The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

CHAP. XVII. Of the cure of other kinds of Ruptures.

EPiplocele is the falling downe of the Kall into the Groine, or Codde, it hath the same causes as an Enterocele. The signes have beene explained. It is not so dangerous, nor infers a consequence of so many evill symp∣tomes, as the Enterocele doth, yet the cure is the same with the other.

Hydrocele is a waterish tumor in the Codde, which is gathered by little and little * 1.1 betweene the membranes encompassing the testicles, especially the Dartos and Ery∣throides; it may be called a particular dropsie, for it proceeds from the same causes, but chiefely from the defect of native heate. The signes are a tumor encreasing slowly * 1.2 without much paine, heavy, and almost of a glassie clearenesse, which you may per∣ceive by holding a candle on the other side, by pressing the Codde above, the water flowes downe, and by pressing it below, it rises upwards, unlesse peradventure in too great a quantity it fills up the whole capacity of the Codde, yet it can never be for∣ced or put up into the belly as the Kall or Guts may, for oft times it is contained in a Cyste, or bagge; it is distinguished from a Saycocele, by the smoothnesse and equality thereof. The cure must first be tried with resolving, drying, and discussing medicines, * 1.3 repeated often before, and in the Chapter of the Dropsie; this which followes I have often tried and with good successe.

℞, Vng. comitissa, & desiccat. rub. an. ℥ij. malaxentur simul; and make a medicine for * 1.4 your ease. The water by this kinde of remedy is digested and resolved, or rather dried up, especially if it be not in too great quantity. But if the swelling, by reason of the great quantity of water will not yeeld to those remedies, there is neede of Chi∣rurgery;

the Cod and membranes wherein the water is contained, must be thrust through with a Seton, that is, with a large three square pointed needle, thred with a skeane of silke; you must thrust your needle presently through the holes of the mul∣lets made for that purpose, not touching the substance of the Testicles. The skean of thred must be left there, or removed twise or thrise a day, that the humor may drop downe, and be evacuated by little and little. But if the paine be more vehement by reason of the Seton, and inflammation come upon it, it must be taken away, and neg∣lecting the proper cure of the disease, we must resist the symptomes.

Some Practitioners use not a Seton, but with a Razor, or incision knife, they open the lower part of the Cod, making an incision some halfe fingers breadth long, pe∣netrating even to the contained water; alwayes leaving untouched the substance of the Testicles and vessels, and they keepe the wound open, untill all the water seemes evacuated; truly by this onely way the cure of a watery rupture whose matter is contained in a Cyste, is safe, and to be expected; as wee have said in our Treatise of Tumors in generall.

The Pneumatocele, is a flatulent tumor in the Codde, generated by the imbecility of heate residing in the part. * 1.5

It is knowne by the roundnesse, lenity, renitencie and shining. It is cured by pre∣scribing a convenient diet, by the application of medicines which resolve and dis∣cusse * 1.6 flatulencies, as the seeds of Annis, Fennell, Faenugreeke, Agnus Castus, Rue, Origanum, other things set downe by Avicen in his Treatise of Ruptures. I have often used with good successe for this purpose, Emplastrum Vigonis cum mercurio; and Em∣plastrum Diacalcitheos, dissolved in some good wine, as Muscadine, with oyle of Bayes.

A Sarcocele is a tumor against nature, which is generated about the stones by a schyrrhus flesh. Grosse and viscide humors breed such kind of flesh, which the part * 1.7 could not overcome and assimulate to it selfe; whence this over-abundance of flesh proceeds, like as Warts doe. Varices, or swollen veines often associate this tumor; and it increases with paine. It is knowne by the hardnesse, asperitie, inequality, and roughnesse. It cannot be cured but by amputation or cutting it away; but you must * 1.8 diligently observe, that the flesh be not growne too high, and have already seazed upon the Groine, for so nothing can be attempted without the danger of life.

But if any may thinke, that he in such a case may somewhat ease the patient by the cutting away of some portion of this same soft flesh, he is deceived. For a Fungt will grow, if the least portion thereof be but left, being an evill fure worse than the former; but if the tumor be either small or indifferent, the Chirurgion taking the whole tumor, that is, the testicle, tumefied through the whole substance, with the * 1.9 processe encompassing it, and adhering thereto on every side, and make an incision in the Codde, even to the tumor; then separate all the tumid body, that is, the testicle from the Codde: then let him thrust a needle with a strong threed in it, through the middest of the processe above the region of the swolne testicle; and then presently let him thrust it the second time through the same part of the processe; then shall both the ends of the threed be tied on a knot, the other middle portion of the Peritonaeum being comprehended in the same knot. This being done, he must cut a∣way the whole processe with the testicle comprehended therein. But the ends of the threed, with which the upper part of the processe was bound, must be suffered to hang some length out of the wound, or incision of the Codde. Then a repercussive medicine shall be applied to the wound, and the neighbouring parts with a convenient ligature. And the cure must be performed as we have formely men∣tioned.

The Cirsocele is a tumor of veines dilated, and woven with a various and mutuall implication about the testicle and codde, and swelling with a grosse and melancholy * 1.10 bloud. The causes are the same as those of the Varices. But the signes are ma∣nifest.

To heale this tumor, you must make an incision in the codde, the bredth of two * 1.11 fingers to the Varix. Then you must put under the varicous veine, a needle having a double threed in it, as high as you can, that you may binde the rootes thereof: then

let the needle be againe put after the same manner about the lower part of the same veine, leaving the space of two fingers betweene the Ligatures. But before you binde the thread of this lowest Ligature, the Varix must bee opened in the middest; al∣most after the same manner as you open a veine in the arme to let bloud; That so this grosse blood causing a tumor in the Cod, may be evacuated as is usually done in the Cure of the varices. The wound that remaines shall be cured by the rules of Art after the manner of other wounds: Leaving the threads in it, which will presently fall away of themselves. To conclude then, it being growne callous especially in the upper part thereof; where the veine was bound, it must be Cicatrized, for so after∣wards the bloud cannot be strained, or run that way.

Hernia Humoralis is a tumor generated by the confused mixture of many humors * 1.12 in the Cod or betweene the tunicles which involue the testicles, often also in the pro∣per substance of the testicles. It hath like causes, signes and cure as other tumors. While the cure is in hand, rest, trusses, and fit rowlers to sustaine and beare up the testicles are to be used.

Notes

• * 1.1

  what a Hydro∣cele is.
• * 1.2

  The signes.
• * 1.3

  The cure.
• * 1.4

  A medicine 〈◊〉〈◊〉 draw forth the contained mat∣ter.
• * 1.5

  What a Pneu∣matocele is.
• * 1.6

  The Cure.
• * 1.7

  What a Sarco∣cele is.
• * 1.8

  The signes. Prognosticks.
• * 1.9

  The signes.
• * 1.10

  What a Cir∣socele is.
• * 1.11

  The Cure.
• * 1.12

  Hernia Hu∣moralis.