1000000031

l1le1íccr

ki :"d, but

its

fluid

g'!ncndly like the white

of <ln

C'gg~

when ir is

f.11all,

rometimes

difperfcs of

¡trdr¡

pref.

fure and fuddcn bJo\Vs do airo remove

it;

bUl

for lhe mo!l

parl

continucs. unlefs it be extirpated.

is no uocam –

moo clfc

m('et with this fpecies of ganglion, running-un–

der .the

ligaIJunlum carpa/c,

and extending ilfelfboth up the

",,'rilt

CI;}d

clown ro (he palm of the hand . The core of this

diforJer

c annOl

dTc:éted

bUl

¡ociGaD through its

""hale Icngth and dividing

Ihe

Itgolllulfmn

carpa/lo'

The drel1ing in ,here eares does not at all difrer from the

:eceral

methods

of treating wounds.

OJ Ih< AlJlpulalion

Ih< Canar<d and Scirrhoul

BREAST.

fuceefs of this operation is exceedingly precarious,

frcm lhe great

d¡fpoGtion (here

in lhe conl1itution, ..fIel'"

:ln amputadon, to farm

new cancer in the wound, or fome

other pan of the body. When a fcirrhus has admitted

of a long deJay befare the operation, the patient feeDls tO

have a bener profpea. of cure without danger of

reJapfe,

than when it has increafed very fan, and with acUte pain.

The fcirrhus may be diHinguifhc:d, by

tts

want of

in·

flamm;uioo

the

fkin,

its Cmoothnc:Cs

and

nipperioefs deep

lhe brean, and generallyby i15 pricking pain, which

is 11!0re or leCs••ncreares lhe danger accordingly ; though

there <lre fome few \Vilh linle or none io the beginning: as

the

tumou r degenerares iota

C<lncer. whicla is the \Vara

degrec of fcirrhus, ir becomes unequal and livid, and the

vefi"els

growing varieous, at laft ulcerates .

extirpating the Ccirrhus, if it be (null,

,a'

longitudi ,

l'Ial iDci(ion \ViII dilate fufficiently for the operation

but if

toO large to be dilI

'ca.ed

oot

lhcn

m~ner.

ao oval piece

of n,i n mofl be cut throogh firfl, the fize of whieh is to be

proportiou:d to that of the tumour; for example, if the

f welling is five inebes long, and three broad, the oval piece

of fkin CUt away mull: be nearly of the fame leogth, aDd

.bout aD ineh and a half iD breadth. lo taking off the

whole breaf!, the fkio may be very mueh prererved, by

making the wound of it a great deal lers ,han the baGs of

the brean, which mull be care(uJly cleared away from lhe

peéloral murcie. This is not diflicolt to do, bee.aure all ,here

fcirrhufes being enlarged glaods, are encompalI'ed

witb

their

proper membranes, which make thcm quite diClina. from

the neighbouring parrs, and eafily feparable; al lean this

lhe

cafe

when lhe

tumour is moveable; (or fome times

it adheres to the (ubj aceot murcie, and that mofcle to the

ríos; in which circumflance, the operation is impraélicable.

vVhen it is atteodtd wi th knots in lhe arm pit, no fervice

can be done by amputation, unlefs lhe knots be ukeo

a–

way;

for there is

fort of dependence

be !aid on

their rubfiding. by the direharge of the \\'ound of the breafl.

T he bleediog of the large arteries is to be Itopped by

pa!ling the needle twice through the fldh, alrooil rou od

cvery vdrel,

and

t)'ing uRon it, whieh will Decdrarily

in·

clode it in the ligalure.

order

difco.,.er the orifices

of the velfels. Ihe wound mull be cI.aDed with a fpunge wruDg

out of

warr.l

water.

The [cin hO\lS tumours which appe:ar aboui tbe lower

j,au', ..re, generally fpeakiog, Ccrophuloos diforders, that dif·

tinguifl1lhe mrelves almofl by the eircuruflanee of fixing on

. he ralivary glands.

