
very
delicate
and
spongy
sort
of
Flesh
,
is
call'd
Balanus
,
or
Glans
,
and
the
Nut
,
the
Skin
that
covers
it
being
nam'd
the
Praeputium
,
or
the
Fore-Skin
.
Thus
by
the
means
of
this
swell'd
Part
,
and
stiff
thro'
the
affluence
of
the
Spirits
,
the
Male
injects
his
Seed
into
the
Matrix
of
the
Female
,
to
propagate
his
Kind
.
What
are
the
Parts
appropriated
to
Generation
in
Women
?
They
are
the
Spermatick
Vessels
,
the
Ovaries
or
Testicles
,
and
the
Matrix
.
The
Spermatick
Vessels
are
a
Vein
and
an
Artery
on
each
side
,
as
in
Men
:
The
Ovaries
or
Testicles
,
situated
on
the
side
of
the
bottom
of
the
Matrix
,
are
almost
of
the
same
bigness
with
those
of
Men
,
but
of
a
round
and
flat
Figure
.
The
Vesiculae
,
or
little
Bladders
which
they
contain
,
are
usually
term'd
Ova
or
Eggs
by
Modern
Anatomists
;
and
the
Vessels
that
pass
from
these
Testicles
or
Ovaries
to
the
Cornua
of
the
Vterus
,
are
call'd
Deferentia
or
Ejaculatoria
.
The
Matrix
,
Vterus
or
Womb
,
is
the
principal
Organ
of
Generation
,
and
the
place
where
it
is
perform'd
,
resembling
the
Figure
of
a
Peat
with
its
Head
upward
,
and
being
situated
between
the
Gut
Rectum
and
the
Bladder
:
It
is
of
a
fleshy
and
membranous
Substance
,
retain'd
in
its
place
by
four
Ligaments
,
fasten'd
to
the
bottom
;
whereof
the
two
upper
are
large
ones
,
proceeding
from
the
Loins
,
and
the
two
lower
round
,
taking
their
Rise
from
the
Groin
,
where
they
form
a
kind
of
Goose-Foot
,
which
is
extended
to
the
Os
Pubis
,
and
the
flat
part
of
the
Thighs
;
which
is
the
cause
that
Women
are
in
danger
of
Miscarrying
when
they
fall
upon
their
Knees
.
The
Exterior
Neck
of
the
Womb
,
call'd
Vagina
,
is
made
almost
in
form
of
a
Throat
or
Gullet
,
extending
it self
outwardly
to
the
sides
of
the
Lips
of
the
Pudendum
,
and
being
terminated
inwardly
at
the
internal
Orifice
of
the
Matrix
,
the
shape
whereof
resembleth
that
of
the
Muzzle
or
Nose
of
a
little
Dog
.
The
outward
Neck
of
the
womb
is
fasten'd
to
the
Bladder
and
the
Os
Pubis
before
,
and
in
the
hinder
part
to
the
Os
Sacrum
:
Between
the
Lips
of
the
Pudendum
lie
the
Nymphae
,
which
are
plac'd
at
the
Extremity
of
the
Canal
of
the
Bladder
,
to
convey
the
Urines
;
and
somewhat
farther
appear
four
Caruncles
,
or
small
pieces
of
Flesh
,
at
the
Entrance
of
the
Vagina
,
which
when
join'd
together
make
the
thin
Membrane
call'd
Hymen
.
CHAP.
XIV
.
Of
the
Anatomy
of
the
Thorax
,
Breast
,
or
middle
Venter
.
WHAT
is
the
Breast
?
It
is
a
Cavity
in
which
the
Heart
and
the
Lungs
are
principally
enclos'd
.
What
is
to
be
consider'd
outwardly
in
the
Breast
?
It
s
extent
,
and
the
situation
of
the
Parts
therein
contain'd
.
What
is
its
extent
?
It
is
extended
from
the
Clavicles
to
the
Xiphoides
,
or
Sword-like
Cartilage
on
the
fore-part
,
and
bounded
on
the
hinder
by
the
twelfth
Vertebra
of
the
Back
,
having
all
the
Ribs
to
form
its
Circumference
,
and
the
Diaphragm
for
its
Bounds
at
bottom
,
separating
it
from
the
Abdomen
or
lower
Belly
.
What
is
the
situation
of
the
Parts
contain'd
in
the
Breast
?
The
Lungs
take
up
the
upper
Region
,
and
fill
almost
the
whole
Space
,
descending
at
the
distance
of
two
Fingers
breadth
from
the
Diaphragm
;
the
Heart
is
situated
in
the
middle
,
bearing
its
Point
somewhat
towards
the
Left
side
,
under
the
Lobes
of
the
Lungs
,
which
are
divided
by
the
Mediastinum
that
distinguishes
them
into
the
Right
and
Left
Parts
.
How
is
the
Breast
Anatomiz'd
or
open'd
?
After
the
dissection
of
the
five
Teguments
,
and
the
removal
of
the
Muscles
,
as
in
the
lower
Belly
,
the
Anatomist
proceeds
to
lift
up
the
Sternum
or
Breast-Bone
,
by
separating
it
from
the
Ribs
;
then
it
is
laid
upon
the
Face
,
or
else
entirely
taken
away
to
the
end
that
the
internal
Parts
of
the
Breast
may
be
more
clearly
discover'd
;
whereupon
immediately
appear
,
the
Heart
,
the
Lungs
,
the
Diaphragm
,
and
the
Mediastinum
,
which
sticks
to
the
Sternum
throughout
its
whole
length
.
What
is
the
Heart
?
It
is
a
most
noble
Part
,
being
the
Fountain
of
Life
,
and
the
first
Original
of
the
Motion
of
a●●
the
others
;
on
which
account
it
is
call'd
Prim●●
vivens
,
&
ultimum
moriens
;
that
is
to
say
,
the
first
Member
that
begins
to
live
,
and
the
la●●
that
dies
.
What
Parts
are
to
be
consider'd
in
the
Heart
?
It
s
fleshy
Substance
,
with
all
its
Fibres
turn●●
round
like
the
Skrews
of
a
Vice
;
its
Basis
,
Poin●
Auricles
,
Ventricles
,
large
Vessels
,
Pericardium
and
Ligatures
or
Tyes
:
The
Basis
is
the
uppermost
and
broadest
part
;
the
Point
is
the
lowermost
and
narrowest
part
;
the
two
Auricles
〈◊〉
small
Ears
being
as
it
were
little
Cisterns
〈◊〉
Reservers
,
that
pour
the
Blood
by
degrees
it
to
the
Heart
,
are
situated
on
each
side
abo●●
the
Ventricles
.
The
Ventricles
,
which
are
likewise
two
in
Number
,
are
certain
Cavities
〈◊〉
its
Right
and
Left
Sides
.
The
large
Vessels
〈◊〉
the
Aorta
or
great
Artery
,
and
the
Vena
Ca●●●
together
with
the
Pulmonary
Artery
and
Ve●●●
The
Pericardium
is
a
kind
of
Bag
fill'd
wi●●
Water
,
wherein
the
Heart
is
kept
;
which
〈◊〉
fasten'd
to
the
Mediastinum
by
its
Basis
,
and
to
the
large
Vessels
that
enter
and
go
out
of
its
Ventricles
.
What
are
the
Terms
appropriated
to
the
continual
beating
of
the
Heart
?
They
are
Diastole
and
Systole
,
from
whence
proceed
two
several
Motions
,
the
first
whereof
is
that
of
Dilatation
,
and
the
other
of
Contraction
,
communicated
to
all
the
Arteries
which
have
the
same
Pulse
.
To
what
use
serves
the
Water
contain'd
in
the
Pericardium
?
It
prevents
the
drying
of
the
Heart
by
its
perpetual
Motion
.
What
are
the
Lungs
?
They
are
an
Organ
serving
for
Respiration
,
of
a
soft
Substance
,
and
porous
as
a
Spunge
,
being
all
over
beset
with
Arteries
,
Veins
,
Nerves
,
and
Lymphatick
Vessels
,
and
perforated
with
small
Cartilaginous
Tubes
,
that
are
imparted
to
it
from
the
Wind-Pipe
,
and
are
call'd
Bronchia
.
Their
Natural
Colour
is
a
pale
Red
,
and
marbl'd
dark
Brown
;
and
their
whole
Body
is
wrapt
up
in
a
fine
smooth
Membrane
,
which
they
receive
from
the
Pleuron
.
They
are
suspended
by
the
Wind-Pipe
,
by
their
proper
Artery
and
Vein
,
and
by
the
Ligatures
that
fasten
them
to
the
Sternum
,
Mediastinum
,
and
frequently
to
the
Pleuron
it self
:
They
are
also
divided
into
the
Right
and
Left
Parts
by
the
Mediastinum
;
having
four
or
five
Lobes
,
whereof
those
on
the
Left
side
cover
the
Heart
.
Their
continual
Motion
consists
in
Inspiration
,
to
take
in
the
Air
,
and
Expiration
,
to
drive
it
out
.
The
Larynx
makes
the
Entrance
of
the
Wind-Pipe
into
the
Lungs
,
and
the
Pharynx
that
of
the
O●sophagus
or
Gullet
,
at
the
bottom
of
the
Mouth
to
pass
into
the
Stomach
.
CHAP.
XV.
Of
the
Anatomy
of
the
Head
,
or
upper
Venter
.
WHAT
is
the
Head
?
It
is
a
bony
Part
,
that
contains
and
encloseth
the
Brain
within
its
Cavity
.
What
is
most
remarkable
in
the
outward
parts
of
the
Head
?
The
Temporal
Arteries
,
the
Crotaphitae
,
of
Temporal
Muscles
,
and
the
Sutures
of
the
Skull
.
Why
are
these
things
considerable
?
The
Temporal
Arteries
are
of
good
Note
because
they
are
expos'd
on
the
outside
,
lying
even
with
the
Skin
.
The
Crotophite
Muscles
are
so
likewise
,
in
regard
that
they
cannot
be
hurt
without
danger
of
Convulsions
,
by
reason
of
the
Pericranium
with
which
they
are
cover'd
.
And
the
Sutures
,
because
the
Meninges
of
the
Brain
proceed
from
thence
to
form
the
Pericranium
.
What
is
the
Pericranium
?
It
is
a
Membrane
that
lies
under
the
thick
hairy
Skin
of
the
Head
,
and
immediately
covers
the
Skull
.
What
are
the
Meninges
?
They
are
two
Membranes
that
enclose
the
Substance
or
Marrow
of
the
Brain
.
What
is
a
Suture
?
It
is
a
kind
of
thick
Seam
or
Stitch
,
that
serves
to
unite
the
Bones
of
the
Skull
.
How
many
sorts
of
Sutures
are
there
?
There
are
two
sorts
,
viz.
the
true
,
and
the
false
or
Bastard
.
What
are
the
true
Sutures
?
They
are
three
in
number
,
namely
the
Sagittal
,
the
Coronal
,
and
the
Lambdoidal
.
What
is
the
disposition
or
situation
of
the
true
Sutures
?
The
Sagittal
is
streight
,
beginning
in
the
middle
of
the
Fore-head
,
and
sometimes
at
the
root
of
the
Nose
,
and
being
terminated
behind
,
at
the
joining
of
the
two
Branches
of
the
Lambdoidal
Suture
?
The
Coronal
appears
in
form
of
a
Crown
,
passing
to
the
middle
of
the
Head
,
and
descending
thro'
the
Temples
,
to
finish
its
Circumference
in
the
Root
of
the
Nose
.
The
Lambdoidal
Suture
is
made
like
an
open
Pair
of
Compasses
,
the
Legs
whereof
are
extended
toward
the
Shoulders
;
and
the
Button
is
in
the
top
of
the
Head
backward
.
What
are
the
Bastard
Sutures
?
They
are
those
that
are
call'd
Squamous
or
scaly
,
What
is
the
disposition
or
natural
situation
of
these
false
Sutures
?
They
are
plac'd
at
the
two
sides
of
the
Head
,
and
make
a
Semi-Circle
of
the
bigness
of
the
Ears
,
round
the
same
Ears
.
What
difference
is
there
between
the
true
and
spurious
Sutures
.
The
true
Sutures
are
made
in
form
of
the
Teeth
of
a
Saw
,
which
enter
one
into
the
other
;
and
the
false
or
Bastard
ones
are
those
that
resemble
the
Scales
of
Fishes
,
which
are
join'd
together
by
passing
one
over
the
other
.
What
is
the
Vse
of
the
Sutures
?
The
Ancients
were
of
Opinion
,
that
they
were
made
to
hinder
the
Fracture
of
one
Skull-Bone
from
passing
thro'
the
whole
Head
;
but
there
is
more
reason
to
believe
that
they
have
the
three
following
Uses
,
that
is
to
say
,
-
1.
To
promote
the
transpiration
of
the
Brain
.
-
2.
To
give
Passage
to
the
Vessels
that
go
to
the
Diploe
.
-
3.
To
retain
the
Meninges
,
and
to
support
the
Mass
of
the
Brain
,
which
is
cover'd
by
them
.
What
are
the
Names
of
the
Bones
that
compose
the
Skull
?
The
Bone
of
the
fore-part
of
the
Head
is
call'd
Sinciput
,
or
the
Fore-head-Bone
,
as
also
the
Frontal
or
Coronal
Bone
.
The
Bone
of
the
hinder-part
,
enclos'd
within
the
Lambdoidal
Suture
,
is
term'd
the
Occipital
.
The
two
Bones
that
form
the
upper-part
,
and
are
distinguish'd
by
the
Sagittal
Suture
,
bear
the
Name
of
Parietals
,
one
being
on
the
Right
side
,
and
the
other
on
the
Left
.
And
those
behind
the
Ears
are
call'd
Temporal
,
Squamosa
,
or
Petrosa
.
These
also
are
distinguish'd
into
the
Right
and
Left
Temporals
,
and
are
join'd
to
the
bottom
of
the
Par●etal
by
a
bastard
squamous
Suture
.
What
is
most
remarkable
in
the
thickness
of
the
Skull-Bones
?
The
Diploe
,
which
is
nothing
else
but
a
Plex●●
or
Contexture
of
small
Vessels
,
that
nourish
the
Bones
,
and
in
the
middle
of
their
thickness
make
the
distinction
of
the
first
and
second
Tablature
of
the
Bones
;
whence
it
sometimes
happens
that
an
exfoliative
Trepan
,
or
Semi-Trepan
,
is
sufficient
,
when
the
first
of
these
two
Tables
is
only
broken
,
the
other
remaining
entire
.
Is
the
Brain
which
is
preserv'd
in
the
Skull
all
of
one
Piece
,
or
one
equal
Mass
?
No
,
it
is
distinguish'd
by
the
means
of
the
Meninges
into
the
Brain
it self
,
and
the
Cerebellum
or
little
Brain
;
the
Brain
,
properly
so
called
,
takes
up
almost
the
whole
Cavity
of
the
Skull
,
and
the
Cerebellum
is
lodg'd
altogether
in
the
hinder-part
,
where
it
constitutes
only
one
entire
Body
;
whereas
the
former
is
divided
into
the
Right
and
Left
Parts
by
the
Meninges
,
which
cut
it
even
to
the
bottom
;
whence
these
Foldings
are
call'd
Falx
;
i.
e.
a
Scythe
or
Sickle
.
What
is
chiefly
remarkable
in
the
Substance
of
the
Brain
?
The
Ventricles
or
Cavities
which
are
found
therein
,
together
with
the
great
Numbe
of
Veins
,
Arteries
,
Lymphatick
Vessels
,
and
Nerves
,
that
carry
Sense
to
all
the
Parts
of
the
Body
,
and
Spirits
for
their
Motion
.
An
exact
Historical
Account
of
all
the
Holes
of
the
Skull
,
and
the
Vessels
that
pass
thro'
them
.
To
attain
to
an
exact
Knowledge
of
all
the
Holes
with
which
the
inside
of
the
Basis
of
the
Skull
is
perforated
,
they
are
to
be
consider'd
either
with
respect
to
the
Nerves
,
or
to
the
Sanguinary
Vessels
.
There
are
nine
Pairs
of
Nerves
that
arise
from
the
Medulla
Oblongata
,
and
go
forth
out
of
the
Skull
through
many
Holes
hereafter
nam'd
.
The
first
Pair
is
that
of
the
Olfactory
Nerves
,
appropriated
to
the
Sense
of
Smelling
,
which
are
divided
below
the
Os
Cribiforme
,
or
Sieve-like
Bone
,
into
dive●s
Threads
,
that
passing
into
the
Nose
through
many
Holes
with
which
this
Bone
is
pierc'd
,
are
distributed
to
the
inner
Tunick
of
the
Nose
.
The
second
Pair
is
that
of
the
Optick
or
Visual
Nerves
,
that
pass
into
the
Orbits
of
the
Eyes
,
thro'
certain
peculiar
Holes
made
in
the
Os
Sphenoides
,
or
Wedge-like
Bone
,
immediately
above
the
Anterior
Apophysis
Clinoides
.
In
the
Portion
of
the
Os
Sphenoides
,
that
makes
the
Basis
of
the
Orbit
,
lies
a
Fissure
about
seven
or
eight
Hairs
breadth
long
,
which
is
to
be
observ'd
chiefly
at
the
bottom
,
that
is
to
say
,
below
the
Hole
,
thro'
which
the
Optick
Nerve
passeth
;
where
it
is
almost
round
,
and
larger
than
at
the
top
,
where
it
is
terminated
in
a
very
long
and
acute
Angle
.
There
are
many
Pairs
of
Nerves
that
enter
into
the
Orbit
thro'
this
Fissure
,
viz.
-
1.
The
third
Pair
,
call'd
the
Motorii
Oculorum
.
-
2.
The
fourth
Pair
,
nam'd
Pathetici
,
by
Dr.
Willis
.
And
-
3.
The
whole
sixth
Pair
.
Besides
these
three
Pairs
,
which
go
entire
thro'
this
Cleft
,
there
is
also
a
Passage
for
the
upper
Branch
of
the
foremost
Fibre
of
the
fifth
Pair
,
which
the
same
renowned
Physician
calls
the
Ophthalmick
Branch
Beyond
the
lower-part
of
the
said
Fissure
,
toward
the
hinder-part
of
the
Head
,
is
to
be
seen
in
the
Os
Sphenoides
on
each
side
,
a
Hole
that
doth
not
penetrate
the
Basis
of
the
Skull
,
but
makes
a
kind
of
Ductus
,
about
an
Hair's
breadth
long
,
which
is
open'd
behind
the
Orbit
on
the
top
of
the
Space
between
the
Apophysis
Pterygoides
,
and
the
third
Bone
of
the
Jaw
;
thro'
this
Ductus
runs
the
lower
Branch
of
the
foremost
Fibre
of
the
fifth
Pair
.
About
the
length
of
two
Hairs
breadth
beyond
these
Ductus's
,
we
may
also
discover
in
the
Os
Sphenoides
,
or
Wedge-like
Bone
,
two
Holes
of
an
Oblong
and
almost
Oval
Figure
,
which
are
plac'd
in
the
hindermost
sides
of
that
of
the
Os
Sphenoides
,
and
gives
passage
to
the
hindermost
Fibre
of
the
fifth
Pair
.
The
Hole
thro'
which
runs
the
Auditory
Nerve
,
that
makes
the
seventh
Pair
,
is
in
the
middle
of
the
hinder-part
of
the
Os
Petrosum
,
that
looks
toward
the
Cerebellum
:
This
Hole
being
very
large
,
is
the
Entrance
of
a
Ductus
that
is
hollow'd
in
the
Os
Petrosum
,
and
which
sinking
obliquely
from
the
fore-part
backward
,
for
the
depth
of
about
two
Hairs
breadth
,
forms
as
it
were
the
bottom
of
a
Sack
,
the
lowermost
part
whereof
is
terminated
partly
by
the
Basis
of
the
Cochlea
,
and
partly
by
a
Portion
of
the
Mouth
of
the
Vestibulum
.
At
the
bottom
of
this
Ductus
are
many
Holes
,
but
the
most
considerable
is
that
of
the
upper-par●●
thro'
which
passeth
a
Portion
of
the
Audito●●
Nerve
.
This
is
also
the
Entrance
of
another
〈◊〉
made
in
the
Os
Petrosum
,
which
is
open'd
b●●●●
〈◊〉
the
Apophysis
Mastoides
and
S●●●des
:
The
other
Holes
afford
a
Passage
to
the
Br●●●
〈◊〉
of
the
soft
Portion
of
the
same
Auditory
〈◊〉
.
Below
this
Ductus
there
is
a
remarkable
Hole
form'd
by
the
meeting
of
two
hollow
Cuts
the
larger
whereof
is
in
the
Occipital
Bor●
and
the
other
in
the
lower-part
of
the
Apophysis
Petros●
:
From
the
middle
of
the
upper-p●●●
of
this
Hole
issueth
forth
a
small
Prominence
〈◊〉
bony
Point
,
whereto
is
join'd
an
Appendix
o●
the
Dura
Mater
,
which
divides
the
Hole
in●●
two
parts
;
so
that
thro'
the
foremost
Orifice
passeth
the
Nerve
of
the
eighth
Pair
,
and
th●●
which
is
call'd
the
Spinal
Nerve
.
We
shal●
have
occasion
hereafter
to
shew
the
Use
of
th●
hinder
Orifice
.
Near
the
great
Hole
of
the
Occipital
Bone
from
whence
proceeds
the
Medulla
Oblongata
,
we
may
observe
a
Hole
almost
round
and
oblong
thro'
which
passeth
the
Nerve
of
the
ninth
Pair
This
Hole
is
entirely
situated
in
the
Occipi●●
Bone
,
and
making
a
little
Way
in
the
Bone
passeth
obliquely
from
the
back-part
forward
In
the
inside
of
the
Skull
this
Hole
is
sometime
double
,
but
it
s
two
Entrances
are
re-united
〈◊〉
the
outward-part
of
the
Skull
;
and
the
tw●
Branches
that
form
the
Origine
of
this
Nerve
and
which
pass
thro'
these
two
Holes
,
are
likewise
re-united
at
their
Departure
,
These
a●●
the
Passages
of
the
nine
Pairs
of
Nerves
th●●
proceed
from
the
Medulla
Oblongata
,
and
it
remains
only
to
show
the
Paths
thro'
which
the
Intercostal
Nerve
goes
forth
,
as
also
that
of
the
tenth
Pair
.
The
Intercostal
runs
out
of
th●
Skull
thro'
the
Ductus
that
gives
Entrance
〈◊〉
the
Internal
Carotick
Artery
.
As
for
the
ten●●
Pair
,
in
regard
that
it
ariseth
from
the
Marrow
which
is
enclos'd
between
the
Occipit●●
Bone
and
the
first
Vertebra
,
it
goes
forth
thro'
the
Hole
of
the
Dura
Mater
,
where
the
Vertebral
Artery
enters
.
To
know
well
the
Holes
thro'
which
the
Vessels
that
belong
to
the
inner-part
of
the
Head
enter
,
and
issue
forth
,
it
is
requisite
to
distinguish
them
into
those
which
are
distributed
to
the
Dura
Mater
,
and
those
that
are
appointed
for
the
Brain
.
The
Vessels
of
the
Dura
Mater
,
are
Branches
of
the
Carotick
or
Vertebral
Arteries
.
In
the
Os
Sphenoides
,
or
Wedge-like
Bone
,
behind
the
Hole
thro'
which
passeth
the
hindermost
Fibre
of
the
fifth
Pair
of
Nerves
lies
another
small
Hole
,
almost
round
,
that
gives
Entrance
to
a
Branch
of
the
External
Carotick
Artery
,
which
in
entring
,
immediately
adheres
to
the
Dura
Mater
,
and
forms
many
Ramifications
to
overspread
the
whole
Portion
of
this
Membrane
,
which
covers
the
sides
,
and
the
upper-part
of
the
Brain
.
