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as circumstances may require, they often-five great relitf.

83a. The other method of diminishing pain is, by ieslening the sensibility of a particular p^trt of the body. It has long been known, that the sensibility of any part may not only be Irssened, but entirely suspended, by compressing the r.erves which simply it. From a knowledge of this circumstance, an instrument (PI. CCCXXV1II. fig. 11}.J wa« invented some years ago by Mr James Moore of London, by which the principal nerves of a member might be so comptefied as to render the parts below "perfectly insensible. A difficulty, however, arises here; for as the nerves must be compressed at least ar hour previous to the operation, in order to render the parts quite insensible, and as it is extremely difficu t to compress the nerves without at the fame time affecting the veins, the latter arc therefore in dangeT of being burst. To prevent this inconvenience, Mr Moore propose* to open a vein; but this might be attended with bad consequ-nces in wesk'y constitutions. Besides, it is said, that by compressing the nerves in this manner, although left pain may be selt in the time of the operation, it is proportionally greater ater the -compression is removed. In certain parts of the body, however, where sufficient compression can he made upon the nerves without acting much upon the veins, it would appear that the method may be practised with advantage; though it has not yet been done, excepting in a few instances.


833. The proper application of bandage* is an object of great importance in surgery: and tho' dexterity is only to be acquired in this branch by practice, yet a few general rules may be useful. Bandage are employed for the retention of dressing, for stopping hemorrhagies, for removing deformities, and for effecting the union of divided part*. They ought to be formed of such matenais as are sufficiently firm, while, at the same time, they give no uneasiness to the parts to which they are applied. They may be composed either of linen, cotton, or flannel. Of late1 years the two last have been preferred by many for their warmth and elasticity, on which account they are certa'nly the most prrjper, especially in winter; and likewise in cases whert the parts arc liable to swelling and trfflammation, as in wounds, luxations, and fractures. Besides, they more read'ly absorb any moisture which may be discharged from the sores.

834. When first applied, they (hould be clean, sufficiently strong, and as free of seams as possible. They ssiould be so tightly applied as to answer the purpose for whieh they are intend-d, without being in danger of impeding the circulation. They should be applied in such a manner that they may be easily loosened, And the parts examined with as much accuracy as possible; and they (hould be laid aside as soon as the purpose for which they are intended is accomplished; for when longer continued, they frequently impede the growth of the parts upon which they arc applied.

835. The couvre chrs of the French, which is a square napkitrtjided corner wise, is most-frequent

ly used where a bandage is wanted for the bead; but a nightcap, having a band to po round the head, and another to tie undtr the chin, appears to be more suitable for this purpose. For making compression on any particulai part of the head, as for stopping of Heeding vessels, the radiated bandage may be employed.

836. For keeping the edee« of wouads together, as in cases of longitudinal cuts of the head, or of any other parts, t!:e milting bandage is usually employed, and i? always to be pieferred t? ftiturrs, where it retains the edges of the wound with sufficient exactness. Tor retaining dressings upon the eyes, several turns of a roller have been used, a::d it is termed monocvliu or iinoculuj according to .its being applied t6 one or both eyes; but the couvre cbtf, and the nrghtcap alre;ldy mentioned, are left apt to flip, and therefore founi more convenient for this purpose.

837. For fractures of the nose, or wounds there,, or on any other part of the face, the uniting banV dage answers best. And in cases of fracture of the lower jaw, a four-headed roller is most convenient: the hole in the centre of the roller rer ceives the chin, and assists in preventing the bandage from shifting. The two upper heads an.- to be carried ba-kwards; and being made to pasa each other at the occiput, they are afterwards brought once or twice round the head. The two other heads of the roller being reflected over the chin, are then to be turned upwards and fixed on * the upper part of the head. ■ 838. The bandage" nec. ssiry for the tied are, the machine already mentioned after tty? operation of bronch'itomy, and one used in cafes of wry nerk. For every other purpose of ba^dagirg a common roller may answer perfectly well. For fractures of the scapula the application of a lor.g roller may be of service.

839. For retaining dressings upon the tborax, the napkin and seapulary are commonly, and very proprrly used; and when the napkin is employed merely for retaining dressings, it need not be longer than to pass once round the body j but if it be used for making pressure over a si assured rib, it ought to pass two or three times round. For both purposes its breadth ought to be 6 or 7 inches for an adult.

