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A47964 A treatise of chirurgical operations after the newest, and most exact method founded on the structure of the parts ... : to which is annex'd A general idea of wounds / written originally by Joseph De la Charier ; and translated into English by R. B. La Charrière, Joseph de, d. 1690.; R. B., fl. ca. 1695. 1696 (1696) Wing L134A; ESTC R43339 135,106 375

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as is convenient and prevent accidents But first it 's important to extract the Bullet if you can since it is its progress which marks the place which is to be dilated If you cannot follow the track which it has taken without making an Incision How to extract the Bullet you put the Patient into the same posture he was in when wounded that you may easier trace the Bullet and observe the place where it stops you afterwards dilate the Wound minding two Circumstances 1. You must avoid the great Vessels 2. You must not discover the Tendons of the Joynts without necessity If the Bullet be engaged near some great Vessels When to leave the Bullet in or in the middle of the Muscles so that it cannot be extracted without causing some ill effect you may leave it in the part provided the Patient be not much incommoded with it If it be in any of the Venters you must leave it to Nature If it stick in the Bones you must gently move it to draw it out more easily because the Bone would of necessity putrifie If it be in the Nervous parts as in the Joynts you must hasten its extraction particularly when it 's sharp or of any corruptible Matter for then you must not only extract it from the Nervous parts but every part whatever You extract the strong Bodies by Attraction or by Impulsion with the Hand Instruments or Medicines according to the part they lie in If for Example a Bullet be passed the great Vessels you will be obliged to extract it from the opposite part but if it be on this side you extract it through its entrance Nevertheless that general Rule hath its exception for if some strange Body be upon the Carpus or Tarsus forc't from without inward and should have passed the Bones It would be a great temerity to Incise the bending Tendons of the Fingers to force a passage through the opposite In that case you must extract it by the same way it went it If the Bullet has ruin'd a Joynt you must cut off the part because the Ligaments and Bones being quite split to pieces and their Splinters irritating the Tendons it causes a Gangrene to seize presently on the part If the Bone of the Thigh be broken you must dilate the Wound as much as is convenient and advance the Suppuration that you may have the liberty of extracting some pieces of the separate Bones if there be any Of the rest you follow the same method as in other Compound Wounds If there be any Vessels open'd as the Subclavian Vessels you make the Ligature and if some Blood be diffused upon the Diaphragm you must come to the Operation of Empiema If the Bullet has carried off a great part of the Bone as we cannot cut proportionably so much Flesh as the substance of the Bone lost for to convey Remedies thither it happens that the Flesh that grows over it becomes callous and sometimes ossified forasmuch as the salt Juice which runs this way hardens it by little and little If the Trunk of a great Vessel be opened we are often obliged to Amputate the part because the part which receives no more Blood for its nourishment Gangrenates If the Wound be only in the Flesh you may bath it presently after the first dressing with Brandy you soak Boulsters in it and bind up the part with Compresses soaked in warm Wine strengthen'd with Spirit of Wine Accidents which attend The chiefest accidents that accompany Gunshot Wounds are Tumours Putrefaction and Hemorrhagy to dissipate the swelling we successfully use Traumatic Fomentations mixt with Spirit of Wine or Cataplasms made of Urine Rye Meal Hony and Infusion of Roses or a Lye made of Vine-Ashes in which you dissolve Sal Armoniac and Brandy If the Tumour be not big Suppuration is enough to carry it off If it be accompanied with hardness you make some slight Scarifications To excite Suppuration in these kinds of Wounds you use a Digestive made of Vngt Basilicon Linament Arcei Ol. ovor Spirit Vini If Corruption be joined you add Theriac Myrrh Aloes Sal Armoniac Ol. Absinth Anthi as you fear the Corruption you animate them the more If the Putrefaction happen to a fleshy and spongy part you dissolve Egyptiac in Spirit of Wine and mix it with the Digestive Egyptiac not to be used in Nervous parts For Egyptiac being entirely a Dissicative if it were used in Nervous parts that are wont to dry up it would dissipate the little humidity that remains there If you use Injections it 's best to use the two Aristolochias boiled in White Wine in which you dissolve Sugar Candy Camphire Myrrh and Theriac Bitter things not to be used in Injections of the Breast You must observe that Injections as well as other Remedies must be managed with prudence according to the parts where they are used Ex. Gr. If you Inject into the Breast of one troubled with an Empiema a bitter and sharp Liquor it would irritate the part so that they would augment the accidents in the like occasion we use with good success a Decoction of Barley Agrimony a very little Wormwood and Centaury Plantain Birthwort in which you dissolve Mel. Rosar If this needs to be fortified you boil them in Whitewine or Brandy The Tincture of Persicaria Maculata made with White wine is also good to resist Putrefaction if you intend to make it stronger you dissolve Myrrh