At
the
bottom
and
top
of
the
lateral
outward
part
of
the
Orbit
of
the
Eye
,
above
the
acute
Angle
,
for
want
of
the
Os
Sphenoides
,
there
is
a
Hole
thro'
which
passeth
an
Artery
,
being
a
Twig
of
a
Branch
of
the
Internal
Carotick
,
which
is
diffus'd
in
the
Eye
,
and
distributed
to
almost
the
whole
Portion
of
the
Dura
Mater
,
that
covers
the
fore-part
of
the
Brain
.
The
Vertebral
Artery
in
entring
into
the
Skull
,
furnisheth
it
on
each
side
with
a
considerable
Branch
,
which
is
dispers'd
throughout
the
whole
Portion
of
the
Dura
Mater
that
covers
the
Cerebellum
.
As
for
the
Veins
that
accompany
these
Arteries
,
they
almost
all
go
out
of
the
Skull
thro'
the
same
Holes
where
the
other
enters
.
There
are
four
thick
Arteries
which
convey
to
the
Brain
the
Matter
with
which
it
is
nourish'd
,
and
that
whereof
the
Spirits
are
form'd
,
viz.
the
two
Internal
Caroticks
,
and
the
two
Vertebrals
.
The
Internal
Carotick
Arteries
enter
into
the
Skull
thro
a
particular
Ductus
made
in
the
Temporal
Bone
,
the
Mouth
thereof
being
of
an
Oval
Figure
,
and
situated
in
the
outward
part
of
the
Basis
of
the
Skull
,
before
the
Hole
of
the
Internal
Jugular
.
This
Ductus
extends
it self
obliquely
from
the
back-side
forward
,
and
after
having
made
about
three
Hairs
breadth
i●
length
,
is
terminated
in
the
hinder-part
of
the
Os
Sphenoides
.
The
Artery
traverseth
the
whole
winding
Compass
of
this
Ductus
,
which
resembles
the
Figure
of
the
Roman
Letter
S.
and
at
the
Mouth
of
the
same
Ductus
runs
under
the
Dura
Mater
along
the
sides
of
the
Os
Sphenoides
to
the
Anterior
Apophyses
Clinoides
,
where
it
riseth
up
again
,
to
perforate
the
Dura
Mater
,
and
to
adhere
to
the
Root
of
the
Brain
.
These
Vessels
,
in
like
manner
,
after
their
departure
from
the
Bone
of
the
Temples
to
the
place
where
they
pierce
the
Dura
Mater
,
make
a
second
Circuit
in
form
of
the
Roman
Character
S.
At
the
place
where
these
Carotick
Arteries
penetrate
the
Dura
Mater
,
they
send
forth
a
thick
Branch
,
which
enters
into
the
Orbit
of
the
Eye
,
by
the
lower-part
of
the
Hole
,
thro'
which
the
Oprick
Nerve
hath
its
Passage
.
The
Vertebral
Arteries
proceeding
from
the
Holes
of
the
transverse
Apophyses
of
the
first
Vertebra
,
turn
about
in
passing
under
the
upper
oblique
Apophyses
of
the
seven
Vertebra's
:
Afterward
they
perforate
the
Dura
Mater
,
and
running
under
the
Marrow
,
enter
into
the
Skull
thro'
the
Occipital
Hole
;
then
inclining
one
toward
another
,
they
are
re-united
,
and
form
only
one
single
Trunk
.
The
Veins
that
bring
back
the
Blood
from
the
Substance
of
the
Brain
,
are
emptied
into
the
Sinus's
of
the
Dura
Mater
,
which
are
all
discharg'd
into
those
that
are
call'd
Lateral
,
which
last
go
out
of
the
Skull
immediately
under
the
Nerves
of
the
eighth
Pair
,
thro'
the
hinder-part
of
the
Hole
made
by
the
meeting
of
the
Occipital
Bone
,
and
the
Apophysis
Petrosa
.
These
Lateral
Sinus's
fall
into
the
Internal
Jugulars
,
which
are
receiv'd
into
a
considerable
Sinking
hollow'd
on
each
side
in
the
outward
part
of
the
Basis
of
the
Skull
,
which
is
nam'd
the
Pit
or
Hole
of
the
Internal
Jugular
.
In
the
upper
and
hinder-part
of
the
Hole
,
from
whence
the
lateral
Sinus's
issue
forth
,
is
to
be
seen
an
opening
in
the
Extremity
of
a
Ductus
,
the
Mouth
whereof
lies
behind
the
Condyli
,
which
are
on
the
sides
of
the
Occipital
Trunk
:
This
Ductus
is
extended
about
the
length
of
two
Hairs
breadth
in
the
Bone
,
and
the
Canal
enclos'd
therein
is
open'd
immediately
into
the
Vertebral
Sinus
:
So
that
one
might
affirm
it
to
be
as
it
were
its
Original
Source
.
Whence
it
appears
that
the
Blood
contain'd
in
the
lateral
Sinus's
is
emptied
thro'
two
places
;
the
greater
Portion
thereof
descending
in
the
Jugulars
from
the
Neck
,
and
the
other
in
the
Verteb●●
Sinus's
:
Sometimes
those
Ductus's
are
fou●
only
on
one
side
,
another
while
both
are
stop
up
,
and
then
the
Blood
contain'd
in
the
lateral
Sinus's
is
discharg'd
into
the
Internal
J●gulars
.
Behind
the
Apophysis
Mastoides
on
each
sid●
is
a
remarkable
Hole
,
thro'
which
passeth
thick
Vein
,
which
brings
back
part
of
th●
Blood
that
hath
been
distributed
to
the
T●guments
and
Muscles
,
which
cover
part
of
t●●
Occiput
or
hinder-side
of
the
Head
:
This
V●●
is
open'd
into
the
lateral
Sinus's
at
the
pla●●
where
they
begin
to
turn
about
.
But
in
th●
Heads
of
some
Persons
,
this
Hole
is
found
●●ly
on
one
side
,
and
even
sometimes
not
at
all
in
which
case
the
Blood
contain'd
in
th●
Vessels
falls
into
the
External
Jugulars
,
wi●●
which
the
Branches
of
this
Vein
have
a
Co●munication
.
In
each
Parietal
Bone
on
the
side
of
the
S●gittal
Suture
,
at
a
little
distance
from
the
La●deidal
,
appears
a
Hole
,
thro'
which
passeth
Vein
,
that
brings
back
the
Blood
of
the
Tegments
of
the
Head
,
and
dischargeth
it self
in
the
upper
Longitudinal
Sinus
.
These
Holes
a●●
sometimes
stopt
up
on
one
side
,
and
sometimes
on
both
;
and
then
the
Blood
contain
in
the
Branches
of
this
Vein
runs
into
the
Eternal
Jugulars
.
In
the
middle
of
the
Sella
of
the
Os
Sph●noides
,
we
may
observe
one
or
two
small
Hole
thro'
which
(
according
to
the
Opinion
〈◊〉
some
Modern
Anatomists
)
the
Lympha
co●tain'd
in
the
Glandula
Pituitaria
is
thrown
i●
to
the
Sinus
of
the
edge
of
the
Os
Sphenoides
;
nevertheless
it
is
certain
,
that
these
Holes
are
fill'd
only
with
Sanguinary
Vessels
,
which
carry
and
bring
back
the
Blood
of
the
Bones
and
Membranes
,
whereof
those
Sinus's
are
compos'd
;
besides
that
,
these
Holes
are
rarely
found
in
adult
Persons
.
Between
the
Spine
of
the
Coronal
Suture
and
the
Crista
Galli
,
is
a
Hole
which
serves
as
an
Entrance
for
a
Ductus
,
which
sinks
from
the
top
to
the
Bottom
,
the
length
of
about
two
Hairs
breadth
in
the
thickness
of
the
inner
Table
of
the
Coronal
:
The
Root
of
the
upper
Longitudinal
Sinus
is
strongly
implanted
in
this
Hole
,
which
also
affords
a
Passage
to
some
Sanguinary
Vessels
appointed
for
the
Nourishment
of
this
inner
Table
.
Many
other
small
Holes
are
found
in
divers
places
of
the
Basis
of
the
Skull
;
the
chief
whereof
are
those
that
are
observ'd
in
the
Apophysis
Petrosa
,
and
give
Passage
to
a
great
number
of
Vessels
that
serve
for
the
Nutriment
of
that
part
of
the
Temporal
Bone
which
is
call'd
the
Tympanum
,
or
Drum
:
The
other
Holes
are
principally
design'd
for
the
Vessels
that
are
serviceable
in
the
nourishing
of
divers
parts
of
the
Basis
of
the
Skull
.
After
what
manner
is
the
opening
of
the
Head
or
Skull
perform'd
?
It
is
done
by
sawing
it
asunder
round
about
and
above
the
Ears
;
then
it
is
taken
off
,
after
having
before
cut
off
the
Hair
,
and
made
a
Crucial
Incision
in
the
Skin
from
the
fore-part
to
the
hinder
,
and
from
one
Ear
to
the
other
;
as
also
after
having
pull'd
off
and
laid
down
the
four
Corners
the
bottom
.
How
is
the
Brain
anatomiz'd
?
It
is
done
by
cutting
it
Superficially
,
a●
by
Leaves
,
in
order
to
discover
by
little
〈◊〉
little
the
Ventricles
,
Vessels
,
and
Nerves
,
w●●
their
Original
Sources
,
&c.
Or
else
it
is
take
entire
out
of
the
Skull
,
(
the
Nerves
havi●●
been
before
examin'd
)
and
laid
down
;
so
t●●
without
cutting
any
thing
,
all
the
parts
of
〈◊〉
Brain
may
be
set
in
their
proper
places
,
to
f●●●
out
those
that
are
sought
for
.
A
TREATISE
OF
THE
DISEASES
OF
THE
BONES
.
CHAP.
I.
Of
the
Dislocation
of
the
Bones
.
WHAT
are
the
Diseases
incident
to
the
Bones
?
They
are
five
in
number
,
viz.
Dislocation
,
Fracture
,
Caries
or
Ulcer
,
Exostosis
,
and
Nodus
.
What
is
a
Dislocation
or
Luxation
?
It
is
the
starting
of
the
Head
of
one
Bone
out
of
the
Cavity
of
another
,
with
an
Interdiction
of
the
proper
Motion
of
the
Part
:
Or
else
it
is
the
disjointing
of
two
Bones
united
together
for
the
Motion
of
a
Part.
How
many
causes
are
there
of
Dislocation
in
general
?
Two
,
that
is
to
say
,
one
violent
,
and
the
other
gentle
;
thus
the
Dislocation
is
made
violently
in
Falls
,
Strains
,
Knocks
,
and
Blows
;
but
it
is
done
gently
and
slowly
in
Defluctions
of
Rheum
;
as
also
by
an
insensible
gathering
together
of
Humours
between
the
Joints
,
and
upon
the
Ligaments
,
the
Relaxation
or
loosening
of
which
gives
occasion
afterward
to
the
Head
of
the
Bone
to
go
out
of
its
place
;
whence
this
Consequence
may
well
be
drawn
,
viz.
that
a
violent
Dislocation
usually
depends
upon
an
external
Cause
,
and
a
gentle
Dislocation
upon
an
internal
.
After
how
many
manners
doth
a
Dislocation
happen
?
Two
several
Ways
;
viz.
the
first
is
called
compleat
,
total
,
and
perfect
;
and
the
second
incompleat
,
partial
,
and
imperfect
:
But
both
may
happen
before
,
behind
,
on
the
inside
,
and
without
;
and
may
also
be
simple
or
complicated
.
What
are
the
signs
of
a
perfect
,
total
,
and
compleat
Dislocation
?
It
is
when
a
hard
Tumour
or
Swelling
is
perceiv'd
near
a
Hole
in
the
place
of
the
Joint
,
great
pain
being
felt
in
the
Part
,
and
the
Motion
of
it
abolith'd
.
What
are
the
signs
of
an
imperfect
,
partial
,
and
incompleat
Dislocation
?
It
is
when
the
Motion
is
streighten'd
,
and
weaker
than
ordinary
,
so
that
some
Pain
is
felt
in
the
Joynt
,
and
a
Deformity
may
be
discern'd
therein
,
by
comparing
the
hurt
Part
with
the
opposite
which
is
sound
:
This
Dislocation
is
otherwise
call'd
a
Sprain
,
when
it
proceeds
from
an
external
Cause
;
or
else
it
is
termed
a
Relaxation
,
when
it
happens
by
an
internal
.
What
is
a
simple
,
and
what
is
a
complicated
Dislocation
or
Luxation
?
The
Dislocation
is
properly
simple
,
when
it
hath
no
concomitant
Accidents
;
and
it
is
complicated
when
accompany'd
with
some
ill
Symptoms
or
Accidents
,
such
as
Swellings
,
Inflammations
,
Wounds
,
Fractures
,
&c.
What
are
the
means
proper
to
be
us'd
in
a
simple
Dislocation
?
A
speedy
and
simple
reducing
thereof
,
which
is
perform'd
by
stretching
out
the
dislocated
or
luxated
.
Member
,
and
thrusting
back
the
Head
of
the
Bone
into
its
natural
place
.
Afterward
the
Joynt
must
be
strengthen'd
with
a
Fomentation
made
with
Provence
Roses
,
the
Leaves
of
Wormwood
,
Rosemary
,
Camomile
,
St.
John's-Wort
,
and
Oak-Moss
boil'd
in
the
Lees
of
Wine
and
Forge-Water
,
keeping
the
Part
well
bound
up
,
and
sustain'd
in
a
convenient
situation
.
But
if
any
ill
Consequence
is
to
be
fear'd
,
apply
Emplastrum
Oxycroceum
,
or
Diapalma
dissolv'd
in
Wine
.
What
is
to
be
done
in
a
complicated
Dislocation
?
The
Accidents
must
be
first
remov'd
,
and
then
the
Bone
may
be
set
,
which
is
impossible
to
be
done
otherwise
;
it
being
dangerous
even
to
make
an
Attempt
before
,
by
reason
of
the
too
great
Violence
with
which
it
is
effected
,
and
which
would
infallibly
produce
a
Convulsion
or
a
Gangrene
.
If
the
Dislocation
be
accompany'd
with
a
Wound
,
must
the
Wound
be
cur'd
before
any
Endeavours
are
us'd
to
reduce
it
?
No
,
but
the
Symptoms
of
the
Wound
,
which
hinder
the
Operation
,
must
be
taken
away
,
as
the
Swelling
,
Inflammation
,
and
others
of
the
like
Nature
;
and
then
it
may
be
reduc'd
,
and
the
Wound
may
be
dress'd
according
to
the
usual
Method
.
If
the
Dislocation
be
complicated
with
the
Fracture
,
what
is
to
be
done
then
?
It
is
necessary
to
begin
with
reducing
of
the
Dislocation
,
and
afterward
to
perform
that
of
the
Fracture
,
by
reason
of
the
Extension
which
must
be
made
to
reduce
the
Dislocation
,
which
would
absolutely
hinder
the
Setling
of
the
Fracture
.
How
is
the
Inflammation
and
Swelling
to
be
asswag'd
?
With
Linnen
Cloaths
dipt
in
Brandy
and
common
Water
,
which
must
be
often
renew'd
;
or
else
with
the
Tops
of
Wormwood
and
Camomile
,
with
Sage
and
Rosemary
boil'd
in
the
Lees
of
Wine
,
wherein
the
Bolsters
and
Bands
are
to
be
steep'd
.
But
all
Repereussives
and
Astringents
must
be
avoided
.
How
doth
it
appear
that
the
Reduction
is
well
perform'd
?
By
the
Re-establishment
of
the
Part
in
its
natural
State
;
by
its
being
free
from
Pain
;
by
its
regular
Motion
;
and
by
its
conformity
to
the
opposite
Part
which
is
sound
.
What
Dislocations
of
Parts
are
most
difficult
to
be
reduc'd
?
They
are
those
of
the
Thighs
with
the
Huckle-Bones
,
which
are
almost
never
perfectly
set
;
that
of
the
first
Vertebra's
is
extremely
difficult
to
be
reduc'd
;
and
those
of
the
Lower-Jaw
and
Soles
of
the
Feet
are
mortal
.
The
reducing
of
Dislocations
is
perform'd
with
greate●
facility
in
Infants
than
in
Persons
advanc'd
in
Years
;
but
it
becomes
most
difficult
when
it
is
deferr'd
for
many
Days
,
by
reason
of
the
overflowing
of
the
Lympha
and
nutritious
Juice
.
If
an
Inflammation
shou'd
happen
before
the
Member
is
reduc'd
,
nothing
can
be
done
till
it
be
allay'd
,
as
we
have
already
intimated
;
but
to
prevent
and
mitigate
it
,
the
dislocated
Joynt
,
and
the
neighbouring
Parts
,
may
be
bath'd
with
luke-warm
Wine
,
in
which
hath
been
boil'd
the
Tops
of
St.
John's-Wort
,
Camomile
,
Rosemary
,
Stoecas
Arabica
,
and
other
Ingredients
of
the
like
Nature
;
the
Bands
must
be
also
steept
in
the
same
Liquor
.
If
an
Oedematous
Tumour
arise
in
the
luxated
Member
after
the
Joint
hath
been
set
,
it
is
requisite
to
take
internal
Sudorificks
,
and
to
apply
Liniments
made
with
the
destill'd
Oil
of
Tartar
,
and
of
Human
Bones
,
which
may
be
rectify'd
with
burnt
Hart's
Horn
,
or
some
other
part
of
Animals
,
to
take
away
its
stink
:
Or
else
take
yellow-Wax
,
and
very
white
Rosin
,
melt
the
whole
Mass
,
and
put
into
it
white
Amber
and
Gum
Elemi
,
a
sufficient
quantity
of
each
to
make
a
Composition
to
be
incorporated
with
Balsam
of
Peru
;
a
Plaister
of
which
may
be
prepar'd
,
and
apply'd
to
the
dislocated
Member
;
but
the
Plaister
must
not
be
laid
a
cross
,
lest
it
shou'd
contract
the
Part
too
much
.
The
whole
Member
may
be
also
anointed
with
Oil
of
St.
John's-Wort
,
or
with
the
destill'd
Oil
of
Turpentine
;
or
rather
with
a
simple
Decoction
of
Nervous
Plants
in
Wine
.
If
the
Bone
be
put
out
of
its
place
by
a
coagulated
sort
of
Matter
like
Mortar
or
Plaister
,
Resolutives
and
Attenuants
are
to
be
us'd
,
such
as
the
volatile
Spirit
of
Tartar
prepar'd
with
the
Lees
of
Wine
,
volatile
Spirit
of
Tartar
destill'd
with
Nitre
in
a
Retort
with
a
long
Neck
,
or
Spirit
of
Tartar
prepar'd
by
Fermentation
with
Tartar
,
and
its
proper
Alkali
:
This
last
is
the
best
of
all
,
and
the
use
thereof
ought
to
be
continu'd
.
The
volatile
Salt
of
Human
Bones
is
also
very
efficacious
;
but
it
is
necessary
to
begin
first
with
the
taking
of
Laxative
and
Sudorifick
Medicines
,
appropriated
according
to
the
respective
Circumstances
.
The
Spirit
of
Earth-Worms
may
be
also
apply'd
outwardly
,
which
is
made
by
Fermentation
,
and
may
be
often
laid
on
the
Part
either
alone
,
or
with
the
Spirit
of
Sal
Ammoniack
.
If
a
dislocated
Bone
be
not
set
in
good
time
,
a
Coagulum
or
kind
of
curdled
Substance
is
form'd
in
the
Cavity
,
which
hinders
the
reducing
of
it
to
its
place
;
but
this
Coagulum
may
be
dissolv'd
with
the
following
Medicament
,
before
you
attempt
to
set
the
Bone
.
Take
one
part
of
the
destill'd
Oil
of
Human
Bones
,
two
parts
of
foetid
Oil
of
Tartar
;
mingle
the
whole
,
and
add
quick
Lime
to
be
destill'd
in
a
Retort
:
Let
the
Parts
be
fomented
with
this
Oil.
If
the
Dislocation
happen'd
by
the
Relaxation
of
the
Ligaments
,
recourse
may
be
had
to
universal
Sudorificks
taken
inwardly
;
as
also
to
such
Medicines
as
are
full
of
an
unctuous
and
volatile
Salt
,
particularly
Aromatick
Oils
,
and
Spirit
of
Sal
Ammoniack
.
In
the
mean
while
Aromaticks
,
Resolutives
,
and
moderate
Astringents
may
be
apply'd
outwardly
.
CHAP
II.
Of
the
Fractures
of
Bones
.
WHAT
is
the
Fracture
of
a
Bone
?
It
is
the
Division
of
the
Continuity
of
its
Parts
.
After
how
many
different
manners
may
a
Bone
be
broken
?
Three
several
ways
,
viz.
cross-wise
,
side-wise
,
in
its
length
,
and
perhaps
in
Shatters
or
Splinters
.
By
what
means
may
a
Bone
be
fractur'd
?
It
may
happen
to
be
done
by
three
sorts
of
Instruments
,
viz.
such
as
are
fit
for
bruising
,
cutting
,
or
wresting
;
that
is
to
say
,
a
Bone
may
be
divided
in
the
Continuity
of
its
proper
Parts
,
by
Contusion
,
Incision
,
or
Contorsion
.
How
is
the
Fracture
of
a
Bone
discover'd
?
Divers
ways
,
viz.
by
the
ill
Disposition
of
the
Part
,
which
becomes
shorter
;
by
its
want
of
Motion
;
by
its
flexibility
or
pliantness
else●
where
than
in
its
Articulations
;
by
the
unevenness
that
may
be
perceiv'd
in
its
Continuity
;
by
the
cracking
which
is
heard
;
sometimes
also
by
the
shooting
forth
of
one
of
its
ends
thro'
the
Flesh
which
it
hath
open'd
;
and
lastly
by
a
Comparison
made
thereof
with
the
sound
Part
on
the
other
side
,
as
that
of
the
Right
Arm
with
the
Left
.
What
kind
of
Fracture
is
most
difficult
to
be
discern'd
?
It
is
that
which
happens
in
the
length
of
the
Bone
,
commonly
call'd
a
Cleft
or
Fissur●
which
gives
occasion
to
very
great
Symptoms
when
it
is
unknown
:
But
it
may
be
found
out
by
the
Pain
and
Swelling
felt
at
the
bottom
of
the
Cleft
in
touching
it
;
besides
the
Conjectures
which
may
be
made
from
the
Relation
of
the
Person
who
hath
had
a
Fall
,
and
might
have
heard
the
cracking
of
the
Bone
.
What
sort
of
Fracture
is
most
difficult
to
be
cur'd
?
The
shattering
or
splitting
of
a
Bone
in
Pieces
,
by
reason
of
the
great
Number
of
Splints
which
daily
cause
new
Pains
and
Suppurations
.
What
is
a
simple
and
what
is
a
complicated
Fracture
?
The
simple
Fracture
is
that
whereby
the
Bone
is
broken
,
without
any
other
Accident
;
and
the
complicated
Fracture
is
that
which
is
follow'd
by
some
Accident
;
as
that
in
which
there
is
a
splitting
of
the
Bone
in
pieces
,
or
where
the
Bone
is
broken
in
two
several
places
,
or
else
when
the
Fracture
is
accompany'd
with
a
Luxation
,
a
Wound
,
an
Inflammation
,
or
other
Circumstances
of
the
like
Nature
.
Are
old
Men
or
Children
most
subject
to
these
Fractures
of
the
Bones
?