840. The sime kind of bandages is also used for making pressure on ibe abdomen, as in cases of umbilical or ventral hernia; and to keep the bar.drge properly placed, a Icipulary is used for preventing it from flipping down, and one or two straps connected with it behind, are brought between the thighs, and fixed to it before to prevent it from moving up. A bandage of flannel, and different kinds of belts are contrived for compressing the abdomen in the operation of tapping; and trusses of vnrious construction are used for the retention of the protruded bowels in cafes ot" hernia.

84t. Bandages of cotton or flannel are used fur supporting the scrotum in the various diseases which may occur there, as well as after the- ope* rations performed upon it. Ore 0+ the best bar dxges for the penis ii a linen or cotton h;>/> fixel by a roller round the body. For re-tiin i.g dressings about the anu, or between tua. 'part an J


the scrotum, the T bandage is commonly used; and it is made either with one or two tails, according to the situation of the part to which it in to be applied.

842- I" iirnp'e fractures, and mod of the other diseases of the arm, fore-arm, and hand, the roller is the bandage commonly used; but in compound fractures of these parts, as well as in the different kinds of fractures of the lower extremities, the a or 18-tailed bandage is necessary.

843. For longitudinal wounds of the extremities, the uniting bandage is used with the fame advantage as has been already mentioned (ojr wounds of a similar nature upon the head..


844. Surgeons arc often called to investigate the cause and seat of diseases and death, either by the relations of the diseased, or the magistrate* to ■whom a report is to be made; therefoic, at the time of performing this operation, minutes should be taken of what is observed. The instruments, and a.l things necessary, should be disposed in order, as for any othrr operation; as ki ives, a razor, a great and small saw, scissars straight and curved, elevators, needles threaded, sponges, tow, saw-dust, or bran, basons with water, towel^and receivers for the viscera when they aie to be taken out of their cavities. The body is to be laid upon a suitable table, advantageously placed for the light, having a cloth thrown over the parts ■which decency demands should be concealed especial'y in females.

84,5. When it is intended onty to inspect the abdomen and its contents, a longitudinal incision from the xiphoid cartilage to the os pubis, intersected by a transverse one at the navel, wiil give a fair opportunity of answering these purposes, •when the angles are reversed. Should it be required to examine all the three cavities, and the parts contained in them, we are to begin by openzing the head, making an incision quite cross to .the bone, from ear to ear; which section is prelferabie to the crucial commonly made on this occasion: then the scalp may be easily dissected "from the skull, and turned down over the face, and towards the neck, giving room for the saw. The head must be held very steadily by an assistant during the sawing, which should be begun on rthe middle of the frontal, proceeding to each teraiporal bone, and so to finish the circle upen the -middle of the occipital bone; which may generally be done conveniently enough, by railing the head and inclining it forward, afier having proceeded as far as this bone; or the body may then ■be turned prom, should that posture be fr.und .more convenient to complete the circle. The cap of the skull is then to be raised with the elevator, occasionally cutting the adhesions cf the dura mater; after this the enccphalon is to be removed, carefully separating the ether attachments of the membrane.

84V To brii'g the thorax and abdomen, with the parts contained in these cavities under one view, an ireilion is to be made on e.-ch side or t'>e ster« urn, in the coin se of the canilai,rs Ui tbe ribs which are annexed to it ; dissecting fioia

thence the muscles with the teguments, the space of two or three inches towards the spire; then cutting through the cartilage0, which will be seen, and easily divided with a knife a little curved near the point; then the incifiors are to be Continued from the sternum through the abJominal cavity, in an oblique direction, to each iliUm or inguen } after which the clavicles ar; to be separated from the sternum, or this bone divided at its superior cartilaginous junction, with a strong knife, dissecting it from the mediastinum, and turning it downwards with the muscles, Sec of the abdomen. This is the most tlegibie manner of opening these cavities and jives an opportunity of scwi;-g them up with a better appearaace for any person's view, afterwards. That kind oi stitch called by sempstresses the herring Uat cxjkl seam has a very pretty a;id neat effect upon tnei'c occasion*,

847. If it is proposed to take out the thoracij and abdominal viscera togethtr, for further summation, the diaphragm is lint to be cut down to the spine on both sides j then, to avoid being incommoded w ith blood, dec. two very strong ligatures are tobe passed round the ossnphagmand large blood-vessels, in which the trachea ma; b: included; tying them strait, and then div.&ng these parts between the ligaluies: the lame measures are to be taken in respect to lue infcliuf vessels upon the iumt-ar region, a little above t"1' .bifurcation of the aerta, including tke vena eava; 'and also upon the rectum. Af;er having observed

these piec.iution?, the viscera, v> ith the diaphragm, are to be removed by a wary dissection, a!i Ire way close to the some} and by gei-liy dnw \< 'them at the same time, the separation wul be greatiy facilitated.