Aloes and Sal Armoniac in Brandy and mix with it the Solution of Sal Armoniac in Spirit of Wine which produces the same effect and to hinder the generation of new Corruption you compass the Dressing with Spirit of Wine Camphorated The Solution of a Drachm of Mercurius sublimate or Arsnic in half a Pint of Spirit of Wine is excellent in great Putrefactions or one Ounce of Mercury in two Ounces of Aquafortis which we mix with Lime Water or Brandy We also use with very good success in these occasions the Solution of the Canstic Stone in Brandy which we mix with the same quantity of Spirit of Wine Camphorated All these Solutions are capable to waste and separate putrified and rotten Flesh and also to consume the Cariosity of Bones After the effect of all these Remedies you use Detorsive Decoctions made of red Roses Consolid Maj. Quinquesolium Plantain Agrimony Nettles Pimpernell Periwinckle St. Johns Wort Purslain Plantain and Poppy Seed with which you slightly siringe the Wound so separate the rest of the Impurities that are there When you use Detersives you ordinarily joyn Suppuratives with them as Turpentine Vnguent ex apto Balsam Arcei Ol. Hyperici If the Wound has long suppurated and the Flesh grows Luxuriant you consume it with the Spirit of Sulphure put in the Mundificative If it be the Humidity of the part which causes this proud Flesh to grow instead of the Mundificative you use Allom Water or the Aq. Phagedenica or the Decoction of the Traumatic Plants made with Lime Water or Lastly Linamentum Arcei mixt with Myrrh and Fine Bole in Powder THE END BOOKS Printed for and sold by Daniel Brown at the Black-Swan and Bible without Temple-Bar THE Secrets of the Famous Lazarus Riverius Councellor and Physician to the French King and Professor of Physick in the University of Montpelier Newly Transsated from the Latin by E. P. M. D. A Physico-Medical Essay concerning the late frequency of Apoplexies Together with a general Method of their Prevention and Cure In a Letter to a Physitian By William Cole M. D. Nova Hypotheseos ad Explicanda Febrium Intermittentium Symptomata Typos Excogitatae Hypotyposis Una cum Aetiologia Remediorum Speciatim vero de Curatione per Gorticem Peruvianum Accessit Dissertatiuncula de Intestinorum Motu Peristaltico Authore Gulielmo Cole M. D. Novum Lumen Chirurgicum Or A New Light of Chirurgery Wherein is Discovered a much more Safe and Speedy way of Curing Wounds than hath heretofore been usually Practised Illustrated with several Experiments made this Year in Flanders Authore Johan Colbatch Med. Novum Lumen Chirurgicum Vindicatum Or The New Light of Chyrurgery Vindicated from the many unjust Aspersions of some unknown Calumniators With the Addition of some few Experiments made this Winter in England By Jo. Coloatch Physitian Christian Practice Described by way of Essay upon the Life of our Saviour By Stephen Skynner Rector of Buckland in Hertfordshire and late Fellow of Trinity-College in Cambridge Rules for Explaining and Decyphering all manner of Secret Writing Plain and Demonstrative With Exact Methods for understanding Intimations by Signs Gestures or Speech Also an Account of the Secret ways of Conveying Written Messages Discovered by Trithemius Schottus Lord Fran. Bacon Bishop Wilkins c. With exact Tables and Examples By J. F. The Traveller's Guide and The Country's Safety Being a Declaration of the Laws of England against Highwaymen or Robbers upon the Road What is necessary and requisite to be done by such Persons as are robbed in order to the recovering their Damages Against whom they are to bring their Action and the manner how it ought to be brought Illustrated with variety of Law-Cases Historical Remarks Customs Usages Antiquities and Authentick Authorities By J. M. The Clerks Grammar wherein are laid down Plain and Easie Rules for the Making any Bond or Bill Obligatory or single with the several Conditions in most Cases also Instructions how to place the Names Sums and Dates of the same in true proper Latine Likewise An Exact Method of Drawing all manner of Deeds of Common use with Instructions how to Raise any Consideration Habendum Redendum Preservation or Covenant used therein made more Plain and Intelligible to the meanest Capacity than Scarron's Novels Vix The Fruitless Precaution The Hypocrites The Innocent Adultery The Judge in his own Cause The Rival Brothers The Invisible Mistress The Chastisement of Avarice The Unexpected Choice Done into English with Additions by J. D. Esq All sorts of Physick Books Latin and English
the Peritonaeum comes only a clear and lump water The Intestine obeys when you pull it provided it adhere not to the Neighbouring parts different from the Peritonaeum which obeys very little and the Patient feels always a dull pain These are the chief Signs which ought to make a Surgeon circumspect I pass to the particulars of the Operation The Intestine being discovered you slip your hollow Probe between the Membranes of the Scrotum and the Body of the Intestine for to widen the Aperture and to discover it naked to be able to separate it the easier from the Testicle A Servant lifts the Intestine and pulls it gently with his Hands towards the Pubis whilst the Surgeon pulls lightly the Testicle with his Hand to have the liberty to break with the Fleam or point of the Bistory the Membranous ties observing alway to cut them nearer to the Testicle than Intestine If their adherance be very strong it wou'd be better to indammage the Testicle because it 's not so necessary for Life and the Accidents not so dangerous you must alway avoid the Spermatic Vessels for fear the Blood trouble