Old
Men
,
because
their
Bones
are
dr●●r
;
whereas
those
of
Infants
are
almost
Cartilaginous
,
and
yield
or
give
way
to
the
violence
offer'd
to
'em
;
from
whence
proceed
the
●inkings
and
hollowness
that
happen
in
their
Skulls
,
especially
in
the
Mould
of
their
Heads
,
or
elsewhere
;
for
which
a
Remedy
is
found
out
by
the
means
of
Plais●ers
,
Splints
,
and
Bandages
,
fitted
to
the
shape
of
the
Parts
.
It
is
also
on
the
same
Account
that
Bones
are
more
easily
broken
in
the
Winter
than
in
the
Summer
.
In
what
Parts
are
the
Fractures
of
Bones
most
dangerous
?
They
are
those
that
happen
in
the
Skull
and
Joints
;
in
the
former
by
reason
of
the
Brain
;
and
in
the
latter
in
regard
of
the
Nervous
Parts
.
What
Course
is
to
be
taken
by
a
Surgeon
who
is
sent
for
to
cure
a
Fracture
?
He
ought
to
do
three
things
,
that
is
to
say
,
at
first
he
must
incessantly
endeavour
to
reduce
it
,
to
the
end
that
Nature
may
re-unite
the
Parts
with
greater
Facility
,
and
that
its
Extremities
may
be
brought
together
again
with
less
trouble
,
before
a
Swelling
,
Inflammation
,
or
Gangrene
happen
in
the
Part.
Afterward
he
is
to
use
means
to
retain
the
Parts
in
their
proper
Figure
,
and
natural
Situation
,
and
to
prevent
all
sorts
of
Accidents
.
How
is
the
setting
of
a
broken
Bone
to
be
perform'd
?
When
the
Fracture
is
Cross-wise
,
it
must
be
reduc'd
by
Extension
and
contra-Extension
;
and
when
it
is
in
length
,
the
Coaptation
or
bringing
together
again
of
the
Sides
,
is
only
necessary
.
What
is
to
be
done
in
a
Fracture
complicated
with
a
Wound
?
The
Operator
must
first
reduce
it
,
and
then
administer
the
other
Helps
,
as
in
a
simple
Fracture
.
How
may
it
be
known
that
the
reducing
of
the
Fracture
is
well
perform'd
?
When
the
Pain
ceaseth
;
when
the
Part
hath
resum'd
its
natural
Shape
;
when
no
Unevenness
is
any
longer
perceiv'd
therein
;
and
when
it
is
conformable
to
the
sound
Part
on
the
other
side
.
What
are
the
Signs
which
shew
that
the
Splints
remain
in
the
Fracture
after
it
hath
been
reduc'd
?
They
are
the
secret
and
continual
Workings
of
the
Fibres
,
or
twitchings
,
that
are
felt
by
Intervals
in
the
Part
,
with
great
Pains
,
which
are
the
Indications
of
an
Abcess
arising
therein
;
and
when
a
Wound
is
join'd
to
the
Fracture
,
the
Lips
of
it
are
puff'd
up
,
and
become
more
soft
and
pale
,
the
purulent
Matter
abounding
also
more
than
ordinary
.
When
the
Splints
appear
,
must
they
be
drawn
out
by
force
?
By
no
means
;
for
great
care
ought
to
be
taken
to
avoid
all
manner
of
violent
Operations
;
it
being
requisite
to
wait
for
their
going
out
with
the
purulent
Matter
;
or
at
most
to
facilitate
their
Passage
by
the
use
of
Injections
of
the
Tincture
of
Myrth
and
Aloes
;
by
the
application
of
Emplastrum
Andreae
Crucii
,
and
by
the
help
of
the
Forceps
.
How
is
a
simple
Fracture
to
be
dress'd
,
after
it
hath
been
reduc'd
?
The
Parts
are
to
be
strengthen'd
and
consolidated
with
Liniments
of
Oleum
Lumbricorum
,
or
of
Oil
of
St.
John's-Wort
mingled
with
Wine
,
Brandy
,
or
Aqua-Vitae
;
with
Fomentations
of
Red
Roses
,
Rosemary
,
and
St.
John's-Wort
boil'd
in
Wine
;
and
with
Emplastrum
contra
Rupturam
,
or
de
Betonica
,
carefully
wrapping
up
the
broken
Member
,
but
after
such
a
manner
that
the
two
Fxtremities
may
not
cross
one
another
;
and
that
a
small
Space
may
remain
open
between
both
.
Afterward
the
Splints
and
Bands
are
to
be
apply'd
,
taking
care
to
avoid
binding
'em
too
hard
,
and
to
take
'em
off
every
three
Days
,
in
order
to
refit
'em
,
to
abate
troublesome
Itchings
,
and
to
give
Air
to
the
Part
;
by
these
means
preventing
the
Gangrene
,
which
might
happen
by
the
Suffocation
of
the
natural
Heat
.
If
the
Thighs
or
Legs
are
broken
,
Scarves
are
to
be
us'd
to
support
and
stay
'em
in
the
Bed
.
What
space
of
time
may
there
be
allow'd
for
curing
the
Fracture
of
a
Bone
?
The
Cure
will
take
up
more
or
less
time
,
according
to
the
variety
of
the
Parts
,
or
the
different
thickness
of
the
Bones
:
Thus
to
form
the
Callus
of
the
broken
Jaw-Bone
,
twenty
Days
may
well
be
allotted
;
for
that
of
the
Clavicle
,
or
that
of
the
Shoulder-Bone
,
twenty
four
;
for
that
of
the
Bones
of
the
Elbow
,
thirty
;
for
that
of
the
Arm-Bone
,
forty
;
for
that
of
the
Wrist-Bone
,
and
those
of
the
Fingers
,
twenty
;
for
that
of
the
Ribs
,
twenty
;
for
that
of
the
Thigh-Bone
,
fifty
;
for
that
of
the
Leg-Bone
,
forty
;
for
that
of
the
Bones
of
the
Tarsus
and
Toes
,
twenty
.
What
ought
to
be
done
in
particular
to
promote
the
formation
of
the
Callus
?
The
fractur'd
Part
must
be
rubb'd
with
Oleum
Lumbricorum
and
Spirit
of
Wine
heated
and
mingled
together
:
The
Decoctions
of
Agrimony
,
Savine
,
and
Saxifrage
are
also
to
be
us'd
,
and
the
Lapis
Osteocolla
is
a
Specifick
:
It
is
usually
given
in
great
Comphrey-Water
,
or
in
a
Decoction
of
Perewinkle
made
with
Wine
,
and
is
often
re-iterated
.
CHAP.
III.
Of
the
particular
Fractures
of
the
Skull
.
WHAT
is
a
Fracture
of
the
Cranium
or
Skull
?
It
is
a
Wound
of
the
Head
complicated
with
a
Fracture
of
the
Skull-Bone
.
After
how
many
manners
may
the
Skull
be
fractur'd
?
Three
several
ways
,
viz.
by
Contusion
,
by
Incision
,
and
by
Puncture
.
What
is
the
most
dangerous
of
these
Fractures
?
It
is
that
which
happens
by
Contusion
;
because
the
Concussion
and
Commotion
is
greater
.
Do
all
the
Fractures
of
the
Skull
require
the
use
of
the
Trepan
?
No
,
the
Fractures
must
be
deep
which
stand
in
need
of
the
help
of
such
an
Instrument
;
for
those
that
are
superficial
may
be
cur'd
by
a
simple
Exfoliation
.
What
is
that
deep
Fracture
,
wherein
the
use
of
the
Trepan
is
absolutely
necessary
?
It
is
that
which
is
made
in
the
two
Tables
of
the
Skull
,
penetrating
to
the
Meninges
of
the
Brain
;
upon
which
at
that
time
the
Blood
is
diffus'd
,
and
must
be
taken
away
by
the
Operation
of
the
Trepan
.
How
may
it
be
discover'd
that
the
●●o
Tables
of
the
Skull
are
broken
?
By
the
Eyes
,
and
by
Ratiocination
.
Are
not
the
Eyes
sufficient
alone
,
and
are
they
not
more
certain
than
Ratiocination
?
Yes
;
but
forasmuch
as
things
are
not
always
seen
,
there
is
often
a
necessity
of
making
use
of
rational
Deductions
to
find
out
that
which
the
Eyes
cannot
discern
.
When
doth
it
happen
that
the
Eyes
alone
discover
the
Eracture
?
When
the
Wound
is
large
and
wide
,
so
that
it
may
be
immediately
view'd
.
When
doth
it
happen
that
Ratiocination
supplies
the
defect
of
the
Eyes
?
When
the
Wound
is
so
small
that
the
Bone
cannot
be
seen
,
and
nothing
appears
but
the
Accidents
.
What
are
the
Accidents
or
Signs
of
the
Fracture
of
the
Skull
?
They
are
a
dimmness
of
the
Sight
,
and
loss
of
the
Understanding
,
which
happen
at
the
very
Moment
when
the
Fall
or
Blow
is
receiv'd
;
with
the
Phlegmatick
Vomittings
that
follow
soon
after
:
These
Signs
are
call'd
Vnivocal
.
And
there
are
others
that
bear
the
Name
of
Equivocal
,
and
which
confirm
the
former
;
as
a
Flux
of
Blood
thro'
the
Nose
,
Eyes
,
and
Ears
,
redness
of
the
Eyes
,
heaviness
of
the
Head
,
and
puffing
up
of
the
Face
;
as
also
afterward
Drowsiness
,
Shivering
of
the
whole
Body
,
Fever
,
Deliriums
,
Convulsions
,
&c.
Must
all
these
Signs
appear
before
a
Determination
can
be
made
of
the
necessity
of
using
the
Trepan
?
No
,
it
is
sufficient
to
have
the
Univocal
Signs
to
make
a
Crucial
Incision
in
the
place
of
the
Wound
,
and
to
lay
bare
the
Bone
,
in
order
to
observe
the
Fracture
,
which
sometimes
is
so
fine
,
that
the
Operator
is
oblig'd
to
make
use
of
Ink
,
which
insinuates
it self
into
the
Cleft
,
and
of
a
particular
Instrument
,
wi●h
which
the
black
Line
that
hath
penetrated
to
the
bottom
,
cannot
be
rubb'd
out
;
whereas
it
may
be
easily
defac'd
when
the
Fracture
is
only
superficial
.
How
long
time
is
commonly
spent
before
the
appearing
of
the
Accidents
?
In
the
Summer
Season
they
appear
in
three
or
four
Days
,
and
at
the
latest
in
seven
;
in
Winter
they
are
slower
,
and
sometimes
do
not
happen
till
the
fourteenth
Day
:
But
at
the
end
of
this
term
,
it
may
be
affirm'd
that
the
Trepan
is
often
unprofitable
.
What
is
requisite
to
be
done
in
a
doubtful
Occasion
;
Must
the
Trepan
be
apply'd
or
omitted
?
The
Surgeon
is
to
have
recourse
to
his
own
conscientious
Discretion
,
which
ought
to
serve
as
a
Guide
,
and
requires
that
we
should
always
act
according
to
the
known
Rules
of
Art
;
insomuch
that
after
having
well
consider'd
the
Accidents
,
with
all
the
Circumstances
of
the
Wound
,
if
there
be
no
good
grounds
for
the
undertaking
of
the
Operation
,
it
is
expedient
to
desist
,
and
in
this
case
to
have
deference
to
the
Advice
of
other
able
Surgeons
of
the
same
Society
,
rather
than
to
rely
too
much
upon
his
own
Judgment
,
to
the
end
that
he
may
be
always
secure
from
all
manner
of
Blame
.
Is
the
Trepan
apply'd
upon
the
Fracture
?
No
;
but
on
one
side
of
it
,
and
always
in
a
firm
place
.
What
Course
is
to
be
taken
when
a
Fracture
is
found
in
a
Suture
?
A
double
Trepan
is
to
be
made
,
and
apply'd
on
each
side
of
the
Suture
,
by
reason
of
the
overflowing
of
the
Blood
,
which
may
happen
therein
.
What
Method
ought
to
be
observ'd
in
the
curing
of
the
Wounds
of
the
Head
,
and
Fractures
of
the
Skull
?
In
simple
Wounds
of
the
Head
,
it
is
necessary
only
to
make
use
of
Balsams
,
and
to
lay
over
'em
Emplastrum
de
Betonica
.
When
there
is
a
Contusion
either
in
the
Pericranium
,
or
in
the
Skull
,
the
Wound
must
be
kept
open
till
after
the
Suppuration
or
Exfoliation
.
When
there
is
only
a
Bunch
without
any
Wound
or
Accident
,
it
must
speedily
be
dissolv'd
with
Plaister
or
Mortar
,
Chimney-Soot
,
Oil
of
Olives
,
and
Wine
,
laid
upon
the
Part
between
two
Linnen-Rags
;
or
else
with
Soot
,
Spirit
of
Wine
,
and
Oil
of
St.
John's-Wort
,
wherein
the
Bolsters
are
soakt
,
to
be
in
like
manner
apply'd
with
a
Band.
Wounds
of
the
Head
accompany'd
with
a
Fracture
,
absolutely
require
the
application
of
the
Trepan
,
wherein
it
is
requisite
to
make
use
of
Oil
of
Turpentine
to
be
dropt
upon
the
Membrane
of
the
Brain
;
or
else
Spirit
of
Wine
mingled
with
Oil
of
Almonds
,
and
not
with
the
Oil
or
Syrrup
of
Roses
;
and
to
endeavour
to
cause
a
plentiful
outward
Suppuration
.
Besides
,
it
must
not
be
neglected
to
enjoyn
the
wounded
Person
to
be
let
Blood
both
before
and
after
the
Operation
,
if
he
hath
a
Fever
or
a
Plethory
;
and
more
especially
it
is
to
be
remember'd
to
cause
his
Body
to
be
kept
open
at
least
every
other
Day
,
with
Clysters
,
obliging
h●m
to
keep
a
good
Diet
,
and
to
avoid
all
violent
Agitations
both
of
Body
and
Mind
,
abstaining
from
eating
Flesh
till
the
Fourteenth
Day
.
All
manner
of
Venery
and
Conjugal
Embraces
,
which
prove
fatal
at
this
time
,
are
to
be
prohibited
during
forty
Days
,
to
be
counted
from
the
Day
of
the
Operation
;
as
they
are
also
in
all
other
considerable
Wounds
.
CHAP.
IV.
Of
the
Caries
or
Vlcer
of
the
Bones
,
Exostosis
,
and
Nodus
.
WHAT
is
Caries
?
It
is
the
Putrifaction
of
the
Substance
of
the
Bone
,
or
else
its
Ulcer
or
Gangrene
.
Whence
doth
the
Caries
of
the
Bone
derive
its
Original
?
It
proceeds
from
an
internal
and
external
Cause
;
the
former
being
that
which
hath
been
produc'd
at
first
in
the
Substance
of
the
Bone
;
and
the
other
that
which
takes
its
Rise
from
an
inveterate
Ulcer
in
the
Flesh
,
which
hath
communicated
its
Malignity
to
the
Substance
of
the
Bone
,
and
by
that
means
corrupted
it
.
How
is
the
Caries
known
which
proceeds
from
an
inward
Cause
?
By
the
continual
and
violent
Pains
which
are
felt
before
,
and
continue
for
a
long
time
without
diminution
;
as
also
afterward
by
the
alteration
of
the
Flesh
that
covers
the
Bone
,
and
which
becomes
soft
,
spongy
,
and
livid
.
By
what
means
is
a
Caries
that
derives
its
Origine
from
an
outward
Cause
,
discover'd
?
By
the
quality
of
the
purulent
Matter
that
issueth
out
of
the
Ulcer
in
the
Flesh
,
which
is
blackish
,
Unctuous
,
and
extremely
stinking
;
as
also
by
the
help
of
the
Probe
,
that
discovereth
asperity
or
roughness
in
the
Bone
when
it
is
laid
bare
.
What
Means
are
to
be
us'd
in
order
to
cure
a
Caries
proceeding
from
an
external
Cause
?
The
Powder
of
Flower-de-luce
may
be
us'd
,
and
it
is
sufficient
for
that
purpose
,
when
the
Caries
is
superficial
;
but
it
is
necessary
to
take
Oleum
Guyaci
,
and
to
soak
Bolsters
therein
,
to
be
laid
upon
the
Ulcer
when
it
is
deep
;
or
else
Aqua-Vitae
or
Brandy
,
in
which
have
been
infus'd
the
Roots
of
Flower-de-luce
,
Cinnamon
,
and
Cloves
.
Lastly
,
the
actual
Cautery
,
which
is
Fire
,
must
be
apply'd
thereto
.
What
is
to
be
done
when
the
Caries
proceeds
from
an
internal-Cause
?
The
Flesh
must
be
open'd
to
give
Passage
to
the
Sanies
that
runs
out
of
the
ulcerated
Bone
,
to
the
end
that
Exfoliation
may
be
procur'd
;
and
if
the
Ulcer
hath
not
as
yet
laid
open
the
Bone
on
the
outside
,
the
Trepan
ought
to
be
apply'd
;
but
the
Ulcer
or
Caries
must
be
afterward
handled
,
as
we
have
even
now
declar'd
.
What
is
Exostosis
?
It
is
the
Swelling
of
a
Bone
made
by
the
settling
of
a
corrupt
Humour
in
its
proper
Substance
.
What
is
Nodus
?
It
is
a
kind
of
gummy
and
wavering
Tumour
,
which
is
form'd
by
the
settling
of
a
gross
Humour
between
the
Bone
and
the
Periosteum
.
Are
Exostoses
and
Nodus
's
suppurable
Tumours
?
Yes
,
because
they
sometimes
produce
Ulcers
and
Gangrenes
in
the
Bone
,
which
are
call'd
Caries
,
proceeding
from
an
internal
Cause
;
nevertheless
they
are
generally
dissolv'd
by
Frictions
with
Vnguentum
Griseum
,
or
by
the
application
of
Plaisters
of
Tobacco
,
or
Emplastrum
de
Vigo
quadruplicato
Mercurio
;
taking
also
to
the
same
purpose
internal
Diaphoretick
and
Sudorisick
Medicines
,
with
convenient
Purgatives
.
CHAP.
V.
Of
Cauteries
,
Vesicatories
,
Setons
,
Cupping-Glasses
,
ond
Leeches
.
WHAT
is
a
Vesicatory
?
The
Name
of
Vesicatory
may
be
attributed
to
every
thing
that
is
capable
of
raising
Bladders
of
Blisters
in
the
Skin
;
nevertheless
in
Surgery
,
by
a
Vesicatory
is
understood
a
Medicament
prepar'd
with
Cantharides
or
Spanish
Flies
dried
,
which
are
beaten
to
Powder
,
and
mingled
with
Turpentine
,
Plaisters
,
Leaven
,
and
other
Ingredients
.
In
what
places
,
and
after
what
manner
are
Vesicatories
usually
apply'd
?
They
are
apply'd
every
where
,
accordingly
as
there
is
occasion
to
draw
out
or
discharge
some
Humour
from
a
Part
:
In
Defluxions
of
Rheum
upon
the
Eyes
or
Teeth
,
they
are
laid
on
the
Neck
and
Temples
;
in
Apoplexies
,
behind
the
Ears
;
and
so
of
the
rest
,
observing
always
to
make
Frictions
on
the
places
where
the
Application
is
to
be
made
,
to
the
end
that
the
Vesicatory
may
sooner
take
effect
.
How
long
time
must
the
Vesicatory
continue
on
the
Part
?
The
Blisters
are
generally
rais'd
by
'em
within
the
space
of
five
or
six
Hours
;
yet
this
Operation
depends
more
or
less
upon
the
fineness
of
the
Skin
;
and
when
the
Bladders
or
Blisters
appear
,
it
is
requisite
to
deferr
the
openning
of
'em
for
some
time
,
to
the
end
that
Nature
may
have
an
Opportunity
to
introduce
a
new
Scarf-Skin
,
by
which
means
the
Pain
may
be
avoided
that
would
be
felt
,
if
the
Skin
were
too
much
expos'd
to
the
Air.
What
is
a
Cautery
?
It
is
a
Composition
made
of
many
Ingredients
,
which
corrode
,
burn
,
and
make
an
Escar
on
the
Part
to
which
they
are
apply'd
.
How
many
sorts
of
Cauteries
are
there
in
general
?
There
are
two
kinds
,
viz.
the
Actual
and
the
Potential
;
the
former
are
those
that
have
an
immediate
Operation
;
as
Fire
,
or
a
red-hot
Iron
;
and
the
others
are
those
that
produce
the
same
Effect
,
but
in
a
longer
space
of
time
;
such
are
the
ordinary
Cauteries
compos'd
of
Caustick
Medicaments
.
Which
are
the
most
safe
,
the
Actual
or
the
Potential
Cauteries
?
A
distinction
is
to
be
made
herein
;
for
Actual
Cauteries
are
safest
in
the
Operation
,
because
they
may
be
apply'd
wheresoever
one
shall
think
fit
,
as
also
for
as
long
a
time
,
or
for
any
purpose
:
Whereas
the
Potential
cannot
be
guided
after
the
same
manner
.
But
in
Haemorrhages
the
Potential
Cauteries
are
most
eligible
,
by
reason
that
the
Escar
produc'd
by
'em
not
being
so
speedily
form'd
,
the
Vessels
are
better
clos'd
,
and
they
are
not
so
subject
to
open
again
when
it
falls
off
;
as
it
often
happens
in
the
Fall
of
an
Escar
made
by
Fire
.
In
what
places
are
Cauteries
usually
apply'd
?
In
all
places
where
an
Attraction
is
to
be
made
,
or
an
Intemperature
to
be
corrected
,
or
a
Flux
of
Humours
to
be
stopt
,
by
inducing
an
Escar
on
the
Part
:
However
they
are
commonly
laid
upon
the
Nape
of
the
Neck
,
between
the
first
and
second
Vertebra
;
on
the
outward
Part
of
the
Arm
in
a
small
Hole
between
the
Muscle
Deltoides
and
the
Biceps
;
above
the
Thigh
,
between
the
Muscle
Sartor
,
and
the
Vastus
Internus
;
and
on
the
inside
of
the
Knee
,
below
the
Flexors
of
the
Leg
;
observing
every
where
that
the
Cautery
be
plac'd
near
the
great
Vessels
,
to
the
end
that
it
may
draw
out
and
cleanse
more
abundantly
.
What
is
the
Composition
of
the
Potential
Cauteries
?
They
may
be
made
with
quick
Lime
,
Soap
;
and
Chimney-Soot
;
or
else
take
an
Ounce
of
Sal
Ammoniack
,
two
Ounces
of
burnt
Roman
Vitriol
,
three
Ounces
of
quick
Lime
,
and
as
many
of
calcin'd
Tartar
;
mingle
the
whole
Mass
together
in
a
Lixivium
of
Bean-Cod
Ashes
,
and
cause
it
to
evaporate
gently
to
a
Consistence
:
Let
this
Paste
be
kept
for
use
in
a
dry
place
,
and
in
a
well-stopt
Vessel
.
Or
else
the
Silver-Cautery
,
or
Lapis
Infernalis
may
be
prepar'd
after
the
following
manner
:
Take
what
quantity
you
please
of
Silver
,
let
it
be
dissolv'd
with
thrice
as
much
Spirit
of
Nitre
in
a
Vial
,
and
set
the
Vial
upon
the
Sand-Fire
,
to
the
end
that
two
third
parts
of
its
Moisture
may
evaporate
:
Then
pour
the
rest
scalding-hot
into
a
good
Crucible
,
plac'd
over
a
gentle
Fire
,
and
the
Ebullition
being
made
,
the
heat
of
the
Fire
must
be
augmented
,
till
the
Matter
sink
to
the
bottom
,
which
will
become
as
it
were
an
Oil
:
Afterward
pour
it
into
a
somewhat
thick
and
hot
Mould
,
and
it
will
coagulate
,
so
as
to
be
fit
for
Use
,
if
it
be
kept
in
a
well-stopt
Vial.
