The Compleat Surgeon Part 11

_What is the Spleen?_

The Spleen is a Bowel resembling a Hart's Tongue in shape, and situated in the Left _Hypochondrium_, over-against the Liver: Its length is about half a Foot, and its breadth equal to that of three Fingers; its Substance being soft, as that of the Liver, and its Colour like dark coagulated Blood: It is fasten'd to the _Peritonaeum_, Left Kidney, Diaphragm, and to the Caul on the inside; as also to the Stomach by certain Veins, call'd _Vasa Brevia_; nevertheless these Ligatures do not hinder it from wandering here and there in the lower Belly, where it often changeth its place, and causeth many dreadful symptoms by its irregular Motions. Its Office is to Subtilize the Blood by cleansing and refining it.

_What are the Reins?_

The Reins or Kidneys are Parts of a Fleshy Consistence, harder and more firm than that of the Liver and Spleen: They are both situated in the sides of the Umbilical Region, upon the Muscle _Psoas_, between the two Tunicks of the _Peritonaeum_; but the Right is lower than the Left: Their Shape resembleth that of a _French_ Bean, and they receive Nerves from the Stomach, whence Vomitings are frequently occasion'd in the Nephritical Colicks: They are fasten'd to the Midriff, Loins, and _Aorta_, by the _Emulgent_ Arteries; as also to the Bladder by the _Ureters_. The Right Kidney likewise adheres to the Gut _Caec.u.m_, and the Left to the _Colon_.

Their Office is to filtrate or strain the Urine in the _Pelves_ or Basons, which they have in the middle of their Body on the inside, and {74} to cause it to run thro' the Vessels call'd _Ureters_ into the Bladder.

Immediately above the Reins on each side, is a flat and soft Glandule, of the thickness of a Nut; they are nam'd _Renal Glandules_, or _Capsulae Atribiliariae_, because they contain a blackish Liquor, which (as they say) serves as it were Leaven for the Blood, to set it a fermenting.

_What is the Bladder?_

It is the Bason or Reserver of Urines, of a Membranous Substance as the Stomach, being plac'd in the middle of the Hypogastrick Region; so that it is guarded by the _Os Sacrum_ behind, and by the _Os Pubis_ before: Two Parts are to be distinguish'd therein, _viz_. its Bottom and Top; by its Membranous Bottom it is join'd to the Navel, and suspended by the means of the _Urachus_, and the two Umbilical Arteries which degenerate into Ligaments in adult Persons: As by its fleshy Neck, longer and crooked in Men, and shorter and streight in Women it cleaves to the _Intestinum r.e.c.t.u.m_ in the former, and to the Neck of the Womb in the latter. Lastly, its Office is to receive the Urines to keep them, and to discharge them from time to time.

_What are the Genitals in Men?_

They are the Spermatick Vessels, the t.e.s.t.i.c.l.es, and the _p.e.n.i.s_. The Spermatick Vessels are a Vein and an Artery on each side; the former proceeding from the _Aorta_, or thick Artery of the Heart; and the other from the Branches of the _Vena Cava_ of the Liver. These Arteries and Veins are terminated in the Body of the {75} t.e.s.t.i.c.l.es, which are two in Number, enclos'd within the _s.c.r.o.t.u.m_.

The Office of the t.e.s.t.i.c.l.es is to filtrate the Seed, which is brought thither from all the parts of the Body, thro' the Spermatick Vessels, called _Praeparantia_, and afterwards to cause it to pa.s.s thro' others nam'd _Deferentia_, to the _Vesiculae Seminales_, from whence it is forc'd into the _Ureter_, thro' two small and very short Ca.n.a.ls.

The _p.e.n.i.s_ or Yard is a Nervous and Membranous Part, well furnish'd with Veins and Arteries, containing in the middle the Ca.n.a.l of the _Ureter_: Its Extremity, which consists of a very delicate and spongy sort of Flesh, is call'd _Bala.n.u.s_, or _Glans_, and the Nut, the Skin that covers it being nam'd the _Praeputium_, or the Fore-Skin. Thus by the means of this swell'd Part, and stiff thro' the affluence of the Spirits, the Male injects his Seed into the _Matrix_ of the Female, to propagate his Kind.

_What are the Parts appropriated to Generation in Women?_

They are the Spermatick Vessels, the Ovaries or t.e.s.t.i.c.l.es, and the _Matrix_. The Spermatick Vessels are a Vein and an Artery on each side, as in Men: The Ovaries or t.e.s.t.i.c.l.es, situated on the side of the bottom of the _Matrix_, are almost of the same bigness with those of Men, but of a round and flat Figure. The _Vesiculae_, or little Bladders which they contain, are usually term'd _Ova_ or Eggs by Modern Anatomists; and the Vessels that pa.s.s from these t.e.s.t.i.c.l.es or Ovaries to the _Cornua_ of the _Uterus_, are call'd _Deferentia_ or _Ejaculatoria_. {76}

The _Matrix_, _Uterus_ or Womb, is the princ.i.p.al Organ of Generation, and the place where it is perform'd, resembling the Figure of a Pear with its Head upward, and being situated between the Gut _r.e.c.t.u.m_ and the Bladder: It is of a fleshy and membranous Substance, retain'd in its place by four Ligaments, fasten'd to the bottom; whereof the two upper are large ones, proceeding from the Loins, and the two lower round, taking their Rise from the Groin, where they form a kind of Goose-Foot, which is extended to the _Os Pubis_, and the flat part of the Thighs; which is the cause that Women are in danger of Miscarrying when they fall upon their Knees.