848. When \lc thoracic and abdominal vi'"c;r. are to be takcp out separably, in the fust case ligatures must be made, as have been described upon the vtsscls, &c. just above the uiiphragir., and in the other jull below it, and upon the rectum.

849. If called upon to perform this office vrii<.a the body is become very putrn', it wiii be absolutely necessary to have such parts of it Well »*&ed with warm vinegar and brandy, and tben sprinkled with lavender water, or some such odoriferous antiputieseent liquor* before the I\m<nation, in order to correct the steiitii, and \tfend us against ihe noxious quality oflhrtflluvia: a precaution, the neg.ect of whic;i maybe attended with vary dire'ul effects.


850. In the errly ages of the world, I'xpWtke of embalming dead b^ies was verycomrnrt, particularly among the Egyptians; but i! b> long been disused in almost all countiics, except fer great personage*. See Embalming. Tl1'? following directions are tatttn from ivir Gowk, to whom they weie communicated h)f a peilix)'"! great character, and well acquainted wilb tae mod rn practice of embalming ntvlhis xing-.W.

851. After evisceration, aa ha6 been directed '» opemrg a dead bo 'y, and containing Ihe i:tif.iri farther upwards, even it to ti e rcoj'h, v c,

pr cti;aB'f' practicable, without cutting the skin of the neck,
all the cavities arc to be well cleansed, and the hu-
midity sucked up with sponges, then washed with
tina, myrrh*, and filled with spices compounded
of fragrant herbs, aromatic drugs, and gums re-
duced to powder not very fine, first restoring the
heart to its former resistance, after having opened
its ventricles, cleansed and washed them with the
tincture, stuffed them with the spices, and sewed
them up; and then the cavities ate to be stitched
very close with the glover's or spiral suture.
Large and deep incisions are also to be made in
all the most fleshy parts, cleaning and washing
them with the tincture in the same manner, filling
them with the antiseptic spices, and stitching them
up. Then the head, trunk, and limbs, are to be
perfectly well covered with cerecloth: putting a
piece under the chin, to be secured by sewing on
the top of the head, after having well adjusted the
cap of the skull, sewed the scalp together, and
cleaned the mouth, as haB been directed for the
other parts, and putting in some of the spices.
The cerecloth is to be prepared, according to art,
with a composition made of wax, rosin, storax,
and painter's drying oil.

85 a. After the application of the cerecloth,
with great care and exactness, cut into suitable
pieces according to the respective parts, and clos-

ing them well everywhere, the face, being close
shaved, is to be covered with some of the above
composition melted, and laid on with a brush of a
proper degree of heat, and of a moderate thick-
ness; which may have a faint flesh colour given it
wjth vermilion; and when it is grown cold and
stiff upon this part, it may be lightly covered with
hard varnilh; or this varnish, applied thick, may
here serve the purpose alone. A cap is to be well
adapted to the head, falling down upon the neck,
and to be sewed under the chin, making a few
circular turns about the neck with a roller of a
proper breadth. All the rest of the corpse is to
be inclosed in a sheet, to be artfully cut, and
sewed on very close and smooth, with the finest
tape, and the flat seam mentioned in the preced-
ing chapter; over which an appropriate dress is
to be put, as the relations or friends think fit
to direct and appoint, and then laid into the cof-
fin, which should be in readiness; but when it is
some i - rat personage, who is to lie in state for
public view before the funeral rites are solemni-
zed, the dress must be appropriated to his dignity
and character. The brain and other viscera ate
to be put with some of the spices into a leaden
box. Sometimes the heart, prepared as has been
directed, to preserve it from putrefaction, is de-
posited in an urn by itself.