This
Cautery
is
the
best
;
and
an
Ounce
of
Silver
will
yield
one
Ounce
and
five
Drams
of
Lapis
Infernalis
.
What
is
a
Seton
?
It
is
a
String
of
Silk
,
Thread
,
or
Cotton
,
threaded
thro'
a
kind
of
Pack-Needle
,
with
which
the
Skin
of
a
Part
is
to
be
pierc'd
thro'
,
to
make
an
Ulcer
therein
,
that
hath
almost
the
same
effect
as
a
Cautery
.
What
is
most
remarkable
in
the
Application
of
a
Seton
?
It
ought
to
be
observ'd
,
that
the
String
must
be
dipt
in
Oil
of
Roses
,
and
that
one
end
of
it
must
always
be
kept
longer
than
the
other
,
to
facilitate
the
running
of
the
Humours
.
In
what
Parts
is
the
to
Seton
be
apply'd
?
The
Nape
of
the
Neck
is
the
usual
place
of
its
Application
,
altho'
it
may
be
made
in
any
part
of
the
Body
where
it
is
necessary
.
It
sometimes
happens
that
a
Surgeon
is
oblig'd
to
use
a
kind
of
Seton
in
such
Wounds
made
with
a
Sword
,
or
by
Gun-shot
,
as
pass
quite
thro'
from
one
side
to
the
other
;
then
the
String
or
Skain
must
be
dipt
in
convenient
Ointments
or
Medicinal
Compositions
;
and
as
often
as
the
Dressings
are
taken
away
,
it
will
be
requisite
to
cut
off
the
Part
soakt
in
the
Purulent
Matter
,
which
must
be
taken
out
of
the
Ulcer
.
What
is
a
Cupping-Glass
?
It
is
a
Vessel
or
kind
of
Vial
,
made
with
Glass
,
the
bottom
whereof
is
somewhat
broader
than
the
top
,
which
is
apply'd
to
the
Skin
to
cause
an
Attraction
.
There
are
two
sorts
of
these
Cupping-Glasses
,
viz
,
the
Dry
,
and
the
Wet
;
the
former
are
those
that
are
laid
upon
the
Skin
without
opening
it
;
and
the
latter
those
that
are
apply'd
with
Scarification
.
In
what
Diseases
are
Cupping-Glasses
us'd
?
In
all
kinds
where
it
is
necessary
to
make
any
Attraction
;
but
more
especially
in
Apoplexies
,
Vapours
in
Women
,
Palsies
,
and
other
Distempers
of
the
like
Nature
.
But
the
Applications
of
Cupping-Glasses
are
altogether
different
;
for
in
Apoplexes
they
are
generally
set
upon
the
Shoulders
or
upon
the
Coccyx
;
in
Vapours
upon
the
inside
of
the
Thighs
;
and
in
Palsies
upon
the
Paralytick
Part
it self
.
What
is
a
Leech
?
It
is
an
Animal
like
a
little
Worm
which
sucks
the
Blood
,
and
is
commonly
apply'd
to
Children
and
weak
Persons
,
to
serve
instead
of
Phlebotomy
:
Leeches
are
also
us'd
for
the
discharging
of
a
Defluxion
of
Humours
in
any
Part
;
as
also
in
the
Haemorrhoidal
Veins
when
they
are
too
full
;
in
the
Varices
,
and
in
several
parts
of
the
Face
.
What
choice
ought
to
be
made
of
Leeches
?
It
is
requisite
to
take
those
that
have
their
Backs
greenish
,
and
their
Bellies
red
;
as
also
to
seek
for
'em
in
a
clear
running
Stream
,
and
to
cast
away
those
that
are
black
and
hairy
.
CHAP.
VI.
Of
Phlebotomy
.
WHAT
is
Phlebotomy
?
It
is
an
evacuation
of
Blood
procur'd
by
the
artificial
Incision
of
a
Vein
or
Artery
,
with
a
design
to
restore
Health
.
Which
are
the
Vessels
that
are
open'd
in
Phlebotomy
or
Blood-letting
?
They
are
in
general
all
the
Veins
and
Arteries
of
the
Body
,
nevertheless
some
of
'em
are
more
especially
appropriated
to
this
Operation
;
as
the
Vena
Praeparata
in
the
Forehead
;
the
Ranulae
under
the
Tongue
;
the
Jugular
Veins
and
Arteries
in
the
Neck
;
the
Temporal
Arteries
in
the
Temples
;
the
Cephalick
,
Median
,
and
Basilick
Veins
in
the
inside
of
the
Elbow
;
the
Salvatella
between
the
Ring-Finger
and
the
Little-Finger
;
the
Poplitaea
in
the
Ham
;
the
Saphena
in
the
internal
Malleolus
or
Ankle
;
and
the
Ischiatica
in
the
external
.
What
are
the
Conditions
requisite
in
the
due
performing
of
the
Operation
of
Phlebotomy
?
They
are
these
,
viz.
to
make
choice
of
a
proper
Vessel
;
not
to
open
any
at
all
Adventures
;
not
to
let
Blood
without
necessity
,
nor
without
the
Advice
of
a
Physician
;
whose
Office
it
is
to
determine
the
Seasons
or
Times
convenient
for
that
purpose
;
as
that
of
Intermission
in
an
Intermitting
Fever
;
that
of
Cooling
in
the
Summer
;
and
that
of
Noon-tide
in
the
Winter
;
and
lastly
,
to
take
away
different
quantities
of
Blood
;
for
in
the
Heat
of
Summer
they
ought
to
be
lesser
,
and
greater
in
the
Winter
.
What
are
the
Accidents
of
Phlebotomy
?
They
are
an
Impostume
,
a
Rhombus
,
an
Echymosis
,
an
Aneurism
,
Lipothymy
,
Swooning
,
and
a
Convulsion
.
What
is
a
Rhombus
?
It
is
a
small
Tumour
of
the
Blood
which
happens
in
the
place
where
the
Operation
is
perform'd
either
by
making
the
Orifice
too
small
,
or
larger
than
the
Capaciousness
of
the
Vessel
will
admit
.
The
Rhombus
is
cur'd
by
laying
upon
it
a
Bolster
dipt
in
fair
Water
,
between
the
Folds
of
which
must
be
put
a
little
Salt
,
to
dissolve
and
prevent
the
Suppuration
.
How
may
it
be
perceiv'd
that
an
Artery
hath
been
prickt
or
open'd
in
letting
Blood
?
The
Puncture
of
an
Artery
produceth
an
Aneurism
;
and
the
Opening
of
it
causeth
a
Flux
of
Vermilion
Colour'd
Blood
,
which
issueth
forth
in
abundance
,
and
by
Leaps
.
Are
the
Leaps
which
the
Blood
makes
in
running
,
a
certain
Sign
that
it
comes
from
an
Artery
?
No
,
because
it
may
so
happen
,
that
the
Basilick
Vein
lies
directly
upon
an
Artery
,
the
beating
of
which
may
cause
the
Blood
of
the
Basilica
to
run
out
leaping
:
Therefore
these
three
Circumstances
ought
to
be
consider'd
jointly
,
that
is
to
say
,
the
Vermilion
Colour
,
the
great
quantity
and
the
Leaps
,
in
order
to
be
assur'd
that
the
Blood
proceeds
from
an
Artery
.
How
may
it
be
discover'd
that
a
Tendon
hath
been
hurt
in
letting
Blood
?
It
is
known
when
in
opening
the
Median
Vein
,
the
end
of
the
Lancet
hath
met
with
some
Resistance
;
when
the
Patient
hath
felt
great
Pain
,
and
afterward
when
the
Tendon
apparently
begins
to
be
puff'd
up
,
and
the
Arm
to
swell
.
A
Remedy
may
be
apply'd
to
this
Accident
thus
;
after
having
finish'd
the
Operation
,
a
Bolster
steep'd
in
Oxycratum
is
to
be
laid
upon
the
Vessel
,
a
proper
Bandage
is
to
be
made
,
and
the
Arm
must
be
wrapt
up
in
a
Scarf
:
If
the
Inflammation
that
ariseth
in
the
Part
be
follow'd
with
Suppuration
,
it
must
be
dress'd
with
a
small
Tent
;
and
if
the
Suppuration
be
considerable
,
it
is
necessary
to
dilate
the
Wound
,
and
to
make
use
of
Oil
of
Eggs
and
Brandy
,
or
Arcaeus's
Liniment
,
with
a
good
Digestive
;
as
also
to
apply
Emplastrum
Ceratum
;
to
make
an
Embrocation
on
the
Arm
with
Oil
of
Roses
;
and
to
dip
the
Bolsters
in
Oxycratum
to
cover
the
whole
Part.
Is
it
not
to
be
fear'd
that
some
Nerve
may
be
wounded
in
letting
Blood
?
No
,
they
lie
so
deep
that
they
cannot
be
touch'd
.
Vnder
what
Vein
is
the
Artery
of
the
Arm
?
It
is
usually
situated
under
the
Basilica
.
What
Course
is
proper
to
be
taken
to
avoid
the
Puncture
of
an
Artery
in
letting
Blood
?
It
must
be
felt
with
the
Hand
before
the
Ligature
is
made
,
observing
well
whether
it
be
deep
or
superficial
;
for
when
it
lies
deep
,
there
is
nothing
to
be
fear'd
;
and
when
it
is
superficial
,
it
may
be
easily
avoided
by
pricking
the
Vein
either
higher
or
lower
.
What
is
to
be
done
when
an
Artery
is
open'd
?
If
it
be
well
open'd
,
it
is
requisite
to
let
the
Blood
run
out
till
the
Person
falls
into
a
Syncope
or
Swoon
,
by
which
means
the
Aneurism
is
prevented
;
and
afterward
the
Blood
will
be
more
easily
stopt
:
It
remains
only
to
make
a
good
Bandage
with
many
Bolsters
,
in
the
first
of
which
is
simply
put
a
Counter
or
a
Piece
of
Money
;
but
a
bit
of
Paper
chew'd
will
serve
much
better
,
with
Bolsters
laid
upon
it
in
several
Folds
.
If
the
Arteries
cause
so
much
trouble
when
open'd
accidentally
,
why
are
those
of
the
Temples
sometimes
open'd
on
purpose
,
to
asswage
violent
Pains
in
the
Head
?
By
reason
that
in
this
place
the
Arteries
are
situated
upon
the
Bones
that
press
'em
behind
;
which
very
much
facilitates
their
re-union
.
Are
not
the
Arteries
of
Persons
advanc'd
in
Years
more
difficult
to
be
clos'd
than
those
of
Children
?
Yes
.
Are
there
not
Accidents
to
be
fear'd
in
letting
Blood
in
the
Foot
.
Much
less
than
in
the
Arm
;
because
the
Veins
of
the
Malleoli
or
Ankles
are
not
accompany'd
either
with
Arteries
or
Tendons
;
which
gave
occasion
to
the
Saying
,
That
the
Arm
must
be
given
to
be
let
Blood
only
to
an
able
Surgeon
,
but
the
Foot
may
be
afforded
to
a
young
Practitioner
.
A
TREATISE
OF
Chirurgical
Operations
.
CHAP.
I.
Of
the
Operation
of
the
Trepan
.
THIS
Operation
is
to
be
perform'd
,
when
it
is
inferr'd
from
the
Signs
of
which
we
have
already
given
a
particular
Account
,
that
some
Matter
is
diffus'd
over
the
Dura
Mater
.
The
Trepan
must
not
be
us'd
in
the
Sinus
Superciliares
,
by
reason
of
their
Cavity
;
nor
in
the
Sutures
,
in
regard
of
the
Vessels
that
pass
thro'
'em
;
nor
in
the
Temporal
Bone
without
great
necessity
,
especially
in
that
part
of
it
which
is
join'd
to
the
Parietal-Bone
,
lest
the
end
of
this
Bone
shou'd
fly
out
of
its
place
,
since
it
is
only
laid
upon
the
Parietal
;
nor
in
the
middle
of
the
Coronal
and
Occipital-Bones
,
by
reason
of
an
inner
Prominence
wherein
they
adhere
to
the
Dura
Mater
;
nor
in
the
Passage
of
the
Lateral
Sinus's
that
are
situated
on
the
side
of
the
Occipital
.
If
the
Fissure
be
very
small
,
the
Trepan
may
be
apply'd
upon
it
,
altho'
it
is
more
expedient
to
use
this
Instrument
on
the
side
of
the
Fissure
in
the
lower
part
;
neither
is
the
Trepan
to
be
set
upon
the
Sinkings
;
and
if
the
Bones
are
loosen'd
or
separated
,
there
needs
no
other
trepanning
than
to
take
'em
away
with
the
Elevatory
The
Operation
must
be
begun
with
Incision
,
which
is
usually
made
in
form
of
a
Cross
,
if
the
Wound
be
remote
from
the
Sutures
,
and
there
are
no
Muscles
to
be
cut
,
and
in
the
shape
of
the
Letter
T.
or
of
the
Figure
7.
if
it
be
near
the
Sutures
,
so
that
the
Foot
of
the
7.
or
of
the
T.
ought
to
be
parallel
to
the
Suture
,
the
top
of
the
Letter
descending
toward
the
Temples
;
it
is
also
made
in
the
middle
of
the
Forehead
.
If
it
be
sufficient
to
make
a
longitudinal
Incision
in
the
Forehead
;
its
Wrinkles
may
be
follow'd
,
and
there
will
be
less
Deformity
in
the
Scar
;
but
it
is
never
done
Crosswise
in
this
Part
,
and
the
Lips
of
the
Wound
are
not
to
be
cut
.
If
an
Incision
be
made
on
the
Muscle
Crotaphites
,
and
on
those
of
the
back-part
of
the
Head
,
it
may
be
done
in
form
of
the
Letter
V.
the
Point
of
which
will
stand
at
the
bottom
of
the
Muscles
;
nevertheless
it
is
more
convenient
to
make
a
longitudinal
Incision
,
by
which
means
fewer
Fibres
will
be
cut
;
and
it
is
always
requisite
to
begin
at
the
lower
part
,
to
avoid
being
hindred
by
the
Haemorrhage
.
The
Incisions
are
to
be
made
with
the
Incision-Knife
,
and
that
too
boldly
when
there
are
no
Sinkings
;
but
if
there
be
any
,
too
much
weight
must
not
be
laid
upon
'em
:
Thus
the
Incision
being
finish'd
,
the
Lips
of
the
Skull
are
to
be
separated
either
with
the
Fingers
,
or
some
convenient
Instrument
;
Then
if
there
be
no
urgent
Occasion
to
apply
the
Trepan
,
it
may
be
deferr'd
till
the
next
Day
,
the
Wound
being
dress'd
in
the
mean
time
with
Plaisters
,
Bolsters
,
Pledgets
,
and
a
large
Kerchief
or
upper
Dressing
,
the
use
of
which
we
shall
shew
hereafter
.
The
Operation
is
begun
with
the
Perforative
,
to
make
a
little
Hole
for
the
fixing
of
the
Pyramid
or
Pin
which
is
in
the
Round
;
afterward
the
Round
is
to
be
apply'd
,
holding
the
Handle
of
the
Trepan
with
the
Left-hand
,
and
turning
;
but
when
the
Round
hath
made
its
way
,
it
is
lifted
up
to
remove
the
Pin
,
lest
this
Point
shou'd
hurt
the
Dura
Mater
:
Thus
the
Round
being
taken
off
from
time
to
time
,
to
be
cleans'd
from
the
Filings
that
stick
thereto
,
is
set
on
again
,
and
the
Operator
begins
his
Work
of
turning
anew
,
which
must
be
carry'd
on
gently
when
any
Blood
appears
,
to
the
end
that
the
first
Table
of
the
piece
of
Bone
which
is
remov'd
may
not
fly
from
the
second
:
When
it
comes
near
the
Dura
Mater
,
the
Operator
must
proceed
,
in
like
manner
,
gently
,
searching
with
a
Feather
round
about
the
Bone
,
to
observe
whether
he
still
continueth
his
Course
in
the
Skull
.
He
must
also
often
lift
up
the
Trepan
to
search
the
Hole
,
to
cleanse
the
Instrument
,
and
to
keep
it
from
growing
hot
.
As
often
as
the
Trepan
is
taken
off
,
let
him
search
with
a
Feather
,
to
see
whether
the
Bone
be
cut
equally
;
and
if
it
be
not
,
he
must
lean
more
on
that
side
which
is
least
cut
.
If
it
be
necessary
to
make
use
of
the
Terebella
,
the
Hole
must
be
made
in
the
beginning
,
whilst
the
Bone
is
as
yet
firm
;
and
when
the
Piece
begins
to
move
,
the
Terebella
is
to
be
put
very
gently
into
its
Hole
,
without
pressing
the
Bone
,
to
draw
it
out
;
or
else
it
may
be
taken
away
with
the
Myrtle-Leaf
,
which
is
an
Instrument
made
of
a
firm
Silver-Plate
somewhat
crooked
.
When
the
Piece
is
thus
remov'd
,
the
uneven
Parts
that
remain
at
the
bottom
of
the
Hole
,
are
to
be
cut
with
the
Lenticula
;
and
if
there
be
any
Sinkings
,
they
may
be
rais'd
with
the
Elevatory
.
Whereupon
the
Dura
Mater
may
be
compress'd
a
little
with
the
Lenticula
,
to
facilitate
the
running
out
of
the
Blood
,
the
Wounded
Person
being
oblig'd
to
stoop
with
his
Head
downward
,
stopping
his
Nose
and
Mouth
,
and
holding
his
Breath
for
a
while
,
to
cause
the
Matter
to
run
out
:
Then
the
Dura
Mater
may
be
wip'd
with
Lint
;
but
if
any
Pus
or
corrupt
Matter
lies
underneath
,
it
must
be
pierc'd
with
a
Lancet
wrapt
up
in
a
Tent
,
that
it
may
not
be
perceiv'd
by
the
Assistants
.
Afterward
a
Sindon
or
very
fine
Linnen
Rag
dipt
in
a
proper
Medicament
,
is
put
between
the
Dura
Mater
and
the
Skull
;
the
Hole
is
fill'd
with
small
Bolsters
steept
in
convenient
Medicinal
Liquors
;
and
the
Wound
is
dress'd
with
Pledgers
,
a
Plaister
,
and
a
Kerchief
.
But
the
Hole
ought
to
be
well
stopt
with
Bolsters
,
because
the
Dura
Mater
is
sometimes
so
much
inflam'd
,
that
it
bursts
forth
;
so
that
if
any
Excrescences
arise
therein
,
and
go
our
of
the
Hole
,
having
small
Roots
,
they
may
be
bound
and
cut
;
but
if
their
Roots
be
large
,
they
must
be
press'd
close
with
little
Bolsters
steept
in
Spirituous
Medicines
.
Here
it
may
not
be
improper
to
observe
,
that
the
Operation
of
the
Trepan
ought
to
be
perform'd
more
gently
in
Children
than
in
adult
Persons
,
in
regard
that
their
Bones
are
more
tender
,
and
that
Oily
Medicines
must
not
be
us'd
,
but
Spirituous
.
The
Exsoliation
is
made
sometimes
sooner
,
and
sometimes
later
;
but
the
Callus
usually
covers
the
opening
of
the
Skull
within
the
space
of
forty
or
fifty
Days
,
if
no
ill
Accident
happens
.
In
great
Fractures
,
where
there
is
no
longer
any
connexion
between
the
Bones
,
it
is
requisite
to
take
'em
away
.
Of
the
Bandagè
of
the
Trepan
.
The
proper
Bandage
to
be
us'd
after
the
Operation
of
the
Trepan
,
is
the
great
Kerchief
,
which
is
a
large
Napkin
folded
into
two
parts
after
such
a
manner
that
the
side
which
toucheth
the
Head
exceeds
that
which
doth
not
touch
it
in
the
breadth
of
four
Fingers
;
it
is
apply'd
to
the
Head
in
the
middle
,
whilst
a
Servant
holds
the
Dressing
with
his
Hand
:
Then
the
two
upper
ends
of
the
Napkin
being
brought
under
the
Chin
,
the
Surgeon
takes
the
two
lower
,
and
draws
'em
streight
by
the
sides
,
so
as
that
side
of
the
Napkin
,
which
is
four
Fingers
broader
than
the
other
,
may
be
laid
upon
the
Forehead
:
Afterward
the
two
ends
of
the
Napkin
are
cross'd
behind
the
Head
,
and
fasten'd
at
their
Extremities
with
Pins
,
without
making
any
Folds
,
that
might
hurt
the
Part
;
but
the
ends
of
the
Napkin
which
fall
upon
the
Shoulders
,
are
rais'd
up
to
the
Head
near
the
lesser
Corner
of
the
Eyes
;
and
the
two
ends
under
the
Chin
are
fasten'd
with
Pins
,
or
else
tied
in
a
Knot
.
CHAP.
II.
Of
the
Operation
of
the
Fistula
Lachrymalis
.
THIS
Operation
is
perform'd
when
there
is
a
Fistulous
Ulcer
in
the
great
Corner
of
the
Eye
,
after
this
manner
:
The
Patient
being
pl●c'd
in
a
convenient
Posture
,
and
having
his
sound
Eye
bound
up
,
to
take
away
the
sight
of
the
Instruments
;
the
Operator
causeth
the
other
Eye
to
be
kept
steady
with
a
Bolster
held
with
an
Instrument
,
and
makes
an
Incision
with
a
Lancer
in
form
a
Crescent
upon
the
Tumour
,
taking
care
to
avoid
cutting
the
Eye-Lid
and
the
little
Cartilage
which
serves
as
a
Pulley
to
the
great
Oblique
Muscle
.
If
the
Bone
be
putrify'd
with
a
Caries
,
an
Actual
Cautery
may
be
apply'd
thereto
,
using
for
that
purpose
a
small
Funnel
or
Tube
,
thro'
the
Canal
of
which
the
Cautery
is
convey'd
to
the
Bone
.
But
the
Bone
must
not
be
pierc'd
,
for
it
is
exfoliated
entire
by
reason
of
its
smallness
;
and
so
the
Hole
is
made
without
any
Perforation
.
The
Dressing
and
Bandage
of
the
Fistula
Lachrymalis
.
The
Wound
is
fill'd
with
small
dry
Pledgets
,
and
cover'd
with
a
Plaister
and
Bolster
:
The
Bandage
is
made
with
an
Handkerchief
folder
triangular-wise
,
the
ends
of
which
are
fasten'd
behind
the
Head
.
If
the
Flesh
grows
too
fast
,
it
may
be
consum'd
with
the
Lapis
Infernalis
;
and
if
there
be
occasion
to
dilate
the
Wound
,
to
facilitate
the
Exsoliation
,
it
may
be
done
with
little
pieces
of
Spunge
prepar'd
,
and
put
into
it
.
Afterward
Causticks
are
to
be
us'd
,
to
eat
away
the
Callous
Parts
,
which
may
be
mingled
with
Oily
Medicines
,
to
weaken
their
Action
,
taking
care
,
nevertheless
,
that
the
Eye
receive
no
dammage
by
'em
.
If
the
Bone
be
corrupted
,
a
little
Euphorbium
may
be
apply'd
;
or
else
the
small
Pledgets
steept
in
the
Tincture
of
Myrrh
and
Aloes
;
then
the
Ulcer
may
be
handled
as
all
others
.
CHAP.
III.
Of
the
Operation
of
the
Cataract
.
