1000000031

tendon of tbe orbicul.,i, m.rcle. At a liule dir..nce rrom

the internal

~ngle,

on tht: cclCe of Ihe eye.Jids may be

obft!n'ed

t WO

black fpots, which are [he onlices of the:

]¡.

chrymal channels, and c.,¡lled the

punfla IIIChr)H/olia.

The

e~aé\

dimenfion of the J"chrymal ehanncls aad

bag; Ihe pricked line reprcfents the.edge al' the orbiL

A fmall incdioD. knife, more httndy than a Jargcr

fOT

opeaing the bago

D ,

Thc perforator to deClray the

unguiJ

e\Ofr

Ihould happen 'o he ncce{fary.

Iron

¡r¡{hument made

thin

and pliable, to

(el

even

on Ihe fo[C!head , and for ufe covered wilil velvet : lhe

holts

al (he three extremities receive two pieces of ribIJand, by

which

¡,

f;¡ (lened on the forehead: (he bulton

the cnd

of {he fcrew is

be placed on [he

[acettl lochrJ1JIulil.

and

tbe

Ccrew

to be twi:!ed

till the burtOD makes

conCiderable

pretrure

(he

bag :

the: bunoo lhould be eO'fered wah vd–

vet, and a linle camprer, of pl>.i(lcr be bid on the haS be–

fore it is applied, tO prevent the O,in from heing galbt hy

t he pretTure. The liule branch of iron which

r~ceives

the

ferew muft he Coft enough to admit

bendtng, olherwlle

it will be dillieult to pl"e ' the bunon ex.é\ly on the hago

T his

inHrum~nt

is for lhe Jeft eye ooly; it fhould ue \. oro

night . nd day in the

begir.n.ng

of a fillul., aDd alier a filtui.

has

been he.led

¡ncilion;

bUl

as the fuccefs

d~pends

u¡lon

the exaét lituation of

the

bunon upoo the bag, it [!touJd

caref,lIy looked after.

BRONCHOTOMY.

operation

hronch% lllJ

í.s 3n

irociG~n

mad,e in lhe

,,/pero arteria,

make way {or the '!.Ir InfO l he IlIngs,

\'Ihen

r~(piralion

obfiruaed

any lumour comprdJing

the

larJnx,

or fome other d,forder of

lhe

glo//iJ

and

aJPaa

Ilr/eri:z.

without any appotrent tumonr

'rhe manoer of doing

1f,

is by makíng

longitudinal in–

cilio" through the (Jctn, three

quart~r s

or an

¡lIch

long. op–

pofite

Ihe third and founh , iog of the

I r14ch~a,

you

have lhe choice of lhe place

and when you cannot make

high, the rule \ViII be (O wound a litde belCJw lhe

tumoU1": it

a)ways

<ldvi(~d

to pínch up

1he

l1cir,

far

!l1IS

procefs.

wh;ch

however

may

be kft ta (he di(cretion of lhe

furgcoD. When t he l1cin

CUt

lh rough, you

IIIU{l

make:

fm alJ tranCverfe ¡ncifion imo lhe wino-pipe, and ímmedlateJy

introduce

CiITer crooked

c,mula

near half an IOch

1001;,

w!th a coople of little ríngs at ,he tap

jt,

through which

a ribband may be patTed rouod the neck, to kccp

Gxed in

the wound.

The

mttr.od

of drefling will he eafily undcr(lood; fince,

2frer the patient can bre:uhe by lhe naturaJ p..\ff,¡ge, if yOQ

withdraw the hollow lene, lhe \Vonnd will becnme a limpie

ooe, ¡nd, oOtwilh(landing its penctration lhrough a cani·

Jage into a Jarge cavilYJ rcqulre a tupaficial tlJlplic:uiun

oDly.

Ihe EXlirpolion of lhe

TON"Ls.

T lfESI!. Rbnds fometimcs grow fo large 3i'.d fcirrhan! as

to o('come io'-uTOable. and evcn

lhrcdten fn trllcauun if not

ext,rpated. ·rhe m:lnncr af

doi"~

:his "'r cl.lljon fe,rmerly,

w as byculting them off: hUl lhe al,"oH cordLlnt 'cunftqucn e

of ,his wllun,) was :\ violent bl. cding• .lIId (oml!uOlcs tou

a mOrfal one

which 3CCOIJne il

I!:

't:jr.:-:léo

in f.l your of

t he

't llre. YJhich lS not onJy \'uiJ uf d.wgcr, but ,,1[0

fel·

d om fails of eurc.