The Exterior Neck of the Womb, call'd _v.a.g.i.n.a_, is made almost in form of a Throat or Gullet, extending it self outwardly to the sides of the Lips of the _Pudendum_, and being terminated inwardly at the internal Orifice of the _Matrix_, the shape whereof resembleth that of the Muzzle or Nose of a little Dog. The outward Neck of the womb is fasten'd to the Bladder and the _Os Pubis_ before, and in the hinder part to the _Os Sacrum_: Between the Lips of the _Pudendum_ lie the _Nymphae_, which are plac'd at the Extremity of the Ca.n.a.l of the Bladder, to convey the Urines; and somewhat farther appear four Caruncles, or small pieces of Flesh, at the Entrance of the _v.a.g.i.n.a_, which when join'd together make the thin Membrane call'd _Hymen_.

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CHAP. XIV.

_Of the Anatomy of the _Thorax_, Breast, or middle _Venter_._

_What is the Breast?_

It is a Cavity in which the Heart and the Lungs are princ.i.p.ally enclos'd.

_What is to be consider'd outwardly in the Breast?_

Its extent, and the situation of the Parts therein contain'd.

_What is its extent?_

It is extended from the _Clavicles_ to the _Xiphoides_, or Sword-like Cartilage on the fore-part, and bounded on the hinder by the twelfth _Vertebra_ of the Back, having all the Ribs to form its Circ.u.mference, and the Diaphragm for its Bounds at bottom, separating it from the _Abdomen_ or lower Belly.

_What is the situation of the Parts contain'd in the Breast?_

The Lungs take up the upper Region, and fill almost the whole s.p.a.ce, descending at the distance of two Fingers breadth from the Diaphragm; the Heart is situated in the middle, bearing its Point somewhat towards the Left side, under the Lobes of the Lungs, which are divided by the _Mediastinum_ that distinguishes them into the Right and Left Parts.

_How is the Breast Anatomiz'd or open'd?_ {78}

After the dissection of the five Teguments, and the removal of the Muscles, as in the lower Belly, the Anatomist proceeds to lift up the _Sternum_ or Breast-Bone, by separating it from the Ribs; then it is laid upon the Face, or else entirely taken away, to the end that the internal Parts of the Breast may be more clearly discover'd; whereupon immediately appear, the Heart, the Lungs, the Diaphragm, and the _Mediastinum_, which sticks to the _Sternum_ throughout its whole length.

_What is the Heart?_

It is a most n.o.ble Part, being the Fountain of Life, and the first Original of the Motion of all the others; on which account it is call'd _Primus vivens_, & _ultimum moriens_; that is to say, the first Member that begins to live, and the last that dies.

_What Parts are to be consider'd in the Heart?_

Its fleshy Substance, with all its Fibres turn'd round like the Skrews of a Vice; its _Basis_, Point, Auricles, Ventricles, large Vessels, _Pericardium_ and Ligatures or Tyes: The _Basis_ is the uppermost and broadest part; the Point is the lowermost and narrowest part; the two Auricles or small Ears being as it were little Cisterns or Reservers, that pour the Blood by degrees into the Heart, are situated on each side above the Ventricles. The Ventricles, which are likewise two in Number, are certain Cavities in its Right and Left Sides. The large Vessels are the _Aorta_ or great Artery, and the _Vena Cava_ together with the Pulmonary Artery and Vein. The _Pericardium_ is a kind of Bag fill'd with Water, wherein the Heart is kept; which is {79} fasten'd to the _Mediastinum_ by its _Basis_, and to the large Vessels that enter and go out of its Ventricles.

_What are the Terms appropriated to the continual beating of the Heart?_

They are _Diastole_ and _Systole_, from whence proceed two several Motions, the first whereof is that of Dilatation, and the other of Contraction, communicated to all the Arteries which have the same Pulse.

_To what use serves the Water contain'd in the _Pericardium_?_

It prevents the drying of the Heart by its perpetual Motion.

_What are the Lungs?_

They are an Organ serving for Respiration, of a soft Substance, and porous as a Sponge, being all over beset with Arteries, Veins, Nerves, and Lymphatick Vessels, and perforated with small Cartilaginous Tubes, that are imparted to it from the Wind-Pipe, and are call'd _Bronchia_. Their Natural Colour is a pale Red, and marbl'd dark Brown; and their whole Body is wrapt up in a fine smooth Membrane, which they receive from the _Pleuron_. They are suspended by the Wind-Pipe, by their proper Artery and Vein, and by the Ligatures that fasten them to the _Sternum_, _Mediastinum_, and frequently to the _Pleuron_ it self: They are also divided into the Right and Left Parts by the _Mediastinum_; having four or five Lobes, whereof those on the Left side cover the Heart. Their continual Motion consists in _Inspiration_, to take in the Air, and _Expiration_, to drive it out. The _Larynx_ makes the Entrance of the Wind-Pipe {80} into the Lungs, and the _Pharynx_ that of the _Oesophagus_ or Gullet, at the bottom of the Mouth to pa.s.s into the Stomach.

CHAP. XV.

_Of the Anatomy of the Head, or upper _Venter_._

_What is the head?_

It is a bony Part, that contains and encloseth the Brain within its Cavity.

_What is most remarkable in the outward parts of the Head?_

The Temporal Arteries, the _Crotaphitae_, or Temporal Muscles, and the Sutures of the Skull.

_Why are these things considerable?_

The Temporal Arteries are of good Note, because they are expos'd on the outside, lying even with the Skin. The _Crotophite_ Muscles are so likewise, in regard that they cannot be hurt without danger of Convulsions, by reason of the _Pericranium_ with which they are cover'd. And the Sutures, because the _Meninges_ of the Brain proceed from thence to form the _Pericranium._