THIS
Operation
is
perform'd
when
there
is
a
small
Body
before
the
Apple
of
the
Eye
,
which
hinders
the
Sight
from
entring
into
it
;
but
it
is
undertaken
only
in
Blew
,
Green
,
and
Pearl-colour'd
Cataracts
,
or
in
those
that
are
of
the
Colour
of
polish'd
Steel
;
and
not
in
Yellow
,
Black
,
or
Lead-colour'd
.
To
know
whether
the
Cataract
be
fit
to
be
couch'd
,
the
Patient's
Eye
must
be
rubb'd
;
so
that
if
the
Cataract
remains
unmoveable
,
it
is
mature
enough
;
but
if
it
changeth
its
place
,
it
is
requisite
to
wait
till
it
become
more
solid
.
The
Spring
and
Autumn
are
the
most
proper
Seasons
for
performing
the
Operation
.
To
this
purpose
the
Patient
being
set
down
with
his
Eyes
turn'd
toward
the
Light
,
and
having
his
sound
Eye
bound
up
,
the
Surgeon
must
likewise
sit
on
a
higher
Seat
,
whilst
the
Patient's
Head
is
held
by
a
Servant
;
and
his
Eye
being
turn'd
toward
his
Nose
,
is
kept
steady
with
a
Speculum
Oculi
,
which
is
a
little
Iron-Instrument
made
like
a
Spoon
,
pierc'd
in
the
middle
,
so
that
the
Ball
of
the
Eye
may
be
let
thro'
this
Hole
:
Then
the
Surgeon
taking
a
a
Steel-Needle
either
round
or
flat
,
accordingly
as
he
shall
judge
convenient
,
perforates
the
Conjunctive
at
the
end
of
the
Corneous
Tunicle
,
on
the
side
of
the
little
Corner
of
the
Eye
,
and
boldly
thrusts
his
Needle
into
the
middle
of
the
Cataract
,
which
he
at
first
pusheth
upward
,
to
loosen
it
with
the
Point
of
the
Needle
;
and
then
downward
,
holding
it
for
some
time
with
his
Needle
below
the
Apple
of
the
Eye
.
If
it
ascend
again
after
it
is
let
go
,
it
must
be
depress'd
a
second
time
;
but
the
Operation
is
finish'd
when
it
remains
in
the
same
place
whereto
it
was
thrust
;
neither
is
the
Needle
to
be
remov'd
till
this
be
done
,
and
the
Cataract
entirely
couch'd
.
In
taking
out
the
Needle
,
the
Eye-Lid
must
be
pull'd
down
,
and
press'd
a
little
over
the
Eye
.
The
Dressing
and
Bandage
,
Is
to
cause
both
the
Patient's
Eyes
to
be
clos'd
and
bound
up
;
then
he
must
be
oblig'd
to
keep
his
Bed
during
seven
or
eight
Days
,
and
some
Defensative
is
to
be
laid
upon
the
sore
Eye
,
to
hinder
the
Inflammation
.
M.
Dupré
,
Surgeon
to
the
Hospital
of
Hôtel-Dieu
at
Paris
,
a
Person
well
vers'd
in
these
kinds
of
Operations
,
hath
observ'd
,
that
after
the
same
manner
as
Cataracts
were
form'd
in
a
very
little
space
of
time
in
perfect
Maturity
;
it
happen'd
also
very
often
,
that
the
Cataracts
which
were
suppos'd
to
have
got
up
again
,
were
not
the
very
same
with
those
that
were
couch'd
,
but
rather
a
new
Pellicula
or
little
Skin
,
which
sometimes
hath
its
Origine
in
the
top
of
the
Weous
Tunicle
,
and
is
caus'd
only
by
a
very
considerable
Relaxation
of
the
Excretory
Vessels
from
the
Sources
of
the
Aqueous
Humour
which
in
filtrating
permits
the
running
of
many
heterogeneous
Parts
,
the
Encrease
of
which
produceth
a
new
Cataract
.
Of
other
Operations
in
the
Eyes
.
Sometimes
a
sort
of
purulent
Matter
is
gather'd
together
under
the
Corneous
Tunicle
;
so
that
to
draw
it
out
,
the
Eye
must
be
fixt
in
a
Posture
with
the
Speculum
Oculi
,
and
after
a
small
Incision
made
therein
with
a
fine
Lancet
,
is
to
be
press'd
a
little
,
to
let
out
the
Matter
;
but
if
it
be
too
thick
,
it
may
be
drawn
forth
by
sucking
gently
with
a
small
Tube
or
Pipe
,
having
a
little
Vial
in
the
middle
,
into
which
the
Matter
will
fall
as
it
is
suck'd
out
.
Sometimes
a
small
Tumour
ariseth
in
the
Eye
,
which
being
ty'd
at
its
Root
with
a
Slip-Knot
,
to
streighten
it
from
time
to
time
,
will
at
length
be
dissolv'd
:
But
if
the
Tumour
lie
in
the
Hole
of
the
Apple
of
the
Eye
,
this
Operation
must
not
be
admitted
,
lest
the
Scar
shou'd
hinder
the
Passage
of
the
Light
.
Sometimes
also
a
somewhat
hard
Membrane
,
call'd
Vnguis
,
appears
in
the
great
Corner
of
the
Eye
,
which
when
it
sticks
thereto
,
may
be
cut
off
by
binding
it
;
this
is
done
with
a
Needle
and
Thread
,
which
is
pass'd
thro'
the
Membrane
,
●nd
afterward
ty'd
.
If
the
Eye-Lids
are
glu'd
together
,
a
crooked
Needle
without
a
Point
may
be
threaded
,
and
pass'd
underneath
'em
;
then
the
ends
of
the
Thread
may
be
drawn
,
to
lift
up
the
Eye-Lids
,
and
they
may
be
separated
with
a
Lancet
.
If
the
Hairs
of
the
Eye-Lids
or
Eye-Brows
offend
the
Eye
,
they
must
be
pull'd
out
with
a
Pair
of
Tweezers
or
Nippers
;
and
when
any
small
,
hard
,
and
transparent
Tumours
arise
in
the
Eye-Lids
,
they
are
to
be
open'd
,
to
let
out
the
corrupt
Matter
.
CHAP.
IV.
Of
the
Operation
of
the
Polypus
.
THIS
Operation
is
necessary
,
when
there
are
any
Excrescences
of
Flesh
in
the
Nostrils
,
which
,
nevertheless
,
when
they
are
livid
,
stinking
,
hard
,
painful
,
and
sticking
very
close
,
must
not
be
tamper'd
with
,
because
they
are
Cancers
.
But
if
they
are
whitish
,
red
,
hanging
,
and
free
from
Pain
,
the
Cure
may
be
undertaken
after
this
manner
:
Take
hold
of
the
Polypus
with
a
Pair
of
Forceps
,
as
near
its
Root
as
is
possible
,
and
turn
'em
first
on
one
side
,
and
then
on
another
,
till
it
be
pull'd
off
.
If
the
Polypus
descends
into
the
Throat
,
it
may
be
drawn
thro'
the
Mouth
with
crooked
Forceps
;
and
if
an
Haemorrhage
shou'd
happen
after
the
Operation
,
it
may
be
stopt
by
thrusting
up
into
the
Nostrils
certain
Tents
soakt
in
some
Styptick
Liquor
;
or
else
by
Syringing
with
the
same
Liquor
.
CHAP.
V.
Of
the
Operation
of
the
Hare-Lip
.
THIS
Operation
is
perform'd
when
the
Upper-Lip
is
cleft
;
but
if
there
be
a
great
loss
of
Substance
,
it
must
not
be
undertaken
;
neither
ought
it
to
be
practis'd
upon
old
nor
scorbutick
Persons
,
nor
upon
young
Children
,
by
reason
that
their
continual
Crying
wou'd
hinder
the
re-union
.
But
if
any
are
desirous
that
it
shou'd
be
done
to
these
last
,
they
are
to
be
kept
from
taking
any
rest
for
a
long
time
,
to
the
end
that
they
may
fall
a-sleep
after
the
Operation
,
which
is
thus
effected
:
If
the
Lip
sticks
to
the
Gums
,
it
is
to
be
separated
with
an
Incision-Knife
,
without
hurting
'em
;
then
the
Hare-Lip
must
be
cut
a
little
about
the
edges
with
Sizzers
,
that
it
may
more
easily
re-unite
,
the
edges
being
held
for
that
purpose
with
a
Pair
of
Pincers
,
whilst
the
Servant
who
supports
the
Patient's
Head
,
presseth
his
Cheeks
before
,
to
draw
together
the
sides
of
the
Hare-Lip
:
Whereupon
the
Operator
passeth
a
Needle
with
wax'd
Thread
,
into
the
two
sides
of
the
Wound
,
from
the
outside
to
the
inside
at
a
Thread
's
distance
from
each
.
But
care
mu●●
be
had
that
the
two
Lips
of
the
Hare-Lip
be
well
adjusted
,
and
very
even
;
the
Thread
being
twisted
round
the
Needle
by
crossing
it
above
.
The
Dressing
and
Bandage
.
After
the
Lips
are
wash'd
with
warm
Wine
,
the
Points
of
the
Needles
must
be
out
off
,
small
Bolsters
being
laid
under
their
ends
;
then
the
Wound
is
to
be
dress'd
with
a
little
Pledget
cover'd
with
some
proper
Balsam
,
putting
at
the
same
time
under
the
Gum
a
Linnen
Rag
steep'd
in
some
desiccative
Liquor
,
lest
the
Lip
shou'd
stick
to
the
Gum
,
if
it
be
necessary
to
keep
'em
a-part
.
Lastly
,
upon
the
whole
is
to
be
laid
an
agglutinative
Plaister
,
supported
with
the
uniting
Bandage
,
which
is
a
small
Band
perforated
in
the
middle
;
it
is
laid
behind
the
Head
,
and
afterward
drawn
forward
,
one
of
its
ends
being
let
into
the
Hole
which
lies
upon
the
Sore
:
Then
the
two
ends
of
the
Band
are
turn'd
behind
the
Head
upon
the
same
Folds
where
they
are
fasten'd
,
sticking
therein
a
certain
Number
of
Pins
,
proportionably
to
the
length
of
the
Wound
.
The
Patient
must
be
dress'd
three
Days
after
;
and
it
is
requisite
at
the
first
time
only
to
untwist
half
the
Needle
,
loosening
the
middle
Thread
if
there
be
three
;
to
which
purpose
a
Servant
is
to
thrust
the
Cheeks
somewhat
forward
.
On
the
eighth
Day
the
middle
Needle
may
be
taken
off
,
if
it
be
a
young
Infant
;
nevertheless
the
Needles
must
not
be
remov'd
till
it
appears
that
the
sides
are
well
join'd
;
neither
must
they
be
left
too
long
,
because
the
Hoses
wou'd
scarce
be
brought
to
close
.
CHAP
VI.
Of
the
Operation
of
Bronchotomy
.
THIS
Operation
becomes
necessary
,
when
the
Inflammation
that
happens
in
the
Larynx
hinders
Respiration
,
and
is
perform'd
after
this
manner
:
The
Wind-Pipe
is
open'd
between
the
third
and
fourth
Ring
,
above
the
Muscle
Cricoides
,
or
else
in
the
middle
of
the
Wind-Pipe
;
but
in
separating
the
Muscles
call'd
Sternohyodei
,
care
must
be
had
to
avoid
cutting
the
recurrent
Nerves
,
lest
the
Voice
shou'd
be
lost
;
as
also
the
Glandules
nam'd
Thyroides
.
The
Space
between
the
Rings
is
to
be
open'd
with
a
streight
Lancet
,
kept
steady
with
a
little
Band
,
and
a
transverse
Incision
is
to
be
made
between
'em
:
Before
the
Lancet
is
taken
out
,
a
Stilet
is
put
into
the
Opening
,
thro'
which
passeth
a
little
Pipe
,
short
,
flat
,
and
somewhat
crooked
at
the
end
,
which
must
not
be
thrust
in
too
far
,
for
fear
of
exciting
a
Cough
.
This
Pipe
hath
two
small
Rings
for
the
fastening
of
Ribbans
,
which
are
ty'd
round
about
the
Neck
;
and
it
must
be
left
in
the
Wound
till
the
Symptoms
cease
.
Afterward
it
is
taken
away
,
and
the
Wound
is
dress'd
,
the
Lips
of
it
being
drawn
together
again
with
the
uniting
Bandage
,
which
hath
been
already
describ'd
.
CHAP.
VII
.
Of
the
Operation
of
the
Uvula
.
WHEN
the
Wula
or
Palate
of
the
Mouth
is
swell'd
so
as
to
hinder
Respiration
or
Swallowing
,
or
else
is
fallen
into
a
Gangrene
,
it
may
be
extirpated
thus
:
The
Tongue
being
first
depress'd
with
an
Instrument
call'd
Speculum
Oris
,
the
Palate
is
held
with
a
Forceps
,
or
cut
with
a
Pair
of
Sizzers
;
or
else
a
Ligature
may
be
made
before
it
is
cut
;
and
the
Mouth
may
be
afterward
gargl'd
with
Astringent
Liquors
.
CHAP.
VIII
.
Of
the
Operation
of
a
Cancer
in
the
Breast
.
THE
Cancer
at
first
is
not
so
big
as
a
Pea
,
being
a
small
,
hard
,
blackish
Swelling
,
sometimes
livid
,
and
very
troublesome
by
reason
of
its
Prickings
;
but
when
it
is
encreas'd
,
the
Tumour
appears
hard
,
Lead-colour'd
,
and
livid
,
causing
in
the
beginning
a
Pain
that
may
be
pretty
well
endur'd
,
but
in
the
increase
it
grows
intolerable
,
and
the
Stink
is
extremely
noisome
.
When
it
is
ready
to
Ulcerate
,
the
Heat
is
vehement
,
with
a
pricking
Pulsation
;
and
the
Veins
round
about
are
turgid
,
being
fill'd
with
black
Blood
,
and
extended
as
it
were
the
Feet
of
a
Crab
or
Crey-Fish
,
till
Death
happen
.
When
this
Tumour
is
not
ulcerated
,
it
is
call'd
an
Occult
Cancer
;
and
an
Apparent
one
when
it
breaks
forth
into
an
open
Ulcer
.
To
palliate
an
Occult
Cancer
,
and
prevent
its
Ulceration
,
a
Cataplasm
or
Pultis
of
Hemlock
very
fresh
may
be
apply'd
to
the
Part.
All
the
kinds
of
Succory
,
the
Decoction
of
Solanum
or
Night-shade
;
the
Juices
of
these
Plants
,
as
also
those
of
Scabious
,
Geranium
or
Stork-Bill
,
Herniaria
or
Rupture-Wort
,
Plantain
,
&c.
are
very
good
in
the
beginning
.
River-Crabs
pounded
in
a
Leaden-Mortar
,
and
their
Juice
beaten
in
a
like
Mortar
,
are
an
excellent
Remedy
;
as
also
are
Humane
Excrements
or
Urine
destill'd
,
and
laid
upon
the
Occult
Concer
:
Or
else
,
Take
an
Ounce
of
calcin'd
Lead
,
two
Ounces
of
Oil
of
Roses
,
and
six
Drams
of
Saffron
;
let
the
whole
Composition
be
beaten
in
a
Mortar
with
a
Leaden
Pestle
,
and
apply'd
.
The
Amalgama
of
Mercury
with
Saturn
is
likewise
a
very
efficacious
Remedy
.
In
the
mean
while
the
Patient
may
be
purg'd
with
black
Hellebore
and
Mercurius
Dulcis
,
taking
also
inwardly
from
one
Scruple
to
half
a
Dram
of
the
Powder
of
Adders
,
given
to
drink
,
with
half
the
quantity
of
Crab's-Eyes
:
But
very
great
care
must
be
taken
to
avoid
the
Application
of
Maturatives
or
Emollients
,
which
wou'd
certainly
bring
the
Tumour
to
Ulceration
.
When
the
Cancer
is
already
ulcerated
,
the
Spirit
of
Chimney-Soot
may
be
us'd
with
good
Success
;
and
the
Oil
of
Sea-Crabs
pour'd
scalding
hot
into
the
Ulcer
,
is
an
excellent
Remedy
.
But
if
it
be
judg'd
expedient
entirely
to
extirpate
the
Cancer
,
it
may
be
done
thus
:
The
sick
Patient
being
laid
in
Bed
,
the
Surgeon
takes
the
Arm
on
the
side
of
the
Cancer
,
and
lifts
it
upward
and
backward
,
to
give
more
room
to
the
Tumour
;
then
having
pass'd
a
Needle
with
a
very
strong
.
Thread
tho'
the
bottom
of
the
Breast
,
he
cuts
the
Thread
to
take
away
the
Needle
,
and
passeth
the
Needle
again
into
the
Breast
,
to
cause
the
Threads
to
cross
one
another
.
Afterward
these
four
ends
of
the
Threads
are
ty'd
together
,
to
make
a
kind
of
Handle
to
take
off
the
Tumour
,
which
is
cut
quite
round
to
the
Ribs
with
a
very
sharp
Rasor
.
The
Cutting
is
usually
begun
in
the
lower
Part
to
end
in
the
Vessels
near
the
Arm-Pit
,
where
a
small
Piece
of
Flesh
is
left
,
to
stop
the
Blood
with
greater
Facility
:
Then
having
laid
a
Piece
of
Vitriol
upon
the
Vessels
,
or
Bolsters
soakt
in
styptick
Water
;
the
sides
of
the
Breast
are
to
be
press'd
with
the
Hand
,
to
let
out
the
Blood
and
Humours
;
and
an
Actual
Cautery
is
to
be
lightly
apply'd
thereto
.
The
Dressing
.
The
Wound
is
to
be
dress'd
with
Pledgets
strew'd
with
Astringent
Powders
,
a
Plaister
,
a
Bolster
,
a
Napkin
round
the
Breast
,
and
a
Scapulary
to
support
the
whole
Bandage
.
But
instead
of
passing
Threads
cross-wise
,
to
form
a
Handle
,
with
which
the
Breast
may
be
taken
off
,
it
wou'd
be
more
expedient
to
make
use
of
a
sort
of
Forceps
turn'd
at
both
ends
in
form
of
a
Crescent
,
after
such
a
manner
that
those
ends
may
fall
one
upon
another
when
the
Forceps
are
shut
.
Thus
the
Surgeon
may
lay
hold
on
the
Breast
with
these
Forceps
,
and
draw
it
off
,
after
having
cut
it
at
one
single
Stroak
with
a
very
flat
,
crooked
,
and
sharp
Knife
.
Neither
is
it
convenient
to
apply
the
Actual
Cautery
to
stop
the
Haemorrhage
,
because
it
is
apt
to
break
forth
again
anew
,
when
the
Escar
,
is
fall'n
off
.
When
the
Tumour
is
not
as
yet
ulcerated
,
a
Crucial
Incision
may
be
made
in
the
Skin
,
without
penetrating
into
the
Glandulous
Bodies
;
then
the
four
Pieces
of
the
Glandules
being
separated
,
the
Cancerous
Tumour
may
be
held
with
the
Forceps
,
and
,
afterward
cut
off
If
there
be
any
Vessels
swell'd
,
they
may
be
bound
before
the
Tumour
is
taken
away
;
but
if
the
Tumour
sticks
close
to
the
Ribs
,
the
Operation
is
not
usually
undertaken
.
CHAP.
IX
.
Of
the
Operation
of
the
Empyema
.
THIS
Operation
is
perform'd
when
it
may
be
reasonably
concluded
that
some
corrupt
Matter
is
lodg'd
in
the
Breast
,
which
may
be
perceiv'd
by
the
weight
that
the
Patient
feels
in
fetching
his
Breath
;
being
also
sensible
of
the
floating
of
the
Matter
when
he
turns
himself
from
one
side
to
another
.
If
the
Tumour
appears
on
the
outside
,
the
Abcess
may
be
open'd
between
the
Ribs
;
but
if
no
external
Signs
are
discern'd
,
the
Surgeon
may
choose
a
more
convenient
place
to
make
the
Opening
.
Thus
when
the
Patient
is
set
upon
his
Bed
,
and
conveniently
supported
,
the
Opening
is
to
be
made
between
the
second
and
third
of
the
Spurious
Ribs
,
within
four
Fingers
breadth
of
the
Spine
,
and
the
lower
Corner
of
the
Omoplata
;
to
this
purpose
the
Skin
is
to
be
taken
up
a-cross
,
to
cut
it
in
its
length
,
the
Surgeon
holding
it
on
one
side
,
and
the
Assistant
on
the
other
.
The
Incision
is
made
with
a
streight
Knife
two
or
three
Fingers
breadth
long
,
and
the
Fibres
of
the
great
Dorsal-Muscle
are
cut
a-cross
,
that
they
may
not
stop
the
Opening
.
Then
the
Surgeon
puts
the
Fore-Finger
of
his
Left-hand
into
the
Incision
,
to
remove
the
Fibres
,
and
divides
the
Intercostal
Muscles
,
guiding
the
Point
of
the
Knife
with
his
Finger
to
pierce
the
Pleuron
,
for
fear
of
wounding
the
Lungs
,
which
sometimes
adhere
thereto
,
the
Opening
being
thus
finish'd
,
if
the
Matter
runs
well
,
it
must
be
taken
out
;
but
if
not
,
the
Fore-Finger
must
be
put
into
the
Wound
,
to
disjoyn
those
Parts
of
the
Lungs
that
stick
to
the
Pleuron
.
To
let
out
the
Matter
,
the
Patient
must
be
oblig'd
to
lean
on
one
side
,
stopping
his
Mouth
and
Nose
,
and
puffing
up
his
Cheeks
,
as
if
he
were
to
blow
vehemently
;
then
if
Blood
appears
,
a
greater
quantity
of
it
may
be
taken
away
than
if
it
were
Matter
,
in
regard
that
a
Flux
of
Matter
weakens
more
than
that
of
Blood
.
It
is
also
worth
the
while
to
observe
,
that
in
making
the
Incision
,
the
Intercostal
Muscles
ought
to
be
cut
a-cross
,
that
the
side
of
the
Ribs
may
not
be
laid
bare
,
by
which
means
the
Wound
will
not
so
soon
become
Fistulous
.
If
it
be
judg'd
that
purulent
Matter
is
contain'd
in
both
sides
of
the
Breast
,
it
is
requisite
that
the
Operation
be
done
on
each
side
;
it
being
well
known
that
the
Breast
is
divided
into
two
Parts
by
the
Mediastinum
:
But
in
this
case
the
two
Holes
made
by
the
Incision
must
not
be
left
open
at
the
same
time
,
for
fear
of
suffocating
the
Patient
.
The
Dressing
and
Bandage
.
The
Wound
is
dress'd
with
a
Tent
of
Lint
arm'd
with
Balsam
,
being
soft
,
and
blunt
at
the
end
,
which
enters
only
between
the
Ribs
,
for
fear
of
hurting
the
Lungs
;
but
a
good
Pledget
of
Lint
is
more
convenient
than
a
Linnen
Tent
,
however
a
Thread
must
be
ty'd
to
the
Pledget
or
Tent
,
lest
it
shou'd
fall
into
the
Breast
;
and
Bolsters
are
to
be
put
into
the
Wound
;
as
also
a
Plaister
or
Band
over
the
whole
.
This
Dressing
is
to
be
kepc
close
with
a
Napkin
fasten'd
round
the
Breast
with
Pins
,
and
supported
by
a
Scapulary
,
which
is
a
sort
of
Band
,
the
breadth
of
which
is
equal
to
that
of
six
Fingers
,
having
a
Hole
in
the
middle
to
let
in
the
Head
:
One
of
its
ends
falls
behind
and
the
other
before
;
and
they
are
both
fasten'd
to
the
Napkin
.
Thus
the
Patient
is
laid
in
Bed
,
and
set
half
upright
.
If
the
Lungs
hinder
the
running
out
of
the
Matter
,
a
Pipe
is
us'd
,
and
the
Wound
afterward
dress'd
according
to
Art
.
