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 ...

X. Cutting of a Wry Neck.

This, though it is not a closed Part, yet is a contracted Part, and may well enough have place in this Chapter.

XIX. This Operation is per∣formed after two manners: The first is done by the Hook, the other without it.

XX. The Wry Neck is caused from the Contraction of one of the Muscles of the lower Jaw, called Musculus Latus, or Quadratus, which arises from the upper part of the Sternum, Clavicula, and Acromium, and is inserted into the inferior Jaw, and firm∣ly fixed in the middle of the Chin.

XXI. But where is this Muscle is very broad, so, seldom or never is it contracted in its whole Lati∣tude, but sometimes more for∣ward, sometimes more backward,

and sometimes more laterally, and accordingly the Seat of the Chord appears.

XXII. Adjacent to this Chord, are the Jugular Veins, the Ar∣teriae Musculae, the Recurrent Nerves, and Nerves of the hinder∣most Branch of the seventh Pair arising from the Neck.

XXIII. These in Cutting, ought all (if possible) to be avoided: chiefly the Jugular Veins, because of the mighty Flux of Blood, endangering the Patients Life: Also the Recurrent Nerves (which spring from the external Branch of the Par Vagum;) for that if they be wounded, or cut asunder, the Voice is lost, and the Crea∣ture becomes dumb.

XXIV. Now this Contraction seems for the most part to be in the Tendons of the Quadratus, chiefly where it is joined to the Clavi∣cula; but, by reason of the ex∣ceeding shortning thereof, the Muscle (in length) seems to be a continued Chord.

XXV. This Chord in many Persons (especially if grown into Years) becomes not only very hard, but perfectly Cartilaginous or Gristly: So that in Cutting, its hardness has caused a kind of cracking noise.

XXVI. The Cutting of a Wry Neck by the Hook. You must carefully avoid all the before-named Vessels, and make a Trans∣verse Apertion of the Skin over the Chord, about an Inch or somewhat more on each side; then with a Hook (made of Steel for this purpose) being put under the said Chord, you must gently pull the contracted part forth, which must immediate∣ly be cut compleatly through by an Incision-Knife, advising the Patient the while to hold his Neck up.

XXVII. This done, you must heal it as a Green-wound, com∣mitting withal the Sick to his Bed. This is the old Butcherly way, which puts the Patient to great pain and danger; and withal, a long Cure.

XXVIII. The Cutting of a Wry Neck, by a new way, without the Hook. Here you must strongly take hold of the Chord with your Thumb and Fore-finger, with which feeling for the Vessels (chiefly the Jugular Vein, whose Approximate is the Recurrent Nerve) you must carefully thrust it by, Then having fast hold of the Chord with your Thumb and Finger, you must warily thrust in your Incision-Knife, as it were beyond the Chord, and just above your Fingers; then making the Patient hold up his Head, the Chord will be a cut asunder, the outward Skin remaining whole; thus will the work be done, with no more but a prick appearing outwardly, and the Wound will be well in about twenty four hours, without any effusion of Blood.