Th.re

>re very flubborn of cure, bot

not fo bad as the Ccirrhus, fince they frequeotly fuppurate,

and hcal arterwards: if

ti,• •

Í\nponhumale af..in after heal-

ing, it is fer waot

a good bottom, which may fome–

times be procurcd by def1:roying th,.eir bad , furface with

caulfick. Befides thefe, there is another fpecies of feir–

rhus in

lhe

neck, thar fuccecds bem:r arter extirpatian

than either of the roriller kind; (his ls ao enlargement

the Iymphatiek

glan~s.

which ron c10Ce "p by the jogular

veio, and is diflinguifhable from the cancers of this pan, by

its moveableods, \9'3nt of

pllin,

lhe laxnefs of (he

Ildn

covering ir, che fnull degree of pre(f'ure it m'akes

the

(o!hagul

aod

Irach<tl,

and laflly the good h.bit of bo–

dy. as it feldom affeéts the confiitlltion, which caneen

here do .,.ery early, afcer their

fidl

appnraoce .

This

tumour, from i15 Cituation. requires

g~eat

exatlnef, in

the cuttiog off:

th~y

foruetimes extenC1 up to the chin

to.

wuds lhe mouth, aod oecarion a divifioD of lhe fal ivary

dua.

in operaling, which proves very troublefome

heal; bur,

when aJl other methods

h~ve

failed. may be cured by a per–

for:uion

ioto

the Qlouth, through thu

pan

of tbe cheek

where it is wouDded, which by

tent or fmall fetoo may be

made finoloos ; then, by properly drelling upon the

outr.de

the oozing of the

faliva

that way will ue pre.,.eDled, and

the external ori6ce healed without difficulty,

The trealment of all thefe wound, may be wilb dry liat

5ra, and aftenurds as in cOlUmon wOllnd,.

O]lhe

Operation

Ih<

TREP~N.

operation of the

tr(pan.

¡,

the making one or more

orifices lhroegh the fcuq, lO ¡dmil ao iofirument for rai·

fiDg any pieces of bODe that by violence are beaten ¡nwarer,

upon the brain. or to gi.,.c i(f

'l.le

b100d or matter lodged

any

part

within the

craniu71/.~

Fraétures of the fkull:are

all times

very

daogerous,

not

conrequence of the injury done to the

cranium

¡t·

relr, but as the buio becomes afFc:Aed either rrom the prer–

(ure of the fraélured booe, or that of theextrava(aled alood

aDd matl... If theD the fymptorn. excited by • frac–

ture do

Cometim.es

folJow from

mere extrnaration

oí

blood, as is the cafe wheo the

craniu1Il

is not beileD

in.

wards, it muft likewife happen that

rupture

the

.,.efTel,

of this part, without a fraéture,

wiU

alCo occafioD lbe lame

diforders: For this reafoo, the operatioo may uke place

where the reull is not rnueh offended, bot only tbe yelfels of

the

dura mate,-,

!he

pia

maJ~r,

or the brain.

When the

c,.ofJium.,

is bealen inward, .w.tthout

::toy frac·

ture, it

called a depreffion; when very much broken,

fr ..éture; or

broken aod beat

airo,

fr",éture witb de_

preffion ; i( it

only cracked without depreilion, thou:n

properly

fraéture, it is ·c.lled

filTure; if none

thefe

diforders appe¡r, where there is a fufpicion of them , the

fymptoms are imputed to a cODcuffion of the brain. Thefe

are the four d,ni.élions in ure, and wbich folly eomprehenJ

.11 the others.

The depreflion of the

c,.anium

wirhout

fra(lure casa

but feldom occur,

and

chen it

h~ ppeDs

tO ehildreb whofe

bones are more pliable and roft th.n thore of adulu .

ID blows of th'!

craniu1J1,

requiring the ufe of tbe

tre·

pan, tbe marks of a fraélure are generally very (videot,

fince the fcalp is orreo laeerated E, mueh , as to expofe ir to

ourfight: But if the wound of the (ealp be ro (ruall , as only

to adrnit • probe, we mufl jodge then by tbe fed of th.

forfaee of the bone, uGng the eautÍon óf not miflakiog a ru–

ture for a fraflure.

,her. b:

wound of thc fealf' yon mufl pref, about

tbe