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CHAP. XX. Of the Varices and their cure by cutting.
AVarix is the dilatation of a Veine, some whiles of one and that a simple branch, otherwhiles of many. Every Varix is either straight or croo∣ked, * 1.1 and as it were infolded into certaine windings within its selfe. Many parts of the body are subject to Varices, as the temples, the regi∣on of the belly under the Navill, the testicles, wombe, fundament, but principally the thighes and legges. The matter of them is usually melancholy blood, for Varices often grow in men of a malancholy temper, and which usually feed on * 1.2 grosse meates, or such as breed grosse and melancholy humors. Also women with child, are commonly troubled with them, by reason of the heaping together of their suppressed menstruall evacuation. The precedent causes are a vehement concussion of the body, leaping, running, a painefull journey on foote, a fall, the carrying of a * 1.3 heavy burden, torture or Racking. This kind of disease gives manifest signes there∣of * 1.4 by the largenesse, thicknesse, swelling and colour of the Veines.
It is best not to meddle with such as are inveterate; for of such being cured there * 1.5 is to be feared a refluxe of the melancholy blood to the noble parts, whence there may be imminent danger of maligne Vlcers, a Cancer, Madnesse or suffoca∣tion.
When as many Varices and diversly implicite are in the legges, they often swell with congealed and dryed blood, and cause paine which is increased by going and compression. Such like Varices are to be opened by dividing the veine with a Lan∣cet, and then the blood must be pressed out, and evacuated by pressing it upwards * 1.6 and downewards; which I have oft times done, and that with happy successe to the patients, whom I have made to rest for some few dayes, and have applyed convenient medicines. A Varix is often cut in the inside of the legge a little below the knee, in which place commonly the originall thereof is seene. He which goes about to in∣tercept a Varix downewards from the first originall and as it were fountaine thereof, makes the cure far more difficult. For hence it is divided as it were into many rive∣lets, all which the Chirurgion is forced to follow.
A Varix is therefore cut or taken away so to intercept the passage of the blood and * 1.7 humors mixed together therewith, flowing to an Vlcer seated beneath; or else least that by the too great quantitie of blood, the vessell should be broken, and death bee occasioned by a haemorrhagie proceeding from thence. Now this is the manner of cutting it. Let the patient lye upon his backe on a bench or table, then make a liga∣ture * 1.8 upon the legge in two places the distance of some foure fingers each from other, wherein the excision may be made, for so the Veine will swell up and come more in sight, and besides you may also marke it with inke; then taking the skin up betweene your fingers cut it longwayes according as you have marked it, then free the bared veine from the adjacent bodies; and put thereunder a blunt pointed needle (least you pricke the veine) thred with a strong double thred, and so binde it fast; and then let it be opened with a Lancet, in the middle under the Ligature just as you open a veine, and draw as much therehence as shall be fit. Then straight make a Ligature in the lower part of the forementioned Veine, and then cut away as much of the sayd Veine as is convenient betweene the Ligatures, and so let the ends thereof withdraw themselves into the flesh above and below; let these ligatures alone untill such time as they fall away of themselves. The operation being performed, let an astringent medicine be applyed to the wound and the neighbouring parts; neither must you stirre the wound any more for the space of three dayes. Then doe all other things as are fit to be done to other such affects.