Abdomen, wounds of the, 36
—39 J 65—67: paracentesis
of the, 529—334.
Abscesses, maturation of, 105

. —110: melancholy cafe from
the delay of opening one, 109:
methods of opening, 111—
114; and of dressing them,
115: abscesses in the breasts
of women, 174, 175: lumbar,
180—183: in the marrow,
033: in the globe of the eye,
410—411: in the antrum max-
illare, 490, 491.

Achillis tendo, cure of rup-
ture of the, 61, 63.

Ægineta, Faulus, an eminent
surgton, Ij.


Æsculapius, 5.

Aetius, his surgical works, 15.

Am in the thorax, 523, 514: 111
the abdomen, 534.

Aitkin, Dr John, 13: he im-

■ proves Gooch's machine, 779.

Albusasis raises the fame of
surgery in Arabia, 17.

Am Be of Hippocrates improv-
ed, 746.

Amputation of the penis, 70J
—708: amputation not al-
ways necessary in compound
fractures, 784: chief object of
it, 794: causes rendering it
necessary, 795—798: the art
now brought to perfection,
Vol. XXI. Part II.


799: method of performing
it, 800, 801: of amputating
the arm, 802; the thigh, 803
—807; the leg, 808—810; at
the joints of the extremities,
811—820; at the hip-joint,
821—823 ; at the joints of the
foot, 824—826; and of the
toes, 827.

Anasarcous hydroccle of the
scrotum, 592—595.

Anatomy, the knowledge of,
necessary to a surgeon, 24.

Anchylosis, 775.

Andre's trocar, 531, 601.

An E L, M. his probe and syringe,

449—45 >» 453-

Aneurisms, not distinguished
by the ancients, 15 : diffused,
32: distinguished, 314—318:
the true, 315: the false, 316,
317: the varicose, 318, 319:
causes, 320: diagnosis, 321,
322: prognosis, 323: extra-
ordinary case and cure of,
329: methods of performing
the operation for, 330—349.

Ankle joint, luxations of tha

'754, 755-

Antiseptics, 122.

Antrum maxillare, diseases of

the, 490, 491.
Anus, diseases about the, 713

— 727: imperforated, 718.
Aquapendente, FabriciusAn,

an- eminent surgeon, 15: his
Y y y y

his system of surgery, 21 : his
screw, 452.
Arabia, history of surgery in,
i6i 17.

Arlhagathus, the first sur-
geon at Rome, 8.
Akistæ, 714.

Arm, luxations of the bones of
the, 747: fractures of them*
773, 774: ampuation of the
arm, 802: at the shoulder
ioint, 813—816.

Arsenic, prescribed for cancer,

Arteries, wounds of, 32: su-
tures of, 295—307: ligatures
of, 308—313.

Arteriotomy seldom practi-
sed, 276: method of perform-
ing it, 477—279.

Ascites, 529, 530: operation
for it, 531, 332: treatment
thereafter, 533.

Asclepiades, an eminent phy-
sician, 8.

Atheroma, 193.

Atheromatous tumours, 192.

Avicenna, a famed Arabian
surgeon and physician, 16:
his works and practice, ib.

Auripigmentum, orpiment,


Bag, suspensory, 601.
Halls often lodge in the body
without harm, 77.


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Breasts of women, cancer in
the, 164 —167: extirpation of
the, 168,169: glasses for milk-
ing them, 516.

Britain, late low state of sur-
gery in, 20.

Bromefield, Mr, his opinion
rf exollclis, 217: of the ob-
structions of the glands, 240:
of concussions of the brj.n,

Bronchocele mentioned by
Albuealis, 17: described,213:
cure, 214.

Bronchotomy, operation of,

5i*< 5»3> « ■
Buboes, venereal, 178', 179.
Bubonocele, 574—579.
Burns, 170—172.
Bursæ mucosæ, sweliingsof the,

197, 198.
Buttocks, excoriation of the,
. 674-


Calculus. See Stone.
Callous ulcers, t28—134-
Cancerous Lips, extirpation

of, 473» 474-

Cancers, different species of,
161—163 : occult, 161 : open,
162: Cfuses and method of
cure, 164: arsenic pi escribed
for, 167: symptoms, and me-
thod ot extirpating, 165—169:
cancer ofiis, 232: Cancer of the
eye, 430, 43«:

Canula, used in bronchotomy,
5t3: in paraceirtelis of the
thorax, 516.

Capsular ligaments, collec-
tions within the, 199—201.

Carbuncle, fatal cafe of, 121.

Caries, 125: ofthrboncs, 136.