CHAP.
X.
Of
the
Operation
of
the
Paracentesis
of
the
Lower-Belly
.
THIS
Manual
Operation
is
sometimes
necessary
in
a
Dropsie
,
when
Watry
Humours
are
contain'd
in
the
Cavity
of
the
Belly
,
or
else
between
the
Teguments
.
The
Disease
is
manifest
by
the
great
Swelling
;
and
the
Operation
is
perform'd
with
a
Cane
,
or
a
Pipe
made
of
Silver
or
Steel
,
with
a
sharp
Stilet
at
the
end
;
altho'
the
Ancients
were
wont
to
do
it
with
a
Lancet
.
The
Patient
being
supported
,
sitting
on
a
Bed
,
or
in
a
great
Elbow-Chair
,
to
the
end
that
the
Water
may
run
downward
,
a
Servant
must
press
the
Belly
with
his
Hands
,
that
the
Tumour
may
be
extended
,
whilst
the
Surgeon
perforates
it
three
or
four
Fingers
breadth
below
the
Navel
,
and
makes
the
Puncture
on
the
side
,
to
avoid
the
White-Line
;
but
before
the
Opening
is
made
,
it
is
expedient
that
the
Skin
be
a
little
lifted
up
.
The
pointed
Stilet
being
accompany'd
with
its
Pipe
,
remains
in
the
Part
after
the
Puncture
;
but
it
is
remov'd
to
let
out
the
Water
;
and
a
convenient
quantity
of
it
is
taken
away
,
accordingly
as
the
Strength
of
the
Patient
will
admit
.
The
Stilet
makes
so
small
an
Opening
,
that
it
is
not
to
be
fear'd
lest
the
Water
shoul'd
run
out
,
which
might
happen
in
making
use
of
the
Lancet
,
because
there
wou'd
be
occasion
for
a
thicker
Pipe
.
When
a
new
Puncture
is
requisite
,
it
must
be
begun
beneath
the
former
;
but
if
the
Waters
cause
the
Navel
to
stand
out
,
the
Opening
may
be
made
therein
,
without
seeking
for
any
other
place
.
The
Bandage
and
Dressing
Are
prepar'd
with
a
large
four-double
Bolster
kept
close
with
a
Napkin
folded
into
three
or
four
Folds
,
which
is
in
like
manner
supported
by
the
Scapulary
.
The
Operation
of
the
Paracentesis
of
the
Scrotum
Is
undertaken
when
those
Parts
are
full
of
Water
,
after
this
manner
:
Assoon
as
the
Patient
is
plac'd
in
a
convenient
Posture
,
either
standing
or
sitting
,
the
Operator
lays
hold
on
the
Scrotum
with
one
Hand
,
presseth
it
a
little
to
render
the
Tumour
hard
,
and
makes
a
Puncture
,
as
in
the
Paracentesis
of
the
Abdomen
.
In
an
Hydrocele
that
happens
to
young
Infants
,
the
Opening
may
be
made
with
a
Lancet
,
to
take
away
all
the
Water
at
once
:
But
in
Men
,
especially
when
there
is
a
great
quantity
thereof
,
it
is
more
expedient
to
do
it
with
the
sharp-pointed
Pipe
;
but
the
Testicles
are
to
be
drawn
back
,
for
fear
of
wounding
'em
with
the
Point
of
the
Instrument
.
If
the
Hydrocele
be
apparently
Encysted
,
the
Membrane
containing
the
Water
is
to
be
consum'd
with
Causticks
,
which
is
done
by
laying
a
Cautery
in
the
place
where
the
Incision
shou'd
be
made
,
and
afterward
opening
the
Escar
with
a
Lancet
.
When
the
Puncture
is
made
,
it
ought
to
be
done
in
the
upper-part
of
the
Scrotum
,
because
it
is
less
painful
than
the
lower
,
and
less
subject
to
Inflammation
.
CHAP
XI
.
Of
the
Operation
of
Gastroraphy
.
THIS
Operation
is
usually
perform'd
when
there
is
a
Wound
in
the
Belly
so
wide
as
to
let
out
the
Entrails
.
If
there
be
a
considerable
Wound
in
the
Intestine
,
it
may
be
sow'd
up
with
the
Glover's
Stitch
,
the
manner
of
making
which
we
have
before
explain'd
.
If
the
Omentum
or
Caul
be
mortify'd
,
the
corrupted
Part
must
be
cut
off
;
to
which
purpose
it
is
requisite
to
take
a
Needle
with
waxed
Thread
,
and
to
pass
it
into
the
sound
Part
a-cross
the
Caul
,
without
pricking
the
Vessels
.
Then
the
Caul
being
ty'd
on
both
sides
with
each
of
the
Threads
that
have
been
pass'd
double
,
may
be
cut
an
Inch
below
the
Ligature
,
and
the
Threads
will
go
thro'
the
Wound
,
so
as
to
be
taken
away
after
the
Suppuration
.
Afterward
the
Intestines
are
to
be
put
up
again
into
the
Belly
,
by
thrusting
'em
alternately
with
the
end
of
the
Fingers
.
But
if
they
cannot
be
restor'd
to
their
proper
Place
without
much
difficulty
,
Spirituous
Fomentations
may
be
made
with
an
handful
of
the
Flowers
of
Camomile
and
Melilot
,
an
Ounce
of
Anise
,
with
as
much
Fennel
and
Cummin-Seeds
;
half
an
Ounce
of
Cloves
and
Nutmegs
:
Let
the
whole
Mass
be
boil'd
in
Milk
▪
adding
an
Ounce
of
Camphirated
Spirit
of
Wine
,
and
two
Drams
of
Saccharum
Saturni
,
with
two
Scruples
of
Oil
of
Anise
,
and
bathe
the
Entrails
with
this
Fomentation
very
hot
.
Otherwise
,
Apply
Animals
cut
open
alive
;
or
else
boil
Skeins
of
raw
Thread
in
Milk
,
and
foment
'em
with
this
Decoction
in
like
manner
very
hot
.
Before
the
Suture
or
Stitching
of
the
Intestines
is
made
,
it
is
expedient
to
foment
'em
with
Spirit
of
Wine
,
in
which
a
little
Camphire
hath
been
dissolv'd
:
But
if
they
be
mortify'd
,
they
must
not
be
sown
up
again
,
but
fomented
with
Spirituous
Liquors
.
No
Clysters
are
to
be
given
to
the
Patient
,
for
fear
causing
the
Intestine
to
swell
;
but
a
Suppository
may
be
apply'd
:
Or
else
he
may
make
use
of
a
Laxative
Diet-Drink
,
if
it
be
necessary
to
open
his
Body
:
He
ought
also
to
be
very
temperate
and
abstemious
during
the
Cure
,
so
as
to
take
no
other
Sustenance
than
Broths
and
Gellies
.
If
the
Intestines
cannot
be
put
up
again
,
the
Wound
is
to
be
dilated
,
avoiding
the
White-Line
,
and
that
too
at
the
bottom
rather
than
at
the
Top
,
if
it
be
above
.
To
this
purpose
the
Intestines
are
to
be
rank'd
along
the
side
of
the
Wound
,
and
a
Bolster
is
to
be
laid
upon
'em
dipt
in
warm
Wine
,
which
may
be
held
by
some
Assistant
.
Then
the
Surgeon
introduceth
a
channel'd
Probe
into
the
Belly
,
and
takes
a
great
deal
of
care
to
six
the
Intestine
between
the
Probe
and
the
Peritonaeum
,
which
may
be
effected
by
drawing
out
the
Intestine
a
little
;
then
holding
the
Probe
with
his
Left-hand
,
to
fit
a
crooked
Incision-Knife
in
its
chanelling
,
he
cuts
the
Teguments
equally
both
on
the
outside
and
within
,
and
thrusts
back
the
Entrails
alternately
into
the
Wound
with
his
Fore-Finger
.
The
Stitch
must
be
intermitted
,
being
made
with
two
crooked
Needles
threaded
at
each
end
with
the
same
Thread
.
The
Surgeon
having
at
first
put
the
Fore-Finger
of
his
Left-Hand
into
the
Belly
,
to
retain
the
Peritoneaum
,
Muscles
,
and
Skin
on
the
side
of
the
Wound
,
passeth
the
Needle
with
his
other
Hand
into
the
Belly
,
the
Point
of
which
is
guided
with
the
Fore-Finger
,
and
penetrates
very
far
:
Then
he
likewise
passeth
the
other
Needle
thro'
the
other
Lip
of
the
Wound
into
the
Belly
,
observing
the
same
thing
as
in
the
former
,
and
without
taking
his
Fingers
off
from
the
Belly
.
If
there
are
many
Points
or
Stitches
to
be
made
,
they
may
be
done
after
the
same
manner
,
without
removing
the
Fingers
from
the
Part
,
whilst
a
Servant
draws
together
the
Lips
of
the
Wound
,
and
ties
the
Knots
.
Afterward
the
Wound
may
be
dress'd
,
and
the
Preparatives
or
Dressings
kept
close
to
the
Part
with
the
Napkin
and
Scapulary
.
But
the
Patient
must
be
oblig'd
to
lie
on
his
Belly
for
some
Days
successively
,
to
cicatrize
the
Wound
thereof
,
or
that
of
the
Entrails
.
If
the
Intestine
were
entirely
cut
,
it
wou'd
be
requisite
to
sow
it
up
round
about
the
Wound
,
after
such
a
manner
that
some
part
of
it
may
always
remain
open
;
for
if
the
Patient
shou'd
recover
,
his
Excrements
might
be
voided
thro'
the
Wound
;
of
which
Accident
we
have
an
Example
in
a
Soldier
belonging
to
the
Hospital
Des
Invalides
at
Paris
,
who
liv'd
a
long
time
in
this
Condition
.
CHAP.
XII
.
Of
the
Operation
of
the
Exomphalus
.
THIS
Operation
is
necessary
when
the
Intestines
or
Entrails
have
made
a
kind
of
Rupture
in
the
Navel
,
and
may
be
perform'd
thus
:
When
the
Patient
is
laid
upon
his
Back
,
an
Incision
is
to
be
made
on
the
Tumour
to
the
Fat
,
by
griping
the
Skin
,
if
it
be
possible
,
or
else
it
may
be
done
without
taking
it
up
.
Then
the
Membranes
are
to
be
divided
with
a
Fleam
to
lay
open
the
Peritonaeum
,
for
fear
of
cutting
the
Intestine
;
and
as
soon
as
the
Peritonaeum
appears
,
it
may
be
drawn
upward
with
the
Nails
,
in
order
to
make
a
small
Opening
therein
with
some
cutting
Instrument
:
Whereupon
the
Surgeon
having
put
the
Fore-Finger
of
his
Left-Hand
into
the
Belly
to
guide
the
Point
of
the
Sizzers
,
with
which
the
Incision
is
enlarg'd
,
restores
the
Intestine
to
its
proper
Place
,
and
loosens
the
Caul
if
it
stick
to
the
Tumour
:
But
if
the
Entrails
are
fasten'd
to
the
Caul
,
it
is
requisite
to
separate
'em
by
cutting
a
little
of
the
Caul
,
rather
than
to
touch
the
Intestine
;
which
last
being
reduc'd
,
a
Servant
may
press
the
Belly
on
the
side
of
the
Wound
;
so
that
if
a
Mass
of
Flesh
be
found
in
the
Caul
,
which
hath
been
form'd
by
the
sticking
of
the
Caul
to
the
Muscles
and
Peritonaeum
,
this
Fleshy
Mass
must
be
entirely
loosen'd
,
and
then
a
Ligature
may
be
made
to
take
it
away
,
with
some
part
of
the
Caul
,
as
we
have
already
shewn
in
the
Gastroraphy
.
Afterward
the
Stitch
is
to
be
made
,
as
in
that
Operation
,
and
the
Wound
must
be
dress'd
,
observing
the
same
Precautions
.
The
Dressing
is
to
be
supported
in
like
manner
with
the
Napkin
and
Scapulary
.
CHAP.
XIII
.
Of
the
Operation
of
the
Bubonocele
,
and
of
the
compleat
Rupture
.
WHEN
the
Intestinal
Parts
are
fall'n
into
the
Groin
or
the
Scrotum
,
the
Operation
of
the
Bubonocele
may
be
conveniently
perform'd
;
to
which
purpose
the
Patient
is
to
be
laid
upon
his
Back
,
with
his
Buttocks
somewhat
high
;
then
the
Skin
being
grip'd
a-cross
the
Tumour
,
the
Surgeon
holds
it
on
one
side
,
and
the
Assistant
on
the
other
,
till
he
makes
an
Incision
,
following
the
Folds
or
Wrinkles
of
the
Groin
;
when
the
Fat
appears
,
it
is
requisite
to
tear
off
either
with
a
Fleam
or
even
with
the
Nails
,
every
thing
that
lies
in
the
way
,
till
the
Intestine
be
laid
open
,
which
must
be
drawn
out
a
little
,
to
see
if
it
do
not
cleave
to
the
Rings
of
the
Muscles
.
The
Intestine
must
be
gently
handl'd
,
to
dissolve
the
Excrements
;
and
those
Parts
must
be
afterward
put
up
again
into
the
Belly
(
if
it
be
possible
)
with
the
two
Fore-Fingers
,
thrusting
'em
alternatively
;
but
if
they
cannot
be
reduc'd
,
the
Wound
is
to
be
dilated
upward
,
by
introducing
a
channell'd
Probe
into
the
Belly
,
to
let
the
Sizzers
into
its
Channelling
.
If
the
Probe
cannot
enter
,
the
Intestine
must
be
taken
out
a
little
,
laying
a
Finger
upon
it
near
the
Ring
,
and
making
a
small
Scarification
in
the
Ring
,
with
a
streight
Incision-Knife
guided
with
the
Finger
,
to
let
in
the
Probe
,
into
which
may
be
put
a
crooked
Knife
,
to
cut
the
Ring
;
that
is
to
say
,
to
dilate
the
Wound
on
the
inside
;
but
care
must
be
had
to
avoid
penetrating
too
far
,
for
fear
of
dividing
a
Branch
of
Arteries
;
and
then
the
Parts
may
be
put
up
into
the
Belly
.
If
the
Caul
had
caus'd
the
Rupture
,
it
wou'd
be
requisite
to
bind
it
,
and
to
cut
off
whatsoever
is
corrupted
,
scarifying
the
Ring
on
the
inside
,
to
to
make
a
good
Cicatrice
or
Scar.
The
Dressing
and
Bandage
.
The
Dressing
may
be
prepar'd
with
a
Linnen-Tent
,
soft
and
blunt
,
of
a
sufficient
thickness
and
length
,
to
hinder
the
Intestines
from
re-entring
into
the
Rings
by
their
Impulsion
,
a
Thread
being
ty'd
thereto
,
to
draw
it
out
as
occasion
serves
.
Then
Pledgets
are
to
be
put
into
the
Wound
,
after
they
have
been
dipt
in
a
good
Digestive
,
such
as
Turpentine
with
the
Yolk
of
an
Egg
,
applying
at
the
same
time
a
Plaister
,
a
Bolster
of
a
Triangular
Figure
,
and
the
Bandage
call'd
Spica
,
which
is
made
much
after
the
same
manner
as
that
which
is
us'd
in
the
Fracture
of
the
Clavicle
.
Of
the
compleat
Hernia
or
Rupture
.
It
happens
when
the
Intestinal
Parts
fall
into
the
Scrotum
in
Men
,
or
into
the
bottom
of
the
Lips
of
the
Matrix
in
Women
.
To
perform
this
Operation
,
the
Patient
must
be
laid
upon
his
Back
,
as
in
the
Bubonocele
,
and
the
Incision
carry'd
on
after
the
same
manner
;
which
is
to
be
made
in
the
Scrotum
,
tearing
off
the
Membranes
to
the
Intestine
.
Then
a
Search
will
be
requisite
,
to
observe
whether
any
parts
stick
to
the
Testicle
;
if
the
Caul
doth
so
,
it
must
be
taken
off
,
leaving
a
little
Piece
on
the
Testicle
;
but
if
it
be
the
Intestine
,
so
that
those
Parts
cannot
be
separated
without
hurting
one
of
'em
,
it
is
more
expedient
to
impair
the
Testicle
than
the
Intestine
.
If
the
Caul
be
corrupted
,
it
must
be
cut
to
the
sound
Part
,
and
the
Wound
is
to
be
dress'd
with
Pledgets
,
Bolsters
,
and
the
Bandage
Spica
;
as
in
the
Bubonocele
.
CHAP.
XIV
.
Of
the
Operation
of
Castration
.
THE
Mortification
or
the
Sarcocele
of
the
Testicles
,
gives
occasion
to
this
Operation
;
to
perform
which
,
the
Patient
must
be
laid
upon
his
Back
,
with
his
Buttocks
higher
than
his
Head
,
his
Legs
being
kept
open
,
and
the
Skin
of
the
Scrotum
taken
up
,
one
end
of
which
is
to
be
held
by
a
Servant
,
and
the
other
by
the
Surgeon
,
who
having
made
a
longitudinal
Incision
therein
,
or
from
the
top
to
the
bottom
,
slips
off
the
Flesh
of
the
Dartos
which
covers
the
Testicle
,
binds
up
the
Vessels
that
lie
between
the
Rings
and
the
Tumour
,
and
cuts
'em
off
a
Fingers
'
breadth
beneath
the
Ligature
:
But
care
must
be
taken
to
avoid
tying
the
Spermatick
Vessels
too
hard
,
for
fear
of
a
Convulsion
,
and
to
let
one
end
of
the
Thread
pass
without
the
Wound
.
If
an
Excrescence
of
Flesh
stick
to
the
Testicle
,
and
it
be
moveable
or
loose
,
it
is
requisite
to
take
it
off
nearly
,
leaving
a
small
Piece
of
it
on
the
Testicle
;
and
if
any
considerable
Vessels
appear
in
the
Tumour
,
they
must
be
bound
before
they
are
cut
.
The
Dressing
and
Bandage
.
The
Dressing
is
made
with
Pledgets
and
Bolsters
laid
upon
the
Scrotum
;
and
the
proper
Bandage
is
the
Suspensor
of
the
Scrotum
,
which
hath
four
Heads
or
Ends
,
of
which
the
upper
serve
as
a
Cincture
or
Girdle
;
and
the
lower
passing
between
the
Thighs
,
are
fasten'd
behind
to
the
Cincture
.
There
is
also
another
Bandage
of
the
Scrotum
,
having
in
like
manner
four
Heads
,
of
which
the
upper
constitute
the
Cincture
;
but
it
is
slit
at
the
bottom
,
and
hath
no
Seams
;
the
lower
Heads
crossing
one
another
,
to
pass
between
the
Thighs
,
and
to
be
join'd
to
the
Cincture
.
Both
these
sorts
of
Bandages
have
a
Hole
to
give
Passage
to
the
Yard
.
CHAP.
XV.
Of
the
Operation
of
the
Stone
in
the
Ureter
.
IF
the
Stone
be
stopt
at
the
Sphincter
of
the
Bladder
,
it
ought
to
be
thrust
back
with
a
Probe
:
If
it
stick
at
the
end
of
the
Glans
,
it
may
be
press'd
to
let
it
out
;
and
if
it
cannot
come
forth
,
a
small
Incision
may
be
made
in
the
opening
of
the
Glans
on
its
side
.
But
if
the
Stone
be
remote
from
the
Glans
,
it
is
requisite
to
make
an
Incision
in
the
Vreter
;
to
which
purpose
,
the
Surgeon
having
caus'd
the
Skin
to
be
drawn
upward
,
holds
the
Yard
between
two
Fingers
,
making
a
Longitudinal
Incision
on
its
side
upon
the
Stone
,
which
must
be
prest
between
the
Fingers
to
cause
it
to
fly
out
;
or
else
it
may
be
taken
out
with
an
Extractor
.
Then
if
the
Incision
were
very
small
,
the
Skin
needs
only
to
be
let
go
,
and
it
will
heal
of
it self
;
but
if
it
were
large
,
a
small
Leaden
Pipe
is
to
be
put
into
the
Vreter
,
lest
it
shou'd
be
altogether
clos'd
up
by
the
Scar
:
It
is
also
expedient
to
anoint
the
Pipe
with
some
Desiccative
Medicine
,
and
to
dress
the
Wound
with
Balsam
.
Afterward
a
little
Linnen-Bag
or
Case
is
to
be
made
,
in
which
the
Yard
is
to
be
put
,
to
keep
on
the
Dressing
;
but
it
must
be
pierc'd
at
the
end
,
for
the
convenience
of
making
Water
,
having
two
Bands
at
the
other
end
,
which
are
ty'd
round
about
the
Waste
.
CHAP.
XVI
.
Of
the
Operation
of
Lithotomy
.
THIS
Operation
is
undertaken
when
it
is
certainly
known
that
there
is
a
Stone
in
the
Bladder
;
to
be
assur'd
of
which
,
it
may
not
be
improper
to
introduce
a
Finger
into
the
Anus
near
the
Os
Pubis
,
by
which
means
the
Stone
is
sometimes
felt
,
if
there
be
any
:
The
Finger
is
likewise
usually
put
into
the
Anus
of
young
Virgins
,
and
into
the
Vagina
Vteri
of
Women
,
for
the
same
purpose
.
But
it
is
more
expedient
to
make
use
of
the
Probe
,
anointed
with
Grease
,
after
this
manner
:
The
Patient
being
laid
on
his
Back
,
the
Operator
holds
the
Yard
streight
upward
,
the
Glans
lying
open
between
his
Thumb
and
Fore-finger
;
then
holding
the
Probe
with
his
Right-hand
on
the
side
of
the
Rings
,
he
guides
it
into
the
Yard
,
and
when
it
is
enter'd
,
turns
the
Handle
toward
the
Pubes
,
drawing
out
the
Yard
a
little
,
to
the
end
that
the
Canal
of
the
Vreter
may
lie
streight
.
If
it
be
perceiv'd
that
the
Probe
hath
not
as
yet
pass'd
into
the
Bladder
,
a
Finger
is
to
be
put
into
the
Anus
,
to
conduct
it
thither
.
Afterward
in
order
to
know
whether
a
Stone
be
lodg'd
in
the
Bladder
,
the
Probe
ought
to
be
staken
a
little
therein
,
first
on
the
Right-side
,
and
then
on
the
Left
;
and
if
a
small
Noise
be
heard
,
it
may
be
concluded
for
certain
that
there
is
a
Stone
:
But
if
it
be
judg'd
that
the
Stone
swims
in
the
Bladder
,
so
that
it
cannot
be
felt
,
the
Patient
must
be
oblig'd
to
make
Water
with
a
hollow
Probe
.
Another
manner
of
searching
may
be
practis'd
thus
:
Let
the
Yard
be
rais'd
upward
,
inclining
a
little
to
the
side
of
the
Belly
;
let
the
Rings
of
the
Probe
be
turn'd
upon
the
Belly
,
and
the
end
on
the
side
of
the
Anus
;
and
then
let
this
Instrument
be
introduc'd
,
shaking
it
a
little
on
both
sides
,
to
discover
the
Stone
.
In
order
to
perform
the
Operation
of
Lithotomy
,
the
Patient
must
be
laid
along
upon
a
Table
of
a
convenient
height
,
so
as
that
the
Surgeon
may
go
about
his
Work
standing
;
the
Patient's
Back
must
also
lean
upon
the
Back
of
a
Chair
laid
down
,
and
trimm'd
with
Linnen-Cloth
,
lest
it
shou'd
hurt
his
Body
;
his
Legs
must
be
kept
asunder
,
and
the
Soles
of
his
Feet
on
the
sides
of
the
Table
,
whilst
a
Man
gets
up
behind
him
to
hold
his
Shoulders
:
His
Arms
and
Legs
must
be
also
bound
with
Straps
or
Bands
.