the Operation Having freed the Intestine from the Testicle you introduce your hollow Probe between the Cutis and Intestine and cut without fear to the ring of the Muscle where consequently you are obliged to give way by a new Incision to disengage the Intestine from the Strangulation in case there be any You pass the third time the hollow Probe between the Ring and Intestine stirring it a little to be certain that the Gut be no way engaged and slip a crooked Bistory into the hollowness and you cut from the ring about two Lines and a Portion of the skin avoiding a little branch of an Arte●y which runs by the Aponeurosis of this Muscle When you free the Intestine by the dilation you pull it out a little for to disengage it from the internal rings and give liberty to the excrements which it contains to spread themselves by this means it grows less tumid and extended so that the reduction of it is much more easie you do it with your two Fore fingers and press not the Intestine too much lest you bruise it Being reduc'd a Servant must press with his Hands the Neighbouring parts to hinder its falling out again Some make several little Incisions on the Circle of the Ring all along the Purse which makes it incarn and cicatrize stronger others content themselves to introduce into the Rings a thick Tent of Lint tied with a wax'd Thread and a length proportionable to the depth of the Wound to bruise them as it were and excite a speedy suppuration some apply them dry and others dip in some digestive according to the pain which is felt or humidity which relaxes these parts But the true method to hinder this Disease from relapsing is to introduce into the Wound a long Tent of Lint which refists the impulsion of the Intestine which alway endeavours to dilate the rings and so often makes the Operation unsuccessful A Servant holds it on whilst the Surgeon applies the rest of the Apparatus especially good defensitives which oppose Fluxions that may happen There are several Practitioners who wou'd that at the same time the Testicle be cut off but this method is not approved of because it contributes not to the cure of the Hernia but rather as Experience demonstrate prolongs the Operation makes the Patient suffer without necessity and deprives him of the proper means of Propagation but if even the Testicles should be alter'd so that they cou'd not be secur'd 't would be always more advantageous to defer the Operation till the Fluxion be a little moderated If the Omentum be in the part and altered you make the Ligature in the sound part and take off the corrupted It may be avoided if the tumor be recent and preserv'd in its natural State if it be strongly fastned to the Gut you must if possible reduce them together provided there appear no sign of mortification Whether it has contracted any tie with the Intestine Testicle rings of the Muscle or with the productions which include the Spermatic Vessels 'T is alway better to take away some of its Substance than of the Substance of any of these parts if necessity compel you to it Yet I own if it should at all adhere to the Sack that contains the Intestine provided it be sound 't wou'd be better to hurt the Purse than Epiploon But as it cannot remain long in that condition without being altered we are alway forc'd to cut a great Portion of it You must take care in making the Ligature that you don't straiten the part too much because 't is of a loose texture spongy and easie to be cut You pass the Thread several times all about slightly straitning it after having pass'd the Needle through its Substance In the Operation of the Bubonocele you make not so great an Aperture but make it according to the extension and bigness of the tumor Concerning the rest you follow the same Rules and observe the same circumstances formerly mentioned When you have discovered the Purse which makes the Hernia you tear it to pieces dexterously with your Nails or the Fleam and if instead of the Intestine you find water be not surpriz'd with the supposal that you have hurt the Intestine but take Courage and remember only the signs of which we have spoken which will fortifie you and put you into a condition successfully to perform the Operation for 't is only the Purse which is full of waters in which the intestine floats These waters are furnished by the Glands of the internal surface of the Peritonaeum and by those of the Intestines or by the eruption of some Lymphatic Vessels These are if I mistake not most of the particulars which this Operation contains after having Embrocated with Oyl of Roses you must apply good defensitives over the part and Hypogastrick region with good compress moistned in Oxycrate and sustain the applications with the simple Spica in all these affects you must alway ease the Purses by a Suspensorium and prefer Clysters before other general Medicines CHAP. XII Of Castration occasion'd by Sarcocele and Varicocele THis Operation is not alway to be Practis'd unless other methods prove ineffectual In the four following cases I suppose it necessary VVhen the Operation must be perform'd 1. When it 's so closely fastned to the Intestine that one is forc'd to take much of its Substance off The 2. is in contusion when the Vessels and Vesicles are crushed together and the course of the Blood interrupted which is known by the blackness of the Testicle and mortification which follows soon after if the progress of this commotion be not hindred The 3. is when the Testicle is varicous and the virulent Humours which cause the tension and dilatation of the Vessels can't by Medicines be resolved this case is not so pressing as