—138, 232.

Carious ulcers, 125, 136, 137:
bones, a.,a, 828.

Carpus, J. an early surgical au-
thor, a 1.

Cartilaccious concretions in
the joints; 203—206.

Cataplasms, 38a.

Cataract, 43a: tieatment of
the, 433—44X.

Catheters,. 685.

Caustic, actiou of, in: lunar:

Cauteries,, much used anu.'iig
the Arabs, 17. .:

Celsus, an account of his sur-
gical works, 9: and excellent
practice, 10—13-

Chalk-stones, in gout, 288.

be improves lithotomy, 659. .

Chilblains, 187, 188.

Cicuta, not uniformly effec-
tual for cancer, 164.

Circocele, 629.

Clavicle, luxation of the, 741:

fracture of the, 766.
Clerk, Le, an eminent surgeon,


Club-foot, 793.
Collar for a distorted spine,

Concretion of the eye-lids,

Conductor, 459.
Conbvlomatous excrescence*

of the anus, 714—716.
Congenita hernia, 580—582.
Contusions, 70—73; 189—


Cord, in setons, 294.

Corns, 216.

Counter Fissure, 362.

CouvjtE chef, 835.

Cranium, fracture and depres-
sion of the, 354t 355: treat-
ment os these, 356—378.

Cruce, J. a writer on surgery,

Crural hernia, 584.

Cu Pping, method of, 281: dry,

103, 287.
Cupping Glasses, 282—286.
Curvature of the spine, 243—


Cystic hernia, 588, 589.

Daviel's method of treating ca-
taract, 437-

Dead Bodies, method of open-
ing, 844—849: of embalming,

Deafness, causes of, 503—507:
remedies for, 507—509.

Dentition, 275.

Derangement of teeth, 476,

Diaphragm, wounds of the,

Diffused aneurism, 316.

Directory, 373.

Distortions, 237, 238: 787—
793: of the bones, 787: of
the spine, 788: of the limbs,
789 — 792 : of the foot, 793.

Divarication of the olkous
fibres, 230.

Dran, Le, quoted, 154.-

Drawing of teeth, 11, 458.

Dropsical swellings of the
joints, 200—202.

Dropsy, 529, 530: operation
for it, 531, 532; and treat-
ment after it, 533.

Ducts, methods of making ar-
tificial nasal, ^57—460.

Ear, diseases of the, and opera-
tions on it, J04—508: best
method of piercing the lobes,

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tions, 568—573: various lpc-
cies of, 574—59°-

Hernia, strangulated, 546—
573: chronic, 562: inguinal
and fcrotal, 574—579: con-
genita, 580—582: femoral or
crural, 584: umbilical, 585,
586: ventral,587: cystic,588,
589: vaginalis, 590: numera-
l's, 637.

Hernial sac, 545.

HlLDANVS, F. 22.

Hill, his opinion of cancer, 164.

Iiip-joint, luxation of the, 749,
750: amputation at the, 821

Hippocrates, his chirurgical

(kill and practice, 6 : his ambe

improved, 746.
Homer's account of ancient

surgery, 5.
Humeralis hernia, 637.
HuMERUs,fracturesofthe, 772,


Humoralis hernit, 176.

Hunter, Dr William, his dis-
section of a gland, 213; his
cises of varicose aneurism,324,

Hunter, Mr John, his opinion
of the symptoms following
blood-letting, 53, 54 : contro-
verted, 55: of stricture of the
urethra, 692.

Hydatides in white swellings,


Hydrocele, 591; of the scro-
tum, 592—595; of the tunica,
vaginalii, 596—618; of the
spermatic cord, 619—625.

Hymen imperforated, 729.

Hypopyon, 421.

I, J.

Jacques invents the lateral o-
peration for the stone, 658.

James, Mr S. his relaxing ma-
chine, 785.

Imperforated anus, 728: hy-
men, 729.

Incarcerated hernia. See

Incontinence of urine, 683,

Indolent tumours, 192, 193.

Inflammation and its conse-
quence*, 90—115 : symptoms
and kinds of, 90: of the brain,

Inflammatory tumours, 173

Inguinal hernia, 574—579.
Innes, Dr, an eminent surgeon,

Insects in the ear, a cause of

deafntss, 505.
Intestines, wounds of the, 38.

See Abdomen.
Y y y y * Joints,

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