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 ...

An Appendix, concerning Cutting an Oscheocele.

XVI. Although this Discourse does not properly belong this place, but rather to Chap. 8. aforegoing; yet, because the Operation of Cut∣tin; was not there taught, we were necessitated to refer it to another place: And here, having an opportunity, under a Branch of the same Head, we thought good to resume that part which was there wanting, and to de∣liver it here.

XVII 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Oscheocele, Hernia Scroti: Hernia intesti∣nalis vel Omentalis, in quae, ob Rupturam, aut Lesi•…•…m ali∣quam Intestinum aut Omentum, in Scrotum delabitur, Lind. Ex. 4. § 45. It is a Rupture in which the Guts or Caul, through

a Breach of the Peritonaeum, fall down into the Cods.

XVIII. By reason Cutting of an Oscheocele is not only dreadful, but also hazardous, it is seldom in use, except when the Substance fallen into the Scrotum, cannot be reduced; yet some have made use of it, to prevent a falling down any more, and so for a perfect Cure.

XIX. To perform this, (when the Guts cannot be reduced, either from the hardned Excrements there, or Narrowness of the Pas∣sage) the Patient must be tied fast to a Form or Table, and In∣cision must be made in the upper Part of the Scrotum, not touch∣ing the Guts; then putting in the Directory at the Incision, and under the Production of the Peritonaeum, with your Knife, cut such a space as is necessary, towards the Belly; after which, reduce the Intestine, and stitch up so much of the Peritonaeum as may be sufficient to hinder the fall of any thing again into the Cod, after it is healed.

XX. But unless the Patient be very strong, this is not to be done; much less the following Operation, which is performed either with, or without taking away the Te∣sticle.

XXI. That, with taking away the Testicle, is so horrid and bloody, as Scultetus has related it, (by which way the famous Gelders of Italy did Cure a Hernia Inte∣stinalis) that we shall forbear to teach it, and come to shew you that Operation, which saves the Testicle intire.

XXII. The Incision is to be made about the Share-bone, into which the Directory is to be put, thrusting it long-ways under the Process of the Peritonaeum, which lift up, and separate it from the adjoining Fibres and Nervous Bo∣dies, to which it adheres: Then forthwith draw aside the Se∣minal Vessels, with the Cre∣master, or hanging Muscles of the Stones, and then draw the Process aside above, and take so much from it as is too loose, with a small Mullet perforated in the midst: and, with a Needle, having Five or Six Threads, thrust it through, as near as you can to the Seminal Vessels and Cremaster; after which, put the Needle again through the midst of the Rem∣nant of the Process, taking up therewith the Lips of the Wound; then tie the Thread with a strait Knot, and cut off the Needle, leaving so much of the Thread, as may hang forth of the Wound; which is not to be drawn out, till there is a sufficient Conglu∣tination, which then heal up ac∣cording to Art.