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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$CHAT. XIX. OF THE GREATER APPARATUS, OR THE OLD WAY. 'pHIS method of cutting, invented by Johannes de Romanis, and pubhfhed by his fcholar Marianus in the year 15 24, has at different times, and with different people, varied con- fidently in fome of its proceffes, and particularly with regard tp the ufe of certain inftruments. What I lhall de- scribe, will be the manner in which it is now praftifed with all its improve- ments. Having laid the patient on a fquare horizontal table, three feet four inches high, with a pillow under his head, let his legs and thighs be bent, and his heels made to approach his but- tocks, by tying his hands to the bot- tom of his feet with a couple of ftrong ligatures, about two yards long; and. \o fecure him more effectually from ft niggling, nafs a double ligature under one of his hams, and carry the four firings round his neck tp the other ham ; then palling the loop un- derneath it, make a knot by thread- ing one of the fingle ends through the loop: after this, the thighs being widened from each other, and firmly fupported by proper perfons, you in- troduce the ftaff, having firft dipped it in oil, which mud be held by your affiftant, a little leaning on the left fide of the feam in perinapo; and be- ginning the external wound juft below the fcrotum (which muft be held out of the way) you continue it down- wards, to within two fingers breadth pf the anus ; then leaving that direc- tion, you flip the knife forwards in the groove, pretty far into the bul- bous part of the urethra ; or, as there js fome danger of wounding the rectum, in the continuation of the incifipn you may turn the knife with the bacjc towards it, and make this part of the incifion from within out- wards. Should a very large veffel be cut, it will be advifeable to tie it before you proceed any farther in the operation. When the wound i? made4 flide the gorget along the groove or the ftaff into the bladder; and to do it with more fafety, when the beak of it is received in the groove, it will be proper to take the ftaff youtfelf in your left hand ; for if the afliftant fhould, unwarily, either incline the 1 handle of it too much towards you, or not refift enough to the force of the J gorget, it is very apt to flip out of the, groove, between the rectum and the,] blayider, which accident is not only' inconvenient to the operator for the prefent, but is attended for the moft part wifh very bad confequences.' The gorget being paffed, dilate the, urethra and neck of the bladder withj your fore-finger, and introduce the.) forceps into the bladder, keeping them fhut till you touch the ftoneJ when you muft grafp it with a mode-! rate force, and extract it by pulling; downwards' towards the rectum* Should you find a difficulty in laying] hold of the ftone, be careful to keeS your forceps in fuch a pofitipn, that they may open upwards and downJ wards (not laterally) which will very! much facilitate the embracing of the ftone, in cafe it fhould happen to be thin and flat. CHAP. XX. OF THE HIGH OPERATION. 'PHIS method of cutting for the ftone was firft publifhed in thf year 1561, by Pierre Franco, who, in his Treatife of Hernias, fays he qnce performed it on a child with vert good fuccefs, buf difcourages the far- ther practice of it. After him, Rof- fetus recommended it with great zeal( in his book intitled Partus Caefareus, printed in 1591 ; but he never per- formed the operation himfelf. Mon$ fieur Tolet makes mention of its han ing been tried in the Hotel Dieuj but without entering into the partis cular caufes of its difcontinuancft fays only that it was found 1 income nienti$

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