Then
a
channell'd
Probe
being
put
up
into
the
Bladder
,
a
Servant
standing
upon
the
Table
on
the
side
of
the
Chair
,
holds
the
Back
of
the
Instrument
between
his
two
Fore-fingers
on
that
Part
of
the
Perinaeum
where
the
Incision
ought
to
be
begun
,
which
is
to
be
made
between
his
Fingers
with
a
sharp
Knife
that
cuts
on
both
sides
:
The
Incision
may
be
three
or
four
Fingers
breadth
on
the
left
side
of
the
Raphe
or
Suture
:
But
in
Children
its
length
must
not
exceed
two
Fingers
breadth
.
If
the
Incision
were
too
little
to
give
Passage
to
the
Stone
,
it
wou'd
be
more
expedient
to
enlarge
it
than
to
stretch
the
Wound
with
the
Dilatators
.
When
the
Convex
Part
where
the
channelling
of
the
Probe
lies
,
shall
be
well
laid
open
,
the
Conductors
may
be
slipt
into
the
same
Channelling
,
between
which
the
Forceps
is
to
be
put
,
having
before
taken
away
the
Probe
.
Some
Operators
make
use
of
a
Gorgeret
or
Introductor
to
that
purpose
,
conveying
the
end
of
it
into
the
Chanelling
of
the
Probe
;
which
is
remov'd
to
introduce
the
Forceps
into
the
Bladder
:
And
as
soon
as
they
are
fixt
therein
,
the
Conductors
or
Gorgeret
must
be
likewise
taken
out
.
Afterward
search
being
made
for
the
Stone
,
it
must
be
held
fast
,
and
drawn
out
of
the
Bladder
:
But
if
the
Stone
be
long
,
and
the
Operator
hath
got
hold
thereof
by
the
two
Ends
,
he
must
endeavour
to
lay
hold
on
it
again
by
the
Middle
,
to
avoid
the
great
scattering
which
wou'd
happen
in
the
Passage
.
The
Stones
are
also
sometimes
so
large
,
that
there
is
an
absolute
necessity
of
leaving
'em
in
the
Bladder
.
Again
,
if
the
Stone
sticks
very
close
to
the
Bladder
,
the
Extraction
ought
to
be
deferr'd
for
some
time
;
and
perhaps
it
may
be
loosen'd
in
the
Suppuration
.
Lastly
,
when
the
Stone
hath
been
taken
out
,
an
Extractor
is
usually
introduc'd
into
the
Bladder
,
to
remove
the
Gravel
,
Fragments
,
and
Clots
of
Blood
.
After
the
Operation
,
the
Patient
is
carry'd
to
his
Bed
,
having
before
cover'd
the
Wound
with
a
good
Bolster
;
and
if
an
Haemorrhage
happens
,
it
is
to
be
stopt
with
Astringents
,
A
Tent
must
also
be
put
into
the
Wound
,
when
it
is
suspected
that
some
Stone
or
Gravel
may
as
yet
remain
therein
:
But
if
it
evidently
appears
that
there
is
none
,
the
Wound
may
be
dress'd
with
Pledgets
,
a
Plaister
,
and
a
Bolster
,
of
a
Figure
convenient
for
the
Part.
The
Dressing
may
be
staid
with
a
Sling
supported
by
a
Scapulary
;
or
else
the
Bandage
of
the
double
T.
may
be
us'd
,
the
manner
of
the
Application
of
which
we
have
shewn
elsewhere
.
The
Patient's
Thighs
must
be
drawn
close
one
to
another
,
and
ty'd
with
a
small
Band
,
lest
they
shou'd
be
set
asunder
again
.
The
Operation
of
Lithotomy
in
Women
is
usually
perform'd
by
the
lesser
Preparative
,
which
is
done
by
putting
the
Fore-finger
and
Middle-finger
into
the
Vagina
Vteri
,
or
into
the
Rectum
in
young
Virgins
,
to
draw
the
Stone
to
the
Neck
of
the
Bladder
,
and
keep
it
steady
,
so
that
it
may
be
taken
out
with
a
Hook
,
or
other
Instrument
.
This
Operation
may
also
be
effected
in
Women
,
almost
in
the
same
manner
as
in
Men
;
for
after
having
caus'd
the
Female
Patient
to
be
set
in
the
same
Posture
or
Situation
as
the
Men
are
usually
plac'd
,
according
to
the
preceeding
Description
,
the
Conductors
may
be
convey'd
into
the
Vreter
,
to
let
in
the
Forceps
between
'em
,
with
which
the
Stone
may
be
drawn
out
:
But
if
it
be
too
thick
,
a
small
Incision
is
to
be
made
in
the
Right
and
Left
side
of
the
Vreter
.
The
lesser
Preparative
was
formerly
us'd
in
the
Lithotomy
of
Men
,
after
this
manner
:
The
Finger
was
put
into
the
Anus
,
to
draw
the
Stone
toward
the
Perinaeum
;
then
an
Incision
was
made
upon
the
Stone
on
the
side
of
the
Suture
,
and
it
was
taken
out
with
an
Instrument
.
CHAP.
XVII
.
Of
the
Operation
of
the
Puncture
of
the
Perinaeum
.
THIS
Operation
is
necessary
in
a
Suppression
of
Urine
,
where
the
Inflammation
is
so
great
,
that
the
Probe
cannot
be
introduc'd
.
Then
an
Incision
is
to
be
made
with
the
Knife
or
Lancet
,
in
the
same
Place
where
it
is
done
in
Lithotomy
;
and
a
small
Tube
or
Pipe
is
to
be
put
in
the
Bladder
,
till
the
Inflammation
be
remov'd
.
CHAP.
XVIII
.
Of
the
Operation
of
the
Fistula
in
Ano.
FISTULA's
are
callous
Ulcers
:
If
one
of
these
happen
in
the
Fundament
,
and
is
open
on
the
outside
,
it
may
be
cur'd
thus
:
After
the
Patient
hath
been
laid
upon
his
Belly
on
the
side
of
a
Bed
,
with
his
Legs
asunder
,
the
Surgeon
makes
a
small
Incision
with
his
Knife
in
the
Orifice
of
the
Fistula
,
in
order
to
pass
therein
another
small
crooked
Incision-Knife
,
at
the
end
of
which
is
a
Pointed
Stilet
with
a
little
Silver
Head
which
covers
it
,
to
the
end
that
it
may
enter
without
causing
Pain
.
When
the
Surgeon
hath
convey'd
his
Knife
into
the
Fistula
,
having
the
Fore-finger
of
his
Left-hand
in
the
Anus
or
Fundament
,
he
pulls
off
its
Head
,
holding
the
Handle
with
one
Hand
,
and
the
Stilet
that
pierceth
the
Anus
with
the
other
;
and
at
last
draws
our
the
Instrument
to
cut
the
Fistula
entirely
at
one
Stroke
.
If
the
Fistula
hath
an
Opening
into
the
Inrestine
,
an
Incision
is
to
be
made
on
the
outside
at
the
Bottom
thereof
,
to
open
it
in
the
Place
where
a
small
Tumour
or
Inflammation
usually
appears
,
or
else
in
the
Place
where
the
Patient
feels
a
Pain
when
it
is
touch'd
.
If
the
Tumour
be
remote
from
the
Anus
,
it
may
be
open'd
with
the
Potential
Cautery
,
to
avoid
a
greater
Inconvenience
.
After
having
thus
laid
open
the
very
bottom
,
the
little
Incision-Knife
and
Stilet
,
with
its
Head
,
is
to
be
pass'd
therein
,
the
end
of
the
Stilet
is
to
be
drawn
thro'
the
Anus
,
and
the
Flesh
is
to
be
cut
all
at
once
.
But
if
the
Fistula
be
situated
too
far
forward
in
the
Fundament
,
the
Sphincter
of
the
Anus
must
not
be
entirely
cut
,
otherwise
the
Excrements
cannot
be
any
longer
retain'd
.
Lastly
,
when
the
Fistula
hath
been
treated
after
this
manner
,
all
its
Sinuosities
or
Winding-Passages
ought
likewise
to
be
open'd
,
and
the
Wound
being
fill'd
with
thick
Pledgets
steept
in
some
Anodyn
,
is
to
be
cover'd
with
a
Plaister
and
a
Triangular
Bolster
;
as
also
with
the
Bandage
call'd
the
T.
CHAP.
XIX
.
Of
the
Suture
or
Stitching
of
a
Tendon
.
IT
is
requisite
to
undertake
this
Operation
when
the
Tendons
are
cut
,
and
when
they
become
very
thick
.
If
the
Wound
be
heal'd
,
it
must
be
open'd
again
to
discover
the
Tendon
,
and
the
Part
must
be
bended
,
to
draw
together
again
the
ends
of
the
Tendons
.
Then
the
Surgeon
taking
a
flat
,
streight
,
and
fine
Needle
,
with
a
double
waxed
Thread
,
passeth
it
into
a
small
Bolster
,
and
makes
a
Knot
at
the
end
of
the
Thread
,
to
be
stopt
upon
the
Bolster
.
Afterward
he
pierceth
the
Tendon
from
the
outside
to
the
inside
,
at
a
good
distance
,
lest
the
Thread
shou'd
tear
it
,
and
proceeds
to
pass
the
Needle
in
like
manner
under
the
other
end
of
the
Tendon
,
upon
which
is
laid
a
small
Bolster
,
for
the
Thread
to
be
ty'd
in
a
Knot
over
it
.
Then
he
causeth
the
Extremities
of
the
Tendons
to
lie
a
little
one
upon
another
,
by
bending
the
Part
,
and
dresseth
the
Wound
with
some
Balsam
.
It
may
not
be
improper
here
to
observe
,
that
Ointments
are
never
to
be
apply'd
to
the
Tendons
,
which
wou'd
cause
'em
to
putrisie
,
but
altogether
Spirituous
Medicaments
;
and
that
the
Part
must
be
bound
up
,
lest
the
Extension
of
it
shou'd
separate
the
Tendons
.
CHAP.
XX.
Of
the
Caesarian
Operation
.
WHEN
a
Woman
cannot
be
deliver'd
by
the
ordinary
means
,
this
bold
and
dangerous
Operation
hath
been
sometimes
perform'd
with
good
Success
.
The
Woman
boing
laid
upon
her
Back
,
the
Surgeon
makes
a
Longitudinal
Incision
beneath
the
Navel
,
on
the
side
of
the
White-Line
,
till
the
Matrix
appears
,
which
he
openeth
,
taking
great
care
to
avoid
wounding
the
Child
:
Then
he
divides
the
Membranes
with
which
it
is
wrapt
up
,
separates
the
After-Burden
from
the
Matrix
,
and
takes
out
the
Child
.
Lastly
he
washeth
the
Wound
with
warm
Wine
,
and
dispatcheth
the
Gastroraphy
or
Stitching
up
of
the
Belly
,
without
sowing
the
Matrix
.
After
the
Operation
,
Injections
are
to
be
made
into
the
Matrix
,
to
cause
a
Flux
of
Blood
;
and
a
pierc'd
Pessary
must
be
introduc'd
into
its
Neck
.
CHAP.
XXI
.
Of
the
Operation
of
Amputation
,
with
its
proper
Dressings
and
Bandages
.
THE
Leg
is
usually
cut
off
at
the
Ham
;
the
Thigh
as
near
as
can
be
to
the
Knee
;
and
the
Arm
as
near
as
is
possible
to
the
Wrist
:
But
an
Amputation
is
never
made
in
a
Joynt
,
except
in
the
Fingers
and
Toes
.
In
order
to
cut
off
a
Leg
the
Patient
is
to
be
set
on
the
side
of
his
Bed
,
or
in
a
Chair
;
and
supported
by
divers
Assistants
;
one
of
'em
being
employ'd
to
hold
the
J●eg
at
the
bottom
,
and
another
to
draw
the
Skin
upward
above
the
Knee
,
to
the
end
that
the
Flesh
may
cover
the
Bone
again
after
the
Operation
.
In
the
mean
while
a
very
thick
Bolster
is
laid
under
the
Ham
,
upon
which
are
made
two
Ligatures
,
viz.
the
first
above
the
Knee
,
to
stop
the
Blood
,
by
screwing
it
up
with
the
Tourniquet
or
Gripe-Stick
;
and
the
second
below
the
Knee
,
●o
render
the
Flesh
firm
for
the
Knife
.
Before
the
Ligature
is
drawn
close
with
the
Gripe-Stick
,
a
little
piece
of
Paste-board
is
to
be
put
underneath
,
for
fear
of
pinching
the
Skin
.
Thus
the
Leg
being
well
fixt
,
the
Surgeon
placeth
himself
between
both
the
Legs
of
the
Patient
,
to
make
the
Incision
with
a
crooked
Knife
,
turning
it
circularly
to
the
Bone
,
and
laying
one
Hand
upon
the
Back
of
the
Knife
,
which
must
,
have
no
Edge
.
Afterward
the
Periosteum
is
to
scrap'd
with
an
Incision-Knife
,
and
the
Flesh
with
the
Vessels
that
lie
between
the
two
Bones
are
to
be
cut
.
When
the
Flesh
is
thus
separated
,
a
Cleft
Band
is
to
be
laid
upon
it
,
with
which
the
Heads
are
cross'd
,
to
draw
the
Flesh
upward
,
to
the
intent
that
the
Bones
may
be
cut
farther
,
and
that
it
may
cover
'em
after
the
Amputation
,
as
also
to
facilitate
the
Passage
of
the
Saw
.
Then
the
Surgeon
holds
the
Leg
with
his
Left-hand
,
and
saweth
with
his
Right
,
which
he
lets
fall
upon
the
two
Bones
,
to
divide
'em
asunder
at
the
same
time
,
beginning
with
the
Perone
or
Fibula
,
and
ending
with
the
Tibia
.
But
it
is
necessary
to
incline
the
Saw
,
and
to
go
gently
in
the
beginning
,
to
make
way
for
it
,
and
afterward
to
work
it
faster
.
The
Leg
being
cut
off
,
the
Ligature
must
be
unty'd
below
the
Knee
,
loosening
the
Gripe-Stick
,
to
let
the
Blood
run
a
little
,
and
to
discern
the
Vessels
with
greater
facility
;
and
then
the
Gripe-Stick
may
be
twisted
again
,
to
stop
the
Blood
;
which
some
Surgeons
effect
,
by
laying
Pieces
of
Vitriol
upon
the
Opening
of
the
Arteries
,
and
Astringent
Powders
,
on
a
large
Bolster
of
Cotton
or
Tow
,
to
be
apply'd
to
the
end
of
the
Stump
;
but
if
such
a
method
be
us'd
,
it
is
requisite
that
some
Person
be
employ'd
to
keep
on
the
whole
Dressing
with
his
Hand
during
twenty
four
Hours
.
However
this
Custom
hath
prevail'd
in
the
Hospital
of
Hôtel-Dieu
at
Paris
.
Others
make
a
Ligature
of
the
Vessels
,
taking
up
the
ends
of
'em
with
a
pair
of
Forceps
,
having
a
Spring
;
or
with
the
Valet
a
Patin
,
which
is
a
sort
of
Princers
that
are
clos'd
with
a
small
Ring
let
down
to
the
bottom
of
the
Branches
.
These
Pincers
being
held
by
a
Servant
,
the
Surgeon
passeth
a
Needle
with
wax'd
Thread
,
into
the
Flesh
,
below
the
Vessel
,
bringing
it
back
again
,
and
with
the
two
ends
of
the
Thread
makes
a
good
Ligature
upon
the
same
Vessel
;
then
he
looseth
the
Gripe-Stick
and
the
Band
,
the
Stump
is
to
be
somewhat
bended
,
and
the
Flesh
let
down
to
cover
the
Bones
.
The
Dressing
and
Bandage
.
After
the
Operation
,
it
is
requisite
to
lay
small
Bolsters
upon
the
Vessels
,
and
dry
Pledgets
upon
the
two
Bones
,
as
also
many
other
Folds
of
Linnen
strew'd
with
Astringent
Powders
;
and
over
all
another
large
Bolster
or
Pledget
of
Cotton
or
Tow
,
cover'd
in
like
manner
with
Astringent
Powders
;
then
the
whole
Dressing
is
to
be
wrapt
up
with
a
Plaister
and
a
Bolster
,
in
form
of
a
Malta
Cross
;
so
that
there
are
three
or
four
Longitudinal
Bolsters
,
and
one
Circular
.
The
Surgeon
usually
begins
to
apply
the
Milta
Cross
and
Bolster
under
the
Ham
,
crossing
the
Heads
or
Ends
upon
the
Stump
,
and
causeth
'em
to
be
held
by
a
Servant
that
Supports
the
Part
;
then
he
likewise
crosseth
the
other
Heads
,
and
layeth
on
the
two
Longitudinal
Bolsters
that
cross
each
other
in
the
middle
of
the
Stump
,
together
with
a
third
Longitudinal
,
which
is
brought
round
about
the
Stump
,
to
stay
the
two
former
:
These
Bolsters
ought
to
be
three
Fingers
broad
,
and
very
long
,
to
pass
over
the
Stump
.
Afterward
he
proceeds
to
apply
,
The
Bandage
commonly
call'd
Capeline
by
French
Surgeons
,
or
the
Head-Bandage
.
Which
is
prepar'd
with
a
Band
four
Ells
long
,
and
three
Fingers
broad
,
roll'd
up
with
one
Ball
,
three
Circumvolutions
being
made
on
the
side
of
the
cut
Part
,
the
Band
is
to
be
carry'd
upward
with
Rollers
,
passing
obliquely
above
the
Knee
;
and
is
brought
down
again
along
its
former
Turns
;
If
it
be
thought
fit
to
make
this
Bandage
with
the
same
Band
,
it
must
be
let
down
to
the
middle
of
the
cut
Part
,
and
carry'd
up
again
to
the
Knee
,
many
back-folds
being
made
,
which
are
stay'd
with
the
Circumvolutions
,
till
the
Stump
be
entirely
cover'd
,
and
the
whole
Bandage
wrapt
up
with
Rollers
or
Bolsters
.
The
Capeline
or
Head-Bandage
,
having
two
Heads
,
is
made
with
a
Band
of
the
same
breadth
,
but
somewhat
longer
.
This
Band
being
at
first
apply'd
to
the
middle
of
the
cut
Part
or
Wound
,
the
Heads
are
carry'd
up
above
the
Knee
;
and
one
of
the
Ends
are
turn'd
backward
,
to
bring
it
down
,
and
to
pass
it
over
the
end
of
the
Stump
.
At
every
back-fold
which
is
form'd
above
and
below
the
Knee
,
a
Circumvolution
is
to
be
made
with
the
other
end
of
the
Band
,
to
strengthen
the
back-folds
,
continuing
to
bring
the
Band
downward
and
upward
,
till
the
whole
Stump
be
cover'd
:
Then
Rollers
are
made
round
the
about
the
Stump
,
and
the
Band
is
stay'd
above
the
Knee
.
Afterward
the
Part
may
be
brought
to
Suppuration
,
cleans'd
and
cicatriz'd
.
CHAP.
XXII
.
Of
the
Operation
of
the
Aneurism
.
THIS
Operation
is
perform'd
when
the
Surgeon
hath
prickt
an
Artery
,
or
when
a
Tumour
ariseth
in
an
Artery
.
To
this
purpose
the
Patient
is
set
in
a
Chair
,
and
a
Servant
employ'd
in
holding
his
Arm
in
a
Posture
proper
for
the
Operation
;
then
a
Bolster
is
to
be
laid
four
double
,
following
the
Progress
of
the
Artery
,
to
the
end
that
the
Ligature
may
better
press
the
Vessel
;
and
the
Arm
may
be
also
surrounded
with
another
single
Bolster
,
on
which
is
made
a
Ligature
screw'd
up
with
a
Gripe-Stick
,
provided
the
Arm
be
not
too
much
swell'd
;
for
in
this
Case
it
wou'd
be
more
expedient
to
deferr
the
Operation
for
fear
of
a
Gangrene
.
The
Artery
being
thus
well
stopt
,
the
Surgeon
lays
hold
on
the
Arm
with
one
Hand
,
below
the
Tumour
,
and
with
the
other
makes
an
Incision
with
his
Lancet
,
beginning
at
the
bottom
of
the
Tumour
,
and
ending
on
the
top
along
the
Progress
of
the
Artery
.
When
the
Tumour
is
open'd
,
the
coagulated
Blood
may
be
discharg'd
with
a
Finger
;
and
if
there
are
any
Strings
at
the
bottom
,
they
may
be
cut
with
a
crooked
Pair
of
Sizzers
,
to
the
end
that
all
the
Clods
of
Blood
,
and
other
extraneous
Bodies
which
are
sometimes
form'd
in
Aneurisms
when
they
are
very
inveterate
)
may
be
more
easily
remov'd
.
But
the
Gripe-Stick
must
be
loosen'd
,
to
discover
the
Opening
of
the
Artery
with
greater
facility
,
and
the
Artery
separated
from
the
Membranes
with
a
Fleam
;
for
it
wou'd
be
dangerous
to
cut
it
with
a
streight
Incision-Knife
:
The
Artery
must
also
be
supported
with
a
convenient
Instrument
to
divide
it
from
the
Nerve
and
Membranes
;
and
to
be
assur'd
of
the
Place
of
its
Opening
,
the
Gripe-Stick
may
be
somewhat
loosen'd
,
and
afterward
screw'd
up
again
.
In
the
mean
time
the
Surgeon
gives
the
Instrument
to
a
Servant
to
hold
,
whilst
he
passeth
under
the
Artery
a
crooked
Needle
with
a
wax'd
String
,
cuts
the
Thread
,
and
takes
away
the
Needle
:
The
he
begins
to
make
the
Ligature
beneath
the
Opening
of
the
Artery
,
tying
at
first
a
single
Knot
,
on
which
may
be
put
(
if
you
please
)
a
small
Bolster
,
that
may
be
kept
steady
with
two
other
Knots
:
It
is
also
necessary
that
another
Ligature
be
made
in
the
lower
part
of
the
Artery
,
by
reason
that
the
little
lateral
Arteries
might
otherwise
let
out
Blood
.
The
Artery
ought
not
to
be
cut
between
the
two
Ligatures
,
lest
the
first
Ligature
shou'd
be
forc'd
by
the
Impulsion
of
the
Blood
;
but
the
Thread
must
be
let
fall
,
that
it
may
rot
with
the
Suppuration
.
Then
the
Wound
may
be
dress'd
with
Pledgets
,
Bolsters
strew'd
with
Astringent
Powders
and
a
Plaister
;
a
Bolster
being
also
laid
in
the
Fold
of
the
Elbow
.
The
Bandage
Is
made
with
a
Band
six
Ells
long
,
and
an
Inch
broad
,
roll'd
with
one
end
,
being
at
first
apply'd
with
divers
Circumvolutions
under
the
Elbow
,
and
moderately
bound
.
Many
turns
are
to
be
made
,
and
a
thick
and
streight
Bolster
,
is
to
be
laid
upon
the
Tumour
,
(
as
in
the
Bandage
for
Phlebotomy
)
along
the
Artery
,
till
it
pass
under
the
Arm-Hole
:
The
Arm
and
Bolster
must
be
surrounded
with
the
Band
,
which
is
brought
up
with
small
Rollers
,
to
the
Arm-Pit
,
and
stay'd
with
Circumvolutions
round
about
the
Breast
.
Afterward
the
Patient
is
to
be
laid
in
his
Bed
,
with
the
Arm
lying
somewhat
bended
on
the
Pillow
,
and
the
Hand
a
little
higher
than
the
Elbow
.
CHAP.
