The Compleat Surgeon Part 35

_The Dressing_

Is made with a Bolster soakt in some Styptick Water, if the Blood will not otherwise stop; or in Brandy or _Aqua-Vitae_ if there be an Inflammation; and it is to be supported with a Bandage proper for the Part.

CHAP. x.x.xV.

_Of the Application of the _Seton_._

To perform this Operation, a Cotton or Silk Thread is to be taken, after it hath been dipt in Oil of Roses, and let into a kind of Pack-Needle; then the Patient sitting in a Chair, is to hold up his Head backward, whilst the Surgeon gripes the Skin transversely in the Nape of the Neck with his Fingers, or else takes it up with a Pair of _Forceps_, and pa.s.seth the Needle thro' the Holes of the _Forceps_, leaving the String in the Skin. As often as the Bolster that covers the Seton is taken off, that part of the String which lies in the Wound is to be drawn out, and cut off.

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CHAP. x.x.xVI.

_Of _Scarifications_._

Scarifications are to be made more or less deep, accordingly as necessity requires, beginning at the bottom, and carrying them on upward, to avoid being hinder'd by the Haemorrhage. They must also be let one into another, that Strings may not be left in the Skin.

CHAP. x.x.xVII.

_Of the Application of _Vesicatories_._

Vesicatories are compounded with the Powder of Cantharides or Spanish flies, mixt with very sower Leaven, or else with Turpentine. Before they are apply'd, a light friction is to be made on the Part with a warm cloth, and a greater or lesser quant.i.ty is to be laid on, accordingly as the Skin is more or less fine, leaving 'em on the Part about seven or eight Hours; then they are to be taken away, and the Blisters are to be open'd, applying thereto some sort of Spirituous Liquor.

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CHAP. x.x.xVIII.

_Of the Application of _Cupping-Gla.s.ses_._

A Good Friction being first made with warm Clothes, lighted Toe is to be put into the Cupping-Gla.s.s, or else a Wax-Candle fasten'd to a Counter, and then it is to be apply'd to the Part till the Fire be extinguish'd, and the Skin swell'd, re-iterating the Operation as often as it is necessary; and afterward laying on a Bolster steept in Spirit of Wine. These are call'd dry Cupping-Gla.s.ses: But if you wou'd draw Blood, every thing is to be observ'd that we have now mention'd, besides that Scarifications are to be made, according to the usual manner; and the Cupping-Gla.s.s is to be set upon the Scarifications: But when the Cupping-Gla.s.s is half full of Blood, it must be taken off to be emptied, and the Application thereof is to be re-iterated, as often as it is required to take away any Blood. Lastly, the Incisions are to be wash'd with some Spirituous Liquor; and a Bandage is to be made convenient for the Part.

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CHAP. x.x.xIX.

_Of the opening of _Abcesses_ or _Impostumes_._

An Abcess or Impostume ought to be open'd in its most mature part, and in the Bias of the Humours, endeavouring to preserve the Fibres of the Muscles from being cut, unless there be an absolute necessity, avoiding also the great Vessels, Tendons, and Nerves. The Opening must be rather large than small, and not too much press'd in letting out the purulent Matter. If the Skin be thick, as it happens in the Heel, it may be par'd with a Razor; and if the Matter be lodg'd under the Nails, it wou'd be required to sc.r.a.pe 'em with Gla.s.s before they are pierc'd.

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A

TREATISE

OF THE

OPERATIONS

OF

FRACTURES.

CHAP. I.

_Of the Fracture of the Nose._

When the Fracture is considerable, the Nostrils are stopt up, and the Sense of Smelling is lost. In order to reduce it, the Surgeon takes a little Stick wrapt up in Cotton, and introduceth it into the Nostrils as gently as is possible, to raise up the Bones again, laying the Thumb of his Left-hand upon the Nose, to retain 'em in their place. The Bones being thus set, he proceeds to prepare {273}

_The Dressing and Bandage_

By conveying into the Nostrils certain Leaden Pipes of a convenient Bigness and Figure, which serve to support the Bones, and to facilitate Respiration. But care is to be had to avoid thrusting 'em up too far, for fear of hurting the sides of the Nose; and they are to be anointed with Oil of Turpentine mixt with Spirit of Wine: These Pipes are also to have little Handles, with which they may be fasten'd to the Cap. If there be no Wound in the Nose, there will be no need of a Bandage; but if the Fracture be accompany'd with a Wound, after having apply'd the proper Medicines, it wou'd be requisite to lay upon each side of the Nose a Triangular Bolster, cover'd with a little piece of Paste-board of the same Figure. This small Dressing is to be supported with a kind of Sling that hath four Heads; being a piece of Linnen-Cloath, two Fingers broad, and half an Ell long; it is slit at both ends, and all along, only leaving in the middle a Plain of three Fingers, that is to say, a part which is not cut. The Plain of this Sling is to be laid upon the Fracture, causing the upper Heads to pa.s.s behind the Nape of the Neck, which are to be brought back again forward; the lower Heads are likewise to be carry'd behind, crossing above the upper, and afterward to be return'd forward. If the Bones of the Nose be not timely reduc'd, a great Deformity soon happens therein, and a Stink caus'd by the Excrescences and _Polypus's_.

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CHAP. II.

_Of the Fracture of the lower Jaw._

The Operator at first puts his Fingers into the Patient's Mouth, to press the Prominences of the Bones; and afterward doth the same thing on the outside. If the Bones pa.s.s one over another, a small Extension is to be made. If the Teeth be forc'd out of their Place, they are to be reduc'd, and fasten'd to the sound Teeth with a wax'd Thread.

_The Dressing and Bandage._

If the Fracture be only on one side, a Bolster sow'd to a piece of Paste-board is to be laid upon the flat side of the Jaw, both being of the Figure and Size of the Jaw it self. The Bandage of this Fracture is call'd _Chevestre_, i.e. _a Cord or Bridle_, by the _French_ Surgeons, and is made by taking a Band roll'd with one Head or End, three Ells long, and two Fingers broad; the Application of it is begun with making a Circ.u.mvolution round about the Head in pa.s.sing over the Fore-head; then the Band is let down under the Chin, and carry'd up again upon the Cheek, near the lesser Corner of the Eye in pa.s.sing over the Fracture; afterward it is rais'd up to the Head, and brought down again under the Chin, {275} to form a Roller or Bolster upon the Fracture: Thus three or four Circ.u.mvolutions and Rollers being made upon the Fracture, the Band is let down under the Chin, to stay and strengthen its several Turns, and is terminated round the Head, in pa.s.sing over the Fore-head.