If the b.•r.s of the tonGI is fOlalkr than ,he up?er p.,t,

you

r~lay p~Js

tr,e figaturc by tring ic tO lhe end of a rrobc,

bent toto

lhe

fo!

.df an areh, anri Cel ioto a handle; whlch

bcing c4rrit'd bt.'ycnd lhe

gl.J.nd,

and round it, is lO be

brought back agam: l itis done, you may c2fily tie it by the

mean~

of 3n tnnrument of !\'Ir.

Che:folJen's

COotl ivanee, which

holds one end of the ltring on tite lide of the looGI next the

throat. wllllc you

make

tite knot by pulliog lhe· other wun

the riRht hand qui(e oue of the

mouth~

as \ViII be ei\fily un–

d<r(lood by t he draughr in ,he

eopper.ph

te.. Should ir

happen

th ..

the tOllli ls are canical,

that lhe

Jig:Hurc

\ViII

neceITarily [JIP over ilS exuemity wben

\Ve

attempt

tie'

this cafe, he has recommeoded an infhumeot hke

crook~

ed needlc, fet

in a

handle, with an eye

no,U"

lhe poinc,

threaded with a ligature, which is to be thrua throllgh ehe

bou om of Ihe gland, and beiog )aid hold of

with

ltoC'k,

the inflrumcnt is tO be withdrawn ; lhen pulling lhe deuble

lig;uure {orwards,

multobe dlvlded, 2nd one pan be tied

ab,:,ve. and the olher hclow the tumour: lhe knots are to

be aJw. ys double, and the ligature

be cut off preu y near

them.

after four or five days they llip, or feem to ha\'e mor–

tified the lonfil oDly

part, you mua repeat the whole o.

peration; ar.d!f ir

f<,il

[ccond time, you

mufi

cven repeac

ag.tin

This kind of cxt;rpation is more praflifcd

large pilu,

lhat are eltetmt·d Incurable. \Vhen the piles are withinfide

of rhe intelline, yOl! mufl place your

pat~i:ot

oyer a fomen_

tation ln a clofdlool, and have a croaked needle \Vith

douhle lig.ture r••dy to pars through thern. whea hy Orain–

inR they are pllt'htd out of lhe

untU

(for fometimes lhe in–

tdtine wdl return

Cudd~nl y,)

and (ie above 2nd oelow as

[he ¡nflance o( ,he lonfil. SometiOlcs lhe pites are of thu

[Jlape

;sS

tO aJmit a (ingle Jtgature

t1 ~d

round theOl

without the help or a necdle. which is lees painrllJ.

there

are fevc ral, you nluCl only tie one or

t~vo

time

for the

pain of the: hgature

exceffive. and would be intolerable

jf many were licd at ODce : however. every five or fix days:oo

lhe operation m:tr be r:-peated Itll al! are extirpaled, and

th.:

pítTts

muft

kept fupple by fome emullient olOtments·.

' Vl)en Iht piles are rmaJl, they m:ly fafely and with much

lefs p,nn be CUt

off.

Tite

ufJula

is fubjcét

fo great a decree of relaxation

fomelimes, lh:it it almoU choaks the

pal.l~nt;

the

readlef~·

cure is cutting off

<tI!

bUI half an ineh of ¡t, which mé/y be

done al one Inip with a p.tlr of CCltTdTS (particul .. r1y eu rved

lor ,h.. purpofe,l

Jay.ng

hold of it wnh a forceps, Lll it

alOuld

Il.p

.way.

EXPLANAT ' ON of Fig

PI.te

CLVIll.

A ,

T he bent probe fixed in a h.tnrile,

wito

the ligature

made of the lame thread as (he liealures for tying Ihe blooJ–

vofl;'ls.

T he iron innrument for tying lhe (Onfi!s.

This inflrumene is aifo of great [en 'lce In extirpating, by

lig.uure, a

rpeCl~s

of Ccirrhus dtat [ometimcs gro'.\'s from Ihe

neck or cavily of lhe

lI/,'rUf.

The nndle wilh lhe e)'e towards the p'J;nt, for par–

fing tI;e lig:\ture lhrough the lonfil, \Vh.:n the! balis is larger

tholn Ihe eXlremlty.

D .

cnmdn

made or filver

t O

be u[ul in Ihe

(n!/,;'ellla.

cOl/ulo

tO be ufed in

brollc!JJu lIIY .

rro

kc<.p lhe canulas

th~ir

p!:\CI:,

fmi.:J

riht.:lOds may