XXIII
.
Of
the
Operation
of
Phlebotomy
.
TO
perform
this
Operation
,
the
Surgeon
holds
the
Lancet
between
his
Thumb
and
Fore-finger
,
and
three
other
Fingers
lying
upon
the
Patient's
Arm
,
and
thrusts
the
Point
of
the
Lancet
into
the
Vessel
,
carrying
the
same
Point
somewhat
upward
,
to
make
the
Orifice
the
greater
.
If
a
Tendon
,
which
is
known
by
its
hardness
;
or
an
Artery
,
which
is
discover'd
by
Pulsation
,
appear
beyond
the
Vein
,
and
very
near
it
,
the
Lancet
must
be
only
set
very
forward
in
the
Vein
,
and
drawn
back
again
streight
,
without
turning
it
up
,
otherwise
the
Artery
of
Tendon
wou'd
be
certainly
cut
with
the
Point
.
If
the
Artery
or
Tendon
lies
immediately
under
the
Vein
,
the
later
must
be
prickt
somewhat
underneath
,
holding
the
Lancet
inclin'd
side-ways
,
and
thrusting
it
very
little
forward
;
so
that
the
Point
will
finish
the
Opening
,
by
turning
it
upward
.
If
the
Artery
stick
too
close
to
the
Vein
,
the
later
is
to
be
prickt
higher
or
lower
than
it
is
ordinarily
done
;
and
if
the
Vein
be
superficial
,
and
lie
close
upon
a
hard
Muscle
,
the
Lancet
must
not
be
thrust
downright
into
the
Vein
,
but
it
is
requisite
to
carry
it
somewhat
obliquely
,
and
to
take
the
Vessel
above
,
lest
the
Muscle
and
its
Membrane
shou'd
be
prickt
,
which
wou'd
cause
a
great
deal
of
Pain
,
and
perhaps
a
vehement
Inflammation
.
It
is
well
known
that
the
Veins
of
the
Right
Arm
are
usually
open'd
with
the
Right-hand
,
and
those
of
the
Left-Arm
with
the
Left-hand
.
The
Bandage
Is
made
thus
:
The
Surgeon
having
laid
a
Bolster
upon
the
Orifice
,
keeps
it
close
with
two
Fingers
,
and
holds
the
Band
or
Fillet
with
the
other
Hand
;
then
taking
one
end
of
the
Fillet
with
the
Middle-Finger
,
Fore-Finger
,
and
Thumb
,
and
applying
it
to
the
Bolster
,
he
makes
with
the
longest
end
of
the
Fillet
divers
Figures
in
form
of
the
Letters
KY
in
the
Fold
of
the
Arm
;
as
also
a
back-fold
with
the
shorter
end
of
the
Fillet
,
held
between
three
Fingers
.
Afterward
both
ends
of
the
Fillet
are
ty'd
beneath
the
Elbow
.
If
an
Inflammation
happens
after
the
Operation
,
The
Bolsters
are
to
be
dipt
in
Oxycratum
:
but
if
the
Orifice
were
so
small
as
to
produce
a
Rhombus
,
it
wou'd
be
requisite
to
press
the
Wound
often
with
two
Fingers
,
and
immediately
to
apply
a
Bolster
dipt
in
Oxycratum
.
CHAP.
XXIV
.
Of
the
Operation
of
Encysted
Tumours
.
IF
the
Tumours
are
small
and
hanging
,
and
have
a
narrow
bottom
,
a
Ligature
may
be
made
with
Horse-Hair
or
Silk
,
dipt
in
Aqua-Fortis
,
which
will
cause
'em
to
fall
off
of
themselves
after
some
time
;
or
else
they
may
be
cut
above
the
Ligature
.
If
the
Tumour
or
Wen
be
thick
,
and
its
bottom
large
,
a
Crucial
Incision
is
to
be
made
in
the
Skin
,
without
impairing
the
Cystis
or
Bagg
;
and
when
the
Incision
is
finish'd
,
the
Bag
may
be
torn
off
with
the
Nails
,
or
with
the
Handle
of
a
Pen-Knife
;
but
sometimes
it
is
necessary
to
dissect
it
.
If
there
be
any
considerable
Vessels
at
the
Root
,
they
may
be
bound
,
or
else
cut
;
and
the
Blood
may
be
stopt
with
Astringents
.
If
any
parts
of
the
Cystis
remain
,
they
are
to
be
consum'd
with
Corrosives
;
and
the
Lips
of
the
Wound
are
to
be
drawn
together
without
a
Stitch
,
making
use
only
of
an
agglutinative
Plaister
.
But
if
the
Tumour
adheres
very
close
to
the
Pericranium
,
it
is
most
expedient
not
to
meddle
with
it
at
all
.
Of
Ganglions
.
Ganglions
are
Tumours
arising
upon
the
Tendons
and
Nervous
Parts
,
which
may
be
cur'd
by
thrusting
'em
violently
,
and
making
a
very
streight
Bandage
,
provided
they
be
very
recent
;
a
resolvent
Plaister
is
to
be
also
apply'd
to
the
Part.
CHAP.
XXV
.
Of
the
Operation
of
the
Hydrocephalus
.
THIS
Operation
is
perform'd
when
it
is
necessary
to
discharge
watry
Humours
out
of
the
Head
:
If
these
Waters
lie
under
the
Skin
,
a
very
large
Opening
is
to
be
made
with
a
Lancet
,
and
a
small
Tube
or
Pipe
left
therein
to
let
'em
run
out
.
If
the
Water
be
situated
between
the
Brain
and
the
Dura
Mater
,
the
Membrane
is
to
be
perforated
with
a
Lancet
,
after
the
Trepan
hath
been
apply'd
,
according
to
the
usual
Method
,
of
which
we
have
already
given
some
account
:
Cauteries
and
Scarifications
may
be
also
us'd
to
very
good
purpose
in
this
Disease
.
CHAP.
XXVI
.
Of
the
Operation
of
cutting
the
Tongue-String
.
WHEN
the
Ligament
of
the
Tongue
in
Infants
is
extended
to
its
Extremity
,
they
cannot
suck
without
difficulty
;
and
when
grown
up
,
they
have
an
impediment
in
their
Speech
.
This
Ligament
may
be
cut
with
a
little
pair
of
Sizzers
;
to
which
purpose
the
Thumb
of
the
Left-hand
being
laid
upon
the
Gum
of
the
lower
Jaw
,
to
keep
the
Mouth
open
,
the
Tongue
may
be
rais'd
upward
with
the
Fore-Finger
of
the
same
Hand
,
and
the
Sizzers
may
be
pass'd
between
the
two
Fingers
,
to
divide
the
String
as
near
as
is
possible
,
to
the
Root
of
the
Tongue
,
avoiding
the
Vessels
:
If
an
Haemorrhage
happens
,
recourse
may
be
had
to
Styptick-Waters
.
Afterward
the
Nurse
must
take
care
to
let
a
Finger
be
often
put
into
the
Child's
Mouth
,
to
prevent
the
re-uniting
of
the
String
.
CHAP.
XXVII
.
Of
the
Operation
of
opening
stopt
Ductus's
.
IF
there
be
only
one
Membrane
that
stops
the
Entrance
of
the
Vagina
,
an
Incision
may
be
made
,
and
a
Leaden
Pipe
put
into
it
,
having
Rings
to
fasten
it
to
the
Waste
,
to
hinder
the
re-uniting
of
the
Wound
.
If
the
Lips
of
the
Pudendum
are
conglutinated
or
clos'd
up
,
the
Patient
must
be
laid
upon
her
Back
,
and
her
Knees
rais'd
up
,
in
order
to
make
an
Incision
with
a
crooked
Incision-Knife
,
beginning
at
the
Top
;
and
then
a
Leaden
Pipe
is
to
be
put
into
the
Opening
.
If
the
Vagina
be
fill'd
with
a
Fleshy
Substance
,
an
Incision
is
to
be
made
therein
,
till
it
be
entirely
perforated
,
putting
at
the
same
time
a
Leaden
Tube
into
the
Orifice
.
If
the
Urinary
Ductus
as
well
in
young
Boys
as
in
Virgins
,
be
stopt
up
,
an
Incision
is
to
be
made
therein
with
a
very
narrow
Lancet
;
and
if
a
small
Leaden
Pipe
can
be
conveniently
introduc'd
,
it
may
be
done
;
but
it
is
not
very
necessary
,
in
regard
that
Children
are
almost
always
making
Water
,
which
wou'd
of
it self
hinder
the
closing
of
the
Orifice
.
If
the
Ductus
of
the
Ear
be
stopt
with
a
Membrane
,
it
must
be
perforated
,
taking
care
not
to
go
too
far
,
for
fear
of
piercing
the
Membrane
of
the
Tympanum
or
Drum
,
and
a
small
Leaden
Pipe
is
to
be
put
into
the
Opening
.
If
there
be
a
carnous
Exerescence
on
the
outside
of
the
Ear
,
a
Ligature
ought
to
be
made
therein
,
or
else
it
may
be
cut
with
a
pair
of
Sizzers
,
to
cause
it
to
fall
off
;
and
the
rest
of
the
Fleshy
Substance
that
remains
in
the
Ear
must
be
consum'd
with
Causticks
,
convey'd
to
the
Part
by
the
means
of
a
small
Tube
,
care
being
had
,
nevertheless
,
to
avoid
cauterizing
the
Tympanum
.
CHAP.
XXVIII
.
Of
the
Operation
of
the
Phimosis
and
Paraphimosis
.
WHEN
the
Praeputium
is
so
streight
that
the
Glans
can
be
no
longer
uncover'd
,
this
Indisposition
is
call'd
Phimosis
;
but
if
the
Praeputium
be
turn'd
back
above
the
Glans
,
after
such
a
manner
that
it
can
no
longer
cover
the
same
Glans
,
it
is
a
Paraphimosis
.
If
in
the
Phimosis
the
Praeputium
cleaves
very
close
round
about
the
Glans
,
it
is
most
expedient
to
let
it
alone
;
but
if
in
handling
the
Glans
it
be
perceiv'd
that
it
is
moveable
,
or
else
that
some
parts
of
it
only
stick
together
,
the
Operation
may
be
perform'd
after
this
manner
:
The
Patient
being
set
in
a
Chair
,
a
Servant
is
employ'd
in
pulling
back
the
Skin
to
the
Root
of
the
Penis
,
to
the
end
that
the
Incision
may
be
made
directly
at
the
bottom
of
the
Glans
:
Then
the
Surgeon
having
drawn
out
the
bottom
of
the
Praeputium
,
introduceth
a
small
Instrument
with
a
very
sharp
Point
on
its
flat
side
,
at
the
end
of
which
is
sixt
a
Button
of
Wax
,
pierceth
the
Praeputium
at
the
bottom
of
the
Glans
on
the
side
of
the
Thread
,
and
finisheth
the
Incision
by
drawing
the
Instrument
toward
himself
.
The
Paraphimosis
is
cur'd
by
making
Fomentations
on
the
Part
,
to
allay
the
Inflammation
if
there
be
any
;
and
it
is
to
be
pull'd
down
with
the
Fingers
.
But
if
Medicinal
Preparations
prove
ineffectual
,
Scarifications
are
to
be
made
round
about
the
Praeputium
;
and
afterward
convenient
Remedies
may
be
apply'd
to
remove
the
Inflammation
,
and
prevent
the
Mortification
of
the
Part
;
so
that
at
length
the
Praeputium
may
be
drawn
over
the
Glans
.
CHAP.
XXIX
.
Of
the
Operation
of
the
Varix
.
IN
order
to
cure
this
Tumour
,
the
Surgeon
having
first
cut
the
Skin
to
discover
the
dilated
Vein
,
separates
it
from
the
Membranes
,
and
passeth
underneath
a
crooked
Neodle
with
a
double
wax'd
Thread
;
then
he
makes
a
Ligature
both
above
and
below
the
dilatation
of
the
Vein
,
opens
the
dilared
Part
with
a
Lancet
,
to
let
out
the
Blood
,
and
applie
;
a
convenient
Bandage
:
But
without
performing
this
Operation
,
the
Vein
might
be
open'd
with
a
Lancet
,
to
draw
out
a
sufficient
quantity
of
Blood
;
and
then
the
Varix
is
to
be
press'd
with
〈◊〉
somewhat
close
Bandage
.
CHAP.
XXX
.
Of
the
Operation
of
the
Panaritium
.
THE
Panaritium
is
an
Abcess
which
ariseth
at
the
end
of
the
Fingers
;
some
of
these
Tumours
are
only
superficial
,
and
others
penetrate
even
under
the
Periosteum
;
neverthe●ess
after
whatsoever
manner
the
Panaritium
may
happen
,
it
ought
to
be
open'd
on
the
side
of
the
Finger
,
that
the
Tendons
may
not
be
●urt
.
If
the
Abcess
be
extended
under
the
Periosteum
,
the
opening
must
be
made
on
the
side
,
and
the
Lancet
thrust
forward
to
the
Bone
:
Afterward
the
Pus
or
corrupt
Matter
is
to
be
discharg'd
,
which
wou'd
cause
the
Tendons
to
putrisie
,
if
it
shou'd
remain
too
long
upon
'em
.
The
Dressing
and
Bandage
Are
made
with
a
Plaister
cut
in
form
of
a
Malta
Cross
,
which
is
apply'd
at
the
middle
to
the
end
of
the
Finger
,
the
Heads
being
cross'd
round
about
.
The
Bolsters
must
be
also
cut
in
the
shape
of
the
Malta
Cross
,
or
of
a
plain
Cross
only
;
the
Band
being
a
Finger's
breadth
wide
,
and
long
enough
to
be
roll'd
about
the
whole
Dressing
:
It
must
be
pierc'd
at
one
of
its
ends
,
and
cut
the
length
of
three
Fingers
at
the
other
;
so
that
the
two
Heads
may
pass
thro'
the
Hole
,
to
surround
the
Finger
with
small
Rollers
.
CHAP.
XXXI
.
Of
the
Reduction
of
the
falling
of
the
Anus
.
TO
reduce
the
Anus
to
its
proper
place
when
it
is
fallen
,
the
Patient
being
laid
upon
his
Belly
,
with
his
Buttocks
higher
than
his
Head
,
the
Operator
gently
thrusts
back
the
Roll
that
forms
the
Anus
with
his
Fingers
dipt
in
the
Oil
of
Roses
:
Then
he
applies
the
Bolsters
steept
in
some
Astringent
Liquor
,
and
causeth
'em
to
be
supported
with
a
sort
of
Bandage
,
the
Nature
of
which
we
shall
shew
in
treating
of
the
Fracture
of
the
Coccyx
,
that
is
to
say
,
the
T.
the
double
T.
or
else
the
Sling
with
four
Heads
.
CHAP.
XXXII
.
Of
the
Reduction
of
the
falling
of
the
Matrix
.
IN
this
Operation
,
the
Patient
being
laid
upon
her
Back
,
with
her
Buttocks
rais'd
up
,
somentations
are
to
be
apply'd
to
the
Part
;
〈◊〉
Linnen
Cloth
is
to
be
laid
upon
the
Neck
of
the
fallen
Matrix
;
and
it
is
to
be
thrust
●ery
gently
with
the
Fingers
,
without
using
●uch
force
.
If
the
Matrix
shou'd
fall
out
a●●in
,
it
wou'd
be
requisite
to
convey
a
Pessa●●
into
it
,
after
it
hath
been
reduc'd
;
and
to
●njoyn
the
Patient
to
lie
on
her
Back
with
her
legs
a-cross
.
CHAP.
XXXIII
.
Of
the
Application
of
the
Cautery
.
THE
Cautery
is
an
Ulcer
which
is
made
in
the
Skin
,
by
applying
Causticks
to
it
,
●●er
this
manner
:
The
Surgeon
having
moisten'd
the
Skin
〈◊〉
a
while
with
Spittle
,
or
else
having
caus'd
〈◊〉
light
Friction
to
be
made
with
a
warm
●●oth
,
applies
a
perforated
Plaister
to
the
Part
,
●●d
breaks
the
Cautery-Stone
,
to
be
laid
in
the
little
Hole
,
leaving
it
for
a
longer
or
shorter
time
,
accordingly
as
he
knows
its
Efficacy
,
or
as
the
Skin
is
more
or
less
Fine
.
Afterward
he
scarifieth
the
Burn
with
his
Lancet
,
and
puts
a
Suppurative
,
or
piece
of
fresh
Butter
into
the
Part
,
till
the
Escar
be
fallen
off
.
The
Dressing
and
Bandage
.
After
the
Application
of
the
Lapis
Infernalis
,
or
any
other
Cautery-Stone
,
it
is
necessary
to
lay
over
it
a
Plaister
,
a
Bolster
,
and
a
Circular
Bandage
,
which
ought
to
be
kept
sufficiently
close
,
to
press
the
Stone
,
after
,
a
Pea
or
little
Piece
of
Orrice-Root
,
hath
been
put
into
the
Ulcer
to
keep
it
open
.
Then
the
Patient
is
to
make
use
of
this
Bandage
,
with
which
he
may
dress
it
himself
.
Take
a
piece
of
very
strong
Cloth
,
large
enough
to
roll
up
the
Part
without
crossing
above
it
:
And
let
three
or
four
Holes
be
made
in
one
of
its
sides
,
as
many
small
Ribbans
or
Pieces
of
Tape
being
sow'd
to
the
other
,
which
may
be
let
into
the
Holes
,
as
occasion
serves
,
to
close
the
Band.
CHAP.
XXXIV
.
Of
the
Application
of
Leeches
.
IT
is
requisite
that
the
Leeches
be
taken
in
clear
running
Waters
,
and
that
they
be
long
and
slender
,
having
a
little
Head
,
the
Back
green
,
with
yellow
Streaks
,
and
the
Belly
somewhat
reddish
.
Before
they
are
apply'd
,
it
is
also
expedient
to
let
'em
purge
during
some
Days
in
fair
Water
,
fast
half
a
Day
in
a
Box
without
Water
.
Afterward
the
Part
being
rubb'd
or
chaf'd
with
warm
Water
,
Milk
,
〈◊〉
the
Blood
of
some
Fowl
,
the
Opening
of
the
Box
is
to
be
set
to
the
Part
,
or
the
Leethes
themselves
laid
upon
a
Cloth
;
for
they
will
not
fasten
when
taken
up
with
the
Fingers
.
The
end
of
their
Tail
may
be
cut
with
〈◊〉
Pair
of
Sizzers
,
to
see
the
Blood
run
,
and
to
determine
its
quantity
,
as
also
to
facilitate
their
sucking
.
When
you
wou'd
take
'em
away
,
put
Ashes
,
Salt
,
or
any
other
sharp
thing
upon
their
Head
,
and
they
will
suddenly
desist
from
their
Work
;
but
they
are
not
to
be
pull'd
off
by
force
,
lest
they
shou'd
leave
their
Head
or
St●ing
in
the
Wound
,
which
wou'd
be
of
very
dangerous
consequence
.
When
they
are
remov'd
,
let
a
little
Blood
run
out
,
and
wash
the
Part
with
salt
Water
.
Is
made
with
a
Bolster
soakt
in
some
Styptick
Water
,
if
the
Blood
will
not
otherwise
stop
;
or
in
Brandy
or
aqua-Vitae
,
if
there
be
an
Inflammation
;
and
it
is
to
be
supported
with
a
Bandage
proper
for
the
Part.
CHAP.
XXXV
.
Of
the
Application
of
the
Seton
.
TO
perform
this
Operation
,
a
Cotton
or
Silk
Thread
is
to
be
taken
,
after
it
hath
been
dipt
in
Oil
of
Roses
,
and
let
into
a
kind
of
Pack-Needle
;
then
the
Patient
sitting
in
a
Chair
,
is
to
hold
up
his
Head
backward
,
whilst
the
Surgeon
gripes
the
Skin
transversely
in
the
Nape
of
the
Neck
with
his
Fingers
,
or
else
takes
it
up
with
a
Pair
of
Forceps
,
and
passeth
the
Needle
thro'
the
Holes
of
the
Forceps
,
leaving
the
String
in
the
Skin
.
As
often
as
the
Bolster
that
covers
the
Seton
is
taken
off
,
that
part
of
the
String
which
lies
in
the
Wound
is
to
be
drawn
out
,
and
cut
off
.
CHAP.
XXXVI
.
Of
Scarifications
.
SCARIFICATIONS
are
to
be
made
more
or
less
deep
,
accordingly
as
necessity
●●quires
,
beginning
at
the
bottom
,
and
carrying
〈◊〉
on
upward
,
to
avoid
being
hinder'd
by
●●e
Haemorrhage
.
They
must
also
be
let
one
to
another
,
that
Strings
may
not
be
left
in
●●e
Skin
.
CHAP.
XXXVII
.
Of
the
Application
of
Vesicatories
.
VESICATORIES
are
compounded
with
the
Powder
of
Cantharides
or
Spanish
●●es
,
mixt
with
very
sower
Leaven
,
or
else
●●th
Turpentine
.
Before
they
are
apply'd
,
a
light
●●●tion
is
to
be
made
on
the
Part
with
a
wram
●eth
,
and
a
greater
or
lesser
quantity
is
to
be
●●d
on
,
accordingly
as
the
Skin
is
more
or
●s
fine
,
leaving
'em
on
the
Part
about
seven
or
〈◊〉
Hours
;
then
they
are
to
be
taken
away
,
●●d
the
Blisters
are
to
be
open'd
,
applying
there●●me
sort
of
Spirituous
Liquor
.
CHAP.
XXXVIII
.
Of
the
Application
of
Cupping-Glasses
.
A
Good
Friction
being
first
made
with
warm
Clothes
,
lighted
Toe
is
to
be
put
into
the
Cupping-Glass
,
or
else
a
Wax-Candle
fasten'd
to
a
Counter
,
and
then
it
is
to
be
apply'd
to
the
Part
till
the
Fire
be
extinguish'd
,
and
the
Skin
swell'd
,
re-iterating
the
Operation
as
often
as
it
is
necessary
;
and
afterward
laying
on
a
Bolster
steept
in
Spirit
of
Wine
.
These
are
call'd
dry
Cupping-Glasses
:
But
if
you
wou'd
draw
Blood
,
every
thing
is
to
be
observ'd
that
we
have
now
mention'd
,
besides
that
Scarifications
are
to
be
made
,
according
to
the
〈◊〉
manner
;
and
the
Cupping-Glass
is
to
be
set
upon
the
Scarifications
:
But
when
the
Cupping-Glass
is
half
full
of
Blood
,
it
must
be
taken
off
to
be
emptied
,
and
the
Application
thereof
is
to
be
re-iterated
,
as
often
as
it
is
requisite
to
take
away
any
Blood
.
Lastly
,
the
Incision●
are
to
be
wash'd
with
some
Spirituous
Liquor
;
and
a
Bandage
is
to
be
made
convenien●
for
the
Part.
CHAP.
XXXIX
.
Of
the
opening
of
Abcesses
or
Impostumes
.
AN
Abcess
or
Impostume
ought
to
be
open'd
in
its
most
mature
part
,
and
in
the
Bias
of
the
Humours
,
endeavouring
to
preserve
the
Fibres
of
the
Muscles
from
being
cut
,
unless
there
be
an
absolute
necessity
,
avoiding
also
the
great
Vessels
,
Tendons
,
and
Nerves
.
The
Opening
must
be
rather
large
than
small
,
and
not
too
much
press'd
in
letting
out
the
purulent
Matter
.
If
the
Skin
be
thick
,
as
it
happens
in
the
H●el
,
it
may
be
par'd
with
a
Razor
;
and
if
the
Matter
be
lodg'd
under
the
Nails
,
it
wou'd
be
requisite
to
scrape
'em
with
Glass
before
they
are
pierc'd
.