Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XIV. OPENING of the WIND-PIPE.

I. BRonchotomia seu Laringo∣tomia, is the opening of the Wind-Pipe, when Persons are troubled with that kind of Quinsey, called Cynanche, where the Sick is in danger of Suffocation, that Disease being more dangerous than this Operation.

II. Let the Sick bend back his Head, both to stretch out, and better shew the Aspera Arteria: Draw a Line with Ink from the middle of the Neck before, almost to the Cavity of the Jugulum: Divide the Skin, according to the length of the Larinx unto the hollow: let him that stands by to assist, pluck by the Skin on each side, that the Artist may see and remove the two long Muscles, called Sternohyoides, with a Knife made either with Wood or Bone: The Larinx then appearing, make an Inci∣sion in the middle, between the third and fourth Annulary Car∣tilage, taking heed that you hurt not the Cartilages them∣selves.

III. When you find the Breath to come forth, take out the Inci∣sion Knife, and put into the place a Pipe of Silver or Lead, yet not so deep as to reach the hin∣der part of the Wind-pipe, lest it cause a continual Cough.

IV. The danger of Suffocation being over, which is generally about the third or fourth day, take forth the Pipe and cure the Wound, as you do others.

V. Before you do this Operation, beware lest the Lungs, Pleura, Gullet, &c. be not also inflamed, or already full of Matter: An Inflammation and Corruption of the Larinx, is most commonly mortal: If therefore upon these Accidents, you attempt this work, the death of the Patient may prove matter of Scandal.

VI. The Epiglottis may some∣times be so indurated, that it may not only hinder speaking, but also

hinder swallowing, except of great pieces of Meat; for Drink, and all other liquid things, run into the Wind pipe, as not being well closed by the indurated E∣piglottis: This Affect is incura∣ble.

VII. The Glottis, or Chink of the Larinx, either from Food or Physick, is sometimes so straitly wrung together, that the Patient cannot make any Noise: for this purpose some commend this; ℞ Cows Milk lbi. Yolks of Eggs N^oij. treble refined Sugar ℥i. mix and dissolve, of which the Patient may often take three or four Spoonfuls.

VIII. Or you may give this; ℞ English Saffron ʒss. Olibanum in fine Pouder ʒi. Juice of Liquo∣rice ʒiss. white Sugar ʒij. Gum Tragacanth ʒiij. mix, and with Damask Rose-water make Tro∣ches, to be continually chew∣ed in the Mouth, and swallow∣ed.

IX. This following is of good use, and has been often proved; ℞ Syrup of Sugar, Oil of sweet Almonds new drawn ana ℥iij. put them into a Glass, and shake them well together; of which let the Patient swallow a spoonful at a time, five, six, or eight times a day.

X. If it be inveterate, and not easily Cured, you must mix with the former Composition Powers of Aniseeds ℥iss. or, for want thereof, of the Oil of Aniseeds ʒij. which mix well by shaking to∣gether, and let it be given as the former.