A treatise on the operations of surgery : with a description and representation of the instruments used in performing them : to which is prefixed an introduction on the nature and treatment of wounds, abscesses and ulcers / by Samuel Sharpe, fellow of the Royal Society, and member of the Academy of Surgery at Paris.

Samuel Sharp

Date:: 1788

Credit: A treatise on the operations of surgery : with a description and representation of the instruments used in performing them : to which is prefixed an introduction on the nature and treatment of wounds, abscesses and ulcers / by Samuel Sharpe, fellow of the Royal Society, and member of the Academy of Surgery at Paris. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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$Treatise of the fcrotum; which, notwith- ftanding the multiplicity of dif- tinctions ufed by writers, is but of two kinds; the one, when the water is contained in the tunica vaginalis, and the other, when in the meinbrana cellularis fcroti; this lalt is almoft always complicated with an anafarca, which fpecies of dropfy is an extra- vafation of the water lodged {in the cells of the membrana adipofa; and when thus circumrhnced, will not be dirricnlt to be diilinguifncd ; befides that, it is fufiicientlv^charaderiiedby the lhining and foftnefs of the (kin,- which gives way to the leaft iin- rircfiion, and remains pitted for fonie time. The penis is lilccwife fometimes enormoufly enlarged, by the' infinu- ation of the fluids into the membrana cellularis, all which fymptoms are ab- folutely wanting in the dropfy of the tunica vaginalis. In thi dropfy of the membrana cellularis fcroti, the puncture with the trocar is recommended by fome, and little, orifice., made here and there with the point of a lancet, by others ; or a fmall ftane of (ilk pnfiTed by a needle through, the fkin, and out again at the diftarice oPtwo or three inches, tt> Be kept in the manner of a felon till the waters are quite drair.ud ; but the two firft methods avail Very little, as they open but two cells; and the laft cannot be fo efficacious in-that xefpecl as incifions, and will be much' moreapt to become troublcforne, and; even to gangrene. Indeed it is not often proper to perform any operation at all'upon this part, fince the membrana cellularis. fcroti, being a continuation of the menibrana adipofa, feanfications made through the ikin in'the ftaall of the legs, will effectually empty the fcro- tum, as I have many times expe. rienced; and this place ought rather to be pkched upon thaii the other, as being more likely to anfwer die pur- pofe, by reafon of its dependency; nowever, it fometimes happens that the waters fall in fo great quantities iuto the- fcrotum, as, by 'diftending on T ft E it, to bccafion great pain, and thrcatcflj a mortification: the prepuce of the. peius alfo becomes very often ei-1 ceffively dilated, and fo twirled, that the patient cannot void his urine*,! In thefe two inftances, I would pro-H pofe an incifion of three inches loog^j to be made on each fide of the fcro-.j turn, quite through the Ikin into the.; cells containing the water, and twofj or three of half an inch long, in any,] part of the penis, with a lancet or. j knife : fill which may be done with.] great fafety, and fometimej with the. fuccefs of carrying off the dif.afe of j the whole body. This I cm pofitivelyjj fay, that though I have done it upon j perfons of a very languid condition, j yet, by making the wound with a iharp inftrument, and tre:ting itj afterwards with fomentations and loft digefiives, I ,have rarely fecn any iri-J fiance of a gangrene, which is gene-j rally fo much apprehended in durj cafe. The dropfy of the tunica vagina-1 Us, is owing to a preternatural dif-'^ charge of that water which is con-j tinually feparating in a fmall quariJ tity on the internal furface of theJ tunic, for the moiiierving^or lubricatyj ing the tefidcle, and which, collecting,] too faft, accumulates and forms, uA time, a fu elling of great magnitude Ll this is what I take to be the other] fpecies of hydrocele, and theordy ori&.i befides; though from the lime oE Celfus, down to our own days, thej writers on this fubjedt make twoJ kinds; one on the in fide of the tunic| vaginalis, and another between the fcrotum and outfide of it ; ani* among the caufes alfigned for this' dii'.-m'per, the principal one is the It derivation of water from the afcites, II which opinion, though univerfally H received, is abfurd in anatomy: for II befides that people afflicted with att hydrocele, are very feldom otheruife1 It dro;->:ical; and on die contrary, thole|fc with an afcites have no hydrocele}It the tunica vaginalis is like a purfe to* H tall/ fhut up on the ontfidc of the ab-ij.- donrcn, lb that no water from anj|l> part||$

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